Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.734
Filtrar
1.
Kardiologiia ; 60(9): 76-83, 2020 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-33131478

RESUMO

Aim To study features of coronary damage and incidence of different types of acute coronary syndrome (ACS) in history associated with primary symptomatic hypothyroidism in patients with ischemic heart disease (IHD) and possible associations of replacement hormonal therapy with lipidogram indexes.Material and methods This retrospective study included 344 patients with IHD and functional class I-III stable angina (ССS, 1976). Of them 100 patients had primary symptomatic hypothyroidism and 244 had no hypothyroidism. Coronary angiography was performed for all patients included into this study. Routine laboratory, instrumental and clinical indexes were analyzed. Hypothyroidism was confirmed by levels of thyrotropic hormone, free triiodothyronine, and thyroxine. Comparative analysis was performed for the incidence of ACS types in history, types of coronary injury, and laboratory, instrumental and clinical indexes with assessment of potential interrelations. Statistically significant results were reported. Type of data distribution was evaluated with the Kolmogorov-Smirnov test. Quantitative data with normal (Gaussian) distribution were presented as mean (M) and standard deviation (SD). Data with attributes of non-normal distribution were presented as median (Me) with maximum and minimum values (min; max). Statistical significance of differences between means was assessed with the Mann-Whitney test. Logistic regression analysis was used in parallel for evaluating dependence of a quantitative variable on values of two or more quantitative or qualitative variables (factors). Significance level for testing of statistical hypotheses was р<0.05.Results Incidence of ST segment elevation ACS (STEACS) was significantly higher in IHD patients with hypothyroidism than in the group without hypothyroidism (61.6 and 35.6 %, р=0.03) and also with three-vessel coronary artery disease (60.6 and 30.6 %, р=0.001). In the IHD group with hypothyroidism, levels of total cholesterol, triglycerides, and low- and very low-density lipoproteins were significantly increased compared to the respective values in patients without hypothyroidism (р<0.0001). An inverse correlation was found between lipidogram indexes and L-thyroxine (р<0.0001).Conclusion The incidence of STEACS associated with primary symptomatic hypothyroidism in history was significantly higher in the patient group with IHD on the background of primary symptomatic hypothyroidism compared to the comparison group. Also, the incidence of three-vessel coronary disease was significantly greater than in the IHD patient group without hypothyroidism. A significant association was found between the replacement hormonal therapy and the best lipidogram indexes. The authors suggested that the key factor for prevention of adverse cardiovascular events in IHD with hypothyroidism is achieving control of clinical manifestations of hypothyroidism with replacement hormonal therapy.


Assuntos
Doença da Artéria Coronariana , Hipotireoidismo , Terapia de Reposição Hormonal , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/epidemiologia , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 99(43): e22936, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120852

RESUMO

RATIONALE: Kallmann syndrome (KS) is a rare inherited genetic disorder characterized by hypogonadotropic hypogonadism and hyposmia/anosmia. Early diagnosis is the key to timely treatment and improvement of prognosis in patients with KS. As the most common complication of KS, renal agenesis can provide clues to early diagnosis and treatment for KS. In this article, we report a case of KS with 8 rare urinary disorders for the first time. PATIENT CONCERNS: A 19-year-old Chinese man presented with 8 rare urinary disorders and a history of bilateral cryptorchidism came to us for micropenis, hyposmia, and delayed puberty. DIAGNOSIS: The patient presented with hyposmia, low levels of sex hormones and showed a weak response to the GnRH stimulation test leading to a diagnosis of KS. Two missense mutations were found in further whole-exome sequencing: 1) Kallmann syndrome 1 (KAL1) gene in exon11, c.1600G > A, p. Val534Ile; 2) Prokineticin receptor 2 (PROKR2) gene in exon 2, c.533G > A, p. Trp178Ser. which led to a diagnosis of KS. INTERVENTIONS: The patient underwent replacement therapy of human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG). The patient had previously undergone six surgeries for cryptorchidism and urinary disorders. OUTCOMES: The patient's puberty retardation was effectively alleviated. His serum testosterone (T) reached a normal level (8.280 nmol/mL). During the follow-up period, he presented with Tanner stage II pubic hair development. CONCLUSION: In this article, we report 8 rare urinary disorders with missense mutations of KAL1 and PROKR2 in a case of KS. Among them, bilateral giant kidneys, urinary extravasation of right renal, bilateral megalo-ureters, left ureteral terminal obstruction, bilateral renal cyst and bladder emptying disorder are reported for the first time, which enrich the integrity of urinary disorder types and provide clues to genetic counseling in patients with KS.


Assuntos
Síndrome de Kallmann/diagnóstico , Síndrome de Kallmann/genética , Doenças Urológicas/etiologia , Criptorquidismo/diagnóstico , Criptorquidismo/etiologia , Criptorquidismo/cirurgia , Éxons , Proteínas da Matriz Extracelular/genética , Doenças dos Genitais Masculinos/diagnóstico , Doenças dos Genitais Masculinos/etiologia , Terapia de Reposição Hormonal/métodos , Humanos , Síndrome de Kallmann/tratamento farmacológico , Masculino , Mutação de Sentido Incorreto/genética , Proteínas do Tecido Nervoso/genética , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/etiologia , Pênis/anormalidades , Puberdade Tardia/diagnóstico , Puberdade Tardia/etiologia , Doenças Raras , Receptores Acoplados a Proteínas-G/genética , Receptores de Peptídeos/genética , Resultado do Tratamento , Sequenciamento Completo do Exoma/métodos , Adulto Jovem
3.
Eur J Endocrinol ; 183(5): 513-520, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33107435

RESUMO

Objective: To determine the natural course of pubertal development, growth during puberty, and development of POI in females with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), also called autoimmune polyendocrine syndrome type I. Design: Longitudinal follow-up study. Methods: A national cohort of females with APECED aged ≥12 years were followed during 1965-2018. Attainment of adult height was defined when patients' height increased less than 1 cm per year. Diagnosis of POI was based on delayed puberty or POI symptoms with amenorrhea, and/or FSH ≥40 IU/L. Results: Altogether 40 women with APECED were followed up to the average age of 37.3 (range: 14.6-61.9) years; 16 females (40%) were ≥ 40 years. Pubertal development started spontaneously in 34 patients and 29 had spontaneous menarche. POI developed in 28 patients (70%) at the median age of 16.0 years (range: 11.3-36.5), and in 20 of them (71%) before attaining adult height. In 11 cases puberty was induced or completed by hormonal therapy. Patients with POI were significantly shorter at menarche, but adult heights did not differ from non-POI females. Patients with POI had more often primary adrenocortical insufficiency (93% vs 58%, P = 0.017) and ovarian antibodies (81% vs 30%, P=0.003) compared to those with normal ovarian function (n = 12). Conclusions: POI developed in the majority of patients with APECED, often before or shortly after menarche. Timely commencement of hormonal replacement therapy is important to ensure optimal pubertal development and growth. The possibility of fertility preservation before development of POI in APECED patients should be further studied.


Assuntos
Poliendocrinopatias Autoimunes/fisiopatologia , Insuficiência Ovariana Primária/fisiopatologia , Puberdade/imunologia , Adolescente , Adulto , Feminino , Seguimentos , Terapia de Reposição Hormonal , Humanos , Estudos Longitudinais , Menarca/imunologia , Pessoa de Meia-Idade , Ovário/crescimento & desenvolvimento , Ovário/imunologia , Poliendocrinopatias Autoimunes/tratamento farmacológico , Poliendocrinopatias Autoimunes/imunologia , Insuficiência Ovariana Primária/tratamento farmacológico , Insuficiência Ovariana Primária/imunologia , Adulto Jovem
5.
Eur J Endocrinol ; 183(6): R167-R183, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33105105

RESUMO

Overt hypogonadism in men adversely affects body composition and metabolic health, which generally improve upon testosterone (TS) therapy. As obese men often display lower serum TS levels, in particular when they present with the metabolic syndrome (MetS) or type 2 diabetes (T2DM), there have been claims that androgen therapy prevents or reverses obesity and improves metabolic health. This has contributed to the increase in TS prescriptions during the past two decades. In this narrative review, based on findings from larger observational studies and randomized controlled intervention trials, we evaluate whether low TS predicts or predisposes to obesity and its metabolic consequences, and whether obese men with low TS are truly hypogonadal. We further describe the mechanisms underlying the bi-directional relationships of TS levels with obesity and metabolic health, and finally assess the evidence for TS therapy in men with obesity, MetS and/or T2DM, considering efficacy, safety concerns and possible alternative approaches. It is concluded that low serum sex hormone-binding globulin and total TS levels are highly prevalent in obese men, but that only those with low free TS levels and signs or symptoms of hypogonadism should be considered androgen deficient. These alterations are reversible upon weight loss. Whether low TS is a biomarker rather than a true risk factor for metabolic disturbances remains unclear. Considering the limited number of sound TS therapy trials have shown beneficial effects, the modest amplitude of these effects, and unresolved safety issues, one cannot in the present state-of-the-art advocate TS therapy to prevent or reverse obesity-associated metabolic disturbances. Instead, the focus should remain on lifestyle measures and management of obesity-related consequences.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Hipogonadismo/tratamento farmacológico , Síndrome Metabólica/tratamento farmacológico , Obesidade/tratamento farmacológico , Testosterona/uso terapêutico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Humanos , Hipogonadismo/sangue , Hipogonadismo/complicações , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Obesidade/sangue , Obesidade/complicações , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Resultado do Tratamento
6.
Eur J Endocrinol ; 183(6): 637-645, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33107439

RESUMO

Objective: First-line treatment of thyrotoxicosis in young people is thionamide anti-thyroid drug (ATD) in a blocking dose with levothyroxine replacement (block and replace, BR) or in a smaller dose tailored to render the patient euthyroid (dose titration, DT). Our objective was to determine which regimen provides more stable biochemical control. Design: A multi-centre phase III, open-label randomised trial comparing BR with DT in patients aged 2-17 years with newly diagnosed thyrotoxicosis at 15 UK centres. Methods: Patients were randomised shortly after diagnosis and treated for 3 years. The primary outcome was the percentage of serum thyroid-stimulating hormone (TSH) levels in the reference range between 6 months and 3 years. Secondary outcomes included the proportion of Free thyroxine (FT4) levels in the reference range, adverse event frequency and 4 years outcome (remission/relapse). Results: Eighty-two patients were randomised, with details on clinical course in 81 (62 Female); 40 were allocated to BR (41 DT). Three withdrew with one ineligible. The mean percentage of serum TSH within reference range was 60.2% in BR and 63.8% in DT patients; adjusted difference 4.3%, 95% CI (-7.8 to 16.4); P = 0.48. Proportions for FT4 were 79.2% in BR and 85.7% in DT patients; adjusted difference 6.8%, (-0.2 to 15.6); P = 0.13. Three patients developed neutropenia - all on BR. 6 BR and 10 DT patients were in remission at 4y. Conclusion: This randomised trial has shown no evidence to suggest that BR, when managing the young patient with thyrotoxicosis, is associated with improved biochemical stability when compared to DT.


Assuntos
Antitireóideos/administração & dosagem , Terapia de Reposição Hormonal/métodos , Tireotoxicose/tratamento farmacológico , Tiroxina/administração & dosagem , Adolescente , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Valores de Referência , Tireotoxicose/sangue , Tireotropina/sangue , Resultado do Tratamento
8.
Medicine (Baltimore) ; 99(37): e22163, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925779

RESUMO

For frozen embryo transplantation patients who failed to use hormone replacement cycle (HRC) transplantation for 2 consecutive times, the third time of transplantation was divided into 2 groups: HRC and natural cycle (NC), and the pregnancy rate of the 2 groups, especially the clinical pregnancy rate, was compared.Retrospective study of 174 patients in the reproductive medicine center of an affiliated hospital of Shandong University of Traditional Chinese Medicine between January 2015 and September 2018.The 174 patients were all infertile with regular menstruation. They had undergone 2 consecutive failed cycles of endometrial preparation with hormone replacement therapy and prepare for the third frozen embryo transplantation.A third cycle of treatment was planned using either NC or HRC for endometrial preparation. All the embryos were obtained during the same oocyte retrieval cycle. Patients were divided into groups based on the method of endometrial preparation: 98 were classified as NC and 76 as HRC.The pregnancy outcomes for the 2 groups were compared. Confounding factors that may affect clinical pregnancy rates were analyzed.We found that on the day of endometrial transformation, estrogen levels and endometrial thickness in the NC group were significantly higher than those in the HRC group. There were no significant differences in the rates of biochemical pregnancy, clinical pregnancy, cumulative pregnancy, miscarriage, multiple pregnancy, ectopic pregnancy, or live birth between the 2 groups. It is concluded by binary regression analysis that the different endometrial preparation protocol have no significant effect on the CPR.NC is as effective as HRC after 2 previous cycles of HRC. Because this was a retrospective study design, selection bias is possible, although the baseline characteristics of the 2 groups of patients were matched.


Assuntos
Transferência Embrionária/métodos , Terapia de Reposição Hormonal/métodos , Resultado da Gravidez/epidemiologia , Taxa de Gravidez , Adulto , Implantação do Embrião/fisiologia , Endométrio/metabolismo , Estrogênios/sangue , Feminino , Humanos , Gravidez , Estudos Retrospectivos
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(4): 372-377, 2020 Apr 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879060

RESUMO

OBJECTIVES: The effects of hormone replacement therapy on the survival rate of female lung cancer patients are still controversial. The Meta-analysis aims to systematically evaluate the effect of hormone replacement therapy on the survival rate of female lung cancer patients. METHODS: Retrospective studies regarding the effect of hormone replacement therapy on female lung cancer patients' survival rate were searched from the database of Embase, Cochrane, Pubmed, CNKI, Wanfang, and Weipu. The Meta-analysis was conducted with Stata 12.0 software. I2 test was used to analyze the heterogeneity among included studies. The analysis was conducted by randomized model. Egger's test and Begg's test were used to assess the publication bias. RESULTS: Five retrospective studies were included, involving 2 582 female patients with lung cancer. There were 1 054 cases of female lung cancer with hormone replacement therapy and 1 528 cases of female lung cancer without hormone replacement therapy. No publication bias was observed among these studies. The sensitivity analysis result showed that the overall results were stable. Meta-analysis showed that compared with patients without hormone replacement therapy, patients with hormone replacement therapy had an increased survival time for 5 years (ES=0.346; 95% CI 0.216 to 0.476; P<0.001). CONCLUSIONS: Hormone replacement therapy improves 5-year survival in female lung cancer patients. Female lung cancer patients with menopausal syndrome can use hormone replacement therapy properly under their doctors' suggestion.


Assuntos
Neoplasias Pulmonares/tratamento farmacológico , Feminino , Terapia de Reposição Hormonal , Humanos , Estudos Retrospectivos , Taxa de Sobrevida
11.
PLoS One ; 15(9): e0239120, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970718

RESUMO

OBJECTIVE: To investigate the impact of endometrial thickness on the embryo transfer(ET) day on the clinical pregnancy outcomes of frozen-thawed embryo transfer cycles which have undergone hormone replacement therapy(HRT-FET). METHODS: A total of 10,165 HRT-FET cycles performed between January 2013 to December 2017 in the Reproductive Medicine Center of Henan Provincial People's Hospital were studied retrospectively. All patients were grouped according to their endometrial thickness on the ET day (each group having an increment of 1mm between two neighboring groups). Multivariate regression analysis, curve fitting and threshold effect analysis were performed on all data. RESULTS: After adjusting for the age, duration of infertility, body mass index(BMI), infertility type and number and type of embryos transferred, a significant correlation was observed to be between the endometrial thickness and implantation rates (aOR: 1.08; 95% CI: 1.06-1.10, p < 0.0001), clinical pregnancy rate(aOR: 1.10; 95% CI: 1.07-1.14, p < 0.0001)and live birth rate (aOR: 1.09; 95% CI: 1.06-1.12, p < 0.0001). The numerical value of the cut-off point for the endometrial thickness was 8.7 mm. When the endometrial thickness was less than 8.7 mm, with each additional 1 mm of endometrial thickness, the implantation rate increased by 32%, the clinical pregnancy rate increased by 36%, and the live birth rate increased by 45%. CONCLUSIONS: In the HRT-FET cycles, the optimal live birth rate would be obtained when the endometrial thickness remains within the range of 8.7-14.5 mm. If the endometrium is too thin or too thick, the live birth rate will be reduced.


Assuntos
Transferência Embrionária/métodos , Endométrio/anatomia & histologia , Terapia de Reposição Hormonal , Infertilidade/terapia , Nascimento Vivo/epidemiologia , Adulto , China/epidemiologia , Criopreservação , Implantação do Embrião/fisiologia , Endométrio/diagnóstico por imagem , Endométrio/fisiologia , Endossonografia , Feminino , Humanos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Resultado do Tratamento
12.
BMC Infect Dis ; 20(1): 713, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993515

RESUMO

BACKGROUND: The clinical features, course and outcome of hantavirus infection is highly variable. Symptoms of the central nervous system may occur, but often present atypically and diagnostically challenging. Even though the incidence of hantavirus infection is increasing worldwide, this case is the first to describe diabetes insipidus centralis as a complication of hantavirus infection in the Western world. CASE PRESENTATION: A 49-year old male presenting with severe headache, nausea and photophobia to our neurology department was diagnosed with acute haemorrhage in the pituitary gland by magnetic resonance imaging. In the following days, the patient developed severe oliguric acute kidney failure. Diagnostic workup revealed a hantavirus infection, so that the pituitary haemorrhage resulting in hypopituitarism was seen as a consequence of hantavirus-induced hypophysitis. Under hormone replacement and symptomatic therapy, the patient's condition and kidney function improved considerably, but significant polyuria persisted, which was initially attributed to recovery from kidney injury. However, water deprivation test revealed central diabetes insipidus, indicating involvement of the posterior pituitary gland. The amount of urine production normalized with desmopressin substitution. CONCLUSION: Our case report highlights that neurological complications of hantavirus infection should be considered in patients with atypical clinical presentation.


Assuntos
Diabetes Insípido Neurogênico/etiologia , Infecções por Hantavirus/complicações , Hantavirus/genética , Hantavirus/imunologia , Hipofisite/etiologia , Hipopituitarismo/etiologia , Poliúria/etiologia , Lesão Renal Aguda/tratamento farmacológico , Anticorpos Antivirais/análise , Antidiuréticos/uso terapêutico , Desamino Arginina Vasopressina/uso terapêutico , Diabetes Insípido Neurogênico/tratamento farmacológico , Seguimentos , Infecções por Hantavirus/virologia , Terapia de Reposição Hormonal , Humanos , Hipofisite/diagnóstico por imagem , Hipofisite/tratamento farmacológico , Hipopituitarismo/diagnóstico por imagem , Hipopituitarismo/tratamento farmacológico , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Filogenia , Reação em Cadeia da Polimerase , Poliúria/tratamento farmacológico , Resultado do Tratamento
14.
Mayo Clin Proc ; 95(8): 1710-1714, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32753145

RESUMO

Given the rapid spread of the coronavirus disease 2019 (COVID-19) pandemic and its overwhelming effect on health care systems and the global economy, innovative therapeutic strategies are urgently needed. The proposed primary culprit of COVID-19 is the intense inflammatory response-an augmented immune response and cytokine storm-severely damaging the lung tissue and rendering some patients' conditions severe enough to require assisted ventilation. Sex differences in the response to inflammation have been documented and can be attributed, at least in part, to sex steroid hormones. Moreover, age-associated decreases in sex steroid hormones, namely, estrogen and testosterone, may mediate proinflammatory increases in older adults that could increase their risk of COVID-19 adverse outcomes. Sex hormones can mitigate the inflammation response and might provide promising therapeutic potential for patients with COVID-19. In this article, we explore the possible anti-inflammatory effects of estrogen and testosterone and the anabolic effect of testosterone, with particular attention to the potential therapeutic role of hormone replacement therapy in older men and women with COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Estrogênios/fisiologia , Pneumonia Viral/fisiopatologia , Testosterona/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Estrogênios/uso terapêutico , Feminino , Terapia de Reposição Hormonal , Humanos , Inflamação/tratamento farmacológico , Inflamação/fisiopatologia , Inflamação/virologia , Masculino , Pandemias , Pneumonia Viral/tratamento farmacológico , Testosterona/uso terapêutico
15.
Eur J Endocrinol ; 183(4): 471-480, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32738133

RESUMO

Context: Growth hormone (GH) deficiency is a common late effect of cranial irradiation. However, concerns have been raised that GH treatment might lead to an increased risk of a second neoplasm (SN). Objective: To study the impact of GH treatment on the risk of SN in a French cohort of survivors of childhood cancer (CCS) treated before 1986. Design and setting: Cohort study and nested case-control study. Participants: Of the 2852 survivors, with a median follow-up of 26 years, 196 had received GH therapy (median delay from cancer diagnosis: 5.5 years). Main outcome measures: Occurrence of SN. Results: In total, 374 survivors developed a SN, including 40 who had received GH therapy. In a multivariate analysis, GH treatment did not increase the risk of secondary non-meningioma brain tumors (RR: 0.6, 95% CI: 0.2-1.5, P = 0.3), secondary non-brain cancer (RR: 0.7, 95% CI: 0.4-1.2, P = 0.2), or meningioma (RR: 1.9, 95% CI: 0.9-4, P = 0.09). Nevertheless, we observed a slight non-significant increase in the risk of meningioma with GH duration: 1.6-fold (95% CI: 1.2-3.0) after an exposure of less than 4 years vs 2.3-fold (95% CI: 0.9-5.6) after a longer exposure (P for trend = 0.07) confirmed by the results of a case-control study. Conclusion: This study confirms the overall safety of GH use in survivors of childhood cancer, which does not increase the risk of a SN. The slight excess in the risk of meningioma in patients with long-term GH treatment is non-significant and could be due to difficulties in adjustment on cranial radiation volume/dose and/or undiagnosed meningioma predisposing conditions.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Hormônio do Crescimento Humano/uso terapêutico , Segunda Neoplasia Primária/epidemiologia , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/induzido quimicamente , Neoplasias Encefálicas/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Irradiação Craniana/efeitos adversos , Feminino , Seguimentos , França/epidemiologia , Terapia de Reposição Hormonal/efeitos adversos , Terapia de Reposição Hormonal/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Neoplasias Meníngeas/induzido quimicamente , Neoplasias Meníngeas/epidemiologia , Meningioma/induzido quimicamente , Meningioma/epidemiologia , Pessoa de Meia-Idade , Segunda Neoplasia Primária/induzido quimicamente , Estudos Retrospectivos , Adulto Jovem
16.
Revista Digital de Postgrado ; 9(2): 227, ago. 2020. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103383

RESUMO

Evaluar los efectos de la terapia hormonal (TH) con Drospírenona (DRSP)/17 ß -estradiol (E2), sobre los parámetros del Síndrome Metabólico (SM) en pacientes postmenopáusicas. Métodos: Investigación comparativa y aplicada, con diseño cuasi experimental, de casos y controles a simple ciego, prospectivo y de campo; realizada en la Consulta de Ginecología. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. Participaron 120 mujeres separadas al azar para recibir la combinación DRSP/E2 (Grupo A) o un placebo (Grupo B). Se evaluaron los componentes del SM antes y posterior a 6 meses de haber recibido la TH. Resultados: Se encontró una alta prevalencia de SM en ambos grupos antes de recibir el tratamiento (53,3% y 48%; grupo A y B respectivamente). Posterior al tratamiento, DRSP/E2 al compararse con un placebo, redujo significativamente tanto la prevalencia del SM como el riesgo de padecerlo (21,7% versus 48,3%, OR [IC95%]= 0,29 [0,13-0,65]; p < 0.001), con reducción significativa (p< 0.001) de la hipertensión arterial, glicemia basal alterada, hipertrigliceridemia y obesidad central; además de una reducción significativa de los síntomas vasomotores, síntomas psicológicos e incontinencia urinaria (p< 0.001). En el grupo B la prevalencia del SM se mantuvo sin cambios, salvo para la glicemia basal alterada y los síntomas vasomotores y psicológicos que mostraron una reducción significativa (p< 0.001). Conclusión: DRSP/E2 (2mg/1 mg) demostró ser eficaz luego de 6 meses de tratamiento tanto para el control de los parámetros que definen al SM; con pocos y leves efectos indeseados(AU)


To assess the effects of hormone therapy (HT) with drospirenone (DRSP)/17 ß -estradiol (E2) on the parameters of the metabolic syndrome (MS) in postmenopausal patients. Methods: We performed a comparative and applied research, with quasiexperimental, case-control, single-blind, prospective and field design. The study was realized in the Gynecology consultation. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. 120 women were included, they were separated to receive either the combination DRSP/E2 (Group A) or placebo (Group B). We assess MS components before and ather 6 months of receiving HT. Results: We found a high prevalence in both groups before receiving treatment (53.3% and 48%, group A and B respectively). A ther treatment, DRSP/E2 when compared to placebo, significantly reduced both the prevalence of MS as the risk of setting it (21.7% versus 48.3%, OR [95%] = 0.29 [0.13-0.65] p <0.001), with a significant reduction (p <0.001) of hypertension, impaired fasting glucose, hypertriglyceridemia, central obesity; and a significant reduction in vasomotor symptoms, psychological symptoms and urinary incontinence (p <0.001). In group B the prevalence of MS was unchanged, except for impaired fasting glycemia and vasomotor and psychological symptoms showed a significant reduction (p <0.001). Conclusion: DRSP/E2 (2mg /1mg), proved to be effective a ther 6 months of treatment both for the control of the parameters that define the SM, with few and mild side effects(AU)


Assuntos
Humanos , Feminino , Progestinas/uso terapêutico , Terapia de Reposição Hormonal , Síndrome Metabólica/fisiopatologia , Estradiol/uso terapêutico , Pós-Menopausa , Endocrinologia , Ginecologia
17.
Eur J Epidemiol ; 35(9): 871-878, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32767022

RESUMO

There are conflicting finds in the literature regarding the association of female estrogen status and the incidence of Parkinson's disease (PD). We aimed to investigate whether female reproductive factors are associated with PD. Using the Korean National Health Insurance System database, 4,729,546 postmenopausal women without PD were identified. The new incidence of PD was defined as subjects with an ICD-10 code for PD (G20) and with a rare intractable disease registration code for PD (V124). The Cox proportional hazard models were used to evaluate the associations of various reproductive factors with incidence of PD. During the median follow-up of 5.84 years, 20,816 individuals were diagnosed with PD. An increased risk of PD was observed in subjects with a later age at menarche (≥ 17 years) compared with reference subjects (13 years ≤ age at menarche ≤ 14 years) (adjusted hazard ratio, aHR 1.10, 95% confidence interval, CI 1.05-1.16). As age at menopause increased, risk of PD decreased (P for trend 0.019). Consistently, decreased risk of PD was observed (aHR 0.91, 95% CI 0.85-0.96) in subjects with longer duration of fertility (≥ 40 years of age) compared with shorter duration of fertility (< 30 years of age). Hormone replacement therapy and oral contraceptives independently increased the risk of PD by 17% and 7%, respectively. Female reproductive factors are independent risk factors for PD, with higher risk associated with shorter lifetime exposure to endogenous estrogen.


Assuntos
Anticoncepcionais Orais/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversos , Menarca , Menopausa , Doença de Parkinson/epidemiologia , História Reprodutiva , Adulto , Idoso , Estudos de Coortes , Anticoncepcionais Orais/administração & dosagem , Feminino , Terapia de Reposição Hormonal/métodos , Humanos , Incidência , Pessoa de Meia-Idade , Doença de Parkinson/etiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
19.
Maturitas ; 139: 20-26, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32747036

RESUMO

OBJECTIVES: Various combinations of estrogens and progestogens are available for menopausal hormone therapy that differ in their efficacy and safety profile. We evaluated the efficacy and long-term safety of low-dose estradiol (0.5 mg) / dydrogesterone (2.5 mg) in subgroups of postmenopausal women with vasomotor symptoms. ANALYSIS: Efficacy analysis was performed on data from 2 previously published studies for subgroups defined by age, duration of menopause, and body mass index at baseline. The primary efficacy variable was the number of moderate to severe hot flushes from baseline to week 13. Long-term safety was evaluated in relation to age and duration of menopause. Safety variables included adverse events to week 52 and change from baseline to endpoint in laboratory and vital sign values. RESULTS: The treatment difference seen in the overall population in favour of low-dose estradiol/dydrogesterone was also observed in the subgroups of patients aged 45 to < 55 years (p < 0.01) and ≥55 years (p < 0.05), with menopause duration of >12 months to <60 months (p < 0.05) and ≥ 60 months (p < 0.005), and with a BMI at baseline of <25 kg/m2 (p < 0.05) and 25 to <30 kg/m2 (p < 0.01). Low-dose estradilol/dydrogesterone was well tolerated across the different subgroups. The incidence of breast-related adverse events was very low. No breast malignancy was reported. Only one adverse endometrial outcome of simple hyperplasia was observed. CONCLUSION: The results of our analyses confirmed the consistent treatment effect on vasomotor symptoms and the favourable safety profile of 0.5 mg 17ß estradiol and 2.5 mg dydrogesterone in different patient subgroups.


Assuntos
Didrogesterona/uso terapêutico , Estradiol/uso terapêutico , Terapia de Reposição Hormonal , Fogachos/tratamento farmacológico , Idoso , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA