Pub Date : 2006-01-01DOI: 10.1017/cbo9781139519557.037
T. Treutler, B. Ruf, J. Beige
Beyond polyuria following psychogenic polydipsia, in a more narrow sense, this condition may be classified into impaired water re-absorption (i) due to tubular injury or (ii) relative or absolute loss of function of antidiuretic hormone (ADH). Tubular injury may be caused by different toxins affecting the ascending Henle loop as hypercalciuria, drugs and antibiotics as tubular necrosis. ADH deficiency, either absolute or relative, occurs with central or peripheral diabetes insipidus, which is based on synthesis failure or loss of peripheral efficacy of ADH due to receptor malfunction. Diagnosis of polyuria rests upon a thirst challenge in conjunction with laboratory studies of osmolality in serum and urine, which discloses the non-function of the hypothalamic-renal axis. Administration of ADH may differentiate between central and peripheral diabetes insipidus.
{"title":"[Polyuria].","authors":"T. Treutler, B. Ruf, J. Beige","doi":"10.1017/cbo9781139519557.037","DOIUrl":"https://doi.org/10.1017/cbo9781139519557.037","url":null,"abstract":"Beyond polyuria following psychogenic polydipsia, in a more narrow sense, this condition may be classified into impaired water re-absorption (i) due to tubular injury or (ii) relative or absolute loss of function of antidiuretic hormone (ADH). Tubular injury may be caused by different toxins affecting the ascending Henle loop as hypercalciuria, drugs and antibiotics as tubular necrosis. ADH deficiency, either absolute or relative, occurs with central or peripheral diabetes insipidus, which is based on synthesis failure or loss of peripheral efficacy of ADH due to receptor malfunction. Diagnosis of polyuria rests upon a thirst challenge in conjunction with laboratory studies of osmolality in serum and urine, which discloses the non-function of the hypothalamic-renal axis. Administration of ADH may differentiate between central and peripheral diabetes insipidus.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"74 1","pages":"615-8"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90205703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-01-01DOI: 10.1016/s0140-6736(74)90820-4
S. Tschudin, L. Sponagel, U. Flückiger
{"title":"[Dangerous fever].","authors":"S. Tschudin, L. Sponagel, U. Flückiger","doi":"10.1016/s0140-6736(74)90820-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(74)90820-4","url":null,"abstract":"","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"228 1","pages":"651-7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81049471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prevalence of allergic diseases has increased in modern Western countries during the last decades. Among the hypotheses for the reasons the idea that environmental pollutants may play a role is intensively discussed. In order to characterise the influence of these pollutants on the development, elicitation and chronification of allergic reactions (allergotoxicology) epidemiological, clinical and experimental data have to be considered. These investigations showed that among the pollutants with an enhancing effect on allergic diseases pollution types with nitrogen oxides (NOx), ozone (O3), tobacco smoke, particulate matter and diesel exhaust particles are of special interest.
{"title":"[Allergy and the environment].","authors":"B. Eberlein-König, J. Ring, H. Behrendt","doi":"10.15036/ARERUGI.53.781","DOIUrl":"https://doi.org/10.15036/ARERUGI.53.781","url":null,"abstract":"The prevalence of allergic diseases has increased in modern Western countries during the last decades. Among the hypotheses for the reasons the idea that environmental pollutants may play a role is intensively discussed. In order to characterise the influence of these pollutants on the development, elicitation and chronification of allergic reactions (allergotoxicology) epidemiological, clinical and experimental data have to be considered. These investigations showed that among the pollutants with an enhancing effect on allergic diseases pollution types with nitrogen oxides (NOx), ozone (O3), tobacco smoke, particulate matter and diesel exhaust particles are of special interest.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"17 1","pages":"259-61"},"PeriodicalIF":0.0,"publicationDate":"2004-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90671408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-07-01DOI: 10.1024/0040-5930.59.7.351
M. Runge
The steep increase in the incidence of hip fractures and other fall-related fractures with advancing age is caused by an age-associated combination of increased fall frequency, typical fall mechanisms and reduced bone strength. This article reviews the current knowledge related to fall risk factors and fall mechanisms. Non-syncopal falls during normal daily activities are predominantly age-associated occurrences with serious consequences. 5% of all falls cause fractures, another 10 to 15% lead to a variety of further injuries. The most serious consequences of the geriatric fall syndrome are fractures of hip, humerus, wrist and pelvis. Fear of falling and self limitation of physical activity are self imposed psychological impairments. There is a pathological cascade from age-associated gait and balance disorders to locomotor falls and further to fall-related fractures. Significantly increased fall risk caused by gait and balance disorders can be considered as a distinct chronic pathological condition. It is strongly age-related and definitely has a multifactorial origin. The term "age-associated multifactorial gait disorder" has been coined for this condition. Assessing fracture risk requires evaluating fall risk, fall mechanisms and bone strength. Older people with gait and balance disorders fall mostly sideways, and the impact of such a fall from standing height generates enough force to break an older non-osteoporotic femur. Osteoporosis can decrease bone strength beyond the age-related grade, and is one of the several most important risk factors for fractures. Prospective studies have consistently found the following independent risk factors for non-syncopal falls: 1. Muscle power of lower extremities, 2. Lateral postural stability, 3. Clinical evaluation of gait, 4. Visual impairment, 5. Four or more different medications or certain psychotropic drugs, 6. Cognitive impairment, and 7. History of falling. The fall-related neuromuscular status can be adequately assessed by three diagnostic procedures: The chair rising test represents muscle power, and has proven its relevance for both fall risk and deterioration of mobility and functional independence. Measurement of lateral postural stability can be done by tandem manoeuvres. Clinical evaluation of gait should focus on the regularity of gait as a cyclic event. The fall risk status of an individual depends strongly on the number of the independent risk factors that one accumulates. Both prevention and therapy must focus on each of these individual risk factors. Preventing falls and its consequences is imperative for successful aging.
{"title":"[Diagnosis of the risk of accidental falls in the elderly].","authors":"M. Runge","doi":"10.1024/0040-5930.59.7.351","DOIUrl":"https://doi.org/10.1024/0040-5930.59.7.351","url":null,"abstract":"The steep increase in the incidence of hip fractures and other fall-related fractures with advancing age is caused by an age-associated combination of increased fall frequency, typical fall mechanisms and reduced bone strength. This article reviews the current knowledge related to fall risk factors and fall mechanisms. Non-syncopal falls during normal daily activities are predominantly age-associated occurrences with serious consequences. 5% of all falls cause fractures, another 10 to 15% lead to a variety of further injuries. The most serious consequences of the geriatric fall syndrome are fractures of hip, humerus, wrist and pelvis. Fear of falling and self limitation of physical activity are self imposed psychological impairments. There is a pathological cascade from age-associated gait and balance disorders to locomotor falls and further to fall-related fractures. Significantly increased fall risk caused by gait and balance disorders can be considered as a distinct chronic pathological condition. It is strongly age-related and definitely has a multifactorial origin. The term \"age-associated multifactorial gait disorder\" has been coined for this condition. Assessing fracture risk requires evaluating fall risk, fall mechanisms and bone strength. Older people with gait and balance disorders fall mostly sideways, and the impact of such a fall from standing height generates enough force to break an older non-osteoporotic femur. Osteoporosis can decrease bone strength beyond the age-related grade, and is one of the several most important risk factors for fractures. Prospective studies have consistently found the following independent risk factors for non-syncopal falls: 1. Muscle power of lower extremities, 2. Lateral postural stability, 3. Clinical evaluation of gait, 4. Visual impairment, 5. Four or more different medications or certain psychotropic drugs, 6. Cognitive impairment, and 7. History of falling. The fall-related neuromuscular status can be adequately assessed by three diagnostic procedures: The chair rising test represents muscle power, and has proven its relevance for both fall risk and deterioration of mobility and functional independence. Measurement of lateral postural stability can be done by tandem manoeuvres. Clinical evaluation of gait should focus on the regularity of gait as a cyclic event. The fall risk status of an individual depends strongly on the number of the independent risk factors that one accumulates. Both prevention and therapy must focus on each of these individual risk factors. Preventing falls and its consequences is imperative for successful aging.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"125 5 1","pages":"351-8"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81710801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-07-01DOI: 10.1024/0040-5930.59.7.341
A. Vogt, R. Nieczaj, H. Thomas, M. Borchelt, E. Steinhagen-Thiessen
Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of disability in advanced age. The relationship between coronary heart disease (CHD) and dyslipoproteinaemia is well known. The fact, however, that atherosclerosis is a systemic disease leads also to the consideration that patients suffering from cerebrovascular and peripheral arterial disease should benefit similarly from lipid lowering therapy as do patients with CHD. There is already growing evidence that the incidence of stroke may be markedly decreased by statin therapy. Though overall, the clinical significance of hypercholesterolaemia seems to decrease with increasing age, patients at age 65 to 75 tend to benefit even more than younger patients when elevated LDL-cholesterol is treated effectively. It should be noticed that prevention or postponement of cardiovascular events may also prevent premature functional limitations and disability in old age. Hence, it is suggested to screen elderly people with CVD for dyslipoproteinaemia and to treat elevated cholesterol levels by means of life style changes, nutritional therapy, and drug therapy. Treatment regimes should be considered depending upon complete risk stratification and geriatric assessment. Chronological age alone cannot be an argument to withhold a proven effective therapy from a growing segment of the population at risk.
{"title":"[Primary and secondary prevention in dyslipidemia in the elderly].","authors":"A. Vogt, R. Nieczaj, H. Thomas, M. Borchelt, E. Steinhagen-Thiessen","doi":"10.1024/0040-5930.59.7.341","DOIUrl":"https://doi.org/10.1024/0040-5930.59.7.341","url":null,"abstract":"Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of disability in advanced age. The relationship between coronary heart disease (CHD) and dyslipoproteinaemia is well known. The fact, however, that atherosclerosis is a systemic disease leads also to the consideration that patients suffering from cerebrovascular and peripheral arterial disease should benefit similarly from lipid lowering therapy as do patients with CHD. There is already growing evidence that the incidence of stroke may be markedly decreased by statin therapy. Though overall, the clinical significance of hypercholesterolaemia seems to decrease with increasing age, patients at age 65 to 75 tend to benefit even more than younger patients when elevated LDL-cholesterol is treated effectively. It should be noticed that prevention or postponement of cardiovascular events may also prevent premature functional limitations and disability in old age. Hence, it is suggested to screen elderly people with CVD for dyslipoproteinaemia and to treat elevated cholesterol levels by means of life style changes, nutritional therapy, and drug therapy. Treatment regimes should be considered depending upon complete risk stratification and geriatric assessment. Chronological age alone cannot be an argument to withhold a proven effective therapy from a growing segment of the population at risk.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"35 1","pages":"341-4"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74606864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-07-01DOI: 10.1024/0040-5930.59.7.371
T. Münzer
Human growth hormone is one of the hormones used most frequently in the setting of so-called anti-aging strategies. To date, the preventive value of such a hormone replacement therapy in relatively healthy and well functioning middle aged persons is unknown. Although growth hormone leads to significant alterations in body composition and changes in serum cholesterol levels in patients with adult growth hormone deficiency, there are currently no data supporting the hypothesis that growth-hormone in non deficient persons prolongs life span or reduces morbidity. Aging is associated with a reduction of GH-secretion, serum levels of insulin like growth factor I (IGF-I) and alterations in body composition and function. Based on the many clinical similarities between aging and acquired growth hormone deficiency, several studies have assessed the effects of growth hormone administration in healthy aged women and men. Only a few studies have addressed functional outcomes in a more frail population. These studies suggest that a defined group of older individuals with functional limitation might benefit from GH as a strategy to prevent further functional decline and delay nursing home admission. Because of the lack of proof in frail patients, uncertain long-term effects and high treatment costs GH-administration in the aged should currently be restricted to research questions. Future studies should address the question whether growth hormone alone or in combination with established strategies, such as exercise or improvement in nutrition will serve as a measure to prevent functional decline in frail geriatric patient populations.
{"title":"[Growth hormone and prevention in elderly patients--fantasy and reality].","authors":"T. Münzer","doi":"10.1024/0040-5930.59.7.371","DOIUrl":"https://doi.org/10.1024/0040-5930.59.7.371","url":null,"abstract":"Human growth hormone is one of the hormones used most frequently in the setting of so-called anti-aging strategies. To date, the preventive value of such a hormone replacement therapy in relatively healthy and well functioning middle aged persons is unknown. Although growth hormone leads to significant alterations in body composition and changes in serum cholesterol levels in patients with adult growth hormone deficiency, there are currently no data supporting the hypothesis that growth-hormone in non deficient persons prolongs life span or reduces morbidity. Aging is associated with a reduction of GH-secretion, serum levels of insulin like growth factor I (IGF-I) and alterations in body composition and function. Based on the many clinical similarities between aging and acquired growth hormone deficiency, several studies have assessed the effects of growth hormone administration in healthy aged women and men. Only a few studies have addressed functional outcomes in a more frail population. These studies suggest that a defined group of older individuals with functional limitation might benefit from GH as a strategy to prevent further functional decline and delay nursing home admission. Because of the lack of proof in frail patients, uncertain long-term effects and high treatment costs GH-administration in the aged should currently be restricted to research questions. Future studies should address the question whether growth hormone alone or in combination with established strategies, such as exercise or improvement in nutrition will serve as a measure to prevent functional decline in frail geriatric patient populations.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"2 1","pages":"371-6"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86392860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1024/0040-5930.59.5.223
H. Hamm
This paper focuses on four important hair diseases mainly occurring in children. Trichotillomania is the most relevant differential diagnosis of alopecia areata in childhood. Meticulous inspection and lack of telogen hairs in the trichogram from the margin of the lesion usually are sufficient for differentiation. The trichogram also plays a significant role for the diagnosis of the loose anagen hair (loose anagen syndrome), a fairly new, but not rare entity, especially in distinguishing it from telogen effluvium. Five different types of clinical presentation are distinguished in tinea capitis. For the necessary systemic therapy; the new antimycotics terbinafine and itraconazole represent good alternatives to the well-tried griseofulvin. Several effective therapeutic options are also available for head lice, the most frequent parasitary infestation of school age. However, because of its neurotoxicity and the increasing problem of lice resistance lindane should not be used any longer for the treatment of head lice.
{"title":"[Hair diseases in childhood].","authors":"H. Hamm","doi":"10.1024/0040-5930.59.5.223","DOIUrl":"https://doi.org/10.1024/0040-5930.59.5.223","url":null,"abstract":"This paper focuses on four important hair diseases mainly occurring in children. Trichotillomania is the most relevant differential diagnosis of alopecia areata in childhood. Meticulous inspection and lack of telogen hairs in the trichogram from the margin of the lesion usually are sufficient for differentiation. The trichogram also plays a significant role for the diagnosis of the loose anagen hair (loose anagen syndrome), a fairly new, but not rare entity, especially in distinguishing it from telogen effluvium. Five different types of clinical presentation are distinguished in tinea capitis. For the necessary systemic therapy; the new antimycotics terbinafine and itraconazole represent good alternatives to the well-tried griseofulvin. Several effective therapeutic options are also available for head lice, the most frequent parasitary infestation of school age. However, because of its neurotoxicity and the increasing problem of lice resistance lindane should not be used any longer for the treatment of head lice.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"29 1","pages":"223-7"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81856592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1024/0040-5930.59.5.251
H. Wolff, C. Kunte
Facial hypertrichosis and hirsutism may cause severe cosmetic and psychologic problems. There are several therapeutic options, both on the cosmetic and medical level. Hirsutism with androgen-excess should be diagnosed and treated by gynecologists. Although frequently used, systemic antiandrogens have not yet proven their efficacy against unwanted hypertrichosis in clinical studies using modern and objective endpoints. Conventional methods of hair removal include plucking, waxing and chemical depilation by thiogycolates, as well as electrolysis and thermolysis. A new medical treatment of hypertrichosis is eflornithine cream. It inhibits the enzyme ornithine-decarboxylase which is essential for the rapidly dividing cells of the hair follicle. Permanent depilation by photothermolysis with lasers and pulsed flash-light systems is currently the most promising treatment.
{"title":"[Hypertrichosis and hirsutism].","authors":"H. Wolff, C. Kunte","doi":"10.1024/0040-5930.59.5.251","DOIUrl":"https://doi.org/10.1024/0040-5930.59.5.251","url":null,"abstract":"Facial hypertrichosis and hirsutism may cause severe cosmetic and psychologic problems. There are several therapeutic options, both on the cosmetic and medical level. Hirsutism with androgen-excess should be diagnosed and treated by gynecologists. Although frequently used, systemic antiandrogens have not yet proven their efficacy against unwanted hypertrichosis in clinical studies using modern and objective endpoints. Conventional methods of hair removal include plucking, waxing and chemical depilation by thiogycolates, as well as electrolysis and thermolysis. A new medical treatment of hypertrichosis is eflornithine cream. It inhibits the enzyme ornithine-decarboxylase which is essential for the rapidly dividing cells of the hair follicle. Permanent depilation by photothermolysis with lasers and pulsed flash-light systems is currently the most promising treatment.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"22 1","pages":"251-5"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90398378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1024/0040-5930.59.4.153
U. Karck, C. Keck
The ovarian function including follicular maturation, ovulation and corpus luteum formation is regulated by a complex control system composed of hypothalamus, pituitary and the ovary itself. These organs communicate via positive and negative feedback loops and can be considered as a functional entity. Special neurons in the hypothalamus produce gonadotropin-releasing hormone (GnRH) being delivered to the anterior pituitary lobe by the pituitary portal vessels. GnRH binds to specific receptors inducing synthesis and release of the gonadotropins FSH and LH into the circulation. After binding to their specific receptors at the ovary FSH and LH induce follicular maturation, ovulation and corpus luteum formation. The ovary responds to gonadotropin stimulation in dual fashion: secretion of sexsteroids and the liberation of a fertilizable oocyte. In addition the ovary is also able to secrete peptide-hormones such as inhibin and activin. Sexsteroids and inhibin modulate the pulsatile secretion of GnRH and gonadotropins. Cooperation of theca- and granulosa cells at the ovarian level and the corpus luteum formation are described and the significance of growth factors and cytocines is emphasized. The effects of estradiol and progesterone are highlighted by the morphological response of the endometrium. The ovary is actively involved in maintaining cyclicity, as reflected by the processes of follicular growth, follicle rupture and formation of the corpus luteum with the dramatic morphological changes involved.
{"title":"[Physiology of ovarian function].","authors":"U. Karck, C. Keck","doi":"10.1024/0040-5930.59.4.153","DOIUrl":"https://doi.org/10.1024/0040-5930.59.4.153","url":null,"abstract":"The ovarian function including follicular maturation, ovulation and corpus luteum formation is regulated by a complex control system composed of hypothalamus, pituitary and the ovary itself. These organs communicate via positive and negative feedback loops and can be considered as a functional entity. Special neurons in the hypothalamus produce gonadotropin-releasing hormone (GnRH) being delivered to the anterior pituitary lobe by the pituitary portal vessels. GnRH binds to specific receptors inducing synthesis and release of the gonadotropins FSH and LH into the circulation. After binding to their specific receptors at the ovary FSH and LH induce follicular maturation, ovulation and corpus luteum formation. The ovary responds to gonadotropin stimulation in dual fashion: secretion of sexsteroids and the liberation of a fertilizable oocyte. In addition the ovary is also able to secrete peptide-hormones such as inhibin and activin. Sexsteroids and inhibin modulate the pulsatile secretion of GnRH and gonadotropins. Cooperation of theca- and granulosa cells at the ovarian level and the corpus luteum formation are described and the significance of growth factors and cytocines is emphasized. The effects of estradiol and progesterone are highlighted by the morphological response of the endometrium. The ovary is actively involved in maintaining cyclicity, as reflected by the processes of follicular growth, follicle rupture and formation of the corpus luteum with the dramatic morphological changes involved.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"1 1","pages":"153-8"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90292616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1024/0040-5930.59.4.183
M. Breckwoldt, C. Keck
The Premenstrual Syndrome (PMS) is defined as the repeated occurrence of psychic disability accompanied by physical symptoms such as weight-gain, mastodynia and edema during the luteal phase. Irritability, depressive mood, lack of concentration and anxiety are the dominant psychiatric features. These symptoms culminate during the premenstrual period and disappear at the onset of menstrual bleeding. The symptomatology is of variable degree. About 2 to 3% of all women of reproductive age are severely impaired by these symptoms. The etiology of PMS is unknown. Disturbance of serotonin metabolism in the central nervous system is discussed. Furthermore abnormalities of the metabolism of sex-steroids in the brain could be involved, since these metabolites are able to modulate the GABA-ergic system. This applies in particular to progesterone-metabolites. Other etiologic concepts favour the ideas of elevated aldosterone activity, variations of endogenous opiod-levels or transient hyperprolactinemia. Thus the unknown etiology and the complex pathophysiology explain the polypragmatic therapeutic strategies including psychotherapy, treatment with psychopharmacologic agents, administration of aldosterone-antagonists, GnRH-analoga and finally prescription of oral contraceptives. The management of PMS requires individualized care by primarily treating the leading symptoms.
{"title":"[Premenstrual syndrome].","authors":"M. Breckwoldt, C. Keck","doi":"10.1024/0040-5930.59.4.183","DOIUrl":"https://doi.org/10.1024/0040-5930.59.4.183","url":null,"abstract":"The Premenstrual Syndrome (PMS) is defined as the repeated occurrence of psychic disability accompanied by physical symptoms such as weight-gain, mastodynia and edema during the luteal phase. Irritability, depressive mood, lack of concentration and anxiety are the dominant psychiatric features. These symptoms culminate during the premenstrual period and disappear at the onset of menstrual bleeding. The symptomatology is of variable degree. About 2 to 3% of all women of reproductive age are severely impaired by these symptoms. The etiology of PMS is unknown. Disturbance of serotonin metabolism in the central nervous system is discussed. Furthermore abnormalities of the metabolism of sex-steroids in the brain could be involved, since these metabolites are able to modulate the GABA-ergic system. This applies in particular to progesterone-metabolites. Other etiologic concepts favour the ideas of elevated aldosterone activity, variations of endogenous opiod-levels or transient hyperprolactinemia. Thus the unknown etiology and the complex pathophysiology explain the polypragmatic therapeutic strategies including psychotherapy, treatment with psychopharmacologic agents, administration of aldosterone-antagonists, GnRH-analoga and finally prescription of oral contraceptives. The management of PMS requires individualized care by primarily treating the leading symptoms.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"34 1","pages":"183-7"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82733630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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