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1.
Menopause ; 24(12): 1360-1364, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28640166

RESUMO

OBJECTIVE: Breast cancer survivors often take hormonal treatments to prevent the recurrence of breast cancer, particularly aromatase inhibitors that can worsen the symptoms of genitourinary syndrome of menopause (GSM) such as dyspareunia, dysuria, and urinary incontinence, all of which may adversely affect survivors' quality of life. Few breast cancer survivors experiencing GSM receive adequate assessment or treatment. METHODS: In this descriptive study, we reviewed medical records for documented GSM and any treatments administered or referrals for treatment in 800 female patients who visited the Breast Cancer Survivorship Clinic at a comprehensive cancer center between July 1, 2010 and June 30, 2011, either at least 5 years after completion of treatment for invasive breast cancer or at least 6 months after completion of treatment for ductal carcinoma in situ. RESULTS: Of the 279 patients with documented symptoms of vaginal atrophy, only 111 (39.8%) had documentation of having received any form of treatment or referral. Of the 71 patients with documented symptoms of urinary tract atrophy, only 33.8% had documentation of having received treatment or referral for treatment. CONCLUSION: Breast cancer survivors often experience GSM due to lack of estrogen. The worrisome lack of documentation of assessment or treatment for GSM in a large breast cancer survivorship practice reveals missed opportunities to improve quality of life. Dissemination of recent progress in the development of GSM assessment tools, patient handouts, and new treatments to providers who care for breast cancer survivors is needed to improve this process.


Assuntos
Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/prevenção & controle , Doenças Urogenitais Femininas/epidemiologia , Recidiva Local de Neoplasia/prevenção & controle , Adulto , Idoso , Inibidores da Aromatase/uso terapêutico , Atrofia , Sobreviventes de Câncer/psicologia , Documentação , Dispareunia/epidemiologia , Disuria/epidemiologia , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/terapia , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Síndrome , Incontinência Urinária/epidemiologia , Vagina/patologia
2.
Gynecol Endocrinol ; 33(6): 418-420, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28277141

RESUMO

The genitourinary syndrome of menopause (GSM) is a frequent complaint among breast cancer (BC) survivors that lead to an important affection of their quality of life (QoL). Lifestyle measures such as smoking cessation or regular sexual activity are usually insufficient to significantly improve GMS and although therapies such as lubricants and polycarbophil moisturized gels are considered first-line therapies to alleviate symptoms of vulvovaginal atrophy, these non-hormonal options are not able to reverse atrophy once it occurs. Instead, this complaint is corrected by local estrogens. The estrogen vaginal treatment usually used to treat GSM, is an issue of concern in this group due to the possible negative effect over the BC outcomes. On the other hand, the worsening of QoL in these patients due to symptoms related to GSM can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly. The goal of this review is to contribute to health care professionals to make an informed decision to care for their BC patients.


Assuntos
Neoplasias da Mama/complicações , Estradiol/administração & dosagem , Estrogênios/administração & dosagem , Doenças Urogenitais Femininas/tratamento farmacológico , Administração Intravaginal , Antineoplásicos/efeitos adversos , Estradiol/análogos & derivados , Estrogênios/análogos & derivados , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Humanos , Menopausa Precoce , Tamoxifeno/administração & dosagem , Tamoxifeno/análogos & derivados
4.
Mayo Clin Proc ; 91(8): 1133-46, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27492917

RESUMO

Cancer survivors often experience symptoms related to hormone deprivation, including vasomotor symptoms, genitourinary symptoms, and sexual health concerns. These symptoms can occur due to natural menopause in midlife women, or they can be brought on by oncologic therapies in younger women or men. We searched PubMed for English-language studies from January 1990 through January 2016 to identify relevant articles on the management of hormone deprivation symptoms, including vasomotor, genitourinary, and sexual symptoms in patients with cancer. The search terms used included hormone deprivation, vasomotor symptoms, hot flash, vaginal dryness, sexual dysfunction, and breast cancer. This manuscript provides a comprehensive description of data supporting the treatment of symptoms associated with hormone deprivation.


Assuntos
Antineoplásicos/efeitos adversos , Doenças Urogenitais Femininas/induzido quimicamente , Hormônios Esteroides Gonadais/deficiência , Terapia de Reposição Hormonal/efeitos adversos , Doenças Urogenitais Masculinas/induzido quimicamente , Neoplasias/complicações , Disfunções Sexuais Fisiológicas/induzido quimicamente , Sistema Vasomotor/efeitos dos fármacos , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Antineoplásicos/uso terapêutico , Antagonistas Colinérgicos/uso terapêutico , Terapia Cognitivo-Comportamental , Estrogênios/efeitos adversos , Estrogênios/uso terapêutico , Feminino , Doenças Urogenitais Femininas/terapia , Terapia de Reposição Hormonal/normas , Fogachos/etiologia , Fogachos/terapia , Humanos , Masculino , Doenças Urogenitais Masculinas/terapia , Neoplasias/dietoterapia , Progesterona/efeitos adversos , Progesterona/análogos & derivados , Progesterona/uso terapêutico , Disfunções Sexuais Fisiológicas/terapia , Sobreviventes , Sistema Vasomotor/fisiopatologia
5.
Clin Breast Cancer ; 15(6): 413-20, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26198332

RESUMO

Breast cancer survivors (BCSs) often suffer from menopausal symptoms induced by systemic treatments, with a consequent negative effect on quality of life. Since the introduction of aromatase inhibitors as the standard therapy for hormone-dependent tumors, genitourinary syndrome of menopause (GSM) has become a main problem for BCSs. This new terminology refers to the wide range of vaginal and urinary symptoms related to menopause, which can be relieved by estrogen therapy. Unfortunately, systemic hormone therapy is contraindicated for BCSs and also vaginal estrogens at standard dosage might influence the risk of recurrence because they cause a significant increase of circulating estrogens. Nonhormonal vaginal moisturizers or lubricants are the first choice for BCSs but only have limited and short-term efficacy. New strategies of management of GSM are now available, including: (1) low-dose or ultra low-dose vaginal estrogens; (2) oral selective estrogen receptor modulators (ospemifene); (3) androgen therapy; (4) physical treatment with vaginal laser; and (5) psychosocial interventions. In this review we discuss and analyze these different options.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Doenças Urogenitais Femininas/induzido quimicamente , Menopausa/efeitos dos fármacos , Sobreviventes , Feminino , Humanos , Síndrome
7.
AJR Am J Roentgenol ; 197(2): W286-94, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21785055

RESUMO

OBJECTIVE: This article provides a comprehensive review of the role of MDCT and MRI in the diagnosis of drug-induced complications in the abdomen and pelvis in adults. A systematic organ-based review of these complications is presented, including but not limited to hepatic changes after chemotherapy, renal complications such as tumor lysis syndrome and lithium nephropathy, gastrointestinal manifestations, various opportunistic infections and secondary neoplasms, mycotic aortic aneurysm from intravesical bacille Calmette-Guérin, complications of anticoagulant therapy, and oral contraceptives. CONCLUSION: Advancements in imaging have led to recognition of radiologic features of previously unsuspected diseases. Occasionally, imaging may also identify effects of treatments instituted for these diseases. Consequently, imaging plays a critical role in the accurate diagnosis of a broad spectrum of drug-induced complications in the abdomen, both in emergent and nonemergent settings. Knowledge of the natural history, clinical manifestations, and salient imaging features of these entities is crucial to facilitate accurate clinical diagnosis in a timely fashion.


Assuntos
Doenças do Sistema Digestório/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/diagnóstico , Imageamento por Ressonância Magnética/métodos , Doenças Urogenitais Masculinas/induzido quimicamente , Doenças Urogenitais Masculinas/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/induzido quimicamente , Doenças Vasculares/diagnóstico , Meios de Contraste , Doenças do Sistema Digestório/diagnóstico por imagem , Feminino , Doenças Urogenitais Femininas/diagnóstico por imagem , Humanos , Masculino , Doenças Urogenitais Masculinas/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem
8.
PLoS One ; 6(1): e16258, 2011 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-21311578

RESUMO

OBJECTIVE: To assess the safety of VivaGel® used vaginally twice daily for 14 days among healthy, sexually-abstinent women, aged 18-24 years in the USA and Kenya. DESIGN: Randomized placebo controlled trial. METHODS: Participants were randomized 2∶1, VivaGel to placebo. Safety was assessed by comparing genitourinary (GU) adverse events (AEs), colposcopy findings, vaginal lactobacilli and laboratory abnormalities by arm. RESULTS: Fifty-four women were enrolled; 35 in the VivaGel arm and 19 in the placebo arm. Twenty-six (74%) and 10 (53%) women reported taking all doses of VivaGel and placebo, respectively. No grade 3 or 4 AEs, or serious AEs occurred. Twenty-five (71%) participants in the VivaGel arm compared to 10 (53%) participants in the placebo arm had at least one grade 1 or 2 GU AE associated with product use (RR = 1.4, 95% CI 0.8-2.2). All seven grade 2 GU AEs associated with product use occurred among four women in the VivaGel arm. Vulvar and cervical erythema, cervical lesions, symptomatic BV, urinary frequency and metrorrhagia were more common in the VivaGel arm than the placebo arm. Twenty-nine (83%) participants in the VivaGel arm had a colposcopic finding compared to 10 (53%) participants in the placebo arm (RR = 1.6, 95%CI = 1.0-2.5). Two women in the VivaGel arm prematurely discontinued product use themselves due to a reported GU AE. Persistence of H2O2-producing and non-producing lactobacilli did not differ by study arm. CONCLUSIONS: GU AEs and colposcopic findings consistent with mild epithelial irritation and inflammation occurred more commonly among women in the VivaGel arm. TRIAL REGISTRATION: ClinicalTrials.gov NCT003311032.


Assuntos
Anti-Infecciosos/efeitos adversos , Polilisina/efeitos adversos , Administração Intravaginal , Adolescente , Adulto , Anti-Infecciosos/administração & dosagem , Colposcopia , Dendrímeros , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eritema/induzido quimicamente , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/prevenção & controle , Géis/uso terapêutico , Humanos , Quênia , Lactobacillus/isolamento & purificação , Polilisina/administração & dosagem , Abstinência Sexual , Estados Unidos , Adulto Jovem
9.
Climacteric ; 14(3): 339-44, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21226657

RESUMO

OBJECTIVE: Aromatase inhibitors are essential as endocrine treatment for hormone receptor-positive postmenopausal breast cancer patients. Menopausal symptoms are often aggravated during endocrine treatment. We investigated whether vaginal estriol is a safe therapeutic option to overcome the urogenital side-effects of aromatase inhibitors. Serum hormone levels were used as the surrogate parameter for safety. METHODS: Fasting serum hormone levels of ten postmenopausal breast cancer patients receiving aromatase inhibitors were prospectively measured by electro-chemiluminescence immunoassays and gas chromatography/mass spectrometry before and 2 weeks after daily application of 0.5 mg vaginal estriol (Ovestin® ovula), respectively. RESULTS: Two weeks of daily vaginal estriol treatment did not change serum estradiol or estriol levels. However, significant decreases in levels of serum follicle stimulating hormone (p = 0.01) and luteinizing hormone (p = 0.02) were observed. Five out of six breast cancer patients noticed an improvement in vaginal dryness and/or dyspareunia. CONCLUSIONS: The significant decline in gonadotropin levels, indicating systemic effects, has to be kept in mind when offering vaginal estriol to breast cancer patients receiving an aromatase inhibitor.


Assuntos
Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Estriol/administração & dosagem , Doenças Urogenitais Femininas , Administração Intravaginal , Inibidores da Aromatase/administração & dosagem , Cromatografia Gasosa , Monitoramento de Medicamentos , Dispareunia/induzido quimicamente , Estriol/sangue , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/tratamento farmacológico , Doenças Urogenitais Femininas/metabolismo , Hormônio Foliculoestimulante/sangue , Humanos , Imunoensaio , Hormônio Luteinizante/sangue , Satisfação do Paciente , Pós-Menopausa/metabolismo , Resultado do Tratamento
11.
Radiology ; 258(1): 41-56, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21183492

RESUMO

Cancer chemotherapy has evolved from cytotoxic agents and now includes several new agents that target specific molecules responsible for the regulation of cell growth, nutrient supply, and differentiation. These molecularly targeted therapies have a different mechanism of action than do classic cytotoxic agents, which predominantly attack rapidly proliferating cells. Not surprisingly, therefore, the toxicity of targeted and cytotoxic agents may differ in both clinical and radiologic presentation. Many of the toxicities of targeted therapies are not cumulative or dose dependent, some are asymptomatic, and others may first manifest radiologically. It is imperative that radiologists be aware of these toxicities and that they learn to recognize the relevant findings so that they can provide a complete differential diagnosis and thus play an important role in patient care.


Assuntos
Antineoplásicos/efeitos adversos , Terapia de Alvo Molecular/efeitos adversos , Neoplasias/diagnóstico por imagem , Neoplasias/tratamento farmacológico , Tomografia Computadorizada por Raios X , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/diagnóstico por imagem , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/diagnóstico por imagem , Humanos , Hepatopatias/diagnóstico por imagem , Hepatopatias/etiologia , Pneumopatias/induzido quimicamente , Pneumopatias/diagnóstico por imagem , Masculino , Doenças Urogenitais Masculinas/induzido quimicamente , Doenças Urogenitais Masculinas/diagnóstico por imagem , Pancreatopatias/induzido quimicamente , Pancreatopatias/diagnóstico por imagem , Doenças Vasculares/induzido quimicamente , Doenças Vasculares/diagnóstico por imagem
12.
Clin Breast Cancer ; 9(2): 108-17, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19433392

RESUMO

BACKGROUND: Data from randomized trials in postmenopausal women receiving endocrine therapy for breast cancer would suggest that the incidence of significant urogenital symptoms is around 40%. As there are inherent reporting biases associated with clinical trials, we sought to assess the prevalence, severity, and effect of urogenital side effects of endocrine therapy in the non-trial setting. PATIENTS AND METHODS: A cross-sectional survey study was undertaken and questionnaires used to assess vulvovaginal and urinary tract symptoms in a group of postmenopausal women receiving endocrine therapy for breast cancer. RESULTS: A total of 251 women were surveyed. Sixty-three percent (158) reported urogenital symptoms. Vaginal dryness was the most common vaginal symptom, occurring in 121 women (48%). This was rated as severe or very severe in 56 of 121 (46%). Thirty-one of 251 (12%) women experienced urinary symptoms. A total of 68 women (27%) had used some form of treatment for vaginal symptoms. Nine women (4%) had considered discontinuing treatment because of urogenital side effects. CONCLUSION: Urogenital side effects are common and often severe in women receiving endocrine therapy for breast cancer. The prevalence in this study was 63%, which is higher than that reported in the clinical trial literature. Less than one third of patients had used some form of treatment for these symptoms. This highlights the need for increased recognition and management of the urogenital side effects of estrogen deprivation therapy and raises the concern of the risk of non-compliance with potentially curative adjuvant therapy.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Terapia de Reposição de Estrogênios , Doenças Urogenitais Femininas/induzido quimicamente , Pós-Menopausa , Antineoplásicos Hormonais/uso terapêutico , Estudos Transversais , Feminino , Doenças Urogenitais Femininas/patologia , Humanos , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
13.
Cancer Imaging ; 8: 135-45, 2008 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-18603495

RESUMO

Tamoxifen is a selective estrogen receptor modulator (SERM) that is widely used in the treatment of patients with breast cancer and for chemoprophylaxis in high risk women. Tamoxifen results in a spectrum of abnormalities involving the genital tract, the most significant being an increased incidence of endometrial cancer and uterine sarcoma. This article reviews the effects of tamoxifen on the genital tract and the strengths and weaknesses of various imaging modalities for evaluating the endometrium.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/diagnóstico por imagem , Tamoxifeno/efeitos adversos , Adulto , Idoso , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/cirurgia , Colo do Útero/diagnóstico por imagem , Colo do Útero/efeitos dos fármacos , Quimioterapia Adjuvante , Relação Dose-Resposta a Droga , Esquema de Medicação , Endossonografia/métodos , Feminino , Doenças Urogenitais Femininas/epidemiologia , Seguimentos , Humanos , Incidência , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Ovário/diagnóstico por imagem , Ovário/efeitos dos fármacos , Medição de Risco , Tamoxifeno/uso terapêutico , Vagina/diagnóstico por imagem , Vagina/efeitos dos fármacos
14.
J Urol ; 177(2): 639-43, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17222649

RESUMO

PURPOSE: Zinc is a common dietary supplement that is widely believed to have beneficial health effects. To assess the impact of high dose supplemental zinc on genitourinary diseases we analyzed a recent randomized trial comparing zinc, antioxidants and their combination to placebo for complications related to the genitourinary tract. MATERIALS AND METHODS: In a further analysis of the recent Age-related Eye Disease Study we examined the data pool for primary International Classification of Diseases, 9th revision codes given for hospital admissions related to urological problems. The Age-Related Eye Disease Study randomized 3,640 patients with age related macular degeneration to 1 of 4 study arms, including placebo, antioxidants (500 mg vitamin C, 400 IU vitamin E and 15 mg beta-carotene), 80 mg zinc and antioxidant plus zinc. Statistical analyses using Fisher's exact test were performed. RESULTS: We found a significant increase in hospital admissions due to genitourinary causes in patients on zinc vs nonzinc formulations (11.1% vs 7.6%, p = 0.0003). The risk was greatest in male patients (RR 1.26, 95% CI 1.07-1.50, p = 0.008). In the study group of 343 patients requiring hospital admission the most common primary International Classification of Diseases, 9th revision codes included benign prostatic hyperplasia/urinary retention (benign prostatic hyperplasia), urinary tract infection, urinary lithiasis and renal failure. When comparing zinc to placebo, significant increases in urinary tract infections were found (p = 0.004), especially in females (2.3% vs 0.4%, RR 5.77, 95% CI 1.30-25.66, p = 0.013). Admissions for urinary lithiasis approached significance in men on zinc compared to placebo (2.0% vs 0.5%, RR = 4.08, 95% CI 0.87-19.10). There was no increase in prostate or other cancers with zinc supplementation. A significant decrease in prostate cancer diagnoses was seen in patients receiving antioxidants vs placebo (RR = 0.6, 95% CI 0.49-0.86, p = 0.049). Subgroup analysis revealed that this finding was significant in men who smoked but not in nonsmokers. CONCLUSIONS: Zinc supplementation at high levels results in increased hospitalizations for urinary complications compared to placebo. These data support the hypothesis that high dose zinc supplementation has a negative effect on select aspects of urinary physiology.


Assuntos
Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/epidemiologia , Doenças Urogenitais Masculinas/induzido quimicamente , Doenças Urogenitais Masculinas/epidemiologia , Admissão do Paciente/estatística & dados numéricos , Zinco/administração & dosagem , Zinco/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Exp Toxicol Pathol ; 58(1): 1-12, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16709447

RESUMO

In this study, two selective estrogen receptor modulators (SERMs), tamoxifen (TAM) and toremifene (TOR) or two estrogens, ethinylestradiol (EE) and diethylstilbestrol (DES) were administered to newborn male and female Sprague-Dawley rats (days 1-5) to investigate the occurrence of developmental abnormalities in the adulthood. The compounds were dosed (s.c.) at an equimolar dose of 24.9 micromol/kg. During the follow-up period, mortality occurred mainly in DES-treated male rats (3/4), associated with obstructive urinary calculi and suppurative renal inflammation in 2/3 rats. Similar lesions were not evident in other groups. At the age of 15 months, the animals were necropsied and organs were collected for histopathology and histomorphometry. Treatment-related abnormalities were restricted to the reproductive organs. Chronic prostatitis and epithelial abnormalities in the vas deferens were observed in all treatment groups. The columnar epithelium of vas deferens showed hyperplasia and development of subepithelial glandular structures resembling epididymal cysts reported in humans exposed in utero to DES. Testicular atrophy was observed especially in estrogen-treated rats. Mainly in SERM-treated female rats, the uterus showed luminal dilation or obstruction, loss of endometrial glands and myometrium disorganization including foci of muscular disruption. TOR-treated female rats showed polyp-like nodules (incidence 4/15) and a high incidence (9/15) of a simple cuboidal epithelium in cervical regions normally occupied by multilayered epithelia. In conclusion, the vas deferens is a main target organ following neonatal administration of SERMs and estrogens. In addition, female rats were significantly more susceptible to SERM treatment than to treatment with estrogens.


Assuntos
Estrogênios/toxicidade , Doenças Urogenitais Femininas/patologia , Doenças Urogenitais Masculinas , Moduladores Seletivos de Receptor Estrogênico/toxicidade , Sistema Urogenital/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Peso Corporal/efeitos dos fármacos , Dietilestilbestrol/toxicidade , Etinilestradiol/toxicidade , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/mortalidade , Longevidade/efeitos dos fármacos , Masculino , Nefrite Intersticial/induzido quimicamente , Nefrite Intersticial/mortalidade , Nefrite Intersticial/patologia , Tamanho do Órgão/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Taxa de Sobrevida , Tamoxifeno/toxicidade , Toremifeno/toxicidade , Cálculos Urinários/induzido quimicamente , Cálculos Urinários/mortalidade , Cálculos Urinários/patologia , Sistema Urogenital/patologia , Ducto Deferente/efeitos dos fármacos , Ducto Deferente/patologia
16.
Wei Sheng Yan Jiu ; 32(5): 504-7, 2003 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-14650202

RESUMO

The progresses on the latest studies at home and abroad on adverse health effects of automobile exhaust were reviewed in this paper. Particulates and poisonous gases from automobile exhaust were considered to be harmful to respiratory system, immune system and reproductive system. It showed that increased prevalence of respiratory disease (e.g. chronic bronchitis and asthma), and decreased lung function, immunity were associated with automobile exhaust. The carcinogenic potential from the exposure to automobile exhausts needs to be further explored because the carcinogenesis is multifactorial.


Assuntos
Emissões de Veículos/efeitos adversos , Animais , Doenças Urogenitais Femininas/induzido quimicamente , Humanos , Doenças do Sistema Imunitário/induzido quimicamente , Doenças Urogenitais Masculinas , Neoplasias/induzido quimicamente , Ratos , Doenças Respiratórias/induzido quimicamente , Emissões de Veículos/toxicidade
17.
Postgrad Med J ; 79(933): 391-6, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12897217

RESUMO

Arsenic toxicity is a global health problem affecting many millions of people. Contamination is caused by arsenic from natural geological sources leaching into aquifers, contaminating drinking water and may also occur from mining and other industrial processes. Arsenic is present as a contaminant in many traditional remedies. Arsenic trioxide is now used to treat acute promyelocytic leukaemia. Absorption occurs predominantly from ingestion from the small intestine, though minimal absorption occurs from skin contact and inhalation. Arsenic exerts its toxicity by inactivating up to 200 enzymes, especially those involved in cellular energy pathways and DNA synthesis and repair. Acute arsenic poisoning is associated initially with nausea, vomiting, abdominal pain, and severe diarrhoea. Encephalopathy and peripheral neuropathy are reported. Chronic arsenic toxicity results in multisystem disease. Arsenic is a well documented human carcinogen affecting numerous organs. There are no evidence based treatment regimens to treat chronic arsenic poisoning but antioxidants have been advocated, though benefit is not proven. The focus of management is to reduce arsenic ingestion from drinking water and there is increasing emphasis on using alternative supplies of water.


Assuntos
Intoxicação por Arsênico , Arsênio/química , Arsênio/metabolismo , Arsênio/uso terapêutico , Intoxicação por Arsênico/diagnóstico , Intoxicação por Arsênico/etiologia , Intoxicação por Arsênico/prevenção & controle , Doenças Cardiovasculares/induzido quimicamente , Doenças Urogenitais Femininas/induzido quimicamente , Gastroenteropatias/induzido quimicamente , Humanos , Doenças Urogenitais Masculinas , Doenças do Sistema Nervoso/induzido quimicamente , Doenças Respiratórias/induzido quimicamente , Dermatopatias/induzido quimicamente
18.
Actas Urol Esp ; 27(3): 173-9, 2003 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-12812113

RESUMO

The recognition, identification and management of the many events taking place in relation to an inflammatory response has become a rapidly growing field in medicine over the last few years. In this sense, the progress made in later years in the study of the molecular and cellular mechanisms of tissue inflammatory reactions in sites such as synovial membranes, gut mucosa, vascular endothelium etc, is considered highly relevant. A number of authors conscious of such events work on the standardization of clinical models of the inflammatory responses of genitourinary organs resulting from the action of a variety of harmful events. This review is warranted by the prevalence and morbidity and mortality of inflammatory conditions, as well as the complex work of incorporating to Urology the findings from other Biomedical Sciences.


Assuntos
Doenças Urogenitais Femininas/patologia , Inflamação/fisiopatologia , Doenças Urogenitais Masculinas , Infecções Bacterianas/complicações , Cistite/induzido quimicamente , Cistite/etiologia , Cistite/microbiologia , Cistite/patologia , Citocinas/fisiologia , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Urogenitais Femininas/epidemiologia , Doenças Urogenitais Femininas/etiologia , Radicais Livres , Humanos , Inflamação/induzido quimicamente , Inflamação/epidemiologia , Inflamação/etiologia , Mediadores da Inflamação/fisiologia , Masculino , Estresse Oxidativo , Fagocitose , Prostatite/microbiologia , Prostatite/patologia , Pielonefrite/microbiologia , Pielonefrite/patologia , Estresse Mecânico
19.
Toxicol Ind Health ; 14(3): 367-87, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9569445

RESUMO

The purpose of the National Exposure Registry is to assess the long-term health consequences to a general population from long-term, low-level exposures to specific substances in the environment. This study investigates the health outcomes of 1,143 persons (1,127 living, 16 deceased) living in south central Texas who had documented environmental exposure to benzene (up to 66ppb) in tap water. As with all subregistries, face-to-face interviews were used to collect self-reported information for 25 general health status questions. Using computer-assisted telephone interviewing, the same health questions were asked 1 year (Followup 1, F1) and 2 years later (Followup 2, F2). The health outcome rates for Baseline and Followup 1 and 2 data collections for the Benzene Subregistry were compared with national norms, that is, the National Health Interview Survey (NHIS) rates. For at least one of the three reporting periods, specific age and sex groups of the Benzene Subregistry population reported more adverse health outcomes when compared with the NHIS population, including anemia and other blood disorders, ulcers, gall bladder trouble, and stomach or intestinal problems, stroke, urinary tract disorders, skin rashes, diabetes, kidney disease, and respiratory allergies. Statistically significant deficits for the Benzene Subregistry population overall were found for asthma, emphysema, or chronic bronchitis; arthritis, rheumatism, or other joint disorders; hearing impairment; and speech impairment. No statistically significant differences between the two populations were seen for the outcomes hypertension; liver disease; mental retardation; or cancer. These results do not identify a causal relationship between benzene exposure and adverse health effects; however, they do reinforce the need for continued followup of registrants.


Assuntos
Benzeno/efeitos adversos , Exposição Ambiental , Saúde Ambiental , Sistema de Registros , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Demografia , Diabetes Mellitus/induzido quimicamente , Feminino , Doenças Urogenitais Femininas/induzido quimicamente , Doenças Hematológicas/induzido quimicamente , Humanos , Lactente , Recém-Nascido , Nefropatias/induzido quimicamente , Masculino , Doenças Urogenitais Masculinas , Pessoa de Meia-Idade , Hipersensibilidade Respiratória/induzido quimicamente , Dermatopatias/induzido quimicamente , Texas , Estados Unidos , Poluentes Químicos da Água/efeitos adversos
20.
Ann Oncol ; 9 Suppl 5: S133-6, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9926253

RESUMO

At the present time, the majority of patients who develop Hodgkin's disease can be cured with radiotherapy and/or chemotherapy. A long follow up of cured patients has shown that the cumulative toxicity from treatment related complication rivals the mortality from Hodgkin's disease. In addition to late fatal complications, delayed adverse effects of therapy on the thyroid, reproductive system, and bones are burdens many patients have to bear. Future treatment regimens for Hodgkin's disease will be designed attempting to minimize these complications. Follow up of those patients now in remission should focus on the prevention of morbidity and mortality by anticipating and preventing late complications.


Assuntos
Antineoplásicos/efeitos adversos , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Radioterapia/efeitos adversos , Doenças Ósseas/induzido quimicamente , Relação Dose-Resposta a Droga , Doenças Urogenitais Femininas/induzido quimicamente , Humanos , Doenças Urogenitais Masculinas , Morbidade , Neoplasias , Neoplasias Induzidas por Radiação , Doenças da Glândula Tireoide/induzido quimicamente
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