Search PubMed⌕ Search

Biomedical subjects

J A Eden

Publications and source records attributed to J A Eden.

At least 37 records · Page 2Linked to original sources
PubMed1996

Estrogen replacement therapy in survivors of breast cancer: a risk-benefit assessment.

The use of hormone replacement therapy (HRT) after breast cancer is controversial. For a minority of such women, menopausal symptoms such as hot flushes can be so severe as to compromise quality of life. Moderate doses of progestogens alone are an effective therapy for hot flushes in around two-thirds of patients and poorly absorbed topical estrogens are well tolerated and effective for vaginal dryness. However, for a small number of women, the only effective therapy for hot flushes is estrogen replacement. Women with early stage breast cancer are unlikely to die from this disease and will be more likely to be affected by age-related diseases such as heart disease, strokes and osteoporotic fractures. These women may also benefit from estrogen replacement. Prospective trials are currently under way to determine the safety of HRT after breast cancer.

Breast Neoplasms↗
PubMed1996

A review of the clinical effects of phytoestrogens.

OBJECTIVE: To review the sources, metabolism, potencies, and clinical effects of phytoestrogens on humans. DATA SOURCES: The MEDLINE data base for the years 1980-1995 and reference lists of published articles were searched for relevant English-language articles concerning phytoestrogens, soy products, and diets with high-phytoestrogen content. METHODS OF STUDY SELECTION: We identified 861 articles as being relevant. Human cell line studies, human epidemiologic studies (case-control or cohort), randomized trials, and review articles were included. Animal studies regarding phytoestrogens were included when no human data were available concerning an important clinical area. TABULATION, INTEGRATION, AND RESULTS: Included were studies containing information considered pertinent to clinical practice in the areas of growth and development, menopause, cancer, and cardiovascular disease. When findings varied, those presented in this study reflect consensus. All studies concurred that phytoestrogens are biologically active in humans or animals. These compounds inhibit the growth of different cancer cell lines in cell culture and animal models. Human epidemiologic evidence supports the hypothesis that phytoestrogens inhibit cancer formation and growth in humans. Foods containing phytoestrogens reduce cholesterol levels in humans, and cell line, animal, and human data show benefit in treating osteoporosis. CONCLUSION: This review suggests that phytoestrogens are among the dietary factors affording protection against cancer and heart disease in vegetarians. With this epidemiologic and cell line evidence, intervention studies are now an appropriate consideration to assess the clinical effects of phytoestrogens because of the potentially important health benefits associated with the consumption of foods containing these compounds.

Animals↗
PubMed1995

Phytoestrogens--a short review.

The wide distribution of plant estrogens or 'phytoestrogens' in cereals, vegetables and medicinal plants raises questions concerning the possible health risks and benefits associated with their consumption. In this article, we provide a synopsis of the literature relating principally to the clinical effects of phytoestrogens on the diseases associated with ageing. The sources, metabolism and properties of the different phytoestrogens are also discussed. The studies included were primarily restricted to those with data pertinent to clinical practice. Our contention is that phytoestrogens are at least part of the reason why vegetarians and Asian populations have a low rate of cancer and heart disease.

Adult↗
PubMed1995

Gynaecological complications of women treated with tamoxifen for breast cancer.

We present 6 cases illustrating some of the gynaecological complications associated with tamoxifen treatment of women with breast cancer. The first 2 represent cases of myometrial hypertrophy secondary to tamoxifen use, a postmenopausal woman and a premenopausal women with recurrent carcinoma of the breast. The third is a case of probable ovulation induction in a perimenopausal women with recurrent breast cancer who was commenced on tamoxifen 20 mg daily. The other 3 cases illustrate some of the endometrial effects associated with tamoxifen therapy in women with a history of breast cancer, namely cystic glandular hyperplasia, endometrial polyps and endometrial cancer.

Adenocarcinoma↗
PubMed1995

Bulimia nervosa and polycystic ovary syndrome.

Ninety-four female-female twins underwent a transabdominal ultrasound examination to detect polycystic ovaries. The scans of 52 individuals showed normal ovaries and 42 had evidence of polycystic ovaries. All the subjects were sent a bulimia investigation test (Edinburgh) (BITE) questionnaire for abnormal eating behavior. A total of 74 responses was received (79%). Overall, 76% of women with polycystic ovaries had an abnormal BITE score and their mean BITE score showed a significant increase compared to those with normal ovaries. Also, model fitting analysis suggested a strong genetic effect for bulimia using the BITE scoring system, and it provided strong evidence of a significant influence of environmental factors in the severity score of bulimia.

Adolescent↗
PubMed1995

A twin study of polycystic ovary syndrome.

OBJECTIVE: To examine the role of genetic and environmental factors in polycystic ovary syndrome (PCOS) by using the classic twin model. SETTING: Outpatient clinic of the Royal Hospital for Women, Paddington, Sydney, New South Wales, Australia. PATIENTS: A group of 19 monozygotic (MZ) and 15 dizygotic (DZ) twin pairs identified from the national twin register. INTERVENTIONS: Ultrasound, clinical, and biochemical parameters were used to define PCOS. RESULTS: Eleven pairs of twins (5 MZ, 6 DZ pairs) were scan-discordant (i.e., one twin had scan-PCOS and the co-twin did not). Model-fitting analysis suggested that fasting insulin level, androstanediol glucuronide, and body mass index (BMI) were significantly influenced by genetic factors. CONCLUSION: This study suggests that PCOS is not the result of a single autosomal genetic defect, but rather environmental factors, perhaps both intrauterine and extrauterine, are involved in the pathogenesis of this disorder or that PCOS may be an X-linked disorder or the result of polygenic factors. However, fasting insulin level, androstanediol glucuronide, and BMI did appear to be under significant genetic influence.

Adolescent↗
PubMed1993

Idiopathic hirsutism or polycystic ovary syndrome?

Polycystic ovaries (PCO) were detected using ultrasound imaging in a series of 173 women who presented with significant hirsutism and in some cases with irregular menstruation. Patients were divided into 3 groups. Those with hirsutism and regular menstruation (cycles > 8 per year, Group 1, n = 96); those with hirsutism and oligomenorrhoea (cycles < 8 per year, Group 2, n = 44) and those with hirsutism and amenorrhoea (cycles < 2 per year, group 3, n = 33). These 3 groups were compared with subjects with normal ovaries and regular cycles of 26-34 days and without hirsutism (n = 29) and also with a group of women with PCO and regular cycles who had no sign of hirsutism (n = 90). PCO were found in 86% of Group 1, 97% of Group 2 and 94% of women within Group 3. The results suggest that the term 'idiopathic hirsutism' may not be appropriate. An abnormal biochemical test consisting of a luteinizing hormone level > 9 U/L, testosterone level > 2.2 nmol/L, sex hormone binding globulin < 32 nmol/L or free androgen index > 4.5 was 100%, 91% and 76% sensitive for detecting PCO amongst women with amenorrhoea, oligomenorrhoea and idiopathic hirsutism respectively.

Adolescent↗
PubMed1993

Menopause before 40--premature, but not always permanent.

Seventy-five women with premature menopause presented to a reproductive endocrinologist over a 3-year interval. Thirty-five had an identifiable cause, usually a chromosomal defect, autoantibodies or cytotoxic chemotherapy. Forty had no apparent cause and of this group 5 conceived on hormone replacement therapy (HRT). Overall, this group of oestrogen deficient women had spent nearly half of their menopausal years to date, not on HRT.

Adult↗
PubMed1993

Relationship between follicular fluid levels of insulin-like growth factor binding protein-1 and sex steroids from normal human ovarian follicles.

The aim of this study was to examine the possible correlations between follicular fluid insulin-like growth factor binding protein 1 (IGFBP-1) and follicular fluid and serum parameters of granulosa cell function. Twenty-six subjects undergoing diagnostic laparoscopy for infertility had follicular fluid samples collected. Subjects were aged 20-42 years, were having regular ovulatory cycles and either had tubal disease or a partner with male factor infertility. Sex steroids, insulin-like growth factor 1 (IGF-1) and IGFBP-1 were measured by radioimmunoassay. Follicular fluid levels of IGFBP-1 were significantly correlated with levels of estradiol, progesterone in follicular fluid and with serum IGFBP-1 levels, and negatively correlated with follicular fluid androstenedione levels. These results suggests that IGFBP-1 may have a role in the regulation of human ovarian follicles.

Adult↗
PubMed1991

The polycystic ovary syndrome presenting as resistant acne successfully treated with cyproterone acetate.

OBJECTIVE: To review a group of Australian women presenting to a reproductive endocrinologist with acne and investigate how many had androgen excess and how they had responded to endocrinological therapy. DESIGN: All patients referred to me over a 12 month period were included in the study and investigated in a standard manner. Medical therapy was given in a non-randomised manner based on clinical and biochemical evidence. SETTING: Most patients were referred to my private practice, but all public patients seen over this period were also included. PATIENTS: Subjects were women who presented with acne. Some were also hirsute and/or had menstrual irregularities. The total group consisted of 157 subjects. Patients with thyroid disease, hyperprolactinaemia, and late-onset congenital adrenal hyperplasia, and menopausal women were excluded, and the final study group consisted of 90 subjects. INTERVENTIONS: Women presenting with acne but no hirsutism and an elevated level of dehydroepiandrosterone sulphate were treated with low-dose dexamethasone. All other subjects were treated with ethinyloestradiol and cyproterone acetate. MAIN OUTCOME MEASURES: (i) The diagnosis of polycystic ovary syndrome and (ii) the effect of endocrinological therapy on their acne. RESULTS: Of the 90 subjects presenting with acne, 67 (74%) were found to have the polycystic ovary syndrome. In all cases the acne was substantially reduced by treatment. All 30 subjects who had previously failed to respond to standard dermatological preparations were successfully treated with combined ethinyloestradiol and cyproterone acetate therapy. CONCLUSIONS: The polycystic ovary syndrome is commonly found amongst women complaining of acne. Some patients will not have excess body hair, obesity or menstrual irregularities. Among women with resistant acne, not responding to conventional treatments, the polycystic ovary syndrome is very common. Treatment with ethinyloestradiol and cyproterone acetate is an extremely effective, safe and well tolerated therapy for these women.

Acne Vulgaris↗
PubMed1991

Progestogens: an occasional review.

Progestogens are drugs which share the ability to stimulate the progesterone receptor, but differ in many other aspects. Some of their uses include the regulation of menstrual bleeding, protection of oestrogen-primed endometrium, contraception and as anticancer therapy. However, progesterone physical and psychological side-effects and potentially adverse metabolic effects including lipoprotein changes must be considered. An understanding of these differences will permit appropriate prescribing of these drugs for gynaecological and medical disorders.

Endometriosis↗
PubMed1990

Insulin-like growth factor binding proteins in follicular fluid from normal dominant and cohort follicles, polycystic and multicystic ovaries.

There is now considerable evidence that the insulin-like growth factors (IGFs) play an important role in the human ovary. It has also recently become apparent that the physiological activity of the IGFs is modulated by a number of specific binding proteins (IGFBPs). In order to understand the role of the IGFs in ovarian physiology, the presence and functions of these IGFBPs will need to be characterized. As an initial step towards this we have investigated the presence of the various binding proteins by Western ligand blotting and have measured the levels of one of them, IGFBP-1, in follicular fluid (FF) obtained from unstimulated dominant and cohort follicles in 19 normal women and in eight patients with polycystic and one with multicystic ovaries. In normal women, IGFBP-1 levels in dominant follicles were similar to matched serum levels but were significantly lower in cohort follicles. IGFBP-1 levels correlated with FF-volume (r = 0.58, P less than 0.001) and with paired serum levels (r = 0.63, P less than 0.001). In post-LH surge dominant follicles this relationship with serum levels no longer held and in three out of nine subjects FF levels were higher than in serum. Thus IGFBP-1 in normal human FF appears to be partly derived from the circulation but with additional local production in the larger developing dominant follicles. Western ligand blotting revealed five IGF-binding proteins in FF running parallel with those identified in serum, suggesting that the IGFBP species previously identified in serum may also be present in FF. The two bands in positions corresponding to the components of the large (150kDa) binding complex were, as in serum, the predominant forms and in most FF samples these were even more prominent than in the accompanying serum sample. This contrasts with previous studies in lymph which suggested that the 150kDa complex was largely retained in the circulation. All three small IGFBPs varied considerably between FF samples even within an individual; each IGFBP varied independently of the other IGFBPs. Our results demonstrate that at least four discrete IGFBPs are present in FF and suggest that each may be produced independently within the ovary.

Adult↗