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Diamel Therapy in Polycystic Ovary Syndrome Reduces Hyperinsulinaemia, Insulin Resistance, and Hyperandrogenaemia
Arturo Hernández-Yero,Felipe Santana Pérez,Gisel Ovies Carballo,Eduardo Cabrera-Rode
International Journal of Endocrinology , 2012, DOI: 10.1155/2012/382719
Abstract: For to determine the effect of Diamel on the insulin resistance, insulin sensitivity, and sexual hormones results in women with polycystic ovary syndrome (PCOS). A study was carried out on 37 patients with this disorder. A triple-blind clinical trial was designed in which the Diamel food supplement was compared with a placebo. The women with reproductive ages were randomly distributed in two groups, with 18 and 19 women respectively, and they took Diamel or placebo and were followed up during 6 months with clinical and biochemical evaluation. A significant decrease in the HOMA-IR from the initial value at six months was observed in the group with Diamel. The insulin sensitivity improved considerably in this group. The rate of menstrual recovery was higher in the group with Diamel, and two patients from this group obtained pregnancy. The hormone levels shows a significant decrease in testosterone at 3 months in the group with Diamel compared with the control group. The LH also decreases in the same group when comparing the start with 6 months.We concluded that the Diamel decreases insulin resistance and improves sensitivity to this hormone in women with PCOS, with improvement in the levels of LH and testosterone. 1. Introduction Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by chronic anovulation and the cutaneous effects of hyperandrogenism [1–3]. There is a high prevalence of PCOS in women with type 2 diabetes mellitus, and there is evidence that insulin resistance and associated compensatory hyperinsulinaemia play a central role in the pathogenesis of PCOS in some women [4–7]. The metabolic aspects of this syndrome include insulin resistance, obesity, lipid abnormalities, and an increased risk for impaired glucose tolerance and type 2 diabetes mellitus [7–9]. Hyperinsulinaemia and insulin resistance are more common among women with PCOS than women without the condition regardless of whether they are obese or not [1, 8]. High insulin levels can increase the amount of androgens produced by ovarian theca cells in synergism with LH. It has been suggested that hyperandrogenism and insulin resistance occur early on in life and might even originate during foetal life and detected clinically before puberty [9, 10]. A potential mechanism for insulin resistance in PCOS women increased serine phosphorylation of the insulin receptors [8]. Serine phosphorylation of IRS-1 (insulin receptor substrate-1) has been suggested as a mechanism for TNF- -mediated insulin resistance and modulated the activity of the key regulatory enzyme of
Bases genéticas del síndrome de ovarios poliquísticos
Ovies Carballo,Gisel; Martínez de Sandelices,Alicia; Monteagudo Pe?a,Gilda; Sardi?as Díaz,Irelys;
Revista Cubana de Endocrinolog?-a , 2011,
Abstract: the syndrome of polycystic ovaries is the endocrine disorder involving more the reproductive sphere of the woman in fertile age, its causes are unknown with accuracy, but most of experts coincide in propose that it is a multifactor entity where the genetic factor more and more have a great significance. in past years, it has been possible to identify some genes involved in the pathogenic processes of this syndrome and among the more important are included those codifying for enzymes of the steroidogenesis, for the insulin receptor and other hormones related to the insulin action, as well as the gonadotropins and its receptors, features that are the aim of present review.
Frecuencia y características clínicas, hormonales y ultrasonográficas sugestivas de síndrome de ovarios poliquísticos en un grupo de mujeres con síndrome metabólico
Ovies Carballo,Gisel; Domínguez Alonso,Emma; Verdeja Varela,Olga L.; Zamora Recinos,Hugo;
Revista Cubana de Endocrinolog?-a , 2008,
Abstract: the polycystic ovarian syndrome is the most frequent endocrine affection in females at reproductive age. nowadays, it is known that insulin resistance and consequent hyperinsulinism seem to be the basis of the disorders characterizing it. that's why, it is not erroneous to think that in females with metabolic syndrome, whose physiopathological bases are insulin resistance and hyperinsulinism, there may appear clinical, humoral and ultrasonographic elements of the polycystic ovarian syndrome. objective: to determine the frequency and clinical, hormonal and ultrasonographic characteristics suggestive of polycystic ovarian syndrome in a group of females with diagnosis of metabolic syndrome. methods: a cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome according to the modified criteria of the world health organization. they were interviewed and physically examined seeking clinical signs of polycystic ovarian syndrome (infertility, menstrual disorders, hirsutism, acne). besides, the folliculostimulating hormone, the luteinizing hormone, prolactin and total testosterone were determined. a transvaginal gynecological ultrasound was performed between the third and the fifth day of the menstrual cycle, if they were menstruating or at any other moment, if they were not. progesterone was also determined between the 21st and the 23rd day of the cycle, provided that they were menstruating. patients were diagnosed polycystic ovarian syndrome when they had one or both clinical criteria, one or both hormonal criteria and the ultrasonographic criterion. results: 67.8 % of females presented oligomenorrhea; 81.1 %, hirsutism; 65.6 %, anovulatory progesterone values; and 55.6 % elevated testosterone. 63.3 % of the studied group had ultrasonographic signs suggestive of polycystic ovaries, and the most frequent sign was the presence of 10 or more follicles of ovarian periphery and stromal thickening. 51.1 % fulfilled the criteria for the
Asociación entre variables hormonales y clínicas y el resultado del ultrasonido ginecológico en mujeres con síndrome metabólico.
Ovies Carballo,Gisel; Domínguez Alonso,Emma; Verdeja Varela,Olga L; Zamora Recinos,Hugo;
Revista Cubana de Endocrinolog?-a , 2008,
Abstract: objective: to determine the association between the result of the ultrasound and the progesterone values, lh/fsh level, testosterone, history of infertility and hirsutism in females with metabolic syndrome. methods: a descriptive cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome. fsh (3-5 days of the menstrual cycle), lh (3-5 days of the menstrual cycle), prolactin (3-5 days of the menstrual cycle), androgens (total testosterone, 3-5 days of the menstrual cycle), progesterone (21-23 days of the menstrual cycle) were determined if they were menstruating; otherwise they were established at any moment. a transvaginal gynecological ultrasound in the early follicular phase was performed if they had menstruation, but if they were amenorrheic it was carried out at any time. a medical history was also made to explore obstetric history, menstrual formula, history of infertility and physical examination. associations between the clinical and hormonal variables and the ultrasonographic result were investigated. results: 83.1 % of the anovulatory showed images suggestive of ovarian polycystosis. when the testosterone levels were associated with the ultrasound, in 80 % of those who had an elevated testosterone, the ultrasound showed images of ovarian polycystosis; however, when testosterone was normal, just 42.5 % had such images. of the 39 patients with an index 3 2, 32 (82.1 %) presented an ultrasonographic image of ovarian polycystosis; however, when it was <2, only 49 % had them. 75 % of the females with infertility showed an ultrasound with signs of polycystic ovaries and 25 % did not. of the 73 hirsute patients, 48 (65.8 %) had a positive ultrasound for ovarian polycystosis, whereas 25 (34.2 %) did not exhibit images suggestive of this disorder, without a significant difference. conclusions: the association between anovulatory progesterone, elevated levels of testosterone, lh/fsh index 3 2, infertility and hirsutism, with
Asociación entre algunos factores psicosociales y el inicio de las relaciones sexuales en adolescentes escolares
Santana Pérez,Felipe; Verdeja Varela,Olga Lidia; Ovies Carballo,Gisel; Fleitas Ruiz,Reina;
Revista Cubana de Medicina General Integral , 2006,
Abstract: an analytical cross-sectional study was conducted in 1 675 adolescents aged 15-18, who live in havana city and study at preuniversity institutes and polytechnics, since there are a series of psychosocial factors that may be associated with the early beginning of sexual relations. our aim was to determine the possible association of some psychosocial factors (group of couples, academic aspects and use of toxic substances) with the initiation of sexual relations in adolescent students of our province. to this end, a self-administered questionnaire was applied to explore certain variables. the percentage of adolescent having sexual intercourse is significantly higher (90.5 %) among those who have a better communication with their group of couples compared with those that do not communicate among themselves (86.5 %). having repeated school grades is connected with a beginning of sexual relations at an early age (82.2 %) on comparing them with those who do not have this antecedent (69.4 %).the adolescents drinking alcoholic beverages present a higher tendency to start sexual relations earlier than those without this toxic habit (82,3 % vs 64,8 %). the higher integration to the group, the low academic performance, as well as the consumption of toxic substances are associated with an earlier beginning of sexual relations in adolescence.
Caracterización del uso del implante subdérmico norplant
Pérez Parra,Zaadia; Ortega Blanco,Myrna; Ovies Carballo,Gisel; Pérez Vives,José L;
Revista Cubana de Medicina General Integral , 2001,
Abstract: summary a descriptive study was carried out to identify the reproductive preconceptional risk factors that lead to the use of the implant, the causes of its removal and the evaluation of the technique used to remove it at the family planning service of the "plaza de la revolución" polyclinic. an analytical cohort study was also conducted to determine the time of permanence of the method during the studied period. data were obtained from a database that had been previously created with the information taken from the medical histories. the norplant subdermal implant is a second generation hormonal contraceptive method, classified as a long-acting release system (5 years) of high efficiency. as in our country there is little experience about its use we propose ourselves to characterize it among women that were implanted for a period of 5 years at the "plaza de la revolución" teaching polyclinic. the most frequent reproductive peconceptional risks were: 3 abortions or more (49,1 %), low weight according to height (46 %) and bronchial asthma (15.6 %). the changes occurred in the menstrual pattern, mainly in adolescents, were the most frequent cause of removal before the expiration date. the time used for removing implants in the first attempt was under 10 min in most of the cases (89.6 %). the time of permanence was 42.49 months as an average. based on our experience, we concluded that norplant is a contraceptive method generally used in women at reproductive risk, and as it is reported by other studies the alteration of the menstrual bleeding is the main cause for its removal, where no serious complications are observed on using the standard technique.
Caracterización de la lactancia materna en un área urbana
Ovies Carballo,Gisel; Santana Pérez,Felipe; Padrón Durán,Rubén S;
Revista Cubana de Medicina General Integral , 1999,
Abstract: a descriptive and cross-sectional study of 872 women who lived in an urban area and had given birth from 1 to 12 months before was conducted in order to know the duration, pattern of breast feeding, and the causes to abandon it. 1.1 % of these women never started breast feeding due to agalactia. women began to breast feed their children in an average time between 1 and 15 days. among those who had abandoned breast feeding at the time of the study the mean time of duration was 108.5 days. the life table technique was applied to the group that was not breast feeding so as to determine the continuity rate and the risk of leaving breast feeding. in the first case there is only 51 % of probability to continue lactating from 4 to 5 months, and in the same period the weaning risk is 0.83 %. the most frequent reason to leave this practice was the complete loss of milk. only 32.6 % of the studied population used breast feeding exclusively. it is concluded that there is a high trend to abandon breast feeding early and, mainly, the exclusive one
Asociación entre variables hormonales y clínicas y el resultado del ultrasonido ginecológico en mujeres con síndrome metabólico. Association among hormonal and clinical variables and the result of the gynecological ultrasound in females with metabolic syndrome.
Gisel Ovies Carballo,Emma Domínguez Alonso,Olga L Verdeja Varela,Hugo Zamora Recinos
Revista Cubana de Endocrinología , 2008,
Abstract: OBJETIVO: determinar la asociación entre el resultado de ultrasonido y los valores de progesterona, índice LH/FSH, testosterona, antecedentes de infertilidad e hirsutismo en mujeres con síndrome metabólico. MéTODOS: se realizó un estudio descriptivo-transversal con 90 mujeres, entre 18 y 45 a os de edad, con diagnóstico de síndrome metabólico. Se les realizó: FSH (3-5 días del ciclo menstrual si menstruaba), LH (3-5 días del ciclo menstrual si menstruaba), prolactina (3-5 días del ciclo menstrual si menstruaba), andrógenos (testosterona total, 3-5 días del ciclo menstrual si menstruaba), de lo contrario en cualquier momento y progesterona (21-23 días del ciclo menstrual si menstruaba), ultrasonido ginecológico transvaginal en la fase folicular temprana si menstruaban, y si estaban en amenorrea en cualquier momento. Además se les realizó una historia clínica que exploraba historia obstétrica, fórmula menstrual, antecedentes de infertilidad y examen físico. Se exploraron asociaciones entre las variables clínicas y hormonales y el resultado ultrasonográfico. RESULTADOS: el 83,1 % de las pacientes anovuladoras mostraron imágenes sugestivas de poliquistosis ovárica. Cuando se asociaron los niveles de testosterona con el ultrasonido, en el 80 % de las que tuvieron testosterona elevada el ultrasonido mostró imágenes de poliquistosis ovárica, sin embargo cuando la testosterona fue normal solo el 42,5 % mostró dichas imágenes. De las 39 pacientes con un índice LH/FSH 3 2, 32 (82,1 %) tenían por imagen ultrasonográfica una poliquistosis ovárica, sin embargo cuando este fue <2, solo el 49 % la presentó. El 75 % de las mujeres con infertilidad exhibían un ultrasonido con signos de ovarios poliquísticos y el 25 % no. De las 73 pacientes hirsutas, 48 (65,8 %) tenían un ultrasonido positivo para poliquístosis ovárica, mientras que 25 (34,2 %) no mostraron imágenes sugestivas de dicho trastorno, sin diferencia significativa. CONCLUSIONES: la asociación entre progesterona anovuladora, niveles elevados de testosterona, índice LH/FSH 3 2, infertilidad e hirsutismo, con imágenes por ultrasonido de poliquistosis, es muy elevada en las mujeres estudiadas con síndrome metabólico. OBJECTIVE: to determine the association between the result of the ultrasound and the progesterone values, LH/FSH level, testosterone, history of infertility and hirsutism in females with metabolic syndrome. METHODS: a descriptive cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome. FSH (3-5 days of the menstrual cycle), LH (3-5 days of the menstrual cy
Tumor virilizante del ovario: Presentación de un caso Tumor virilizante del ovario: Presentación de un caso
Gisel Ovies Carballo,Marelys Yanes Quesada,Jeddú Cruz Hernández,Lisbet Rodríguez Fernández
Revista Cubana de Endocrinología , 2008,
Abstract: Los tumores del ovario se dividen en no funcionantes y funcionantes. Dentro de este último grupo existen los que presentan actividad endocrina y producen androgenización, como son los de células de Sertoli-Leydig. Presentamos el caso de una paciente de 50 a os de edad que clínicamente se presenta con signos de virilización progresiva. Se encuentra en estudio de imagen por ultrasonido y TAC un tumor en ovario derecho, por lo que se decide intervención quirúrgica que da como resultado tumor de células de Sertoli-Leydig. Ovarian tumors are divided into functioning and non-functioning. Those presenting endocrine activity and producing androgenization, such as the tumors of Sertoli cells are within the latter group. A case of a 50-year-old female patient that clinically showed signs of progressive virilization was presented. A tumor on the right ovary was found by ultrasound and CAT. After performing surgery, the existence of a Sertoli-Leydig cell tumor was confirmed.
Bases genéticas del síndrome de ovarios poliquísticos Genetic bases of polycystic ovary syndrome
Gisel Ovies Carballo,Alicia Martínez de Sandelices,Gilda Monteagudo Pe?a,Irelys Sardi?as Díaz
Revista Cubana de Endocrinología , 2011,
Abstract: El síndrome de ovarios poliquísticos es el trastorno endocrino que más afecta la esfera reproductiva de la mujer en la edad fértil, sus causas se desconocen con exactitud, pero la mayoría de los expertos coinciden en plantear que es una entidad multifactorial, en la que los factores genéticos cada vez cobran mayor importancia. En los últimos a os se han identificado varios genes involucrados en los procesos patogénicos de este síndrome, y dentro de estos, los más importantes son aquellos que codifican para enzimas de la esteroidogénesis, para el receptor de insulina y otras hormonas relacionadas con la acción de la insulina, así como las gonadotropinas y sus receptores, aspectos sobre los cuales trata la siguiente revisión. The syndrome of polycystic ovaries is the endocrine disorder involving more the reproductive sphere of the woman in fertile age, its causes are unknown with accuracy, but most of experts coincide in propose that it is a multifactor entity where the genetic factor more and more have a great significance. In past years, it has been possible to identify some genes involved in the pathogenic processes of this syndrome and among the more important are included those codifying for enzymes of the steroidogenesis, for the insulin receptor and other hormones related to the insulin action, as well as the gonadotropins and its receptors, features that are the aim of present review.
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