Biomedical subjects

E Maurer-Major

Publications and source records attributed to E Maurer-Major.

6 recordsLinked to original sources

PubMed2000

[Climacteric syndrome].

The most frequent symptoms of the climacteric syndrome are hot flushes. Although usually they disappear after a few years, hot flushes persist for five or more years in a quarter of the affected women. Aetiology and pathomechanism are not clear. Apart from oestrogen deficiency other diseases should be evaluated as potential causes of hot flushes such as psychosomatic disorders, hyperthyroidism and a neoplasm. The treatment of the first choice is an oestrogen replacement therapy. By assaying a single serum sample for oestradiol an oestrogen replacement therapy can be monitored reliably only in the case of transdermal application.

Administration, Cutaneous↗

PubMed1999

[Breast cancer and hormone replacement therapy].

There are more than 50 studies and at least 6 metaanalyses with varying results concerning breast cancer risk related to hormone replacement therapy. According to the literature the breast cancer risk in hormone replacement therapy may be slightly increased, especially after long-term treatment. After discontinuing hormone therapy the risk decreases and reaches baseline 5 years later. Since prospective randomised studies are lacking, it is still unclear whether hormone replacement therapy really promotes breast cancer or if the increase is due to methodological biases such as more frequent breast examination or mammography. According to the literature there is no evidence that under hormone replacement therapy the risk of relapse is elevated or the prognosis less favourable in women treated for breast cancer. Since prospective randomised studies with long-term follow-up are lacking, we recommend the use of the guidelines of the "Deutsche Gesellschaft für Senologie", based on oestrogen receptor levels and lymph node involvement. Risks and benefits of hormone replacement therapy should be discussed with the well-informed patient and alternative therapy modalities evaluated.

Breast Neoplasms↗

PubMed1998

[Menopause and its sequelae: an interdisciplinary syndrome].

Menopausal loss of ovarian estradiol production has numerous unfavourable effects on woman's health. Frequency and intensity of hot flushes mostly decline after some years. However, urogenital atrophy, incontinence, bone loss and rising risk for cardiovascular disease and probably for M. Alzheimer are of greatest importance as their incidence increases after menopause and because they play a major role in causing morbidity and mortality in elderly women. We discuss the pathophysiology of hot flushes, estradiol's effects on bone turnover, on the arterial vessel wall, on serum lipids and some aspects of estradiol action in the brain.

Aged↗

PubMed1998

Impairment of the developmental potential of frozen-thawed human zygotes obtained after intracytoplasmic sperm injection.

OBJECTIVE: To evaluate the effects of cryopreservation on the survival, cleavage, and morphology of embryos and on the implantation and embryonic loss rates of human zygotes obtained after ICSI compared with frozen-thawed zygotes obtained after traditional IVF. A further objective was to evaluate the same parameters in nonfrozen sibling ICSI and IVF zygotes and to compare them with corresponding frozen-thawed zygotes. DESIGN: Open, retrospective, comparative study. SETTING: University-associated assisted reproductive program. PATIENT(S): Couples with severe male factor infertility and couples undergoing IVF during the same period. INTERVENTION(S): A cohort of 408 ICSI zygotes and 299 IVF zygotes was frozen in 1,2 propanediol and sucrose using a slow-freezing protocol. Both groups of zygotes were frozen at approximately the same time after microassisted or conventional insemination. One hundred and eighty-seven ICSI and 110 IVF frozen zygotes were rapidly thawed during 44 ICSI cycles and 24 IVF cycles. Zygotes that appeared to have survived were cultured for 24 hours, and most of these embryos that were morphologically normal were transferred into patients. MAIN OUTCOME MEASURE(S): Survival rate (morphologically intact after thawing), cleavage rate and morphology of embryos, implantation rate, and the incidence of embryonic losses. RESULT(S): Except for survival rates, for which both ICSI and IVF frozen-thawed zygotes showed similar and relatively high values (87.7% and 89.1%), the outcomes of other parameters evaluated were significantly different. Thus, from a total of 128 ICSI and 68 IVF embryos transferred, 14 (10.9%) and 17 (25.0%) implanted in 44 ICSI and 24 IVF frozen-thawed cycles, respectively. This difference in implantation corresponded with the rate of cleavage and morphology of the replaced embryos; the embryos that developed from frozen-thawed IVF zygotes cleaved faster and were more regular compared to the frozen-thawed ICSI zygotes. The embryonic loss rate was 57.1% for cryopreserved ICSI zygotes and 11.8% for IVF zygotes. On the other hand, no difference in cleavage pattern, embryo morphology, implantation, and embryonic loss rates was found between nonfrozen sibling ICSI and IVF zygotes. CONCLUSION(S): The zygotes arising from ICSI cycles survived cryopreservation at a rate similar to IVF zygotes, but their ability to implant and develop further was probably affected by the cryopreservation procedure. The timing of zygote freezing was considered to be the principal reason for the lower developmental potential of frozen-thawed ICSI zygotes in the present study.

Adult↗

PubMed1997

[Contraceptive agents and risk of thrombosis].

In the late sixties and seventies, publications of the Royal College of General Practitioners in England reported that in women using oral contraceptiva the incidence of venous thromboembolism is increased by two to four fold. Moreover, it was demonstrated, that these alterations in coagulation were induced by ethinylestradiol in a dose dependent manner. Following these findings, its dosage was lowered from more than 100 micrograms to 20-30 micrograms per day. More recently, the role of gestagens in inducing thrombosis has also been debated. Different authors observed an increased risk for venous thromboembolism in women using third generation pills containing gestoden or desogestrel compared with users of second generation levonorgestrel contraceptiva. These reports have generated a lot of concern and fear in the patients as well as doctors and have led to a drastic fall in the use of oral contraceptives. Due to the unavailability of safe contraceptive alternatives, the number of women experiencing unwanted pregnancy and its complications increased significantly. Indeed, direct proof for the role of gestagens in inducing thromboembolism is still lacking as the protocol designs of these studies do not allow us to infer whether the effects are due to the gestagens or to confounding variables. Hence, the discussions were beneficial for clinicians to remember the importance of checking the patient for individual and family risks for thrombosis before handling out a pill prescription.

Contraceptives, Oral, Hormonal↗

PubMed1997

[Hormone substitution in menopause].

Postmenopausal estrogen deprivation is a major cause for vasomotor and psychic complaints and for urogenital dysfunction, it is also a risk factor for osteoporosis, hip fracture, cardiovascular disease and possibly dementia. Hormone replacement therapy is highly effective in improving hot flushes, insomnia, depression and genital atrophia, but it prevents bone mineral loss and coronary heart disease as well. The potential risk for thromboembolism remains small and there is no final proof for a significant increase of breast cancer. Hysterectomized women may be treated with unopposed estrogens, otherwise progestogens must be added in a cyclic or continuous manner in order to protect the endometrium. Natural estrogens are to be preferred, they may be administered orally, percutaneously or vaginally. Long acting subcutaneous implants are also gaining interest. Prolonged treatment for many years is essential in order to be preventive. Compliance by motivation and comprehensive care is therefore indispensable.

Adult↗