- Email: [email protected]
CHANGES ON BODY COMPOSITION ANALIZED BY TOTAL BODY DENSITOMETRY IN POSTMENOPAUSAL WITH AND WITHOUT HORMONE THERAPY
S82
8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136
FSH). Sedentees aged 45-49 reach the limits of detection of inhibin B much earlier (40-44) compared to either Europeans (>59) or migrants (45-49). Conclusions: Earlier, we showed that women aged 19-39 who developed in Bangladesh have significantly lower levels of salivary progesterone and ovulation rates compared to Bangladeshi and European women who grew up in London, suggesting an early life effect on adult ovarian function. These new hormonal data reflecting ovarian reserve show an effect of time spent in UK during adulthood which appears to lengthen reproductive lifespan. Physiological mechanisms to explain this are unknown. Keywords: Ovarian reserve, Bangladeshis, migration
316 CHANGES ON BODY COMPOSITION ANALIZED BY TOTAL BODY DENSITOMETRY IN POSTMENOPAUSAL WITH AND WITHOUT HORMONE THERAPY J.R. Silvestri, M.G. Ceniceros, S.E. Pérez. National Institute of Perinatology, Distrito Federal, Mexico Objective: to examine the body composition changes evaluated by dual X-ray densitometry in postmenopausal women with and without hormone therapy. Methods: This is a retrospective and comparative study whereby we review the National Institute of Perinatology database including postmenopausal women with two body composition evaluation performed by dual X-ray densitometry with two years of difference between them. We determined on kilograms lean and fat mass of android and gynecoid regions, considering as android the mass of the trunk and abdomen area, and gynecoid the mass of the hip and thigh area. We created two groups, group A: postmenoapusal women using hormone therapy and group B: postmenopausal women without hormone therapy. Statistics analysis was performed using T test to identify differences between the means of the groups. We used the SPSS software 14.0 version, level of significance was set at 0.05. Results: A total of 80 patients were include, 42 patients on group A and 38 patients on group B. There was not difference between basal findings of both groups. On having done the comparison of the body composition evaluation after two years, we found that the only statistically significant difference was on the android lean mass, which diminished 0.085 kg in group A, and diminished 0.018 kg in group B (p=0.050). When comparing the rest of the variables we did not found statistically significant differences. Conclusion: Hormone therapy use for a two years period in postmenopausal women reduces android lean mass. Keywords: Body composition, hormone therapy, dual X-ray densitometry, postmenopausal.
317 PYOMETRA: CLINICAL SIGNIFICANCE K. Dahiya. Pt.BDS, PGIMS, Gyne & Obst, Rohtak, India Objectives: To evaluate the clinical outcome of pyometra. Methods: Retrospective study conducted between Jan 04- Dec. 07 in a tertiary care hospital. All patients admitted with pyometra were analyzed. Results: Pyometra represented 0.042% of gynaecological admissions. During this period 31 women were admitted with pyometra. All women were postmenopausal with hemorrhage and discharge were main symptoms. Nine (29%) were associated with malignancy, 2 (6.4%) were admitted with spontaneous perforation of the uterus and 1patient had submucus fibroid. Three were diagnosed with chronic endometritis, 2 were with senile endometritis and 2 were associated with forgotten lippes loop. Twelve (38.7%) were idiopathic. Conclusions: Pyometra is a potentially lethal condition. Endometrial and endocervical curettage after dilatation is essential to rule out associated malignant disease. Keywords: Pyometra, Malignancy, spontaneous perforation.
318 LAPAROSCOPIC APPROACH OF THE INFLAMATORY ACCUTE ABDOMEN G. Gomes-da-Silveira 1 , M. Pontremoli Salcedo 2 , P. El Beitune 2 . 1 Santa Casa Hospital, Gynecology, Porto Alegre, Brazil; 2 UFCSPA, Porto Alegre, Brazil Objectives: Evaluate the diagnostic and therapeutic potential of laparoscopic approach in the inflamatory accute abdomen condition. Methods: It was a prospective study of therapeutic intervention type. The study was performed on female patients aged 14 to 51, who came to the gynecological emergency department and were diagnosed clinically with acute inflammatory abdomen. All of them had complaints of major recent onset abdominal and pelvic pain and fever. At examination they presented signs of peritoneal irritation, with pain at decompression of the abdominal wall. Patients with a more likely diagnostic hypothesis of ectopic pregnancy and acute appendicitis were excluded. Fifteen patients were included in the study. All the patients were submitted to exploratory laparoscopy, performed always by the same surgeon. Results: Of the fifteen patients, eleven had tubo-ovarian abscesses measuring between 3 and 12 cm. A patient with diverticulitis presented a retro-uterine abscess due to a ruptured diverticulum in the rectosigmoid transition, and the other three had acute appendicitis., one of them suppurating with pelvic peritonitis. A condition of diffuse bacterial peritonitis with extensive adhesions blocking access to the pelvis was found in eight patients.The surgical treatment was always completed by laparoscopy; there were no cases of immediate re-intervention. Conclusions: The laparoscopic approach proved safe and effective in the diagnostic and treatment of this group of patients. The experience of surgical team with the laparoscopic surgery is essential in approaching acute abdomen, which commonly requires great technical skill. Keywords: Pelvic inflammatory disease, laparoscopic surgery, accute abdomen.
319 CYSTIC CERVICAL ENDOMETRIOSIS: PRESENTATION OF AN UNUSUAL CASE D. Papoutsis, P. Belitsos, N. Goumalatsos, G. Vlachos, A. Antsaklis. Alexandra Maternity Hospital/University of Athens, 1st Dept of Obstetrics & Gynaecology, Athens, Greece Objectives: To present an unusual case of cystic cervical endometriosis diagnosed upon excision of a cervical mass and confirmed by histological examination. Methods: A 42 years old G4P2 woman present with menometrorragia, lower abdominal pain and dyspareunia over the past 3 years. The speculum examination revealed a solid mass protruding through the external cervical causing a dilation of 2-3 cm. The initial clinical diagnosis and by U/S was cervical fibroid with central degeneration.The patient underwent surgical excision of the cervical mass. During the procedure the mass ruptured and the suspicion of an endometriotic cyst was posed. The cyst was complentey excised and histological examination confirmed the endometriotic nature of the cyst. Conclusions: Cystic cervical endometriosis though uncommon must always be considered due to its increasing frequency because of the growing number of cervical procedures performed and also due to massive hemorrhage its surgical excision may cause. Keywords: Cervical endometriosis, cervical procedures, menometrorrhagia.
320 AN AUDIT OF THE WORK OF MENOPAUSE NURSES WITHIN THE UK D. Holloway 1 , K. Abernethy 2 . 1 Guys and St Thomas NHS Foundation Trust, Women’s Services, London, United Kingdom; 2 The Menopause Clinical and Research Unit, Northwest London NHS Trust, London, United Kingdom Objectives: To undertake an audit of the work, roles and clinical skills of nurses working within the field of menopause within the UK, undertaken on behalf on the Royal College of Nursing (RCN) menopause group. Methods: A prospective ongoing audit of nurses working with menopause within both secondary and primary care. Audit forms given out at conferences, courses and via a data base of nurses maintained by the RCN menopause group. Access to the questionnaire is also via the RCN website
8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136
FSH). Sedentees aged 45-49 reach the limits of detection of inhibin B much earlier (40-44) compared to either Europeans (>59) or migrants (45-49). Conclusions: Earlier, we showed that women aged 19-39 who developed in Bangladesh have significantly lower levels of salivary progesterone and ovulation rates compared to Bangladeshi and European women who grew up in London, suggesting an early life effect on adult ovarian function. These new hormonal data reflecting ovarian reserve show an effect of time spent in UK during adulthood which appears to lengthen reproductive lifespan. Physiological mechanisms to explain this are unknown. Keywords: Ovarian reserve, Bangladeshis, migration
316 CHANGES ON BODY COMPOSITION ANALIZED BY TOTAL BODY DENSITOMETRY IN POSTMENOPAUSAL WITH AND WITHOUT HORMONE THERAPY J.R. Silvestri, M.G. Ceniceros, S.E. Pérez. National Institute of Perinatology, Distrito Federal, Mexico Objective: to examine the body composition changes evaluated by dual X-ray densitometry in postmenopausal women with and without hormone therapy. Methods: This is a retrospective and comparative study whereby we review the National Institute of Perinatology database including postmenopausal women with two body composition evaluation performed by dual X-ray densitometry with two years of difference between them. We determined on kilograms lean and fat mass of android and gynecoid regions, considering as android the mass of the trunk and abdomen area, and gynecoid the mass of the hip and thigh area. We created two groups, group A: postmenoapusal women using hormone therapy and group B: postmenopausal women without hormone therapy. Statistics analysis was performed using T test to identify differences between the means of the groups. We used the SPSS software 14.0 version, level of significance was set at 0.05. Results: A total of 80 patients were include, 42 patients on group A and 38 patients on group B. There was not difference between basal findings of both groups. On having done the comparison of the body composition evaluation after two years, we found that the only statistically significant difference was on the android lean mass, which diminished 0.085 kg in group A, and diminished 0.018 kg in group B (p=0.050). When comparing the rest of the variables we did not found statistically significant differences. Conclusion: Hormone therapy use for a two years period in postmenopausal women reduces android lean mass. Keywords: Body composition, hormone therapy, dual X-ray densitometry, postmenopausal.
317 PYOMETRA: CLINICAL SIGNIFICANCE K. Dahiya. Pt.BDS, PGIMS, Gyne & Obst, Rohtak, India Objectives: To evaluate the clinical outcome of pyometra. Methods: Retrospective study conducted between Jan 04- Dec. 07 in a tertiary care hospital. All patients admitted with pyometra were analyzed. Results: Pyometra represented 0.042% of gynaecological admissions. During this period 31 women were admitted with pyometra. All women were postmenopausal with hemorrhage and discharge were main symptoms. Nine (29%) were associated with malignancy, 2 (6.4%) were admitted with spontaneous perforation of the uterus and 1patient had submucus fibroid. Three were diagnosed with chronic endometritis, 2 were with senile endometritis and 2 were associated with forgotten lippes loop. Twelve (38.7%) were idiopathic. Conclusions: Pyometra is a potentially lethal condition. Endometrial and endocervical curettage after dilatation is essential to rule out associated malignant disease. Keywords: Pyometra, Malignancy, spontaneous perforation.
318 LAPAROSCOPIC APPROACH OF THE INFLAMATORY ACCUTE ABDOMEN G. Gomes-da-Silveira 1 , M. Pontremoli Salcedo 2 , P. El Beitune 2 . 1 Santa Casa Hospital, Gynecology, Porto Alegre, Brazil; 2 UFCSPA, Porto Alegre, Brazil Objectives: Evaluate the diagnostic and therapeutic potential of laparoscopic approach in the inflamatory accute abdomen condition. Methods: It was a prospective study of therapeutic intervention type. The study was performed on female patients aged 14 to 51, who came to the gynecological emergency department and were diagnosed clinically with acute inflammatory abdomen. All of them had complaints of major recent onset abdominal and pelvic pain and fever. At examination they presented signs of peritoneal irritation, with pain at decompression of the abdominal wall. Patients with a more likely diagnostic hypothesis of ectopic pregnancy and acute appendicitis were excluded. Fifteen patients were included in the study. All the patients were submitted to exploratory laparoscopy, performed always by the same surgeon. Results: Of the fifteen patients, eleven had tubo-ovarian abscesses measuring between 3 and 12 cm. A patient with diverticulitis presented a retro-uterine abscess due to a ruptured diverticulum in the rectosigmoid transition, and the other three had acute appendicitis., one of them suppurating with pelvic peritonitis. A condition of diffuse bacterial peritonitis with extensive adhesions blocking access to the pelvis was found in eight patients.The surgical treatment was always completed by laparoscopy; there were no cases of immediate re-intervention. Conclusions: The laparoscopic approach proved safe and effective in the diagnostic and treatment of this group of patients. The experience of surgical team with the laparoscopic surgery is essential in approaching acute abdomen, which commonly requires great technical skill. Keywords: Pelvic inflammatory disease, laparoscopic surgery, accute abdomen.
319 CYSTIC CERVICAL ENDOMETRIOSIS: PRESENTATION OF AN UNUSUAL CASE D. Papoutsis, P. Belitsos, N. Goumalatsos, G. Vlachos, A. Antsaklis. Alexandra Maternity Hospital/University of Athens, 1st Dept of Obstetrics & Gynaecology, Athens, Greece Objectives: To present an unusual case of cystic cervical endometriosis diagnosed upon excision of a cervical mass and confirmed by histological examination. Methods: A 42 years old G4P2 woman present with menometrorragia, lower abdominal pain and dyspareunia over the past 3 years. The speculum examination revealed a solid mass protruding through the external cervical causing a dilation of 2-3 cm. The initial clinical diagnosis and by U/S was cervical fibroid with central degeneration.The patient underwent surgical excision of the cervical mass. During the procedure the mass ruptured and the suspicion of an endometriotic cyst was posed. The cyst was complentey excised and histological examination confirmed the endometriotic nature of the cyst. Conclusions: Cystic cervical endometriosis though uncommon must always be considered due to its increasing frequency because of the growing number of cervical procedures performed and also due to massive hemorrhage its surgical excision may cause. Keywords: Cervical endometriosis, cervical procedures, menometrorrhagia.
320 AN AUDIT OF THE WORK OF MENOPAUSE NURSES WITHIN THE UK D. Holloway 1 , K. Abernethy 2 . 1 Guys and St Thomas NHS Foundation Trust, Women’s Services, London, United Kingdom; 2 The Menopause Clinical and Research Unit, Northwest London NHS Trust, London, United Kingdom Objectives: To undertake an audit of the work, roles and clinical skills of nurses working within the field of menopause within the UK, undertaken on behalf on the Royal College of Nursing (RCN) menopause group. Methods: A prospective ongoing audit of nurses working with menopause within both secondary and primary care. Audit forms given out at conferences, courses and via a data base of nurses maintained by the RCN menopause group. Access to the questionnaire is also via the RCN website