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91217900 Hormone replacement therapy in general practice: A survey of doctors in the MRC's general practice research framework
237
Maturitas, 14 (1992) 237-250
Elsevier Scientific Publishers Ireland Ltd.
MAT 00667
Abstract Section
91214785 Asaeaamentof endometrium in postmenopausal women via vaginal sonography Degenhardt F.; Bohmer S.; Frisch K.; Schneider J. Frauenklinik. Medizinische Hochschule Hannover im Krankenhaus Oststadt, Podbielskistrasse 380. D-3000 Hannover 5 I
ULTRASCHALL
MED. 1991 12/3 (119-123)
Early detection of endometrial cancer is hardly possible. In nearly 90% of all cases irregular vaginal bleeding is the first clinical sign of this disease. New ultrasound technique, small scanner probes and especially higher ultrasound frequencies rendered a better resolving power and higher quality medical imaging. Hence, now the examination of the organs in the female pelvis is very exact using vaginal sonography (VS). A clinical study was performed to examine the relevance of VS assessing changes and details of the endometrium. In particular, the sonographical criteria of early endometrial cancer should be defined. In 137 postmenopausal women VS was performed after irregular vaginal bleeding and prior to D and C. All findings were described concerning alteration in echogenicity and thickness of the endometrium. Only one case of 37 histological confirmed endometrial cancers among the study group was not detected by VS prior to curettage. Therefore 0.7% of the sonographical findings showed a false negative result and 6.6% were false. positive in comparison to the histological outcome. VS seems to be a relatively reliable technique in assessing the endometrium. In conclusion VS could be a useful additional method to detect hyperplasia or malignant disorders of the endometrium.
91217900 Hormone repracement therapy in genera1 practice: A survey of doctors in the MRC’s general practice research framework Wilkes H.C.; Meade T.W. MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Harrow HAI 3UJ
BR. MED. J. 1991 302/6788 (1317-1320) Objectives: To survey current prescribing practice for hormone replacement therapy among general practitioners and to elicit their views on the role of hormone replacement therapy in the prevention of osteoporosis and cardiovascular disease; to determine whether they would participate in randomised controlled trials to evaluate the long term beneficial and adverse effects of hormone replacement therapy, Design: Postal questionnaires to general practitioners throughout the United Kingdom. Participants: 1268 general practitioners in the Medical Research Council’s general practice research framework. Results: 1081 (85%) doctors in 220 (95%) pracrices responded. The doctors were currently prescribing hormone replacement therapy to an estimated 9% of their female patients aged 40 to 64, and 55% of doctors were prescribing opposed hormone replacement therapy (oestrogen plus progestogen) to more patients than a year previously. Over half the doctors would consider prescribing hormone replacement therapy for prevention of osteoporosis (670, 62%) and cardiovascular disease (611,57”/~)to asymptomatic women. Overall, 79% of the doctors (851) would definitely or probably consider entering women who have had a hysterectomy into a randomised controlled trial comparing unopposed (oestrogen only) hormone replacement therapy with opposed hormone replacement therapy; 49”/u(524) would enter patients
238 with a uterus into such a trial. Among a subsample, 85% (180/210) would consider entering patients without menopausal symptoms into a trial comparing hormone replacement therapy with no treatment (unopposed in patients who have had a hysterectomy, opposed in those with a uterus). Conclusion: There is considerable uncertainty among general practitioners as to the balance of beneficial and harmful effects of hormone replacement therapy in the long term, particularly relating to its use for prevention of osteoporosis and cardiovascular disease. Most of these doctors would be prepared to participate in randomised controlled trials to determine the long term effects of this increasingly widely used treatment. 91218804 Relationhip between serum testosterone and sex hormone binding globulin in menstruating and postmenopausalwomen
Carlstrom K.; Doeberl A.; Gershagen S.; Rannevik G. Department of Obstetrics and Gynecology, K 57, Huddinge University Hospital, S-14186 Huddinge
GYNECOL. ENDGCRINOL.
1991 512 (95-100)
The relationship between total testosterone(T), sex hormone binding globulin (SHBG) and calculated non-SHGB-bound testosterone (NST) was studied in randomly collected blood samples from healthy menstruating (n = 61) and postmenopausal (n = 65) women. In I2 of the menstruating women, blood samples were also collected more frequently during the menstrual cycle. Total T and SHBG were positively correletad in menstruating women in random samples as well as during different phases of the menstrual cycle, but not in postmenopausal women. Upper and lower limits of NST were independent of SHBG in menstruating but not in postmenopausal women. The data are at variance with the common concept about SHBG regulation and suggest a kind of compensatory mechanism in order to maintain a constant androgen homeostasis in menstruating but not in postmenopausal women. Consequently, supranormal total T or subnormal SHBG values do not necessarily indicate hyperandrogenicity in normally menstruating women. 91220799 The effects of etidronate on trdecular bone remodeling in postmenopausalspinal osteoporosis:A randomized study comparing intermittent treatment and an ADFR regime
Steiniche T.; Hasling C.; Charles P.; Eriksen E.F.; Melsen F.; Mosekilde L. University Institute of Pathology. Aarhus Amtssygehus. T. Hansensgade DK-8000 Aarhus C
BONE 1991 12/3 (155-163) Thirty-seven patients were randomized to receive intermittent cyclic etidronate (400 mgday oral for 2 weeks, followed by 13 weeks off treatment) or an ADFR treatment (100 &day oral triiodothyronine for 7 days, followed by 400 mg/day etidronate for 2 weeks and I2 weeks off treatment). Supplemental calcium (120 mg/day) and vitamin Ds (400 IUMay) were given throughout the study period to all patients. Biochemical analyses, iliac-crest bone biopsies, and lumbar bone mineral content (BMC) measurements were performed before and during 60 weeks of treatment. Sixteen patients in the intermittent cyclic etidronate group and 15 in the ADFR group completed 60 weeks of treatment. Serum alkaline phosphatase decreased from 185 (43) (mean, (SD)) to I44 (35) (p
Maturitas, 14 (1992) 237-250
Elsevier Scientific Publishers Ireland Ltd.
MAT 00667
Abstract Section
91214785 Asaeaamentof endometrium in postmenopausal women via vaginal sonography Degenhardt F.; Bohmer S.; Frisch K.; Schneider J. Frauenklinik. Medizinische Hochschule Hannover im Krankenhaus Oststadt, Podbielskistrasse 380. D-3000 Hannover 5 I
ULTRASCHALL
MED. 1991 12/3 (119-123)
Early detection of endometrial cancer is hardly possible. In nearly 90% of all cases irregular vaginal bleeding is the first clinical sign of this disease. New ultrasound technique, small scanner probes and especially higher ultrasound frequencies rendered a better resolving power and higher quality medical imaging. Hence, now the examination of the organs in the female pelvis is very exact using vaginal sonography (VS). A clinical study was performed to examine the relevance of VS assessing changes and details of the endometrium. In particular, the sonographical criteria of early endometrial cancer should be defined. In 137 postmenopausal women VS was performed after irregular vaginal bleeding and prior to D and C. All findings were described concerning alteration in echogenicity and thickness of the endometrium. Only one case of 37 histological confirmed endometrial cancers among the study group was not detected by VS prior to curettage. Therefore 0.7% of the sonographical findings showed a false negative result and 6.6% were false. positive in comparison to the histological outcome. VS seems to be a relatively reliable technique in assessing the endometrium. In conclusion VS could be a useful additional method to detect hyperplasia or malignant disorders of the endometrium.
91217900 Hormone repracement therapy in genera1 practice: A survey of doctors in the MRC’s general practice research framework Wilkes H.C.; Meade T.W. MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Harrow HAI 3UJ
BR. MED. J. 1991 302/6788 (1317-1320) Objectives: To survey current prescribing practice for hormone replacement therapy among general practitioners and to elicit their views on the role of hormone replacement therapy in the prevention of osteoporosis and cardiovascular disease; to determine whether they would participate in randomised controlled trials to evaluate the long term beneficial and adverse effects of hormone replacement therapy, Design: Postal questionnaires to general practitioners throughout the United Kingdom. Participants: 1268 general practitioners in the Medical Research Council’s general practice research framework. Results: 1081 (85%) doctors in 220 (95%) pracrices responded. The doctors were currently prescribing hormone replacement therapy to an estimated 9% of their female patients aged 40 to 64, and 55% of doctors were prescribing opposed hormone replacement therapy (oestrogen plus progestogen) to more patients than a year previously. Over half the doctors would consider prescribing hormone replacement therapy for prevention of osteoporosis (670, 62%) and cardiovascular disease (611,57”/~)to asymptomatic women. Overall, 79% of the doctors (851) would definitely or probably consider entering women who have had a hysterectomy into a randomised controlled trial comparing unopposed (oestrogen only) hormone replacement therapy with opposed hormone replacement therapy; 49”/u(524) would enter patients
238 with a uterus into such a trial. Among a subsample, 85% (180/210) would consider entering patients without menopausal symptoms into a trial comparing hormone replacement therapy with no treatment (unopposed in patients who have had a hysterectomy, opposed in those with a uterus). Conclusion: There is considerable uncertainty among general practitioners as to the balance of beneficial and harmful effects of hormone replacement therapy in the long term, particularly relating to its use for prevention of osteoporosis and cardiovascular disease. Most of these doctors would be prepared to participate in randomised controlled trials to determine the long term effects of this increasingly widely used treatment. 91218804 Relationhip between serum testosterone and sex hormone binding globulin in menstruating and postmenopausalwomen
Carlstrom K.; Doeberl A.; Gershagen S.; Rannevik G. Department of Obstetrics and Gynecology, K 57, Huddinge University Hospital, S-14186 Huddinge
GYNECOL. ENDGCRINOL.
1991 512 (95-100)
The relationship between total testosterone(T), sex hormone binding globulin (SHBG) and calculated non-SHGB-bound testosterone (NST) was studied in randomly collected blood samples from healthy menstruating (n = 61) and postmenopausal (n = 65) women. In I2 of the menstruating women, blood samples were also collected more frequently during the menstrual cycle. Total T and SHBG were positively correletad in menstruating women in random samples as well as during different phases of the menstrual cycle, but not in postmenopausal women. Upper and lower limits of NST were independent of SHBG in menstruating but not in postmenopausal women. The data are at variance with the common concept about SHBG regulation and suggest a kind of compensatory mechanism in order to maintain a constant androgen homeostasis in menstruating but not in postmenopausal women. Consequently, supranormal total T or subnormal SHBG values do not necessarily indicate hyperandrogenicity in normally menstruating women. 91220799 The effects of etidronate on trdecular bone remodeling in postmenopausalspinal osteoporosis:A randomized study comparing intermittent treatment and an ADFR regime
Steiniche T.; Hasling C.; Charles P.; Eriksen E.F.; Melsen F.; Mosekilde L. University Institute of Pathology. Aarhus Amtssygehus. T. Hansensgade DK-8000 Aarhus C
BONE 1991 12/3 (155-163) Thirty-seven patients were randomized to receive intermittent cyclic etidronate (400 mgday oral for 2 weeks, followed by 13 weeks off treatment) or an ADFR treatment (100 &day oral triiodothyronine for 7 days, followed by 400 mg/day etidronate for 2 weeks and I2 weeks off treatment). Supplemental calcium (120 mg/day) and vitamin Ds (400 IUMay) were given throughout the study period to all patients. Biochemical analyses, iliac-crest bone biopsies, and lumbar bone mineral content (BMC) measurements were performed before and during 60 weeks of treatment. Sixteen patients in the intermittent cyclic etidronate group and 15 in the ADFR group completed 60 weeks of treatment. Serum alkaline phosphatase decreased from 185 (43) (mean, (SD)) to I44 (35) (p