Efficacy and tolerability of low-dose transdermal estrogen (Oesclim) in the treatment of menopausal symptoms.

OBJECTIVE: To establish the proportion of symptomatic postmenopausal women who can be satisfactorily maintained on a low HRT dose of 25 microg/day 17-beta-estradiol (Oesclim 25 transdermal patches), after 8 weeks of treatment. STUDY DESIGN AND PATIENTS: This was a multicenter open label non-comparative trial. Treatment was initiated with 25 microg/day dosage, which could be increased to 50pg/day if required after 8 weeks, according to clinical evaluation. Sequential treatment with an oral progestogen was also given for > or = 12 days/month in all non-hysterectomized women. The primary criterion for evaluation of efficacy was the proportion of patients who remained on Oesclim 25 after 8 weeks of treatment in comparison to patients requiring Oesclim 50. RESULTS: Sixty-two patients were included in the study and 60 were treated. 88.3% of treated patients [CI: 78.7-94.9] fulfilled the primary criterion, remaining with the Oesclim 25 dosage after 8 weeks of treatment. All clinical menopausal symptoms showed a decrease from baseline to the end of the study. The mean daily number of vasomotor symptoms decreased from 8.2 (+/- 5.6) at baseline, for the entire treated population, to 1.0 (+/- 2.2) and 1.0 (+/- 1.2) at the end of the study in patients remaining with Oesclim 25 and in those requiring Oesclim 50, respectively. At the interim visit, patients in the Oesclim 50 group had a higher number of symptoms than those maintained on Oesclim 25. The global efficacy of the treatment was evaluated as very effective/effective by 93% of all patients and very good/good by investigators for 91% of their patients. Overall 91% of all patients evaluated the global tolerability as very well/well, while investigators rated it very good/good for 97% of their patients. The vast majority of all patients (93%) were very satisfied/satisfied with the trial treatment, and 90% of them were willing to continue the study drug. CONCLUSION: Oesclim low dose (25microg) hormonal transdermal therapy was efficient in management of climacteric symptoms in this 16-week study. The good acceptance of the treatment was associated with its high efficiency and tolerability.

[The results of GnRH analog treatment of endometriosis]. / Wyniki leczenia endometriozy analogami GnRH.

Our study consisted of 146 patients with endometriosis diagnosed during laparoscopy. The age of those women varied from 19 to 43. Pathological changes were classified according to Revised American Fertility Society scale. Numeric scale was also used to evaluate clinical symptoms characteristic to this disease. During the initial laparoscopy biopsies were taken, endometrial implants were coagulated, pelvic adhesions deliberated and endometriomas were enucleated or their wall cut out and coagulated. When endometriosis was histopathologically confirmed the hormonal treatment was undertaken during a period of time from 3 to 6 months depending on the severity of the disease. The patients were treated with 3.6 mg gosereline and 3.75 mg triptorelin monthly or with 400 mcg of naphareline daily. The hormonal therapy was monitored by the concentration of estradiol in blood serum. After full cycle of GnRH analogues treatment laparoscopy was repeated. The mean of The Symptom Severity Scores decreased from 7.1 to 2.1 after the treatment which is a 70% decrease. In the group of women with pain complains 96% of patients noticed improvement, in the group suffering from infertility there were 26.3% of patients who got pregnant. GnRH analogues were good tolerated by patients during the treatment.

[The atherogenic lipid profile parameters and fibrinogen serum concentration in climacteric women under various routes of hormone replacement therapy administration]. / Ocena stezenia aterogennych czynników lipidowych i fibrynogenu w surowicy kobiet stosujacych rózne formy hormonalnej terapii zastepczej w okresie klimakterium.

OBJECTIVES: Influence of various routes of HTR on atherogenic lipid profile parameters and serum fibrinogen concentration was investigated. DESIGN: In 85 women in four groups receiving HRT transvaginally, transdermally, orally and intramuscularly, the total cholesterol, HDL-cholesterol, triglycerides, apoB, apoA, LpA and fibrinogen serum concentration was assessed before treatment and after six month. RESULTS: Most of tested parameters: total cholesterol, LpAI, apoB, LDL cholesterol, non HDL cholesterol, changed favorably (lowered concentration) in group using HRT orally and intramuscularly. CONCLUSION: Orally and intramuscularly route of administration HRT have better cardioprotective effects.

[The efficacy of low estrogen transdermal therapy in climacteric symptoms management]. / Skutecznosc niskodawkowej terapii przezskórnej w usuwaniu objawów klimakterycznych.

The aim of the study was to evaluate the efficacy and tolerability of low doses estrogen transdermal system treatment in management of climacteric symptoms. On the basis of performed researches it seems to be reasonable to start hormonal replacement therapy with the very low dosage of estrogen to achieve sufficient results and avoid side effects.

Lipids in serum of patients with malignant ovarian neoplasms.

OBJECTIVE: In numerous papers, different associations of serum lipids and lipoproteins with neoplastic diseases were found. The aim of our work was to find out associations between levels of 11 serum lipids, lipoproteins and ovarian cancer. METHODS: 25 healthy women and 25 patients with ovarian cancer underwent examinations. Uni- and multivariate analysis of variance and discrimination analysis were used to analyze our results. RESULTS: The analysis demonstrates that ovarian carcinoma is associated with a significant reduction of total cholesterol and its esters in serum and in high density lipoprotein fractions compared to controls. CONCLUSION: It could be shown that using multivariate analysis of variance it is possible to find the optimal set of serum lipid parameters, containing serum esterified cholesterol, serum total cholesterol and high density lipoproteins esterified cholesterol, to differentiate healthy persons from patients affected by ovarian cancer.

Cancer of the larynx in Warsaw and in selected rural areas.

Incidence of the laryngeal cancer especially in males, dramatically increased in Poland. Patterns and time trend of the laryngeal cancer, based on the data from Warsaw Cancer Registry from 1963-1977 have been presented. Tobacco and alcohol consumption in Poland has been discussed considering the observed increase in laryngeal incidence.

Epidemiological evaluation of incidence of lung cancer in inhabitants of Warsaw in the period 1966--1975.

Lung cancer is most frequent in men and occupies the first place among the causes of cancer deaths. In the period 1956--1975 in Poland the incidence rate of lung cancer increased about ten times in men and seven times in women. Analysis of age-specific incidence shows a significant increase in the group age of 35--39 years in men and in 45--49 in women. The absolute increase of incidence of lung cancer, the poor prognosis and the high mortality should call the attention of the whole population to canecerogenic factors, especially the noxious influence of smoking.