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4.
Heart Fail Clin ; 16(1): 11-21, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735309

RESUMO

"Chronic heart failure (CHF) is a complex syndrome characterized by symptoms and signs supported by different forms of cardiac impairment. The link between multiple hormonal and metabolic derangements and the development of CHF and the beneficial effects seen with hormonal replacement therapy suggest that a reduction of anabolic pathways might contribute to the onset of CHF. Therefore, an imbalance between anabolic and catabolic forces could be responsible for the development of CHF. There are sufficient evidence to support the screening in patients with CHF of hormonal deficiencies and their correction with replacement therapy."


Assuntos
Hormônio do Crescimento/sangue , Insuficiência Cardíaca/metabolismo , Resistência à Insulina , Doenças Metabólicas/etiologia , Testosterona/sangue , Hormônios Tireóideos/sangue , Biomarcadores/sangue , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Humanos , Doenças Metabólicas/tratamento farmacológico , Doenças Metabólicas/metabolismo
5.
Medicine (Baltimore) ; 98(51): e17532, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860945

RESUMO

BACKGROUND: Discordant results about the causal relationship between hormone replacement therapy use (HRT) and lung cancer risk in women had been reported. We therefore conducted a meta-analysis of cohort studies to evaluate this association. METHODS: The PubMed and Embase databases were searched. Fixed- or random-effects model was used to pool the study-specific relative risks (RRs) with corresponding 95% confidence intervals (CIs). Sensitivity analysis, publication bias, and subgroup analysis were performed. RESULTS: A total of 13 cohort studies met the inclusion criteria. Combined results indicated that compared with nonusers, women with HRT use were at a decreased risk (RR: 0.95, 95% CI: 0.91-0.99, I = 30.8%, P for heterogeneity = .137). In subgroup analysis by geographic area, smoking statue, type of hormones, and histology type of lung cancer, no significant association between HRT use and lung cancer was observed in most subgroups except in those studies which reported risk estimates adjusted for age, body mass index, smoking, and other confounders (RR: 0.95, 95 CI: 0.91-0.99, I = 33.0%, P for heterogeneity = .214). Both Begg funnel plot and Egger test (P = .243) suggested no evidence for publication bias. CONCLUSION: Our meta-analysis suggests ever use of HRT is associated with a decreased risk of lung cancer in women.


Assuntos
Terapia de Reposição Hormonal/efeitos adversos , Terapia de Reposição Hormonal/métodos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Feminino , Humanos , Neoplasias Pulmonares/fisiopatologia , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Prevalência , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Análise de Sobrevida
7.
Pan Afr Med J ; 33: 221, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692807

RESUMO

Kallmann-de Morsier syndrome (KS) is a genetic disease of the olfactory system characterized by the association of hypogonadotropic hypogonadism also referred to as gonadotropin-releasing hormone (GnRH) deficiency and anosmia or hyposmia (with hypoplasia or aplasia of the olfactory bulbs). Apart from sporadic cases that occur most often, familial Kallmann's syndrome is being described with increasing frequency. Diagnosis is mainly made in adolescents with absence of spontaneous puberty associated with smell disorders with hypoplasia or even aplasia of the bulbs and/or of the olfactory lobes on MRI. Sometimes, the diagnosis may be suspected in early childhood due to the association of cryptorchidism and micropénis. A mutation in one of known genes is only found in less than 30% of cases and, therefore, many other genes are still to be found. Hormone therapy allows pubertal growth in all cases and fertility can be obtained in most of the cases. We here report 3 cases of patients with this syndrome.


Assuntos
Terapia de Reposição Hormonal/métodos , Síndrome de Kallmann/diagnóstico , Adulto , Feminino , Hormônio Liberador de Gonadotropina/deficiência , Humanos , Síndrome de Kallmann/tratamento farmacológico , Síndrome de Kallmann/fisiopatologia , Masculino , Adulto Jovem
8.
Pan Afr Med J ; 34: 7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762876

RESUMO

Myxedema coma is a rare complication of hypothyroidism. Clinical examination may reveal hypotension, bradycardia, and hypothermia. Laboratory tests may show hyponatremia, lipid disorders, and elevations of creatine kinase, liver, and cardiac enzymes. We describe four cases diagnosed in our hospital during the period 1999-2017. The patients were related to amiodarone treatment, noncompliance with hormone replacement therapy, or a new diagnosis of hypothyroidism. Intravenous hormone replacement therapy was effective in three of the cases and one died. The outcome of this disease may be fatal as seen in one of our cases.


Assuntos
Coma/etiologia , Terapia de Reposição Hormonal/métodos , Hipotireoidismo/complicações , Mixedema/etiologia , Idoso , Idoso de 80 Anos ou mais , Amiodarona/administração & dosagem , Coma/tratamento farmacológico , Feminino , Hospitais Universitários , Humanos , Masculino , Adesão à Medicação , Mixedema/tratamento farmacológico , Espanha
10.
Gynecol Oncol ; 155(3): 508-514, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31606283

RESUMO

Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions on reproductive and hormonal health. This document reviews potential options for cancer prevention, family building, genetic testing and management of surgical menopause in this patient population. Capsule: Women predisposed to hereditary gynecologic cancer have options for fertility preservation, preimplantation genetic testing to select embryos without pathogenic variants, pregnancy through gestational carriers after hysterectomy and hormone replacement.


Assuntos
Neoplasias dos Genitais Femininos/genética , Neoplasias dos Genitais Femininos/terapia , Reprodução/fisiologia , Medicina Baseada em Evidências , Feminino , Preservação da Fertilidade , Neoplasias dos Genitais Femininos/fisiopatologia , Neoplasias dos Genitais Femininos/prevenção & controle , Terapia de Reposição Hormonal , Humanos
11.
BMJ ; 367: l5928, 2019 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604711
13.
Cancer Causes Control ; 30(11): 1201-1211, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31542834

RESUMO

PURPOSE: Menopausal hormone therapy (MHT) use induces alterations in circulating estrogens/estrogen metabolites, which may contribute to the altered risk of reproductive tract cancers among current users. Thus, the current study assessed associations between circulating estrogens/estrogen metabolites and ovarian and endometrial cancer risk among MHT users. METHODS: We conducted a nested case-control study among postmenopausal women using MHT at baseline in the Women's Health Initiative Observational Study (179 ovarian cancers, 396 controls; 230 endometrial cancers, 253 controls). Multivariable logistic regression was utilized to estimate odds ratios and 95% confidence intervals overall and by subtype. RESULTS: Estrogen/estrogen metabolite levels were not associated with overall or serous ovarian cancer risk, examined separately. However, unconjugated estradiol was positively associated with non-serous ovarian cancer risk [quintile 5 vs. quintile 1: 3.01 (1.17-7.73); p-trend = 0.03; p-het < 0.01]. Endometrial cancer risk was unrelated to estrogen/estrogen metabolite levels among women who took combined estrogen/progestin therapy (EPT). CONCLUSIONS: These findings provide novel evidence that may support a heterogeneous hormonal etiology across ovarian cancer subtypes. Circulating estrogens did not influence endometrial cancer risk among women with EPT-induced high-estrogen levels. Larger studies are needed to delineate the relationship between ovarian/endometrial cancer subtypes and estrogen levels in the context of MHT use.


Assuntos
Neoplasias do Endométrio/sangue , Estradiol/sangue , Estrogênios/sangue , Terapia de Reposição Hormonal , Neoplasias Ovarianas/sangue , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Risco
14.
Maturitas ; 128: 60-63, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31561825

RESUMO

INTRODUCTION: The interpretation of the literature on menopause hormone therapy (MHT) has evolved enormously over the last decade. In recent years, guidelines have reinstated the place of MHT. AIM: This survey analyzes the prescription (initiation and maintenance) of MHT in relation to patient age and therapy indications. MATERIAL AND METHOD: Two vignettes were sent to gynecologists working in Belgium in a random survey. One vignette concerned the initiation of therapy for a woman who was either 52 or 62 years old, suffering either from severe vasomotor symptoms (VSM) or from osteoporosis. The second vignette concerned the maintenance of MHT or switching to another medication in a woman aged 62 years who suffered either from VSM (when stopping MHT) or from osteoporosis. The physicians were asked how they would treat these two patients. RESULTS: We analyzed 443 vignettes from 222 physicians. INITIATION OF MHT: 84% of the respondents would initiate MHT for a 52-year-old woman with VMS, whereas only 32% would do so for a 52-year-old woman who had osteoporosis (chi square = 33; p < 0.001). 51% would initiate MHT for a 62-year-old woman with VMS, whereas only 14% would do so for a 62-year-old woman with osteoporosis (chi square = 17; p < 0.001). MAINTENANCE OF THERAPY: 87% would maintain MHT for a 62-year-old woman with severe VMS and 52% would do so for a 62-year-old woman with osteoporosis (Chi Square 31; p < 0.001). CONCLUSION: VMS are recognized as an indication for MHT, but osteoporosis much less so, even for women around the age of 50.


Assuntos
Atitude do Pessoal de Saúde , Ginecologia , Terapia de Reposição Hormonal , Menopausa , Osteoporose Pós-Menopausa/tratamento farmacológico , Fatores Etários , Bélgica , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Pessoa de Meia-Idade
15.
Urologiia ; (4): 58-61, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31535806

RESUMO

AIM: to compare the efficiency of monotherapy with -blockers vs combined therapy (-blockers in combination with Androgel) in patients with BPH and hypogonadism. MATERIALS AND METHODS: a total of 60 men with BPH and hypogonadism, who were randomly selected from outpatient department were included in the study. All patients were divided into 2 groups (n=30). In Group 1 patients received silodosin, while in Group 2 men were prescribed to silodosin plus Androgel 1% topically. The duration of therapy was 6 months. The results of treatment were evaluated during baseline assessment and further visits every 2 months after starting therapy (total 4 time points). RESULTS: according to the ICEF-5 questionnaire, in the Group 2 an improvement in sexual function domain score (from 6.3 to 26.8 points) was shown. In addition, in combination group there were significant changes in PSA level (from 2.25 to 1.8 ng/ml), prostate volume (from 55.1 to 61.3 cm3), residual urine volume (from 72 to 19 ml), urine flow rate (from 13.34 to 21.1 ml/s), waist circumference (from 116 to 103.2 cm) and body mass index (from 35.4 to 27.2 kg/m2), while in monotherapy group none of these indicators significantly improved. CONCLUSIONS: the use of topical hormone replacement therapy in combination with -blockers in patients with BPH and concomitant hypogonadism is justified and effective in comparison with monotherapy with -blockers.


Assuntos
Hipogonadismo , Hiperplasia Prostática , Quimioterapia Combinada , Terapia de Reposição Hormonal , Humanos , Masculino , Resultado do Tratamento
16.
Maturitas ; 129: 30-39, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31547910

RESUMO

Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. Long-term benefits for postmenopausal insomnia may also be achieved with non-drug strategies such as cognitive behavioral therapy (CBT) and aerobic exercise. Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) both reduce blood pressure and cortisol levels in postmenopausal women suffering from OSA. However, the data regarding MHT on postmenopausal restless legs syndrome are conflicting.


Assuntos
Antidepressivos/uso terapêutico , Terapia de Reposição Hormonal , Menopausa , Transtornos do Sono-Vigília/terapia , Terapia Cognitivo-Comportamental , Pressão Positiva Contínua nas Vias Aéreas , Depressão , Exercício , Feminino , Humanos , Mirtazapina/uso terapêutico , Qualidade de Vida , Síndrome das Pernas Inquietas/tratamento farmacológico , Inibidores de Captação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Sono , Apneia Obstrutiva do Sono/terapia , Distúrbios do Início e da Manutenção do Sono/terapia
19.
BMJ Case Rep ; 12(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31401581

RESUMO

In patients with substituted hypothyroidism, laparoscopic sleeve gastrectomy may interfere with thyroid balance by varying body weight or by altering the absorption of hormone therapy. A 58-year-old female patient presented with a major thyroid imbalance after sleeve gastrectomy, manifesting itself in large-scale changes in thyroid stimulating hormone (TSH) levels. The transition from a tablet treatment to a liquid form alleviated burden of treatment, unfortunately without normalising TSH. Our case emphasises the importance of the understanding of hypothalamic-pituitary-thyroid feedback control mechanisms together with good galenic choice, management of associated conditions and the elimination of other causes of variations of TSH levels during the management of hypothyroid patients after sleeve gastrectomy.


Assuntos
Gastrectomia/efeitos adversos , Derivação Gástrica/efeitos adversos , Hipotireoidismo/tratamento farmacológico , Tiroxina/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Terapia de Reposição Hormonal/métodos , Humanos , Hipotireoidismo/sangue , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Tireotropina/sangue , Tiroxina/sangue
20.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413060

RESUMO

Quite a few lesions of the oral cavity specifically of the gingiva have a greater inclination towards women and mostly occur during the first four decades of life, the cause of which may be credited to the changing levels of sex hormones. Out of all such lesions, one lesion whose aetiology is still unclear and which originats from the periosteum or periodontal ligament is central giant cell granuloma. Repeatedly, it is has been described as a reactive lesion, the cause of which may be secondary to local irritants or trauma, specifically plaque or calculus, which is not considered to be a true neoplasm. Here we present a case of a 51-year-old female patient with aggressive gingival growth within 10-13 months of hormonal replacement therapy. The aetiology, histological features and appropriate treatment are discussed in the light of current literature.


Assuntos
Doenças da Gengiva/diagnóstico , Granuloma de Células Gigantes/diagnóstico , Diagnóstico Diferencial , Feminino , Doenças da Gengiva/diagnóstico por imagem , Doenças da Gengiva/patologia , Doenças da Gengiva/cirurgia , Granuloma de Células Gigantes/diagnóstico por imagem , Granuloma de Células Gigantes/patologia , Granuloma de Células Gigantes/cirurgia , Terapia de Reposição Hormonal , Humanos , Menopausa , Pessoa de Meia-Idade
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