Promoting networks between evidence-based medicine and values-based medicine in continuing medical education.

Background: In recent years, medical practice has followed two different paradigms: evidence-based medicine (EBM) and values-based medicine (VBM). There is an urgent need to promote medical education that strengthens the relationship between these two paradigms. This work is designed to establish the foundations for a continuing medical education (CME) program aimed at encouraging the dialogue between EBM and VBM by determining the values relevant to everyday medical activities.

Celecoxib inhibits cellular growth, decreases Ki-67 expression and modifies apoptosis in ovarian cancer cell lines.

Background: There is controversy on the safety of inhibitors of cyclooxygenase administered at high doses; however, these drugs have been reported to be effective in the prevention of a variety of human cancers. To determine if celecoxib influences cellular growth, we evaluated several effects in ovarian carcinoma cell lines.

Methods: CAOV3, OVCAR3 and SKOV3 cell lines were exposed to different concentrations of celecoxib (0-100 microM) for 24-96 h.

Ovarian expression of markers associated with proliferation or apoptosis in women with diminished ovarian reserve.

Objective: To determine DNA fragmentation and several molecules associated with apoptosis or proliferation in ovaries of patients with diminished ovarian reserve.

Design: Cross-sectional analysis.

Setting: Tertiary institutional hospital.

[Serum levels of IL-1beta, IL-6 and TNF-alpha in infertile patients with ovarian dysfunction].

Background: Some cytokines that take part in the ovarian cycle regulation, such as IL-1beta, IL-6 and TNF-alpha play an important role during growth and development of ovarian follicle. Quantification of some cytokines is promissory in the work-up of ovarian reproductive pathology.

Objective: To determine serum levels of IL-1beta, IL-6 and TNF-alpha in infertile patients with ovarian dysfunction and to compare them with those found in ovulatory patients.

Ovarian biopsy in infertile patients with ovarian dysfunction.

Evaluation of ovarian histology is feasible by obtaining ovarian tissue through laparoscopy; however, the role of an ovarian biopsy in an infertility workup is not widely accepted. To gain insight into the role of ovarian biopsy in reproductive medicine, we conducted a cross-sectional study in infertile patients with ovarian dysfunction and correlated follicle stimulating hormone (FSH) and estradiol serum concentrations with ovarian follicular counts. Fifty women were recruited and classified into four groups: premature ovarian failure (POF), chronic anovulation, diminished ovarian reserve, and ovulatory patients (control group).

Spontaneous pregnancy in a woman with premature ovarian failure: a case report.

Background: Women with premature ovarian failure often receive hormonal replacement therapy as part of the management strategy. However, it is very unusual for patients to become pregnant while on hormonal therapy.

Case: A 33-year-old woman with a history of infertility and secondary amenorrhea was diagnosed with premature ovarian failure.

[Ovarian fibrothecal tumor: case report].

Tumors with stromal or sex-cords origin are scarce, and comprise only 5% or less of all ovarian tumors. Nevertheless functional tumor types are the most striking ones, only few of them produce hormonal symptoms. Fibrothecal tumors belong to the stromal cells tumor class, with differentiation towards both fibroblastic-type cells of thecal cell.

[Ovarian apoptosis].

Apoptosis, or programmed cell-dead is one of the main mechanisms in the process of tissular loss. This is an active process of cellular depletion that participates in a direct manner in tissular homeostasis during the life span. This apoptotic process is a key event on the pathology of tumors development.

[Plasma concentration of biochemical markers in pre-eclampsia-eclampsia and its association with the severity of the disease].

Unlabelled: It has been demonstrated that the concentrations of molecules related to endothelial cell dysfunction, coagulation and vasoconstriction are altered in preeclamptic patients, but they have not been evaluated in their relationship with the severity of preeclampsia.

Objective: To determine the relationship between the plasmatic concentrations of fibronectin ED1+, antithrombin III, prostacyclin and thromboxane, and the severity of preeclampsia.

Methods: Peripheral blood was collected from 215 women in the third trimester of pregnancy, admitted to the Luis Castelazo Ayala Gynecology and Obstetrics Hospital with mild preeclampsia (n = 103), severe preeclampsia (n = 71), HELLP syndrome (n = 25) or eclampsia (n = 16).

[Clomiphene acetate and prednisone: alternative approach for the management of patients with chronic anovulation and clomiphene treatment failure].

Chronic anovulation is a common neuroendocrine cause of infertility. Pharmacological management of such condition includes the use of clomiphen citrate (CC), which is the most utilized of the ovulation inductors. Clinical efficacy of CC provides ovulation rates of around 70%.

[The participation of apoptosis in the development and function of the male gonad].

The normal development and function of the male and female gonads is characterized by a massive cell decrease in which apoptosis plays a key role. This event is a controlled program of cell death, fundamental for development and homeostasis. In the male gonad up to 75% of the germinal cells undergo this process, probably as a mechanism to eliminate the germinal cells incompatible with the preservation of the species.

[Heterotopic pregnancy following ovulation induction by clomiphene citrate and prednisone. Report of a case].

Heterotopic pregnancy (HP) is a very rare pathologic event. The incidence of ectopic pregnancy has increased as the consequence of assisted reproduction and the wider use of ovulation induction agents. The diagnosis of HP is frequently done not as earlier as it should be, and it has serious repercussions.

Deconvolution analysis of bioassayable LH secretion and half-life in men with idiopathic oligoasthenospermia.

To further investigate the nature of neuroendocrine disturbances of the hypothalamopituitary-gonadal axis in idiopathic male infertility, we studied 12 infertile men with oligoasthenozoospermia and 13 euspermic controls, matched for age and body mass index, by blood withdrawal at 10-min intervals for 8 h to analyse pulsatile release of bioactive LH (b-LH). The rat interstitial cell testosterone (RICT) bioassay was used in conjunction with a recently validated multiparameter deconvolution algorithm, to estimate the endogenous half-life of b-LH, its secretory burst frequency, amplitude, duration and mass. Oligoasthenospermic men exhibited significant (p < 0.

Alterations in pulsatile luteinizing hormone and follicle-stimulating hormone secretion in idiopathic oligoasthenospermic men: assessment by deconvolution analysis--a clinical research center study.

To investigate the nature of neuroendocrine disturbances of the hypothalamo-pituitary-gonadal axis in idiopathic male infertility, we studied 14 infertile men with oligoasthenozoospermia (OLIGO) and 15 age-, body mass index-, and community-matched euspermic controls by blood withdrawal at 10-min intervals for 12 h to encompass basal (8-h) and exogenous GnRH-stimulated (4-h) pulsatile release of LH and FSH (by immunoradiometric assay) as well as testosterone (by RIA). Deconvolution analysis was used to estimate endogenous LH and FSH half-lives, secretory burst frequency, amplitude, duration, and mass. OLIGO men exhibited normal serum concentrations of total, free, and percent dialyzable testosterone and estradiol, but distinct dynamic alterations within the LH and FSH axes; namely (P < 0.

Neuroendocrine physiology of the normal male gonadal axis.

The normal male reproductive axis requires coordinate control of hypothalamo-pituitary testicular components. Such coordinate control is accomplished by specific feedback regulation. Here, we have reviewed the physiology of neuroendocrine feedback controls operating within the healthy male reproductive axis.

[Ultrastructural identification of human immunodeficiency virus in placenta, embryonic tissue and semen].

The objective of this paper was to evaluate, ultrastructurally the placental site, placenta, umbilical cord, embryonal tissues, and semen from 10 patients (5 females and 5 males), seropositive for the Human Immunodeficiency Virus. The tissue samples were processed by the routine techniques for electronic microscopy, and were examined with a Zeiss EM-10C Electronic, transmission microscope. Among the decidual cells of the placental site, macrophages were found, which contained vacuoles with particles similar to a virus, inside.

[The morphological aspects of the placenta, embryonic tissues and semen in human immunodeficiency virus infections].

Tissue samples from a therapeutic curettage performed in a woman with acquired immunodeficiency syndrome and a semen sample of the husband were studied with the electron microscope. The samples were processed according to routine technique for electron microscopy. Calcifications, basement membrane thickening and hyperplasia of Hofbauer cells were seen in the placenta villi.

[Evaluation and preparation of gametes].

The aim of this paper is to review some topics related to the management and evaluation of the male and female gametes to be used in any assisted reproduction procedure. First, the international criteria for the quantitative morphological and biochemical evaluation of the semen samples are presented, both for the initial analysis and when chosen procedure is performed. Next, we discuss the biochemical characteristics of the solutions used to in vitro induce capacitation and acrosome reaction, indispensable events previous to the in vivo or in vitro interaction of the gametes.