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Biomedical subjects

J E Blumel

Publications and source records attributed to J E Blumel.

13 recordsLinked to original sources

Effect of a compound containing isoflavones, primrose oil and vitamin E in two different doses on climacteric symptoms.

The object of this study was to evaluate the effect of different doses of a compound containing isoflavones 60 mg, primrose oil 440 mg and vitamin E 10 mg. (IOVE) on menopausal complaints. This was an open, multicentre, randomised, group comparative, efficacy and safety trial. A total of 1,080 postmenopausal women, with climacteric symptoms, were allocated into one of two treatment groups to receive one (Group 1; n = 562) or two IOVE capsules (Group 2; n = 518) per day. The Blatt - Kupperman scale and safety parameters including weight, body mass index, blood pressure and adverse effects were assessed at the first visit before initiating the treatment, and 3 - 6 months thereafter. In addition, cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride levels were measured at baseline and at the 6th month visit. Finally, at the end of follow-up, the patient's satisfaction was assessed. No differences between groups at the beginning of the study and during the follow-up were observed. A significant reduction in Blatt - Kupperman scores were observed in the two groups. In addition, the reduction of the symptoms was more intense in the first 3 months. Increasing doses of IOVE add no beneficial effects since both studied doses were equally effective in the reduction of climacteric complaints.

Climacteric↗

Prevalence of sexual dysfunction in a cohort of middle-aged women: influences of menopause and hormone replacement therapy.

In order to determine the prevalence of sexual dysfunction (SD) and related risk factors in a cohort of middle-aged women the Laumann's test (DSM-IV) was passed to 534 healthy women between 40 and 64 years old (mean: 52.4+/-5.7) attending the Southern Metropolitan Health Service in Santiago de Chile. Of all the women, 82.8% were peri- or postmenopausal, 23% had received hormone replacement therapy (HRT) and 79.2% were sexually active. Among those who were sexually active a total of 51.3% presented SD. The prevalence of SD increased with age (from 22.2% in the 40-44-year age group to 66% in the 60-64-year age group). HRT users and healthy women presented a lower risk of SD (OR: 0.1 CI: 0.0-0.1 and OR: 0.6 CI: 0.3-0.9, respectively). The risk increased after the menopause (OR: 3.3 CI: 1.6-6.9) and with age older than 49 years (OR: 3.4 CI: 1.8-6.4), hysterectomy (OR: 3.7 CI: 1.3-10.6) and when male partners presented erectile dysfunction (OR: 3.2 CI: 1.2-8.6). In conclusion sexual dysfunction affects more than 51% of middle-aged women who are sexually active and increases with age. Ovarian function and HRT significantly influence sexual activity.

Adult↗

Quality of life after the menopause: a population study.

OBJECTIVE: To assess the impact of menopause and some sociodemographic variables on quality of life (QoL). MATERIALS AND METHODS: Four hundred and eighty-one women aged 40-59 years attending the Southern Metropolitan Health Service in Santiago de Chile were studied using the Specific Quality of Life Questionnaire for Menopause from Toronto University. RESULTS: Univariate analysis showed that menopausal women have worse QoL scores than women conserving cycles in the four areas of the questionnaire: They show a 10.6-fold higher risk for suffering vasomotor disorders affecting QoL, a 3.5-fold higher risk for psychosocial impairment, a 5.7-fold higher risk for physical disorders, and a 3.2-fold higher risk for sexual disorders (P < 0.0001). Regarding the influence of social markers (age, marital status, school years, work, number of children and sexual activity), housewives were found to have higher, worse, scores than working women in all test components (vasomotor, 3.11+/-1.90 versus 2.57+/-1.71, P < 0.003; psychosocial, 3.44+/-1.59 versus 2.92+/-1.45, P < 0.0007; physical, 3.45+/-1.36 versus 2.96+/-1.20, P < 0.0001; sexual, 3.63+/-2.23 versus 2.49+/-1.95, P < 0.0001). However, logistic regression demonstrated that the only variable found to cause a significant impairment in QoL was menopause. CONCLUSION: Menopause causes a decrease in quality of life, which is independent from age and other sociodemographic variables.

Adult↗

[Knowledge and beliefs of the effect of menopause and estrogenic therapy on health. Study in women attending the Barros Luco-Trudeau Hospital].

The benefits of hormonal replacement therapy are widely known. In spite of this, the proportion of women under treatment is low. The study aims to evaluate the amount of knowledge that patients have, about menopause, and how it influences compliance with therapy. In our study, 494 women attending the outpatient's clinic of Hospital Barros Luco-Trudeau were interviewed; 93.5% considered that menopause has adverse effects upon health; 87.9% believes that it produces emotional disturbances; 55.1% bone-related and 40.9% cardiac problems. Sixty six point eight percent of the consulted women know that there is a treatment for menopause. Half of the women interviewed had consulted the physician specifically for this reason; however, only one third are or were under treatment. Obesity, hirsutism and cancer are considered to be the main secondary effects to treatment. Patients who have not received hormone therapy have a much lower degree of knowledge about menopause than the treated ones, and amongst the latter, those who abandon treatment have less information than the ones that remain under treatment. As a conclusion, we may say that our patients have information about menopause and also that they attend to the physician's office for this reason. The knowledge about the matter and related beliefs influence both adherence to and compliance with therapy.

Adult↗

[Symptomatic profile of the climacteric female. Clinical experience].

UNLABELLED: To describe the symptoms of the climacteric female, 287 climacteric patients had their symptoms evaluated according to the criteria of Blatt-Kupperman for menopause. The median age was 50 years (P10 = 43 and P90 = 58). The main complaint was flushing in 46%, psychiatric symptoms in 17.8% a health examination in 14.6%, osteoporosis in 11.1%, menstrual problems in 6.3%, and other symptoms in 4.5%. Asthenia was a prominent symptom in 82% of patients, followed closely by headache, irritability and depression. Flushing was present in 77% of patients. Symptoms not usually associated to menopause, such as vertigo, palpitations and bone pain were quite prevalent. Only 69% of females were sexually active. Among them, 45% complained of dyspareunia and 58% of decreased or absent libido. The median Blatt index was 27. Working capacity was affected in 87% of patients. CONCLUSION: The menopausal period is associated to many symptoms which may motivate females to consult an internist.

Adult↗

[Menopause: a disease?].

As life expectancy lengthens, the period that women must live deprived of estrogens is also lengthened. Not only does this hormonal deficit produce the known vasomotor symptoms, but it also increases the risk of cardiovascular disease and bone fractures. The fact that replacement therapy using hormones during the postmenopause attenuates these risks has lead to the thought that we might be facing a disease. Moreover, menopause meets the criteria that define disease. In spite of considering that to define menopause as a disease might be daring, we cannot rule it out.

Estrogen Replacement Therapy↗

[Variation of bone density in relation to age: analysis of 259 necropsies].

In a previous study we reported a relatively low incidence of hip fracture in our population compared to figures reported elsewhere and speculated that this could be related to differences in bone density. Accordingly, we measured bone density in 259 subjects at necropsy. In 172 males we found that bone density decreased from 0.88 g/cc at age 21-30 to 0.80 at age 70 (NS). In women, density decreased from 1.0 at age 21-30 to 0.84 at age 50, 0.69 at age 60 and 0.64 in those older than 70 years (p less than 0.01). These figures are higher than those reported from USA at all ages and could explain the lower incidence of hip fractures in our population.

Adult↗

[Postmenopausal women: changes in plasma lipids with different estrogen replacement therapies].

We measured total, HDL and LDL cholesterol and triglycerides in 183 postmenopausal women before and 4 weeks after hormone therapy. Ethinyl estradiol or conjugated estrogens alone or in association with medroxyprogesterone, norethyndrone or norgestrel were used in different dosages either continuously or sequentially. Total cholesterol decreased from 206 to 196 mg/dl and HDL raised from 47 to 53 mg/dl (p less than 0.001) except in the group treated with estradiol-levonorgestrel in which HDL fell from 41 to 36 mg/dl (p less than 0.001). HDL cholesterol decreased from 133 to 113 mg/dl, overall. The total cholesterol/HDL ratio decreased from 4.8 to 4.2 in all groups except the group previously mentioned. Estrogen therapy, isolated or in association to medroxyprogesterone induced a moderate increase in serum triglyceride levels (132 to 149 mg/dl, p less than 0.001). Thus, the administration of estrogens in postmenopausal women is associated with a decrease in total, LDL and total/HDL cholesterol ratio and an increase in triglycerides. Norgestrel but not medroxyprogesterone partially revert these effects.

Adult↗

[Adverse effects of valproic acid in epileptic infants and adolescents].

Although valproic acid as well as its derivatives are effective in the treatment of some epileptic seizures, they are not free of adverse side effects. The purpose of this work was to describe the collateral clinical effects of valproic acid, the associated changes that take place in some serum laboratory parameters, and correlations among these adverse clinical effects, drug serum level and therapeutic response. One hundred patients aged 7 months to 19 years (average 5 year and 6 month old) were followed for at least 13 months. Clinical collateral effects were observed in 14% patients, anorexia and hair loss being the most frequent. One third of patients showed raised serum alkaline phosphatase and transaminases values, while lower than normal prothrombin time and platelet counts were detected in 4% and 1% of patients, respectively. In one patient treatment was interrupted because of low platelet counts which persisted in spite of drug withdrawal, but basal counts were not done, so it is not possible to establish causal relationships between both events. No correlation between adverse clinical symptoms and valproic acid plasma levels was observed. In spite of the fact that basal laboratory values were not known and that abnormal tests were not repeated for confirmation, collateral clinical effects and laboratory findings associated to treatment with valproic acid seemed not severe in this series. Anyway, taking into account drug characteristics, it should always be used with caution.

Adolescent↗