Evidencias en indicaciones de la progesterona / Evidence in progesterone prescription

Resumen ANTECEDENTES: la progesterona es una hormona esteroide con participación en la ovulación, implantación, embarazo y regulación de la función uterina durante el ciclo menstrual y de otros órganos, como la glándula mamaria. Por su mecanismo de acción, la progesterona está indicada en distintos padecimientos ginecológicos y obstétricos: síndrome premenstrual, amenaza de aborto, parto pretérmino, hemorragia uterina disfuncional y mastalgia relacionada con el ciclo menstrual. OBJETIVO: evaluar la seguridad y eficacia de la progesterona en pacientes con: síndrome premenstrual, amenaza de aborto y de parto pretérmino, hemorragia uterina disfuncional, mastalgia y terapia hormonal en la menopausia. METODOLOGÍA: revisión sistemática de la evidencia científica acerca de las distintas indicaciones de la progesterona. RESULTADOS: se encontraron 92 artículos de los que se seleccionaron 41 para revisión. CONCLUSIONES: la evidencia clínica evaluada acerca de las indicaciones de la progesterona demuestra ventajas en eficacia y seguridad en los diferentes esquemas.

Abstract BACKGROUND: Progesterone is a steroid hormone involved in ovulation, implantation, pregnancy and regulation of uterine function during the menstrual cycle and other organs such as the mammary gland. Because of its mechanism of action, progesterone is indicated in different gynecological and obstetric conditions: premenstrual syndrome, threatened abortion, preterm birth, dysfunctional uterine bleeding and mastalgia related to the menstrual cycle. OBJECTIVE: To evaluate the safety and efficacy of progesterone in patients with: premenstrual syndrome, threatened abortion, preterm birth, dysfunctional uterine bleeding, mastalgia and hormone therapy in menopause. MATERIAL AND METHODS: Systematic review of scientific evidence about different indications of progesterone. RESULTS: We found 92 articles from wich 41 were selected for review. CONCLUSIONS: The clinical evidence evaluated on different indications of progesterone demonstrates advantages in efficacy and safety in different regimens.

[The treatment of cervical human papillomavirus (HPV) infection with trichloroacetic acid]. / Tratamiento de la infección cervical por el virus del papiloma humano (VPH) con ácido tricloroacético.

Ever since the alterations caused by the HPV on the cervix were discovered, countless treatments have been employed but the ideal method still remains unknown. The objective of the experiment was to assess the efficiency of handling the cervical infection caused by the HPV, by means of trichloroacetic acid, 85% rate. During the period comprised between April 1989 and March 1990, 60 patients were subject to close analysis. The general diagnosis drawn cytology, colposcopy, and histopathology was cervical condyloma, lacking any collateral evidence of intraepithelial cervical neoplasia. The treatment consisted of 3 weekly applications of trichloroacetic acid at 85% rate directly upon the cervix. They were all assessed through cytology and colposcopy every 3 months, during a year's period. After the first 3 months, a 73.4% healing rate was observed, which decreased to 68% after 6 months and to a 65% after 9 months; this last healing rate remained unchanged after 12 months. Pregnant patients showed higher healing rates. We have drawn the conclusions that the trichloroacetic acid is an efficient agent to treat the referred injuries, and it offers as well the advantages of low costs, no secondary effects and an easy application and handling.

[Study of the basal temperature, cervix mucus, vaginal cytology, spermatic penetration, and length of the menstrual cycle, in patients under clomiphene treatment]. / Estudio de la temperatura basal, moco cervical citología vaginal, penetración espermática y duración del ciclo menstrual, en las paientes en tratamiento con clomifeno.

PIP: 55 patients under clomiphene treatment were studied during 149 cycles. In addition to the usual tests and controls, the authors made a basal temperature curve, took samples of cervical mucus and performed vaginal cytology tests, and calculated the average duration of the cycle. The cycle study based on the Sims Huhner test was also performed on 13 patients. Changes in the results of the tests were found to be related to the dosage and, above all, to the date on which treatment is started. Knowing the changes that occur in the cervical mucus and basal temperature, these 2 tests helped in detecting ovulation. Postcoital cervical sperm penetration improved 1 week after taking the last tablet. The duration of the menstrual cycle increased while taking the drug, and this prolongation of the cycle increased as the drug was administered at a later stage. With respect to vaginal cytology, it is necessary to know the changes that occur in order to interpret the findings correctly; vaginal cytology studies are unreliable in determining the occurrence and especially the probable date of ovulation.^ieng