Treatment of hyperthyroidism with a combination of methimazole and cholestyramine.

The entero-hepatic circulation of thyroid hormones is increased in thyrotoxic states. Based on this observation, the use of ionic exchange resins to bind thyroid hormones in the intestine has been tried. The present study evaluates the effectiveness of cholestyramine as an adjunctive therapy in the management of hyperthyroid Graves' disease. Thirty patients with newly diagnosed hyperthyroid Graves' disease were randomly assigned to one of the following treatment groups: methimazole, propranolol and cholestyramine for 4 weeks (group I); methimazole and propranolol for 4 weeks (group II); methimazole, propranolol, and cholestyramine for 2 weeks, followed by 2 weeks of methimazole and propranolol (group III). At the end of the study, total and free T4 as well as T3 levels had decreased more in group I compared with group II: 61%, 78%, 68% in group I compared with 43%, 65%, 50% in group II (P = 0.037 for T4, P = 0.038 for free T4, P = 0.012 for T3). Group III behaved like group I while patients were receiving cholestyramine, but once the drug was discontinued, the rate of decline of thyroid hormones slowed down. We conclude that cholestyramine represents an effective and well-tolerated adjunctive therapy in patients with hyperthyroid Graves' disease, and it produces a more rapid and complete decline in thyroid hormone levels in these patients.

[Torsade de pointes in myxedema. Report of a case and review of the literature]. / Torsade de pointes en mixedema. Informe de un caso y revisión de la literatura.

A 57 years old female suffered from recurrent attacks of ventricular tachycardia including one episode of torsade de pointes, she had hypothyroidism with myxedema secondary to Sheehan Syndrome, following thyroid replacement therapy the tachyarrhythmia did not relapse and there was no need to give specific antiarrhythmic therapy.

[Preoperative management of uterine leiomyomatosis using pituitary gonadotropin-releasing hormone analogues]. / Tratamiento médico preoperatorio de leiomiomatosis uterina con análogos de hormona liberadora de gonadotropinas hipofisarias.

Uterine leiomyomatosis shows a frequency from 25 to 30% in reproductive age women. Traditional treatment is hysterectomy or myomectomy independently from fertility wishes of the woman. Its growth has been associated to estrogenic activity. Because of this, several substances have been used to diminish tumour size, pre-operatively. The use of analogues of liberating hormone of hypophysiary gonadotropins (GnRH), given to favor surgical technique, to diminish trans-operative bleeding and to avoid blood transfusions. Clinical efficiency of the use of nafarelin acetate in women with uterine leyomiomatosis, pre-operatively during three months, was studied in this paper. The study was prospective, comparative, blind and with longitudinal measurements. Twenty eight women were included. Group I (n = 13) and Group II (n = 15) control without treatment. Observation units included FSH, LH, E2, BHC, HCT, USG basal, 30, 60, 90 days. Results showed a diminution of more than 80% of the initial uterine volume, and of 30% of the myomas independently measured. Side effects, tolerance and efficacy of the used compound, are mentioned.

[The evaluation of the usefulness of ultrasound independent of estradiol as a prognostic criterion for ovular capture and maturity. A comparative double-blind study]. / Evaluación de la utilidad del ultrasonido independiente de estradiol como criterio pronóstico para captura y madurez ovular. Estudio comparativo doblemente ciego.

One hundred and twenty women were studied which had primary or secondary sterility, and underwent into the GIFT or IVF-ET program at the INPer. They were divided in two groups. Group I had 96 women in which only was taken in account the follicular development measured by vaginal ultrasound to decide continuation or cancellation, in this group estradiol serum levels determination was done, but it was not used for decision making; group II had 24 women in which estradiol was taken in account in addition with ultrasound. There were no differences in the number of follicles seen by ultrasound neither in the estradiol serum levels between the groups. Correlation coefficients between follicles seen by ultrasound and retrieved oocytes and mature oocytes, thus partial correlation coefficients for follicles seen by ultrasound plus estradiol serum levels and retrieved oocytes and captured oocytes were higher in group I in all days with the exception of day 10 in which they were similar. By the aforementioned in can be concluded that in this group of patients the ultrasound was the most reliable variable to give a quantitative and qualitative prognostic of oocyte retrieval.

[The evolutionary anthropometric profile of the child of a mother with a change in glucose metabolism]. / Perfil antropométrico evolutivo del hijo de madre con alteración en el metabolismo de la glucosa.

There is not sufficient information about the follow up of children belonging to mothers with some degree of glucose metabolism disorder. At The National Institute of Perinatology were studied 151 newborn. The babies were divided into four groups. The group 1 consisting of babies born from mothers with diabetes mellitus type I; group 2 of babies born from mothers with diabetes mellitus type II; group 3 including babies from mother with gestational diabetes and group 4 babies from mothers who presented alteration in glucose metabolism during pregnancy. After the evaluation of the somatic indicator we found an harmonic behavior in group 3 in weight, height and head circumference again. The most important finding was the low correlation in anthropometry at birth and one year of age. Finally we conclude that a strict control on the follow-up of the somatic growth of children, must be achieved because the hypertrophy during the first year of age depends on sociocultural and economic patterns.

[Anthropometry in a group of women with a change in glucose metabolism and its somatic effect on the newborn infant]. / Antropometría en un grupo de mujeres con alteración en el metabolismo de la glucosa y su efecto somático en el recién nacido.

A total of 156 mothers with alterations in the metabolism of glucose and a control group of 42 other women with their respective children were studied at the National Institute of Perinatology. The group of 156 women was divided in four. The first group included mothers with type I diabetes mellitus; group 2 included mothers with type II diabetes mellitus; group 3 included mothers with gestational diabetes and group 4 contained those mothers with gestational alterations to the tolerance of glucose. The anthropometric indicators of the mother, weight and height at the end of the pregnancy, were compared to their respective children according to sex, while considering the group to which they belonged. The greatest weight medium for those mothers for both the male and female population, was found in group 3. With respect to height, the tallest mothers were found in group 2. When using the correlation coefficient, no significant crossovers were found between the weight and height the mother and the weight, length and cephalic perimeter of the newborn. Our results show that women with greater weight at the end of their pregnancy, had heavier babies, but this does not apply to height. We conclude that the presence of macrosomias or alterations in fetal growth can be reduced when an efficient control and early detection of the alteration of glucose metabolism is found in the mother.