Pulsatile luteinizing hormone secretion in women with polycystic ovary syndrome under clomiphene citrate. Differences between responders and nonresponders

Although administration of Clomiphene Citrate (CC) is an effective therapy for ovulation induction in PCO patients, 15 to 20% of PCO patients do not ovulate following CC treatment. The aim of this study was to compare the endocrine dynamics (LH pulsatile pattern, FSH and steroid hormone changes) in 6 patients who ovulated (PCOS) and 6 PCO patients who did not ovulate in response to CC (PCOR). Blood was collected at 15 min intervals for 4 hr on day 9 of the first menstrual cycle (control cycle) and on day 9 of the following (treatment) cycle. In this cycle all women received 100 mg CC/day from day 5 to day 9. LH was determined in all samples whereas FSH and estradiol were measured every 60 min. No significant differences were observed regarding the age, body mass index, degree of hirsutism, ovarian volumes and basal levels of reproductive hormones between both groups of PCO women. During the control cycle, the LH pulse amplitude and transverse LH mean concentrations in PCOR patients were higher than in PCOR patients whereas the LH pulse frequency was similar in both groups. No difference was found in FSH and estradiol values between both groups. Compared to the control cycle, PCOR patients showed no change in the pulse amplitudes and no difference in LH, FSH and estradiol values following CC treatment. In contrast, during the CC therapy in PCOS patients an increase in the LH amplitude (p less than 0.05), the transverse mean LH concentration (p less than 0.05), FSH and estradiol was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Survey of smoking habits of the medical personnel at the Hospital San Pedro de Alcántara (Cáceres)]

The prevalence and social and health aspects of smoking habits among physicians of the Hospital San Pedro de Alcántara (Cáceres) were evaluated with the questionnaire used in the course on smoking habits delivered by the INSALUD in 1988. The sample consisted of 123 physicians. 47.1% (+8.7%) declared to be smokers. This prevalence is higher than that in the general population. The rate of female nonsmokers was significantly higher than that of male nonsmokers (p less than 0.05). 51.7% of smokers had not made any attempt to give up smoking. 90% thought that the role of the doctors as a model is important, and that the health system should undertake their treatment. 97.2% declared to lack therapeutic resources. The results disclose the need for specific programs directed to exemplary groups of professionals, such as those devoted to health care, so as to achieve a reduction in the smoking habit.

[Hospital overuse: evaluation and follow-up of endocrine diseases in primary health care]

On the base of a preestablished protocol, 350 patients from a hospital endocrinological clinic were evaluated to assess the possible role of primary care teams to reduce its possible massification. A comparative evaluation of the causes for consultation was carried out in those patients requiring specialized attention and those which do not need the complexities of hospital organization for their appropriate care and which should be best directed to primary care. It was concluded that there is an overload of hospital clinics, as 34.5% of patients should have been diagnosed and treated in the primary level of care. On the basis of these results, the endocrine diseases requiring primary care would basically be obesity and type II diabetes mellitus, which, in addition, are present in more than 50% of the patients on care.

Paroxysmal nocturnal hemoglobinuria associated with the acquired immunodeficiency syndrome

Pancytopenia is a well-recognized manifestation of clinical illness related to human immunodeficiency virus infection. The mechanism of this has been debated, but has been thought to relate either to a nonspecific marrow suppressive effect of opportunistic infections, or to direct involvement of bone marrow hematopoietic precursors as a target of human Immunodeficiency virus. We report the unique temporal association of the acquired immunodeficiency syndrome and paroxysmal nocturnal hemogloblnuria.

Gallium-67 scintigraphy in well-differentiated lymphocytic lymphoma of the skin

Skin lymphomas are now divided into "T" or thymic cell lymphomas (mycosis fungoides being the principal type) and "B" cell lymphomas after the bursa of Fabricius. The "T" cell lymphomas all are identified by the thymic or cerebriform cell. Those lymphomas of the skin which do not contain these characteristic cells are derived from the bursa cells and are termed "B" cell lymphomas. A large percentage of these non "T" cell lymphomas have been histologically diagnosed as lymphocytic lymphoma of the skin (1). The authors had an opportunity to scan a patient with histologically proven lymphocytic lymphoma of the skin with Ga-67 and obtained on excellent correlation between gallium accumulation in the skin lesions and histologic confirmation of lymphocytic lymphoma.

Prolymphocytic leukemia: postmortem findings after long-term survival

A patient had prolymphocytic leukemia and survived for 44 months. A partial remission for more than 11 months and a short complete remission were induced by agents commonly used for the treatment of acute myelocytic leukemia. However, surface markers identified the disease as of B-cell origin.