Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

Source: Dissertation Abstracts International, Volume: 69-10, Section: B, page: 6009. Adviser: Dorothy K. Waller. Includes bibliographical references.

Avaliar a eficácia de duas formulações de contraceptivos orais combinados, uma contendo 20&#61549;g de etinilestradiol e 100 &#61549;g de levonorgestrel (grupo 1) e outra contendo 30&#61549;g de etinilestradiol e 150 &#61549;g de levonorgestrel (grupo 2), no controle da dismenorréia moderada a grave. Ensaio clínico aberto, prospectivo e randomizado. O cálculo amostral evidenciou que 11 pacientes seriam necessárias em cada grupo para detectar uma diferença de 1,5 pontos na escala analógica visual. As pacientes foram avaliadas no início do estudo e com 6 meses de uso de medicação. A escala analógica visual foi usada para avaliar a dismenorréia, a dispareunia e a dor não-cíclica. O questionário de Beck foi usado para avaliar depressão e o Short-Form-36 foi usado para avaliar a qualidade de vida. Outros desfechos avaliados foram os efeitos adversos e o controle do ciclo. No grupo 1, oito pacientes completaram o estudo e no grupo 2, dez pacientes. Não houve diferença, aos seis meses, entre os grupos 1 e 2 nos desfechos avaliados. Ao combinarmos os dois grupos, houve redução significativa dos escores para dismenorréia (p<0,0001), dispareunia (p<0,04) e dor não cíclica (p<0,006) com o uso dos contraceptivos hormonais. Houve melhora da qualidade devida observada em todos os domínios do Short-form 36 e redução dos escores do questionário de Beck em 8 dos 12 questionários analisados. Não ocorreram eventos adversos graves. Os contraceptivos orais de uso contínuo mostraram-se muito eficientes no controle da dismenorréia moderada a grave. Este efeito pode ser medido também pela melhora na qualidade de vida das pacientes tratadas. Como são medicações de baixo custo e com poucos efeitos colaterais, constituem uma das primeiras opções no tratamento de pacientes com dismenorréia moderada a grave. / Evaluate the efficacy of two different oral contraceptive formulations, one containing 20 &#61549;g of etinilestradiol and 100 &#61549;g of levonorgestrel (group 1) and the other with 30 &#61549;g of etinilestradiol and 150 &#61549;g of levonorgestrel(group 2). Methods: This is an open label, prospective and randomized clinical trial. It was calculated that 11 patients in each group were necessary to detect a difference of 1,5 points on the pain scale. After randomization, each group was evaluated at the beginning and at 6 months of treatment. The visual analogue scale was used to assess dysmenorrhea, dyspareunia and non-menstrual pain. To asses quality of life the Short-form 36 questionnaire was used and the beck inventory was used to measure depression. Adverse events and bleeding episodes were also recorded. On group 1 a total of eight patients completed the study and on group 2 there were ten patients. There was no statistical difference between the two groups after six months of treatment on all outcomes evaluated. Combining the two groups, there was a significative reduction of dysmenorrhea (p<0,0001), dyspareunia (p<0,04) and non-menstrual pain (p<0,006) with the oral contraceptives and there were no major adverse events. It was also observed an important improvement on all short-form 36 domains and reduction on 8 out of 12 Becks questionnaires. Conclusion: Continuous oral contraceptive use is very effective on the management of moderate to severe dysmenorrhea. This effect could also be seen on quality of life improvement after the treatment. Because of the low cost and few side effects of the medication, oral contraceptives should be used as first line treatment.

Avaliar a eficácia de duas formulações de contraceptivos orais combinados, uma contendo 20&#61549;g de etinilestradiol e 100 &#61549;g de levonorgestrel (grupo 1) e outra contendo 30&#61549;g de etinilestradiol e 150 &#61549;g de levonorgestrel (grupo 2), no controle da dismenorréia moderada a grave. Ensaio clínico aberto, prospectivo e randomizado. O cálculo amostral evidenciou que 11 pacientes seriam necessárias em cada grupo para detectar uma diferença de 1,5 pontos na escala analógica visual. As pacientes foram avaliadas no início do estudo e com 6 meses de uso de medicação. A escala analógica visual foi usada para avaliar a dismenorréia, a dispareunia e a dor não-cíclica. O questionário de Beck foi usado para avaliar depressão e o Short-Form-36 foi usado para avaliar a qualidade de vida. Outros desfechos avaliados foram os efeitos adversos e o controle do ciclo. No grupo 1, oito pacientes completaram o estudo e no grupo 2, dez pacientes. Não houve diferença, aos seis meses, entre os grupos 1 e 2 nos desfechos avaliados. Ao combinarmos os dois grupos, houve redução significativa dos escores para dismenorréia (p<0,0001), dispareunia (p<0,04) e dor não cíclica (p<0,006) com o uso dos contraceptivos hormonais. Houve melhora da qualidade devida observada em todos os domínios do Short-form 36 e redução dos escores do questionário de Beck em 8 dos 12 questionários analisados. Não ocorreram eventos adversos graves. Os contraceptivos orais de uso contínuo mostraram-se muito eficientes no controle da dismenorréia moderada a grave. Este efeito pode ser medido também pela melhora na qualidade de vida das pacientes tratadas. Como são medicações de baixo custo e com poucos efeitos colaterais, constituem uma das primeiras opções no tratamento de pacientes com dismenorréia moderada a grave. / Evaluate the efficacy of two different oral contraceptive formulations, one containing 20 &#61549;g of etinilestradiol and 100 &#61549;g of levonorgestrel (group 1) and the other with 30 &#61549;g of etinilestradiol and 150 &#61549;g of levonorgestrel(group 2). Methods: This is an open label, prospective and randomized clinical trial. It was calculated that 11 patients in each group were necessary to detect a difference of 1,5 points on the pain scale. After randomization, each group was evaluated at the beginning and at 6 months of treatment. The visual analogue scale was used to assess dysmenorrhea, dyspareunia and non-menstrual pain. To asses quality of life the Short-form 36 questionnaire was used and the beck inventory was used to measure depression. Adverse events and bleeding episodes were also recorded. On group 1 a total of eight patients completed the study and on group 2 there were ten patients. There was no statistical difference between the two groups after six months of treatment on all outcomes evaluated. Combining the two groups, there was a significative reduction of dysmenorrhea (p<0,0001), dyspareunia (p<0,04) and non-menstrual pain (p<0,006) with the oral contraceptives and there were no major adverse events. It was also observed an important improvement on all short-form 36 domains and reduction on 8 out of 12 Becks questionnaires. Conclusion: Continuous oral contraceptive use is very effective on the management of moderate to severe dysmenorrhea. This effect could also be seen on quality of life improvement after the treatment. Because of the low cost and few side effects of the medication, oral contraceptives should be used as first line treatment.

The proposed thesis is comprised of eleven papers connected by the employment of the evolutionary psychological approach in research on various aspects of human sexuality. The aim of the first monothematic part is to demonstrate the evolutionary-psychological approach to one recent phenomenon in female sexuality - the use of oral contraceptives (OC). OC use has been shown to suppress psychological mechanisms that are considered to be adaptive in the fertile period of the natural menstrual cycle. In particular, OC users' ratings of male stimuli that provide the cues of genetic quality and compatibility are lower in comparison with normally cycling women. Moreover, the increase in sexual desire and in the prevalence of proceptive behaviour observed during mid-cycle in normally cycling women is diminished. However, the impact of this phenomenon on mate-choice and relationship dynamics in an ecological context has not been studied. In the first study, we have analyzed the data of Czech women obtained via representative sampling within the Czech National Survey of Sexual Behavior. Results indicated that normally cycling women had a significantly higher number of one-night stands during the last year in comparison to OC users even when living in a long-term relationship. OC usage was also shown to have...

Orientador: Jose Martins Filho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-09T02:26:44Z (GMT). No. of bitstreams: 1 Armani_MariaAlicedeAraujo_M.pdf: 1038895 bytes, checksum: adcfc4043fc5d61848bdc4e6bb54ae29 (MD5) Previous issue date: 2007 / Resumo: Objetivo: Pesquisar, entre adolescentes de diferentes níveis sócio-culturais, estudantes de escolas públicas e privadas, uso de medicações específicas (fórmulas laboratoriais que visam emagrecimento, inibidores do apetite, ¿orlistat¿, anabólicos e esteróides, laxantes, diuréticos), tabagismo, consumo de bebidas alcoólicas, início de vida sexual, prevenção de gestações e DST e utilização de métodos anticoncepcionais. Métodos: Foi realizada uma pesquisa entre adolescentes estudantes do sexo feminino, com idades de 14 a 18 anos, sendo 171 de duas escolas públicas e 105 de três escolas privadas de distintas regiões de Campinas, SP, aplicando-se a elas um questionário elaborado que buscou elucidar as referidas indagações, com prévia entrega de Termos de Consentimento Livre e Esclarecido. As respostas obtidas foram colocadas em banco de dados e submetidas a análise estatística específica. Resultados: No estudo, referiam tabagismo 26,32% (n=45) das alunas de escolas públicas e 28,57% (n=30) das alunas de escolas particulares. Afirmava uso de algum tipo de bebida alcoólica 80,70% (n=138) das alunas de escolas públicas e 94,29% (n=99) das alunas de escolas particulares. Foi relatada influência de amigos e familiares para ambos os hábitos. Em relação ao questionamento sobre modelagem corporal, possuía desejo de emagrecer 29,82% (n=51) de alunas de escolas públicas e 57,14% (n=60) de alunas de escolas particulares, havendo prevalência de uso de laxantes, fórmulas para emagrecer e moderadores de apetite, respectivamente entre 22,86% (n=24), 14,29% (n=15) e 16,19% (n=17) de alunas de escolas particulares. Ao serem interrogadas se utilizavam medicações com prescrição médica, apenas 4,68% das alunas de escolas públicas respondeu afirmativamente, contra 14,29% das alunas de escolas particulares. Já tinha iniciado vida sexual 52,05% (n=89) das alunas de escolas públicas e 23,81% (n=25) das alunas de escolas particulares, sendo que a idade predominante foi de 15 anos para as de escolas públicas e 16 anos para as estudantes de escolas particulares. Das alunas de instituições públicas que haviam iniciado vida sexual, 19,30% e 1,17% tinha, respectivamente, um e dois filhos. Referiram usar pílula anticoncepcional, 43,82% das alunas de escolas públicas e 60% das alunas de escolas particulares sexualmente ativas, respectivamente, 4,62% e 4,76% com receita médica. Apesar de ser o método mais usado entre as estudantes, havia adolescentes sexualmente ativas que negavam a utilização do preservativo (10,11% das estudantes de escolas públicas e 12% das de particulares), não evitando, portanto, gestação indesejada ou doença sexualmente transmissível. Bebiam, fumavam , faziam uso de algum medicamento e anticoncepcional: 41,67% (n=10) das alunas de escolas públicas e 58,33% (n=14) das alunas de escolas particulares. Conclusão: Considerável número de adolescentes, de níveis socioeconômicos e culturais diversos, com pesos adequados, gostariam de ser mais magras e, para tanto, principalmente estudantes de instituições particulares, usavam medicações. Há influência de familiares e amigos nos hábitos de fumar e beber. Havia adolescentes sexualmente ativas que ainda não utilizavam preservativo, não evitando, portanto, gestação indesejada ou doença sexualmente transmissível. O uso de anticoncepcional com prescrição médica foi escasso, tanto entre alunas de escolas públicas como alunas de escolas particulares. A associação do tabagismo e hábito de beber com início de vida sexual foi evidenciado, não se definindo, entretanto, qual hábito foi precursor / Abstract: Objective: To study the habit of tabagism and the use of alcool, specific drugs (laxants, diuretics, formulations to reduce weight, drugs that reduce hunger, orlistat, steroids), sexual initiation, utilization of contraceptives methods, prevention of pregnancy and sexual transmited diseases, between female teenagers attending classes and regularly enrolled at public and private schools in the city of Campinas, São Paulo. Methods: A research was based at a questionary applied into female students with ages between 14 and 18 years, 171 from public and 105 from private schools, situated at city of Campinas, that were submitted to a list of self response questions, in order to answer doubts about habits, Knowledges and use of medications in adolescents with different social classes. Results: In the study, 26,32% (n=45) of girls from public schools and 28,17% (n= 30) of girl from private schools refered tabagism. The use of alcool was mentioned by 80,70% (n=138) of girls from public schools and 94,29% (n=99) of girls from private schools, with influence of friends and family. Several numbers of female teenagers expressed the desire of been thinner: 28,82% (n=51) of students from public schools and 57,14% (n=60) of students from private schools. The use of laxants, formulations to lose weight and drugs that reduce hunger were refered specially between students from private schools. Only 4,68% of female pupils from public schools and 14,29% from private schools refered medical prescriptions. Fifty two percent of girls that studied in public schools and 23,81% of girls from private schools confirmed sexual relations. The prevalent age of the beginning of sexual life was 15 years old among teenagers from public schools and 16 among teenagers from private schools. Only girls from public schools that had sexual relations refered pregnancy (19,30% had 1 kid and 1,17% had 2). The birth control pill was used by 43,82% of female teenagers from public schools and 60% of female teenagers from private schools, that mentioned sexual relations, but only 4,62% of public pupils and 4,76% of female teenagers from private schools had previous medical prescription. Dispate of the prevalence use of condom, girls that already had sexual relations denied this kind of protection (10,11% from public schools and 12% from private schools). The study also analysed the presence of all the habits at the same time in students and discovered that the use of alcool, tabagism, utilization of any drug and birth control pill together occurred in 41,67% (n=10) of female teenagers that studied in public schools and 58,33% (n=14) of female teenagers that studied in private schools. Conclusion: The research noticed that a considerable number of female teenagers expressed the desire of been thinner and used specific drugs with the intention to lose weight (specially girls from private schools). Family and friends had influence in the habit of tabagism and use of alcool. There were adolescents that refered sexual relations and denied the use condom to prevent pregnancy and sexual transmited diseases. The birth control pill was rarely used with previous medical prescription among students from both kind of schools. The association of tabagism, alcool and sexual initiation also was found / Mestrado / Saude da Criança e do Adolescente / Mentre em Saude da Criança e do Adolescente

Magister Artium (Human Ecology) - MA(HE) / A study investigating the contraceptive knowledge, attitudes, beliefs and practices of coloured unmarried pregnant teenagers. / South Africa

Orientadores: Maria Cristina Cintra Gomes Marcondes, Dora Maria Grassi Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T12:12:43Z (GMT). No. of bitstreams: 1 Camargo_EricaAparecidaMariano_M.pdf: 3544834 bytes, checksum: d9515fe1a07bef154d0bed7c21be4a79 (MD5) Previous issue date: 2015 / Resumo: A importância da validação científica de técnicas coadjuvantes a diversos tratamentos de saúde é inquestionável. Assim a influência da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica, bem como, no sistema nervoso autonômico ainda precisa ser investigada. O objetivo deste trabalho foi avaliar o efeito da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica e na modulação autonômica da frequência cardíaca em homens e mulheres. Foram estudados 11 homens; 11 mulheres não usuárias de anticoncepcional oral e 12 mulheres usuárias de anticoncepcional oral, com 21,3 ± 2,9 anos de idade, saudáveis, sedentários e eutróficos. As amostras urinárias foram coletadas em um dia, sem intervenção terapêutica, denominado controle e em outro dia com aplicação da drenagem linfática manual. Na urina, foram analisadas osmolaridade, concentração de sódio, fluxo e concentração de glicerol. A variabilidade da frequência cardíaca foi registrada no início, durante e ao final do experimento, nos dias controle e drenagem linfática manual. Os resultados mostram que a drenagem linfática manual promoveu em homens redução dos eletrólitos urinários e aumento do fluxo e em mulheres não usuárias de anticoncepcional oral houve apenas aumento do fluxo. A técnica induziu diluição urinária em homens e mulheres não usuárias de anticoncepcional, sugerindo que os mecanismos são sexo-dependentes. Para usuárias de anticoncepcional oral, a drenagem linfática manual não diferiu do dia controle, onde houve redução dos eletrólitos e aumento do fluxo urinário. A análise da concentração de glicerol urinário mostrou que a drenagem linfática manual não altera a taxa lipolítica nos voluntários dos grupos estudados. Os resultados da modulação autonômica da frequência cardíaca indicaram que a técnica promoveu predomínio simpático no grupo de homens sem alterações nos grupos das mulheres. Conclui-se que a drenagem linfática manual foi eficaz na diluição urinária de homens e mulheres não usuárias de anticoncepcional oral, assim como, foi eficaz em promover predomínio simpático em homens. A técnica não foi eficaz em promover alterações na taxa lipolítica / Abstract: The importance of scientific validation techniques supporting the various health treatments is unquestionable. Thus, the influence of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate as well as in the autonomic nervous system has to be investigated. The objective of this study was to evaluate the effect of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate and autonomic modulation of heart rate in men and women. 11 male patients; 11 women not using oral contraceptives and 12 women used oral contraceptives, with 21.3 ± 2.9 years old, healthy, sedentary and eutrophic. The urine samples were collected in one day, without therapeutic intervention, denominated as the control and on another day with application of manual lymphatic drainage. In the urine, were analyzed osmolality, sodium concentration, flow, and the concentration of glycerol. The heart rate variability was registered at the outset, during and at the end of the experiment, in the days control and manual lymphatic drainage. The results showed that the manual lymph drainage in men promoted reduction of urinary electrolytes and increased flow and in women non-users oral contraceptives there was only increased flow. The technique induced urinary dilution in men and women non-users oral contraceptives, suggesting that the mechanisms are sex-dependent. For oral contraceptive users, manual lymphatic drainage did not differ from control day where there was a reduction of electrolytes and increased urine flow. The analysis of urinary glycerol concentration showed that manual lymphatic drainage does not change the lipolytic rate in voluntary groups studied. The results of the autonomic modulation of heart rate indicated that the technique promoted sympathetic predominance in men group and without changes in women. We conclude that manual lymphatic drainage was effective in urinary dilution of men and women non-users oral contraceptives, as well as, it was effective in promoting sympathetic predominance in men. The technique was not effective in promoting changes in lipolytic rate / Mestrado / Fisiologia / Mestra em Biologia Funcional e Molecular

Fibroadenome (FA) sind die häufigsten gutartigen Tumoren der weiblichen Brust und treten vor allem im reproduktionsfähigen Alter der Frau auf. Ziel dieser retrospektiven Studie war es, mittels immunhistochemischer Färbung und Datenrecherche herauszufinden, ob sich die FA von 113 Patientinnen in der Ausprägung ihrer Steroidhormonrezeptoren, ihres Proliferationspotenzials (Ki-67) und ihrer Größe bezogen auf diverse Anamnesefaktoren unterscheiden. Damit könnten Rückschlüsse auf die Entstehung von FA allgemein, aber auch auf ihr Wachstumsverhalten in Abhängigkeit dieser Faktoren gezogen werden. Besonderes Interesse galt dabei der Einnahme oraler hormoneller Kontrazeptiva (oral hormonal contraceptives, OHC), da die Inzidenz von FA ihren Gipfel in der Altersgruppe der 20- bis 30-jährigen Frauen hat. Es zeigten sich hochsignifikante Unterschiede in Abhängigkeit vom Patientinnenalter. Die FA älterer Frauen waren kleiner, zeigten weniger proliferative Aktivität, wiesen jedoch deutlich mehr Östrogenrezeptoren (ER) auf, was als Reaktion auf den postmenopausalen Hormonmangel zu werten sein könnte. Frauen mit Nikotinkonsum zeigten eine stärkere Ausprägung des Androgenrezeptors (AR), was auf einen beschleunigten Alterungsprozess, induziert durch Nikotinkonsum, hindeutet. Für die Anamnesefaktoren Körpermasseindex (Body-Mass-Index, BMI), Parität und das Vorliegen eines simultanen Mammakarzinoms zeigten sich keine Unterschiede in Bezug auf die Fibroadenomgröße und das immunhistochemische Profil. Die Einnahme von OHC bedingte analog normalem Brustgewebe lediglich eine verminderte Expression des Progesteronrezeptors (PR). Es ergaben sich keine Unterschiede hinsichtlich proliferativer Aktivität oder Fibroadenomgröße im Ultraschall. Die Exzidate der FA von Frauen mit OHC-Einnahme waren größer; der Größenunterschied verlor jedoch mit besserer Anpassung der Vergleichsgruppen hinsichtlich des Patientinnenalters an statistischer Signifikanz. Insgesamt hatte das Alter der Patientinnen in unserer Studie den größten Einfluss auf die betrachteten abhängigen Variablen (immunhistochemisches Profil und Fibroadenomgröße) und scheint daher eine wichtige Rolle für das klinische Erscheinungsbild von FA zu spielen. Daraus lassen sich möglicherweise in Zukunft verschiedene therapeutische Strategien zur Behandlung von FA in Abhängigkeit vom Patientinnenalter ableiten.:Inhaltsverzeichnis Inhaltsverzeichnis I Abbildungsverzeichnis V Tabellenverzeichnis VI Abkürzungsverzeichnis VIII 1. Einleitung 1 1.1. Fibroadenome 1 1.1.1. Definition 1 1.1.2. Epidemiologie 1 1.1.3. Pathogenese 1 1.1.4. Makroskopie und Histologie 1 1.1.5. Klinisches Erscheinungsbild 2 1.1.6. Diagnostik 2 1.1.7. Therapie 3 1.2. Orale Hormonelle Kontrazeptiva 3 1.2.1. Statistik 3 1.2.2. Wirkungsprinzip 4 1.2.3. Weitere Anwendungsgebiete 4 1.2.4. Einteilung 5 1.2.5. Verschreibungshäufigkeit der einzelnen OHC in Deutschland 5 1.2.6. OHC in der Studie 6 1.3. Weitere Hormonpräparate in der Studie 6 1.3.1. Mirena® 6 1.3.2. Dreimonatsspritze 7 1.3.3. Clomifen 7 1.3.4. Activelle 7 1.3.5. Chlormadinon 7 1.3.6. Estreva-Gel und Utrogest 8 1.3.7. Tamoxifen 8 1.4. Steroidhormonrezeptoren und Ki-67 8 1.4.1. Steroidhormonrezeptoren allgemein 8 1.4.1.1. Definition 8 1.4.1.2. Einteilung der NR3 Superfamilie 8 1.4.1.3. Aufbau der Steroidhormonrezeptoren 9 1.4.1.4. Wirkmechanismus 9 1.4.2. Östrogenrezeptor 10 1.4.3. Progesteronrezeptor 10 1.4.4. Androgenrezeptor 11 1.4.5. Ki-67 11 2. Zielstellung 12 3. Methoden 13 3.1. Erfassung des Patientinnenkollektivs 13 3.2. Deskription des Patientinnenkollektivs 13 3.3. Material 14 3.3.1. Geräte und Hilfsmittel 14 3.3.2. Chemikalien 15 3.3.2.1. Standardchemikalien 15 3.3.2.2. Färbekits für Immunhistochemie 15 3.4. Methoden 16 3.4.1. Prinzip der immunhistochemischen Färbung 16 3.4.2. Gemeinsame Schritte der immunhistochemischen Färbung 16 3.4.2.1. Gemeinsame Schritte vor der immunhistochemischen Färbung 16 3.4.2.2. Gemeinsame Schritte während der immunhistochemischen Färbung 17 3.4.2.3. Gemeinsame Schritte nach der immunhistochemischen Färbung 17 3.4.3. Färbeschritte für Ki-67 und den Androgenrezeptor 17 3.4.4. Färbeschritte für Östrogen- und Progesteronrezeptor 20 3.4.5. Bewertung der Färbeergebnisse 22 3.5. Statistische Auswertung 23 4. Ergebnisse 24 4.1. Lokalisation der Fibroadenome 24 4.1.1. Lokalisation bezüglich der Brust 24 4.1.2. Lokalisation intramammär 24 4.2. Kliniko-pathologische Anlage 25 4.2.1. Anamnesedaten als Variablen 25 4.2.2. Variablen aus der Immunhistochemie 28 4.2.3. Die Variablen Schalldurchmesser und Exzidatgröße 30 4.2.4. Tests auf Normalverteilung und daraus resultierende statistische Tests 30 4.2.5. Korrelation der Variablen nach Spearman 33 4.3. Alter der Patientinnen 34 4.3.1. Beschreibung der Altersverteilung 34 4.3.2. Auswertung nach Altersklassen 34 4.4. BMI der Patientinnen 36 4.4.1. Beschreibung der Gewichtsverteilung 36 4.4.2. Auswertung mit dem BMI nach WHO 36 4.4.3. Auswertung nach BMI-Cut-Off (Trennwert) von 25 kg/m² 37 4.5. Einfluss von BMI und Alter 37 4.5.1. Auswertung nach Altersklassen getrennt nach BMI-Cut-Off 37 4.5.1.1. Auswertung nach Altersklassen (I, II, III) für Frauen mit einem BMI <25 kg/m² 37 4.5.1.2. Auswertung nach Altersklassen (I, II, III) für Frauen mit einem BMI ≥25 kg/m² 37 4.5.2. Auswertung nach BMI-Cut-Off getrennt für jede Altersklasse 37 4.5.2.1. Auswertung nach BMI-Cut-Off für Frauen der Altersklasse I (<30 Jahre) 38 4.5.2.2. Auswertung nach BMI-Cut-Off für Frauen der Altersklasse II (≥30 und <60 Jahre) 38 4.5.2.3. Auswertung nach BMI-Cut-Off für Frauen der Altersklasse III (≥60 Jahre) 38 4.5.3. Vergleichende Korrelationen nach Spearman für Alter und BMI 38 4.5.4. Schlussfolgerung 38 4.6. Nikotinkonsum 39 4.7. Menopausenstatus 40 4.7.1. Deskription der postmenopausalen Frauen 40 4.7.2. Auswertung anhand des Menopausenstatus 40 4.8. Parität 40 4.8.1. Auswertung anhand der Parität für alle Patientinnen 40 4.8.2. Auswertung anhand der Parität für Frauen von 26 bis 52 Jahren 41 4.9. Hormoneinnahme 41 4.9.1. Hormoneinnahme allgemein 41 4.9.2. Auswertung nach Hormoneinnahme für Frauen von 32-66 Jahren; exklusive Einnahme von OHC 41 4.10. Einnahme von OHC 42 4.10.1. Auswertung anhand der Einnahme von OHC; Vergleich mit allen Frauen ohne Einnahme von OHC inklusive und exklusive anderer Hormoneinnahme 42 4.10.2. Auswertung anhand der Einnahme von OHC für Frauen ≤52 Jahre 42 4.10.3. Auswertung anhand der Einnahme von OHC getrennt für jüngere und ältere Frauen 42 4.10.3.1. Auswertung anhand der Einnahme von OHC für Frauen ≤25 Jahre 43 4.10.3.2. Auswertung anhand der Einnahme von OHC für Frauen >25 und ≤52 Jahre 43 4.10.3.3. Zusammenfassende Betrachtung 44 4.10.3.4. Auswertung für jüngere vs. ältere Anwenderinnen von OHC 45 4.10.4. Lokalisation der Fibroadenome bei Einnahme von OHC 45 4.10.5. OHC geordnet nach Östrogengehalt 46 4.10.6. OHC geordnet nach Gestagengruppe 46 4.11. Einnahme von Valette 47 4.11.1. Einnahme von Valette vs. Einnahme von anderen OHC 47 4.11.2. Einnahme von Valette vs. Einnahme von anderen OHC vs. keine Einnahme von OHC 47 4.12. Simultanes Mammakarzinom 49 4.12.1. Deskription der Patientinnen mit Mammakarzinom 49 4.12.2. Auswertung anhand des Vorliegens eines simultanen Mammakarzinoms für alle Patientinnen 49 4.12.3. Auswertung anhand des Vorliegens eines simultanen Mammakarzinoms für Frauen ≥48 Jahre 49 5. Diskussion 51 5.1. Lokalisation der Fibroadenome 51 5.2. Größe der Fibroadenome 51 5.3. Einfluss der Steroidhormonrezeptoren 52 5.4. Einfluss von Ki-67 55 5.5. Einfluss des Alters der Patientinnen 55 5.6. Einfluss des BMI 58 5.7. Einfluss des Nikotinkonsums 59 5.8. Einfluss des Menopausenstatus 60 5.9. Einfluss der Parität 61 5.10. Einfluss der Hormoneinnahme, exklusive Einnahme von OHC 61 5.11. Einfluss der Einnahme von OHC 62 5.12. Einfluss eines simultanen Mammakarzinoms 65 5.13. Einfluss anderer Entstehungsfaktoren 66 6. Zusammenfassung 68 7. Literaturverzeichnis 71 8. Eidesstattliche Erklärung 81 9. Danksagung 82 10. Lebenslauf 83

This diploma thesis analyses the legislation governing interruptions in Czechoslovakia in the time frame between 1950 and 1986 when this legislation went through many changes. The thesis studies consequences of these changes, their influence on the population in Czechoslovakia and even opinions of its inhabitants living in above mentioned time period. The thesis focuses also on so called "interruption commission"; institutions of former Czechoslovakia, which used to decide about the future of unwanted pregnancies. One part of this diploma thesis is also dedicated to the development and accessibility of contraceptives, which were directly influenced by the legislation.