[Clinical effects of treatment with phytoestrogens in postmenopausal women]. / Effetti clinici del trattamento con fitoestrogeni in donne in post-menopausa.

AIM AND METHODS: Phytoestrogens are plant substances that have estrogenic properties; they haven't steroid structure but they are heterocyclic phenols and for this reason are similar to 17 ß estradiol from the functional and structural point of view; they compete for the same receptor sites of endogenous estrogens, but with an activating capacity a thousand times lower. For this reason, the isoflavones are an alternative to hormone-replacement treatment: they are prescribed to all those women who cannot be treated with HRT for several contraindications, such as thrombosis or breast tumor familiarity. The aim of our study was to demonstrate the effectiveness of soy isoflavones on menopausal symptoms. RESULTS AND CONCLUSION: In our experience, literature data were confirmed, with a 40% reduction of the vasomotor symptoms after 6 months of treatment. Associated with this improvement, there is also the reduction in the degree of insomnia and depressive symptoms. The musculoskeletal pains, however, are not reduced significantly as no positive change was found on vaginal dryness, a major cause of dyspareunia in postmenopausal period.

Laryngeal cytological aspects in women with surgically induced menopause who were treated with transdermal estrogen replacement therapy.

OBJECTIVE: To investigate the effects of estrogen replacement therapy (ERT) on laryngeal cytology in postmenopausal women. DESIGN: Prospective open clinical trial. SETTING: Outpatient menopausal clinic in the Department of Gynecology, University of Catania, Catania, Italy. PATIENT(S): Eighty-four healthy, surgically postmenopausal women, of whom 48 were treated with ERT and 36 were considered as a control group. INTERVENTION(S): Transdermal E(2) treatment by patches or gel, evaluation of laryngeal cytology with cytobrush by indirect laryngoscopy, and questionnaire for the voice history. MAIN OUTCOME MEASURE(S): Changes in cytologic aspects of laryngeal cells with respect to vaginal cytology by hematoxylin and eosin staining; subjective voice changes. RESULT(S): Sixty-seven women completed the study. Ten women from the ERT group and five from the control group dropped out because of the invasive laryngoscope method; two subjects in the control group were excluded because of pathologies of the vocal cord. Hematoxylin and eosin staining confirmed similar superficial-intermediate aspects of the cells between the laryngeal and the vaginal smears in ERT-treated women. In the control group, both smears showed aspects of atrophy-dystrophy. The ERT group had a subjectively better quality of voice than the control group. CONCLUSION(S): Our study confirms that the larynx is an estrogen target, as are vaginal cells. ERT may provide prevention and treatment of dystrophic pathologies of the vocal cords in postmenopausal women.

Laparoscopy diagnosis of chlamydial salpingitis using a tubal cytobrush.

This is a report of our nontraumatic technique using a tubal cytobrush for epithelial tubal cell recovery during laparoscopy diagnosis of C. trachomatis salpingitis. We performed a three-way laparoscopy in 95 women and inserted a long flexible fallopian tube brush through one of the trocars. This technique showed that it is possible to reach the infection site avoiding vaginal contamination and that sufficient tubal cells can be obtained for isolation of intracellular pathogens. The technique also allowed rapid antigen detection directly on tubal cells by IFA and C. trachomatis isolation on cell culture. Tubal scraping did not cause bleeding or adhesions as later observed in a matched group of women who underwent further laparoscopy during GIFT.

Osteopenia in female beta-thalassemic patients.

Sixty-four women with thalassemia major aged 13-28 years were studied. 49 patients had primary amenorrhea and 15 had secondary amenorrhea. Bone density of the spine was performed using lunar DPX. The Z score was used to evaluate the degree of osteopenia. In 82% of the patients a Z score less than -2 was found. BMD correlated negatively with the duration of amenorrhea and age of thalassemic patients.

Some pharmacokinetic data on miocamycin II. Concentrations in gynaecological tissues.

The gynaecological tissue levels of miocamycin were studied in ten female patients after pre-operative administration. The patients were divided into two groups on the basis of the scheduled sampling time. All the patients received 4200 mg of the drug, divided in 7 tablets of 600 mg each every 8 h, last administration 2 or 3 h before surgery. The tissue levels, obtained by means of the microbiological method (Sarcina lutea 9341), were frequently higher than those obtained in the serum at the same time. Miocamycin reached the highest concentration in the endometrium (2.5 micrograms/g) and the lowest in the vagina (1.1-0.8 micrograms/g).

Efficacy of miocamycin in the therapy of non-specific genital infections (NSGI): non-gonococcal urethritis (NGU) and acute urethral syndrome (AUS).

The therapeutic efficacy of miocamycin against Ureaplasma urealyticum and Chlamydia trachomatis was the object of this study. Two different groups of patients were included in the trial: 40 males and 20 females affected by NGU and AUS respectively. All the patients positive for chlamydiae and/or ureaplasmas received 1200 mg/die of miocamycin for 12 days; a microbiological examination was performed 5 days from the end of the therapy. The therapy with miocamycin caused the resolution of both symptoms and microorganisms present. The use of miocamycin in current therapy could be favourable.

Econazole-polycarbophil, a new delivery system for topical therapy: microbiological and clinical results on vaginal candidiasis.

The aim of this study was to demonstrate that the addition of a bioadhesive polymer to econazole, which increases the duration of the active drug at the site of infection, leads to a greater frequency of negative culture after treatment and probably reduces the recurrence rate of vaginal candidiasis.180 women with vaginal candidiasis were treated with 150 mg vaginal ovules econazole nitrate with (group A) or without (group B) polycarbophil. After 3 days of treatment the negative culture of Candida albicans reached 98.6% in group A and 84.8% in B group, while the overall persistence (C. albicans, C. glabrata, C. krusei, and C. parapsilosis) was 5.6% and 30%, respectively. During a 60-day follow-up, only one case out of 85 (1.2%) in group A reported recurrence while in group B there were 6 out of 63 (9.5%) recurrences. We conclude that, since the women were treated with the same amount of econazole, the better clinical and microbiological results can be attributed to polycarbophil, as confirmed by a significant reduction of recurrences.

Ovarian hyperstimulation: diagnosis and therapy.

The administration of exogenous gonadotropins to induce ovulation is often associated with ovarian hyperstimulation syndrome. The authors discussed the pathophysiological mechanisms involved in such syndrome to suggest a treatment of choice. Moreover the authors reported their related clinical experience carried out on 9 patients suffering from such syndrome. All the patients studied improved 6-19 days after admission and start of treatment (mean 9.5 +/- 4.7 days). The patients were free from pain and general disorders at discharge and at follow up echographic examination revealed a significant reduction in the volume of the ovary.

Two new point mutations at A2062 associated with resistance to 16-membered macrolide antibiotics in mutant strains of Mycoplasma hominis.

We describe two mutants of Mycoplasma hominis PG-21 which show resistance to 16-membered macrolides but susceptibility to lincosamides, obtained by in vitro exposure to increasing doses of josamycin. The 23S rRNA gene showed that each had a mutation (A2062G and A2062T) corresponding to nucleotide 2062 in Escherichia coli, which was associated with the acquired phenotype.

Levels of flurithromycin in female genital tissue.

The levels of flurithromycin in gynecological tissue in 20 female patients were studied after preoperative administration. The tissue flurithromycin levels obtained were comparable to those obtained in serum at 3 and 4 h but were frequently higher than those in serum at 6 and 12 h. Flurithromycin reached the highest concentrations in ovary at 4 h and in endometrium at 6 h.