of the relation between use ofNSAIDs and gastrointestinal adverse reactions were reported. The first examined data based on "yellow card" reporting in the United Kingdom for the first five years of marketing of several NSAIDs," many of which were identical with those compared in our study. The Committee on Safety of Medicines concluded that piroxicam fell into a group of 12 NSAIDs for which differences in safety ".... cannot be clearly distinguished from each other based on yellow card reports." The second study compared five NSAIDs, only one of which (piroxicam) was included in this study, in an innovative postmarketing surveillance scheme, prescription event monitoring.'2 That study examined a wider range of adverse events than either our study or that of the Committee on Safety of Medicines, but the findings relating to the events affecting the gastrointestinal system were interpreted as reflecting no noteworthy differences between the drugs examined. Thus it seems reasonable to conclude that large and clinically important differences in rates of upper gastrointestinal bleeding, perforation, and ulcer between piroxicam and the rest of the NSAIDs probably do not exist. Abstract Serum selenium concentrations were found to be significantly lower in women with intrahepatic cholestasis of pregnancy than in women with normal pregnancies during the last trimester of pregnancy and post partum. The activity of the selenoenzyme glutathione peroxidase had a significant positive correlation with selenium concentration and it was also significantly lower in women with the disease.These findings suggest that selenium deficiency and reduced glutathione peroxidase activity are associated with the aetiopathogenesis of intrahepatic cholestasis of pregnancy.
IntroductionThe aetiology of intrahepatic cholestasis of pregnancy is unknown. Patients with this condition are abnormally sensitive to oestrogens.
To evaluate the effects of season on the function of the pituitary-ovarian axis and the adrenal cortex in a northern area with great seasonal variation in the length of daylight, 10 healthy women were investigated over 1 menstrual cycle in spring (May-June), autumn (August-September), early winter (November-December) and late winter (February-March). Serum concentrations of LH, FSH, prolactin, estradiol, progesterone, total and free testosterone, cortisol, sex hormone binding globulin (SHBG) and cortisol binding globulin (CBG) were measured, and the indices of free estradiol (FEI), free androgen (FAI) and free cortisol (FCI) were calculated on cycle days 3-4, 6-7, 10-11, on the presumed day of ovulation, and 6-7 and 9-10 days after the presumed ovulation. Spring was the season that most significantly differed from the other seasons. It was characterized by a significantly decreased concentration of SHBG and an increased FAI throughout the whole menstrual cycle, an increased FSH concentration during the follicular phase, significantly increased estradiol concentration and an increased FEI, and significantly decreased concentrations of FSH and LH during the luteal phase of the cycle. The concentration of cortisol and the FCI were significantly increased in the autumn compared with late winter, both seasons having similar day-length. The present data demonstrate that spring, with a long photoperiod, seems to be associated with increased pituitary-ovarian axis activity and androgenic activity, whereas adrenal cortex function did not show any association with day-length.
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