ABSTRACT
El labetalol, un antihipertensivo que actúa como bloqueador de los receptores alfa-beta adrenérgicos, se utiliza ampliamente para el tratamiento de la hipertensión durante la gestación así como en el tratamiento tensional de la preeclampsia y de la eclampsia. Además, es un fármaco con un buen perfil de seguridad y escasos efectos secundarios, entre los que por su frecuencia destaca el ortostatismo. La hepatotoxicidad, aunque poco frecuente, también se ha descrito en relación con la utilización de este fármaco. (AU)
Subject(s)
Adult , Pregnancy , Female , Humans , Chemical and Drug Induced Liver Injury/etiology , Labetalol/adverse effects , Pregnancy Complications/etiology , Hypertension/complications , Hypertension/drug therapyABSTRACT
This prospective randomized study compared human chorionic gonadotropin (hCG) and micronized transvaginal progesterone for luteal support in 310 in vitro fertilization (IVF) patients treated with leuprolide acetate and gonadotropins in a long protocol, and showing normal ovarian response. Both treatment groups were homogeneous for age, BMI, stimulation treatment and ovarian response. Pregnancy rates per embryo transfer were not significantly different (33.1% for the hCG group versus 38.7% for the progesterone group). For IVF patients with a normal response to stimulation under pituitary suppression, the use of hCG or progesterone for luteal support does not seem to have any effect on pregnancy rate. The choice of luteal treatment must balance medical hazard and patient convenience, as both therapeutic regimens seem equally effective.
Subject(s)
Chorionic Gonadotropin/therapeutic use , Fertilization in Vitro/methods , Luteal Phase/physiology , Progesterone/therapeutic use , Administration, Intravaginal , Adult , Embryo Transfer , Estradiol/blood , Female , Humans , Oocytes , Pregnancy , Progesterone/administration & dosage , Prospective Studies , Treatment OutcomeSubject(s)
Abortion, Spontaneous/prevention & control , Fertilization in Vitro/methods , Oocytes/physiology , Ovarian Hyperstimulation Syndrome/metabolism , Polycystic Ovary Syndrome/therapy , Albumins/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Buserelin/therapeutic use , Estradiol/metabolism , Female , Fertilization in Vitro/statistics & numerical data , Follicle Stimulating Hormone/therapeutic use , Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/therapeutic use , Growth Hormone/therapeutic use , Humans , Luteinizing Hormone/metabolism , Menotropins/therapeutic use , Oocytes/drug effects , Ovarian Hyperstimulation Syndrome/prevention & control , Polycystic Ovary Syndrome/metabolism , PregnancyABSTRACT
An open pure total lateral dislocation of the right talus with extrusion of the whole talar body is reported. Immediately surgical debridement, reduction, and primary closure were accomplished under antibiotic coverage. The ankle was immobilized for 6 weeks, and weight-bearing was restricted for 6 more weeks. Neither avascular necrosis (AVN) of the talus nor infection developed. Both ankle and foot regained full pain-free range of motion at 16 weeks, except for a mild restriction of the last 5 degrees of supination. Four years postinjury, the patient continues in the same preinjury occupation. A thorough review of the literature suggested that (a) immediate closed or open reduction is preferable; (b) if AVN develops, it can be treated in most cases by weight-bearing restrictions; and (c) talectomy, alone or associated with a tibiocalcaneal arthrodesis, should be reserved for an eventual reconstructive procedure, particularly in the event of talus infection.
