Abnormal Menstrual Bleeding: Oligomenorrhea

2019 ◽  
Author(s):  
Yelena Dondik ◽  
Kelly Pagidas
Keyword(s):  
Menstrual Cycle ◽  
Menstrual Bleeding ◽  
Menstrual Dysfunction ◽  
Common Causes ◽  
Normal Menstrual Cycle ◽  
Müllerian Agenesis ◽  
The Common ◽  
Diagnostic Work ◽  
Reproductive Aged Women ◽  
Work Up

A normal menstrual cycle is the end result of a sequence of purposeful and coordinated events that require an intact hypothalamic-pituitary-ovarian, uterine, and genital outflow tract axis. Any derailment along this compartmental axis can lead to an abnormal menstrual cycle. Infrequent menstrual bleeding, oligomenorrhea, or absent menstrual bleeding, amenorrhea, are common complaints in reproductive-aged women. Amenorrhea, or the absence of menses, is defined as primary if no prior menses have occurred and secondary if cessation of prior menses occurs. A thorough understanding of the spectrum of etiologies that can affect each of these compartments will allow the clinician to systematically evaluate a patient with oligomenorrhea and to identify the source of the menstrual dysfunction. In this chapter, we review the definitions and classifications of oligomenorrhea and amenorrhea as well as the common causes, diagnostic work-up, and management considerations involved. This review contains 5 figures, 4 tables, and 19 references. Key Words: amenorrhea, eating disorders, gonadal dysgenesis, hyperprolactinemia, hypogonadal, hypothyroidism, intrauterine adhesions, müllerian agenesis, primary ovarian insufficiency, Turner syndrome 

SOME OBSERVATIONS ON PREGNANEDIOL EXCRETION DURING THE NORMAL MENSTRUAL CYCLE

1957 ◽  
Vol 24 (3_Suppl) ◽  
pp. S207
Author(s):  
A. Klopper
Keyword(s):  
Menstrual Cycle ◽  
Corpus Luteum ◽  
New Method ◽  
Menstrual Bleeding ◽  
Normal Menstrual Cycle ◽  
The Relationship ◽  
New View

Abstract The changes in view on the significance and amount of urinary pregnanediol in the menstrual cycle are reviewed; in particular the effects of the discovery that the adrenals in both sexes normally contribute to the urinary pregnanediol. Pregnanediol excretion during the menstrual cycle was studied by means of a new method of assay (Klopper et al., 1955) and the results applied to present day concepts of the growth and duration of the corpus luteum. The relationship between pregnanediol excretion and ovulation or the onset of menstrual bleeding was studied. A new view is put forward on the influence of age and parity on the production of progesterone by the corpus luteum.

scholarly journals Age-related aspects of differential diagnosis of acute cough in children and adults

2018 ◽  
Vol 28 (4) ◽  
pp. 461-468
Author(s):  
I. V. Leshchenko ◽  
S. A. Tsar’kova ◽  
A. D. Zherebtsov
Keyword(s):  
Differential Diagnosis ◽  
Anatomical Location ◽  
Pathological Changes ◽  
Review Of Literature ◽  
Acute Cough ◽  
Age Related ◽  
Common Causes ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Cough is one of the most common causes of seeking the primary medical care, especially during the autumn and the spring. This article is a review of literature  aimed at differential diagnosis of possible causes of acute cough in children and  adults. Given a vast majority of diseases associated with cough, differential diagnosis  have to consider several issues. The key issue is cough duration and possible  anatomical location of the pathological changes. An algorithm of differential diagnosis  of acute cough in children and adults and description of most common diseases  associated with acute cough are given in the review. Further diagnostic work-up  should be driven by the duration of cough as soon as the acute cough could be first  manifestation of a chronic disease.

scholarly journals Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: A cohort study

2020 ◽  
Author(s):  
Jing Zhang ◽  
Yiqun Hao ◽  
Wuling Ou ◽  
Fei Ming ◽  
Gai Liang ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Survival Outcome ◽  
Critical Groups ◽  
Hospital Death ◽  
The Common ◽  
Critical Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Kinetics Of

Abstract Background Interleukin-6 (IL-6) was proposed to be associated with the severity of coronavirus disease 2019 (COVID-19). The present study aimed to explore the kinetics of IL-6 levels, validate this association in COVID-19 patients, and report preliminary data on the efficacy of IL-6 receptor blockade. Methods We conducted a retrospective single-institutional study of 901 consecutive confirmed cases. Serum IL-6 concentrations were tested on admission and/or during hospital stay. Tocilizumab was given to 16 patients with elevated IL-6 concentration. Results 366 patients were defined as common cases, 411 patients as severe, and 124 patients as critical according to the Chinese guideline on diagnosis and treatment of COVID-19. The median concentration of IL-6 was < 1.5 pg/ml (IQR < 1.50–2.15), 1.85 pg/ml (IQR < 1.50–5.21), and 21.55 pg/ml (IQR 6.47–94.66) for the common, severe, and critical groups respectively (P༜0.001). The follow-up kinetics revealed serum IL-6 remained high in critical patients even when cured. An IL-6 concentration higher than 37.65 pg/ml was predictive of in-hospital death (AUC 0.97 [95%CI 0.95–0.99], P < 0.001) with a sensitivity of 91.7% and a specificity of 95.7%. In the 16 patients who received tocilizumab, IL-6 concentrations were significantly increased after administration, and survival outcome was not significantly different from that of propensity-score matched counterparts (n = 53, P = 0.12). Conclusion Serum IL-6 should be included in diagnostic work-up to stratify disease severity, but the benefit of tocilizumab needs further confirmation. Trial registration: retrospectively registered.

scholarly journals Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: A cohort study

2020 ◽  
Author(s):  
Jing Zhang ◽  
Yiqun Hao ◽  
Wuling Ou ◽  
Fei Ming ◽  
Gai Liang ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Survival Outcome ◽  
Critical Groups ◽  
Hospital Death ◽  
The Common ◽  
Critical Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Kinetics Of

Abstract Background: Interleukin-6 (IL-6) was proposed to be associated with the severity of coronavirus disease 2019 (COVID-19). The present study aimed to explore the kinetics of IL-6 levels, validate this association in COVID-19 patients, and report preliminary data on the efficacy of IL-6 receptor blockade. Methods: We conducted a retrospective single-institutional study of 901 consecutive confirmed cases. Serum IL-6 concentrations were tested on admission and/or during hospital stay. Tocilizumab was given to 16 patients with elevated IL-6 concentration. Results: 366 patients were defined as common cases, 411 patients as severe, and 124 patients as critical according to the Chinese guideline on diagnosis and treatment of COVID-19. The median concentration of IL-6 was <1.5 pg/ml (IQR <1.50-2.15), 1.85 pg/ml (IQR <1.50-5.21), and 21.55 pg/ml (IQR 6.47-94.66) for the common, severe, and critical groups respectively (P＜0.001). The follow-up kinetics revealed serum IL-6 remained high in critical patients even when cured. An IL-6 concentration higher than 37.65 pg/ml was predictive of in-hospital death (AUC 0.97 [95%CI 0.95-0.99], P<0.001) with a sensitivity of 91.7% and a specificity of 95.7%. In the 16 patients who received tocilizumab, IL-6 concentrations were significantly increased after administration, and survival outcome was not significantly different from that of propensity-score matched counterparts (n=53, P=0.12). Conclusion: Serum IL-6 should be included in diagnostic work-up to stratify disease severity, but the benefit of tocilizumab needs further confirmation.Trial registration: retrospectively registered.

Female sex Hormones do not Influence Arterial wall Properties during the Normal Menstrual Cycle

1997 ◽  
Vol 92 (5) ◽  
pp. 487-491 ◽  
Author(s):  
Christine Willekes ◽  
Henk J. Hoogland ◽  
Hans A. Keizer ◽  
Arnold P. Hoeks ◽  
Robert S. Reneman
Keyword(s):  
Menstrual Cycle ◽  
Carotid Artery ◽  
Femoral Artery ◽  
Common Carotid Artery ◽  
Arterial Wall ◽  
Common Femoral Artery ◽  
Cross Sectional ◽  
Wall Properties ◽  
Normal Menstrual Cycle ◽  
The Common

1. In previous studies, the elastic properties of the common carotid artery were found to differ between men and women. In these studies, however, the phase of the menstrual cycle was not taken into consideration. It was the aim of the present study to investigate the effect of changing ovarian hormone levels during the normal menstrual cycle on the arterial wall properties of female large arteries. 2. We investigated the elastic right common carotid artery and the muscular right common femoral artery of normotensive young (18–35 years) female subjects (n = 12). The arterial distensibility and cross-sectional compliance coefficients were determined by the use of a specially designed ultrasonic wall-tracking device and measurements of automatic brachial artery cuff blood pressure. The phase of the menstrual cycle was assessed by ultrasonographic evaluation and measurement of 17β-oestradiol and progesterone blood plasma levels. 3. The distensibility coefficient and the cross-sectional compliance coefficient of both the common carotid and the common femoral artery did not change significantly during the normal menstrual cycle despite evidently changing ovarian hormone levels. 4. We conclude that the menstrual cycle does not influence the arterial wall properties of either the elastic common carotid artery or the muscular common femoral artery.

scholarly journals Abnormal Uterine Bleeding: a Focus on Polycystic Ovary Syndrome

2009 ◽  
Vol 5 (3) ◽  
pp. 313-324 ◽  
Author(s):  
Martha Hickey ◽  
Krish Karthigasu ◽  
Sweta Agarwal
Keyword(s):  
Polycystic Ovary ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Ovary Syndrome ◽  
Menopausal Women ◽  
Common Causes ◽  
Reproductive Life ◽  
The Common ◽  
Irregular Bleeding

Abnormal uterine bleeding imposes major medical, social and financial problems for women, their families and the health services. Abnormal uterine bleeding refers to the regularity, frequency, duration and volume of bleeding. Irregular menstrual bleeding is most common at the extremes of reproductive life, in the initial 12–18 months after menarche and 5–6 years before the menopause begins. In Australia, the estimated cost of investigating and managing heavy menstrual bleeding alone is approximately AUS $6 million per annum. This article addresses the common causes of irregular bleeding in pre- and peri-menopausal women and presents an investigational approach.

scholarly journals Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: a cohort study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jing Zhang ◽  
Yiqun Hao ◽  
Wuling Ou ◽  
Fei Ming ◽  
Gai Liang ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Survival Outcome ◽  
Critical Groups ◽  
Hospital Death ◽  
The Common ◽  
Critical Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Kinetics Of

Abstract Background Interleukin-6 (IL-6) was proposed to be associated with the severity of coronavirus disease 2019 (COVID-19). The present study aimed to explore the kinetics of IL-6 levels, validate this association in COVID-19 patients, and report preliminary data on the efficacy of IL-6 receptor blockade. Methods We conducted a retrospective single-institutional study of 901 consecutive confirmed cases. Serum IL-6 concentrations were tested on admission and/or during hospital stay. Tocilizumab was given to 16 patients with elevated IL-6 concentration. Results 366 patients were defined as common cases, 411 patients as severe, and 124 patients as critical according to the Chinese guideline on diagnosis and treatment of COVID-19. The median concentration of IL-6 was < 1.5 pg/ml (IQR < 1.50–2.15), 1.85 pg/ml (IQR < 1.50–5.21), and 21.55 pg/ml (IQR 6.47–94.66) for the common, severe, and critical groups respectively (P < 0.001). The follow-up kinetics revealed serum IL-6 remained high in critical patients even when cured. An IL-6 concentration higher than 37.65 pg/ml was predictive of in-hospital death (AUC 0.97 [95% CI 0.95–0.99], P < 0.001) with a sensitivity of 91.7% and a specificity of 95.7%. In the 16 patients who received tocilizumab, IL-6 concentrations were significantly increased after administration, and survival outcome was not significantly different from that of propensity-score matched counterparts (n = 53, P = 0.12). Conclusion Serum IL-6 should be included in diagnostic work-up to stratify disease severity, but the benefit of tocilizumab needs further confirmation. Trial registration retrospectively registered.

scholarly journals Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: A cohort study

2020 ◽  
Author(s):  
Jing Zhang ◽  
Yiqun Hao ◽  
Wuling Ou ◽  
Fei Ming ◽  
Gai Liang ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Survival Outcome ◽  
Critical Groups ◽  
Hospital Death ◽  
The Common ◽  
Critical Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Kinetics Of

Abstract Background Interleukin-6 (IL-6) was proposed to be associated with the severity of coronavirus disease 2019 (COVID-19). The present study aimed to explore the kinetics of IL-6 levels, validate this association in COVID-19 patients, and report preliminary data on the efficacy of IL-6 receptor blockade. Methods We conducted a retrospective single-institutional study of 901 consecutive confirmed cases. Serum IL-6 concentrations were tested on admission and/or during hospital stay. Tocilizumab was given to 16 patients with elevated IL-6 concentration. Results 366 patients were defined as common cases, 411 patients as severe, and 124 patients as critical according to the Chinese guideline on diagnosis and treatment of COVID-19. The median concentration of IL-6 was < 1.5 pg/ml (IQR < 1.50–2.15), 1.85 pg/ml (IQR < 1.50–5.21), and 21.55 pg/ml (IQR 6.47–94.66) for the common, severe, and critical groups respectively (P༜0.001). The follow-up kinetics revealed serum IL-6 remained high in critical patients even when cured. An IL-6 concentration higher than 37.65 pg/ml was predictive of in-hospital death (AUC 0.97 [95%CI 0.95–0.99], P < 0.001) with a sensitivity of 91.7% and a specificity of 95.7%. In the 16 patients who received tocilizumab, IL-6 concentrations were significantly increased after administration, and survival outcome was not significantly different from that of propensity-score matched counterparts (n = 53, P = 0.12). Conclusion Serum IL-6 should be included in diagnostic work-up to stratify disease severity, but the benefit of tocilizumab needs further confirmation. Trial registration: retrospectively registered.

EXCRETION OF FOLLICLE-STIMULATING AND LUTEINIZING HORMONE DURING LACTATION

1968 ◽  
Vol 57 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Paul J. Keller
Keyword(s):  
Menstrual Cycle ◽  
Luteinizing Hormone ◽  
Chorionic Gonadotrophin ◽  
Menstrual Bleeding ◽  
Unknown Mechanism ◽  
Nursing Mother ◽  
Normal Menstrual Cycle ◽  
Biological Methods ◽  
The Relationship ◽  
Pooled Samples

ABSTRACT The excretion of follicle-stimulating and luteinizing hormone (FSH, LH) during lactation in women was studied by biological methods in individual and pooled samples of urine. During the first and second postpartum weeks, the FSH activity was low and the LH activity quite high, probably due to contamination with remaining chorionic gonadotrophin. Thereafter the FSH and LH values and the relationship between these hormones did not differ from those found during the normal menstrual cycle. Moreover, an increase in the LH excretion was observed in one nursing mother, though ovulation and menstrual bleeding did not follow. It was concluded, that anovulation and amenorrhoea during lactation might be due to ovarian refractoriness by an unknown mechanism, rather than to gonadotrophic dysfunction.

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