References of "Obstetrics & Gynecology"
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See detailRandomized comparison of intranasal and transdermal estradiol.
Lopes, P.; Merkus, H. M.; Nauman, J. et al

in Obstetrics & Gynecology (2000), 96(6), 906-12

To compare the efficacy and patient acceptability of intranasal versus transdermal 17 beta-estradiol (E2) delivery systems for postmenopausal symptoms. METHODS: Postmenopausal women were randomly assigned ... [more ▼]

To compare the efficacy and patient acceptability of intranasal versus transdermal 17 beta-estradiol (E2) delivery systems for postmenopausal symptoms. METHODS: Postmenopausal women were randomly assigned to intranasal 17 beta-E2, 300 microg daily (n = 176) or transdermal 17 beta-E2 (delivering 50 microg/day), two patches per week (n = 185) for 12 weeks, followed by a 4-week period with the alternate treatment. Efficacy was compared between groups using the Kupperman Index and vasomotor symptoms at week 12. Patient acceptability was compared by patient choice of administration route and by questionnaire at week 16. RESULTS: Intranasal and transdermal therapy produced significant reductions in the Kupperman Index and in the occurrence of hot flushes and night sweats at week 12. Alleviation of climacteric symptoms was statistically equivalent in the two treatment groups (P <.001). The difference between groups in the Kupperman Index score of -0.5 +/- 0.9 (95% confidence interval -2.3, 1.3) was within the predetermined interval of equivalence. Both therapies were well tolerated with similar adverse event rates, except for moderate and severe mastalgia which was significantly less frequent with intranasal E2 (7.2%) than with the patch (15.5%, P =.02). Sixty-six percent of patients chose to continue the intranasal therapy and 34% the transdermal therapy (P <.001). Satisfaction was greater with intranasal therapy at week 16 (P <.001). CONCLUSION: Intranasal and transdermal estrogen delivery systems had equivalent efficacy and similar safety profiles. Intranasal therapy was the patients' choice for long-term treatment. [less ▲]

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Peer Reviewed
See detailEndometrial laser interstitial hyperthermy: a potential modality for endometrial ablation.
Donnez, Jacques; Polet, Roland; Mathieu, Pierre-Emmanuel et al

in Obstetrics & Gynecology (1996), 87(3), 459-64

This study was undertaken to evaluate the efficacy and safety of an intrauterine device designed for endometrial ablation by Nd-YAG laser interstitial hyperthermy. Eight hysterectomy specimens were ... [more ▼]

This study was undertaken to evaluate the efficacy and safety of an intrauterine device designed for endometrial ablation by Nd-YAG laser interstitial hyperthermy. Eight hysterectomy specimens were treated in vitro with an output power of 30 W for 5 minutes; tissue temperatures, recorded by thermocouples, were plotted to draw time-temperature and time-distance curves. As a preliminary series, ten patients were treated, with the first five subjected to local temperature monitoring; all ten were followed-up for 6-17 months. Immediate and delayed (6 weeks) histologic data were obtained. The intramural temperature at 6 mm from the fibers ranged from 55-60C). In vivo, the cooling effect of the arterial blood flow lowered the serosal temperatures under 41C. The histologic data and the hysterographic pictures suggest that endometrial ablation was effective. This new device does not require distending medium, hysteroscopic control, or high-powered Nd-YAG laser machines. Preliminary long-term results suggest that the device could be used for endometrial ablation. [less ▲]

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