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Biomedical subjects

V Simunić

Publications and source records attributed to V Simunić.

18 recordsLinked to original sources
PubMed2003

Local estrogen treatment in patients with urogenital symptoms.

OBJECTIVES: Determination of the efficacy and safety of vaginally administered low dose (25 microg) micronized 17beta-estradiol in the management of patients with urogenital symptoms. METHODS: A total of 1612 patients with urogenital complaints were randomized to receive 25 microg of micronized 17beta-estradiol (n=828) or placebo (n=784) in a multicenter double-blind placebo-controlled study running for 12 months. Female patients were treated once a day over a period of 2 weeks, and then twice a week for the remaining of the 12 months with an active or placebo tablet. The assessment included full history-questionnaire, micturition diary, gynecologic and cystometric examination, transvaginal ultrasound, and serum 17beta-estradiol level determination. It was carried out at the beginning, and after 4 and 12 months of treatment. RESULTS: The overall success rate of micronized 17beta-estradiol and placebo on subjective and objective symptoms of postmenopausal women with vaginal atrophy was 85.5%, and 41.4%, respectively. A significant improvement of urinary atrophy symptoms was determined in vaginal ERT group as compared with the beginning of the study (51.9% vs. 15.5%, P=0.001). The maximal cystometric capacity (290 ml vs. 200 ml, P=0.023), the volume of the urinary bladder at which patients first felt urgency (180 vs. 140, P=0.048), and strong desire to void (170 ml vs. 130 ml, P=0.045) were significantly increased subsequent to the micronized 17beta-estradiol treatment. The number of patients with uninhibited bladder contractions significantly decreased following micronized 17beta-estradiol as compared with pretreatment values (17/30, P=0.013). Side effects were observed in 61 (7.8%) patients treated with low dose micronized 17beta-estradiol. Therapy with 25 microg of micronized 17beta-estradiol did not raise serum estrogen level nor stimulated endometrial growth. CONCLUSIONS: Local administration of 25 microg of micronized 17beta-estradiol is an effective and a safe treatment option in the management of women with urogenital complaints.

Administration, Intravaginal↗
PubMed1996

[National consensus on hyperandrogenemia].

Croatian Endocrine Society and Croatian Academy of Medical Sciences organized Symposium on Hyperandrogenaemia on March 22nd, 1996. Different aspects of this syndrome were discussed: epidemiology, classification and clinical features, steroid biosynthesis in the adrenal gland and ovarium, the genetics of polycystic ovarian syndrome (PCOS), clinical significance of testosterone and dihydrotestosterone metabolism, androgen excess and metabolic syndrome (syndrome X), insulin disturbances in PCOS, increased risk for development of non insulin dependent diabetes mellitus, androgen effects on serum lipoproteins, insulin like growth factors and function of ovarium, Doppler parameters in PCOS, treatment of hyperandrogenaemia, skin changes in PCOS, tests for adrenal and ovarial function, arterial hypertension and hyperinsulinism. National Board of Hyperandrogenaemia has been elected.

Adult↗
PubMed1988

Lipid and lipoprotein contents of human follicular fluid.

The concentrations of total cholesterol, phospholipids, triacylglycerols and lipoproteins were measured in 87 follicular fluids obtained from 35 women undergoing in vitro fertilization and embryo transfer. The results were correlated with the levels of progesterone in follicular fluid. Two different types of ovarian stimulation were used. High density lipoproteins were the dominant lipoproteins found in the preovulatory follicular fluid. Low density lipoproteins were absent or appeared in trace amounts. Significantly higher triacylglycerol and high density lipoprotein levels were found when stimulation with human menopausal gonadotropins and chorionic gonadotropin was applied, as compared to the clomiphene citrate-menopausal gonadotropin-chorionic gonadotropin menstrual cycle. In both groups, extracorporal fertilization resulted in cleavage of oocytes and embryo transfer. No significant correlation between any follicular fluid lipid and progesterone concentration was found. The lipids estimated in the follicular fluid appeared to have no influence on the oocyte fertilizability. The presence of triacylglycerols and high density lipoproteins in the follicular fluid may indicate follicular wall permeability under the treatment with menopausal gonadotropins.

Adult↗
PubMed1976

[Aequidensitometrie of the labyrinthic capsule with special regard of the bottom of the internal auditory meatus].

It has been proved by densitometry that the thickness of the separating wall between the basal coil and the fundus of the internal auditory meastus as well as the thickness of the labyrinthic wall increase with age. The mineral contents is simultaneously reduced. The diameter of the cochlear canal is also reduced with age. These facts have been demonstrated by aequidensitometry and by summation color pictures of aequidensites.

Adolescent↗
PubMedDate not supplied

[Hyperprolactinemia and primary amenorrhea].

Six patients with primary amenorrhea and hyperprolactinemia are presented. The patients had normal secondary characteristics and normal body proportions. In four patients a tumour of the hypophysis was diagnosed radiologically, while in two patients the cause of hyperprolactinemia remained unknown. The gonadotropin concentration in the serum was normal. Reaction to Gn-RH was the same as that in women with the normal cycle in the follicular phase. In all the patients with function of the thyroid was normal. Primary amenorrhea was found in 14.6% of women with a disturbed cycle and hyperprolactinemia. In all the patients the administration of bromocryptin normalized prolactin concentrations, induced ovulation, and four patients became pregnant.

Amenorrhea↗
PubMedDate not supplied

Further contribution in the densitometric study of the labyrinthic capsule with special reference to the bottom of the internal auditory meatus.

The quantity of minerals in the labyrinthic capsule of the basal coil and of the separating wall facing the internal auditory meatus in different life periods was determined by the densitometric method. The quantity of minerals is reduced in the labyrinthic capsule and in the separating wall in spite of the bone apposition and increasing thickness of the separating wall.

Adolescent↗
PubMedDate not supplied

[Validity of the direct immunofluorescent monoclonal antibody test in the diagnosis of chlamydial infection].

The sensitivity and specificity of direct fluorescent monoclonal antibody staining were compared with the isolation of the organisms in McCoy cells. For both diagnostic methods cervical smears were taken in 120 women. Of 120 women 25 (20.8%) were infertile, 60 (50.0%) healthy fertile women and 35 (29.8%) adolescents who came for control gynecological examination. C. trachomatis was isolated in 5/25 (20.0%) of infertile women, in 5/60 (8.3%) of healthy fertile women and in 4/35 (11.4%) adolescents. With the cell culture as the reference method, the antigen detection test had a sensitivity of 92.8%, a specificity of 98.1%, a positive predictive value of 86.7% and a negative predictive value of 99.1%.

Adolescent↗
PubMedDate not supplied

[Fertilization in vitro in the treatment of male infertility].

Thirty marital couples were included in an in vitro fertilization study of male infertility. Second-degree oligospermia (less than or equal to 5 X 10(6)/ml mobile sperms) was found in 3 couples, first-degree oligospermia (less than or equal to 12 X 10(6)/ml mobile sperms) in 21 couples, and asthenospermia (less than 20% of mobile sperms) in 6 couples. The semen for insemination was prepared by the standard procedure and the overlay technique. After the separation (removal) of seminal fluid and capacitation the sperms were found to be significantly more mobile. Ovarian cells obtained by laparoscopy were inseminated with 50,000 to 250,000 mobile sperms. The results were compared with those in a group of patients with normospermia (greater than or equal to 12 X 10(6)/ml mobile sperms). The number of fertilized ovarian cells proved to be significantly lower in patients with second-degree oligospermia (P less than 0.001). There was no difference in the rate of fertilization and ovarian cell division either in patients with first-degree oligospermia or asthenospermia or normospermia. Seven clinical pregnancies were recorded: 2 in the second-degree oligospermia group, 4 in the first-degree oligospermia group, and 1 in the asthenospermia group.

Female↗
PubMedDate not supplied

[Pregnancy after fertilization in vitro and embryo transfer].

The first 13 pregnancies established by in vitro fertilization and embryo transfer. A tubal factor was the main indication for in vitro fertilization (IVF) in 10 patients, whereas in three couples infertility was caused by the infertile sperm. The mean age and duration of infertility in female patients were 33.5 and 11.4 years, respectively. Multiple follicular growth was stimulated by either clomiphene citrate (100-150 mg during 5 days), clomiphene citrate + HMG + HCG, or HMG + HCG. Timing of ovulation was determined by assaying serum estradiol, progesterone and LH levels. The ultrasound monitoring of follicular growth was determined on a daily basis. Endogenous LH surge was observed in one patient, whereas in others 5000-10,000 IU HCG were needed to induce ovulation. All oocytes were recovered by laparoscopy. There were 3.8 oocytes per patient on an average. Fifty-six percent of oocytes were preovulatory. All oocytes were allowed to mature in vitro for 3 to 7 hours (mean 5.7 hours). The fertilization and cleavage rates were 76% and 72% respectively. Only one polyspermic fertilization was observed. Forty-five hours after the insemination the embryos between the 2-cell and 6-cell stages were reimplanted into the uterus. Using various ET cannulas, one to seven embryos per patient (2.7 embryos on the average) were replaced into the uterine cavity, 5 mm below the fundus. Only four embryo replacements were completely atraumatic. No medications were used for the luteal phase support. The corpus luteum function and early pregnancy were controlled by serial measurements of serum progesterone, estradiol and beta HCG. Three clinical miscarriages and full-term deliveries were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The effect of delayed insemination on fertilization in vitro and the development of human embryos].

Extracorporeal fertilization of 363 oocytes was applied in 148 patients with tubal infertility. The aspiration of the follicles was performed 36 to 38 hrs after the onset of the endogenous LH rise or 36 hrs after injection of hCG. Oocytes maturity was evaluated on the basis of the morphological appearance of the cumulus oophorus. The eggs were incubated in culture medium before insemination. The duration of delayed insemination had a marked effect on the proportion of fertilized oocytes and the development of embryos (X2 = 10.34, P = 0.05). After maturation of 1.5 to 3.5 hrs, minimal preovulatory oocytes were fertilized and developed to embryos. Maturation of 3.5 to 5.5 hrs increased the number of fertilized oocytes from 56% to 71.7% and the number of embryos from 50% to 55.1%. After 5.5 to 7.5 hrs of maturation significantly more fertilized oocytes (t = 2.4, P less than 0.02) and developed embryos (t = 2.41, P less than 0.02) were obtained. Preincubation of intermediary preovulatory or immature oocytes had no beneficial effect on the fertilization rate and the development of embryos.

Adult↗
PubMedDate not supplied

[Human beta chorionic gonadotropin in the early diagnosis of extrauterine pregnancy].

In 1979 and 1980, at the University Hospital Department of Gynecology and Obstetrics, 115 patients with extrauterine pregnancy were surgically treated. In 26 patients the value of the radioimmunologic determination of beta chorionic gonadotropin (HCG) in the serum was analysed. Along with it, also other clinicodiagnostic procedures (immunochemical test for pregnancy, culdocentesis, curettage) wire carried out. Not in a single case of extrauterine pregnancy in which the serum beta HCG level was determined, was the result falsely negative. The immunochemical test for pregnancy was falsely negative in 32.6% and the result of culdocentesis was falsely negative in 13.6% of the patients examined. In patients with negative culdocentesis laparoscopy was performed (10.4%), showing ectopic pregnancy. In the course of extrauterine pregnancy the elimination of beta HCG was significatly reduced in relation to its level in normal pregnancy. The concentration of beta HCG in the observed patients with extrauterine pregnancy ranged from 27 to 3924 IU/L. On the basis of a low beta HCG concentration in the serum it is possible to determine with much certainty that pregnancy is not quite normal. Of great help is the observation of changes in the elimination of this hormone over a short period of time. A timely diagnosis of extrauterine pregnancy improves prognosis of future fertility.

Adult↗
PubMedDate not supplied

[Persisting suppression of hyperprolactinemia after bromcriptine withdrawal].

The 22-years old patient with secondary amenorrhea, galactorrhea and macroprolactinoma of hypophysis was observed. After the therapy with Parlodel, which lasted 34 months, her menstrual cycle became regular and the level of prolactin was normal. The quantity of Parlodel used daily for the normalization of prolactin was 20 mg at the beginning, and only 2,5 mg later on. This quantity was taken intermittently, only until the ovulation. She conceived 5 months after therapy withdrawal. During the pregnancy period, prolactin in serum was not higher then physiological value. The pregnancy did not cause any growth of tumor. After the delivery and the break of lactation, hyperprolactinemia persisted, but only 29,1-34,4% of the value before the beginning of the therapy.

Adult↗