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Biomedical subjects

R Lindgren

Publications and source records attributed to R Lindgren.

15 recordsLinked to original sources

The climacteric among South-American women, who immigrated to Sweden and age-matched Swedish women.

Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42-67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.

Adult

Transdermal hormonal replacement therapy with transdermal progestin every second month.

OBJECTIVES: Unopposed estrogen therapy may induce endometrial hyperplasia. To protect the endometrium, estrogen replacement therapy should be combined with a progestin in menopausal women with an intact uterus. The aim of this open non-comparative study was to evaluate the effects on bleeding control and endometrium of 'spacing-out' the 14-day progestin therapy to every second month during transdermal combined hormonal replacement therapy. METHODS: Sixty-eight healthy women, previously treated with sequential combined transdermal hormonal replacement therapy every month for 3 years, were treated for the following 2 years in cycles with 6 weeks of transdermal estradiol 50 micrograms/daily (Estraderm, Ciba-Geigy), followed by 2 weeks of combined norethisterone acetate 0.25 mg/day and 50 micrograms estradiol per day. RESULTS: Annual endometrial biopsies diagnosed hyperplasia in one woman during the second year whereas most biopsies showed a secretory endometrium. Vaginal ultrasound showed no correlation to either bleeding-pattern or histopathological diagnosis. Most women had a regular bleeding-pattern. CONCLUSIONS: Transdermal progestin every second month might be an alternative to regular monthly sequential hormonal replacement therapy.

Administration, Cutaneous

Plasma lipid and lipoprotein effects of transdermal administration of estradiol and estradiol/norethisterone acetate.

To evaluate the effect of transdermal sequential treatment with estradiol and estradiol/norethisterone acetate on lipoprotein metabolism, 25 postmenopausal women received treatment for 12 cycles of 4 weeks each (2 weeks estradiol 50 micrograms/day and 2 weeks a combined patch delivering norethisterone acetate 0.25 mg/day and estradiol 50 micrograms/day). Blood samples for lipoprotein analyses were drawn before treatment and in estrogen and combined phases in cycles 3 and 12. Plasma total cholesterol, low (LDL) and high (HDL) density lipoprotein were all significantly reduced in both estrogen and combined phases. Eighteen of the women continued the treatment for 36 cycles. In this group the HDL-cholesterol had returned to baseline values in combined phase in cycle 24. Plasma cholesterol and LDL-cholesterol values remained significantly reduced throughout the whole study compared to the pre-trial values. The present study by transdermal sequential hormonal treatment results in a lipid and lipoprotein pattern with reduced total cholesterol and LDL cholesterol in postmenopausal women.

Administration, Cutaneous

Endometrial effects of transdermal estradiol/norethisterone acetate.

The efficacy of transdermal norethisterone acetate in sequence with transdermal estradiol has been investigated in a multicenter study of 136 post-menopausal women to determine the incidence of endometrial hyperplasia, the effects on the vaginal cytology and the control of bleeding. Treatment consisted of 12 cycles of 4 weeks each (2 weeks estradiol 50 micrograms/day followed by 2 weeks of a new combined patch delivering norethisterone acetate 0.25 mg/day and estradiol 50 micrograms/day). Endometrial histology was assessed by two pathologists. Of the 136 pre-treatment biopsies 89% provided no material, an inadequate sample or an inactive (atrophic or non-secretory) endometrium. Of the post-treatment biopsies from 110 women who completed the study: 65% showed secretory, 3% proliferative and 24% inadequate material or inactive endometrium. Hyperplasia was found in two biopsies (2%); in one of these focal atypical hyperplasia was agreed by both pathologists, in another a hyperplastic endometrial polyp was diagnosed by one pathologist. The bleeding was regular in 80% of the 1195 cycles and irregular in 11%. No bleeding occurred in 9% of the cycles. Vaginal cytology showed a significant shift towards increased maturation during treatment.

Administration, Cutaneous

Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women.

The long-term effect on aspects of quality of life (QoL) of treatment with transdermal oestrogen for 2 weeks followed by transdermal oestrogen/progestogen norethisterone acetate/oestradiol TTS 0.25/0.05 mg/day for the next 2 weeks was investigated in postmenopausal women within the framework of a 1-year seven-centre trial. Of the 136 women who were included (mean age 53 +/- 4.8 years), 110 completed the study. Aspects of QoL that are of relevance in the perimenopause and postmenopause were evaluated using the Psychological General Well-Being (PGWB) index, the Women's Health Questionnaire (WHQ) and the Sleep Dysfunction Scale before and after 3 and 9 months of therapy in the oestrogen phase. Climacteric complaints were also assessed by means of the Kupperman Index. Improved well-being, i.e. less anxiety and depression, increased vitality and better self-control (P less than 0.0001) were observed, as well as reduced sleep disturbance (P less than 0.0001). The WHQ showed decreased vasomotor and somatic symptoms, and improved sex life, emotions and cognitive function (P less than 0.0001). Improvement was the same at 3 and 9 months. According to the Kupperman Index, climacteric symptoms were alleviated (P less than 0.0001). Relief of vasomotor symptoms was correlated with improvement in the WHQ (r = 0.82), the PGWB index (r = 0.58, P less than 0.0001) and sleep (r = 0.51, P less than 0.0001). Because of the absence of a placebo control group, the results must be regarded with caution until confirmed in a placebo-controlled trial.

Administration, Cutaneous

Does physical exercise influence the frequency of postmenopausal hot flushes?

The frequency of moderate and severe hot flushes was investigated in a group of women (n = 142) who took part in organized physical exercise on a regular basis, and a control group of all women 52 and 54 years old in the city of Linköping, Sweden (n = 1,246). Only women with natural menopause and without a history of hormonal replacement treatment were statistically compared in the study. It appeared that moderate and severe vegetative symptoms with hot flushes and sweatings were only half as common among the physically active postmenopausal women (21.5%) as in the control group (43.8%). Although this could be due to a positive selection of these physically active women, it might also be due to the fact that exercise may affect the mechanisms that elicit hot flushes in peri- and postmenopausal women.

Climacteric

Climacteric symptoms among women aged 60-62 in Linköping, Sweden, in 1986.

By means of a simple postal questionnaire, all women aged 60, 61 and 62 (n = 2015) living in the community of Linköping, Sweden, were screened for vasomotor symptoms and local vaginal complaints. After one reminder, answers were received from 73% of the women. At the time of the survey (April 1986) all the women were post-menopausal, the median period since menopause being 11 yr. Slightly over one in four of the women (27%) were suffering from sweating and hot flushes. Ten percent (10%) of the women who were more than 15 yr post-menopausal still had moderate to severe climacteric symptoms. Vasomotor symptoms were significantly more common among oophorectomized women than among those whose ovaries were intact. Local vaginal symptoms were positively correlated with urinary problems, repeated urinary tract infections and a high risk of disturbance of sexual activity. It was concluded that climacteric symptoms often persist for more than 15 yr after the menopause.

Climacteric

Which fetal growth charts should be used?

Fetal intra-uterine growth charts are generally based on last menstrual period (LMP) data. Such charts may not really be applicable to infants whose gestational age is ultrasonically determined in early pregnancy. 1369 consecutive singleton pregnancies were studied. All fetuses had their gestational age estimated both by ultrasonic measurement of fetal crown-rump length and from registered last menstrual period data. All infants were weighed at birth as a part of the routine care. The age determination according to the two methods differed in 664 out of 1369 cases and in 516 of these 664 cases the age according to LMP was higher than according to CRL--a highly significant difference (p less than 0.001). Mean values for birth weight were found to be larger when correlated to age in terms of CRL determinations than when related to age as calculated from LMP data. Birth weight also showed a significant increase between 40 and 42 weeks when age was determined ultrasonically. This was not the case when age determination was based on LMP data. The explanation of this fact is that age is overestimated in late pregnancy when calculated from LMP data. These facts ought to be considered when future fetal growth charts are constructed.

Birth Weight

Purification of a bovine counterpart to human prealbumin and its interaction with a bovine retinol-binding protein.

A bovine counterpart to human prealbumin was purified from bovine serum by thiol-disulfide exchange chromatography on thiol-Sepharose 4B and affinity chromatography on human retinol-binding protein linked to Sepharose 4B. The bovine prealbumin had alpha1-mobility on agarose gel electrophoresis at pH 8.6. It has the same molecular weight as human prealbumin on gel filtration and consisted of subunits with a molecular weight of 12 500. This is compatible with a tetrameric structure for the bovine protein. Antiserum against human prealbumin cross-reacted with bovine prealbumin and vice versa. The bovine prealbumin formed at high ionic strength complexes with another bovine serum protein which were dissociated at low ionic strength. This property was used to isolate a protein from bovine serum, by chromatography on bovine prealbumin linked to Sepharose which cross-reacted with antiserum against human retinol-binding protein; had a molecular weight of 21 000 and alpha 2-mobility on agarose gel electrophoresis. It was concluded that the latter protein was a bovine retinol-binding protein.

Animals

Antibodies to Chlamydia trachomatis in women with infertility, pelvic inflammatory disease and ectopic pregnancy.

Sixty-three women admitted to the gynecological ward at the University Hospital, Linköping, were studied for the presence of antibodies to Chlamydia trachomatis. 48% of infertile women, 78% of women with ectopic pregnancy and 44% of women with pelvic inflammatory disease had higher titer (greater than or equal to 1:128) IgG/IgA/IgM antibodies to C. trachomatis. Among 55 healthy pregnant women, used as controls, 13% had this high antibody titer. Among 30 women with a titer of greater than or equal to 1:128, 33% of previous conceptions resulted in ectopic pregnancy and 31% resulted in child birth. The corresponding figures among women with no antibodies to C. trachomatis were 12% and 60%, respectively. The prevalence of IgA antibodies varied from 22% to 38% in women with pelvic inflammatory disease, ectopic pregnancy or infertility. The results indicate the importance for C. trachomatis in development of sequelae to lower genital tract infections in women.

Antibodies, Bacterial