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Biomedical subjects

F Escudero

Publications and source records attributed to F Escudero.

11 recordsLinked to original sources
PubMed1999

Factors associated with discontinuation rates of the copper T380A IUD in a Peruvian public hospital.

The objectives of this study were to evaluate performance and causes of discontinuation of the Copper T380A IUD by users at the Family Planning Service at Hospital Arzobispo Loayza in Lima, Peru, during a period of three years. The study included 3167 acceptors of the CuT380A attending the service during 1992-1994. IUDs were inserted during interval timing. Follow-up was at 1, 12, 24 and 36 months after insertion. The following events were recorded: number of pregnancies, expulsions and all causes of discontinuation. The cumulative rates per 100 woman-years using the life-table method was calculated. Also calculated were the relative risks for expulsion and for pregnancy. At the end of the study, 361 women had discontinued the method for various reasons, whereas 1667 women continued using the method. The lost-to-follow-up proportion increased over time from 35.9 per 100 woman-years for the first year to 38.2 for the third year. The cumulative discontinuation rate over three years was 22.6 +/- 1.3 (cumulative rate +/- standard error) per 100 woman-years. The cumulative pregnancy rate for three years was 1.2 +/- 0.4 per 100 woman-years, whereas the cumulative rate of expulsion was 4.9 +/- 0.4 for the first, 6.4 for the second and 6.8 for the third year. The main cause of discontinuation during the first year of use was expulsion (4.9 per 100 woman-years) followed by personal reasons (2.1 per 100 woman-years). At the end of the third year, the main cause was personal reasons (11.4) and the second cause was expulsion (6.8). A higher probability of expulsion, pregnancy and discontinuation for bleeding and/or pain was associated with age less than 20 years. In conclusion, the effectiveness of the CuT380A IUD after three years of use was 98.8 per 100 woman-years, whereas continuation was 39.2, and loss to follow-up increased over time.

Female↗
PubMed1997

A comparative trial of labor induction with misoprostol versus oxytocin.

OBJECTIVE: To determine the efficacy and safety of intravaginal misoprostol compared with intravenous oxytocin in cervical ripening and labor induction. METHOD: The study was carried out at the Department of Obstetrics and Gynecology at the Hospital Loayza, Lima, Peru. The sample included 123 pregnant women with any indication for labor induction. The study was prospective and randomized. We compared the effect of 50 micrograms of intravaginal misoprostol administered every 4 h up to 600 micrograms with that observed using the standard protocol of oxytocin by continuous infusion. RESULTS: 57 patients with misoprostol (group 1) and 63 with oxytocin (group 2) were enrolled. Delivery occurred in 45 patients (78.9%) in group 1 and in 37 (58.7%) in group 2 (P < 0.017). Complications including tachysystole, uterine hypertony and hyperstimulation were higher in group 1, 21.1% than in group 2, 7.9% (P < 0.04). The incidence of cesarean section in both groups was similar to the overall incidence in our center. No differences were observed between groups in perinatal and postpartum adverse outcomes. The interval from start of induction to vaginal delivery was significantly shorter in the oxytocin group (8.4 +/- 4.1 vs. 11.3 +/- 6.9 h, P < 0.005). CONCLUSION: Intravaginal administration of misoprostol is a safe and effective alternative for cervical ripening and labor induction. Maternal and neonatal complications did not increase significantly.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

Hormone profile during the menstrual cycle at high altitude.

OBJECTIVES: To determine the hormone profile during the menstrual cycle in women at sea level and at high altitude, and whether the time between the gonadotropin peak and ovulation is different at high altitude from that at sea level. METHODS: The study was carried out in Lima (150 m) and Cerro de Pasco (4340 m), Peru. The hormone profile of 10 adult regularly menstruating women at sea level and 10 women at high altitude was assessed. Ovulation was identified by vaginal ultrasonography. RESULTS: The pre-ovulatory follicle diameter was lower (P < 0.001) at high altitude than at sea level. Ovulation after LH peak occurred earlier at high altitude than at sea level. Serum FSH levels were higher at late luteal phase and early follicular phase at high altitude than at sea level (P < 0.05). The serum LH and FSH peaks were similar in women at sea level and at high altitude. During the early follicular phase serum estradiol levels were significantly higher at high altitude than at sea level (P < 0.05). During the late follicular phase the production of estradiol was higher at sea level than at high altitude (P < 0.05). The peak of serum estradiol was at day -1 in Lima and in day 0 at high altitude. At ovulation, the serum estradiol levels in women at sea level were 55.1% of the peak, but remained at high levels (80% of the peak) in women at high altitude (P < 0.05). The second increase of serum estradiol occurred earlier at sea level than at high altitude. From days +12 to +15, there was a significant decline in serum estradiol levels in women at sea level (P < 0.05) but not in those from high altitude (P > 0.05). Serum progesterone levels at days +5, and +8 to +12 were significantly higher at sea level than at high altitude. CONCLUSION: Our data suggest that hormone profile during menstrual cycle is different at high altitude than at sea level, probably as an effect of low barometric pressure.

Altitude↗
PubMed1994

[Treatment of puerperal endometritis. Evaluation of the efficacy and safety of clindamycin + gentamycin vs. penicillin + chloramphenicol + gentamycin].

This was a prospective, single-blind, comparative study in patients with diagnosis of puerperal endometritis, carried out at the Loayza Hospital in Lima, Peru. The objective of this study was to evaluate the efficacy and safety of clindamycin and gentamicin in the management of endometritis vs. penicillin, chloramphenicol and gentamicin for 10 days. Sixty-five patients were enrolled and 62 were evaluable for efficacy. Both treatment groups were comparable in the pre-treatment period in terms of age, history of pregnancies, controls by gynecologist, days of disease and fever, clinical symptoms like fever, pelvic pain, pulse, uterine size and in laboratory, in hematocrit and leukocytes count. In the culture of endometrium tissue, 27/32 patients (84.4%) in Group A (penicillin + CAF + gentamicin) and 27/30 patients (90%) in Group B (clindamycin + gentamicin) had positive cultures at baseline; 18 and 22 patients showed anaerobes; 8 and 4 patients showed anaerobes plus aerobes and, one patient in each treatment group showed aerobes only. Peptostreptococcus and Bacteroides fragilis were the most frequently isolated pathogens. Improvement in lochia fetidity was more rapid in Group B, it turned transparent and not fetid since day 3. Complete cure was significantly better in Group B 24/30 (80%) in comparison with Group A 16/32 (50%) (p = 0.02). Partial response was found in 15 patients (43.3%) in Group A and 5 patients (16.6%) in Group B. Only one case was considered as bacteriological failure in Group A and only one patient in Group B was considered as failure and required an additional operation due to residual abscess.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Pregnancy rate in an oocyte donation program.

Oocyte donation programs offer an alternative treatment for infertile women with ovarian failure or abnormal ovarian function. Seventeen cycles of in vitro fertilization and embryo transfer with donated oocytes were performed in 13 women, with a mean age of 34.8 years. The hormonal replacement therapy consisted of a fixed dose of oral estradiol valerate, 6 mg daily, and intramuscular progesterone in oil, 100 mg daily. Estrogen and progesterone were continued for 10 more weeks after embryo transfer if pregnancy was established. After 13 embryo transfers, 8 pregnancies were obtained, for a pregnancy rate per transfer of 61.5%. Today seven pregnancies are progressing normally, including one set of twins. This results suggest that an oocyte donation program using a fixed and simple hormonal replacement therapy is an adequate treatment for these infertile couples.

Adult↗
PubMed1990

Deletion of chromosome 4: 46,XY, del(4) (q31.3) after gamete intrafallopian transfer and in vitro fertilization-embryo transfer.

It seems that assisted reproduction technology does not increase the rate of chromosome abnormalities, and up to now, a few cases have been reported. The case we describe here is the first one of monosomy 4q31 in a full-term liveborn after a combined GIFT-IVF procedure. Once more, this case raises the question of whether pregnancies resulting from IVF should be monitored for chromosome abnormalities or not.

Adult↗
PubMed1988

Inhibitory action of tumor-promoting phorbol esters upon beta-adrenergic agonist stimulation of cyclic AMP accumulation in rat prostatic epithelial cells.

The pretreatment of rat prostatic epithelial cells with 4 beta-phorbol 12-myristate 13-acetate resulted in an attenuation of beta-adrenergic stimulated cyclic AMP accumulation. The effect was dependent on time and concentration. The maximal extent of isoproterenol stimulation of cyclic AMP production was reduced by 35% after 15-min pretreatment with the phorbol ester at 25 degrees C. Since a similar action was exerted by other protein kinase C stimulators, present results suggest the involvement of this enzyme in a process of desensitization to beta-adrenergic agonists of the adenylate cyclase system in rat prostatic epithelium.

Adrenergic beta-Agonists↗
PubMed1987

Tumor-promoting phorbol esters interfere with the vasoactive intestinal peptide receptor/effector system in rat prostatic epithelial cells.

Pretreatment of rat prostatic epithelial cells with the tumor-promoting phorbol ester 4 beta-phorbol 12-myristate 13-acetate resulted in a decrease of both the potency of vasoactive intestinal peptide (VIP) upon the stimulation of cyclic AMP accumulation and the affinity of the receptors of this peptide. These effects were dose-dependent and could be reproduced by other stimulators of protein kinase C (PKC). Thus, it is conceivably that phosphorylation of VIP receptors by PKC regulates VIP receptor function in the prostate gland.

Animals↗
PubMed1987

Somatostatin inhibits VIP- and isoproterenol-stimulated cyclic AMP accumulation in rat prostatic epithelial cells.

The dual regulation of cyclic AMP accumulation was studied in rat prostatic epithelial cells incubated with somatostatin, vasoactive intestinal peptide (VIP), and the beta-adrenergic agent isoproterenol. Somatostatin noncompetitively inhibited the stimulatory effect of VIP and isoproterenol, but it did not alter basal cyclic AMP levels. In addition to the multifactorial regulation of the cyclic AMP system in rat prostatic epithelium, these results suggest that somatostatin may play a physiological role at this level.

Adenylyl Cyclase Inhibitors↗