Oral estrogens decrease bleeding time and improve clinical bleeding in patients with renal failure
Article Abstract:
Hemostasis, the arrest of bleeding, is defective in patients with kidney failure and results in prolonged bleeding time, increased bruising, and bleeding from mucous membranes, especially the digestive tract. Common laboratory measures of bleeding are usually normal in these patients, but increased bleeding time (the time required for blood to stop flowing from a pin prick) usually correlates with the patient's medical condition. Several therapies for correcting this platelet-related defect have been advocated, including intravenous estrogen (female sex hormone) therapy. The mechanism by which estrogen works is unclear. Because many complications are associated with intravenous administration of estrogen, the effects of orally administered estrogen were studied in 14 patients with kidney failure and prolonged bleeding time. In one group of four patients, bleeding symptoms, including gastrointestinal bleeding, decreased within two days of estrogen therapy. Bleeding time normalized in two patients, was reduced by half in a third patient, and did not change in the fourth patient. In another study of 10 renal disease patients, bleeding times normalized or decreased by more than half in the five treated patients and remained unchanged in the patients who received placebo. Maximal reduction in bleeding time was achieved after an average of seven treatment days. No adverse side effects were observed with the estrogen treatment. These results suggest that orally administered estrogen is a safe and effective treatment for abnormal nonhemorrhagic bleeding in patients with chronic kidney disease. More extensive research is needed to confirm these findings and to determine the mechanism by which estrogen is working. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Lack of correlation of clinical breast examination with high-risk histopathology
Article Abstract:
In the clinical breast examination, the tissue is examined for lumps and irregularities by palpating the breast. The relationship between the findings of the clinical breast examination and the histopathologic findings (based on examination of tissue specimens) was assessed. A system for determining the degree of density and nodularity (lumpiness) of breast tissue was developed and tested on 199 breasts by repeat examinations performed four or more months apart. Then the density and nodularity of breast tissue was compared with histopathologic findings in breast tissue from 60 women who underwent surgery for breast cancer. In these 60 women, high-risk histopathologic findings were detected in 37 percent (the tissue examined was that surrounding, or at the margins of, the cancerous tissue which was removed). The results showed that there was no correlation between density or nodularity and the presence of high-risk histopathologic findings. The nodularity of the breast increased with age, and was inversely related to density. In other words, as breast nodularity increased, clinical density decreased. Thus, the physical examination of the breast by palpation should not be used to determine whether high-risk histopathology may be present in the breast. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
User Contributions:
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