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Biomedical subjects

A Tamborini

Publications and source records attributed to A Tamborini.

At least 19 recordsLinked to original sources
PubMed2004

[Current role of hormone replacement therapy in the prevention of postmenopausal osteoporosis: gynecologic point of view].

Hormonal Replacement Therapy (HRT) of the menopause has already proved to be effective in preventing bone loss and reducing the risk of fractures in postmenopausal women. Up until 2002, HRT was widely proposed and prescribed by French practitioners, in particular with regard to the prevention of osteoporosis. The results of two major studies, one American, the Women's Health Initiative (WHI) Study, and the other British, the Million Women Study (MWS), published in July 2002 and August 2003, have called into question the hitherto favourable benefits/risks ratio of HRT after finding an increased incidence of breast cancer and heart disease amongst women undergoing this treatment. Following these studies, the European and French health authorities have issued new recommendations regulating and restricting the use of HRT with a drastic restriction on the indications for its use in the prevention of osteoporosis. These new recommendations are the subject of controversy and pose new problems for practitioners.

Aged↗
PubMed2003

[Reality of menopausal hormone replacement therapy by French gynaecologists: OCEANIDES, a transversal and longitudinal national epidemiology study].

OBJECTIVE: To describe the initiation of hormone replacement therapy (HRT) in standard gynaecological practice in France, and to assess treatment adherence factors at 1 year follow-up. MATERIALS AND METHODS: Six hundred and nineteen gynaecologists distributed on the French territory and 1428 menopausal women were included in a transversal then longitudinal epidemiology study run over a period of 1 year. They filled out a questionnaire specially made for the purpose. All patients underwent patch HRT. RESULTS: One year after initiation of HRT, 1161 patients completed the study; 959 (82.6%) were still under HRT, and 202 (17.4%) had stopped altogether. Very few differences were found between those patients continuing with and those having stopped HRT. The two groups were comparable for the whole range of their own socio-demographic characteristics and for the demographic characteristics and medical practice of their gynaecologists. It had, however, more often been for renewal of an ongoing treatment that the patients who later ceased HRT had come to the consultation at which HRT was initiated, and these patients had less often enquired about the sexual benefits of HRT. DISCUSSION AND CONCLUSIONS: Adherence to physician-initiated patch HRT was good at 1 year follow-up. This result may be related to the quality of care provided by the gynaecologists, who listened to their patients, explained the treatment, and initiated personalised low-dose regimens, which they adapted to the patients' needs.

Cross-Sectional Studies↗
PubMed2002

Epidemiology of bloodstream infections and time to detection of positive blood cultures: an evaluation of the automated BacT/Alert and BACTEC 9240 systems.

Data of 3,097 blood culture sets processed with the BacT/Alert system in 1997 were compared to those of 3,158 blood culture sets processed with BACTEC 9240 in 1999. Agents responsible for bloodstream infections (BSI) were detected in 15.9% and 20.0% of blood cultures in 1997 and 1999, respectively. The incidence of BSI was 9.3 (1997) vs. 11.3 (1999) per 1,000 admissions. In both years, S. aureus was the most frequent isolate, followed by E. coli. Overall, the mean detection time (MDT) obtained with the BACTEC 9240 was significantly shorter than that of the BacT/Alert. Significant MDT differences were found for all organisms, except for Enterobacteriaceae (12.7 vs. 10.6 h). With both systems, over 95% positive samples were detected within 3 days, indicating that a 4-day incubation protocol may disclose most BSI agents. Thus, the added speed of the BACTEC 9240 allowed a particularly fast clinical management of septic patients.

Automation↗
PubMed2002

Identification and antimicrobial susceptibility testing of clinical isolates of nonfermenting gram-negative bacteria by the Phoenix Automated Microbiology System.

The Phoenix Automated Microbiology System (Becton Dickinson, Sparks, MD) was evaluated for its ability to identify nonfermenting gram-negative pathogens and measure their drug susceptibility. Isolates producing rare extended-spectrum beta-lactamases (PER-1, IMP-2, VIM-1, and VIM-2) were included in the study. Species identification was compared to that given by the ATB System (bio-Mérieux, Marcy l'Etoile, France), whereas susceptibility results were compared to those produced by a reference broth microdilution test (panels manufactured by Pasco Laboratories, Becton Dickinson). The Phoenix system consistently identified all isolates of Pseudomonas aeruginosa (n = 55) and Stenotrophomonas maltophilia (n = 28), while in other cases species agreement was obtained for 47/53 isolates (Acinetobacter baumannii, 29/31; Pseudomonas putida, 10/11; Burkholderia cepacia, 6/7; and Pseudomonas fluorescens, 2/4). Overall, the Phoenix and ATB systems gave equal results in 130/136 cases (95.6%). For two isolates, consistent identification was obtained at the genus level, thus bringing the cumulative agreement to 97.1%. MIC values (interpreted according to NCCLS guidelines) gave essential and categorical agreement in 94.2% and 93.1% of cases, respectively. Minor and major errors were 5.1% and 5.2%, respectively. No very major errors were produced. The mean time to results (TTR) for the Phoenix system was 14.8 +/- 1.6 h (mean +/- SD), with the shortest TTR being observedfor A. baumannii (13.0 +/- 1.8 h) and the longest one for P. aeruginosa (15.6 +/- 1.2 h). In conclusion, the Phoenix system performed rapidly and correctly in the identification of clinical isolates of important opportunistic pathogens and in measuring their susceptibility to antipseudomonal drugs.

Automation↗
PubMed2000

Efficacy and tolerability of a low-dose of Oesclim (25 mcg daily) in the management of symptomatic menopausal women: a French open-label study.

OBJECTIVE: To establish the proportion of symptomatic postmenopausal women, whose HRT treatment is initiated on Oesclim 25, who can be satisfactorily maintained on this low dose after two months. STUDY DESIGN AND PATIENTS: This was an open-label, multicentre, non-comparative, four-month treatment study. Treatment was initiated with Oesclim 25 (17 beta-oestradiol transdermal patch, 25 mcg/day). Dosage could be increased to Oesclim 50 if required after two months, according to clinical evaluation. Sequential treatment with an oral progestagen was also given for > or = 12 days/month in all non-hysterectomised women. A total of 1465 women were included in the study. RESULTS: 82.3% (CI: 80.1-84.4) of patients remained on Oesclim 25 across the whole study. The mean number of hot flushes was reduced similarly by 93% and 94% at month 4 in the Oesclim 25 group and Oesclim 50 group, respectively. However, at month 2 the decrease in hot flushes and other menopausal symptoms was less marked until the dose was adjusted, in patients switching to Oesclim 50. In a global evaluation, 97.5% of the investigators and 95.7% of the patients rated the overall efficacy of the treatment as good/very good. Overall, treatment initiated at a low dose was well tolerated throughout the study, with a trend showing Oesclim 25 as being better tolerated than Oesclim 50. CONCLUSION: Oesclim low dose (25 mcg) can effectively reduce symptoms in most postmenopausal women with a very satisfactory level of tolerability. The risk/benefit ratio observed is probably one key reason for good patient compliance.

Administration, Cutaneous↗
PubMed1975

[Hormonal function of the ovarian corpus luteum during benign mammary diseases].

Plasma progesterone and oestradiol levels were estimated in 54 women who were suffering from breast pathology. (There were 18 cases of benign breast dysplasia, 28 cases of cystic disease of the breast and 8 cases of adenofibromata.) All these women had menstrual cycles that were apparently ovulatory, and the blood sampling was carried out on the 4th day after the rise in the temperature plateau. By way of controls, the same estimations were carried out on 20 normal women of the equivalent age at the same stage of the raised plateau. The levels of plasma oestradiol in patients who had breast pathology (136 +/- 75 pg/ml) were not significantly different from those of normal women (120 +/- 50 pg/ml). On the other hand patients with mastopathies had a far lower level of progesterone in the phase of the cycle that was considered to be luteal (5-7 +/- 3-1 ng/ml) in comparison with normal women (13-2 +/- 3-5 ng/ml). From these results the conclusion can be drawn that women who have benign breast disease while they are active from the ovulation point of view show a defect in secretion of progesterone by the corpus luteum. This defect is an isolated one. The physiopathological implications derived from this observation are discussed.

Adenofibroma↗
PubMedDate not supplied

[Inadequate corpus luteum function in benign breast-diseases (author's transl)].

The amount of progesterone and estradiol secreted by human corpus luteum depends upon an adequate release of FSH and LH by pituitary gland during follicular phase and ovulation. In this paper, plasma determination of progesterone and estradiol were carried out in 109 women with benign breast disease during the luteal phase of their menstrual cycle. Results obtained were compared with those observed in 25 normal women studied in the same conditions. In women with benign breast disease, the curve of daily progesterone concentrations during luteal phase was lower than that of normal women. The progesterone peak at 5th day of luteal phase was only 8,1 +/- 3.8 ng/ml instead of 17.2 +/- 3.5 ng/ml in normal women. No significative difference was observed concerning plasma estradiol between patients and normal women. These results indicate that women with benign breast disease have an inadequate corpus luteum function which may be the result of disorder of ovulation. Pathophysiological implications resulting from this observation are discussed.

Breast Diseases↗
PubMedDate not supplied

[Variability of bone response to hormone replacement therapy].

Bone response to hormone replacement therapy (HRT) was assessed in a retrospective longitudinal study. 115 women started on HRT for the first time and 252 controls underwent initial densitometric evaluation (spine and femur) and a second evaluation on average 29 months later. Patients were classified as post-menopausal or perimenopausal according to whether they had had more or less than 6 months amenorrhea. Oral or non-oral 17-beta estradiol was used at the dose generally accepted to be skeletally protective. In the post-menopausal group, prescription of HRT was followed by spinal and femoral bone gain (+ 2.85% and + 1.06% per year respectively). There was no bone gain with HRT in the peri-menopausal women, but the stability seen contrasted greatly with the very marked bone loss found in controls (spine - 3.09% per year and femur - 1.78% per year). Lumbar densitometric variations were correlated, at least in the post-menopausal group, with those in the femur, but the amplitude of femoral variations was half that of the spine. Body mass index (BMI) was not found to be a predictive factor of bone response to HRT in this group, but the time since the menopause and initial densitometric results were. For the spine, the % of subjects losing their bone mass in response to the start of HRT, nil in the post-menopausal group, was 16% in peri-menopausal women. The % of good responders increased from 8% peri-menopausally to more than 59% 2 years after the menopause. The response in the femur appeared to be very different, with 20% good responders and a % of stable subjects similar to that of the control group. Femoral variations and the existence regarding the spine of a group showing no or only a poor response to HRT would be in favor of densitometric monitoring when initial bone mass is low.

Absorptiometry, Photon↗