Objective. To assess chances of adequate cyto- colposcopic follow- up after laser conization performed in postmenopausal screening population by the evaluation of postoperative cervical stenosis and unsatisfactory col...Objective. To assess chances of adequate cyto- colposcopic follow- up after laser conization performed in postmenopausal screening population by the evaluation of postoperative cervical stenosis and unsatisfactory colposcopy rates. Patients and methods. One thousand two hundred eighteen patients were submitted to laser CO2 conization for cervical intraepithelial neoplasia (CIN). Incidence and risk factors for cervical stenosis and unsatisfactory follow- up were retrospectively evaluated comparing fertile with postmenopausal patients. Results. Global incidences of postoperative unsatisfactory colposcopy and cervical stenosis were 46.2% and 7.1% . These rates were higher in postmenopausal patients compared with fertile ones, revealing a statistical correlation between unsatisfactory follow- up and postmenopausal status at the time of conization. Association between CIN relapse and cervical stenosis was significantly higher in postmenopausal group (66.7% vs. 8.6% ; P < 0.05), where two cases of recurrence were detected only after hysterectomy, because of an insurmountable cervical stenosis. Univariate and multivariate analysis revealed HRT use as the only significant factor in influencing postoperative cervical stenosis. Conclusion. Conization is still considered as the standard treatment for CIN at any woman’ s age, when excisional management is indicated, but all postmenopausal patients should be counseled about the possibility of postoperative stenosis that could exclude an adequate follow- up, configuring a failure of the conservative treatment. HRT use is associated with a low risk of stenotic complications; therefore, if possible, users should be encouraged to continue therapy at least 1 year after laser conization.展开更多
This is a preliminary study investigating the efficacy of aromatase inhibitor anastrozole in treating endometrial hyperplasia in obese postmenopausal women. We administered anastrozole for 12 months to 11 obese postme...This is a preliminary study investigating the efficacy of aromatase inhibitor anastrozole in treating endometrial hyperplasia in obese postmenopausal women. We administered anastrozole for 12 months to 11 obese postmenopausal women with high operative risk, in order to treat endometrial hyperplasia (four simple, five complex and two atypical). Endometrial thickness in all cases and histology too in the two cases with atypia, revealed atrophical endometrium during treatment and additional mean follow- up of 10.2 months. The safety and tolerance profile was satisfactory. Anastrozole appears to be an interesting new modality for the treatment of endometrial hyperplasia in obese postmenopausal women.展开更多
Objective: This study shows the effect of hormone replacement therapy(HRT), using oral estrogen exclusively or in combination with progestin, on platelet activation in healthy menopaused women. Background: Recent evid...Objective: This study shows the effect of hormone replacement therapy(HRT), using oral estrogen exclusively or in combination with progestin, on platelet activation in healthy menopaused women. Background: Recent evidence from studies of postmenopausal HRT in healthy women demonstrated a short-time increased risk of coronary heart disease. Platelet activation, which generates vasoconstrictory thromboxane A2(TxA2), has been related to the risk of cardiovascular diseases. Methods: Bymeans of a placebo-controlled study twenty-seven postmenopausal patients were continuously orally administered estrogen in combination with progestin or estrogen exclusively for an 8-week period. Platelet activation was evaluated by flow cytometric P-selectin expression and by enzyme immunoassay plasmatic TxA2(TxB2) concentrations. Results: P-selectin binding index changed from 6.3±3.6 to 7.0±3 in the placebo group(n=10); from 5.9+2.2 to 7.9±3.3 in the E+P group(n=8) and from 6.4+2.7 to 7.1±1.9 in the E group(n=9). Plasma concentrations of TxB2 before and after intervention, changed from 1.2±1.2 to 1.5±1.4(pg/well) in the placebo group; significantly(p=0.005) in the E+P group(n=8), from 0.9±0.3 to 6.1±6.5(pg/well), and from 1.3±1.5 to 0.8±0.4(pg/well) in the E group(n=8; mean±standard deviation, basal x therapy, p< 0.05). Conclusions: Healthy menopaused women who were administered estradiol in association with norethisterone continuously had an increase of plasmatic thromboxane, possibly determined by platelet activation, which indicates a higher short-term thrombotic risk. P-selectin expression analyses failed to demonstrate the impact of HRT on platelets.展开更多
文摘Objective. To assess chances of adequate cyto- colposcopic follow- up after laser conization performed in postmenopausal screening population by the evaluation of postoperative cervical stenosis and unsatisfactory colposcopy rates. Patients and methods. One thousand two hundred eighteen patients were submitted to laser CO2 conization for cervical intraepithelial neoplasia (CIN). Incidence and risk factors for cervical stenosis and unsatisfactory follow- up were retrospectively evaluated comparing fertile with postmenopausal patients. Results. Global incidences of postoperative unsatisfactory colposcopy and cervical stenosis were 46.2% and 7.1% . These rates were higher in postmenopausal patients compared with fertile ones, revealing a statistical correlation between unsatisfactory follow- up and postmenopausal status at the time of conization. Association between CIN relapse and cervical stenosis was significantly higher in postmenopausal group (66.7% vs. 8.6% ; P < 0.05), where two cases of recurrence were detected only after hysterectomy, because of an insurmountable cervical stenosis. Univariate and multivariate analysis revealed HRT use as the only significant factor in influencing postoperative cervical stenosis. Conclusion. Conization is still considered as the standard treatment for CIN at any woman’ s age, when excisional management is indicated, but all postmenopausal patients should be counseled about the possibility of postoperative stenosis that could exclude an adequate follow- up, configuring a failure of the conservative treatment. HRT use is associated with a low risk of stenotic complications; therefore, if possible, users should be encouraged to continue therapy at least 1 year after laser conization.
文摘This is a preliminary study investigating the efficacy of aromatase inhibitor anastrozole in treating endometrial hyperplasia in obese postmenopausal women. We administered anastrozole for 12 months to 11 obese postmenopausal women with high operative risk, in order to treat endometrial hyperplasia (four simple, five complex and two atypical). Endometrial thickness in all cases and histology too in the two cases with atypia, revealed atrophical endometrium during treatment and additional mean follow- up of 10.2 months. The safety and tolerance profile was satisfactory. Anastrozole appears to be an interesting new modality for the treatment of endometrial hyperplasia in obese postmenopausal women.
文摘Objective: This study shows the effect of hormone replacement therapy(HRT), using oral estrogen exclusively or in combination with progestin, on platelet activation in healthy menopaused women. Background: Recent evidence from studies of postmenopausal HRT in healthy women demonstrated a short-time increased risk of coronary heart disease. Platelet activation, which generates vasoconstrictory thromboxane A2(TxA2), has been related to the risk of cardiovascular diseases. Methods: Bymeans of a placebo-controlled study twenty-seven postmenopausal patients were continuously orally administered estrogen in combination with progestin or estrogen exclusively for an 8-week period. Platelet activation was evaluated by flow cytometric P-selectin expression and by enzyme immunoassay plasmatic TxA2(TxB2) concentrations. Results: P-selectin binding index changed from 6.3±3.6 to 7.0±3 in the placebo group(n=10); from 5.9+2.2 to 7.9±3.3 in the E+P group(n=8) and from 6.4+2.7 to 7.1±1.9 in the E group(n=9). Plasma concentrations of TxB2 before and after intervention, changed from 1.2±1.2 to 1.5±1.4(pg/well) in the placebo group; significantly(p=0.005) in the E+P group(n=8), from 0.9±0.3 to 6.1±6.5(pg/well), and from 1.3±1.5 to 0.8±0.4(pg/well) in the E group(n=8; mean±standard deviation, basal x therapy, p< 0.05). Conclusions: Healthy menopaused women who were administered estradiol in association with norethisterone continuously had an increase of plasmatic thromboxane, possibly determined by platelet activation, which indicates a higher short-term thrombotic risk. P-selectin expression analyses failed to demonstrate the impact of HRT on platelets.
