RESUMO
Wilms' tumor (nephroblastoma) is rare in adults. Its occurrence as a primary tumor outside the kidney is exceptional. Only 4 cases [1-4] have occurred in the uterus. This report adds the fifth instance of primary uterine Wilms' tumor. The patient, a 77-year-old woman (G2P2), is the oldest ever described with a Wilms' tumor.
Assuntos
Neoplasias Uterinas/patologia , Tumor de Wilms/patologia , Idoso , Feminino , HumanosRESUMO
A single, endocervical application of a new commercial preparation of prostaglandin E2 (PGE2) gel, 0.5 mg of PGE2 in 2.5 ml (3 g), was evaluated for preinduction cervical softening. Safety and efficacy were assessed in a comparison with a 2.0 mg PGE2 vaginal tablet and placebo in normal nulliparous women at term, with low Bishop scores. Treatment was administered in randomized, double blind fashion. Overall success, defined as a progression in Bishop score of at least 3 points within 12 hours, was achieved in 22/40 (55%) of the gel group, 15/41 (37%) in the tablet treated women, and 8/40 (20%) in those receiving placebo. Of interest was the observation that of women with very unfavorable induction features (Bishop score 0-2), the cervical gel treatment resulted in a 6/8 (75%) success rate compared with 2/13 (15%) success for the vaginal tablet and 0/17 (0%) for placebo. In as much as a very low incidence of side effects accompanied this treatment scheme, expanded multi-center testing is recommended.
Assuntos
Colo do Útero/fisiologia , Trabalho de Parto Induzido , Prostaglandinas E/uso terapêutico , Adulto , Colo do Útero/efeitos dos fármacos , Ensaios Clínicos como Assunto , Dinoprostona , Feminino , Humanos , Placebos , Gravidez , Prostaglandinas E/administração & dosagem , Prostaglandinas E/efeitos adversosRESUMO
The effects of low concentration chloroprocaine in continuous lumbar epidural analgesia during labor and delivery, were evaluated in 21 subjects. The final analysis was made on 18 parturientis, 9 receiving 1.5% (group A) and 9 1.33% chloroprocaine (group B), in a standard dose of 7-8 ml (first test dose 2-3 ml), and of 12 ml for the second stage of labor. Onset of analgesia occurred 7.4 +/- 1.2 (mean +/- S.D.) (group A) and 9.6 +/- 1.8 min. (group B) after injection (difference significant). Mean interval between first and second doses was 50.5 +/- 6.3 (group A) and 47.5 +/- 10.8 (group B) min. (difference N.S.). In group A 6 patients and in group B only 1 patient had a temporarily decrease in bloodpressure below 100 mm Hg. During routine monitoring, pathological F.H.R. patterns were recorded in 2 cases. Apgar scores and acid-base parameters were within normal limits in both groups (difference N.S.).
Assuntos
Anestesia Epidural , Anestesia Obstétrica , Procaína/análogos & derivados , Adulto , Índice de Apgar , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Gravidez , Procaína/efeitos adversosRESUMO
Seven anorexia nervosa (A.N.) patients had reduced urinary excretion values of tetrahydrocortisone (THE), androsterone (A) and 5alpha-tetrahydrocortisol (5alpha-THF). THE to tetrahydrocortisol (THF), A to aetiocholanolone (Ae) and 5alpha-THF to THF ratios were all significantly reduced. Six A.N. patients had oral metyrapone tests with quantitatively normal but delayed urinary 3alpha,17alpha,21-trihydroxy-5beta-pregnan-20-one (THS) response. The steroid determinations were done by capillary gaschromatography, which proves to be of value in the study of the above mentioned metabolic abnormalities.