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Impaired sexual function is an important cause of depression in uraemic females. Hyperprolactinaemia is frequent, and often associated with decreased serum oestradiol concentration, which can significantly contribute to accelerated bone loss. The aim of the study was to evaluate the effect of hormone replacement therapy (HRT) on sexual function, serum 17beta-oestradiol and prolactin, and bone mineral density (BMD) in pre-menopausal women undergoing haemodialysis.

Background. Impaired sexual function is an important cause of depression in uraemic females. Hyperprolactinaemia is frequent, and often associated with decreased serum oestradiol concentration, which can significantly contribute to accelerated bone loss. The aim of the study was to evaluate the effect of hormone replacement therapy (HRT) on sexual function, serum 17β-oestradiol and prolactin, and bone mineral density (BMD) in pre-menopausal women undergoing haemodialysis.
Methods. Among 63 women on haemodialysis, aged 18-45 years, 23 with secondary amenorrhoea and serum oestradiol <30 pg/ml were enrolled into the 1 year study. They were divided into: group I (n=13) treated with transdermal oestradiol with cyclic addition of norethisterone acetate, and control group II (n=10). BMD was measured with dual energy X-ray absorptiometry (DEXA).
Results. No important changes in sexual function and hormonal profile were observed in the control group, whereas in all women from group I the treatment induced regular menses and a marked improvement of libido and sexual activity. Serum 17β-oestradiol increased after the first month from 20.5±11.7 to 46.8±13.6 pg/ml (P<0.001) and remained at that level until the end of the study, accompanied by a decrease of serum prolactin (from 1457±1045 to 691±116 mIU/ml after 12 months; P<0.001). In group I, the treatment induced an increase in BMD, although significant only in L2-L4 (P<0.05), whereas in group II a mild insignificant decrease was observed. However, a comparison of BMD values after 12 months in both groups revealed marked (P<0.01-P<0.05) differences at all studied sites.
Conclusions. Transdermal HRT allows sustained physiological serum oestradiol concentrations in pre-menopausal women with oestrogen deficiency on haemodialysis, with the restoration of regular menses and a marked improvement in their sexual function. The treatment inhibits bone demineralization and can play an important role in the prevention of early osteoporosis in this group of patients.

Concentrations of Mycobacterium avium-M. intracellulare ranging from 10(-1) to 10(3) CFU/ml were added to blood, placed in Isolator tubes, and held at room temperature for intervals ranging from 4 h to 56 days before being processed (centrifugation and culture on Middlebrook 7H10 agar). At all concentrations tested, M. avium-M. intracellulare was recovered after hold times ranging from 4 h to 7 days; the number of final CFU actually increased progressively for hold times of 8 h or more. Hold times of up to 7 days did not increase the time from processing to the first appearance of visible colonies. At an inoculum of 10(2) CFU/ml, M. avium-M. intracellulare was recovered from Isolator tubes processed 56 days after inoculation. Two Isolator blood cultures were drawn from a patient with AIDS; M. avium-M. intracellulare was recovered from the sample processed immediately and from the sample processed after a hold time of 7 days. Since M. avium-M. intracellulare survives for prolonged periods in Isolator tubes, blood cultures may be collected in outpatient settings or in hospitals without mycobacterial culture facilities and shipped to reference laboratories for processing without loss of viability.

Broth microdilution MICs were determined for pairs of strains isolated from five AIDS patients with polyclonal Mycobacterium avium infection. Four (80%) of the five patients were infected simultaneously with strains having different antimicrobial susceptibility patterns. These findings have implications for the interpretation of susceptibility data in M. avium prophylaxis and treatment trials.