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PubMed2002

Liver transplantation for Budd-Chiari syndrome.

BACKGROUND: Budd-Chiari syndrome (BCS) is a clinical condition characterized by hepatic venous outflow obstruction secondary to an underlying systemic predisposition to thrombosis. METHODS: We reviewed our experience of 19 adult patients who underwent orthotopic liver transplantation for BCS from April 1988 to May 1999 to assess their long-term outcome and specific complications related to this procedure. RESULTS: Of these patients, 13 presented with chronic and 6 with acute liver failure. At presentation predisposing factors included polycythemia rubra vera in five, an undefined myeloproliferative disorder in four, essential thrombocythemia in two, presence of lupus anticoagulant in one, antiphospholipid antibody positivity in one, post-gestational in one, oral contraceptive pill in one, and idiopathic in four. Five patients had undergone previous porto-systemic shunt. Of the 19 patients, 16 are alive at a median follow-up of 89 months (range 1-119) with 2 patients developing disease recurrence at 4 months and 7 years posttransplant, respectively. Four patients have been retransplanted: one for progressive graft dysfunction due to nodular regenerative hyperplasia secondary to azathioprine toxicity, two for hepatic artery thrombosis (one soon after and the other 47 months posttransplant), and one for recurrent BCS. Three patients have died: one from an intra-abdominal bleed secondary to acute hemorrhagic pancreatitis 8 years posttransplant, another from acute myeloid leukemia at 6 years posttransplant, and the third patient from graft failure secondary to severe rejection 1 month posttransplant. CONCLUSION: Liver transplantation for BCS provides good long-term survival with acceptable morbidity. Long-term survival may be prejudiced by progression of the underlying hematological disorders.

Actuarial Analysis↗
PubMed2000

Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea.

BACKGROUND: Dysmenorrhoea is the occurrence of painful menstrual cramps of uterine origin and is a very common gynaecological complaint. Medical therapy for dysmenorrhoea includes oral contraceptive pills (OCP) and nonsteroidal anti-inflammatory drugs (NSAIDS) which both act by suppressing prostaglandin levels. While these treatments are very successful there is still a 20-25% failure rate and surgery has been an option for cases of dysmenorrhoea that fail to respond to medical therapy. Uterine nerve ablation (UNA) and presacral neurectomy (PSN) are two surgical treatments that have become increasingly utilised in recent years. These procedures both interrupt the majority of the cervical sensory nerve fibres, thus diminishing uterine pain. Uncontrolled studies have supported the use of these procedures for primary dysmenorrhoea however both operations only partially interrupt some of the cervical sensory nerve fibres in the pelvic area; therefore dysmenorrhoea associated with additional pelvic pathology may not always benefit from this type of surgery. OBJECTIVES: To assess the effectiveness of surgical interruption of pelvic nerve pathways as treatment for primary and secondary dysmenorrhoea, and to determine the most effective surgical treatment. SEARCH STRATEGY: Electronic searches of the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials, MEDLINE, and EMBASE were performed to identify relevant randomised controlled trials (RCTs). Attempts were also made to identify trials from citation lists of review articles and handsearching. In most cases, the first or corresponding author of each included trial was contacted for additional information. SELECTION CRITERIA: The inclusion criteria were randomised comparisons of surgical techniques of interruption of the pelvic nerve pathways (both open and laparoscopic procedures) for the treatment of primary and secondary dysmenorrhoea. The main outcome measures were pain relief and adverse effects. DATA COLLECTION AND ANALYSIS: Seven RCTs were identified that fulfilled the inclusion criteria for this review. One trial (Sutton 1994) was excluded because another treatment was given in combination with destruction of pelvic nerve pathways and the effects of these two treatments could not be separated. Of the remaining six trials, three were included in the meta-analysis (Chen 1996, Candiani 1992, Lichten 1987). The results of the other three trials (Dover 1999, Tjaden 1990, Vercellini 1997) were included in the text of the review for discussion because the data were not available in a form that allowed them to be combined in a meta-analysis. MAIN RESULTS: For the treatment of primary dysmenorrhoea there is some evidence of the effectiveness of uterine nerve ablation (UNA) when compared to a control of no treatment. The comparison between UNA with presacral neurectomy (PSN) for primary dysmenorrhoea showed no significant difference in pain relief in the short term, however long term PSN was shown to be significantly more effective. For the treatment of secondary dysmenorrhoea the identified RCTs addressed only endometriosis. The treatment of UNA combined with surgical treatment of endometrial implants versus surgical treatment of endometriosis alone showed that the addition of UNA did not aid pain relief. For PSN combined with endometriosis treatment versus endometriosis treatment alone there was also no overall difference in pain relief, although the data suggests a significant difference in relief of midline abdominal pain. Adverse events were significantly more common for presacral neurectomy, however the majority were complications such as constipation, which may spontaneously improve. REVIEWER'S CONCLUSIONS: There is insufficient evidence to recommend the use of nerve interruption in the management of dysmenorrhoea, regardless of cause. Future RCTs should be undertaken.

Adult↗
PubMed2001

Mifepristone as a late post-coital contraceptive.

This study was undertaken to assess the efficacy of mifepristone as a post-coital contraceptive beyond 72 h and up to 5 days in women who found the intrauterine contraceptive device (IUCD) unacceptable. During a 2 year period 219 consecutive women fulfilling the inclusion criteria and presenting late for emergency contraception were approached and offered a choice of methods. Fifteen (6.8%) women wished to have the IUCD fitted, but 204 (93.2%) who found this unacceptable were offered and accepted mifepristone 200 mg. In one woman there was a technical problem fitting the IUCD and mifepristone was administered. Women who had mifepristone were younger (mean age 21.4 versus 26.9 years, P = 0.004) and more likely to be nulliparous (81 versus 25 %, P < 0.001) than the IUCD group. A total of 155 (75.6%) women who had mifepristone and all 14 who had the coil fitted were followed up. There were no true failures in either group. There was one user failure in the mifepristone group, where pregnancy occurred from an act of intercourse subsequent to treatment, giving a crude pregnancy rate of 0.65%. Mifepristone prevented 85% of expected pregnancies. Most women find the IUCD an unacceptable method of post-coital contraception. Mifepristone is an effective late post-coital contraceptive, which can be offered to women who decline the IUCD.

Adult↗
PubMed1997

A multicenter, uncontrolled clinical investigation of the contraceptive efficacy, cycle control, and safety of a new low dose oral contraceptive containing 20 micrograms ethinyl estradiol and 100 micrograms levonorgestrel over six treatment cycles.

The aim of the trial was to demonstrate the contraceptive efficacy of a new low dose oral contraceptive containing 20 micrograms ethinyl estradiol and 100 micrograms levonorgestrel and to observe cycle control and safety. Data from 805 treated women resulted in 4400 treatment cycles. One pregnancy occurred while on the trial medication as a result of method failure, resulting in a Pearl index of 0.29. Cycle control was good, and cycle length as well as duration and intensity of withdrawal bleeding were not significantly changed during the trial. Intermenstrual bleeding usually occurred as spotting and decreased considerably during the treatment phase. Spotting alone was reported in 12.4% of cycles, breakthrough bleeding alone in 4.5% of cycles, and breakthrough bleeding and spotting together in 1.4% of treatment cycles. The rate of absence of withdrawal bleeding declined throughout the trial to 2.4% in cycle 6. There were no serious adverse events related to treatment, and most adverse events were those commonly observed in clinical trials with oral contraceptives. Headache, breast tension, and nausea were reported by 17.3%, 11.0%, and 7.7% of the women, respectively. There were no clinically relevant changes in laboratory parameters, blood pressure, or weight. In this trial, the new low dose oral contraceptive containing 20 micrograms ethinyl estradiol and 100 micrograms levonorgestrel was shown to be effective, safe, and well tolerated. Cycle control was found to be good and there was a low incidence of adverse events.

Adolescent↗
PubMed1979

Contraceptive properties of endotoxin in rabbits.

Endotoxin derived from Salmonella enteritidis-Boivin at a dose of 20 micrograms/kg intravenously interfered with follicular rupture normally induced by human chorionic gonadotropin (hCG) in rabbits. This action was greatest when the endotoxin was given 5 to 6 hours after the administration of hCG. The failure of follicular rupture resulted in entrapment of ova. Endotoxin (5 micrograms/kg) given intravenously to rabbits on day 4 of pregnancy resulted in failure of implantation. Indomethacin (2 micrograms/kg) given intramuscularly concomitantly was unable to reverse this action. Endotoxin (5 micrograms/kg) given intravenously to rabbits on day 8 of pregnancy had an immediate lethal action on embryonic development, and this effect was inhibited by concomitant indomethacin treatment. Nevertheless, most fetuses died after the indomethacin treatment. Whether this was due to a direct toxic action of indomethacin or to a secondary action of endotoxin not blocked by indomethacin is not clear. Endotoxin did not exert its antifertility actions through a luteolytic mechanism.

Animals↗
PubMed2002

[Tolerance and acceptability of Norplant contraceptive devices].

OBJECTIVES: Norplant implants have been used for long-lasting contraception in Senegal since 1986. The purpose of this work was to assess tolerance and acceptability of the method among Senegalese women. MATERIAL AND METHODS: A prospective non-comparative study including 300 women was undertaken in the Obstetrics and Gynecology Clinic at the University Teaching Hospital A Le Dantec of Dakar between December 1986 and July 1991. Women meeting inclusion criteria were seen at 1 month, 3 months, and 6 months after insertion then every 6-month until device removal. RESULTS: The mean age of women was 31.3+/-5.45 years and mean parity was 4.7+/-2.45. Almost half of the women no longer desired pregnancy and 67.6% of the women who had not used contraceptive method the month before admission decided to use Norplant. During follow-up visits, 45.2% had menstrual side effects mainly amenorrhea 23.4% and irregular bleeding 12.5%. Non-menstrual side effects were local reactions at the implant site (19.9%). The other side effects were dizziness, asthenia, insomnia, anemia, and high blood pressure and weight change. Overall, 58.8% of the women kept their implants and had them removed after 5 years of use. The failure rate was 3.3+/-1.25. At the end of five years of use, satisfaction was 84.8% and nearly two-thirds of the women decided to recommend Norplant to a friend or relative or to use it again. CONCLUSION: Norplant is a method of choice among the range of contraceptive methods available in Senegal. Because of its advantages and its ease of use, Norplant could be a widely used method in Senegal.

Adolescent↗
PubMed1978

Assessment of ovarian function in perimenopausal women after stopping oral contraceptives.

Ovarian function was assessed by measuring plasma gonadotrophins, urinary oestrogen and urinary pregnanediol levels, every week for four weeks, in 34 women, aged 45 to 57 years, after withdrawal of oral contraceptive therapy. A rise in urinary pregnanediol excretion occurred in 14 patients suggesting that ovulation had occurred and that these patients were "premenopausal". Elevated serum gonadotrophin values and persistently low urinary oestrogen and pregnanediol excretion occurred in 13 patients suggesting ovarian failure or a "postmenopausal" state. However, one apparently "postmenopausal" patient later showed hormonal evidence of ovulation, indicating fluctuation in ovarian function. There were 7 patients with "indeterminate" hormone profiles whose ovarian function was difficult to assess. All patients excreting more than 45 nmol of oestrogen a day had a spontaneous period within 45 days of stopping hormone therapy.

Adult↗
PubMed1997

A fifteen-year review of female sterilization by minilaparotomy under local anesthesia in Kenya.

This paper is a comprehensive review of literature concerning the Kenyan experience with female sterilization through minilaparotomy under local anesthesia (ML/LA). A composite picture from analysis of several studies that include some 12,000 clients since 1979 reveals an average Kenyan user to be 31-34 years old (SD 4.9) with 5.9-6.8 children (SD 1.7-1.8). In up to 96% of cases, the indication for choosing sterilization is personal socio-economic considerations. The majority of clients (97%-99%) report satisfaction with their choice of sterilization at the first follow-up visit, and 96-99% state that they would recommend the method to others. The operation takes an average of 14 min (SD 4.5-5.3) "skin-to-skin" through a 2.5.2.8 cm incision (SD 0.5). A mean of 18 cm3 of 1% lignocaine is used (SD 2.7). Most clients (76.4%) have no post-operative complaints; those who do have any complaints report minor transitory problems. Similarly, most clients (96%) have moderate, little, or no peri-operative pain, but 1.9%-5% report much pain. The intra-operative and early complication rate is 0.9%. Some 3.3% of clients suffer at least one complication, some multiple, and the complication rate at 6 weeks is 4.1%, with major complications occurring in 0.7% of cases, and minor complications in 3.4%. The crude failure rate is 0.4% in the first year and 0.1% in the second year, when corrected for luteal phase pregnancies, which account for 50% of all "failures," the actual failure rate is 0.2% in the first year and 0.1% in the second year both for interval and postpartum procedures. This literature review finds outpatient ML/LA to be a relatively safe, simple, effective, and well-accepted option for most Kenyan couples seeking contraception that is intended to be permanent. Counseling, adequate client assessment, and voluntarism have been shown to be essential elements, not only for client satisfaction and avoidance of possible future regret, but also for technical ease of the operative procedure. Recommendations that derive from the Kenya experience are made.

Female↗
PubMed1980

[Family planning-the pill or natural method of birth control (author's transl)].

Observations made at the Family Planning Clinic and a review of the literature show that there is no increased tendency towards the natural contraceptive method among advice-seeking couples. On the contrary-apart from a few exceptions-the most effective method is always chosen. The natural method presupposes a high degree of motivation, of readiness to communicate and of clarification. These prerequisites underly the relatively high rate of failure because not all couples have the right degree of understanding. Nevertheless, to many people this method is the only acceptable and morally justifiable one. Thus, precise and detailed instructions and frequent check-ups would be necessary especially during the first few months, until adequate experience is gained.

Body Temperature↗
PubMed2001

Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial.

CONTEXT: Oral contraceptive (OC) pills are effective, but poor compliance increases rates of pregnancy during treatment. OBJECTIVE: To compare the contraceptive efficacy, cycle control, compliance, and safety of a transdermal contraceptive patch and an OC. DESIGN: Randomized, open-label, parallel-group trial conducted October 1997 to June 1999. SETTING: Forty-five clinics in the United States and Canada. PARTICIPANTS: A total of 1417 healthy adult women of child-bearing potential. INTERVENTIONS: Participants were randomly assigned to receive a transdermal contraceptive patch (n = 812) vs an OC (n = 605) for 6 or 13 cycles. Patch treatment consisted of application of 3 consecutive 7-day patches followed by 1 patch-free week. MAIN OUTCOME MEASURES: Overall and method-failure Pearl Indexes (number of pregnancies/100 person-years of use) and life-table estimates of the probability of pregnancy were calculated. Cycle control, compliance, patch adhesion, and adverse events were also assessed. RESULTS: Overall and method-failure Pearl Indexes were numerically lower with the patch (1.24 and 0.99, respectively) vs the OC (2.18 and 1.25, respectively); this difference was not statistically significant (P =.57 and.80, respectively). The incidence of breakthrough bleeding and/or spotting was significantly higher only in the first 2 cycles in the patch group, but the incidence of breakthrough bleeding alone was comparable between treatments in all cycles. The mean proportion of participants' cycles with perfect compliance was 88.2% (811 total participants, 5141 total cycles) with the patch and 77.7% (605 total participants, 4134 total cycles) with the OC (P <.001). Only 1.8% (300/16 673) of patches completely detached. Both treatments were similarly well tolerated; however, application site reactions, breast discomfort, and dysmenorrhea were significantly more common in the patch group. CONCLUSION: The contraceptive patch is comparable to a combination OC in contraceptive efficacy and cycle control. Compliance was better with the weekly contraceptive patch than with the OC.

Administration, Cutaneous↗
PubMed2005

Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea.

BACKGROUND: Dysmenorrhoea is the occurrence of painful menstrual cramps of uterine origin and is a very common gynaecological complaint with negative effect on a sufferer's quality of life. Medical therapy for dysmenorrhoea includes oral contraceptive pills (OCP) and nonsteroidal anti-inflammatory drugs (NSAIDs) which both act by suppressing prostaglandin levels. While these treatments are very successful there is still a 20 to 25% failure rate and surgery has been an option for such cases. Uterine nerve ablation (UNA) and presacral neurectomy (PSN) are two surgical treatments that have become increasingly utilised in recent years due to advances in laparoscopic procedures. These procedures both interrupt the majority of the cervical sensory pain nerve fibres. Observational studies have supported the use of these procedures for primary dysmenorrhoea. However, both operations only partially interrupt the cervical sensory nerve fibres in the pelvic area and, therefore, this type of surgery may not always benefit women with dysmenorrhoea. OBJECTIVES: To assess the effectiveness of surgical interruption of pelvic nerve pathways as treatment for primary and secondary dysmenorrhoea, and to determine the most effective surgical treatment. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (searched 9 June 2004), CENTRAL (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to Nov 2003), EMBASE (1980 to Nov 2003), and CINAHL (1982 to Oct 2003). Attempts were also made to identify trials from the metaRegister of Controlled Trials and the citation lists of review articles and included trials. In most cases the first or corresponding author of each included trial was contacted for additional information. SELECTION CRITERIA: The inclusion criteria were randomised comparisons of surgical techniques of interruption of the pelvic nerve pathways (using both open and laparoscopic procedures) for the treatment of primary and secondary dysmenorrhoea. The main outcome measures were pain relief and adverse effects. DATA COLLECTION AND ANALYSIS: Eleven randomised controlled trials (RCTs) were identified that initially appeared to fulfil the inclusion criteria for this review. Two trials were subsequently excluded (Garcia Leon 2003; Sutton 1991). Of the remaining nine trials, eight were included in the meta-analysis. The results of one trial were included in the text of the review for discussion because the data were not available in a form that allowed them to be combined in the meta-analysis. Five trials investigated laparoscopic uterine nerve ablation (LUNA), two trials laparoscopic presacral neurectomy (LPSN) and two open presacral neurectomy (PSN). MAIN RESULTS: For the treatment of primary dysmenorrhoea there was some evidence of the effectiveness of laparoscopic uterine nerve ablation (LUNA) when compared to a control or no treatment. The comparison between LUNA and laparoscopic presacral neurectomy (LPSN) for primary dysmenorrhoea showed no significant difference in pain relief in the short term; however, long-term LPSN was shown to be significantly more effective than LUNA. For the treatment of secondary dysmenorrhoea six identified RCTs addressed endometriosis and one included women with uterine myomas. The treatment of LUNA combined with surgical treatment of endometrial implants versus surgical treatment of endometriosis alone showed that the addition of LUNA did not aid pain relief. For PSN combined with endometriosis treatment versus endometriosis treatment alone there was an overall difference in pain relief although the data suggests this may be specific to laparoscopy and for midline abdominal pain only. Adverse events were significantly more common for presacral neurectomy; however, the majority were complications such as constipation, which may spontaneously improve. AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend the use of nerve interruption in the management of dysmenorrhoea, regardless of cause. Future methodologically sound and sufficiently powered RCTs should be undertaken.

Adult↗
PubMed1995

Amidolytic assay of factor XI in human plasma--significance of kallikrein for the activity measured.

Factor XI (FXI) deficiency is associated with an abnormal bleeding state. The extent of bleeding does not correlate well with the plasma concentration of FXI, and it has been suggested that also unknown factors interfere with the bleeding tendency. In a recent paper (Thromb. Res. 74, 477-485, 1994) we found that FXIa activated in human plasma was present in association with part of factor XIIa (FXIIa) and part of kallikrein, influencing their functional activities. Should the activity level of FXIa also be altered by the other contact factors this might provide one approach to the problem of the failure of assays of FXIa to correlate with bleeding tendency. In the present study we have developed an assay procedure for FXIa based on its amidolytic (S-2366) activity, and allowing at the same time a quantification of the amount of FXIa associated to kallikrein. The total amidase activity obtained was separated into two main fractions by use of soybean trypsin inhibitor (STI), corn inhibitor (CI) and lima bean trypsin inhibitor (LTI). One fraction contained free FXIa which could be specifically blocked by LTI. An inhibitor resistant fraction was found to contain FXIa inactive in association with kallikrein. The content of FXIa could be assessed in experiments with mixtures of normal plasma and plasma deficient in prekallikrein, and was taken into account in the calculations. This fraction increased during storage of plasma at -70 degrees C. To obtain stable and comparable assay conditions the method was based on plasma stored for at least four weeks. The specificity of the method was verified by parallel radial immunodiffusion tests. The results imply that the activity level of FXIa is dependent on kallikrein present. If the experimental results has relevance to the situation under physiological conditions, they indicate one possible cause of the failure of assays of FXI to correlate with bleeding tendency.

Adult↗
PubMed2003

Survey of IUD replacing status in Sichuan, PR China.

To investigate the status of copper-bearing intrauterine device (IUD) replacing inert IUD in Sichuan Province, cluster random sampling method was adopted for the survey. Questionnaires were completed and IUD were inspected through ultrasound among 12,804 subjects of 15 counties, who were inserted an IUD from 1994 to 1998. The insertion rate of copper-bearing IUD was 42.1%, in a gradually increasing trend; it was lower in mountain areas than in plain and hilly areas and increased after induced abortion and previous IUD failure. Some factors, such as lower pregnancy rate, lower expulsion rate and easy removal, etc., contributed to copper-bearing IUD use. On the other hand, other factors like longer contraception period, lower side effects and lower cost contributed to inert IUD use. The results show that the adoption of copper-bearing IUD is increasing, but those factors influencing copper-bearing IUD replacement should not be neglected.

Adolescent↗
PubMed1997

Diagnosis and therapy of hyperandrogenism.

Diagnostic categories in hyperandrogenism include polycystic ovary syndrome (PCOS) and its variants, adrenal and ovarian steroidogenic enzyme deficiencies, adrenal and ovarian androgen secreting tumours and other endocrine disorders such as hyperprolactinaemia, Cushing syndrome and acromegaly. About 95% of hyperandrogenic women will have PCOS. Endometrial hyperplasia can be prevented in hyperandrogenic, anovulatory women by the oral contraceptive pill or progestins. Hirsutism is best treated by a combination of the oral contraceptive pill and an anti-androgen. The first line of therapy for ovulation induction is clomiphene citrate, with human menopausal gonadotrophins (hMG) or laparoscopic ovulation induction reserved for clomiphene failures. hMG together with gonadotrophin-releasing hormone agonist may decrease the risk of spontaneous abortion following ovulation induction in PCOS. Weight loss should be vigorously encouraged to ameliorate the metabolic consequences of PCOS.

Androgen Antagonists↗
PubMed2001

Unmet need for reproductive health in India.

Using data from the National Family Health Survey of 1992-93 and the individual reproductive histories of a cross-section of 70 women from rural Tamil Nadu, this paper exposes the limited extent to which women in India have been able to achieve their reproductive intentions and the failure of health services to meet their considerable reproductive health needs. Of the 70 women, 69 had been unable to achieve their reproductive intentions, not only non-users of contraception but also ever-users, and all 69 had an unmet need for reproductive health services. Sterilisation is often the first and only method of contraception taken up and only after a series of wanted, mistimed and unwanted pregnancies, miscarriages, induced abortions and neonatal and infant deaths. Women who wanted to have more children than they were able to were also found. Given the paradigm policy shift in India from promoting fertility reduction only to meeting women's reproductive and sexual health needs, a more useful concept for measuring 'unmet need' for services in programme planning is required, one such as the HARI index, that would capture the extent to which individual women are achieving their reproductive intentions in good health. Without this, the same problems will only recur in younger women.

Birth Intervals↗
PubMed2002

Carbohydrate-deficient transferrin levels reflect heavy drinking in alcohol-dependent women seeking treatment.

BACKGROUND: Carbohydrate-deficient transferrin (CDT) is a biochemical marker that has been shown to be sensitive in detecting heavy drinking in men, but studies examining CDT in women have been inconsistent because of small sample sizes and failure to consider hormonal status. In healthy female subjects, CDT levels are significantly higher in premenopausal women with higher estradiol (E2) levels (>30 pg/ml) and those taking exogenous estrogens (oral contraceptives, hormone replacement therapy) compared with men and postmenopausal women. This study examined the relationship between drinking behavior and CDT levels in a large sample of alcohol-dependent women and contrasted findings in a comparison group of alcohol-dependent men. The study also examined the extent that E2 levels mediated the relationship between CDT levels and heavy drinking in the alcohol-dependent women. METHODS: This study examined the association between CDT level at treatment entry and alcohol consumption the month before initiating treatment in 96 women with a DSM-III-R diagnosis of alcohol dependence, as compared with similar data in 123 male alcoholics. To explore the relationship between E2 and CDT, E2 was measured in women at the time of CDT sampling. Linear regression was used to examine whether patterns of alcohol consumption in the 28 days before the CDT blood sampling predicted the CDT level in women and men presenting for treatment for alcohol dependence. RESULTS: CDT levels were higher in women than men and were related to quantitative alcohol consumption (total standard drinks, percentage of days drinking, percentage of days of heavy drinking) in the month before initiating treatment, irrespective of E2 levels in women. CONCLUSIONS: These results suggest that in a larger sample of female alcoholics, the amount of alcohol consumed predicted CDT, similar to what has been reported in male alcoholics. The E2 status did not seem to mediate these results.

Adult↗