摘要:

The vaginal absorption of 0.5-mg tablets of micronized estradiol was evaluated in postmenopausal women. In a single-dose study, one hour after insertion, a 5.3-fold rise in mean serum estradiol levels and 1.5-fold rise in mean serum estrone levels were observed. Mean levels of luteinizing hormone and follicle-stimulating hormone were significantly depressed. In a three-week alternate-day regimen, mean serum levels of estradiol were consistently two to three times greater than those of estrone 12 hours after insertion. Vaginal absorption of micronized estradiol tablets into the systemic circulation was found to be rapid and efficient. The vaginal route was acceptable and well tolerated by patients. In addition, the major conversion of estradiol to estrone that follows oral or sublingual administration was reduced. The vagina may be a preferred alternate route for estrogen replacement therapy in selected patients.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Forty-eight women with menstrual dysfunction and clinical evidence of excess androgen production were subjected to an adrenocorticotropic hormone stimulation test that demonstrated the presence of a late-onset 11-or 21-adrenocortical hydroxylase deficiency. Adrenocortical suppression therapy with prednisone was then instituted. Eighty-three percent of the women improved and either conceived, established normal regular menstrual cycles, or noted a significant increase in menstrual regularity. In patients desiring fertility, there was an overall pregnancy rate of 64% and a corrected pregnancy rate of 93%. Some of these patients were given clomiphene in addition to the prednisone. The present study has demonstrated that an adrenocortical abnormality, characterized by a partial deficiency of either 11-hydroxylase or 21-hydroxylase, plays a significant role in many women with clinical evidence of hyperandrogenism and menstrual abnormalities. In such women, adrenocortical suppression is indicated and often results in a significant improvement of the menstrual disturbance.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The objective of this study was to examine the mechanisms by which physical activity affects the menstrual cycle. Women with high, medium, and low levels of physical activity were compared for menstrual function, physical characteristics, and urinary and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, estradiol-17β, and 2-hydroxyestrone. None of the physical characteristics other than age and muscle area were significantly different in the three groups. The percentage of body fat did not appear to be a factor in the amenorrhea induced by strenuous exercise, as the percent of body fat in all three groups was less than 22%. The group of athletes under strenuous exercise which correlated with oligomenorrhea had decreased serum levels of luteinizing hormone, prolactin, and estradiol-17β but elevated levels of 2-hydroxyestrone. These data suggest that anovulatory cycles are correlated with the amount of exercise and increased levels of catechol estrogens. Catecholamines and β-endorphin elevated by exercise may interact to suppress luteinizing hormone release at the hypothalamic pituitary axis.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The frequency of hysterectomy as treatment for abortion complications may reflect the incidence of serious abortion morbidity. To examine this use of hysterectomy, the authors analyzed reports of approximately 237,000 legal abortions performed in the United States from 1970 to 1978. Overall, the rate of hysterectomy associated with curettage abortion decreased from 4.6 per 10,000 abortions in 1970 to 1971 to 1.4 per 10,000 in 1975 to 1978; the rate of hysterectomy associated with instillation abortion fell from 6.8 to 4.3 per 10,000 for the same years. A history of older age, previous births, use of instillation abortion, and preexisting gynecologic disorders increased the likelihood of hysterectomy. In cases of curettage abortion, hysterectomy rates increased significantly with advancing gestational age. Changes in abortion technology, improvements in physician skill, and more conservative management of complications have likely contributed to the decreasing frequency of hysterectomy necessitated by abortion complications.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Recent investigations suggested a possible immunologic etiology for endometriosis. To determine whether cellular immunity may be affected in patients with endometriosis, peripheral lymphocyte populations were investigated in 31 confirmed endometriosis patients and 22 control patients. No statistical differences in OKT3, OKT4, OKT8, OKM1, and OKTal cells could be observed. Total lymphocyte numbers were within normal ranges for both groups. Helper/suppressor ratios were not statistically different and were in a normal range for both groups. It is concluded that numeric differences in lymphocyte subpopulations represent only a very unlikely contributing factor in a potential immunologic etiology of endometriosis.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

One hundred one women undergoing elective abdominal hysterectomy were given perioperative cefoperazone or cefoxitin in a prospective randomized blinded study. Both regimens were well tolerated and no significant toxic or allergic manifestations were observed. Interrelationships between antimicrobial concentration in serum and pelvic tissues, intraoperative cardinal ligament cultures, febrile morbidity, and major postoperative infection were determined. At uterine removal, mean cefoperazone concentrations in serum (56.1µg/mL) and pelvic tissues (18.6 n-g/g) were significantly higher than mean concentrations of cefoxitin, ie, 16.1 µg/mL and 8.1 µg/g, respectively (P<.001). The incidence of major postoperative infection was 6% or less with both regimens. Perioperative prophylaxis significantly reduced the incidence of this infection. When it did develop, however, it continued to cause significant morbidity, prolonging hospital stay a mean of more than four days (P<.001) and increasing the hospital bill a mean of almost $1500 (P<.001).

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Necrotizing fasciitis is a rare, rapidly progressive, and often fatal infection of the superficial fascia and subcutaneous tissues. The integrity of the deep muscle fascia is usually not breeched, thus limiting the depth of involvement. Centrifugal spread within the planes of the superficial fascia and subcutaneous tissues is characteristic. Patients with diabetes mellitus constitute the group most vulnerable to necrotizing fasciitis, and a vulvar or perineal origin is associated with particularly high mortality. The authors report four such patients. Other apparent predisposing factors are advancing age, peripheral vascular disease, chronic debilitating illness, malnutrition, and possibly other states predisposing patients to immunodeficiency. None of these factors is an absolute prerequisite to the development of necrotizing fasciitis.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A study of 215 middle income, predominantly white, suburban women for herpes simplex virus infection revealed that ten (4.6%) had positive herpes cultures near term and thus were at risk for transmission of herpes simplex virus to their newborn. Eight of these women had a previous history of herpes simplex virus infection, and seven of the eight had lesions suggestive of herpes simplex virus at the time of study. Only one patient had lesions at delivery. On the basis of past history of genital herpes or partners with herpes, 25 of the 215 women were at high risk for genital herpes near term. Thus, careful questioning identified a high-risk group of 25 patients in which eight (32%) were shedding virus near term, and this group included the majority (eight of ten) of the herpes simplex virus-infected women in the study population. There were no cases of neonatal herpes in the children born from the 215 pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

There is general agreement that a solution to the problem of dystocia would go a long way toward resolving the contentious issue of high cesarean birth rates that have become such a prominent feature of obstetric practice in recent years. At the National Maternity Hospital in Dublin, one of the largest obstetric units in Western Europe, this situation has been averted through a coordinated policy of early detection and effective treatment of abnormal uterine action over a period of 15 years. During 1980 the number of births was 8742, the incidence of cesarean section was 4.8%, and mothers were assured of delivery within 12 hours after admission to the labor unit. It is proposed that these results could be reproduced elsewhere.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The Dubowitz gestational age was compared to the obstetric clinical age of 119 predominantly black mother-infant pairs for whom certain clinical criteria were met. Forty-five hypertensive and 74 nonhypertensive gestations with infant birth weight less than 2500 g were evaluated. Overall the clinical age was 33.6 ± 4.5 weeks versus 34.7 ± 4.3 weeks by Dubowitz age (P = NS). The Dubowitz age differed from clinical age by more than 2 weeks in 33.6% (40/119). Of gestations under 33 weeks (clinical age) (N = 45) the clinical age was 30.1 ± 2.4 weeks as compared to the Dubowitz age of 32.2 ± 2.7 weeks (P < .01). Fifty-one percent (23/45) of Dubowitz ages were more than two weeks discordant with the clinical age. The Dubowitz assessment of gestational age may be unacceptably inaccurate in the determination of gestational age in low birth weight infants, particularly in those whose gestational age is less than 33 weeks. The findings suggest that studies in which conclusions were based on the Dubowitz age assessment may need reevaluation.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID