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Biomedical subjects

D W Sturdee

Publications and source records attributed to D W Sturdee.

13 recordsLinked to original sources
PubMed1979

Prevention and treatment of endometrial disease in climacteric women receiving oestrogen therapy.

The treatment regimens are described in 74 patients with endometrial disease among 850 climacteric women receiving oestrogen therapy. Cystic hyperplasia was associated with unopposed oestrogen therapy without progestagen. Two courses of 21 days of 5 mg norethisterone daily caused reversion to normal in all 57 cases of cystic hyperplasia and 6 of the 8 cases of atypical hyperplasia. 4 cases of endometrial carcinoma referred from elsewhere demonstrated the problems of inappropriate and unsupervised unopposed oestrogen therapy and the difficulty in distinguishing severe hyperplasia from malignancy. Cyclical low-dose oestrogen therapy with 7--13 days of progestagen does not seem to increase the risk of endometrial hyperplasia or carcinoma.

Adenocarcinoma↗
PubMed1979

Thermography of menopausal hot flushes.

The skin temperature changes associated with menopausal hot flushes have been examined by thermography on a small group of patients. The subjective sensation of heat during a flush seems to be out of proportion to the actual skin temperature increase which was only about 1 degrees C on the face, neck and upper chest during this study. The increased temperature on the cheeks often persisted for several minutes after the symptoms of the flush had subsided, whereas sweating on the forehead produced a more rapid local cooling effect. Sequential temperature changes were portrayed by using an AGA Thermovision Model 680 Medical System with a colour isotherm attachment. This study provided colourful objective evidence that the symptoms of menopausal flushing is associated with an increase of skin temperature which may be monitored by thermography.

Climacteric↗
PubMed1979

The effect of menopausal status and sequential mestranol and norethisterone on serum cholesterol, triglyceride and electrophoretic lipoprotein patterns.

The serum cholesterol, triglycerides and electrophoretic lipoprotein patterns of 35 postmenopausal women, who subsequently received sequential mestranol and norethisterone, were compared with those of 35 premenopasual women of the same age and weight. The postmenopausal women had a significantly higher level of serum cholesterol (p less than 0.01) than the premenopausal women, and a significant reduction (p less than 0.001) occurred in this group after two months of therapy. There was no significant difference in level of serum cholesterol between the premenopausal group and the postmenopausal group receiving sequential mestranol and norethisterone for two months. The serum triglycerides were not significantly higher in the postmenopausal group but there was a significant increase (p less than 0.001) after two months of therapy. The marked alteration in lipid levels at the menopause may in part account for the great increase in coronary artery disease in postmenopausal women but whether these changes are reversible by giving hormone therapy remains speculative.

Adult↗
PubMed1979

Acute leukaemia relapse presenting as ovarian tumour.

Relapse of acute lymphoblastic leukaemia is described in a woman with a leukaemic ovarian tumour from which reseeding of the bone marrow had occurred. It is proposed that irradiation of the ovaries with the initial leukaemic therapy may prevent this form of relapse.

Acute Disease↗
PubMed1978

Physiological aspects of menopausal hot flush.

Eighteen hot flushes experimenced by eight menopausal women were studied and compared with the effects of warming in six premenopausal women. The hot flushes were associated with an acute rise in skin temperature, peripheral vasodilatation, a transient increase in heart rate, fluctuations in the electrocardiographic (ECG) baseline, and a pronounced decrease in skin resistence. Although premenopausal women had greater maximum increases in skin temperature and peripheral vasodilatation, they showed a much smaller decrease in skin resistance and no changes in heart rate or ECG baseline. These findings suggest that the onset of the hot flush is associated with a sudden and transient increase in sympathetic drive. Further investigations may lead to the development of a more specific alternative to oestrogen for relieving menopausal hot flushes.

Blood Pressure↗
PubMed1978

Relations between bleeding pattern, endometrial histology, and oestrogen treatment in menopausal women.

Vacuum curettage was performed on 348 women who had received various regimens of oestrogen treatment for an average of 9.7 months for climacteric symptoms. In 62 cases (18%) the specimens were unsatisfactory for histological assessment; among the remainder, however, they showed a normal endometrium in 257 cases (90%), cystic hyperplasia in 21 (7%), adenomatous hyperplasia in 7 (2%), and endometrial adenocarcinoma in one. Cyclical unopposed oral oestrogen treatment (98 cases) was associated with a 12% incidence of endometrial hyperplasia, but among those given an additional five-day course of progestogen in each cycle (37 cases) the incidence was only 8%. No case of hyperplasia occurred among 102 women taking regimens including 10 or 13 days of progestogen. Among women treated with subcutaneous oestradiol implants and monthly five-day courses of oral progestogen (50 cases) there was a 28% incidence of hyperplasia including the one case of carcinoma, though some of those with hyperplasia may not have taken the full course of progestogen. Regular withdrawal bleeding during treatment was associated with a lower incidence of endometrial hyperplasia (6%) than unscheduled breakthrough bleeding (28%), but the one patient with carcinoma had experienced regular bleeding only.The risk of developing endometrial carcinoma from oestrogen treatment may be reduced by avoiding the use of unopposed oestrogen regimens, the addition of more than five days' treatment with a progestogen, and recognising that a regular bleeding response to oestrogen is no guarantee of a healthy endometrium.

Climacteric↗
PubMed1976

Pregnancy associated alpha2-glycoprotein in post-menopausal women receiving hormone replacement therapy.

Serum pregnancy associated alpha2-glycoprotein (P.A.G.) concentrations were measured in a group of post-menopausal women receiving hormone replacement therapy. The P.A.G. concentrations increased from a mean basal level of 48.1 mug/ml (range 20.6--104.4 mug/ml) to a maximum after six months therapy of 359 mug/ml (range 82--1290 mug/ml). This represents a mean increase of 647%. Two months after cessation of therapy the P.A.G. concentrations decreased but the mean level (60.3 mug/ml) was still significantly higher than the pre-treatment level. There was a significant correlation between the pre-treatment P.A.G. concentrations and the levels after six months of therapy. These findings may be of relevance to the use of P.A.G. determinations in the monitoring of malignant disease.

Adult↗
PubMed1976

Diazepam: routes of administration and rate of absorption. A study of women with pre-eclampsia.

Plasma diazepam concentrations were determined following oral, i.m. and i.v. administration to a group of pregnant women with pre-eclampsia and a group of normal pregnant women. Diazepam concentrations were greater following oral as compared with i.m. administration in the control group, who received a single 5-mg dose, and this confirms previous similar reports. In the patients with pre-eclampsia, who were pre-loaded with diazepam, the i.m. route provided much higher plasma diazepam concentrations than did the oral route. This was probably a result of reduced gastric motility and gastric secretion caused by diazepam which affected the absorption of subsequent diazepam administered orally, and it is unlikely that pre-eclampsia contributed to these differences. Mist. magnesium trisilicate seemed to improve the rate of absorption of diazepam from the intestine in five patients studied, although this effect is unlikely to have much clinical importance.

Administration, Oral↗