Effect of ovarian suppression with gonadotropin-releasing hormone agonist on glucose disposal and insulin secretion.

Several lines of evidence suggest that ovarian hormones influence glucose homeostasis, although their exact role in humans has not been clearly defined. In the present study, we sought to test the hypothesis that ovarian hormones regulate glucose homeostasis by examining the effect of pharmacologically induced ovarian hormone deficiency on glucose disposal and insulin secretion. Young, healthy women with regular menstrual patterns were studied during the follicular and luteal phases of their cycle at baseline and after 2 mo of treatment with gonadotropin-releasing hormone agonist (GnRHa; n = 7) or placebo (n = 6).

Resolution of endometrial hyperplasia with adjuvant anastrozole treatment in postmenopausal breast cancer: a case report.

Background: Endometrial hyperplasia in patients with a history of breast cancer presents a therapeutic dilemma. The standard conservative therapy for hyperplasia, high-dose progestins, is contraindicated in breast cancer. Anastrozole, an aromatase inhibitor, is becoming first-line adjuvant therapy for breast cancer in postmenopausal women and may have protective effects on the endometrium.

Ovarian suppression with a gonadotropin-releasing hormone agonist does not alter insulin-stimulated glucose disposal.

Objective: Aging is associated with reduced tissue sensitivity to insulin. In women, these age-related changes may be accelerated by menopause. The effect of ovarian hormone deficiency on tissue insulin sensitivity in humans, however, has not been defined clearly.

Effect of a daily supplement of soy protein on body composition and insulin secretion in postmenopausal women.

Objective: To determine whether a supplement of soy protein improves body composition, body fat distribution, and glucose and insulin metabolism in postmenopausal women without diabetes compared with an isocaloric casein placebo.

Design: Randomized, double-blind, placebo-controlled 3-month trial.

Setting: Clinical Research Center.

Perceived infertility-related stress correlates with in vitro fertilization outcome.

To determine the effect of perceived infertility-related stress on IVF outcome, all couples undergoing their first cycle of IVF were administered the Fertility Problem Inventory from May 2002 and April 2005 at our institution. Couples who conceived during their first cycle of IVF had significantly higher measures of need for parenthood and loss of sexual enjoyment, compared with couples who did not conceive. Couples who achieved ongoing pregnancies had higher scores on measures of a negative view of a child-free lifestyle, need for parenthood, and total stress than those who did not.

Insulin resistance with hormone replacement therapy: associations with markers of inflammation and adiposity.

Objective: This study was undertaken to determine whether insulin resistance associated with combination hormone replacement therapy (HRT) is mediated by changes in serum markers of inflammation or in serum adipocyte hormones.

Study Design: Forty-five postmenopausal women, aged 55 +/- 7 years, were examined from a randomized, double-blind placebo-controlled trial evaluating the effect of HRT on insulin-stimulated glucose disposal and body composition. Volunteers were randomly assigned to conjugated estrogens 0.

Conservative treatment of placenta accreta.

Prolonged retained placenta causing a delayed postpartum hemorrhage is a relatively common occurrence. However, there is a dearth of medical literature describing fertility-preserving treatments when standard therapy fails. We present two cases in which protracted retained placenta due to placenta accreta was successfully treated by hysteroscopic resection.

Testosterone replacement increases vasodilatory reserve in androgen-deficient female rats.

Testosterone replacement leads to increased coronary pressure-induced tone and vasodilatory reserve in oophorectomized rats. The mechanisms involve changes in endothelial nitric-oxide modulation of smooth-muscle constriction and are not a result of the peripheral conversion of T to estrogen.

Evidence against a role for ovarian hormones in the regulation of blood flow.

Objective: To determine the effect of ovarian hormone deficiency on peripheral vascular function.

Design: Randomized, single-blind, placebo-controlled.

Setting: General clinical research center.

Syndrome of inappropriate antidiuretic hormone in a healthy woman after diagnostic laparoscopy and hysteroscopy: a case report.

Background: Hyponatremia is common after major surgery. It is now recognized as a potential complication after minor surgery. Premenopausal women are more likely to suffer permanent brain damage or death from hyponatremic encephalopathy than are men or postmenopausal women.

Novel modification of the vertical rectus abdominis myocutaneous flap for neovagina creation.

Objective: We describe a modification of the traditional vertical rectus abdominis myocutaneous flap for neovagina creation and our experience to date.

Methods: Our modified vertical rectus abdominis myocutaneous flap uses a smaller flap size with a full-thickness skin graft posteriorly to decrease the size of the abdominal wall defect. We have used the modified vertical rectus abdominis myocutaneous flap in 18 patients between March 1998 and March 2004 to create a neovagina after exenterative surgery.

The effect of hormone replacement therapy on body composition, body fat distribution, and insulin sensitivity in menopausal women: a randomized, double-blind, placebo-controlled trial.

Purpose: After menopause, women gain abdominal fat and become less sensitive to insulin. We sought to determine whether hormone replacement therapy (HRT) reduced intraabdominal and sc abdominal fat and improved insulin sensitivity in early menopausal women.

Methods: Seventy-six postmenopausal women, age 51.

Pseudoaneurysm of the uterine artery requiring bilateral uterine artery embolization.

Objective: To report a case of uterine artery pseudoaneurysm which initially failed unilateral uterine artery embolization that subsequently responded to bilateral embolization.

Design: A case report.

Setting: University hospital.

Implementation of assisted reproductive technologies following conservative management of FIGO grade I endometrial adenocarcinoma and/or complex hyperplasia with atypia.

Objective: The objective was to report a series of infertility therapy outcomes following conservative management of endometrial adenocarcinoma and/or complex hyperplasia with atypia.

Methods: A retrospective review of the University of Iowa assisted reproductive technology database was performed. All women presenting with International Federation of Obstetrics and Gynecology (FIGO) grade I uterine adenocarcinoma and/or complex hyperplasia with atypia were assessed for type and duration of medical management, initial, interim treatment, and preinfertility treatment endometrial biopsy (BX) findings.

Presumed antepartum amniotic fluid embolism.

Background: Amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult.

Case: A 37-year-old woman at 28 weeks' gestation presented with signs and symptoms consistent with amniotic fluid embolism including disseminated intravascular coagulopathy.

Preoperative serum vascular endothelial growth factor levels: significance in ovarian cancer.

Purpose: To assess the clinical relevance of serum vascular endothelial growth factor (VEGF) levels in distinguishing patients with ovarian cancer from those with benign adnexal masses.

Experimental Design: Preoperative serum VEGF levels were assessed in 101 women with invasive epithelial ovarian cancer, 16 with low malignant potential (LMP) ovarian tumors, and 34 women with benign ovarian tumors. VEGF levels were determined using an ELISA (R&D Systems, Minneapolis, MN).

Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer.

Objective: To estimate the association of preoperative CA 125 levels with outcome in primary ovarian cancer patients.

Methods: One hundred forty-two patients with epithelial ovarian cancer, who had a serum CA 125 level drawn before surgery, were retrospectively evaluated. The relationship of preoperative CA 125 levels and various preoperative and postoperative variables was evaluated.