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At least 1,279 records · Page 71Linked to original sources
PubMed2004

[Diagnosis of polycystic ovary syndrome].

Polycystic ovary syndrome (PCOS) is the most common endocrine disorders among women in reproductive age, but diagnostic criteria used in clinical practice are still controversial. In 1990 the National Institute of HEALTH (NIH) conference on PCOS recommended that diagnostic criteria should include biochemical evidence of hyperandrogenism and ovarian dysfunction (in the absence of non-classical adrenal hyperplasia) without considering the morphological diagnosis of polycystic ovary by ultrasound as an essential part of the diagnosis. In the Rotterdam PCOS workshop of May 2003, however, PCOS is diagnosed when 2 of the following criteria are recognized: oligomenorrhea and/or anovulation, clinical or biochemical signs of hyperandrogenism, ultrasound findings of polycystic ovary. Further-more, it is underlined that the metabolic study is not necessary for PCOS diagnosis, while it is suggested for "at risk patients" (obesity, diabetes, familiar and obstetrical history) with an oral glucose tolerance test (OGTT). A recent study carried out by our group underlined the role of ultrasound parameter, in particular suggesting a ratio between ovarian stroma area and total area of the ovarian section (S/A), with a cut-off of 0.34, as "gold parameter" for PCOS diagnosis, because it shows high sensitivity and specificity (96.3%, 97.0% for the S/A).

Adult↗
PubMed2004

The treatment of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women in reproductive age. As for the treatment of this disease the lack of a clear etiology for PCOS has led to a symptom-orientated treatment. However, the overall aims of treatment are to induce ovulation for women desiring conception, to reduce androgen levels, to reduce body weight and to reduce long-term health risks of diabetes mellitus and cardiovascular disease. Clomiphene citrate (CC) is recommended as first line treatment for induction of ovulation in patients with PCOS by virtue of its efficacy, safety, and ease of administration. Alternatives for CC-resistant patients include gonadotrophin therapy (better with low-dose step-up protocol) and laparoscopic ovarian diathermy. Recently, recombinant FSH (rFSH) has been introduced in clinical practice and it seems more effective than urinary FSH as demonstrated by a significantly higher number of follicles recruited and embryos obtained with a shorter treatment period. The addition of GnRH-agonist to the stimulation protocol for women affected by PCOS could reduce premature luteinization and increase cycle fecundity. Other drugs under investigation are metformin and cabergoline. Hirsutism is the manifestation of hyperandrogenemia in PCOS. The primary goal of the treatment of hirsutim is central or peripheral androgen suppression using 3 groups of drugs: inhibitors of androgen production (oral contraceptives, GnRH analogues), peripheral androgen blockers (cyproterone acetate, flutamide, finasteride and spironolactone), and insulin-sensitizing agents (metformin). Weight reduction and exercise could also improve not only menstrual disturbances and infertility, but also insulin resistance and its adverse metabolic con-sequences.

Adult↗
PubMed2004

[Von Willebrand disease in women with menorrhagia].

Excessive menstrual bleeding is a common clinical problem in women of reproductive age. Hereditary bleeding disorders, such as von Willebrand disease, may be one of the causes of menorrhagia. The aim of our study was to assess the frequency of von Willebrand disease and other hemostatic defects in women with unexplained menorrhagia and without uterine pathology. Sixty-five women (mean age 31 +/- 8.7, range 18-48 years) presenting with menorrhagia were screened. An inherited bleeding disorder was diagnosed 9 (13.8%) patients; the disorders were von Willebrand disease of mild severity (type 1) in 8 cases (12.3%) and a platelet dysfunction (storage pool disease) in 1. The frequency of bleeding symptoms was higher in patients with an inherited hemostatic defect than in women without bleeding disorder. The results of this study underscore the need for hemostatic evaluation in women with excessive menstrual bleeding and without obvious pelvic abnormality.

Adult↗
PubMed1992

Principles of ultrasound.

Ultrasound is increasingly important as a diagnostic tool in the management of disorders of the female reproductive system. This paper reviews the basic principles of ultrasound to familiarize gynecologists with some of the currently available technology.

Gynecology↗
PubMed2004

Do environmental factors play a role in the aetiology of carcinoma in situ testis and the testicular dysgenesis syndrome?

The hypothesis of the Testicular Dysgenesis Syndrome (TDS), first suggested in 2001, propose that several disorders of the male reproductive system such as infertility, hypospadias, cryptorchidism and testicular cancer are all symptoms of TDS, which is most likely initiated during early foetal development, and may be provoked by external factors such as endocrine disruptors in addition to genetic predisposition. Testicular germ cell tumours (TGCTs), considered the most severe symptom of TDS, have increased in incidence during the last 60 years, to become the most common malignancy in young Caucasian men aged 17-45 years. TGCTs of young men originate from carcinoma in situ (CIS) cells. In the last few years, progress has been made identifying candidate genes involved in the neoplastic development of CIS, which may elucidate the timing of the initiation of CIS, currently thought to originate in foetal life from primordial germ cells or early gonocytes. Histological dysgenetic features are frequently seen in testes affected with the TDS components testis cancer or cryptorchidism. A TDS-like phenotype can be induced in male rats by in utero exposure to high concentrations of dibutyl phthalate (DBP) suggesting that ubiquitously present environmental endocrine disruptors may play a role in the aetiology of human TDS. So far, no animal model has been able to mimick all the symptoms of TDS including TGCTs although CIS-like cells have been found in a spontaneous testicular neoplasm in a rabbit.

Adolescent↗
PubMed1991

[Skin and plumage changes in domestic birds. I. Skin changes].

This study presents modifications of the common integument and specific integumental structures developed during the domestication process of different poultry species. These modifications include dewlaps, variations of the comb, ear lobes, and wattles, size and form variations of the beak, exuberances of the cere and orbital skin, spur defects, loss of the uropygial gland, and crop dilatations. Most skin modifications were genetically manifested by exhibition poultry, and perpetuated by deliberate selective breeding. Several of the skin modifications described severely impair the normal, species-typical way of life of the animals concerned. The range of negative influences exerted by some of the fancy breed characteristics includes physical disabilities as well as disorders in food intake, reproduction, and social behaviour. Additionally, genetic defects and pathogenic predispositions can be found.

Animals↗
PubMed1990

[Maturation of the pituitary-gonadal system in girls born at term with low birth weight].

Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and progesterone have been assayed in 92 girls of 10 to 17 years of age who were term low birthweights and in 114 girls of matched ages who had normal birthweights. The girls with perinatal complications were found to have an aberrant pituitary-gonadal status: an increased FSH and estradiol level in the pubertal phase, relatively early age of menarche, delayed maturation of steroid and ovulatory ovarian function, significant incidence of menstrual disorders. These abnormalities of reproductive maturation are likely to be associated with adverse factors of the antenatal period of ontogenesis.

Adolescent↗
PubMed1985

[Contribution of urology in the interdisciplinary treatment concept of fertility disordered males].

The most important disturbances of male infertility are described in detail. The varicocele is in 30 to 40% the main cause of subfertility. 106 out of 125 patients are operated because of unability to conceive a child. Postoperatively, the results show a significant improvement of the sperm density, total sperm count, sperm morphology and the initial and late forward progression. 26% of the couples were achieve pregnancies. In obstructive azoospermia microsurgical repair is the preferable method. The obstruction, whether developmental or acquired, is most frequently at the epididymal junction. Vasography is performed intraoperative immediately before the planned reconstruction to demonstrate the block. In only 5 of 12 patients microsurgical repair was possible. The other patients had developmental abnormalities or scarring and long-distant obstruction. The diagnostic and therapeutic procedures in erectile impotence are described, 5 patients are operated by implantation of a penile prosthesis. The most important step in prophylaxis of infertility is the treatment of cryptorchidism. The therapy should be closed at the end of the second year of life. The role of testicular autotransplantation in selected cases is discussed. Because of more recent data suggest that a male factor is present in or contribute to as many as 50 per cent of the infertility problems and the urologist has the best training and expertise to examine and to diagnose disorders of the male reproductive tract, he should be at the forefront of treatment of these problems.

Constriction, Pathologic↗
PubMedDate not supplied

New observations on the significance of nipplelike protrusions in the nuclei of endocervical cells.

Nuclear nippling was noted in the endocervical columnar cells in smears taken from women of child-bearing age who were using a progesterone-only contraceptive. The phenomenon occurred most consistently in smears from women who were amenorrheic, a condition indicative of a marked decrease of estrogen activity. These observations do not support the previous explanations linking nuclear nippling to estrogenic stimulation. Close observation of the progress of these nuclear protrusions showed that they represented an arrested attempt at nuclear division, with the inhibition possibly due to the rapid rise of the progestogen level, which may be caused either by the use of progesterone-only contraceptives or by the onset of ovulation. The presence of nuclear nippling in normal smears may thus establish the occurrence of ovulation; its observation in metastatic tumors should indicate that the primary tumor has a columnar cell component.

Adult↗
PubMed1985

Diagnosis of noncardiac chest pain in older patients.

Barium swallow and gallbladder study may reveal esophageal or gastric cancer, esophageal or duodenal ulcer, or gallstones. If serious GI tract disorders such as these are ruled out, the next step is to seek an esophageal source of recurring chest pain. Intraesophageal acid infusion and edrophonium chloride (Tensilon) stimulation can be used in the office to reproduce chest pain secondary to an esophageal disorder. With either test, reproduction of the patient's typical chest pain is positive. About one-third of patients seen in our laboratory with noncardiac chest pain have a positive response.

Aged↗