Pulmonary embolism in menopausal hormone therapy: a population-based register study.

OBJECTIVE: Oral but not transdermal menopausal hormone therapy (MHT) increases the risk of venous thromboembolism. There is no evidence regarding the risk of the serious complication pulmonary embolism (PE). The aim was to investigate the risk of PE in women using MHT depending on administration route, type of progestin and treatment duration. METHOD: The population-based case-control study covered 1,771,253 women aged 40-69 years, during 2006-2015. Diagnoses of PE (n = 13,974) and drug dispensations were received from national validated registers. RESULTS: Current MHT users had a higher risk of PE than non-users (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.05-1.26). First ever users had the highest risk (OR 2.07, 95% CI 1.23-3.50). Transdermal administration was not associated with increased risk of PE. The OR was slightly but non-significantly higher with estrogen combined with medroxyprogesterone acetate than with norethisterone acetate. DISCUSSION: The risk of PE was significantly increased in users of oral but not transdermal MHT, with the highest risk in first ever users of oral estrogen combined with medroxyprogesterone acetate. The risk was considerably lower in women with recurrent treatment, probably because of the healthy user effect. CONCLUSION: PE was most common close to initiation of oral treatment. Transdermal MHT did not increase the risk of PE.

Alcohol Withdrawal, Psychological Symptoms, and Treatment Success.

Twenty-nine chronic male alcoholics were examined with the Profile of Mood States (POMS). Tests with the POMS scale were carried out on the ward on Days 1 and 5 and after 21 days of sobriety. Our aim was to study the mood change in chronic alcoholics during detoxification and after 3 weeks of sobriety compared with a standard group (college students) and with psychiatric outpatients. A further aim was to study whether the patients who later underwent a Minnesota treatment program(n = 6) differed in mood compared with those who did not. An improvement was observed over time regarding all six POMS factors. The results for Day 21 were generally better than the expected normal values for the POMS profile sheet with regard to both psychiatric outpatients and college norms. The follow-up based on the patients' records 1.5-2 years after the detoxification occasion in question showed that 18 patients had been hospitalized, generally for alcohol detoxification. The 6 patients who participated in a Minnesota treatment program had no documented relapses. A comparison of these 6 patients with the rest showed that the former had significantly lower values on five of the subscales.

Sex hormones during alcohol withdrawal: a longitudinal study of 29 male alcoholics during detoxification.

It is a well-known fact that alcohol affects sex hormone levels in males. Even in the absence of liver dysfunction, there is still a direct toxic effect of ethanol on testosterone synthesis resulting in acutely decreased values. This study is based on 29 male alcoholics without severe signs of liver disease treated on the alcohol detoxification ward at Huddinge hospital in Stockholm, Sweden during 1995. The aim was to study levels of sex hormones in male alcoholics during detoxification with benzodiazepines and after 3 weeks of sobriety. Blood samples were taken three times: one day after admission (day 2) when the patient was sober, at discharge (day 5) and after 3 weeks of sobriety (day 21). Levels of testosterone and sex hormone-binding globulin (SHBG) showed the same pattern during detoxification and follow-up. They were both low, but generally within normal limits, on days 2 and 5, but raised after 3 weeks of sobriety. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were initially high, but were substantially depressed during detoxification. Levels of FSH recovered after 3 weeks, whereas LH remained at the same level. Most patients exhibited generally low levels of both FSH and LH, however. Levels of oestrone decreased steadily. There were no correlations between levels of sex hormones and the number of milligrams of oxazepam administered to the patients during detoxification either at admission, at discharge or at follow-up. In summary, the endocrinological response to alcohol intake is complex. This study suggests that the duration of endocrinological recovery after drinking is a quite long-lasting process, that different hormones need different times to recover and that the normal glandular-pituitary feed-back processes may be partly put out of order.

B16 melanoma in hairless mice: a model for thermographic research.

Little is understood concerning the mechanism of tumor-induced thermographic abnormalities observed in man. An ideal animal model is lacking. In an effort to create such a model we have worked with hairless mice, subcutaneously inoculated with B16 melanoma cells. This report documents the progress of that work and the subsequent development of a totally satisfactory system for the study of such tumors in a hairless animal.