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Biomedical subjects

V Godfree

Publications and source records attributed to V Godfree.

6 recordsLinked to original sources
PubMed1997

Endometrial effects of three doses of trimegestone, a new orally active progestogen, on the postmenopausal endometrium.

OBJECTIVE: To study the effects of oral trimegestone on endometrial histology and vaginal bleeding when given in combination with oral 17-beta-oestradiol. METHODS: This was a prospective, randomised, double-blind, parallel groups, pilot comparative study. Thirty-eight healthy postmenopausal women with normal endometrial histology were given oral 17-beta-oestradiol, 2 mg/day for three continuous cycles of 28 days, plus oral trimegestone, 0.10, 0.25 or 0.50 mg/day from day 15 to day 28 of each cycle. A Vabra biopsy was performed late in the oestradiol/trimegestone phase of cycle 3 and examined for histological evidence of secretory transformation of the endometrium. Characteristics of vaginal bleeding were recorded on a daily basis. RESULTS: Thirty-seven women completed the study, of whom 31 yielded adequate tissue for histological assessment. All showed secretory transformation of the endometrium. Bleeding was of earlier onset and longer duration with the lowest dose of trimegestone. CONCLUSIONS: Trimegestone is a highly effective oral progestogen for endometrial protection, all doses inducing secretory endometrial transformation. Although bleeding patterns suggest a weaker effect of the lowest dose used, the minimum effective dose for endometrial protection has still to be determined and may be lower than those used in this study.

Administration, Oral↗
PubMed1997

Venous thrombo-embolism and hormone replacement therapy.

Recent data have indicated that hormone replacement therapy (HRT) is associated with an increased risk of venous thrombo-embolism. Although the relative risk is significantly higher, the absolute risk remains small. Epidemiological studies on which the increased risk was based may have been open to biases, including those of referral, investigation and diagnosis. None the less, the association appears real albeit the mechanism poorly understood. Potential mechanisms include unmasking of an underlying thrombophilia or combination with other recognized risk factors for venous thrombo-embolism. The implications of these findings have to be placed firmly in the clinical context and weighed against the established benefits of hormone replacement therapy, including relief of menopausal symptoms, prevention of osteoporosis and arterial-vascular disease. Patients with a personal or family history of venous thrombo-embolism should be screened for underlying thrombophilia and such screening may be extended to relatives. However, the risk of venous thrombo-embolism following initiation of HRT is not yet known. None the less, HRT should be used with caution in this situation and may be best avoided, unless associated with concomitant antithrombotic therapy, in certain thrombophilias, expert advice should be sought. Patients without risk factors should be advised of the small increase in risk of venous thrombosis which is greatest during the first year. Where additional risk factors are present the situation will have to be assessed on an individual basis for each patient. For example, the beneficial effects of HRT in an obese patient at risk of arterial disease may outweigh the small risk of thrombosis. Patients already on HRT should have some assessment of the risk of venous thrombosis made and where there are features suggestive of thrombophilia screening performed.

Estrogen Replacement Therapy↗
PubMed1987

Maternal plasma bicycling PGE2 levels following vaginal administration of prostaglandin E2 pessaries in full term pregnancies.

Plasma levels of bicyclic PGE2 (PGE2M) were measured after administration of a 5mg, PGE2 slow release hydrogel pessary and a 3mg vaginal tablet (Upjohn). Twenty-four women of low parity with favourable induction features were randomised to receive either the hydrogel pessary or the vaginal tablet. A single pessary was administered and amniotomy was performed after 4 hours. Augmentation with oxytocin was carried out after amniotomy if required. Both groups showed a rise in plasma PGE2 levels in keeping with the release profiles of the pessaries. Wide interindividual differences in absorption were found.

Administration, Intravaginal↗