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#1
26.03.2007, 21:27
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Ïîäåëèòåñü èíôîðìàöèåé
Óâàæàåìûå êîëëåãè! Ïîäåëèòåñü ïîæàëóéñòà èíôîðìàöèåé ïî ÇÃÒ. Êàê êòî îòíîñèòñÿ ê íàçíà÷åíèþ ñèíòåòè÷åñêèõ è íàòóðàëüíûõ ãîðìîíîâ?
Êàê ïîñòóïèòü ñ æåíùèíîé ïðîîïåðèðîâàííîé ïî ïîâîäó àäåíîêàðöèíîìû ýíäîìåòðèÿ ( ýêñòèðïàöèÿ ìàòêè ñ ïðèäàòêàìè)? Ïîäåëèòåñü ññûëêàìè ïîæàëóéñòà. 
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#2
26.03.2007, 22:26
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Ñ÷èòàåòñÿ, ÷òî äëÿ êóïèðîâàíèÿ/ïðîôèëàêòèêè ñèìïòîìîâ ðàííåé ìåíîïàóçû æåíùèíàì ñëåäóåò íàçíà÷àòü ÇÃÒ, ýòî ïîõîæå ñíèæàåò ðèñê ÑÑÇ è îñòåîïîðîçà. Êàêîé ïðåïàðàò íàèáîëåå îïòèìàëåí (à òàêæå ïóòü ââåäåíèÿ) è íà êàêîé ñðîê (äî 50 ëåò? 60 ëåò?) - ýòè è äðóãèå âîïðîñû ïîêà îñòàþòñÿ äîñòàòî÷íî íåèçó÷åííûìè:
Once the ovaries are removed or fail to produce endogenous sex steroids, exogenous estrogens are almost always needed for symptom relief. The risks and benefits of these agents in women with premature menopause have not been studied. In these women HT is used as true replacement therapy, just as thyroid hormone is used as the replacement therapy for thyroid deficiency... Women who have had surgical menopause experience more severe symptoms and will be faced with the decision to stop estrogen therapy at some time in their lives. When they do try to discontinue therapy, many of these women will redevelop intense symptoms such as hot flashes, night sweats, and insomnia. Therefore, before ovarian removal, they must be informed about the need for long-term HT use and the greater difficulty in discontinuing therapy. We do not know what percentage of women redevelop symptoms after stopping long-term HT or how best to stop therapy (i.e., immediate or taper). Future research on menopausal symptoms in women undergoing premature menopause should focus on addressing the following critical gaps in our knowledge of this topic: 1 Is premature menopause a deficiency disease requiring physiologic replacement? 2 Should women with idiopathic premature ovarian failure or bilateral oophorectomy be treated with exogenous estrogen with or without progestin? 3 What form of HT is most appropriate: combination oral contraceptives, continuous menopausal HT, or sequential therapy? 4 Is physiologic estradiol replacement safer than synthetic forms of HT? 5 For how long should hormonal treatment be administered? 6 How safe is HT in women with premature versus natural menopause at average age 51 years? Èç Am J Med. 2005 Dec 19;118 Suppl 12B:131-5. Bilateral oophorectomy and premature menopause
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#3
27.03.2007, 00:15
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Ìíîãèå ñ÷èòàþò. ÷òî " êëèìàêñ íóæíî âñòðå÷àòü ñ âûñîêî ïîäíÿòîé ãîëîâîé" è íå äîâîäèòü äî ïàòîëîãè÷åñêîãî òå÷åíèÿ, ò.å íà÷èíàòü ÇÃÒ ïðè ïåðâûõ ïðèçíàêàõ ìåíîïàóçû. Èíòåðåñíî çíàòü ðàçëè÷íûå ìíåíèÿ ïî ýòîìó âîïðîñó. Êàêîâû îòäàëåííûå ïîñëåäñòâèÿ ïðèåìà ÇÃÒ? Íî âåäü æåíùèíû ïðèíèìàþùèå ÇÃÒ äåéñòâèòåëüíî îòëè÷àþòñÿ ïî ñâîåìó ñîìàòè÷åñêîìó ñîñòîÿíèþ îò æåíùèí íå ïðèíèìàþùèõ ãîðìîíàëüíóþ òåðàïèþ.
À òðàíñäåðìàëüíûå ôîðìû - êàêèå îòçûâû ó äîêòîðîâ î íèõ?
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#4
27.03.2007, 00:28
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Öèòàòà:
Ïîõîæå, íåïëîõàÿ ýôôåêòèâíîñòü è òàêîãî ïóòè ââåäåíèÿ: Br J Clin Pract. 1997 Jan-Feb;51(1):20-3, 25-6. A randomised study to compare the efficacy and safety of new 17 beta-oestradiol transdermal matrix patch with Estraderm TTS 50 in hysterectomised postmenopausal women. The Lyrelle Study Group.al-Azzawi F, Van der Mooren MJ, Rolland R, Hirvonen E. Menopause Research Unit, University of Leicester. This study was designed to compare the efficacy and safety of two sizes of Lyrelle, a new matrix design transdermal oestrogen patch, with Estraderm TTS 50, a reservoir system. Three hundred and ninety-four (394) hysterectomised postmenopausal women between 30 and 65 years of age participated in this open-label, randomised, multicentre clinical trial. The main efficacy criterion was the reduction in the mean number of hot flushes per day at six months. Secondary efficacy end points included other climacteric symptoms as well as various psychofunctional and genitourinary disorders. A significant decrease from baseline in the mean number of hot flushes/day was observed in all three groups from the end of cycle 1, reaching 90% at the end of cycle 7. there was no statistically significant difference between Lyrelle 50 and Estraderm at any time point for any parameter; however, between-group differences between Lyrelle 80 and Estraderm for various parameters were seen in the first three cycles in favour of Lyrelle 80. A similar impact on blood lipid levels was observed in all three groups, without significant between-group differences. We conclude that the new Lyrelle patch is a highly effective system for transdermal oestrogen replacement therapy that may enhance long-term patient compliance.
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#5
29.03.2007, 22:01
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Äà! Òðàíñäåðìàëüíûé ïóòü ââåäåíèÿ õîðîø. À âîò êàê ïîñòóïèòü ñ æåíùèíîé 47 ëåò êîòîðàÿ ïðîîïåðèðîâàíà ïî ïîâîäó àäåíîêàðöèíîìû ýíäîìåòðèÿ. Ïðîâîäèòü åé ÇÃÒ èëè íåò. Îíêêîëîãè ïðîòèâ . Ïîñëå îïåðàöèè ïðîâåëè èìóíîöèòîõèìèþ îïóõîëè è íàçíà÷èëè íà 6 ìåñÿöåâ Äåïî-Ïðîâåðà. Ïðîâåäåíà ýêñòèðïàöèÿ ìàòêè ñ ïðèäàòêàìè, ëèìôîóçëû íå óáèðàëè. Ñ êàêîé öåëüþ Äåïî-Ïðîâåðà íå ïîéìó? Ìîæåò êòî òî îáúÿñíèò??????
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#7
01.04.2007, 14:20
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Öèòàòà:
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#8
01.04.2007, 22:06
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Öèòàòà:
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#9
01.04.2007, 22:20
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 èíåòå ïîñìîòðèòå ïî íàçâàíèÿì èññëåäîâàíèé. Îíè åñòü â ñâîáîäíîì äîñòóïå.
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#11
02.04.2007, 19:07
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Äà åñòü â ïåðèîäèêå. Ïðè÷åì ðàçèðàëîñü è òàê, è ñÿê. Âñå êîìó íå ëåíü óæå ïðî ýòî íàïèñàëè, íà÷èíàÿ ñ Òàòàð÷óê Ò.Ô.
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#13
02.04.2007, 21:23
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 ñóááîòó åå âèäåë, íè÷åãî çà ýòî íå ãîâîðèëà.
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#15
02.04.2007, 22:26
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Çàíÿòîé îíà ñåé÷àñ ÷åëîâåê î÷åíü. Çàì äèðåêòîðà ÏÀÃà ïî íàóêå âñå æå.
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Ëèíåéíûé âèä
