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Biomedical subjects

H Hackl

Publications and source records attributed to H Hackl.

At least 37 records · Page 2Linked to original sources

[Non-virilizing hormonal therapy in women with secondary disorders of sexual responsiveness].

26 women with secondary disturbance of sexual responsiveness were treated mainly with dehydroepiandrosterone preparations. The sexual tonus was tested before and after treatment by a sexual score system previously described. Urinary 17-ketosteroid and plasma testosterone fractions were controlled in 17 patients; these values were, in general, below the normal range before treatment. Treatment was considered to be successful in 17 patients, while in the remaining 9, who mainly belonged to the group of younger patients, no success was achieved. However, the results point out that therapeutic success with hormones of low biological activity can be expected only after numerous months of treatment. The pattern obtained on determination of hormonal parameters usually corresponded to the results of treatment.

Adult↗

[127 operated small lung cancers (1973-1980)].

We report upon 127 small-size carcinomas which have been operated from 1973 to 1980 at the "Pulmologisches Zentrum der Stadt Wien". The different parameters of tumours are brought into relation one to each other. 61 patients on which surgery was performed during the years 1973 to 1976 have been observed for 5 years or more. It has been investigated whether the time a patient survives is influenced by the size, by the location, by the type or by the stage of the tumour.

Adenocarcinoma↗

[Effects of antiandrogenic treatment with cyproterone acetate on the sexual tonus in virilized women].

Sexual responsiveness was assessed in 46 virilized women during cyproterone acetate treatment over a period of several years according to a sexual score previously described. In general, sexual tonus was depressed by intensive cyproterone acetate medication of several months' duration without concurrent oestrogen. By changing to sequential therapy according to Hammerstein, however, sexual tonus returned to initial levels in the group with normal pre-medication responsiveness. Furthermore, in another group with diminished sexual tonus before treatment, sexual responsiveness, in particular the capacity for orgasm, was stimulated to the level of the first group. The endocrinological basis for this observation is discussed with aid of results of the plasma testosterone/sex hormone binding globulin complex.

Adult↗

[Long-term treatment of virilized women with cyproterone acetate (author's transl)].

76 women with virilizing features (68 women suffering from hirsutism and 8 from acne) were treated on average for 25 months according to different models of Androcur medication. Success of treatment was clinically assessed as good in 3/4 of the cases and slight in the remaining 1/4. However, treatment is more successful in cases of adrenal hirsutism than in idiopathic hirsutism. Moreover, success of treatment seems to be better in women below 35 than over 35 years of age. Side effects, mostly bleeding anomalies and fatigue, were found in 31 women; these must be attributed to the gestagenic component of cyproterone acetate. By contrast, 12 women showed positive side effects such as weight reduction, improvement in depression states and reversal of hair loss, which must be attributed to the antiandrogenic component. The selected continuation rate in all subjects was 86% and the unselected 72%, over a treatment period of 4.5 years. Furthermore, hormonal controls were carried out under treatment. These showed, on average, a depression of plasma androstendione of 17%, of total plasma testosterone of 47%, as well as an inhibition of the testosterone/sex hormone-binding globulin quotient of 58%. These inhibition effects speak in favour of alterations taking place in steroid metabolism. However, by inhibition of androgenic serum levels, the mechanism of cyproterone acetate is only assisted, while the main mechanism is based on peripheral receptor inhibition. Furthermore, as additional component in this action a slight increase in plasma binding capacity was found during combined cyproterone-oestrogen treatment.

Acne Vulgaris↗

Catabolic effects and the influence on hormonal variables under treatment with Gynodian-Depot or dehydroepiandrosterone (DHEA) oenanthate.

53 patients from a mainly climacteric population were treated monthly with 200 mg dehydroepiandrosterone (DHEA) oenanthate or with 1 ampoule Gynodian-Depot. Pronounced adiposity was present in 15 of these cases. Hormonal variables were determined before the treatment and during the depot effect of the preparations in order to study the principle which supports the oestrogenic influence and any weight-reducing influence under administration of DHEA. The elimination of low-polar oestrogens increased considerably in 4 out of 13 post-menopausal cases treated with DHEA. This effect is probably indirect and presupposes intact ovaries. The incorporation of exogenous DHEA into the excretion of 17-ketosteroids and of 17-ketogenic steroids, such as those of androsterone + aethio-cholanolone, depends on the size of the initial pool inasmuch as it is higher in small initial pools than in saturated pools- the size of the pool being age-dependent. An average weight loss of greater than 1 kg/mth was observed under DHEA treatment in 7 out of 15 adipose cases. In comparison to the other 8 adipose cases, these 7 were younger and therefore also displayed higher values for 17-ketosteroids and their individual fractions. These circumstances appeared to explain why the administration of DHEA resulted in higher levels of free plasma DHEA which, in contrast to the cases without loss of weight, also resulted in an increase of renal DHEA-sulphate clearance. It was concluded from the findings that this is the explanation for the catabolic effect of exogenous DHEA. Post-menopausally increased FSH and LH fractions were markedly suppressed in about half of the determinations after Gynodian-Depot administration, the findings indicating that DHEA is probably involved in suppression of the LH fraction.

17-Hydroxycorticosteroids↗

[Analysis of the true death-rate due to alcoholism (author's transl)].

For various administrative and technical/registrational reasons, statistics on the death rate of chronic alcoholism are wrong. Exact studies have shown that official figures have to be multiplied by a factor of between 45 and 69 to arrive at the true rate. If one also takes into consideration the reduction in the collective life expectancy, the factor increases to about 100. The common practice of identifying death due to alcoholism by equating it with the number of deaths due to cirrhosis of the liver, provides a figure which is too low for the Central European area. Various suggestions are made on how to obtain the true death-rate.

Accidents, Traffic↗

[Pelvic pain syndrome in women--a psychiatric-gynaecological study (author's transl)].

77 selected patients suffering from dyspareunia and pelvic pain on moving, with normal findings on gynaecological palpation were submitted to laparoscopy or laparotomy, as well as to a psychiatric investigation. In 25% of the cases no pathological changes were seen--group I; in a further 40% signs of slight--group II--and in the remaining 35% of cases signs of serious pelvic congestion were present--group III. Serious pelvic congestion occurred most frequently between 26 and 35 years of age and seemed to be connected with more than one delivery. Furthermore, in the total material, 65% of patients showed psychologically inadequate personalities whereby nearly 90% of the women in group I, but only a little over 40% in group III, displayed psychological inadequacy, with the women in group II occupying an intermediate position. On the basis of this observation and other investigated personality variables, pelvic pain without pathological findings seems to be caused by neuromuscular spasm in psychologically vulnerable persons. Pelvic pain with different degrees of pelvic congestion cannot be entirely dissociated from the possibility of psychological overlay, which may, however, be of a secondary nature.

Adult↗

A comparison of two different dosages of pivampicillin and doxycycline in patients with gynaecological infections.

The efficacy of 500 mg pivampicillin twice daily, 350 mg pivampicillin 3-times daily and 100 mg doxycycline daily was compared in 106 patients with salpingitis, parametritis or endometritis. Both the pivampicillin regimens were equally effective. The average duration of therapy needed to produce a satisfactory clinical response was shorter with pivampicillin (14 days) than with doxycycline (21 days). Pivampicillin improved the patients' gynaecological status in 90% of the subjects treated compared to only 70% of patients given doxycycline. Fewer relapses were recorded in women given pivampicillin (4%) than in subjects treated with doxycycline (15%). Gonococci were isolated from 10% of vaginal swabs. The involvement of Chlamydia and Mycoplasma was not studied. However, the high cure rate indicated that, if present, they did not pose a therapeutic problem. Side-effects, mainly dyspepsia, were observed in 2 patients in each group. The twice-daily administration of pivampicillin is recommended, since it is more practical and increases patient compliance.

Adult↗