Ivanna V. Tataryn

Postmenopausal hot flushes: A disorder of thermoregulation

The changes in cutaneous and body temperature and cutaneous conductance during hot flushes in eight postmenopausal women were studied. The vasomotor changes occurred approx. 45 sec after the patients experienced the initial subjective symptoms of the attacks. The rise in skin conductance appeared to be a more reliable index of the flushing episode than did the change in skin temperature. On the basis of the changes recorded it is suggested that the hot flush syndrome may represent a specific thermoregulatory disorder rather than being due to a non-specific central autonomic discharge. The episodes may be triggered by a neuroendocrine imbalance following the disruption of ovarian function and fall in estrogen production. In assessing the frequency and severity of hot flushes, and the effects of treatment, objective measurements of skin and core temperature and skin conductance should replace subjective criteria.

Elevations in skin temperature of the finger as an objective index of postmenopausal hot flashes: Standardization of the technique

The present study was designed to validate and standardize a technique of continuous recording of skin temperature of the finger as an objective index of hot flashes. Significant skin temperature rises (greater than 1 degree C) were recorded in close temporal relationship to 69% of subjective hot flashes experienced by seven postmenopausal women. The temperature elevations occurred at an interval of 54 +/- 10 minutes (mean +/- standard error) and lasted an average of 31 minutes. The mean increase was 2.7 degrees +/- 0.2 degrees C. The extent of the temperature elevations found in the postmenopausal subjects was significantly greater than in premenopausal control subjects (P less than 0.05) and was reduced by estrogen treatment (P less than 0.02). This study substantiates that the recording of skin temperature changes of the finger provides an objective index of hot flashes. This should assist in the investigation of the underlying disturbance and provide more accurate evaluation of modes of therapy.

THERMOREGULATORY CHANGES FOLLOWING THE MENOPAUSE

Publisher Summary This chapter presents a study to examine thermoregulatory changes following menopause. Eight patients were studied of whom five had spontaneously entered the climacteric and three had undergone oophorectomy. The age range was 37–66 years. Four normal menstruating subjects in the early follicular phase of the cycle were also studied. Measurements were carried out during a 24 h period on two separate occasions, approximately 7 days apart, with the subjects lightly clothed in bed in a thermally controlled room. During the first period of study, the patient was allowed to sleep during the normal time; in the second period, her sleeping time was reversed. Twenty-five flushing episodes were analyzed in detail in the postmenopausal patients. The mean values of the measured parameters are illustrated in the chapter.

Algorithmic analysis of estriol time concentration curves as a guide to timing of amniocentesis for fetal lung maturity

Utilizing a computerized algorithm which estimates gestational age (GA) by analyses of third trimester plasma estriol (E3) concentration curves, we predicted L/S ratios at the time of 64 amniocentesis indicated for assessment of fetal maturity. In the identification of immature fetuses, both methodologies concur in 95% of cases if an L/S ratio of less than or equal to 2.3 and projected GA of less than or equal to 36 weeks are accepted as cut-off points. In the identification of mature fetuses there is agreement in only 54% of cases if an L/S ratio of greater than or equal to 2.3 and projected GA of greater than or equal to 37 weeks are accepted as cut-off points. The data show that the E3 algorithm is of value in the postponing of premature and therefore unnecessary amniocenteses for fetal maturity. However the poor correlation between the E3 algorithm, a method previously shown to be accurate in GA prediction, and mature L/S ratios demonstrates the need to utilize more accurate indicators of mature amniotic fluid surfactant activity in future investigations.