By means of pelvic ultrasonography, a multifollicular ovarian appearance was observed in women with weight-loss-related amenorrhoea. Multifollicular ovaries (MFO) are normal in size or slightly enlarged and filled by six or more cysts 4-10 mm in diameter; in contrast to women with polycystic ovaries (PCO), stroma is not increased. Unlike PCO patients, women with MFO were not hirsute and serum concentrations of luteinising hormone and follicle stimulating hormone were normal and decreased, respectively. The uterus was small indicating oestrogen deficiency. In MFO, treatment with gonadotropin releasing hormone (LHRH) induced ovulation in 83% of cycles and there were seven pregnancies in 8 women; in PCO, only 40% of cycles were ovulatory and there were eleven pregnancies (8 women) but six of these aborted. In MFO ovarian morphology reverted to normal in ovulatory cycles, whereas in PCO the polycystic pattern persisted despite the presence of a dominant follicle. MFO may represent a normal ovarian response to weight-related hypothalamic disturbance of gonadotropin control.

Amenorrhea↗

PubMedDate not supplied

Intrafallopian egg replacement without IVF back-up.

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Adult↗

PubMedDate not supplied

A decision aid for women at increased risk for ovarian cancer.

This paper reviews changes that have occurred within and without the medical profession that have fostered an increasing demand for decision aids as adjuncts to practitioners' counseling to prepare patients for decision making. In the absence of data on the efficacy of ovarian cancer screening and prophylactic strategies, decisions about optimal care are difficult for both women and their doctors. Because surveillance and preventive options are an area of great uncertainty, a decision aid has been developed specifically aimed at facilitating decisions involving ovarian cancer risk management options. This was achieved by reviewing and integrating the available literature on models of medical decision making, patient preferences for information and involvement in decision making, the utility of decision aids, and management options for ovarian cancer risk. Findings indicate that patients wish to be informed participants in the decision-making process and that decision aids are an acceptable and effective method of providing quality information in a format that facilitates an inclusive model of shared decision making. A decision aid designed for women at increased risk of ovarian cancer that facilitates informed decision making may be a valuable addition to patient support. A randomized controlled trial of this type of educational material will provide timely and much needed evidence on its acceptability and efficacy.

Adult↗

PubMedDate not supplied

New ceramics-related industry implicated in elevated blood lead levels in children.

Elevated lead levels have been implicated as a cause of a variety of health problems in children. Blood lead, erythrocyte protoporphyrin, and hemoglobin levels were measured for family members of workers exposed to lead borosilicate dust in a capacitor and resistor plant in Colorado. Previous studies in other lead-related industries have shown an increased risk of lead poisoning among workers' children through exposure to dust brought home on work clothes. Eighty-nine family members of 41 exposed workers were tested along with 62 family members of 30 unexposed comparison households. The mean blood lead level in the family members of exposed workers was significantly elevated compared with that of the unexposed group (10.2 vs. 6.2 micrograms/dl, p = .0001).

Adolescent↗

PubMedDate not supplied

Physiologic responses to maximal treadmill and deep water running in men and women.

Maximal physiologic responses to treadmill running and deep water running using a flotation device were compared in 12 trained men and 12 trained women. Although the men had significantly higher ventilation volumes, VO2max (liters of oxygen per minute and milliliters of oxygen per kilogram per minute), there were no significant differences in maximal heart rates or respiratory exchange ratios between the sexes. Significantly lower ventilation volumes, VO2max (LO2.min-1 and mlO2.kg-1.min-1), and heart rates were obtained in response to maximal water running compared to treadmill running, regardless of gender. Neither the men's nor women's maximal respiratory exchange ratios were significantly different between modes. The analysis of variance indicated that there were no significant interactions for any of the maximal responses to the tests between the sexes. The magnitude of these differences is similar to that found between treadmill running and cycling ergometry and should not preclude deep water running as a training technique. Caution, however, is advised if the training intensity is to be prescribed on the basis of land-determined heart rates.

Adult↗