dinoprost and Rupture--Spontaneous

Postprandial hyperglycemia was reported to play a key role in established risk factors of coronary artery diseases (CAD) and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of short-term postprandial glucose (PPG) excursions. Low serum 1,5-AG levels have been associated with occurrence of CAD. However, the relationship between 1,5-AG levels and coronary plaque rupture has not been fully elucidated. The aim of this study was to evaluate 1,5-AG as a predictor of coronary plaque rupture in diabetic patients with acute coronary syndrome (ACS).. A total of 144 diabetic patients with ACS were included in this study. All patients underwent intravascular ultrasound examination, which revealed 49 patients with plaque rupture and 95 patients without plaque rupture in the culprit lesion. Fasting blood glucose (FBG), hemoglobin A. Serum 1,5-AG may identify high risk for coronary plaque rupture in diabetic patients with ACS, which suggests PPG excursions are related to the pathogenesis of plaque rupture in diabetes.

Topics: Acute Coronary Syndrome; Aged; Biomarkers; Blood Glucose; Coronary Artery Disease; Coronary Vessels; Deoxyglucose; Diabetes Mellitus, Type 2; Dinoprost; Female; Glycated Hemoglobin; Humans; Male; Middle Aged; Plaque, Atherosclerotic; Predictive Value of Tests; Prospective Studies; Rupture, Spontaneous; Ultrasonography, Interventional

The purpose of the study was to evaluate the effects of drug therapy on the throphoblast and on the tubal wall when protaglandin F2 alpha (PGF2 alpha) was administered in cases of tubal pregnancies. 42 patients were divided into two groups: women of group I (n = 30) were secondarily treated by surgery because of raising serum HCG levels. Group II (n = 12) consisted of patients who were operated on because of acute symptoms (abdominal pains, intraabdominal haemorrhage), despite already failing HCG values. In group I in 66% (n = 20) of the histological specimens an intact (vital) trophoblast was found. Five cases (17%) showed partly necrotic gestational tissue, whereas in another five cases (17%) the whole trophoblast was necrotic. In patients of group II all ectopic pregnancies showed histological signs of necrosis. In the histopathology of the Fallopian tubes no signs of trophic regression could be found. However, ten out of 22 cases showed ruptured tubal pregnancies. In this analysis we could show that the instillation of PGF2a electively destroys the ectopic trophoblast and does not exercise any necrotic action on the tubal wall.

Topics: Abortifacient Agents, Nonsteroidal; Adult; Combined Modality Therapy; Dinoprost; Fallopian Tubes; Female; Humans; Injections, Intralesional; Laparoscopy; Necrosis; Pregnancy; Pregnancy, Tubal; Rupture, Spontaneous; Trophoblasts

Topics: Adult; Dinoprost; Dose-Response Relationship, Drug; Drug Administration Schedule; Fallopian Tubes; Female; Humans; Injections; Insemination, Artificial, Homologous; Laparoscopy; Methotrexate; Pregnancy; Pregnancy, Tubal; Rupture, Spontaneous

Over the past years laparoscopic surgery has become widely accepted in the treatment of tubal pregnancy and instillation of prostaglandin is well established. However, the failure rate is around 20%. This report describes a case of tubal pregnancy treated according to this procedure where the therapy initially seemed to be successful. Instillation of prostaglandin F2 alpha was followed by decreasing beta-HCG values, which continued to decrease after discharge. Thus, rupture of the operated tube on day 17 after surgery was completely unexpected.

Topics: Adult; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Dinoprost; Dinoprostone; Fallopian Tube Diseases; Female; Humans; Injections, Intralesional; Injections, Intramuscular; Laparoscopy; Peptide Fragments; Postoperative Complications; Pregnancy; Pregnancy, Tubal; Rupture, Spontaneous

Topics: Adult; Dinoprost; Fallopian Tubes; Female; Humans; Injections; Laparoscopy; Pregnancy; Pregnancy, Tubal; Rupture, Spontaneous