Comparative study on the acceptability of two modern monophasic oral contraceptive preparations: 30 microgram ethinyl estradiol combined with 150 microgram desogestrel or 75 microgram gestodene

Cycle control and tolerability of two monophasic oral contraceptive pills containing 30 microg ethinyl estradiol (EE) with either 150 microg desogestrel (DSG) or 75 microg gestodene (GSD) were compared in women starting oral contraception. A minimum of 200 healthy women at risk for pregnancy were to be treated for a total of 6 cycles per patient in a prospective, randomized open parallel-group multicenter trial. Two hundred and forty-one subjects were randomized, 115 to DSG/EE and 126 to GSD/EE. Compliance to the study preparation was high (around 95%) in both groups and no pregnancies occurred during the study. Cycle control was excellent; there were no differences between the two groups with regard to incidence of spotting and breakthrough bleeding or duration and intensity of withdrawal bleeding. Side-effects were mild and in general comparable in the two groups. Both at baseline and during treatment, a higher proportion of women taking GSD/EE complained about breast tenderness. This resulted in more early withdrawals because of breast tenderness in the GSD/EE group. It was concluded that monophasic DSG/EE and GSD/EE are equally effective, have similar cycle control and both are generally well tolerated.

Dual effect of female sex steroids on drug-induced gastroduodenal ulcers in the rat

Since the sexual dimorphism of gastroduodenal ulcers is well known and might possibly relate to the actions of sex hormones, we studied the role of the female sex steroids, progesterone and 17beta-estradiol in cysteamine-induced mucosal ulcers in female Wistar rats (200-220 g). Administration of cysteamine (400 mg/kg, s.c.) provoked macroscopic gastroduodenal mucosa injury as assessed planimetrically, an increase in microvascular permeability in the stomach and the duodenum as assessed by extravasation of radiolabelled albumin, and decreased gastroduodenal mucus levels as assessed by the Alcian blue technique. Ovariectomy (2 weeks before cysteamine) decreased plasma 17beta-estradiol level as assessed by radioimmunoassay, gastroduodenal macroscopic injury and albumin extravasation, and increased mucus levels following cysteamine challenge. Administration of progesterone (10-50 mg/kg/week, s.c.) attenuated in a dose-dependent manner cysteamine-induced gastroduodenal mucosa injury and microvascular leakage, while it increased mucus levels in the stomach and the duodenum. In contrast, administration of 17beta-estradiol (1-5 mg/kg/week, s.c.) dose-dependently augmented gastric and duodenal macroscopic mucosa lesions and microvascular injury provoked by cysteamine, and caused a further reduction in gastroduodenal mucus levels observed after cysteamine administration. In different experiments, ovariectomy decreased indomethacin-induced gastroduodenal injury. The injection of 17beta-estradiol (1-5 mg/kg/week) did not affect gastroduodenal damage, while treatment with progesterone (10-50 mg/kg/week) protected against indomethacin-provoked mucosa ulcers. It is concluded that female sex steroids play a role in drug-induced gastroduodenal ulcers by modulating microvascular permeability and mucus secretion.

Expression of alpha6 and beta4 integrin subunits on human endometrium throughout the menstrual cycle and during early pregnancy

OBJECTIVE

To evaluate the expression of alpha6 and beta4 integrin subunits on surface and glandular endometrium throughout the menstrual cycle and during early pregnancy.

SETTING

Second Department of Obstetrics and Gynecology, University of Catania, Catania, Italy.

PATIENT(S)

Thirty-two women. Nineteen of the women regularly menstruated in different phases of the cycle, and 13 were in the sixth to ninth week of gestation and required voluntary abortion.

INTERVENTION(S)

Endometrial specimens collected during endometrial biopsy, hysterectomy, or voluntary abortion.

MAIN OUTCOME MEASURE(S)

Immunohistochemical staining for alpha6 and beta4 integrin subunits in endometrial tissues.

RESULT(S)

Both subunits (poorly expressed in preimplantation days) reached a significant peak on the endometrial surface during the implantation window, which tended to disappear in the postimplantation phase. On glandular endometrium they exhibited an opposite trend, showing high levels in the preimplantation and postimplantation days, whereas their expression decreased during the implantation window. The two subunits tended to disappear in early pregnancy.

CONCLUSION(S)

alpha6 and beta4 integrin subunits are uniformly distributed and highly expressed on the endometrial surface during the implantation window; they decreased dramatically in the postimplantation phase. These results could suggest involvement of integrin-extracellular matrix components in blastocyst-endometrium interaction during the early stages of implantation.

Effects of pregnancy in rats on cysteamine-induced peptic ulcers: role of progesterone

After mating with a sexually active male, groups of female Sprague-Dawley rats were injected with cysteamine (400 mg/kg, subcutaneously) at day 0 (controls), day 5 (early-stage pregnancy), and day 18 (late-stage pregnancy) of pregnancy. In contrast to late-stage pregnancy rats, early-stage pregnancy animals showed a decrease of cysteamine-induced gastroduodenal lesions. When subjected to cysteamine injection, both nonpregnant female and male rats treated for eight days with progesterone (300 microg/rat, subcutaneously) showed a reduced incidence of gastroduodenal lesions. No effect was found in animals pretreated with 17beta-estradiol (200 microg/rat, subcutaneously). Furthermore, increased gastroduodenal mucus levels were found in early-stage pregnancy rats and in animals pretreated with progesterone. These results suggest that increased progesterone plasma levels during early-stage pregnancy may be involved in pregnancy-induced gastric and duodenal protection. This effect may be related to an increase in gastric and duodenal mucus production induced by this hormone.

Damaging actions of testosterone on cysteamine-induced gastroduodenal ulceration and vascular leakage in the rat

The sexual dimorphism of gastroduodenal ulceration is suggested on the basis of clinical and experimental observations. This difference probably relates to the actions of endogenous sexual steroids. In the present study, the role of testosterone was evaluated in the generation of gastroduodenal mucosal injury provoked by cysteamine (400 mg/kg, s.c.). We found that macroscopic mucosal damage and microvascular (125)I-human serum albumin leakage (2 microCi/kg, i.v.) developed in the stomach and duodenum of male rats 24 h after the administration of cysteamine. This mucosal injury was prevented by orchidectomy and by the pretreatment with the antiandrogen, cyproterone acetate (12 mg/kg per day for 8 consecutive days). It was also shown that pretreatment with testosterone (4-20 mg/kg per week) dose-dependently aggravated cysteamine-induced gastroduodenal mucosal injury. Our results thus suggest an aggressive role of testosterone in the generation of cysteamine-induced gastroduodenal ulceration.

Growth hormone and somatostatin interaction in the ulcerogenic effect of cysteamine in female rats

It is known that cysteamine's ulcerogenic effect depends, among others, on a depletion of somatostatin (SRIH). Since growth hormone (GH) affects the release of hypothalamic SRIH, we have studied the influence of GH and the GH-SRIH interaction on the severity of gastric mucosa lesions induced by cysteamine. Female rats of the Sprague-Dawley strain were pretreated with GH (1 mg/kg) and subjected to cysteamine-induced gastric lesions. We found that these animals showed an increased mortality and severity of gastric lesions. Pretreatment with SRIH (25 or 50 micrograms/kg) was followed by a decrease in mortality and of incidence and severity of gastric mucosa lesions as compared to those found in control animals pretreated with saline. The dose of 5 micrograms/kg was ineffective in this respect. The combined administration of GH and SRIH revealed that cysteamine ulcerogenic action remained unchanged. It is possible that high levels of plasma GH, as induced by exogenous GH administration, may decrease the release of gastro-intestinal SRIH and this in turn may potentiate the ulcerogenic activity of cysteamine.

Influence of growth hormone on cysteamine-induced gastro-duodenal lesions in rats: the involvement of somatostatin

It is known that cysteamine ulcerogenic effect depends, among others, on a depletion of somatostatin in the gastro-intestinal tract. Since growth hormone (GH) causes the release of hypothalamic somatostatin (SRIH) and potentiates the ulcerogenic action of cysteamine we have studied the influence of GH on gastro-duodenal mucosa levels of SRIH, and its relevance for the ulcerogenic action of cysteamine. Female rats of the Sprague-Dawley strain were pretreated with GH (0.25, 0.5 or 1 mg/kg) and subjected to cysteamine-induced gastric lesions. These animals showed an increased mortality and severity of gastric lesions. The measurement of gastric and duodenal barrier mucus levels revealed that GH administration was followed by a decrease in mucus production. Pretreatment with SRIH (25 or 50 microg/kg) was followed by a decreased percent incidence and severity of gastric mucosa lesions induced by cysteamine. The mucus production was increased by SRIH administration. GH pretreatment was followed by a reduction of SRIH-like immunoreactivity in gastro-duodenal mucosa and an increase of insulin plasma levels. Acute injection of cysteamine per se was also followed by a decrease of gastro-duodenal SRIH and an increase in insulin plasma levels. These results suggest that high levels of plasma GH, as induced by exogenous GH administration, may cause a decrease of SRIH gastro-intestinal content and this in turn may potentiate the ulcerogenic activity of cysteamine.

[Clinical study of the efficacy and tolerability of nimesulide in suppositories compared to flurbiprofen in gynecology]

The efficacy and tolerability of nimesulide in a new pharmaceutical suppository form were assessed in a double blind study versus flurbiprofen in pain-inflammatory pathologies of obstetrico-gynecological nature. One hundred patients with pelvic inflammatory disease were randomly assigned to treatment with nimesulide or flurbiprofen. Both drugs, administered in a dose of 2 suppositories a day for 7 days, evidenced speedy, effective analgesic and anti-inflammatory activity combined with good tolerability. Specifically, as regards the pain component, nimesulide demonstrated a significantly more marked analgesic effect than flurbiprofen in the first two hours of treatment.

Urinary steroid profiles in gestosis syndrome

Urinary steroid profiles were studied using gas chromatography in eighteen pregnant women with EPH-gestosis. A drastic and probably aspecific decrease in urinary steroid concentrations was observed in all metabolic profiles when compared with physiological counterparts. The phenomenon seems to be strictly dependent upon the syndrome and disappears after effective therapy.

Spontaneous fluctuations of human placental lactogen during normal pregnancy

Six women in the 3rd trimester of normal pregnancy had measurements of circulating placental lactogen (hPL) levels using a continuous blood sampling technique for 10-15 h. In addition, in 3 pregnant women hPL was assayed at 10-min intervals for 60-90 min. Both these procedures showed that hPL serum levels fluctuate irregularly during normal pregnancy. The magnitude and frequency of these fluctuations make the significance of a single hPL determination less reliable as a test of placental function.