HDL concentration, lipid transfer to HDL, and HDL size in normolipidemic nonobese menopausal women.

OBJECTIVE: To determine the impact of menopause on lipid transfer from donor lipoproteins to high-density lipoproteins (HDLs) -- a process that is related to the protective function of HDL -- and the size of HDL particles. METHOD: Plasma from 22 premenopausal and 18 postmenopausal nonobese, normolipidemic women paired for age (40-50 years) was incubated in an artificial nanoemulsion labeled with radioactive lipids. Then the HDL fraction was assessed for radioactivity; the percentage of radioactive lipids transferred from the nanoemulsion to HDL was determined; and the size of HDL particles was measured by laser light scattering. RESULTS: There were no differences between the 2 groups in serum concentration of HDL cholesterol (61+/-12 mg/dL vs 61+/-14 mg/dL) or apolipoprotein A(1) (1.5+/-0.3 g/L vs 1.5+/-0.2 g/L); lipid transfer to HDL; or size of HDL particles (8.8+/-0.8 vs 9.0+/-0.5 nm). CONCLUSION: Menopause was not found to affect HDL cholesterol plasma concentration, lipid transfer to HDL, or size of HDL particles in normolipidemic nonobese women.

Progesterone receptor (PROGINS) polymorphism and the risk of ovarian cancer.

The present case-control study evaluates the role of the progesterone receptor (PR) polymorphism known as PROGINS as a risk factor for ovarian cancer development and investigates the association between these genetic variants and clinical/pathologic variables of ovarian cancer. PROGINS polymorphism was examined, by polymerase chain reaction, in a total of 80 patients with ovarian cancer and 282 control subjects. The frequencies of PROGINS polymorphism T1/T1, T1/T2, and T2/T2 were 71.3, 15.0 and 13.8% in ovarian cancer patients and 78.37, 21.63 and 0% in controls, respectively. The chi(2)-test showed a higher incidence of the T2/T2 genotype (P=0.001) in the ovarian cancer group. In addition, women carrying a mutated allele (T2) showed approximately 2.2 times higher risk of ovarian cancer development as compared to women who have a variant allele (odds ratio (OR)=2.2; 95% CI=1.80-3.54). Regarding the clinical and pathologic findings observed within the cancer group, there was a significant correlation between PROGINS polymorphism and patients with a familial history (chi(2)=6.776; P=0.009; Fischer exact test, P=0.01). In this regard, patients with familial antecedents have a 4.7 times higher likelihood to have at least one risk allele (T2) as compared with patients without familial antecedents (OR=4.69; 95% CI=1.38-15.87). No correlations were observed among the other variables. These data suggest that the PROGINS polymorphism T2/T2 genotype might be associated with an increased risk of ovarian cancer.

Could statins constitute a novel treatment for endometriosis? Systematic review of the literature.

Endometriosis, defined as the presence of endometrial glands and/or stroma outside the uterine cavity, is an estrogen-dependent disease that affects about 10% of reproductive age women. Theories to explain the etiology of endometriosis abound. These include the alteration of epithelial cells on peritoneal surface, metaplasia of embryonic remnants of the mullerian ducts, immune system abnormalities, and the dissemination of endometrial cells through the circulation or lymphatic system, as well as retrograde menstruation, the hypothesis currently favored for the development of endometriosis. Angiogenesis, the development of new capillaries from pre-existing blood vessels, has been proposed as a key mechanism in the pathogenesis of endometriosis. Again from an etiological perspective, the formation of endometriotic implants requires ectopic fixation and proliferation of endometrial stroma and glands. The process of invasive insertion of endometriotic tissues involves the degradation of the extracellular matrix, and altered expression of matrix metalloproteinases (MMPs) in the eutopic and ectopic endometrium. Considering the antiproliferative, antiangiogenic, antioxidant, anti-inflammatory properties and matrix metalloproteinase activity inhibition of statins and the original studies addressing the possible mechanisms of action in endometriosis, the aim of this systematic review was to synthesize the research conducted to date in order to propose statins as possible and effective tools for controlling this disease.

Metabolism of triglyceride-rich lipoproteins and lipid transfer to high-density lipoprotein in young obese and normal-weight patients with polycystic ovary syndrome.

OBJECTIVE: To clarify whether the metabolism of triglyceride-rich lipoproteins and lipid transfer to high-density lipoprotein (HDL) are altered in patients with polycystic ovary syndrome (PCOS). DESIGN: Case-control study. SETTING: Endocrinology clinics. PATIENT(S): Eight normal-weight (NW) and 15 obese (Ob) patients with PCOS were compared with 10 NW and 10 Ob women without PCOS paired for age and body mass index. INTERVENTION(S): Determination of triglyceride-rich lipoprotein metabolism and lipid transfer to HDL. MAIN OUTCOME MEASURE(S): Participants were injected triglyceride-rich emulsions labeled with (14)C-cholesteryl esters and (3)H-triglycerides and the fractional clearance rate (FCR, in min(-1)) of labels was determined. Lipid transfer from artificial nanoemulsions to HDL was performed by incubating radioactively labeled lipid nanoemulsions with plasma during 1 hour, followed by radioactive counting of HDL-containing supernatant after chemical precipitation. RESULT(S): Lipolysis estimated by triglyceride FCR was equal in PCOS groups (NW = 0.043 +/- 0.032, Ob = 0.033 +/- 0.009) and respective controls (NW = 0.039 +/- 0.015, Ob = 0.044 +/- 0.019). However, the remnant removal as estimated by cholesteryl ester FCR was reduced in both PCOS groups (NW = 0.005 +/- 0.006, Ob = 0.005 +/- 0.005) compared with controls (NW = 0.016 +/- 0.006, Ob = 0.011 +/- 0.072). Lipid transfer rates were not different among groups, but triglyceride transfer rates were positively correlated with homeostasis model assessment estimate of insulin resistance in PCOS. CONCLUSION(S): PCOS patients showed decreased removal of atherogenic remnants even when fasting glucose was <100 mg/dL. This reinforces the usefulness of the measures taken to prevent cardiovascular events in PCOS patients.

The effects of paradoxical sleep deprivation on estrous cycles of the female rats.

The present purpose was to examine how sleep deprivation affects the estrous cycle of the female rat. Paradoxical sleep-deprived (PSD) adult female Wistar rats were compared to home-cage control (CTRL) on their estrous cyclicity. Forty-four PSD and forty-four CTRL female rats were distributed into 4 subgroups of 11 animals each according to the phase of estrous cycle and were subjected to sleep deprivation for 96 h by the multiple platform technique. After PSD period, vaginal estrous cycles were taken for an additional 9 days. Animals that were submitted to PSD in diestrus phase (PSD-diestrus) had their estrous cycles disrupted during the recovery period by showing a constant diestrus during the first week. As for hormone alterations, progesterone concentrations were statistically higher in PSD-diestrus compared to respective phase control and to PSD-proestrus and PSD-estrus rats while CTRL-metestrus had higher levels than CTRL-proestrus and estrus groups. Testosterone was significantly decreased in PSD-estrus in relation to PSD-proestrus and PSD-diestrus groups and was lower in CTRL-diestrus rats than in home-cage rats in proestrus. In addition, PSD-diestrus phase exhibited higher concentrations of corticosterone and lower estrogen than the respective control rats. These data indicate that PSD may modulate the ovarian hormone release through alterations in hormonal-neurochemical mechanisms.

Terapia hormonal da pós-menopausa e câncer: [revisão] / Postmenopausal hormone therapy and cancer: [review]

O objetivo desta revisão é analisar as principais evidências clínicas sobre os efeitos da terapia hormonal da pós-menopausa no risco de desenvolver neoplasias mamária, endometrial, ovariana e colorretal. As principais considerações: a) as mulheres devem ser orientadas sobre a associação entre terapia hormonal e risco de câncer de mama, apesar do risco absoluto ainda permanecer relativamente baixo b) mulheres com antecedente de câncer de mama devem considerar terapias alternativas para o tratamento de sintomas de menopausa c) mulheres com útero devem receber terapia combinada com estrogênio e progesterona.

Correção da incontinência urinária de esforço com sling: resultados iniciais / Stress urinary incontinence correction with sling: first results

Objetivo: analisar os resultados cirúrgicos após slings com mucosa vaginal, no tratamento de mulheres incontinentes com hipermobilidade do colo vesical, que apresentam alto risco de falha cirúrgica para outras técnicas ou naquelas com defeito esfincteriano intrínseco e, ainda, recidivas cirúrgicas. Métodos: foram avaliadas 21 pacientes submetidas à cirurgia para correção de incontinência urinária pela técnica de sling vaginal, com seguimento pós-operatório que variou de 1 a 14 meses (média de 8,2). Todas as pacientes foram avaliadas antes da cirurgia por meio de anamnese, exame clínico, estudo ultra-sonográfico e urodinâmico, sendo o grau de perda urinária acentuado em 66,7 por cento e moderado em 33,3 por cento das pacientes. Todas as pacientes apresentavam hipermobilidade da junção uretrovesical (superior a 10 mm) e 12 pacientes apresentavam cirurgia prévia para correção de incontinência urinária. Ao estudo urodinâmico, as pacientes apresentavam perda urinária com pressão máxima de fechamento uretral (PMFU) variando de 20 a 124 cmH2O (média de 55,2) e "Valsalva leak point pressure" (VLPP) variando de 18 a 128 cmH2O (média de 60,3). As indicações das cirurgias foram: defeito esfincteriano (11 pacientes - 52,4 por cento), obesidade (5 pacientes - 23,8 por cento), defeito esfincteriano e obesidade (2 pacientes - 9,5 por cento), recidiva cirúrgica (2 pacientes - 9,5 por cento) e defeito esfincteriano e prolapso uterino de 1º grau (1 paciente -4,8 por cento). Resultados: como complicações, 6 pacientes (28,6 por cento) apresentaram retenção urinária temporária no pós-operatório, 1 (4,8 por cento) infecção do trato urinário, 1 (4,8 por cento) presença de fio de polipropileno na vagina, 1 (4,8 por cento) infecção da ferida cirúrgica, 4 pacientes (19 por cento) evoluíram com urgência/incontinência, 1 (4,8 por cento) com urgência miccional e 1 (4,8 por cento) com dificuldade para urinar (elevado resíduo pós-miccional). O grau de satisfação das pacientes foi satisfatório, com 15 pacientes (71,4 por cento) referindo cura, 3 (14,3 por cento) melhora, 2 (9,5 por cento) quadro de perda urinária inalterado e 1 (4,8 por cento) piora da perda urinária. Conclusões: a cirurgia de sling com mucosa vaginal é eficaz para o tratamento de casos específicos de incontinência urinária de esforço, destacando-se defeito esfincteriano, recidivas cirúrgicas e fatores predisponentes para falha de outras técnicas.

Resposta da prolactina ao hormonio liberador de tireotropina (TRH) em mulheres com osteoporose / Prolactin response to thyrotropin releasing hormone (TRH) in osteoporotic women

Se a prolactina tem ou näo algum efeito sobre o metabolismo de calcio ainda näo esta bem estabelecido. Alguns autores mostraram que mulheres com hiperprolactinemia desenvolvem uma forma particular de osteoporose e estudos mais recentes mostraram que mulheres com osteoporose apresentam niveis basais de prolactina mais baixos que o grupo controle. O presente estudo objetivou avaliar a resposta da prolactina após estimulo com TRH em mulheres com osteoporose...

Avaliaçäo histeroscópica do endométrio de pacientes com carcinoma de mama na pós-menopausa antes e após o uso de tamoxifeno / Hysteroscopical evaluation of the endometrium of post-menopausic patients with breast cancer before and after tamoxifen use

Objetivo: avaliar a influência do tamoxifeno no aspecto histeroscópico e histopatológico do endométrio de pacientes com câncer de mama na pós-menopausa, por meio da histeroscopia. Método: estudaram-se, prospectivamente, 46 pacientes, das quais 20 utilizaram a droga por período médio de 12 meses. Efetuou-se, antes e após o tratamento pelo fármaco, a histeroscopia associada à biópsia endometrial. Resultados: a taxa de endométrio ativo, antes e após a hormonioterapia adjuvante com tamoxifeno näo aumentou a taxa de atividade proliferativa endometrial em pacientes com câncer de mama na pós-menopausa. Observaram-se numerosas vesículas disseminadas por toda a cavidade uterina e isso constituiu o aspecto histeroscópico mais usual, talvez devido à atrofia cística do endométrio