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1. A Comparison of Complications between Open Abdominal Sacrocolpopexy and Laparoscopic Sacrocolpopexy for the Treatment of Vault Prolapse

Author

Anne-Lotte W. M. Coolen, Anique M. J. van Oudheusden, Hugo W. F. van Eijndhoven, Tim P. F. M. van der Heijden, Rutger A. Stokmans, Ben Willem J. Mol, and Marlies Y. Bongers

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Introduction. Sacrocolpopexy is a generally applied treatment for vault prolapse which can be performed laparoscopically or by open laparotomy. Methods. Between October 2007 and December 2012, we performed a multicenter prospective cohort study in 2 university and 4 teaching hospitals in the Netherlands. We included patients with symptomatic posthysterectomy vaginal vault prolapse requiring surgical treatment, who either had abdominal or laparoscopic sacrocolpopexy. We studied surgery related morbidity, which was divided in pre-, peri-, and postoperative characteristics. Results. We studied 85 patients, of whom 42 had open abdominal and 43 laparoscopic sacrocolpopexy. In the laparoscopic sacrocolpopexy group, estimated blood loss was significantly less compared to the abdominal group: 192 mL (±126) versus 77 mL (±182), respectively (P≤.001). Furthermore, hospital stay was significantly shorter in the laparoscopic group (4.2 days) as compared to the abdominal group (2.4 days) (P≤.001). The overall complication rate was not significantly different (P=.121). However there was a significant difference in favor of the laparoscopic group in peri- and postoperative complications requiring complementary (conservative) treatment and/or extended admittance (RR 0.24 (95%-CI 0.07–0.80), P=.009). Conclusion. Laparoscopic sacrocolpopexy reduces blood loss and hospital stay as compared to abdominal sacrocolpopexy and generates less procedure related morbidity.

Published
2013
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2. Reproductive endocrinology

Author

A. Nazzaro, A. Salerno, L. Di Iorio, G. Landino, S. Marino, E. Pastore, F. Fabregues, A. Iraola, G. Casals, M. Creus, S. Peralta, J. Penarrubia, D. Manau, S. Civico, J. Balasch, I. Lindgren, Y. L. Giwercman, E. Celik, I. Turkcuoglu, B. Ata, A. Karaer, P. Kirici, B. Berker, J. Park, J. Kim, J. Rhee, M. Krishnan, O. Rustamov, R. Russel, C. Fitzgerald, S. Roberts, S. Hapuarachi, B. K. Tan, R. S. Mathur, A. van de Vijver, C. Blockeel, M. Camus, N. Polyzos, L. Van Landuyt, H. Tournaye, N. O. Turhan, D. Hizli, Z. Kamalak, A. Kosus, N. Kosus, H. Kafali, A. Lukaszuk, M. Kunicki, J. Liss, A. Bednarowska, G. Jakiel, K. Lukaszuk, M. Lukaszuk, B. Olszak-Sokolowska, T. Wasniewski, M. Neuberg, V. Cavalcanti, C. Peluso, B. L. Lechado, E. B. Cordts, D. M. Christofolini, C. P. Barbosa, B. Bianco, C. A. Venetis, E. M. Kolibianakis, J. Bosdou, B. C. Tarlatzis, M. Onal, D. N. Gungor, M. Acet, S. Kahraman, E. Kuijper, J. Twisk, M. Caanen, T. Korsen, P. Hompes, M. Kushnir, A. Rockwood, W. Meikle, C. B. Lambalk, X. Yan, X. Dai, J. Wang, N. Zhao, Y. Cui, J. Liu, F. Yarde, A. H. E. M. Maas, A. Franx, M. J. C. Eijkemans, J. T. Drost, B. B. van Rijn, J. van Eyck, Y. T. van der Schouw, F. J. M. Broekmans, F. Martyn, B. Anglim, M. Wingfield, T. Fang, G. J. Yan, H. X. Sun, Y. L. Hu, J. Chrudimska, P. Krenkova, M. Macek, J. Teixeira da Silva, M. Cunha, J. Silva, P. Viana, A. Goncalves, N. Barros, C. Oliveira, M. Sousa, A. Barros, S. M. Nelson, S. M. Lloyd, A. McConnachie, A. Khader, R. Fleming, D. A. Lawlor, L. Thuesen, A. N. Andersen, A. Loft, J. Smitz, M. Abdel-Rahman, S. Ismail, J. Silk, M. Abdellah, A. H. Abdellah, F. Ruiz, M. Cruz, M. Piro, D. Collado, J. A. Garcia-Velasco, A. Requena, Z. Kollmann, N. A. Bersinger, B. McKinnon, S. Schneider, M. D. Mueller, M. von Wolff, A. Vaucher, B. Weiss, P. Stute, U. Marti, J. Chai, W. Y. T. Yeung, C. Y. V. Lee, W. H. R. Li, P. C. Ho, H. Y. E. Ng, S. M. Kim, S. H. Kim, B. C. Jee, S. Ku, C. S. Suh, Y. M. Choi, J. G. Kim, S. Y. Moon, J. H. Lee, S. G. Kim, Y. Y. Kim, H. J. Kim, K. H. Lee, I. H. Park, H. G. Sun, Y. I. Hwang, N. Y. Sung, M. H. Choi, S. H. Cha, C. W. Park, J. Y. Kim, K. M. Yang, I. O. Song, M. K. Koong, I. S. Kang, H. O. Kim, C. Haines, W. Y. Wong, W. S. Kong, L. P. Cheung, T. K. Choy, P. C. Leung, R. Fadini, G. Coticchio, M. M. Renzini, M. C. Guglielmo, F. Brambillasca, A. Hourvitz, D. F. Albertini, P. Novara, M. Merola, M. Dal Canto, J. A. A. Iza, J. L. DePablo, C. Anarte, A. Domingo, E. Abanto, G. Barrenetxea, R. Kato, S. Kawachiya, D. Bodri, M. Kondo, T. Matsumoto, L. G. L. Maldonado, A. S. Setti, D. P. A. F. Braga, A. Iaconelli, E. Borges, C. Iaconelli, R. C. S. Figueira, K. Kitaya, S. Taguchi, M. Funabiki, Y. Tada, T. Hayashi, Y. Nakamura, M. Snajderova, D. Zemkova, V. Lanska, L. Teslik, R. N. - Calonge, L. Ortega, A. Garcia, S. Cortes, A. Guijarro, P. C. Peregrin, M. Bellavia, M. H. Pesant, D. Wirthner, L. Portman, D. de Ziegler, D. Wunder, X. Chen, S. H. L. Chen, Y. D. Liu, T. Tao, L. J. Xu, X. L. Tian, D. S. H. Ye, Y. X. He, A. Carby, E. Barsoum, S. El-Shawarby, G. Trew, S. Lavery, N. Mishieva, N. Barkalina, I. Korneeva, T. Ivanets, A. Abubakirov, R. Chavoshinejad, G. m. Hartshorne, W. Marei, A. a. Fouladi-nashta, G. Kyrkou, E. Trakakis, C. H. Chrelias, E. Alexiou, K. Lykeridou, G. Mastorakos, N. Bersinger, H. Ferrero, R. Gomez, C. M. Garcia-Pascual, C. Simon, A. Pellicer, A. Turienzo, B. Lledo, J. Guerrero, J. A. Ortiz, R. Morales, J. Ten, J. Llacer, R. Bernabeu, V. De Leo, R. Focarelli, A. Capaldo, A. Stendardi, L. Gambera, A. L. Marca, P. Piomboni, J. J. Kim, J. H. Kang, K. R. Hwang, S. J. Chae, S. H. Yoon, S. Y. Ku, S. Iliodromiti, T. W. Kelsey, R. A. Anderson, H. J. Lee, A. Weghofer, V. A. Kushnir, A. Shohat-Tal, E. Lazzaroni, D. H. Barad, N. N. Gleicher, T. Shavit, E. Shalom-Paz, O. Fainaru, M. Michaeli, E. Kartchovsky, A. Ellenbogen, J. Gerris, F. Vandekerckhove, A. Delvigne, N. Dhont, B. Madoc, J. Neyskens, M. Buyle, E. Vansteenkiste, E. De Schepper, L. Pil, N. Van Keirsbilck, W. Verpoest, D. Debacquer, L. Annemans, P. De Sutter, M. Von Wolff, N. a. Bersinger, F. F. Verit, S. Keskin, A. K. Sargin, S. Karahuseyinoglu, O. Yucel, S. Yalcinkaya, A. N. Comninos, C. N. Jayasena, G. M. K. Nijher, A. Abbara, A. De Silva, J. D. Veldhuis, R. Ratnasabapathy, C. Izzi-Engbeaya, A. Lim, D. A. Patel, M. A. Ghatei, S. R. Bloom, W. S. Dhillo, M. Colodron, J. J. Guillen, D. Garcia, O. Coll, R. Vassena, V. Vernaeve, H. Pazoki, G. Bolouri, F. Farokhi, M. A. Azarbayjani, M. S. Alebic, N. Stojanovic, R. Abali, A. Yuksel, C. Aktas, C. Celik, S. Guzel, G. Erfan, O. Sahin, H. Zhongying, L. Shangwei, M. Qianhong, F. Wei, L. Lei, X. Zhun, W. Yan, A. De Baerdemaeker, K. Tilleman, S. Vansteelandt, J. B. A. Oliveira, R. L. R. Baruffi, C. G. Petersen, A. L. Mauri, A. M. Nascimento, L. Vagnini, J. Ricci, M. Cavagna, F. C. Massaro, A. Pontes, J. G. Franco, W. El-khayat, M. Elsadek, F. Foroozanfard, H. Saberi, A. Moravvegi, M. Kazemi, Y. S. Gidoni, A. Raziel, S. Friedler, D. Strassburger, D. Hadari, E. Kasterstein, I. Ben-Ami, D. Komarovsky, B. Maslansky, O. Bern, R. Ron-El, M. P. Izquierdo, F. Araico, O. Somova, O. Feskov, I. Feskova, I. Bezpechnaya, I. Zhylkova, O. Tishchenko, S. K. Oguic, D. P. Baldani, L. Skrgatic, V. Simunic, H. Vrcic, D. Rogic, J. Juras, M. S. Goldstein, L. Garcia De Miguel, M. C. Campo, A. Gurria, J. Alonso, A. Serrano, E. Marban, L. Shalev, Y. Yung, G. Yerushalmi, C. Giovanni, J. Has, E. Maman, M. Monterde, A. Marzal, O. Vega, J. m. Rubio, C. Diaz-Garcia, A. Eapen, A. Datta, A. Kurinchi-selvan, H. Birch, G. M. Lockwood, M. C. Ornek, U. Ates, T. Usta, C. P. Goksedef, A. Bruszczynska, J. Glowacka, K. Jaguszewska, S. Oehninger, S. Nelson, P. Verweij, B. Stegmann, H. Ando, T. Takayanagi, H. Minamoto, N. Suzuki, N. Rubinshtein, S. Saltek, B. Demir, B. Dilbaz, C. Demirtas, W. Kutteh, B. Shapiro, H. Witjes, K. Gordon, M. P. Lauritsen, A. Pinborg, N. L. Freiesleben, A. L. Mikkelsen, M. R. Bjerge, P. Chakraborty, S. K. Goswami, B. N. Chakravarty, M. Mittal, R. Bajoria, N. Narvekar, R. Chatterjee, J. G. Bentzen, T. H. Johannsen, T. Scheike, L. Friis-Hansen, S. Sunkara, A. Coomarasamy, R. Faris, P. Braude, Y. Khalaf, A. Makedos, S. Masouridou, K. Chatzimeletiou, L. Zepiridis, A. Mitsoli, G. Lainas, I. Sfontouris, A. Tzamtzoglou, D. Kyrou, T. Lainas, A. Fermin, L. Crisol, A. Exposito, B. Prieto, R. Mendoza, R. Matorras, Y. Louwers, O. Lao, M. Kayser, A. Palumbo, V. Sanabria, J. P. Rouleau, M. Puopolo, M. J. Hernandez, J. M. Rubio, S. Ozturk, B. Sozen, A. Yaba-Ucar, D. Mutlu, N. Demir, H. Olsson, R. Sandstrom, L. Grundemar, E. Papaleo, L. Corti, E. Rabellotti, V. S. Vanni, M. Potenza, M. Molgora, P. Vigano, M. Candiani, M. Fernandez-Sanchez, E. Bosch, H. Visnova, P. Barri, B. J. C. M. Fauser, J. C. Arce, P. Peluso, C. M. Trevisan, F. A. Fonseca, P. Bakas, N. Vlahos, D. Hassiakos, D. Tzanakaki, O. Gregoriou, A. Liapis, G. Creatsas, E. Adda-Herzog, J. Steffann, S. Sebag-Peyrelevade, M. Poulain, A. Benachi, R. Fanchin, D. Zhang, F. Aybar, S. Temel, O. Hamdine, N. S. Macklon, J. S. Laven, B. J. Cohlen, A. Verhoeff, P. A. van Dop, R. E. Bernardus, G. J. E. Oosterhuis, C. A. G. Holleboom, G. C. van den Dool-Maasland, H. J. Verburg, P. F. M. van der Heijden, A. Blankhart, B. C. J. M. Fauser, F. J. Broekmans, J. Bhattacharya, A. Mitra, G. B. Dutta, A. Kundu, M. Bhattacharya, S. Kundu, P. Pigny, A. Dassonneville, S. Catteau-Jonard, C. Decanter, D. Dewailly, J. Pouly, F. Olivennes, N. Massin, M. Celle, N. Caizergues, M. Gaudoin, M. Messow, L. Vanhove, M. Peigne, P. Thomas, and G. Robin

Subjects
Gynecology, Gerontology, medicine.medical_specialty, Index (economics), Reproductive Medicine, business.industry, Rehabilitation, Obstetrics and Gynecology, Medicine, Stimulation, business
Abstract

Sao Paulo State Univ UNESP, Ctr Human Reprod Prof Franco Jr, Paulista Ctr Diag Res & Training, Dept Gynecol & Obstet,Botucatu Med Sch, Ribeirao Preto, Brazil

Published
2013
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3. REPRODUCTIVE ENDOCRINOLOGY

Author

Y. Karasu, B. Dilbaz, B. Demir, S. Dilbaz, O. Secilmis Kerimoglu, C. M. Ercan, U. Keskin, C. Korkmaz, N. K. Duru, A. Ergun, I. de Zuniga, M. Horton, A. Oubina, L. Scotti, D. Abramovich, N. Pascuali, M. Tesone, F. Parborell, N. Bouzas, X. H. Yang, S. L. Chen, X. Chen, D. S. Ye, H. Y. Zheng, A. Nyboe Andersen, M. P. Lauritsen, L. L. Thuesen, M. Khodadadi, S. Shivabasavaiah, R. Mozafari, Z. Ansari, O. Hamdine, F. Broekmans, M. J. C. Eijkemans, B. J. Cohlen, A. Verhoeff, P. A. van Dop, R. E. Bernardus, C. B. Lambalk, G. J. E. Oosterhuis, C. Holleboom, G. C. van den Dool-Maasland, H. J. Verburg, P. F. M. van der Heijden, A. Blankhart, B. C. J. M. Fauser, J. S. E. Laven, N. S. Macklon, D. Agudo, C. Lopez, M. Alonso, E. Huguet, F. Bronet, J. A. Garcia-Velasco, A. Requena, M. Gonzalez Comadran, M. A. Checa, M. Duran, F. Fabregues, R. Carreras, A. Ersahin, S. Kahraman, M. Kavrut, B. Gorgen, M. Acet, N. Dokuzeylul, F. Aybar, S. Y. Lim, J. C. Park, J. G. Bae, J. I. Kim, J. H. Rhee, A. Mahran, A. Abdelmeged, A. El-Adawy, M. Eissa, J. Darne, R. W. Shaw, S. A. Amer, A. Dai, G. Yan, Q. He, Y. Hu, H. Sun, H. Ferrero, R. Gomez, C. M. Garcia-Pascual, C. Simon, F. Gaytan, A. Pellicer, C. M. Garcia Pascual, R. C. Zimmermann, T. Madani, L. Mohammadi Yeganeh, S. H. Khodabakhshi, M. R. Akhoond, F. Hasani, C. Monzo, D. Haouzi, S. Assou, H. Dechaud, S. Hamamah, S. Amer, M. Mahran, R. Shaw, V. Lan, G. Nhu, H. Tuong, M. A. Mahmoud Youssef, I. Aboulfoutouh, H. Al-inany, F. Van Der Veen, M. Van Wely, Q. Zhang, T. Fang, S. Wu, L. Zhang, B. Wang, X. Li, L. Ding, A. Day, B. Fulford, J. Boivin, I. Alanbay, M. Sakinci, H. Coksuer, M. Ozturk, S. Tapan, C. K. Chung, Y. Chung, S. Seo, S. Aksoy, K. Yakin, S. Caliskan, Z. Salar, B. Ata, B. Urman, P. Devroey, J. C. Arce, K. Harrison, J. Irving, J. Osborn, M. Harrison, F. Fusi, M. Arnoldi, M. Cappato, E. Galbignani, A. Galimberti, L. Zanga, L. Frigerio, S. A. Taghavi, M. Ashrafi, L. Karimian, M. Mehdizadeh, M. Joghataie, R. Aflatoonian, B. Xu, Y. G. Cui, L. L. Gao, F. Y. Diao, M. Li, X. Q. Liu, J. Y. Liu, F. Jiang, B. C. Jee, G. Yi, J. Y. Kim, C. S. Suh, S. H. Kim, S. Liu, L. B. Cai, J. J. Liu, X. Ma, E. Geenen, R. S. G. M. Bots, J. M. J. Smeenk, E. Chang, W. Lee, H. Seok, Y. Kim, J. Han, T. Yoon, L. Lazaros, N. Xita, K. Zikopoulos, G. Makrydimas, A. Kaponis, N. Sofikitis, T. Stefos, E. Hatzi, I. Georgiou, R. Atilgan, B. Kumbak, L. Sahin, Z. S. Ozkan, M. Simsek, E. Sapmaz, M. Karacan, F. A. Alwaeely, Z. Cebi, M. Berberoglugil, M. Ulug, T. Camlibel, H. Yelke, Z. Kamalak, A. Carlioglu, D. Akdeniz, S. Uysal, I. Inegol Gumus, N. Ozturk Turhan, S. Regan, J. Yovich, J. Stanger, G. Almahbobi, M. Kara, T. Aydin, N. Turktekin, M. Youssef, H. Al-Inany, F. van der Veen, M. van Wely, R. Hart, D. Doherty, H. Frederiksen, J. Keelan, C. Pennell, J. Newnham, N. Skakkebaek, K. Main, H. T. Salem, A. a. Ismail, M. Viola, T. I. Siebert, D. W. Steyn, T. F. Kruger, G. Robin, D. Dewailly, P. Thomas, M. Leroy, C. Lefebvre, B. soudan, P. Pigny, C. Decanter, M. ElPrince, F. Wang, Y. Zhu, H. Huang, F. Valdez Morales, V. Vital Reyes, A. Mendoza Rodriguez, A. Gamboa Dominguez, M. Cerbon, J. Aizpurua, B. Ramos, B. Luehr, I. Moragues, S. Rogel, A. P. Cil, Z. B. Guler, U. Kisa, A. Albu, S. Radian, F. Grigorescu, D. Albu, S. Fica, L. Al Boghdady, M. E. Ghanem, M. Hassan, A. S. Helal, S. Ozdogan, O. Ozdegirmenci, O. Cinar, U. Goktolga, B. Seeber, I. Tsybulyak, B. Bottcher, T. Grubinger, T. Czech, L. Wildt, J. Wojcik, C. M. Howles, B. Destenaves, P. Arriagada, E. Tavmergen, G. Sahin, A. Akdogan, R. Levi, E. N. T. Goker, A. Loft, J. Smitz, L. Ricciardi, C. Di Florio, M. Busacca, D. Gagliano, V. Immediata, L. Selvaggi, D. Romualdi, M. Guido, P. Bouhanna, S. Salama, Z. Kamoud, A. Torre, B. Paillusson, F. Fuchs, M. Bailly, R. Wainer, V. Tagliaferri, C. Tartaglia, E. Cirella, A. Aflatoonian, M. Eftekhar, F. Mohammadian, F. Yousefnejad, S. De Cicco, G. Campagna, R. Depalo, C. Lippolis, M. Vacca, C. Nardelli, A. Cavallini, T. Panic, G. Mitulovic, M. Franz, K. Sator, W. Tschugguel, D. Pietrowski, T. Hildebrandt, S. Cupisti, E. J. Giltay, L. J. Gooren, P. G. Oppelt, J. Hackl, C. Reissmann, C. Schulze, K. Heusinger, M. Attig, I. Hoffmann, M. W. Beckmann, R. Dittrich, A. Mueller, S. Sharma, S. Singh, A. Chakravarty, A. Sarkar, S. Rajani, B. N. Chakravarty, E. Ozturk, S. Isikoglu, S. Kul, T. Hillensjo, H. Witjes, J. Elbers, B. Mannaerts, K. Gordon, K. Krasnopolskaya, A. Galaktionova, O. Gorskaya, D. Kabanova, R. Venturella, M. Morelli, R. Mocciaro, S. Capasso, F. Cappiello, F. Zullo, M. Monterde, A. Marzal, O. Vega, J. M. Rubio-Rubio, C. Diaz-Garcia, E. Kolibianakis, G. Griesinger, C. Yding Andersen, P. Ocal, O. Guralp, B. Aydogan, T. Irez, M. Cetin, H. Senol, N. Erol, L. Rombauts, J. Van Kuijk, J. Montagut, D. Nogueira, G. Porcu, M. Chomier, C. Giorgetti, B. Nicollet, J. Degoy, P. Lehert, C. Alviggi, P. De Rosa, R. Vallone, S. Picarelli, M. Coppola, A. Conforti, I. Strina, C. Di Carlo, G. De Placido, L. Haeberle, O. Demirtas, H. Fatemi, B. S. Shapiro, B. M. Mannaerts, M. N. Chimote, B. N. Mehta, N. N. Chimote, N. M. Nath, N. M. Chimote, S. Karia, M. Bonifacio, M. Bowman, S. McArthur, J. Jung, S. Cho, Y. Choi, B. Lee, K. H. Lee, C. H. Kim, S. K. Kwon, B. M. Kang, K. S. Jung, G. Basios, E. Trakakis, E. Hatziagelaki, V. Vaggopoulos, A. Tsiavou, P. Panagopoulos, C. Chrelias, D. Kassanos, A. Sarhan, A. Elsamanoudy, M. Harira, S. Dogan, G. Bozdag, I. Esinler, M. Polat, and H. Yarali

Subjects
Gynecology, medicine.medical_specialty, business.industry, Rehabilitation, Dietary management, Obstetrics and Gynecology, Overweight, medicine.disease, Polycystic ovary, law.invention, Reproductive Medicine, Randomized controlled trial, Weight loss, law, Internal medicine, Meta-analysis, medicine, medicine.symptom, business, Body mass index, hirsutism
Abstract

Introduction: Weight loss amongst women with polycystic ovary syndrome (PCOS) is crucial to reduce the risk of endocrine, reproductive and metabolic complications including hirsutism, menstrual disturbances and cardiovascular disease. With approximately 50% of women with PCOS being overweight or obese, effective dietary management of weight in PCOS is essential. However, there is inconsistent evidence as to whether specifically modified diets (e.g. reduced carbohydrate diets) are more effective at achieving weight loss amongst women with PCOS than are conventional healthy hypocaloric diets. Material and Methods: A systematic review and meta-analysis of randomized controlled trials that had compared weight and BMI between women with PCOS who had undergone either a specifically modified diet or a conventional healthy hypocaloric diet were performed. Six electronic databases were searched, a manual search of the reference lists of the included studies was carried out and authors were contacted for additional information. Nine studies with a total of 395 participants (all with a body mass index [BMI] ≥30) were included in the meta-analysis. The effect size used was the mean difference in post-intervention weight and BMI between participants who had undergone a specifically modified diet and participants who had undergone a conventional healthy hypocaloric diet. Results: There were no differences between groups in post-intervention weight (mean difference 1.26, 95% confidence interval (CI) -0.92 to 3.43, p = .26; heterogeneity I2 = 50%, p = .04) or BMI (mean difference 0.15, 95% CI -0.93 to 1.23, p = 0.79; heterogeneity I2 = 44%, p = 0.10). Subgroup analyses according to the presence of a dietary run-in period (a period at the start of the study during which all participants are placed on an identical diet in order to equalize them on variables influenced by diet), intervention duration and type of diet and a sensitivity analysis according to study quality were not significant. Conclusions: Whilst the results should be interpreted in light of the moderate heterogeneity observed, they suggest that specifically modified diets offer no added benefit for weight loss in women with PCOS over conventional healthy hypocaloric diets. The findings of this meta-analysis may promote the unification of guidelines for the dietary management of PCOS and allow clinicians to be confident in prescribing conventional healthy hypocaloric diets for weight loss amongst their PCOS patients.

Published
2012
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4. Lactation inhibition by the dopamine agonist CV 205-502

Author

Jan A.M. Kremer, Rune Rolland, J. Brownell, and P. F. M. van der Heijden

Subjects
Agonist, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Dopamine Agents, Administration, Oral, Pilot Projects, Dopamine agonist, Drug Administration Schedule, Electrocardiography, Pregnancy, Lactation, Internal medicine, medicine, Humans, Pulse, Bromocriptine, Chemotherapy, business.industry, Postpartum Period, Obstetrics and Gynecology, Prolactin, medicine.anatomical_structure, Epinephrine, Endocrinology, Aminoquinolines, Female, Blood Coagulation Tests, business, Breast feeding, medicine.drug
Abstract

Summary. In an open pilot study with a parallel group design 30 bottle feeding women were randomly assigned in a two to one ratio to receive either the new dopamine agonist CV 205–502 or bromocriptine for lactation inhibition. Ten women who intended to breast feed served as normal controls. All treated women reached prepregnant prolactin levels within 72 h with once-daily 0.075 mg of CV 205–502 or twice-daily 2.5 mg of bromocriptine, at starting doses of 0.05 mg and 2.5 mg respectively. Fifteen of the 20 women treated with CV 205–502 reported breast symptoms, 50% occurring on days 3 and 4 of treatment. Three of the 10 women treated with bromocriptine had breast symptoms between days 2 and 28. Overall efficacy and tolerance in the two groups was very good. Side effects did not differ between the groups, with the exception of pulse rate in the standing position, which was significantly higher in the bromocriptine treated group than in either the CV 205–502 group (P = 0.02) or the breast feeding group (P < 0.01). The coagulation tests (fibrinogen, AT III, PTT and APTT) showed no significant differences between the three groups.

Published
1991
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5. Papillary carcinoma in struma ovarii: an unusual presentation

Author

J F C, Tomee, P F M, van der Heijden, J H W, van den Hout, M, Brinkhuis, and Th F, Veneman

Subjects
Diagnosis, Differential, Ovarian Neoplasms, Ovariectomy, Humans, Female, Middle Aged, Tomography, X-Ray Computed, Carcinoma, Papillary, Struma Ovarii, Endosonography, Follow-Up Studies
Abstract

Struma ovarii is the presence of thyroid tissue as the major cellular component in an ovarian tumour. Papillary carcinoma in struma ovarii is exceptionally rare. We report a case of papillary carcinoma in struma ovarii in a postmenopausal 51-year-old female who initially presented clinically with hyperthyroidism. Serology, however, did not confirm hyperthyroidism. During a re-admission to our hospital later that year she appeared to have had periods of postmenopausal vaginal haemorrhage. An abdominal mass was located by radiography and pathological investigation revealed a papillary carcinoma in struma ovarii. Some striking features of this unusual presentation of importance to the internal medicine physician are discussed.

Published
2008

6. Lactation inhibition by a single injection of a new depot-bromocriptine

Author

M. B. J. G. Vosmar, I. Lancranjan, P. F. M. van der Heijden, L. A. Schellekens, Jan A.M. Kremer, and Rune Rolland

Subjects
Adult, Drug, medicine.medical_specialty, Dose, media_common.quotation_subject, Pharmacology, Drug Administration Schedule, Pharmacokinetics, Pregnancy, Lactation, Internal medicine, Injection site, medicine, Humans, Bromocriptine, media_common, business.industry, Postpartum Period, Obstetrics and Gynecology, Drug Tolerance, Single injection, Prolactin, medicine.anatomical_structure, Endocrinology, Delayed-Action Preparations, Depression, Chemical, Female, business, medicine.drug
Abstract

Summary. Recently, long-acting injectable forms of bromocriptine have become available for the prevention of lactation. The first developed depot-form was very effective, but had the disadvantage of a slowly metabolized carrier. We investigated the pharmacokinetics, efficacy, tolerance and safety of 40 and 50 mg of a new rapidly eliminated depotform in 61 postpartum women. Bromocriptine rapidly increased after injection and prolactin was effectively suppressed during the studyperiod of 60 days. Overall efficacy was very good or good in 98% and no rebound lactation occurred. Sixteen women experienced side effects. Tolerance at the injection site was good and safety tests did not show abnormalities. There were no differences between the two dosages. We conclude that this new depot-bromocriptine is a safe, well tolerated and effective drug in the suppression of prolactin and the prevention of postpartum lactation.

Published
1990
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7. Postpartum return of pituitary and ovarian activity during lactation inhibition with the new dopamine agonist CV 205-502 and during normal lactation

Author

Chris M.G. Thomas, L. A. Schellekens, P. F. M. van der Heijden, Jan A.M. Kremer, J. Brownell, and Rune Rolland

Subjects
endocrine system, medicine.medical_specialty, Pituitary gland, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Dopamine Agents, Dopamine agonist, Follicle-stimulating hormone, Endocrinology, Internal medicine, medicine, Humans, Lactation, Ovulation, Bromocriptine, media_common, Estradiol, business.industry, Ovary, Postpartum Period, General Medicine, Luteinizing Hormone, Prolactin, Fertility, medicine.anatomical_structure, Pituitary Gland, Aminoquinolines, Female, Follicle Stimulating Hormone, Luteinizing hormone, business, Postpartum period, medicine.drug
Abstract

The new nonergot dopamine agonist CV 205-502 appears to be a promising alternative in the treatment of hyperprolactinemia. Regarding the potential use of CV 205-502 in infertility practice, we studied the influence of CV 205-502 on the return of endocrine fertility parameters during the physiological hyperprolactinemia of the puerperium. The resumption of pituitary and ovarian activity in 18 CV 205-502 treated women was compared with that in 10 bromocriptine-treated women. LH was measured by a new specific assay, which does not cross-react with hCG. This assay was also used in a second part of the study in which the pituitary function of 10 breast-feeding women was investigated. Both dopamine agonists adequately suppressed PRL. Pituitary secretion returned in the second week and was initially characterized by a high FSH/LH ratio. There were no major differences between CV 205-502 and bromocriptine. Ovulations occurred from day 18 on. The PRL rebound at the end of treatment seemed to play a role in the ovulation process. An acute increase of PRL just before midcycle was able to prevent ovulation. Breastfeeding women showed a delayed return of pituitary secretion: after a hypogonadotropic period, FSH returned in the third week and was followed by a period with a high FSH/LH ratio and follicular inactivity.

Published
1990
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8. Nafarelin versus danazol in the treatment of endometriosis

Author

Rune Rolland and P. F. M. van der Heijden

Subjects
Adult, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Endometriosis, Urology, Placebo, Gonadotropin-Releasing Hormone, Nafarelin, Pregnadienes, medicine, Humans, Danazol, Gynecology, business.industry, Obstetrics and Gynecology, Middle Aged, medicine.disease, Nafaréline, Clinical trial, Multicenter study, Nasal spray, Female, business, medicine.drug
Abstract

A double-blind, double-dummy, 6-month multicenter study comparing the effects of nafarelin and danazol in the treatment of endometriosis was completed recently by investigators from 13 institutions in seven European countries. The 194 patients (aged 18 to 45 years) selected for the study were divided into two groups. One group received nafarelin, 200 micrograms twice daily, and placebo capsules identical to danazol, twice daily. The other group received danazol capsules, 200 mg twice daily, and a placebo nasal spray identical to nafarelin, twice daily. A comparison of decreases in both groups of American Fertility Society endometriosis scores and in severity scores developed by the investigators indicates that nafarelin and danazol are equally effective in the treatment of endometriosis.

Published
1990

9. Prolactin suppressant effect of CQP 201–403, a new dopamine agonist, in hyperprolactinemic women

Author

P. F. M. van der Heijden, Rune Rolland, and J. Brownell

Subjects
Drug, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Dopamine Agents, Pharmacology, Placebo, Dopamine agonist, Drug Administration Schedule, Random Allocation, Endocrinology, Double-Blind Method, Internal medicine, medicine, Humans, Ergolines, Available drugs, media_common, Clinical Trials as Topic, Dose-Response Relationship, Drug, business.industry, Obstetrics and Gynecology, CQP-201-403, Hormones, Prolactin, Hyperprolactinemia, Tolerability, Female, Once daily, business, medicine.drug
Abstract

To meet the need for a dopamine agonist compound which would offer longer action and improved tolerability, CQP 201-403 has been developed. CQP is a propyl-ergoline which has shown specific and strong 24-hour prolactin suppression in healthy volunteers at oral doses from 0.01 mg and higher. In the study 24 hyperprolactinemic women were given once daily doses of 0.01 mg, 0.02 mg or 0.03 mg CQP 201-403, or placebo for 7 days in a double-blind study to assess the prolactin suppressant action and tolerability of the compound. The results show dose-dependent prolactin suppression following the initial CQP dose which was sustained in steady state, when a clear 24-hour action was seen. Tolerability was good and no drug attributable changes in safety measures occurred. On the basis of its facility to suppress prolactin at well tolerated once daily doses, CQP would offer an advantage over currently available drugs. Long-term therapeutic studies in hyperprolactinemia are therefore warranted.

Published
1987
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10. Endocrine effects of CV 205-502, a new dopamine agonist, in hyperprolactinemic women

Author

Chris M.G. Thomas, J. Brownell, Rune Rolland, and P. F. M. van der Heijden

Subjects
Adult, endocrine system, medicine.medical_specialty, Dopamine, Endocrinology, Diabetes and Metabolism, Placebo group, Dopamine agonist, Random Allocation, Endocrinology, Double-Blind Method, Pituitary Hormones, Anterior, Internal medicine, medicine, Humans, Prospective Studies, Prolactin serum, Progesterone, Clinical Trials as Topic, Estradiol, business.industry, Dopaminergic, Obstetrics and Gynecology, Capsule, Prolactin, Hyperprolactinemia, Aminoquinolines, Female, Endocrine effects, business, Pituitary Hormone-Releasing Hormones, hormones, hormone substitutes, and hormone antagonists, medicine.drug, Hormone
Abstract

CV 205-502 (CV) is a potent dopaminergic compound which exerts a strong and sustained suppression of prolactin secretion in healthy volunteers. In a prospective double-blind, randomized, placebo-controlled trail, 12 hyperprolactinemic women (greater than or equal to 2000 mU/l), divided into 2 groups of 6 women each, were treated for 4 weeks. Combined pituitary challenge tests (GnRH, TRH, CRH and GHRH) were performed before and after treatment. The 6 CV-treated women (0.05 micrograms daily) showed approximately a 64% decrease of their initial prolactin serum concentrations after 4 weeks of capsule intake. Placebo-treated women showed no change in their prolactin serum level. After TRH administration, a blunted prolactin response was present in all women before treatment. After CV treatment a trend towards normalization of the prolactin response to TRH was seen, whereas the response pattern in the placebo group remained unaltered. The responses of GH, TSH, LH and ACTH to their releasing hormones and cortisol showed no significant changes after administration. FSH, however, showed a significant decrease in response to LH-RH, which could be explained by an increase in estradiol (E2) as ovarian function normalized in CV-treated women. In conclusion, CV shows strong dopamine agonistic properties in hyperprolactinemic women treated with 0.05 micrograms daily. The profile of this new quinoline compound, as judged from the pituitary challenge tests, does not differ from that of dopamine agonists of the ergoline type.

Published
1988
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