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M Castillo

Publications and source records attributed to M Castillo.

At least 271 records · Page 15Linked to original sources
PubMed1984

Oxytocin augmentation of dysfunctional labor. IV. Oxytocin pharmacokinetics.

Plasma oxytocin levels ([OT[p) were measured every 20 minutes during infusions of oxytocin. The initial dose of 1 mU/min was incremented, if necessary, by 1 mU/min at 40-minute intervals until sufficient contractility was obtained to effect cervical dilatation. The results demonstrated: the [OT]p rises linearly with each dose for the first 40 minutes of the infusion; there is no difference between the 40- and 60-minute sample values, suggesting that the peak [OT]p of each dose is achieved in 40 minutes; the increment in [OT]p required to produce effective contractility varies widely from 0.58 to 5.09 microU/ml; the plasma clearance rate varied from 11.2 to 32.5 ml/kg/min. Approximately 40 minutes is required for any particular dose of oxytocin to reach a "steady-state" [OT]p and the maximal uterine contractile response. The design of regimens for the augmentation or induction of labor should be based on this knowledge.

Cervix Uteri↗
PubMed1984

[Vaginal hysterectomy with bilateral adnexectomy].

102 bilateral adnexectomies in simple vaginal uterectomy (UE.A.) were researched between 1975-1980 and compared to the same number of patients who had vaginal uterectomy without adnexectomy (VK). The average age of the UE.A. was 51.9 years and of the VK 36.8 years of age. The parity of both groups was balanced. The most frequent indication for operation of both collectives was uterus myomatosus. In 52.9% we found a pathology of the ovar: In 46% benign ovarial tumor, in 4.9% ovarial tumor, in 4.9% ovarial endometriosis, in 0.9% ovarial metastasis of breast carcinoma and in 0.9% tubal carcinoma with micrometastasis at the ovar of the same side. The most frequent postoperative histological diagnosis of both groups was uterus myomatosus. The number of complications (post operative bleeding, course of fever more than 38.5 degrees C) was the same in both groups.

Adnexa Uteri↗
PubMed1984

Similar metabolic effects of pulsatile versus continuous human insulin delivery during euglycemic, hyperinsulinemic glucose clamp in normal man.

Seven normal volunteers were studied on two different occasions during which 4-h pulsatile (PULS: 0.8 mU X kg-1 X min-1, 7.5 min of 15) and continuous (CONT: 0.4 mU X kg-1 X min-1) intravenous (i.v.) infusions of human insulin (Actrapid HM, Novo) were randomly compared. A euglycemic glucose clamp was performed and a 3-3H-glucose infusion was used for determination of endogenous glucose production (EGP) and metabolic clearance rate (MCR) of glucose. Plasma glucose was similar in both conditions; plasma insulin was stable at about 29 mU/L (CONT) and fluctuated between 10 and 45 mU/L (mean: 28, PULS). Exogenous glucose infused was 1.137 +/- 0.058 and 1.088 +/- 0.099 g X kg-1 X 4 h-1 in CONT and PULS, respectively (NS). EGP was totally suppressed in both conditions. Glucose MCR increased similarly to a maximum of 6.71 +/- 0.19 (CONT) and 6.79 +/- 0.59 (PULS) ml X kg-1 X min-1 during the fourth hour. C-peptide plasma levels remained stable, whereas plasma glucagon, free fatty acids, and 3-hydroxybutyrate were similarly suppressed in both tests. Thus, under these conditions, pulsatile and continuous insulin infusions have similar metabolic effects. These data contrast with those of Matthews et al. (1983) who reported that, at lower plasma concentrations (5-19 mU/L), pulsatile insulin had greater hypoglycemic effect than did continuous delivery. It is concluded that pulsatile insulin shows no greater activity under normoglycemic, moderately hyperinsulinemic conditions in man.

3-Hydroxybutyric Acid↗
PubMed1983

Oxytocin augmentation of dysfunctional labor. III. Multiparous patients.

The effectiveness of a specific oxytocin regimen characterized by a small dose, a slow rate of oxytocin incrementation, and a specific computer-defined goal of contractile activity was evaluated. The group managed by this protocol was compared with a similar group of multiparous patients managed by the same physicians using their own choice of oxytocin therapies and electronic monitoring of intrauterine pressure. The patients managed by protocol and computer had shorter mean durations of time from onset of treatment to complete cervical dilatation and received smaller mean doses of oxytocin than the control group of patients. The most significant factor determining these results was the rate of incrementation of the oxytocin dose.

Cervix Uteri↗
PubMed1983

Oxytocin augmentation of dysfunctional labor. II. Uterine activity data.

The intrauterine pressure data obtained from oxytocin-treated patients in dysfunctional labor, managed by a specific oxytocin regimen and a computer-defined goal of uterine activity, are analyzed. Questions asked concern the efficacy of the computer diagnosis of hypocontractility, the quantity of uterine activity needed to effect cervical dilatation, and the effectiveness of the quantitative data as an aid in selecting the necessary dose. The false positive diagnostic rate was one of 45 and the false negative, one of 42. The results demonstrate that there were no statistically significant differences between the computer-defined goal of activity and that associated with cervical dilatation if the dose used was permitted the time to accomplish its maximum effect. Quantitation of uterine contractility provided the information necessary to select the dose of oxytocin associated with cervical dilatation in approximately 75% of the patients.

Cervix Uteri↗
PubMed1983

A 6-hour nocturnal interruption of a continuous subcutaneous insulin infusion: 1. Metabolic and hormonal consequences and scheme for a prompt return to adequate control.

Interruption of a continuous subcutaneous insulin infusion, most often due to technical problems occurring during the night, is a not uncommon event whose metabolic consequences have received relatively little attention until now. We have therefore investigated the changes in blood glucose, plasma non-esterified fatty acids, 3-hydroxybutyrate, glucagon and free insulin in eight C-peptide negative Type 1 diabetic patients whose pumps were deliberately stopped between 23.00 h and 05.00 h. A control test with the pump functioning normally was carried out in each patient and the studies were randomized. Considering the values at 23.00 h as reference, interruption of the insulin infusion resulted in (1) a rapid decrease in plasma free insulin significant after 1 h and reaching a nadir of 6 +/- 2 mU/l after 6 h; (2) a rise in blood glucose which was significant at hour 3 and reached 17.4 +/- 1.9 mmol/l at hour 6; (3) a moderate increase in plasma nonesterified fatty acids which remained in the range of 700-800 mumol/l; (4) an early and linear rise in plasma 3-hydroxybutyrate, significant after 1 h and averaging 1290 +/- 140 mumol/l after 6 h; (5) a late increase (hour 5) in plasma glucagon. The second aim of our study was to provide for the patient a precise scheme of insulin supplements administered via the pump and based on blood glucose monitoring (Dextrostix - Glucometer) and semi-quantitative evaluation of ketonuria (Acetest). Resetting the pump at its basal rate at 05.00 h and giving insulin supplements (2-8 U) at 06.45 h (with the usual breakfast dose) and again at 10.00 h have proved efficacious in restoring satisfactory metabolic control by noon the day after starting the experiment. These results form practical recommendations to patients undergoing this type of accident.

3-Hydroxybutyric Acid↗
PubMed1983

Circadian profiles of blood glucose and plasma free insulin during treatment with semisynthetic and biosynthetic human insulin, and comparison with conventional monocomponent preparations.

Sixteen hospitalized insulin requiring diabetics treated with a single daily subcutaneous injection were randomly allocated either to a mixture of porcine Actrapid + Lente MC or a mixture of Regular + NPH-Biosynthetic human insulin (Study 1). In Study 2, 10 patients receiving two daily insulin injections were treated at random with either porcine Actrapid + Monotard, or Actrapid + Monotard-Semisynthetic human insulin or Regular + NPH--Biosynthetic human insulin. Once an optimal insulin regimen was obtained, circadian blood glucose and plasma free insulin profiles (7-9 time points) were determined with the two (Study 1) or three (Study 2) insulin preparations, keeping the doses of insulin constant. In Study 1 no significant difference in blood glucose (BG) or plasma free insulin (FIRI) profiles was observed. The mean daily blood glucose, the mean amplitude of glycaemic excursions (MAGE), the index of blood glucose control (M-value of Schlichtkrull), as well as the postbreakfast increases in blood glucose and mean free IRI, were similar with both types of insulin. In Study 2, BG and FIRI profiles were also similar, except for a significantly lower (p less than 0.02) BG at 8.30 p.m. with both human insulins. No significant differences were found in free IRI at that time. Mean BG, M index, MAGE and mean FIRI were similar but the postbreakfast increase was significantly smaller with SHI. In conclusion, the pharmacokinetics of animal monocomponent, semisynthetic and biosynthetic human insulin appear similar, but evening BG control was better with both types of human insulins given twice daily.

Blood Glucose↗