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PubMed1982

There is no place in gynecological endoscopy for unipolar of bipolar high-frequency current.

In 1981 we showed that there is a clear relationship between the extent of destruction of the vascular and nervous systems within the mesosalpinx, and the occurrence of menstrual disorders, and menopausal symptoms. Depending upon the individual sterilization technique, varying portions of the tubes are destroyed and considerable in jury is done to extensive parts of the mesosalpinx. Since two-thirds of the ovarian blood supply passes through the tubal branch of the uterine artery, after destruction of large areas of the mesosalpinx, a marked disturbance of ovarian metabolism must be expected. Using a patient questionnaire, we investigated the effects of the unipolar high frequency current method and the endo-coagulation procedure with respect to late complications. In the years following high-frequency sterilization (in a total of 258 women) 23 women (8.9) were hysterectomized; in the endocoagulation group only 9 patients (2.3%) underwent hysterectomy, primarily for recurrent therapy-resistent menometrorrhagia. Of the women sterilized by the unipolar HF- technique (total number 258) 20 (7.8%) required post-operative curettage 1-3 times while only 8 patients (2.1%) of the endocoagulation group required such a procedure. We found that 79 patients of the HF-group (30.9%) exhibited menstrual disorders compared with only 45 women 11.7% in the endocoagulation group.

Electrocoagulation↗
PubMed1976

[Cytogenetic studies in women with primary amenorrhea (author's transl)].

During the past 10 years, 106 women with primary amenorrhea were studied. According to the X chromatin determination the cases were subdivided into 2 main groups. In the X chromatin negative group the Y chromatin positive and the Y chromatin negative cases were differentiated by fluorescent methods. The diagnosis was made according to the chromosome analysis. The X chromatin positive cases were classified following in detail clinical and cytogenetic studies. In our series, 50% of the cases showed chromosomal abnormalities whereas the literature reports 20-25% chromosomal abnormalities.

Adolescent↗
PubMedDate not supplied

Pharmacological management of premenstrual disorder.

Over the last decade there has been increasing recognition of premenstrual disorders, and numerous treatments have been tried for symptom relief. A literature search using Medline was conducted to locate all articles written in English and including the terms "premenstrual treatment," "premenstrual syndrome," "late luteal phase dysphoric disorder," or "menstruation and mood" over the last 30 years. Although more than 300 articles were retrieved, only one-third of them described double-blind studies and just 41 of the double-blind studies involved prospective diagnosed patients. The definition of the disorder varied across studies, as did research design and outcome measures. Many studies did not assess for Axis I comorbidity, which may have a significant impact on drug response. We attempted to do a metaanalysis of the existing double-blind, prospectively diagnosed studies, broken down by drug class and symptom reduction. However, we could not make statistical comparisons within or across drug groups to assess efficacy of treatment for specific symptoms due to differences in outcome-assessment measures across studies. Several promising pharmacological strategies exist to treat the patient with premenstrual dysphoric disorder. We review double-blind studies for each class of drugs, highlight some open studies, and present guidelines. Additional double-blind studies with prospectively diagnosed patients are needed. Standardization of definition, design, and outcome measures used in this field is important to enable direct comparison across studies of different treatment strategies.

Clinical Protocols↗
PubMed1990

Oral contraceptives in risk groups: exclusion or monitoring?

Careful consideration of absolute and relative contraindications, including newly appreciated factors such as past pregnancy-related hypertension, is essential to select what is termed the "safer women." A family history of either arterial or venous thrombosis indicates preliminary blood analysis to exclude atherogenic lipid states and thrombophilias. The goal then is to prescribe "safer pills." One should also allow for biologic variation in pharmacokinetics and end-organ responses. This can be done to a limited extent in clinical practice by using bleeding from the uterus as a "threshold bioassay." Namely, by identifying for each woman the lowest dose of a chosen estrogen-progestogen combination that is just sufficient to prevent breakthrough bleeding. Thereafter, monitoring requires attention to the development of new risk factors, regular blood pressure checks, and specific attention to the important side effects of headaches and migraines, especially if there are focal (cerebral ischemic) symptoms.

Cardiovascular Diseases↗
PubMed1964

PROBLEMS OF ADOLESCENCE.

Adolescence is a period of active growth and development-physical, sexual, social and emotional. There are wide normal variations between the time of onset and the attainment of full maturity. Many adolescents present few if any problems during this potentially turbulent period, and make the necessary adjustments without undue stress to themselves, their family or their friends. Problems in growth and hormonal balance, presenting as short and tall teenagers, menstrual irregularities, obesity and acne are discussed. The impact of chronic disease-diabetes, convulsive disorders and rheumatic carditis-is a challenge to the skills and patience of the practising physician.

Acne Vulgaris↗