妇女围绝经期雌激素的变化与症状

围绝经期（perimenopausal period）是指从卵巢功能开始衰退直至绝经后1年内的时期[1]。围绝经期雌激素水平并非逐渐下降，在绝经过渡早期，FSH水平升高，导致雌二醇分泌过多；在卵泡完全停止生长发育后，雌激素水平迅速下降。雌激素水平降低，可出现月经紊乱、血管舒缩障碍和神经精神等症状，表现为潮热、出汗、激动易怒、抑郁或烦躁、失眠等。上述一系列症状的治疗，主要采用激素补充治疗，并鼓励锻炼身体和健康饮食，建立健康生活方式。     

潍坊市部分围绝经期妇女相关症状与性生活情况调查

[目的]了解围绝经期妇女相关症状、性生活状况，为今后更有针对性地开展围绝经期预防保健工作提供依据。[方法]对2007年9月至2008年5月就诊于潍坊市某高等学校门诊的180名40～60岁妇女进行调查。[结果]调查的180人中，已绝经的占37．78％。自然绝经者所占比例，40～45岁为14．29％，46～50岁为21．43％，51～55岁为65．91％，56-60岁为90．00％；绝经时年龄为（49±5）岁。调查180人中，已出现更年期症状的占82．22％。更年期症状发生率，40-45岁为66．67％，46-50岁为95．24％，51～55岁为75．00％，56～60岁为70．00％（P〈0．01），出现更年期症状时的年龄为（47±5）岁。出现更年期症状的148例中，64．87％有潮热出汗，66．22％有烦躁易怒，44．60％有阴道干燥，43．92％有疲乏失眠，16．89％有心慌，12．84％有骨关节肌肉痛，18．92％有性欲下降，接受激素治疗的占18．92％。[结论]更年期妇女的相关症状主要是烦躁易怒、潮热出汗、阴道干燥、疲乏失眠、性欲下降。70％以上有性生活。     

围绝经期综合征

围绝经期是指绝经前后的时期 ,包括临床特征、内分泌学及生物学开始出现绝经趋势 ,即卵巢功能衰退的征兆 ,一直持续到最后一次月经后1年。围绝经期开始年龄约在40岁左右 ,持续时间个体差异较大 ,短者1年、长者高达12年 ,绝经的年龄一般在45～55岁。在围绝经期 ,由于卵巢功能衰退 ,体内雌激素水平急剧下降 ,神经内分泌系统不适应雌激素水平骤降而发生紊乱 ,出现一系列神经内分泌失调症状 ,称此为围绝经期综合征。其发病率占75 % ,其中25 %的患者症状明显 ,需要治疗。1发病机制妇女进入围绝经期后 ,卵巢功能开始衰退 ,卵巢对垂体促性腺激素不…     

围绝经期的激素替代治疗研究

围绝经期是指从近绝经期时出现与绝经有关的内分泌、生物学和临床特征开始到绝经后一年的这段时间[1]。在此期间内妇女因为卵巢功能衰退、雌激素水平下降或波动,多出现植物神经、血管舒缩功能紊乱[2],并常伴有泌尿生殖系统萎缩、骨质疏松与一定程度的神经心理症状。患者常会感觉到潮热,出汗,心悸,眩晕,胸闷,体力、记忆力和工作能力下降等[3];心理上情绪波动大     

围绝经期及其征候群的保健与治疗

围绝经期是女性卵巢功能从成熟到逐渐衰退的一个过渡时期,由此而引起内分泌发生变化,植物神经系统功能紊乱,而出现一系列征候群。进入围绝经期的妇女不少人会出现一些症状,其中5％－10％的症状严重影响生活与工作。从临床观察,从事脑力劳动的妇女出现症状比体力劳动者为重。因我校中老年教师较多,通过对80例病人的治疗,对围绝经期妇女特点及保健与治疗,总结如下。l围约经用及其征侯群的特点及治疗1．l绝经前期由于卵巢功能开始衰退,排卵功能丧失,缺少孕激素,成为无排卵月经周期。此期出现月经紊乱,经期不定,时多时少经量不等。…     

更年期综合征试试"三子苁蓉汤"

正多数妇女在45~55岁卵巢功能开始衰退,引起相关激素分泌失调,出现月经时间或先或后,经量或多或少,直至月经闭止。在围绝经期,可出现一系列以植物神经系统紊乱为主的症状,俗称更年期综合征。主要表现为情绪不稳定,容易烦躁激动,或忧郁、恐惧、焦虑、潮热出汗、头晕心悸、颜面与颈部潮红、手足麻木、头痛、失眠、腰酸、背部蚁行感等。     

更年期女性还有那种想法吗

正西方国家女性的平均绝经年龄为51岁,大约有1%的女性会出现卵巢早衰。我国女性平均绝经年龄为49.5岁,80%在44～54岁之间。更年期仍需避孕更年期更专业的术语是"围绝经期",是指女性从开始出现绝经趋势直至最后一次月经的时期。可始于40岁,历时短至1～2年,长至10～20年。更年期的女性常出现月经紊乱、潮热、出汗、情绪不稳等血管舒缩障碍和神经精神症状,这部     

更年期不可怕

女性从出生到进入老年，生理上要经过几个阶段——新生儿期、幼年期、青春期、生育期、围绝经期及绝经后期。医学上的围绝经期就是我们习惯说的更年期，这一阶段是女性从生殖功能旺盛状态向老年衰萎过渡，卵巢功能由成熟走向衰退直至终止的时期。据统计，我国妇女绝经年龄平均为49岁，40岁以前绝经称为早绝经，也就是卵巢早衰。围绝经期包括绝经前期、绝经及绝经后数年。妇女进入围绝经期后首先表现为月经开始不规律，多数表现为月经错后，经量减少，然后逐渐过度至绝经。绝经在医学上是一个回顾性的概念，指月经已经停止一年以上，最后的一次月经被称为绝经。     

阴道超声对围绝经期妇女卵巢功能观察的应用价值

妇女进入围绝经期后,卵巢功能逐渐衰退。体积缩小,趋于停止排卵,雌激素(E2)分泌减少,临床表现为月经紊乱而步入绝经后期。本研究采用阴道超声观察卵巢和子宫大小,并测定血清雌二醇的水平来研究围绝经期卵巢功能情况。     

妇女围绝经期的激素替代治疗

围绝经期又称更年期,指妇女自性成熟期进入老年期的过渡期。1994年WHO人类生殖特别规划委员会在日内瓦召开有关90年代绝经研究进展会议,提出废除“更年期”,推荐使用围绝经期、绝经过渡期、绝经、绝经后期等术语。围绝经期的定义为妇女出现卵巢功能衰退征兆(40岁左右)到最后一次月经后一年;绝经过渡期即卵巢功能开始衰退的征兆到最后一次月经;绝经即妇女一生中最后一次月经;绝经后期即妇女一生中最后一次月经以后一直到生命终止。1内分泌改变与雌激素缺乏相关病症1.1生殖激素的变化卵巢功能衰退是一个渐进过程,从绝经过渡期开始,最早出现…     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.