Acta obstetricia et gynecologica Scandinavica. Supplement最新文献

{"title":"XV FIGO World Congress of Gynecology and Obstetrics. Copenhagen, Denmark, 3-8 August 1997. Abstracts. Part 3.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"167 Pt 3 ","pages":"1-118"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20227781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of vaginally delivered estrogens.","authors":"G Heimer,&nbsp;G Samsioe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Atrophic condition in the vagina and lower parts of the urethral tract are common in elderly women. From population based surveys it has been estimated that 40% or more of women over 60 complain of insufficient control of micturation. In addition, lower urinary tract infections are common in this age group and recurrent cystitis is a scourge for many women (1, 2). Vaginal problems such as vaginal dryness, dyspareunia as well as infectious and non infectious disorders in the vagina may be even more common in elderly women (3) Vasomotor symptoms such as sweats and hot flushes commonly commence around the time of the menopause. In the majority of cases urogenital dysfunction does not become a problem until a decade later. Endogenous estrogens decline during the climacteric and the fall of estradiol levels from the time of onset of vasomotor symptoms until commencement of urogenital problems cannot be disregarded. In other words, it seems as if urogenital integrity can be maintained at lower estrogen levels than those required to resist vasomotor symptoms and conserve bone mass. Further evidence for this concept is achieved from numerous clinical studies in which various estrogens have been administered both orally and vaginally to elderly women with signs of urogenital atrophy which have resulted in amelioration. Such an alleviation of urogenital symptoms can be achieved without provoking endometrial growth.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"163 ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19880308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrogens--pharmacokinetics and pharmacodynamics with special reference to vaginal administration and the new estradiol formulation--Estring.","authors":"A Johnston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The consequences of diminished plasma estrogens in post-menopausal women are reviewed. The various options for estrogen replacement therapy are discussed with reference to the risks and benefits of estrogen therapy. The changes in estrogen plasma concentrations and the resulting systemic actions that occur following vaginal administration of different formulations of estrogens are reviewed with reference to Estring, a new intra-vaginal formulation designed to give sustained delivery of estradiol to the vaginal mucosa. The possibility of Estring causing local, adverse, actions on the endometrium and the reasons why this is unlikely are described.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"163 ","pages":"16-25"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19880314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30th Congress of the Federation of Scandinavian Societies of Obstetrics and Gynecology. Stockholm, Sweden, 19-22 May 1996. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"162 ","pages":"1-104"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19660996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic data on estradiol in light of the estring concept. Estradiol and estring pharmacokinetics.","authors":"J Gabrielsson,&nbsp;I Wallenbeck,&nbsp;L Birgerson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pharmacokinetics and pharmacodynamics of estradiol in humans are briefly reviewed in this paper. The estradiol vaginal ring was designed and developed to obtain controlled local delivery of very low doses of estradiol resulting in a marginal effect on plasma concentrations of estradiol, associated with a margin of safety over a prolonged period of time. Three clinical studies in postmenopausal women with signs and symptoms while plasma levels remain virtually unchanged in the lower part of the normal postmenopausal range. No pharmacodynamic effects of estrogen could be detected, reflecting a very low systemic exposure. The estradiol exposure and the plasma concentration time course during treatment with first and second ring during first month of the intended three month treatment period are compared. The very low systemic exposure is discussed in relation to existing therapies. Ongoing pharmacokinetic work with estradiol vaginal ring is briefly described. It is concluded that the estradiol vaginal ring is a very stable alternative to existing vaginal therapies, resulting in a very low systemic exposure to estradiol, and is associated with a minimal risk of drug interaction and has a high margin of safety.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"163 ","pages":"26-31; discussion 32-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19880213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A morphologist's approach to the vagina.","authors":"J G Forsberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The author reviews basic facts on vaginal histology and ultrastructure with respect to passage of different substances and drugs through the epithelium. Particular interest is given to the action mechanism of topically applied intravaginal estrogen, its binding to receptors in different vaginal cell types, and possible local metabolic routes for estrogen. Differences in estrogen sensitivity between uterus and vagina are discussed as well as the background for the high sensitivity in the vagina.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"163 ","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19880310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low endogenous estrogen levels--analytical problems and tissue sensitivity.","authors":"K Carlström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Measurement of low peripheral concentrations of estradiol-17 beta with radioimmunoassay techniques has frequently produced extremely variable results, due to methodological problems. One such problem is variable non-specifically bound radioactivity (NSB) in methods using precipitation for separation of free and bound radioactivity. This problem can be overcome either by substituting the precipitation technique with dextran coated charcoal separation which drastically reduces NSB or by correcting for individual NSB values in samples and calibrators. These simple modifications of an existing commercial kit make convenient determination of estradiol-17 beta at low concentrations in postmenopausal women possible. Estrone sulfate is the quantitatively most important circulating estrogen in non-pregnant individuals. Studies of the metabolism of tritiated estrone sulfate in vitro evidently show that estrone sulfate is converted into estradiol-17 beta in several estrogen target tissues, including the vaginal mucosa. This conversion is probably important for the estradiol-17 beta supply to target organs in individuals with low circulating levels of estradiol-17 beta such as postmenopausal women.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"163 ","pages":"11-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19880311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal therapies for endometriosis: implications for bone metabolism.","authors":"M Y Dawood","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The non-surgical treatment of endometriosis involves hormone therapy that either affects the lesions directly, or indirectly inhibits endometrial proliferation and induces atrophy through estrogen deprivation, or through a combination of these effects. The medications used to treat endometriosis are progestins (e.g. norethindrone, medroxyprogesterone acetate), oral contraceptives (e.g. estrogen-progesterone acetate), androgens and their derivatives (e.g. danazol, gestrinone), and gonadotropin-releasing hormone (GnRH) agonists (e.g. buserelin, leuprolide acetate, nafarelin, goserelin, tryptorelin). Agents such as GnRH agonists that produce sustained and prolonged hypoestrogenemia, similar to the postmenopausal hypogonadal state, can have a significant negative impact on trabecular bone mass. Evidence from the use of oral contraceptives and medroxyprogesterone acetate indicated that they had no apparent adverse effect on bone mass. Initial studies with dual-photon absorptiometry were unable to detect any appreciable bone loss with GnRH agonists. Later studies, however, have invariably found significant bone loss as early as 3 months after the start of treatment. Quantitated computerized tomography always shows significant trabecular bone loss of the vertebrae and hip with GnRH agonists. Depot preparations appear to produce more marked loss than daily intranasal sprays. Recovery of bone loss may take 6-12 months after the end of therapy, with considerable individual variations. In contrast, treatment of endometriosis with danazol produces bone gain. If endometriosis has to be treated with bone-depleting agents, prevention or attenuation of bone loss using combined therapy with progestins, etidronate or calcitonin together with GnRH agonists should be considered; however, further studies are necessary to define the efficacy of such combined therapy. Smoking and excessive caffeine intake should be avoided. The risk of bone loss should be considered when choosing the appropriate management of endometriosis, the selection of patients, repeat therapies for recurrent endometriosis, and the formulation of such therapies, in order to minimize or overcome it.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"22-34"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19200614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Action of danazol on plasma lipids and lipoprotein metabolism.","authors":"C J Packard,&nbsp;J Shepherd","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Danazol, a weakly androgenic, heterocyclic compound with anabolic properties, is used primarily in the treatment of endometriosis and other gynecological complaints. Early reports indicated that the drug had little effect on plasma lipid (cholesterol and triglyceride) levels but recently concern has been expressed over more subtle changes reported in plasma lipid and lipoprotein metabolism after danazol treatment. Therapy produces a rapid reduction in high density lipoprotein (HDL) cholesterol (particularly in the putatively cardioprotective HDL2 subfraction) coupled with a rise in the pro-atherogenic low density lipoprotein (LDL). These apparently unwanted actions are balanced against a possibly beneficial reduction in the atherogenic lipoprotein(a) fraction. The mechanism of these changes induced by danazol is unknown but probably relates to effects on hepatic lipase, LDL receptor and lecithin cholesterol acyl transferase activity. While it is prudent to recognize the potential detriment that may follow these perturbations, concern is only warranted where therapy is prolonged (> 12 months) or given to subjects with a high background risk of ischemic heart disease.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19199099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of humoral immunity in endometriosis.","authors":"N Gleicher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In many ways endometriosis represents yet another form of unexplained infertility. The disease is clearly associated with a decrease in fecundity and while in advanced stages of the condition this infertility can be attributed to tubal factors, in mild stages of the disease the cause for the decrease in fertility is unknown. As in unexplained infertility, we have suggested that the impairment in fertility is due to autoantibody abnormalities. Endometriosis patients exhibit the same immunologic profile as previously described in women with unexplained infertility and repeated pregnancy loss. In fact, endometriosis is not only characterized by unexplained infertility but also by repeated and excessive pregnancy wastage. Its clinical presentation mimics that of an autoimmune disease, raising the question whether endometriosis is, in fact, an autoimmune disease. Endometriosis demonstrates immunologic abnormalities not only in respect to autoreactivity. Abnormalities in immune function have been widely reported in reference to almost any lymphocyte and macrophage function and, once again, the similarity to findings in patients with unexplained infertility is blatant. Abnormalities can be found in peripheral blood and especially prominently in peritoneal fluid. Treatment of immunologic abnormalities, and especially of autoantibody abnormalities, restores a level of fertility in endometriosis patients. It has also been demonstrated, in an animal model, that non-specific immune modulation may improve fertility.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"15-7"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19200612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}