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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Various aspects of OC (oral contraceptive) use are discussed. The combination and sequential preparations are the 2 most frequently used OCs. OCs regulate hormone secretion through a "feedback mechanism" which in turn regulates ovulation. The initial choice of the type of OC to be prescribed is made according to the length and volume of and the interval between menstrual bleedings. The risk of developing thromboembolic diseases is the most freqeunt serious side effect of OC use; this is, however, influenced by several predisposing and risk factors. Hypertension has also been observed in OC users, as well as irregularities in liver function (cholestasis), the endocrine system, and glucose tolerance. There is no evidence that OC use is related to a higher incidence of cancer. Studies show that OC use has no effect on later fertility, except perhaps in the case of the abortion rate.
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PMID:[Evaluation of modern contraception]. 75 9

A brief survey of the literature on the side effects of oral contraceptives is given. Of the many influences on laboratory results those related to (reversible) cholestasis or to a change in protein synthesis are the most important ones. A decrease of the tolerance for glucose is sometimes observed. Few of the clinical side effects attributed to oral contraceptives can be directly correlated with the pharmaceutical action of these drugs. Many so-called side effects of the pill are due to other factors such as altered psychosociological or sexual behavior, etc. However, among users of oral contraceptives there is a significant decrease in the number of benign tumors, particularly of the breast, the uterus and the ovaries. It is still an open question if this also signifies protection against cancer. Anemias due to iron deficiency are less frequent among users of the pill. According to recent studies arterial hypertension and cholecystopathies are probably directly related to oral contraceptives, but a causal relation has not been proven for migraine, headaches, depression etc. An elevated risk for vascular complications seems to be well established: there is a 4-6-fold increase of the estimated risk for venous thrombo-embolism and a 4-9-fold increase for cerebrovascular accidents among users of oral contraceptives when compared with nonpregnant women of the same age not using the pill. Oral contraceptives act as a supplementary factor of risk which may cumulate with other similar factors, such as arterial hypertension, hyperlipidemia, overweight, smoking etc. Mortality due to oral contraceptives is very much 10-50 x) inferior to the one caused by delivery and the post partum state. Since the number of failures in prevention of pregnancies is less for oral contraceptives than for any other method of contraception, the overall risk of death under oral contraceptives in this age group of women is least.
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PMID:[Real and seeming side-effects of oral contraceptives with an emphasis on medical and haematological problems. Review of literature (author's transl)]. 79 Mar 74

Oral contraceptives have been implicated as a causative factor of venous thrombosis and thromboembolism. Compounds containing over 50 mcg of estrogen have developed this complication most frequently. Steroid hormones have a marked influence on liver function. Large doses have caused cholestasis and hepatocellular damage. Disturbances in carbohydrate metabolism have been recorded. Lipid metabolism have also been shown to be disturbed with increased serum levels of triglycerides and low density lipoproteins. A rise in the cholesterol serum level seems to be correlated with the progestogen content of the compound. The ''minipill'' with a small dose of progestogen alone had been effective by alteration of the cervical mucus. The ''one-a-month pill'' is a combination of a long-acting estrogen, quinestrol, and a chorter acting progestogen, qunigestanol acetate. It has not been as acceptable or as effective as combined compounds. The ''morning-after'' pill consists of large doses of stilbestrol. The method has been effective but when de-ethylstilbestrol has been given to a patient already pregnant to prevent an early spontaneous abortion, adenocarcinoma of the cervix or vagina has been reported. Hypertension has been more common with increased duration of pill use. High dosage of progestogens and increasing age of patients have increased the incidence of hypertension. Cerebrovascular disease had also been more frequent among pill users. An increased incidence of gallbladder disease and of gallstones has been shown in pill users. Urinary tract and vaginal infections were reported more often in pill users. Increased sexual activity may have been a factor in this relationship. Resumption of ovualation after discontinuation of oral contraceptives usually follows within 4-6 weeks. In about 1% of patients amenorrhea and anovulation result for 6 months or more. This is often accopanied by galactorrhea. There is evidence that mestranol is demethylated to ethinyl estradiol in the liver. Progesterone seems to interfere with conversion. Therefore ethinyl estradiol is preferred as a compound of the pill. Also the different progestogens used are metabolized in the liver to norethisterone before they exert their biological effects. Several drugs, as ampicillin and barbiturates, have been shown to interfere with the efficacy of oral contraceptives. It is concluded that the overall results have shown oral contraceptives to be an excellent form of contraception with minimal and acceptable side effects and the least metabolic disturbance.
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PMID:Current status of oral contraceptive. 82 61

Report of a 10-year-old boy with congenital hypoplasia of the intrahepatic bile ducts, the socalled MacMahon-Thannhauser-Syndrome. The patient had been suffering from a varying degree of jaundice since his 2nd day of life and from pruritus since his 21st month of life. Furthermore, he had hepatomegaly, a systolic cardiac murmur, hypogenitalism, retarded growth, and finally hypertension. Transitory xanthomas existed between 1 3/4 and 2 3/4 years of age. Signs of persistent intrahepatic cholestasis was manifested by increased levels of bilirubin and bile acids in serum as well as raised activities of leucine aminopeptidase, gamma-glutamyl transpeptidase and alkaline phosphatase. Pathological values of serum glutamic dehydrogenase pointed to a persistent destruction of liver cells. Without treatment, the activities of vitamin K dependent clotting factors were decreased. Cholesterol, phosphatides and triglycerides in serum were increased and lipoprotein-X was detectable. Aortography revealed stenosis of both renal arteries. An exploratory laparotomy and 5 liver biopsies led to the diagnosis of hypoplasia of the intrahepatic bile ducts. Therapeutic trials with steroids and the anion exchange resin "cholestyramine" were ineffective. Phenobarbital relieved the pruritus. Parenteral administration of fat soluble vitamins restored the activity of vitamin K dependent clotting factors to normal. The high blood pressure fell significantly due to treatment with adelphan. The etiology of hypoplasia of the intrahepatic bile ducts is unknown. It may be a malformation or an obliteration secondary to inflammation. In our patient, narrowing of the renal arteries, increase of plasma-renin activity and hypertension were probably secondary to hyperlipidemia. It has been suggested that hyperlipemia secondary to cholestasis may be due to a disturbance of lipoprotein metabolism. A review of reports on 118 patients suffering from intrahepatic bile ducts hypoplasia is included.
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PMID:[Hypertension and bilateral stenosis of the renal artery associated with congenital hypoplasia of the intrahepatic bile ducts (author's transl)]. 124 84

We report the pregnancy of a 35 year old diabetic woman with a positive Australia antigen, 3 years after a successful cadaver kidney transplant. Immunosuppressive therapy with prednisone, azathioprine and cyclosporine was maintained. Pregnancy was complicated by an acute rejection episode on week 13, mild hypertension and intrahepatic cholestasis on week 22. Cesarean section and tubal ligation were performed at 32 and a half weeks. A 2020 g female infant was delivered, with Apgar scores of 8 and 9 at 1 and 5 min, respectively. Mild respiratory distress, jaundice and hypocalcemia were noted. The Australia antigen was negative. No fetal anomalies were detected. The high risk of pregnancy in a class T diabetic patient is confirmed in this case.
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PMID:[Pregnancy in a class-T diabetic patient]. 134 82

The paper reports the case of a 58-year-old woman suffering from mucosal and cutaneous lichen planus (LP) with esophageal and oral involvement, who had complained of dysphagia for approximately the past two years. The diagnosis of esophageal LP was made using esophagoscopy with mucosal biopsy. The differential diagnosis between LP and progressive systemic sclerosis is discussed; a cold-test, plethysmography of the limbs, an anti-ENA Sci-70 antibody assay, X-rays of soft tissues and esophagomanometry were performed for this purpose, and all proved normal. The presence of conditions implicated in the etiopathogenesis of LP (psychic disorders and the administration of psychoactive drugs, anti-hypertensives and FANS) were observed, together with an already known association with arterial hypertension. Altered hepatic function (with an increase in cholestasis enzymes) was also noted which is probably attributable to the prolonged use of psychoactive drugs (hepatic biopsy showed severe steatosis).
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PMID:[Mucocutaneous lichen planus with esophageal involvement. A clinical case]. 154 25

Angiotensin I-converting enzyme (ACE) is a peptidyldipeptide hydrolase that is located mainly on the luminal surface of vascular endothelial cells but also in cells derived from the monocyte-macrophage system. Physiologically, ACE is a key enzyme in the renin-angiotensin system, converting angiotensin I into the potent vasopressor angiotensin II and also inactivating the vasodilator bradykinin. Increased serum ACE activity (SACE) has been reported in pathologies involving a stimulation of the monocytic cell line, primarily granulomatous diseases. Sarcoidosis is the most frequent and the better studied of these diseases; high SACE is not only a well-established marker for the diagnosis but is also a useful tool for following its course and evaluating the effect of therapy. SACE can also be increased in nonsarcoidotic pulmonary granulomatous diseases such as silicosis and asbestosis, in extrathoracic granulomatous pathologies such as Gauchers disease and leprosis, and, to a lesser extent, in nongranulomatous disorders such as hyperthyroidism or cholestasis. On the other hand, monitoring sarcoidosis obviates the measurement of ACE activity in other biological fluids, e.g., broncho-alveolar and cerebrospinal fluids, in the search of a locoregional dissemination or dis-simulation of the disease. Decreased SACE has been reported in vascular pathologies involving an endothelial abnormality, e.g., deep vein thrombosis, and in endothelium dysfunctions related to the toxicity of chemo- and radiotherapy used in cancers, leukemias, and hematopoietic or organ transplantations. SACE is also of interest for monitoring arterial hypertension treated with specific synthetic ACE inhibitors. These various reasons for determining ACE activity have led to the development of numerous methods. The most widely used is the spectrophotometric assay using hippuryl-histidyl-leucine as substrate. Fluorimetric and radiochemical assays using both classic and novel substrates have been proposed, but they are time consuming, require special apparatus, and are not suited to automation. Kinetic spectrophotometry of furylacryloyl-phenylalanyl-glycyl-glycine hydrolysis is now used extensively because it is easy to automatize. Efforts are now required to standardize one or more of these assays. Indeed, "normal" plasma values differ not only according to the substrate, but also to the method of determination and to sex and age.
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PMID:Angiotensin-converting enzyme: clinical applications and laboratory investigations on serum and other biological fluids. 166 62

During 1989-90 there were a total of 3,475,862 prescriptions of oral contraceptives (OCs) made in Australia by general practitioners. A 2- sided insert to facilitate deciding on the proper dosage for patients with various conditions was developed containing the estrogen- progestogen doses of OC preparations, management of minor side effects (nausea, vomiting, weight gain, chloasma, breakthrough bleeding, breast tenderness, or acne), and the relative contraindications to OC use. The simple, user-friendly, and flexible flow chart contains relative contraindications: age over 35 in heavy smokers, migraine or severe vascular headache, age over 45, previous cholestasis during pregnancy, hypertension, smoking, diabetes mellitus, long term immobilization, abnormal vaginal bleeding, gallbladder disease, impaired liver function, acute infectious mononucleosis, and use of rifampin or anticonvulsants.
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PMID:Prescribing oral contraceptives and the medical record. 179 98

This article reports the first successful human orthotopic liver transplantation performed in Mexico. The recipient was a 41 year old white male, with a history of essential hypertension and hepatitis in 1975. The diagnosis of postnecrotic cirrhosis was made in 1985 by liver biopsy. The HBsAg was negative and the functional reserve of the liver was limited (Stage "C" of the Child-Pugh classification). A liver graft was obtained through the National Cadaver Organ Transplant Program on May 2, 1988 and an orthotopic liver transplantation was performed without incidents, using the portosystemic veno-venous bypass. Inmunosuppression was carried out with triple drug therapy, cyclosporine, azathioprine, and prednisone. His postoperative course was characterized by idiopathic cholestasis, one episode of acute rejerction, arterial hypertension, renal dysfunction, esophageal herpes and inguinal lymphocele, all of which resolved. Currently the patient is alive 22 months postransplantation with normal liver function and adequate quality of life.
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PMID:[Liver transplantation in Mexico. Report of the first successful case]. 206 9

An 81-year-old man who had suffered from hypertension for the preceding three years was admitted as an emergency to the department of neurology of our hospital with the chief complaint of dysarthria. He was diagnosed to have multiple lacunar cerebral infarcts by cranial CT, while the laboratory data showed liver dysfunction characteristic of cholestasis. Mild respiratory insufficiency and renal dysfunction were also found. Further radiological examinations on the liver and biliary tree (US, CT and ERC) were performed, and they revealed that the common bile duct was dilated due to two stone-like masses. He was referred to our department of surgery and underwent laparotomy. Intraoperative endoscopy disclosed intraductal papillomatous lesions. Because of the multiple complications of the patient, resection of the entire common bile duct including the gallbladder and the papilla of Vater without any resection of the pancreas was performed instead of pancreatoduodenectomy. The postoperative course was uneventful and he was discharged on the 31st POD. One year after operation, there is no sign of recurrence either clinically or radiologically. The potentially curative operation for cancer of the distal bile duct is pancreatoduodenectomy, but this is of so great a surgical stress that such a high risk case as described above might be unable to survive it. Even if he survived the perioperative period, he might have a poor quality of life due to postoperative complications. The macroscopic appearance of bile duct cancer is correlated to its invasive spread and prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Selective resection of the distal bile duct in a high risk patient with polypoid cancer of the intrapancreatic bile duct]. 213 Jul 95


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