1,720,981 research outputs found
A clinical trial of the effects of tibolone administered with gonadotropin-releasing hormone analogues for the treatment of uterine leiomyomata
No full textObjective: To evaluate the effects of tibolone therapy in association with GnRH-a on uterine leiomyomata, on climacteric-like symptoms, on bone metabolism, and on the lipid profile.Design: A prospective, randomized, double-blind, placebo-controlled, clinical trial.Setting: Department of Gynecology and Obstetrics, University of Naples "Federico II," Naples, Italy.Patient(s): Fifty women with symptomatic uterine leiomyomata.Intervention(s): Six months of treatment with leuprolide acetate (3.75 mg every 28 days IM) combined with daily placebo tablets (group A) or with 2.5-mg of tibolone per os (group B).Main Outcome Measure(s): Uterine and uterine leiomyomata sizes, lumbar spine bone mineral density, biochemical markers of bone metabolism, lipid profile, and myoma-related symptoms were measured at baseline and after 6 months of treatment Daily symptom diary in which hot flushes and vaginal bleeding episodes were recorded.Result(s): No differences between the 2 groups in uterine and uterine leiomyomata size and myoma-related symptoms were detected. After 6 months of treatment, there were statistically significant changes from baseline in bone mineral density and in biochemical markers of bone metabolism in group A but not in group B. Vasomotor symptoms were significantly lower in group B than in group A. There was a statistically significant increase (P<.01) in serum total cholesterol, high-density lipoprotein cholesterol, and triglycerides in group A after 6 months of treatment in comparison with baseline values. The difference in serum total cholesterol and triglyceride levels after 6 months of treatment in group B was not statistically significant in comparison with baseline values, but was statistically significant in comparison with group A values (P<.01). In group B, levels of high-density lipoprotein cholesterol were significantly lower after 6 months of therapy in comparison with baseline values and in comparison with group A values (P<.01). There were no statistically significant changes at baseline and after 6 months of treatment in the level of low-density lipoprotein cholesterol in either group.Conclusion(s): Administration of tibolone in association with GnRH-a reduces vasomotor symptoms and prevents bone loss, without compromising the therapeutic efficacy of GnRH-a alone. (Fertil Steril(R) 1998;70:111-8. (C) 1998 by American Society for Reproductive Medicine.)
Case report: a most peculiar family with spontaneous, recurrent ovarian hyperstimulation syndrome.
No full textConscious sedation versus general anaesthesia for minilaparoscopic gamete intra-Fallopian transfer: a prospective randomized study
No full textBACKGROUND: Gamete intra-Fallopian transfer (GIFT) is a successful technique for infertile women, and is performed almost exclusively by laparoscopy under general anaesthesia. METHODS: We performed a prospective randomized study of 67 infertile patients to assess the efficacy of minilaparoscopic GIFT under conscious sedation/local anaesthesia (group A) compared with general anaesthesia (group B). Operative and discharge times and pregnancy outcome were evaluated in both groups. RESULTS: Operative time was similar in both groups. The rate of patients discharged 2 h after surgery was significantly higher in group A. The necessity for postoperative analgesics was significantly higher in group B. No significant differences were noted between the two study groups in terms of pregnancy outcome. CONCLUSIONS: Conscious sedation and local anaesthesia will allow us to perform an outpatient minilaparoscopic GIFT without the need for general anaesthesia. The simplicity of the method, and the quicker discharge time in comparison with general anaesthesia, offer a detectable benefit for patients
Efficacy of methods for determining ovulation in a natural family planning program
No full textObjective: To evaluate the efficacy in ovulation detection of methods used in natural family planning in comparison with pelvic ultrasonography.Design: Prospective analysis of ovulation detection by natural family planning methods and ultrasonography.Setting: Natural family planning clinic, Department of Obstetrics and Gynecology, University of Naples "Federico II".Patient(s): Forty healthy women who were highly motivated to use natural family planning.Intervention(s): None.Main Outcome Measure(s): Transvaginal ultrasonographic findings, urinary LH levels, salivary P-glucuronidase activity, salivary ferning levels and characteristics of cervical mucus, and BBT.Result(s): Urinary LH level determination yielded a 100% correlation with the simultaneous ultrasonographic diagnosis of ovulation. Mucus sensations and characteristics yielded a 48.3% correlation when simultaneously evaluated with ovulation. beta-Glucuronidase levels yielded a 27.7% correlation. The salivary ferning test had a 36.8% ovulation-detection rate the day of ovulation, but 58.7% of results were uninterpretable. Body temperature measurements yielded a 30.4% correlation with the simultaneous ultrasonographic diagnosis of ovulation.Conclusion(s): Measuring urinary LH levels is an excellent method for determining ovulation. Although variations in mucus characteristics and basal body temperature correlate somewhat with ovulation, the length of the fertile period is overestimated with these methods. The salivary ferning test and measurement of beta-glucuronidase levels are not good methods for home ovulation testing. (Fertil Steril(R) 1999;72:900-4 (C)1999 by American Society for Reproductive Medicine.)
Ultrasonographic evaluation of the positioning of TVT-O vs. TVT-secur and their effect on the uretra: an ancillary analysis of a 36-months follow-up randomized study
No full textSerum leptin levels in postmenopausal women: effects of transdermal hormone replacement therapy
No full text- …
