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H P Schneider

Publications and source records attributed to H P Schneider.

At least 19 recordsLinked to original sources
PubMed2005

The World Veterinary Association and animal welfare.

The World Veterinary Association, as the global representative of the veterinary profession, recognises the global influences on animal welfare and the changing role of the veterinarian in response to the changing attitudes of the human population. While urban populations are now dictating animal welfare standards, many practices still have a cultural and even religious basis. Veterinarians recognise these influences, but base their recommendations for animal welfare on scientifically justified practices. Veterinarians work not only for urban clients with their companion animals, but also very importantly with rural clients who provide the source of animal-based foodstuffs and goods sought by an increasingly demanding human population. The controversial areas of intensive animal production and the transportation that is required to move large numbers of animals around the world require veterinary supervision to ensure that animal welfare is preserved. The development of animal welfare standards is an ongoing process, with the major international effort being led by the World Organisation for Animal Health.

Abattoirs↗
PubMed2002

[Reliability of the Menopause Rating Scale (MRS): Investigation in the German population].

The Menopause Rating Scale (MRS) is a well accepted instrument to measure the severity of menopausal symptoms. As yet, however, investigations had not specifically been directed towards short-term test-retest reliability of the scale. The MRS was twice applied in a random sample of 45-65 years aged women of the German Cohort Study of Women's Health with a distance between the measurements of 14 days. The response rate in the sample was 70 %. The correlation coefficient (Pearson) of the sum-score of the two measurements was r = 0.82. The high repeatability of the test results confirms our clinical experience and emphasizes excellent practical applicability. The MRS can be recommended for the clinical practice as a reliable scale both for the measurement and long-term surveillance of menopausal complaint dynamics.

Aged↗
PubMed2001

[Hormone replacement therapy - less is often more].

Symptomatic postmenopausal women do not accept Hormone Therapy for longer time periods that might also serve the purpose of prevention. Main objectives are bleeding problems, breast tenderness, weight gain and fear of cancer. Risks of HRT may effectively be reduced by low-dose transdermal application as seen from clinical experience with Ephelia(R).

Administration, Cutaneous↗
PubMed2000

Application and factor analysis of the menopause rating scale [MRS] in a post-marketing surveillance study of Climen.

OBJECTIVES: The menopause rating scale (MRS) has been developed as a modern tool for the assessment of menopausal complaints. It combines in practice excellent applicability and a good reliability, and there are normal values for the population available. For further practical evaluation, the MRS was applied in order to define the course of menopausal profiles in a large post-marketing surveillance study of a sequential oral hormone replacement therapy (HRT) preparation. MATERIALS AND METHODS: A total of 10904 pre- and postmenopausal women (median age 49 years) with menopausal symptoms who so far had not used the sequential preparation (Climen) were included in the study. Patients were admitted who were experienced with previous HRT (45.2%) or could be classified as never-users (54.8%). Users commonly switched over to Climen due to signs of androgenisation, irregular bleeding, other adverse drug effects as well as inadequate efficiency. Demographic data and medical history were recorded together with a listing of body weight, blood pressure, waist and hip circumference and any skin lesions. Following 3 and 6 months of application, the observation parameters were rechecked and data on tolerability, cycle pattern and adverse drug effects were recorded. Efficacy, tolerability, and reasons for withdrawal were documented. A total of 1801 gynaecologists took part, recruiting an average of six patients in each practice. Pre- and postmenopausal cases with a median age of 49 years were represented with similar frequency. A factorial analysis known as the varimax method was used to define the 'all-or-none' structure of the loadings in order to determine the structure of the variables and their relationship to the menopausal factors. RESULTS: The pre-treatment profile of the menopausal complaints by factor analysis splits up into four independent subscores of the MRS with the factors HOT FLUSHES, ATROPHY, psychological symptoms (PSYCHE), and somatic symptoms (SOMA). Current or ever-HRT did not alter the factorial profile of the MRS. Differences were observed in the intensity of the subscores with a tendency towards weaker symptoms following previous treatment with sequential preparations. SOMA appears to be related to increasing age, postmenopausal status, or co-morbidity requiring treatment. After six months of treatment, factorial loading of HOT FLUSHES, ATROPHY, PSYCHE and SOMA all dropped significantly. CONCLUSION: The MRS in its original ten-item profile suitably characterizes menopause-specific symptoms both with regard to profile and intensity of the symptoms. The MRS adequately monitors differentiated symptom variation with and without hormone replacement. Climen confirmed a wide spectrum of activity in all aspects of the MRS. The subscore structure of the factors remained stable during treatment. Only slight modulations were seen with marked emphasis on psychic aspects and sexual complaints.

Cyproterone Acetate↗
PubMed2000

A randomised controlled trial of delayed cord clamping in very low birth weight preterm infants.

UNLABELLED: This study was carried out to assess the feasibility of late cord clamping of 45 s in preterm infants delivered mainly by caesarean section and the effects on postpartal adaptation and anaemia of prematurity. Prior to delivery, 40 infants of < 33 gestational weeks were randomised to either 20 s or 45 s of late cord clamping. After the first shoulder was delivered, oxytocin was given intravenously to the mother in order to enhance placento-fetal transfusion while the infant was held below the level of the placenta. The 20 infants in group 1 (20 s) had a mean birth weight of 1070 g and a mean gestational age of 29 + 4/7 weeks versus 1190 g and 30 weeks in group 2 (45 s). On day 42 of life there were ten infants without transfusions in group 2 versus three in group 1 (P < 0.05). Out of the 20 infants in group 1, 19 and 15/19 in group 2 were delivered by caesarean section. There were no significant differences in Apgar scores, temperature on admission, heart rate, blood pressure and requirements for artificial ventilation. CONCLUSION: Delayed cord clamping of 45 s is feasible and safe in preterm infants below 33 weeks of gestation. It is possible to perform the procedure at caesarean section deliveries and it should be performed whenever possible. It reduces the need for packed red cell transfusions during the first 6 weeks of life.

Anemia, Neonatal↗
PubMed2000

Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women.

OBJECTIVE: To investigate the effect of differences in endometrial thickness and pattern as visualized with present-day high-resolution transvaginal ultrasound equipment on the outcome of assisted reproductive treatment. DESIGN: Prospective cohort study. SETTING: Two large infertility units in university hospitals. PATIENT(S): The endometrial characteristics of 981 patients during 1,600 assisted reproductive treatment cycles were compared with those of 205 untreated women. In addition, abnormal echogenic patterns of the endometrium were characterized histologically in 44 patients. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy rates. RESULT(S): The endometrium was significantly thinner in untreated women and women treated with IUI than in women treated with IVF or intracytoplasmic sperm injection. The exponential proliferation of the endometrium was similar in conception and nonconception cycles. The odds for a successful pregnancy were significantly lower in the presence of a thin endometrium in women treated with IUI but not in women treated with the long stimulation protocol for IVF or intracytoplasmic sperm injection. Singleton pregnancies were more common than multiple pregnancies in patients with thin endometria. CONCLUSION(S): The pregnancy rates of assisted reproductive procedures are influenced only marginally by the degree of endometrial proliferation, and treatment should not be canceled because of inadequate endometrial thickness.

Cell Division↗
PubMed2000

Prediction of ovulation by urinary hormone measurements with the home use ClearPlan Fertility Monitor: comparison with transvaginal ultrasound scans and serum hormone measurements.

The timing of sexual intercourse in relation to ovulation strongly influences the chance of conception. Daily serum LH measurements or transvaginal ultrasonography are not practical to determine ovulation in consecutive cycles for an individual. A prospective study was initiated to test the home use performance of the ClearPlan Fertility Monitor (CPFM) in ovulation prediction compared with transvaginal ultrasonography and serum hormone measurements. A total of 53 women aged 18-39 years with a normal uterus and at least one ovary, cycle length between 21-42 days and not using medication which interferes with ovarian function contributed 150 cycles for analysis. One cycle was anovulatory and no LH surge, indicating peak fertility, was detected by the monitor. Of the remaining 149 cycles, 135 (90.6%) had a monitor LH surge and ultrasonographically confirmed ovulation. Ovulation was detected in 91.1% of cycles during the 2 days of CPFM peak fertility. Ovulation was observed in 51.1% of cycles 1 day and in 43.2% of cycles 2 days after the surge in serum LH. Ovulation never occurred before CPFM peak fertility or the serum LH surge day. CPFM can help women who desire pregnancy to time intercourse. It may also have potential as a diagnostic aid and for monitoring the treatment of infertility.

Adolescent↗
PubMed2000

The Menopause Rating Scale (MRS): comparison with Kupperman index and quality-of-life scale SF-36.

OBJECTIVE: To evaluate further the Menopause Rating Scale (MRS) for scoring menopausal symptoms by comparison with other instruments relevant for women in their menopausal transition: the Kupperman index and the quality-of-life scale SF-36. METHOD: A population sample of 306 women, who had been randomly selected from an initially representative survey of German women (aged 40-60), completed three questionnaires in 1997: the Menopause Rating Scale (MRS), the Kupperman index and the short form-36 (SF-36). RESULTS: A comparison of the MRS with the Kupperman index produced a high correlation of raw scores (r = 0.91). The highest association of scores (80%) was found in the highest quartile of the MRS. The terms 'mild', 'moderate' and 'severe', relating to the degree of severity of menopausal symptoms, reflect different contents and spread in each scale, i.e. are not directly comparable. There is a strikingly good association between the subscales of the SF-36 and the MRS. The MRS correlates best with those dimensions of the SF-36 that are highly relevant for women in the menopausal transition. For this reason, the MRS can be utilized as an age- and condition-specific quality-of-life instrument. CONCLUSIONS: The Menopause Rating Scale is a valuable modern tool for the assessment of menopausal complaints. It combines in practice excellent applicability and good reliability, and there are normal values for the population available. The MRS could serve as an adequate diagnostic instrument for menopausal quality of life.

Adult↗
PubMed2000

The Menopause Rating Scale (MRS): reliability of scores of menopausal complaints.

OBJECTIVE: To analyze the reliability of scores of the recently developed self-administrative Menopause Rating Scale (MRS) in a follow-up investigation of a cohort after approximately one and a half years, and to look for possible reasons for variation. METHOD: A follow-up investigation of a random sample of an initially representative survey of German women (aged 40-60), which dated back to early 1996, was performed in late 1997. A subsample of 306 women participated. The MRS scale, a self-administrative standardized questionnaire, was applied with additional, mainly health-related, questions. RESULTS: The MRS results at baseline and follow-up were significantly correlated (r = 0.60). The majority of women remained in the category 'no or mild menopausal symptoms'. The kappa statistics showed significant agreement of the various subscales (total, somatic, psychological and urogenital scales) between the two measurements. Neither age nor social factors contributed to a change of score according to a multiple regression analysis. Some, but not all, health-related variables showed a slight association with change of score, such as satisfaction with health in general and, specifically, the presence of hypertension, cardiac and gastrointestinal diseases. No overall relation to hormone replacement therapy (HRT) was found during this observation period. CONCLUSIONS: The majority of women demonstrated sufficient reliability of MRS scores. Changes in the score after one and a half years were little influenced by the variables tested, except some health conditions such as cardiac disease. It should be stressed that the MRS has the benefit of being a self-administrative tool for the assessment of climacteric complaints with convenient applicability, and representative reference data have been collected in a German population.

Adult↗
PubMed2000

Enhancement of glutamate uptake transport by CO(2)/bicarbonate in the leech giant glial cell.

Glutamate uptake into glial cells via the excitatory amino acid transporter (EAAT) is accompanied by an influx of sodium and acid equivalents into the cells. The sodium-bicarbonate cotransport (NBC) in glial cells moves sodium and base equivalents across the glial membrane in both directions. We have studied possible interactions between these two electrogenic transporters in the giant glial cell of isolated ganglia of the leech Hirudo medicinalis. Changes in membrane potential, membrane current, intracellular sodium, and intracellular pH evoked by aspartate (1 mM), an EAAT agonist, were measured both in the absence and in the presence of CO(2)/bicarbonate. When 5% CO(2) and 24 mM bicarbonate was added to the saline (at constant pH 7.4), the aspartate-induced membrane current was increased, while the change in intracellular sodium was decreased. The acid influx evoked by aspartate was enhanced by CO(2)/bicarbonate but, because of the increased intracellular CO(2)/bicarbonate-dependent buffering power, the change in intracellular pH was decreased. 4,4'-Diisothiocyanatostilbene-2, 2'-disulfonic acid (DIDS, 0.5 mM), which inhibits the NBC, reversed the effects of CO(2)/bicarbonate on the aspartate-induced current and pH change. Our results suggest that the NBC helps counteract dissipation of the sodium and the acid-base gradients induced by the EAAT, enhancing the rate and capacity of glutamate uptake by glial cells.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed2000

[The Menopause Rating Scale (MRS II): methodological standardization in the German population].

The Menopause-Rating-Scale (MRS I) was used in clinical practice since 1992. The physician had to document the severity of 10 important estrogen-related climacteric symptoms. Practical experience and a critical methodological evaluation justified a revision: The MRS I should be converted into a self-administrative rating scale, the wording somewhat optimized, the layout adjusted and one item added. The standardization of the new scale (MRS II) was performed in a representative sample of the German population aged 45-60 years. Three dimensions were extracted from the menopausal symptoms using multivariate statistical techniques: somato-vegetative, psychological, and urogenital complexes of symptoms. A simple evaluation scheme was developed for the MRS II by summing up scoring points. Reference values for the frequency of 4 levels of intensity of complaints in the population were defined and provided for purposes of comparison. The MRS II meets a high methodological standard as an instrument standardized in the population. Moreover, it is convenient to apply this instrument in daily practice in order to quantitate variation of menopausal complaints.

Climacteric↗
PubMed2000

The role of antiandrogens in hormone replacement therapy.

The most widely used antiandrogens in clinical practice are cyproterone acetate, a derivative of 17-hydroxyprogesterone, and dienogest, a 19-norprogestin. An established sequential preparation for hormone replacement therapy (HRT) consists of 11 days of 2 mg estradiol valerate, 10 days of 2 mg estradiol valerate with 1 mg cyproterone acetate, followed by a 7-day drug-free interval (Climen, Schering AG, Berlin, Germany). Cyproterone acetate is highly progestogenic, has no androgenic properties, and is antiandrogenic above a certain dose. Cyproterone acetate does not counteract the estrogenic effects of estradiol valerate in Climen. This therapy, therefore, has optimal effects on lipid metabolism and coronary heart disease risk, protects the endometrium and reduces menopausal symptoms, preserves bone and reduces osteoporotic fracture risk, and has antiandrogenic effects on the skin and other androgen-sensitive epidermal structures. Dienogest, on the other hand, will soon be introduced in a continuous combined HRT. Dienogest has a 17 alpha-cyanomethyl group instead of the 17 alpha-ethinyl group typical of the common 19-nortestosterone derivatives. It is also referred to as a hybrid progestogen because it has pharmacodynamic properties (e.g. antiandrogenicity) in common with progesterone derivatives. A fixed formulation containing 2 mg estradiol valerate and 2 mg dienogest (Climodien) for continuous combined HRT has been developed. This formulation had excellent effects on vasomotor and neurovegetative symptoms. The bleeding pattern was generally highly satisfactory and similar to that with Kliogest, as were the results of endometrial biopsies after 12 cycles of treatment. Lipid metabolic changes may be interpreted as beneficial. Dienogest had no adverse effects on the vasorelaxant effect of estradiol valerate in postmenopausal women, as shown by markers of vascular function. Neuropsychological studies utilizing evoked potentials showed shortening effects on sleep latency and an improvement in cognitive information processing. Continuous combined HRT with dienogest, therefore, may come to be regarded as the HRT of choice in postmenopausal patients with mood defects. In summary, HRT with antiandrogenic progestogens has its specific indications with respect to preserving metabolic estrogenicity, specific antiandrogenic effects and specific effects on vigilance and mood disorders.

Androgen Antagonists↗
PubMed1999

Helix 8 and helix 10 are involved in substrate recognition in the rat monocarboxylate transporter MCT1.

Transport of lactate, pyruvate, and the ketone bodies, acetoacetate and beta-hydroxybutyrate, is mediated in many mammalian cells by the monocarboxylate transporter MCT1. To be accepted as a substrate, a carboxyl group and an unpolar side chain are necessary. Site-directed mutagenesis of the rat MCT1 was used to identify residues which are involved in substrate recognition. Helices 8 and 10 but not helix 9 were found to contain critical residues for substrate recognition. Mutation of arginine 306 to threonine in helix 8 resulted in strongly reduced transport activity. Concomitantly, saturable transport was transformed into a nonsaturable dependence of transport activity on lactate concentration, suggesting that binding of the substrate was strongly impaired. Furthermore, proton translocation in the mutant was partially uncoupled from monocarboxylate transport. Mutation of phenylalanine 360 to cysteine in helix 10 resulted in an altered substrate side chain recognition. In contrast to the wild-type transporter, monocarboxylates with more bulky and polar side chains were recognized by the mutated MCT1. Mutation of selected residues in helix 9 and helix 11 (C336A, H337Q, and E391Q) did not cause alterations of the transport properties of MCT1. It is suggested that substrate binding occurs in the carboxy-terminal half of MCT1 and that helices 8 and 10 are involved in the recognition of different parts of the substrate.

Amino Acid Sequence↗
PubMed1999

Characterization of the high-affinity monocarboxylate transporter MCT2 in Xenopus laevis oocytes.

Observations on lactate transport in brain cells and cardiac myocytes indicate the presence of a high-affinity monocarboxylate transporter. The rat monocarboxylate transporter isoform MCT2 was analysed by expression in Xenopus laevis oocytes and the results were compared with the known characteristics of lactate transport in heart and brain. Monocarboxylate transport via MCT2 was driven by the H(+) gradient over the plasma membrane. Uptake of lactate strongly increased with decreasing pH, showing half-maximal stimulation at pH 7.2. A wide variety of monocarboxylates and ketone bodies, including lactate, pyruvate, beta-hydroxybutyrate, acetoacetate, 2-oxoisovalerate and 2-oxoisohexanoate, were substrates of MCT2. All substrates had a high affinity for MCT2. For lactate a K(m) value of 0.74+/-0.07 mM was determined at pH 7.0. For the other substrates, K(i) values between 100 microM and 1 mM were measured for inhibition of lactate transport, which is about one-tenth of the corresponding values for the ubiquitously expressed monocarboxylate transporter isoform MCT1. Monocarboxylate transport via MCT2 could be inhibited by alpha-cyano-4-hydroxycinnamate, anion-channel inhibitors and flavonoids. It is suggested that cells which express MCT2 preferentially use lactate and ketone bodies as energy sources.

Animals↗
PubMed1999

Moderation of the daily dose of HRT: benefits for patients.

INTRODUCTION: Hormone replacement therapy (HRT) has many benefits yet compliance rates remain low. One of the main reasons for discontinuing therapy is hyperestrogenic side effects which may be dose related, and the initiation of treatment is critical to a patient's chances of gaining long-term benefits. The introduction of low dose HRT means that physicians have an option to initiate or titrate patients to a low dose. The purpose of this review is to examine current literature on the benefits for patients of low dose HRT. RESULTS: Low dose estrogen (25 mcg/day transdermally or 0.3 mg/day orally) are effective in controlling postmenopausal symptoms, reducing bone loss and reducing cardiovascular risk factors. Low dose therapy is also effective at reducing vasomotor symptoms in highly symptomatic women. In one study, patients on a daily dose of 25 mcg estrogen experienced an 86% reduction in vasomotor symptoms compared to a 55% reduction in patients on placebo. In addition, many adverse events related to estrogens were reduced using a low dose. CONCLUSION: Compliance with traditional doses of HRT is currently a problem for many women who may stop taking therapy because they experience hyperestrogenic side effects. Low dose HRT is effective at reducing vasomotor symptoms and controlling symptoms even in highly symptomatic women. Hyperestrogenic side effects may be reduced by initiating treatment at the lowest dose and titrating upwards if necessary. This may have benefits for patients in terms of offering effective control of symptoms whilst minimising hyperestrogenic effects.

Administration, Cutaneous↗
PubMed1999

HRT and cancer risk: separating fact from fiction.

INTRODUCTION AND METHODS: The benefits of hormone replacement therapy (HRT) in postmenopausal women are well known including control of vasomotor symptoms and long-term benefits on the cardiovascular, skeletal and central nervous systems. However, some studies have reported a link between long-term HRT use and cancer. This paper reviews some of the data related to HRT and major gynaecological cancers. RESULTS: Appropriate HRT regimens can reduce the risk of endometrial hyperplasia in non-hysterectomised women and can reduce the incidence of colorectal cancer. There is no consensus on a link between HRT and ovarian cancer, and the data relating to HRT and breast cancer presents differing risk analyses. However, it is generally accepted that HRT taken for 5 years or less does not increase the risk of breast cancer. When HRT is taken for 10 years or more, the relative risk of being diagnosed with breast cancer is 1.46. Individual risk must be weighed against the benefits offered by HRT, especially in terms of the long-term beneficial effects on the cardiovascular, skeletal and central nervous systems. Whilst one in 8-12 women may contract breast cancer in the western world, one in 3 women over 65 will have cardiovascular disease and 30-50% of postmenopausal women will have osteoporosis. CONCLUSION: Fear of cancer is one of the main reasons why women object to HRT. Physicians must be able to counteract this fear with fact, and counsel patients on their individual risk, as well as putting any cancer risk into perspective with other long-term benefits.

Breast Neoplasms↗