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Spontaneous apoptosis in the endometrium in the impaired myomatous uterus
Efficacy of Eletriptan in Treating Women with Menstrually Associated Migraine and Women on Oral Contraceptives or Hormone Replacement Therapy* Daniela Pitei, MD, PhD Pfizer Central Research, Sandwich, United Kingdom
Jayasena Hettiarachchi Objectives: Menstrually associated migraines are common and are reported to be particularly severe, long-lasting, and refractory to treatment. Use of oral contraceptives (OC’s) or hormone replacement therapy (HRT) also may exacerbate migraine symptoms leading to more frequent and severe attacks. Oral eletriptan is an effective antimigraine agent in the overall population in clinical trials, and its efficacy has now been assessed in these important, but difficult-to-treat, groups who experience migraines. Methods: A prospectively planned meta-analysis was performed using data from six double-blind, placebo-controlled parallel group trials of similar design involving 698 women with menstrually related migraines (attacks occurring from 1 day before to 4 days after onset of menses) and for women who were (n ⫽ 1,230) or were not (n ⫽ 3,704) taking OCs or HRT. Results: Eletriptan was effective at treating menstrually related migraines, with a significantly higher proportion of patients who received eletriptan reporting a headache response at 2 hours compared with those receiving placebo (64% for 40 mg and 68% for 80 mg doses versus 26% for placebo; P ⬍ 0.001). Eletriptan was as effective in women who were taking OCs or HRT as in women who were not, with headache response rates at 2 hours of 65% and 58% for 40 mg, 68% and 65% for 80 mg, and 25% and 24% for placebo, respectively. Conclusions: Oral eletriptan provided effective headache relief for patients with migraines taking OCs or HRT, and in women with menstrually associated migraine.
Morbidity of Uterine Fibroids in Japanese Women Kazunori Ochiai, MD, PhD The Jikei University School of Medicine, Tokyo, Japan
Mizue Oda, MD, PhD, Mineo Omura, MD, PhD, and Tadao Tanaka, MD, PhD Objective: To elucidate the morbidity of uterine fibroids among healthy Japanese women. * This document includes a discussion of use of a product that is unapproved by the U.S. Food and Drug Administration.
32S Monday Posters
Subjects and methods: Medical records of 11,258 women older than 30 years who visited the Tokyo Metropolitan Cancer Screening Center for Pap tests between April 1996 and March 1997 were studied retrospectively. Uterine fibroids were diagnosed by pelvic examination and transvaginal ultrasonography. The morbidity of uterine fibroids and correlation to age, number of pregnancies and births, the years between menarche and menopause, and body mass index were analyzed. Results: The morbidity of uterine fibroids was 10.1% in general and 20.4% in the age group 45– 49 years. It was higher in premenopausal women than postmenopausal women (P ⬍0.001). There was a positive correlation between the morbidity and the time from menarche to menopause (P ⬍0.001), and there was a negative correlation with the number of pregnancies and births (P ⬍0.01). However, no correlation was found between body mass index and the morbidity of uterine fibroids. Conclusions: The morbidity of uterine fibroids in Japanese women was less than American women. Hormonal fluctuation during the menstrual cycle seems to have strong influence on the growth of uterine fibroids.
Spontaneous Apoptosis in the Endometrium in the Impaired Myomatous Uterus Ali Farid Mohamed Ali, MD Infertility Research Center, Cairo, Egypt
Baha Fateen, Ahmed Ezzet, Hoda Badawy, Asherf Ramadan, and Alaa El-tobge Objective: Apoptosis maintains cellular homeostasis. The purpose of this study was to determine whether apoptosis is decreased in the endometrial tissue from the myomatous uterus or an unexplained new mechanism of infertility caused by the myoma and bleeding. Methods: Twenty endometrial biopsies from a myomatous uterus (infertile) and 20 endometrial biopsies from a control (fertile) were taken. All these biopsies were enrolled in the study. Single cell suspensions were prepared by enzymatic digestion of uterine tissue with collagenase and DNA as analyzed for spontaneous apoptosis. Twenty endometrial biopsies of bleeding myoma were also enrolled in the study. Results: The susceptibility of uterine endometrium to spontaneous apoptosis was significantly reduced in an infertile myoma patient (75%) and 55% of bleeding myomatous patients, compared with healthy control. The P value of infertile myoma was P ⬍0.002, and the P value for bleeding myoma was P ⬍0.005. Conclusions: Spontaneous apoptosis is significantly reduced in the uterine endometrium obtained from infertile myoma and reduced in the endometrium in the bleeding myoma, therefore a new mechanism for infertility and bleeding from myoma has been born.
Obstetrics & Gynecology
Jayasena Hettiarachchi Objectives: Menstrually associated migraines are common and are reported to be particularly severe, long-lasting, and refractory to treatment. Use of oral contraceptives (OC’s) or hormone replacement therapy (HRT) also may exacerbate migraine symptoms leading to more frequent and severe attacks. Oral eletriptan is an effective antimigraine agent in the overall population in clinical trials, and its efficacy has now been assessed in these important, but difficult-to-treat, groups who experience migraines. Methods: A prospectively planned meta-analysis was performed using data from six double-blind, placebo-controlled parallel group trials of similar design involving 698 women with menstrually related migraines (attacks occurring from 1 day before to 4 days after onset of menses) and for women who were (n ⫽ 1,230) or were not (n ⫽ 3,704) taking OCs or HRT. Results: Eletriptan was effective at treating menstrually related migraines, with a significantly higher proportion of patients who received eletriptan reporting a headache response at 2 hours compared with those receiving placebo (64% for 40 mg and 68% for 80 mg doses versus 26% for placebo; P ⬍ 0.001). Eletriptan was as effective in women who were taking OCs or HRT as in women who were not, with headache response rates at 2 hours of 65% and 58% for 40 mg, 68% and 65% for 80 mg, and 25% and 24% for placebo, respectively. Conclusions: Oral eletriptan provided effective headache relief for patients with migraines taking OCs or HRT, and in women with menstrually associated migraine.
Morbidity of Uterine Fibroids in Japanese Women Kazunori Ochiai, MD, PhD The Jikei University School of Medicine, Tokyo, Japan
Mizue Oda, MD, PhD, Mineo Omura, MD, PhD, and Tadao Tanaka, MD, PhD Objective: To elucidate the morbidity of uterine fibroids among healthy Japanese women. * This document includes a discussion of use of a product that is unapproved by the U.S. Food and Drug Administration.
32S Monday Posters
Subjects and methods: Medical records of 11,258 women older than 30 years who visited the Tokyo Metropolitan Cancer Screening Center for Pap tests between April 1996 and March 1997 were studied retrospectively. Uterine fibroids were diagnosed by pelvic examination and transvaginal ultrasonography. The morbidity of uterine fibroids and correlation to age, number of pregnancies and births, the years between menarche and menopause, and body mass index were analyzed. Results: The morbidity of uterine fibroids was 10.1% in general and 20.4% in the age group 45– 49 years. It was higher in premenopausal women than postmenopausal women (P ⬍0.001). There was a positive correlation between the morbidity and the time from menarche to menopause (P ⬍0.001), and there was a negative correlation with the number of pregnancies and births (P ⬍0.01). However, no correlation was found between body mass index and the morbidity of uterine fibroids. Conclusions: The morbidity of uterine fibroids in Japanese women was less than American women. Hormonal fluctuation during the menstrual cycle seems to have strong influence on the growth of uterine fibroids.
Spontaneous Apoptosis in the Endometrium in the Impaired Myomatous Uterus Ali Farid Mohamed Ali, MD Infertility Research Center, Cairo, Egypt
Baha Fateen, Ahmed Ezzet, Hoda Badawy, Asherf Ramadan, and Alaa El-tobge Objective: Apoptosis maintains cellular homeostasis. The purpose of this study was to determine whether apoptosis is decreased in the endometrial tissue from the myomatous uterus or an unexplained new mechanism of infertility caused by the myoma and bleeding. Methods: Twenty endometrial biopsies from a myomatous uterus (infertile) and 20 endometrial biopsies from a control (fertile) were taken. All these biopsies were enrolled in the study. Single cell suspensions were prepared by enzymatic digestion of uterine tissue with collagenase and DNA as analyzed for spontaneous apoptosis. Twenty endometrial biopsies of bleeding myoma were also enrolled in the study. Results: The susceptibility of uterine endometrium to spontaneous apoptosis was significantly reduced in an infertile myoma patient (75%) and 55% of bleeding myomatous patients, compared with healthy control. The P value of infertile myoma was P ⬍0.002, and the P value for bleeding myoma was P ⬍0.005. Conclusions: Spontaneous apoptosis is significantly reduced in the uterine endometrium obtained from infertile myoma and reduced in the endometrium in the bleeding myoma, therefore a new mechanism for infertility and bleeding from myoma has been born.
Obstetrics & Gynecology