The relationship of longitudinal change in reproductive hormones and vasomotor symptoms during the menopausal transition

CONTEXT: The relationship of reproductive hormones to vasomotor symptoms (VMS) has been incompletely explored, although an increase in such symptoms at midlife and their reduction with hormone therapy suggest a strong and direct relationship. Vasomotor symptoms are reported by 65-76% of women traversing the menopausal transition and are a primary reason for medical intervention during this life stage. OBJECTIVE: The purpose of this report was to relate longitudinal serum concentrations of the reproductive hormones estradiol (E2), FSH, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), and SHBG and the free hormone indices free E2 index (FEI) and free T index (FTI) with the occurrence of VMS in women traversing the menopausal transition. Design and Setting: The Study of Women's Health Across the Nation is a multisite, longitudinal, cohort study of the menopausal transition being conducted in community-based groups of women. PARTICIPANTS AND MAIN OUTCOME MEASURES: At baseline, 3302 menstruating women who belonged to one of five ethnic/racial groups were recruited and followed up with annual visits. Frequencies of symptoms (hot flashes, night sweats) for the prior 2 wk and measures of other covariates as well as potentially confounding variables were self-reported in the annual interview. Serum was obtained annually, on d 2-5 of a spontaneous cycle in cycling women or within 90 d of the anniversary of the baseline study visit in noncycling women and assayed for FSH, E2, T, SHBG, and DHEAS. FTI and FEI were calculated. This analysis incorporated available longitudinal data from 3293 women, excluding information collected at or after first report of hormone therapy use or hysterectomy. Data were analyzed using longitudinal marginal logistic regression models and a partial proportional odds model. RESULTS: After adjusting for age, body mass index, and other related covariates, VMS prevalence increased with higher (log)FSH concentrations, and the increase was greater when blood was drawn more than 5 d after menses began. FSH concentrations were positively associated with the frequency of either hot flashes or night sweats, and higher FSH concentrations were associated with greater odds of reporting more frequent symptoms. Vasomotor symptom prevalence decreased with higher (log)E2, (sqrt)SHBG, and (log)FEI but only when these hormone values were modeled independently of (log)FSH values and the specimens were obtained outside the d 2-5 window. When modeled simultaneously with (log)FSH, (log)E2, (sqrt)SHBG, and (log)FEI were no longer significantly associated with symptom prevalence. (Cubic root)T and (sqrt)DHEAS concentrations and (log)FTI were not associated with the prevalence of VMS. CONCLUSIONS: Annual serum FSH concentrations, but not E2, T, DHEAS, FTI, or FEI when collectively modeled longitudinally, are associated with both the prevalence and frequency of VMS in women at midlife.     

Membrane digestion in the early postoperative period during enteral tube feeding

The investigation of the membrane digestion has established that in the early postoperative period pronounced alterations of the hydrolytic system in the small intestine take place in all its links (synthesis, translocation and adsorption of enzymes). The main compensatory mechanism responsible for the hydrolytic processes in the early postoperative period is the membrane digestion, so the level of the amylolytic activity of the small intestine in the early postoperative period allows the enteral tube nutrition to be performed not only with mono- and oligosaccharides but also with polysaccharides.     

Disturbed behavior of rats suffering intrauterine hypoxia is corrected by postnatal treatment with piracetam

Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 115, No. 1, pp. 43–45, January, 1993     

Computerized echotomography with target puncture biopsy in the diagnosis of thyroid gland lesions

Combined investigation of 200 patients with different thyroid lesions was conducted. The program of investigation included computerized echotomography of the thyroid with spot puncture and rapid cytological examination. Of them 138 patients were operated upon. In 125 patients (87.4%) combined investigation including spot aspiration puncture biopsy and echotomography helped to establish morphological diagnosis of lesion, to specify indications for surgical intervention and to optimize its use.     

Prevention and treatment of necrosis of the downward transposed intestine following abdomino-anal resection of cancer

The article analyzes an experience with treatment of 83 patients with necrosis of the descended gut after 1128 sphincter-preserving resections of the rectum. The rectum resection if performed at high professional level and the drug correction of coexistent diseases were found to reduce the amount of necroses of the descended gut up to 4%. In 33.7% of the patients inflammatory phenomena in the small pelvis were arrested with satisfactory functional results.