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Biomedical subjects

J W Studd

Publications and source records attributed to J W Studd.

At least 91 records · Page 5Linked to original sources
PubMed1988

Skeletal effects of oral oestrogen compared with subcutaneous oestrogen and testosterone in postmenopausal women.

STUDY OBJECTIVE: To compare oral and implanted oestrogens for their effects in preventing postmenopausal osteoporosis. DESIGN: Non-randomised cohort study of postmenopausal women treated with oral or depot oestrogens and postmenopausal controls. SETTING: Gynaecological endocrine clinic in tertiary referral centre. PATIENTS: Oral treatment group of 37 postmenopausal women (mean age 57.5 years, median 8.75 years from last menstrual period), compared with 41 women given oestrogen implants (mean age 56.2 years, median 9.5 years from last menstrual period) and 36 controls (mean age 51.8 years, median 2.0 years from last menstrual period). Weight was not significantly different among the groups. INTERVENTIONS: Oral treatment group was given continuous treatment with cyclic oestrogen and progesterone preparations (Prempak C or Cycloprogynova) for a median of 8.0 years. Implant group was given subcutaneous implants of oestradiol 50 mg combined with testosterone 100 mg, on average six monthly for a median of 8.5 years. Controls were not treated. END POINT: Significant increase in bone density. MEASUREMENTS AND MAIN RESULTS: Bone density measured by dual beam photon absorptiometry was 1.02 (SD 0.13) g hydroxyapatite/cm2 in implant group versus 0.89 (0.11) in oral group (p less than 0.01) and 0.87 (0.14) in controls (p less than 0.01). Serum oestradiol concentration in implant group was (median) 725 pmol/l versus 170 pmol/l in oral group (p less than 0.01) and 99 pmol/l in controls (p less than 0.01). Serum follicular stimulating hormone was median 1 IU/l (range 1-11) in implant group (equivalent to premenopausal values) versus 43 (4-94) IU/l in oral group (p less than 0.01) and 72 (28-99) IU/l in controls (p less than 0.01). CONCLUSIONS: Subcutaneous oestrogen is more effective than oral oestrogen in preventing osteoporosis, probably owing to the more physiological (premenopausal) serum oestradiol concentrations achieved. It also avoids problems of compliance that occur with oral treatment.

Administration, Oral↗
PubMed1988

A simple method for the diagnosis of premenstrual syndrome by use of a self-assessment disk.

A diagnostic disk based on the obstetric calculator was developed for the self-assessment of menstrual cycle symptoms. The instrument, called the PMT-Cator (Rocket of London, Watford, England) can be used to monitor five symptoms for up to 6 weeks. A set of simple calculations are described inside the disk to determine whether the symptom scores are suggestive of premenstrual syndrome. Results of the PMT-Cator correlate well with those of more complex analysis. The PMT-Cator may have other uses as well.

Female↗
PubMed1988

The prevalence of variation of resting urethral pressure in women and its association with lower urinary tract function.

Variation of resting urethral pressure has been reported and it has been postulated that this is important in the genesis of lower urinary tract symptomatology in women. In order to differentiate between normal and abnormal urethral pressure variations several arbitrary values have been chosen and the prevalence of abnormality in symptomatic women reported. However, large variations in urethral pressure may be seen in healthy, asymptomatic volunteers. We have identified the prevalence of urethral pressure variation in a large group of female volunteers and have shown that "abnormal" urethral pressure variation is not associated with lower urinary tract symptomatology.

Female↗
PubMed1988

Early experience with gamete intrafallopian transfer (GIFT) and direct intraperitoneal insemination (DIPI).

We present our early experience with gamete intrafallopian transfer (GIFT) and direct intraperitoneal insemination (DIPI) combined with intrauterine insemination (IUI), two recently described methods of assisting conception in patients with patent fallopian tubes. Sixty-nine patients (93 cycles) were entered into the study. Thirty-three patients (51 cycles) entered the DIPI/IUI programme and 36 patients (42 cycles) entered the GIFT programme. The mean age, duration and aetiology of infertility were similar in both groups. In the GIFT programme 12 pregnancies occurred, which is a 29% pregnancy rate per cycle and a 33% pregnancy rate per patient. In the DIPI/IUI programme only 3 pregnancies occurred, being a 6% pregnancy rate per cycle and a 9% pregnancy rate per patient. With the live birth rate of in vitro fertilization (IVF) being 12% per embryo transfer, we conclude that GIFT is more successful than either DIPI/IUI or IVF in patients with patent fallopian tubes. Further controlled studies are required to assess the future role of DIPI/IUI in clinical practice.

Adult↗
PubMed1987

Effect of oestrogen and testosterone implants on psychological disorders in the climacteric.

In a double-blind trial oestradiol, oestradiol/testosterone, or placebo implants were assessed for their effects on psychological symptoms in women attending a menopause clinic. After two months, women receiving active treatment scored better than the placebo group on a self-rating scale of distress, on anxiety, and on depression (p less than 0.05). Postmenopausal but not perimenopausal women improved after placebo, and at 4 months the scores in the three groups no longer differed significantly.

Adult↗
PubMed1987

Skin collagen changes in post-menopausal women receiving oestradiol gel.

Sixteen post-menopausal women who had never previously received any hormonal treatment applied Oestrogel cream 1.5 mg/day percutaneously for 1 yr. Skin biopsies were taken from the abdomen and from the lateral aspect of the thigh at 0, 3, 6 and 12 mth, and the changes in skin collagen content were noted. The abdominal skin collagen content increased significantly (P less than 0.001) over the 1-yr treatment period. The thigh skin collagen content also increased, but did not reach significant levels. There was a strong correlation between the change in skin collagen content (in both the abdomen and the thigh) and the original skin collagen content, indicating that the change in collagen content in response to oestrogen therapy is dependent on the original level. There is no further increase once an 'optimum' skin collagen level has been reached.

Administration, Topical↗
PubMed1987

Effects of subcutaneous oestradiol implants on ovarian activity.

The effects of subcutaneous oestradiol implants on ovarian activity were investigated in 14 ovulating premenopausal women. Treatment with either 100 mg or 150 mg oestradiol was combined with cyclical oral norethisterone from days 20 to 26 of the cycle to ensure regular withdrawal periods and prevent endometrial hyperplasia. Ovarian function was monitored by regular pelvic ultrasonography and urinalysis over a period of nine cycles. During the first three cycles after hormone implantation, follicular development continued in almost half the study group, but only one of the women in each treatment group showed signs of follicular rupture and luteinization. By the sixth cycle, over half the women given the lower dose of oestradiol were developing follicles, including a large functional cyst in one, but none of them ovulated. A further implant given early in the seventh cycle was associated with ovarian suppression in all cases. Both doses of implant elevated the excretion of oestrone-3-glucuronide compared to pretreatment. The contraceptive and therapeutic implications of these results are discussed.

Adult↗
PubMed1987

Prophylactic blood transfusion in maternal sickle cell syndromes.

An assessment of the benefits of prophylactic blood transfusion during 51 pregnancies in women with haemoglobin SS, haemoglobin SC and haemoglobin S-beta-thalassaemia in a retrospective study from 1978 to 1984 has failed to demonstrate any clear conclusions as to their efficacy. Of the transfused patients, 22% developed atypical red cell antibodies and 14% had immediate minor transfusion reactions. Our data show no significant difference in fetal or maternal outcome between those patients who were transfused prophylactically and those who were not. A prospective study to clarify the appropriate place of this important aspect of management in women with sickle cell disease in pregnancy is suggested.

Anemia, Sickle Cell↗
PubMed1987

Decline in skin collagen content and metacarpal index after the menopause and its prevention with sex hormone replacement.

The thigh skin collagen content and the metacarpal index were measured in 69 untreated postmenopausal women and in 37 postmenopausal women who had been receiving oestradiol and testosterone implants for 2-10 years. There was a significant positive correlation between the skin collagen content and the metacarpal index in both groups of patients. In the untreated group, there was a statistically significant decrease both in the thigh skin collagen content and in the metacarpal index with the years since the menopause. This decrease was preventable in women who were on sex hormone replacement therapy.

Collagen↗
PubMed1987

A study of the decrease of skin collagen content, skin thickness, and bone mass in the postmenopausal woman.

The skin collagen content, skin thickness, metacarpal index, and forearm bone mineral content in postmenopausal women showed a similar decline of between 1-2% per year after the menopause. All four parameters showed a decline that was significant when compared with the years from the menopause. Significant correlations between all four parameters suggest that a similar pathology causes the decrease in bone mass and skin thickness--a decline in the connective tissue element that is common to both bone and skin.

Bone and Bones↗
PubMed1987

Postmenopausal osteoporosis.

Postmenopausal osteoporosis is a common disabling condition, which is almost completely preventable with oestrogen therapy. Unfortunately unjustified anxiety about the safety of oestrogens still limits the acceptability of this therapy. The role of calcium and the calcium-regulating hormones in the aetiology, prevention and treatment remains unproven.

Aged↗
PubMed1987

Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy.

Collagen is a widespread body constituent that is affected by estrogen status in women. Its decrease after menopause can be prevented and/or restored by estrogen treatment. We explored the effect of four different hormonal replacement regimens on total skin collagen content by measuring hydroxyproline in skin biopsy specimens taken from postmenopausal women. All regimens showed increases in skin collagen levels proportionate to the levels at the start of the treatment. Estrogen replacement therapy is shown to be prophylactic in women who have higher skin collagen levels and both prophylactic and therapeutic in women with lower skin collagen levels.

Administration, Cutaneous↗
PubMed1987

Response of skin thickness and metacarpal index to estradiol therapy in postmenopausal women.

A radiologic method for measuring skin thickness and metacarpal index was used to investigate 41 postmenopausal women treated with estradiol (100-mg) subcutaneous implants (Organon, UK). All the women completed the first six months of the study, and 33 completed one year. Both skin thickness and metacarpal index increased to a statistically significant degree over the one-year period, with most of the increase occurring in the first six months of therapy. Skin thickness showed the largest increases, from a mean of 0.86 mm at the start of the study to 0.97 mm at six months and 1 mm at one year. The metacarpal index increased from a mean of 0.77 at the start of the study to a mean of 0.799 and 0.8 at six months and one year, respectively.

Estradiol↗