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Sample records for continuous-combined hormone therapy

  1. Trimegestone in a low-dose, continuous-combined hormone therapy regimen prevents bone loss in osteopenic postmenopausal women

    DEFF Research Database (Denmark)

    Warming, Lise; Ravn, Pernille; Spielman, Danièle

    2004-01-01

    OBJECTIVE: To determine the efficacy of estrogen + progestogen therapy with 1 mg 17beta-estradiol and 0.125 mg trimegestone in the prevention of postmenopausal osteoporosis. DESIGN: For this study, 360 healthy, postmenopausal women with osteopenia [lumbar spine bone mineral density (BMD) between -1.......0 and -2.5 SD of the premenopausal mean value] were enrolled in a 2-year prospective, randomized study, and 70% completed. Treatments were 1 mg 17beta-estradiol + 0.125 mg trimegestone (n = 179) or placebo (n = 181), given as daily oral therapy. All received a daily supplement of 500 mg calcium and 400 IU...... bone-specific alkaline phosphatase revealed a more retarded decrease of 40% and 33%, respectively. Of the women receiving hormone therapy, 75% had amenorrhea from the first cycle, and 5% withdrew prematurely due to metrorrhagia or mastalgia. CONCLUSION: This new estrogen + progestogen therapy...

  2. A comparison of two different dosages of conjugated equine estrogen in continuous combined hormone replacement therapy with progestin

    Institute of Scientific and Technical Information of China (English)

    邢淑敏; 吴宜勇; 刘建立; 徐茹兰; 张忠兰; 王莹

    2003-01-01

    Objective To investigate the effects of two different dosages of conjugated equine estrogen (CEE) on preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause. Results Overall, 213 cases (90%) completed the 1-year study and 176 cases (75%) completed the 2-year study.The percentage changes in L2-4 BMD at the 12th and 24th month in Group A were +2.3% and +3.7%, respectively, with the posttreatment values being significantly higher than pretreatment values (P0.05) in Group B. And that of Group C were -0.4% at 12th month and -1.6% at 24th month (P>0.05). L2-4 BMD in both Group A and B was significantly higher than that in Group C at 12th and 24th month (A vs C, P<0.001; B vs C, P<0.05). Kupperman Scores were significantly reduced after 1, 3, 6 ,12 and 24 months in all 3 groups when compared with baseline (P<0.001). Scores in Group A and Group B were significantly lower than that in Group C (P<0.001). However, the vaginal bleeding rates in Group A were significantly higher than that in Group B or in Group C. There was no atypical hyperplasia of endometrium in the 3 groups by the end of the study. One patient in Group A developed superficial thrombophlebitis by the end of 12th month.Conclusion Continuous combination of CEE and MPA is effective in preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause. The vaginal bleeding rates in the Group treated with 0.625 mg/d CEE were significantly higher than those treated with 0.3 mg/d CEE.

  3. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  4. Hormone Therapy

    Science.gov (United States)

    ... types of estrogen therapy relieve vaginal dryness. • Systemic estrogen protects against the bone loss that occurs early in menopause and helps prevent hip and spine fractures. • Combined estrogen and progestin therapy may reduce the risk of ...

  5. Hormone therapy for transgender patients

    Science.gov (United States)

    2016-01-01

    Many transgender men and women seek hormone therapy as part of the transition process. Exogenous testosterone is used in transgender men to induce virilization and suppress feminizing characteristics. In transgender women, exogenous estrogen is used to help feminize patients, and anti-androgens are used as adjuncts to help suppress masculinizing features. Guidelines exist to help providers choose appropriate candidates for hormone therapy, and act as a framework for choosing treatment regimens and managing surveillance in these patients. Cross-sex hormone therapy has been shown to have positive physical and psychological effects on the transitioning individual and is considered a mainstay treatment for many patients. Bone and cardiovascular health are important considerations in transgender patients on long-term hormones, and care should be taken to monitor certain metabolic indices while patients are on cross-sex hormone therapy. PMID:28078219

  6. Types of Cancer Treatment: Hormone Therapy

    Science.gov (United States)

    Describes how hormone therapy slows or stops the growth of breast and prostate cancers that use hormones to grow. Includes information about the types of hormone therapy and side effects that may happen.

  7. Hormone therapy and ovarian borderline tumors

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms

    2012-01-01

    Little is known about the influence of postmenopausal hormone therapy on the risk of ovarian borderline tumors. We aimed at assessing the influence of different hormone therapies on this risk.......Little is known about the influence of postmenopausal hormone therapy on the risk of ovarian borderline tumors. We aimed at assessing the influence of different hormone therapies on this risk....

  8. Deciding about hormone therapy

    Science.gov (United States)

    ... your risk for endometrial cancer. Taking progestin with estrogen seems to protect against this cancer. So if you have a ... menopause without taking hormones. They can also help protect your bones, improve your heart health , and help you stay ...

  9. Controversies in hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    A. Baziad

    2001-09-01

    Full Text Available Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine. (Med J Indones 2001; 10: 182-6Keywords: controversies, HRT

  10. Hormone therapy and ovarian cancer

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms

    2009-01-01

    CONTEXT: Studies have suggested an increased risk of ovarian cancer among women taking postmenopausal hormone therapy. Data are sparse on the differential effects of formulations, regimens, and routes of administration. OBJECTIVE: To assess risk of ovarian cancer in perimenopausal...... of Medicinal Product Statistics provided individually updated exposure information. The National Cancer Register and Pathology Register provided ovarian cancer incidence data. Information on confounding factors and effect modifiers was from other national registers. Poisson regression analyses with 5-year age...... bands included hormone exposures as time-dependent covariates. PARTICIPANTS: A total of 909,946 women without hormone-sensitive cancer or bilateral oophorectomy. MAIN OUTCOME MEASURE: Ovarian cancer. RESULTS: In an average of 8.0 years of follow-up (7.3 million women-years), 3068 incident ovarian...

  11. Progestogens in menopausal hormone therapy

    Directory of Open Access Journals (Sweden)

    Małgorzata Bińkowska

    2015-06-01

    Full Text Available Progestogens share one common effect: the ability to convert proliferative endometrium to its secretory form. In contrast, their biological activity is varied, depending on the chemical structure, pharmacokinetics, receptor affinity and different potency of action. Progestogens are widely used in the treatment of menstrual cycle disturbances, various gynaecological conditions, contraception and menopausal hormone therapy. The administration of progestogen in menopausal hormone therapy is essential in women with an intact uterus to protect against endometrial hyperplasia and cancer. Progestogen selection should be based on the characteristics available for each progestogen type, relying on the assessment of relative potency of action in experimental models and animal models, and on the indirect knowledge brought by studies of the clinical use of different progestogen formulations. The choice of progestogen should involve the conscious use of knowledge of its benefits, with a focus on minimizing potential side effects. Unfortunately, there are no direct clinical studies comparing the metabolic effects of different progestogens.

  12. Postmenopausal hormone therapy and cognition.

    Science.gov (United States)

    McCarrey, Anna C; Resnick, Susan M

    2015-08-01

    This article is part of a Special Issue "Estradiol and cognition". Prior to the publication of findings from the Women's Health Initiative (WHI) in 2002, estrogen-containing hormone therapy (HT) was used to prevent age-related disease, especially cardiovascular disease, and to treat menopausal symptoms such as hot flushes and sleep disruptions. Some observational studies of HT in midlife and aging women suggested that HT might also benefit cognitive function, but randomized clinical trials have produced mixed findings in terms of health and cognitive outcomes. This review focuses on hormone effects on cognition and risk for dementia in naturally menopausal women as well as surgically induced menopause, and highlights findings from the large-scale WHI Memory Study (WHIMS) which, contrary to expectation, showed increased dementia risk and poorer cognitive outcomes in older postmenopausal women randomized to HT versus placebo. We consider the 'critical window hypothesis', which suggests that a window of opportunity may exist shortly after menopause during which estrogen treatments are most effective. In addition, we highlight emerging evidence that potential adverse effects of HT on cognition are most pronounced in women who have other health risks, such as lower global cognition or diabetes. Lastly, we point towards implications for future research and clinical treatments. Published by Elsevier Inc.

  13. Postmenopausal hormone therapy and cognition

    Science.gov (United States)

    McCarrey, Anna C.; Resnick, Susan M.

    2015-01-01

    Prior to the publication of findings from the Women’s Health Initiative (WHI) in 2002, estrogen-containing hormone therapy (HT) was used to prevent age-related disease, especially cardiovascular disease, and to treat menopausal symptoms such as hot flushes and sleep disruptions. Some observational studies of HT in midlife and aging women suggested that HT might also benefit cognitive function, but randomized clinical trials have produced mixed findings in terms of health and cognitive outcomes. This review focuses on hormone effects on cognition and risk for dementia in naturally menopausal women as well as surgically induced menopause, and highlights findings from the large-scale WHI Memory Study (WHIMS) which, contrary to expectation, showed increased dementia risk and poorer cognitive outcomes in older postmenopausal women randomized to HT versus placebo. We consider the ‘critical window hypothesis’, which suggests that a window of opportunity may exist shortly after menopause during which estrogen treatments are most effective. In addition, we highlight emerging evidence that potential adverse effects of HT on cognition are most pronounced in women who have other health risks, such as cerebrovascular disease or diabetes. Lastly, we point towards implications for future research and clinical treatments. PMID:25935728

  14. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

    Ravn, S H; Rosenberg, J; Bostofte, E

    1994-01-01

    in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin....... Physical activity should be promoted, and cigarette smoking reduced if possible. Women at risk of cardiovascular disease will also benefit from hormone replacement therapy. There is overwhelming evidence that hormone therapy will protect against both coronary heart disease and stroke...... suggest that every woman showing any signs of hormone deprivation should be treated with hormone replacement therapy. This includes women with subjective or objective vaso-motor symptoms, genito-urinary symptoms, women at risk of osteoporosis (fast bone losers), and women at risk of cardiovascular...

  15. Postmenopausal hormone therapy in clinical perspective.

    Science.gov (United States)

    Hodis, Howard N; Mack, Wendy J

    2007-01-01

    Although many of the risks and benefits of postmenopausal hormone therapy are known, only recently has the magnitude of these effects and their perspective to other therapies become more fully understood. Careful review of randomized controlled trials indicates that the risks of postmenopausal hormone therapy including breast cancer, stroke and venous thromboembolism are similar to other commonly used agents. Overall, these risks are rare (less than 1 event per 1,000 women) and even rarer when initiated in women less than 60 years of age or within 10 years of menopause. In addition, the literature indicates similar benefit of postmenopausal hormone therapy, in women who initiate hormone therapy in close proximity to menopause, to other medications used for the primary prevention of coronory heart disease in women.

  16. Hormone therapy and different ovarian cancers

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms;

    2012-01-01

    , including information about tumor histology. The authors performed Poisson regression analyses that included hormone exposures and confounders as time-dependent covariates. In an average of 8.0 years of follow up, 2,681 cases of epithelial ovarian cancer were detected. Compared with never users, women......Postmenopausal hormone therapy use increases the risk of ovarian cancer. In the present study, the authors examined the risks of different histologic types of ovarian cancer associated with hormone therapy. Using Danish national registers, the authors identified 909,946 women who were followed from...... 1995-2005. The women were 50-79 years of age and had no prior hormone-sensitive cancers or bilateral oophorectomy. Hormone therapy prescription data were obtained from the National Register of Medicinal Product Statistics. The National Cancer and Pathology Register provided data on ovarian cancers...

  17. Hormone therapy and different ovarian cancers

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms;

    2012-01-01

    Postmenopausal hormone therapy use increases the risk of ovarian cancer. In the present study, the authors examined the risks of different histologic types of ovarian cancer associated with hormone therapy. Using Danish national registers, the authors identified 909,946 women who were followed from...... 1995-2005. The women were 50-79 years of age and had no prior hormone-sensitive cancers or bilateral oophorectomy. Hormone therapy prescription data were obtained from the National Register of Medicinal Product Statistics. The National Cancer and Pathology Register provided data on ovarian cancers......, including information about tumor histology. The authors performed Poisson regression analyses that included hormone exposures and confounders as time-dependent covariates. In an average of 8.0 years of follow up, 2,681 cases of epithelial ovarian cancer were detected. Compared with never users, women...

  18. Therapy for obesity based on gastrointestinal hormones

    DEFF Research Database (Denmark)

    Bagger, Jonatan I; Christensen, Mikkel; Knop, Filip K;

    2011-01-01

    It has long been known that peptide hormones from the gastrointestinal tract have significant impact on the regulation of nutrient metabolism. Among these hormones, incretins have been found to increase insulin secretion, and thus incretin-based therapies have emerged as new modalities...

  19. Menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2001-12-01

    Full Text Available The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many  menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an  important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT. Natural HRT is usually prefened. Synthetic  estrogen in oral contraceptives (oc are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death. (Med J Indones 2001;10: 242-51Keywords: estrogen deficiency, climacteric phases, tibolone.

  20. Effect of growth hormone replacement therapy on pituitary hormone secretion and hormone replacement therapies in GHD adults

    DEFF Research Database (Denmark)

    Hubina, Erika; Mersebach, Henriette; Rasmussen, Ase Krogh;

    2004-01-01

    We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes.......We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes....

  1. Menopausal Hormone Therapy and Cancer

    Science.gov (United States)

    ... Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer ... Myths and Misconceptions Diet Hormones Immunosuppression Infectious Agents Obesity Radiation Sunlight Tobacco Genetics NCI Cancer Genetics Services ...

  2. Breast density changes associated with postmenopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Nielsen, Mads; Pettersen, Paola; Alexandersen, P

    2010-01-01

    Objective: The aim of this study was to assess the impact of oral hormone therapy (HT) on breast density in postmenopausal women and to compare the use of computer-based automated approaches for the assessment of breast density with reference to traditional methods. Methods: Low-dose oral estrogen...... (1 mg) continuously combined with drospirenone (2 mg) was administered to postmenopausal women for up to 2 years (26 treatment cycles, 28 d/cycle) in a randomized, placebo-controlled trial. This post hoc analysis assessed the changes in breast density measured from digitized images by two radiologist.......01) but not in the placebo group. Conclusions: HT for 2 years in postmenopausal women significantly increased radiologist-assessed breast density compared with placebo, in addition to significant changes in estrogen levels, markers of bone metabolism, and bone mineral density. Computer-automated techniques may be comparable...

  3. [Hormone replacement therapy: curse or blessing?].

    Science.gov (United States)

    Schmidt, M; Fink, D; Lang, U; Kimmig, R

    2006-01-01

    There is a controversial discussion on the risks and benefits of hormonal replacement therapy (HRT), and many women and doctors have revised their opinions of HRT over the last few years. Complementary and alternative therapies can be considered an option to treat menopausal symptoms. The following issue summarizes the actual knowledge of treatment options of menopausal symptoms.

  4. Growth hormone therapy in progeria.

    Science.gov (United States)

    Sadeghi-Nejad, Ab; Demmer, Laurie

    2007-05-01

    Catabolic processes seen in Hutchinson-Gilford progeria resemble those of normal aging and, in the affected children, usually result in death at an early age. In addition to its growth promoting effects, growth hormone (GH) has potent anabolic properties. Administration of GH ameliorates some of the catabolic effects of normal aging. We report the results of GH treatment in a young child with progeria.

  5. [Hormone replacement therapy--growth hormone, melatonin, DHEA and sex hormones].

    Science.gov (United States)

    Fukai, Shiho; Akishita, Masahiro

    2009-07-01

    The ability to maintain active and independent living as long as possible is crucial for the healthy longevity. Hormones responsible for some of the manifestations associated with aging are growth hormone, insulin-like growth factor-1 (IGF-1), melatonin, dehydroepiandrosterone (DHEA), sex hormones and thyroid hormones. These hormonal changes are associated with changes in body composition, visceral obesity, muscle weakness, osteoporosis, urinary incontinence, loss of cognitive functioning, reduction in well being, depression, as well as sexual dysfunction. With the prolongation of life expectancy, both men and women today live the latter third life with endocrine deficiencies. Hormone replacement therapy may alleviate the debilitating conditions of secondary partial endocrine deficiencies by preventing or delaying some aspects of aging.

  6. Growth hormone replacement therapy in Costello syndrome.

    Science.gov (United States)

    Triantafyllou, Panagiota; Christoforidis, Athanasios; Vargiami, Euthymia; Zafeiriou, Dimitrios I

    2014-12-01

    Costello syndrome (CS) is considered an overgrowth disorder given the macrosomia that is present at birth .However, shortly after birth the weight drops dramatically and the patients are usually referred for failure to thrive. Subsequently, affected patients develop the distinctive coarse facial appearance and are at risk for cardiac anomalies and solid tumor malignancies. Various endocrine disorders, although not very often, have been reported in patients with CS, including growth hormone deficiency, hypoglycemia, ACTH deficiency, cryptorchidism and hypothyroidism. We report a case of Costello syndrome with hypothyroidism, cryptorchidism and growth hormone deficiency and we evaluate the long-term safety and efficacy of growth hormone replacement therapy. The index patient is a paradigm of successful and safe treatment with growth hormone for almost 7 years. Since patients with CS are at increased risk for cardiac myopathy and tumor development they deserve close monitoring during treatment.

  7. Hormone replacement therapy and risk of glioma

    DEFF Research Database (Denmark)

    Andersen, Lene; Friis, Søren; Hallas, Jesper;

    2013-01-01

    Aim: Several studies indicate that use of hormone replacement therapy (HRT) is associated with an increased risk of intracranial meningioma, while associations between HRT use and risk of other brain tumors have been less explored. We investigated the influence of HRT use on the risk of glioma...

  8. Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?

    Science.gov (United States)

    Hormone replacement therapy: Can it cause vaginal bleeding? I'm taking hormone therapy for menopause symptoms, and my monthly menstrual periods have returned. Is this normal? Answers from Shannon K. Laughlin- ...

  9. Hypoparathyroidism: Replacement Therapy with Parathyroid Hormone

    Directory of Open Access Journals (Sweden)

    Lars Rejnmark

    2015-12-01

    Full Text Available Hypoparathyroidism (HypoPT is characterized by low serum calcium levels caused by an insufficient secretion of parathyroid hormone (PTH. Despite normalization of serum calcium levels by treatment with activated vitamin D analogues and calcium supplementation, patients are suffering from impaired quality of life (QoL and are at increased risk of a number of comorbidities. Thus, despite normalization of calcium levels in response to conventional therapy, this should only be considered as an apparent normalization, as patients are suffering from a number of complications and calcium-phosphate homeostasis is not normalized in a physiological manner. In a number of recent studies, replacement therapy with recombinant human PTH (rhPTH(1-84 as well as therapy with the N-terminal PTH fragment (rhPTH(1-34 have been investigated. Both drugs have been shown to normalize serum calcium while reducing needs for activated vitamin D and calcium supplements. However, once a day injections cause large fluctuations in serum calcium. Twice a day injections diminish fluctuations, but don't restore the normal physiology of calcium homeostasis. Recent studies using pump-delivery have shown promising results on maintaining normocalcemia with minimal fluctuations in calcium levels. Further studies are needed to determine whether this may improve QoL and lower risk of complications. Such data are needed before replacement with the missing hormone can be recommended as standard therapy.

  10. Growth hormone therapy for people with thalassaemia.

    Science.gov (United States)

    Ngim, Chin Fang; Lai, Nai Ming; Hong, Janet Yh; Tan, Shir Ley; Ramadas, Amutha; Muthukumarasamy, Premala; Thong, Meow-Keong

    2017-09-18

    Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs such as the pituitary glands which can affect growth hormone production. Growth hormone deficiency is one of the factors that can lead to short stature, a common complication in people with thalassaemia. Growth hormone replacement therapy has been used in children with thalassaemia who have short stature and growth hormone deficiency. To assess the benefits and safety of growth hormone therapy in people with thalassaemia. We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles, reviews and clinical trial registries. Our database and trial registry searches are current to 10 August 2017 and 08 August 2017, respectively. Randomised and quasi-randomised controlled trials comparing the use of growth hormone therapy to placebo or standard care in people with thalassaemia of any type or severity. Two authors independently selected trials for inclusion. Data extraction and assessment of risk of bias were also conducted independently by two authors. The quality of the evidence was assessed using GRADE criteria. One parallel trial conducted in Turkey was included. The trial recruited 20 children with homozygous beta thalassaemia who had short stature; 10 children received growth hormone therapy administered subcutaneously on a daily basis at a dose of 0.7 IU/kg per week and 10 children received standard care. The overall risk of bias in this trial was low except for the selection criteria and attrition bias which were unclear. The quality of the evidence for all major outcomes

  11. Breast cancer and post-menopausal hormone therapy.

    Science.gov (United States)

    Kenemans, P; Bosman, A

    2003-03-01

    From the introduction of post-menopausal hormone replacement therapy (HRT) there has been great concern that HRT could possibly increase the risk of breast cancer. Prolonged exposure to endogenous oestrogens undeniably increases the risk of breast cancer. Questions that are important and until now only partly answered, are the following. Are oestrogens tumour promoters, as they induce mitosis, lead to proliferation and, therefore, accelerated growth of clinically occult pre-existing tumours? In addition to this, are they genotoxic mutagenic carcinogens, or could they initiate tumours by way of accumulation of incessant DNA-replication damage mechanism? Opinions vary as to the effect of the addition of a progestogen. There is a multitude of different progestogens which could bind with differing affinity to progesterone receptor PR-A or PR-B, and which have different physiological functions via differential gene regulation. The action of a progestogen on the oestrogen-induced cellular mitotic activity could be synergistic or antagonistic (by different pathways: oestrogen receptor downregulation, activating of metabolic pathways within the breast or stimulation of apoptosis)? Over 60 observational studies and two randomized trials provide evidence that the small but significant increase in risk appears with long-term current post-menopausal hormone use. The addition of a progestogen does not decrease the risk as seen with oestrogens alone and might increase the risk further. It is not clear whether there is a difference in risk with sequentially combined versus continuously combined HRT. Many questions nevertheless still remain. Is the risk increase limited to lean women only? What about risk-modifying factors such as alcohol use and a positive family history for breast cancer? Are tumours detected under HRT less aggressive, is there a better prognosis and is the mortality not increased while morbidity is? And is HRT contraindicated for women with a positive family

  12. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    OpenAIRE

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women a...

  13. [Localized lipohypertrophy during growth hormone therapy].

    Science.gov (United States)

    Mersebach, Henriette; Feldt-Rasmussen, Ulla F

    2002-04-01

    Accumulation of subcutaneous fat is described in a 51-year-old woman with panhypopituitarism treated on all insufficient pituitary axes, including growth hormone (GH). Malnutrition and alcoholic liver disease caused reduced synthesis of hepatic insulin-like growth factor I (IGF-I), and the function of IGF-I as biochemical marker of the GH effect was compromised. Peripheral levels of GH and IGF-I in tissues may have reached supra physiological levels and induced localised lipohypertrophy. Adjustment of GH treatment should not rest in all cases on IGF-I alone, but also depend on the clinical effect. Adjustment should follow suspected adverse events, such as lipohypertrophy, which is, however, an unusual complication of GH therapy.

  14. Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

    DEFF Research Database (Denmark)

    Vestergaard, P; Hermann, A P; Gram, J

    1997-01-01

    To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

  15. Risk of Stroke With Various Types of Menopausal Hormone Therapies

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen; Nielsen, Lars Hougaard; Keiding, Niels

    2017-01-01

    BACKGROUND AND PURPOSE: Double-blind randomized studies on the effects of oral postmenopausal hormone therapies were stopped mainly because of increased risk of stroke. We aimed to assess the risk of all strokes and various subtypes associated with hormone therapy and explore the influence of reg...

  16. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  17. Growth Hormone Therapy in Adults with Prader-Willi Syndrome

    Directory of Open Access Journals (Sweden)

    Karen S. Vogt

    2015-04-01

    Full Text Available Prader-Willi syndrome (PWS is characterized by hyperphagia, obesity if food intake is not strictly controlled, abnormal body composition with decreased lean body mass and increased fat mass, decreased basal metabolic rate, short stature, low muscle tone, cognitive disability, and hypogonadism. In addition to improvements in linear growth, the benefits of growth hormone therapy on body composition and motor function in children with PWS are well established. Evidence is now emerging on the benefits of growth hormone therapy in adults with PWS. This review summarizes the current literature on growth hormone status and the use of growth hormone therapy in adults with PWS. The benefits of growth hormone therapy on body composition, muscle strength, exercise capacity, certain measures of sleep-disordered breathing, metabolic parameters, quality of life, and cognition are covered in detail along with potential adverse effects and guidelines for initiating and monitoring therapy.

  18. Hormones for therapy of climacteric afflictions

    Directory of Open Access Journals (Sweden)

    Greiner, Wolfgang

    2007-03-01

    Full Text Available Background: In Western countries hormone replacement therapy (HT is widely used in the treatment of climacteric women who are affected with hot flashes and night sweats. Besides, long-term HT was frequently used to manage the higher risks for osteoporosis and heart attack in postmenopause. Estrogens alone or combined with progestin feature most frequently in HT. Objectives: This HTA report addresses the questions on medical efficacy and cost-effectiveness of HT as a treatment of hot flashes and night sweats as well as in the primary prevention of osteoporosis and cardiovascular disease in postmenopause in general healthy women. Methods: The literature search for articles published after 1998 was conducted in March 2004 in standard medical and economic databases. The analysis included randomised controlled trials, systematic reviews, meta-analysis and economic evaluations considering relevant clinical endpoints in English or German language. The quality of the studies was assessed using checklists corresponding to the study type. Results: HT is highly effective in treating hot flashes in climacteric women. The question of economical efficiency cannot be answered due to the scarce database. As the positive effects (lower risk for fractures and endometrial cancer do not outweigh the negative effects (higher risk for breast cancer and general cardiovascular risk estrogen-progestin combination HT cannot be recommended for primary prevention of osteoporosis and cardiovascular disease in postmenopausal women. Discussion: The observation period of most of the studies regarding therapy of hot flashes and night sweats were too short to evaluate possible risks of long-term HT. The economic publications assessing HT for this indication varied vastly in terms of applied methods and were not carried out with respect to the German health care system. Conclusions: HT can be recommended in the short-term treatment of hot flashes and night sweats in climacteric

  19. Hormone replacement therapy in Denmark, 1995-2004

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen; Lidegaard, Ojvind; Møller, Lisbeth Nørgaard;

    2007-01-01

    Recently, the Danish National Register of Medicinal Product Statistics (NRM) was opened for research purposes, and therefore, on an individual basis, can merge with other national registers. The aim of this study was to analyse the use of hormones based on the individual data of the entire Danish...... female population, with the focus on a detailed evaluation of specific hormone regimens and factors associated with systemic hormone replacement therapy (HRT)....

  20. Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

    Science.gov (United States)

    According to a January 28, 2011 article in the Journal of the National Cancer Institute, women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later.

  1. Endocrine therapy use among elderly hormone receptor-pos...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Clinical guidelines recommend that women with hormone-receptor positive breast cancer receive endocrine therapy (selective estrogen receptor modulators or aromatase...

  2. Hormone Therapy Not Advised for Preventing Disease After Menopause

    Science.gov (United States)

    ... Hormone Therapy Not Advised for Preventing Disease After Menopause Benefits of treatment don't outweigh the risks, ... attack, stroke and blood clots. Women typically enter menopause around the age of 50. Following menopause, women's ...

  3. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    OpenAIRE

    2012-01-01

    Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year...

  4. Effects of hormone therapy on brain structure

    Science.gov (United States)

    Tosakulwong, Nirubol; Lesnick, Timothy G.; Zuk, Samantha M.; Gunter, Jeffrey L.; Gleason, Carey E.; Wharton, Whitney; Dowling, N. Maritza; Vemuri, Prashanthi; Senjem, Matthew L.; Shuster, Lynne T.; Bailey, Kent R.; Rocca, Walter A.; Jack, Clifford R.; Asthana, Sanjay; Miller, Virginia M.

    2016-01-01

    Objective: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Methods: Participants (aged 42–56 years, within 5–36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 μg/d transdermal 17β-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n = 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Results: Higher rates of ventricular expansion were observed in both the CEE and the 17β-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p = 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r = −0.58; p ≤ 0.001) and with rates of increase in white matter hyperintensity volume (r = 0.27; p = 0.01) after adjusting for age. The changes were not different between the CEE and 17β-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Conclusions: Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. Classification of evidence: This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. PMID:27473135

  5. Hormone Replacement Therapy After Breast Cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2008-01-01

    Full Text Available So far, patient samples in all studies investigating hormone replacement therapy (HRT after breast cancer have been small.Therefore, HRT should only be used if alternatives such as specifically not contraindicated phytopreparations or selective sero-tonin reuptake inhibitors (SSRIs are not effective. This is primarily due to forensic reasons since clinical data on the risk ofalternatives (based on present evidence are even more sparse. Regarding HRT, four prospective randomized studies and at least15 observational studies after breast cancer are available. Only the HABITS study shows an increased risk of relapse. The authorssuggest that this is probably associated with the relatively high number of patients with HRT treatment after ER-positive cancersas well as due to the preferred use of estrogen/progestin-combined preparations. Based on the results of the randomized pla-cebo-controlled study Women’s Health Initiative (WHI as well as of at least 12 observational studies, the progestin componentseems to be mainly responsible for the probability of increased diagnosis frequency of primary breast cancer. However, no dataare available on the impact of progestin on the use of combined HRT after breast cancer. However, also with estrogen only anincreased risk of relapse must be expected and patients should be informed about it. This has to be concluded due to biologicalplausibility and observational studies although the estrogen-only arm in WHI did not show any increased primary risk. Thus, anyform of HRT should only be performed in exceptional cases, and treatment duration should be as short as possible with thelowest effective dose.

  6. Increased survival in men with metastatic prostate cancer receiving chemo and hormone therapy

    Science.gov (United States)

    Men with hormone-sensitive metastatic prostate cancer who received the chemotherapy drug docetaxel given at the start of standard hormone therapy lived longer than patients who received hormone therapy alone, according to early results from a NIH-supporte

  7. Functional and molecular neuroimaging of menopause and hormone replacement therapy

    DEFF Research Database (Denmark)

    Comasco, Erika; Frøkjær, Vibe; Sundström-Poromaa, Inger

    2014-01-01

    The level of gonadal hormones to which the female brain is exposed considerably changes across the menopausal transition, which in turn, is likely to be of great relevance for neurodegenerative diseases and psychiatric disorders. However, the neurobiological consequences of these hormone fluctuat......The level of gonadal hormones to which the female brain is exposed considerably changes across the menopausal transition, which in turn, is likely to be of great relevance for neurodegenerative diseases and psychiatric disorders. However, the neurobiological consequences of these hormone...... fluctuations and of hormone replacement therapy in the menopause have only begun to be understood. The present review summarizes the findings of thirty-five studies of human brain function, including functional magnetic resonance imaging, positron and single-photon computed emission tomography studies, in peri......-controlled multi-modal prospective neuroimaging studies as well as investigation on the related molecular mechanisms of effects of menopausal hormonal variations on the brain....

  8. Optimization of growth hormone therapy in growth hormone deficient children

    NARCIS (Netherlands)

    S.M.P.F. de Muinck Keizer-Schrama (Sabine)

    1991-01-01

    textabstractIt is obvious that the results published so far as well as the present preliminary data do not answer many questions regarding the optimal therapeutic regimen in GH deficiency. In particular, long-term follow-up must be organized to evaluate efficacy and safety of GH therapy not only in

  9. Hormone Therapy for Breast Cancer in Men

    Science.gov (United States)

    ... of testosterone and other androgens (male hormones). Most male breast cancers have androgen receptors that may cause the cells ... into estrogens in the body. Orchiectomy shrinks most male breast cancers, and may help make other treatments like tamoxifen ...

  10. Hormone therapy in hypospadias surgery: a systematic review.

    Science.gov (United States)

    Netto, Jose Murillo B; Ferrarez, Carlos Eduardo P F; Schindler Leal, Anucha Andrade; Tucci, Silvio; Gomes, Carlos Augusto; Barroso, Ubirajara

    2013-12-01

    Surgical correction of hypospadias is proposed to improve the aesthetic and functional quality of the penis. Hormone therapy preceding surgical correction is indicated to obtain better surgical conditions. However, there is divergence in the literature regarding the hormone therapy of choice, time of its use before surgery, appropriate dose, and route of application. To try to elucidate this matter, an electronic survey of the databases PubMed and Cochrane Central Library was conducted, limited to articles in English published since 1980. Search strategy identified 14 clinical trials that matched the inclusion criteria. Analysis was made in terms of study design, classification of hypospadias, association with chordee and cryptorchidism, type of hormone, route of application, dose and duration of treatment, penile length before and after hormone therapy, glans circumference before and after hormone therapy, adverse effects, and surgical complications. From the trials evaluated it was not possible to determine the ideal neoadjuvant treatment. A preference for use of testosterone was observed. Intramuscular administration seems to have fewer adverse effects than topical treatment. Side effects were seldom described, and treated patients were not followed on a long-term basis. The scarcity of randomized and controlled clinical trials regarding the topic impairs the establishment of a protocol. In conclusion, although preoperative hormone therapy is currently used before hypospadias surgery, its real benefit in terms of improvement of the penis and surgical results has not been defined.

  11. Hormone replacement therapy and risk of non-fatal stroke

    DEFF Research Database (Denmark)

    Pedersen, A T; Lidegaard, O; Kreiner, S;

    1997-01-01

    BACKGROUND: The effect of postmenopausal hormone replacement therapy (HRT) on the risk of subtypes of stroke is as yet unclear. To investigate the effect of oestrogen and combined oestrogen-progestagen therapy on the risk of non-fatal haemorrhagic and thromboembolic stroke, we carried out a case-...

  12. Therapy of hypoparathyroidism by replacement with parathyroid hormone

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Underbjerg, Line; Sikjaer, Tanja

    2014-01-01

    Hypoparathyroidism (HypoPT) is a state of hypocalcemia due to inappropriate low levels of parathyroid hormone (PTH). HypoPT is normally treated by calcium supplements and activated vitamin D analogues. Although plasma calcium is normalized in response to conventional therapy, quality of life (Qo......L) seems impaired and patients are at increased risk of renal complications. A number of studies have suggested subcutaneous injections with PTH as an alternative therapy. By replacement with the missing hormone, urinary calcium may be lowered and QoL may improve. PTH replacement therapy (PTH-RT) possesses...

  13. Menopausal depression:comparison of hormone replacement therapy and hormone replacement therapy plus fiuoxetine

    Institute of Scientific and Technical Information of China (English)

    刘平; 何方方; 白文佩; 郁琦; 史蔚; 吴宜勇; 贺丹军; 肖计划; 郑晔; 廖秦平

    2004-01-01

    Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with ]4 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combination with HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy. Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events. Conclusion HRT plus fluoxetine therapy was effective in the treatment of menopausal depression with a satisfactory safety profile.

  14. Hormone therapy for patients with advanced or recurrent endometrial cancer.

    Science.gov (United States)

    Lee, Wen-Ling; Yen, Ming-Shyen; Chao, Kuan-Chong; Yuan, Chiou-Chung; Ng, Heung-Tat; Chao, Hsiang-Tai; Lee, Fa-Kung; Wang, Peng-Hui

    2014-05-01

    The "gold standard" treatment for endometrial cancer is completely staged surgery, followed by radiation or chemotherapy, based on the final pathological surgical stage and requirements. In the primary treatment of endometrial cancers, hormones are rarely taken into consideration after primary surgery. Primary treatment with hormones to preserve fertility in younger women with endometrial cancer is an attractive option, and many successful cases have been reported, although the majority of them finally received definite therapy, including total hysterectomy. The role of hormone therapy is often delayed in recurrent disease; response rates to progestins and tamoxifen or aromatase inhibitors in advanced/recurrent endometrial cancers are approximately 15-20% and nearly ≤ 10%, respectively. This review is focused on updated information and recent knowledge on the use of hormones in the management of women with advanced or recurrent endometrial cancers.

  15. The influence of hormone therapies on colon and rectal cancer

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Lidegaard, Øjvind; Keiding, Niels;

    2016-01-01

    followed 1995-2009. Information on HT exposures was from the National Prescription Register and updated daily, while information on colon (n = 8377) and rectal cancers (n = 4742) were from the National Cancer Registry. Potential confounders were obtained from other national registers. Poisson regression...... analyses with 5-year age bands included hormone exposures as time-dependent covariates. Use of estrogen-only therapy and combined therapy were associated with decreased risks of colon cancer (adjusted incidence rate ratio 0.77, 95 % confidence interval 0.68-0.86 and 0.88, 0.80-0.96) and rectal cancer (0......Exogenous sex hormones seem to play a role in colorectal carcinogenesis. Little is known about the influence of different types or durations of postmenopausal hormone therapy (HT) on colorectal cancer risk. A nationwide cohort of women 50-79 years old without previous cancer (n = 1,006,219) were...

  16. Cognitive effects of hormonal therapy in older adults.

    Science.gov (United States)

    Mitsiades, Nicholas; Correa, Denise; Gross, Cary P; Hurria, Arti; Slovin, Susan F

    2008-12-01

    There is ample preclinical evidence that gonadal steroids (estrogens and androgens) play an important role in central nervous system development and function. The abrupt decline of estrogen levels in women after menopause, and the slower, subtler decline in total and bioavailable testosterone serum levels that occurs in aging men ("andropause," "male menopause," partial androgen deficiency in ageing males [PADAM]), have been implicated in the pathogenesis of cognitive dysfunction prevalent in elderly adults. However, the current clinical evidence supporting hormonal replacement as a neuroprotective therapy is at best inconclusive. Anti-estrogen and anti-androgen hormonal therapies are used in the treatment of breast and prostate carcinomas, respectively. Although generally considered less toxic than conventional cytotoxic chemotherapy, these hormonal manipulations have side effects that are not trivial. This review will summarize the available evidence regarding the impact of these hormonal therapies on cognitive function in older adults. Additional clinical research in this field is needed to confirm the existence and severity of such a possible cognitive impact, which may then need to be considered prior to initiating hormonal therapies in the elderly, as many patients may be in the prodromal phase or early stages of a neurodegenerative disorder, such as Alzheimer's disease, and this information may influence treatment decision-making and subsequent management.

  17. The adverse effects of hormonal therapy.

    Science.gov (United States)

    Bush, T L

    1986-02-01

    Estrogen therapy must be cycled with progestin therapy in women with intact uteri in order to prevent uterine cancer. However, these women cannot be expected to benefit (with regard to cardiovascular disease) from any estrogen-induced changes in the lipoprotein profile, as progestins will either negate or overwhelm any estrogen effects. However, such women will definitely benefit from estrogen's effects with regard to menopausal symptoms and bone loss. These clearly beneficial effects of estrogen-progestin therapy are not outweighed by any known risks. However, in women without uteri (approximately 30 per cent of women), unopposed estrogen therapy in the menopause may protect against cardiovascular disease, as well as have beneficial effects on bone metabolism and menopausal symptoms. In this special case, the beneficial effects of unopposed estrogen therapy clearly outweigh any known risk.

  18. Functional and molecular neuroimaging of menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Erika eComasco

    2014-12-01

    Full Text Available The level of gonadal hormones to which the female brain is exposed considerably changes across the menopausal transition, which in turn, is likely to be of great relevance for neurodegenerative diseases and psychiatric disorders. However, the neurobiological consequences of these hormone fluctuations and of hormone replacement therapy in the menopause have only begun to be understood. This review summarizes the findings of thirty-four studies of human brain function, including functional magnetic resonance imaging, positron and single-photon computed emission tomography studies, in peri- and postmenopausal women treated with estrogen, or estrogen-progestagen replacement therapy. Seven studies using gonadotropin-releasing hormone agonist intervention as a model of hormonal withdrawal are also included. Cognitive paradigms are employed by the majority of studies evaluating the effect of unopposed estrogen or estrogen-progestagen treatment on peri- and postmenopausal women’s brain. In randomized-controlled trials, estrogen treatment enhances activation of fronto-cingulate regions during cognitive functioning, though in many cases no difference in cognitive performance was present. Progestagens seems to counteract the effects of estrogens. Findings on cognitive functioning during acute ovarian hormone withdrawal suggest a decrease in activation of the inferior frontal gyrus, thus essentially corroborating the findings in postmenopausal women. Studies of the cholinergic and serotonergic systems indicate these systems as biological mediators of hormonal influences on the brain. More, hormonal replacement appears to increase cerebral blood flow in cortical regions. On the other hand, studies on emotion processing in postmenopausal women are lacking. These results call for well-powered randomized-controlled multi-modal prospective neuroimaging studies as well as investigation on the related molecular mechanisms of effects of menopausal hormonal

  19. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    Science.gov (United States)

    de Medeiros, Sebastião Freitas; Yamamoto, Márcia Marly Winck; Barbosa, Jacklyne Silva

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman’s characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation. Conclusion To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies. PMID:24665210

  20. Continuation of growth hormone therapy versus placebo in transition-phase patients with growth hormone deficiency

    DEFF Research Database (Denmark)

    Jørgensen, Jens; Nørrelund, Helene; Vahl, Nina

    2002-01-01

    In a placebo-controlled, parallel study of 18 patients with a mean age of 20 years who had confirmed growth hormone (GH) deficiency, we evaluated body composition, insulin sensitivity, and glucose turnover at baseline (when all were receiving GH replacement); after 12 months of continued GH therapy...... or placebo; and after a 12-month open phase of GH therapy. In the placebo group, insulin sensitivity and fat mass increased and lipid oxidation decreased, whereas glucose oxidation increased (p...

  1. Concomitant therapies (glucocorticoids and sex hormones) in adult patients with growth hormone deficiency.

    Science.gov (United States)

    Scaroni, C; Ceccato, F; Rizzati, S; Mantero, F

    2008-09-01

    Adult-onset GH deficiency (GHD), mostly due to organic lesions of the pituitary-hypothalamic region, is frequently associated with multiple anterior pituitary deficiencies that need long-term substitutive treatment. The GH-IGF-I axis may play an important role in modulating peripheral metabolism of hormones (adrenal, thyroid, and sex hormones) and these interactions may have clinically significant implications on the phenotypes of adult GHD patients and on the effects of the combined replacement hormonal treatment of this condition. By accelerating the peripheral metabolism of cortisol, GH therapy may precipitate adrenal insufficiency in susceptible hypopituitary patients; estrogen replacement blunts the response to GH in women whereas in men with androgen substitution the responsivity increases over time. Endocrinologists should be mindful of these phenomena when starting patients with hypopituitarism on GH replacement therapy.

  2. [Hormonal therapy for prostatic cancer--state of the art].

    Science.gov (United States)

    Miyakita, Hideshi

    2005-02-01

    Following the studies of Huggins and colleagues in 1941, the hormonal treatment of prostatic cancer has been aimed at neutralizing the influence of testicular androgens through surgical castration or the administration of high dose estrogen. Labrie et al introduced combined use of a LHRH agonist and an androgen antagonist for prostatic cancer. Various reports demonstrated a beneficial effect for combined androgen blockade using nonsteroidal antiandrogens for advanced prostatic cancer through meta-analysis of published randomized control trials. In Japanese status, a combined androgen blockade is popular for advanced prostatic cancer as well as local cancer by J-Cap survey. There is a lot of controversy about adjuvant hormonal therapy for prostatic cancer including intermittent hormonal therapy, but the results are not gotten yet.

  3. Continuation of growth hormone therapy versus placebo in transition-phase patients with growth hormone deficiency

    DEFF Research Database (Denmark)

    Jørgensen, Jens; Nørrelund, Helene; Vahl, Nina

    2002-01-01

    In a placebo-controlled, parallel study of 18 patients with a mean age of 20 years who had confirmed growth hormone (GH) deficiency, we evaluated body composition, insulin sensitivity, and glucose turnover at baseline (when all were receiving GH replacement); after 12 months of continued GH therapy...

  4. Therapy for obesity based on gastrointestinal hormones

    DEFF Research Database (Denmark)

    Bagger, Jonatan I; Christensen, Mikkel; Knop, Filip K;

    2011-01-01

    for the treatment of type 2 diabetes. In contrast to other antidiabetic treatments, these agents have a positive outcome profile on body weight. Worldwide there are 500 million obese people, and 3 million are dying every year from obesity-related diseases. Recently, incretin-based therapy was proposed...... for the treatment of obesity. Currently two different incretin therapies are widely used in the treatment of type 2 diabetes: 1) the GLP-1 receptor agonists which cause significant and sustained weight loss in overweight patients, and 2) dipeptidyl peptidase 4 (DPP-4) inhibitors being weight neutral. These findings...... have led to a greater interest in the physiology of intestinal peptides with potential weight-reducing properties. This review discusses the effects of the incretin-based therapies in obesity, and provides an overview of intestinal peptides with promising effects as potential new treatments for obesity....

  5. Type of hormone therapy and risk of misclassification at mammography screening

    DEFF Research Database (Denmark)

    Njor, Sisse H; Hallas, Jesper; Schwartz, Walter;

    2011-01-01

    Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy.......Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy....

  6. Growth hormone deficiency in adults--an indication for therapy?

    Science.gov (United States)

    Preece, M A; Round, J M; Jones, D A

    1987-01-01

    Case studies are presented for two patients, one with isolated hGH deficiency and one with multiple hormone deficiencies. The patients were studied 3 months before, and 3 and 9 months after discontinuing hGH therapy, at 19 and 18 years of age, respectively. Strength in the quadriceps femoris, cross-sectional area of the quadriceps muscles and cross-sectional muscle fibre area were measured. In the patient with multiple hormone deficiencies, clear decreases in all three parameters were evident after discontinuing hGH treatment. There were no significant changes in the other patient. Reasons for these differences are discussed.

  7. Parathyroid hormone and parathyroid hormone-related protein analogs as therapies for osteoporosis.

    Science.gov (United States)

    Augustine, Marilyn; Horwitz, Mara J

    2013-12-01

    Osteoporotic fractures result in significant morbidity and mortality. Anabolic agents reverse the negative skeletal balance that characterizes osteoporosis by stimulating osteoblast-dependent bone formation to a greater degree than osteoclast-dependent bone resorption. Parathyroid hormone (PTH) and parathyroid hormone- related protein (PTHrP) are peptide hormones, which have anabolic actions when administered intermittently. The only FDA-approved anabolic bone agent for the treatment of osteoporosis in the United States is PTH 1-34, or teriparatide, administered by daily subcutaneous injections. However, PTH 1-84 is also available in Europe. Synthetic human PTHrP 1-36 and a PTHrP 1-34 analog, BA058, have also been shown to increase lumbar spine bone density. These agents and several other PTH and PTHrP analogs, including some which are not administered as injections, continue to be investigated as potential anabolic therapies for osteoporosis.

  8. Hormonal therapy for acne: why not as first line therapy? facts and controversies.

    Science.gov (United States)

    Katsambas, Andreas D; Dessinioti, Clio

    2010-01-01

    Standard systemic therapeutic agents used in acne include oral antimicrobials, isotretinoin, and hormonal agents. Appropriate patient selection is the key to decide when to use hormonal agents as first-line therapy as well as to achieve optimal results. Indications of hormonal therapy in acne in girls and women include proven ovarian or adrenal hyperandrogenism, recalcitrant acne, acne not responding to repeated courses of oral isotretinoin, acne tarda, polycystic ovary syndrome, or the presence of clinical signs of hyperandrogenism such as androgenic alopecia or the presence of the seborrhea, acne, hirsutism, alopecia syndrome. We describe the hormonal agents currently available for acne treatment, discuss their indications and contraindications, and address the question of whether they may be used as a first-line therapy in acne.

  9. Hormone replacement therapy and risk of non-fatal stroke

    DEFF Research Database (Denmark)

    Pedersen, A T; Lidegaard, O; Kreiner, S

    1997-01-01

    BACKGROUND: The effect of postmenopausal hormone replacement therapy (HRT) on the risk of subtypes of stroke is as yet unclear. To investigate the effect of oestrogen and combined oestrogen-progestagen therapy on the risk of non-fatal haemorrhagic and thromboembolic stroke, we carried out a case......-control study. METHODS: From the Danish National Patient Register we identified all Danish women aged 45-64 years who had a non-fatal, first-ever cerebrovascular attack during 1990-92. Two age-matched controls were randomly selected for each case from the Danish National Person Register. Important correlates...... of hormone use and stroke, on which information was obtained from postal questionnaires, were controlled for by multivariate analyses based on log-linear graphical models. The analyses included data on 1422 cases classified in four subtypes of stroke (160 subarachnoid haemorrhage, 95 intracerebral...

  10. Hormone replacement therapy and the prevention of postmenopausal osteoporosis

    OpenAIRE

    Marco Gambacciani; Marco Levancini

    2014-01-01

    Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a ...

  11. Adherence to hormone therapy among women with breast cancer.

    Science.gov (United States)

    Brito, Claudia; Portela, Margareth Crisóstomo; de Vasconcellos, Mauricio Teixeira Leite

    2014-06-03

    Despite the excellent results obtained with hormone therapy, the long treatment period and the side effects associated with its use make patient adherence difficult. Moreover, certain aspects of health care can mitigate or exacerbate non-adherence. This study aimed to identify the factors associated with adherence to hormone therapy for breast cancer, with the goal of contributing to the reformulation of the care process and to improvements in outcomes. This was a retrospective longitudinal study based on secondary data. The study integrated and analyzed data from a cohort of 5,861 women with breast cancer who were identified in the databases of the Brazilian National Cancer Institute [Instituto Nacional de Câncer - INCA] and the Unified Health System [Sistema Único de Saúde - SUS]. All of the patients were treated at INCA, which dispenses free medication, and the follow-up period lasted from 01/01/2004 to 10/29/2010. The outcome of interest was hormone treatment adherence, which was defined as the possession of medication, and a logistic regression model was employed to identify the socio-demographic, behavioral, clinical, and health care variables that were independently associated with the variations in this outcome. The proportion of women who adhered to hormone therapy was 76.3%. The likelihood of adherence to hormone therapy increased with each additional year of age, as well as among women with a secondary or higher level education, those with a partner, those who underwent surgery, those who had more consultations with a breast specialist and clinical oncologist, and those who underwent psychotherapy; the effect for the latter increased with each additional consultation. Conversely, the likelihood of adherence was lower among patients at a non-curable stage, those who were alcohol drinkers, those who received chemotherapy, those who had undergone more tests and had more hospitalizations, and those who used tamoxifen and combined aromatase inhibitors

  12. Adherence and discontinuation of oral hormonal therapy in patients with hormone receptor positive breast cancer.

    Science.gov (United States)

    Ayres, Lorena Rocha; Baldoni, André de Oliveira; Borges, Anna Paula de Sá; Pereira, Leonardo Régis Leira

    2014-02-01

    Oral treatment in women with breast cancer has been increasingly used. However, a potentially negative side of oral medication is poor patient adherence and/or discontinuation, which reduces the treatment effectiveness, accelerating progression of the disease and reducing the patient survival rate. To compare the rates of adherence and/or discontinuation and the methodologies used to assess these outcomes. It was conducted an integrative review of original articles published from 2000 to 2012, in which their primary outcome was to quantify medication adherence and/or discontinuation of oral hormonal therapy in patients with hormone receptor positive breast cancer. Original studies were searched in the PubMed/MEDLINE, Scopus, Embase and SciELO databases. The Medical Subject Heading was used to define descriptors. The descriptor "breast neoplasms" was used in all combinations. Each of the descriptors "medication adherence" and "patient compliance" were combined with each of the following descriptors "tamoxifen", "aromatase inhibitors", "selective estrogen receptor modulators", or the terms "letrozole", "anastrozole", and "exemestane". Twenty-four original articles were included. Our study showed a wide range of adherence and discontinuation rates, ranging from 45-95.7 and 12-73 %, respectively. Regarding the methodological development of the selected articles, a high prevalence (87.5 %) of prospective and/or retrospective longitudinal studies was found. In addition, there was a high prevalence of studies using a database (70.8 %). Among some of the studies, it was shown that patient adherence to hormonal therapy gradually reduces, while discontinuation increases during the treatment. It was observed a great diversity among rates of adherence and/or discontinuation of hormonal therapy for breast cancer, which may be due to a lack of methodology standardization. Therefore, adequate and validated methods to ensure reliability of the results and allow comparison in the

  13. Hormone therapy in transgender adults is safe with provider supervision; A review of hormone therapy sequelae for transgender individuals

    OpenAIRE

    Jamie D. Weinand, BS, BA; Joshua D. Safer, MD

    2015-01-01

    Introduction: Some providers report concern for the safety of transgender hormone therapy (HT). Methods: This is a systematic literature review of HT safety for transgender adults. Results: Current literature suggests HT is safe when followed carefully for certain risks. The greatest health concern for HT in transgender women is venous thromboembolism. HT among transgender men appears to cause polycythemia. Both groups experienced elevated fasting glucose. There is no increase in cancer...

  14. Effects of Growth Hormone Replacement Therapy on Bone Mineral Density in Growth Hormone Deficient Adults: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Peng Xue

    2013-01-01

    Full Text Available Objectives. Growth hormone deficiency patients exhibited reduced bone mineral density compared with healthy controls, but previous researches demonstrated uncertainty about the effect of growth hormone replacement therapy on bone in growth hormone deficient adults. The aim of this study was to determine whether the growth hormone replacement therapy could elevate bone mineral density in growth hormone deficient adults. Methods. In this meta-analysis, searches of Medline, Embase, and The Cochrane Library were undertaken to identify studies in humans of the association between growth hormone treatment and bone mineral density in growth hormone deficient adults. Random effects model was used for this meta-analysis. Results. A total of 20 studies (including one outlier study with 936 subjects were included in our research. We detected significant overall association of growth hormone treatment with increased bone mineral density of spine, femoral neck, and total body, but some results of subgroup analyses were not consistent with the overall analyses. Conclusions. Our meta-analysis suggested that growth hormone replacement therapy could have beneficial influence on bone mineral density in growth hormone deficient adults, but, in some subject populations, the influence was not evident.

  15. Isolated growth hormone deficiency type 2: from gene to therapy.

    Science.gov (United States)

    Miletta, Maria Consolata; Lochmatter, Didier; Pektovic, Vibor; Mullis, Primus-E

    2012-01-01

    Isolated growth hormone deficiency type-2 (IGHD-2), the autosomal-dominant form of GH deficiency, is mainly caused by specific splicing mutations in the human growth hormone (hGH) gene (GH-1). These mutations, occurring in and around exon 3, cause complete exon 3 skipping and produce a dominant-negative 17.5 kD GH isoform that reduces the accumulation and secretion of wild type-GH (wt-GH). At present, patients suffering from IGHD-2 are treated with daily injections of recombinant human GH (rhGH) in order to reach normal height. However, this type of replacement therapy, although effective in terms of growth, does not prevent toxic effects of the 17.5-kD mutant on the pituitary gland, which can eventually lead to other hormonal deficiencies. Considering a well-known correlation between the clinical severity observed in IGHD-2 patients and the increased expression of the 17.5-kD isoform, therapies that specifically target this isoform may be useful in patients with GH-1 splicing defects. This chapter focuses on molecular strategies that could represent future directions for IGHD-2 treatment.

  16. Hormone Replacement Therapy and Physical Function in Healthy Older Men. Time to Talk Hormones?

    Science.gov (United States)

    Giannoulis, Manthos G.; Martin, Finbarr C.; Nair, K. Sreekumaran; Umpleby, A. Margot

    2012-01-01

    Improving physical function and mobility in a continuously expanding elderly population emerges as a high priority of medicine today. Muscle mass, strength/power, and maximal exercise capacity are major determinants of physical function, and all decline with aging. This contributes to the incidence of frailty and disability observed in older men. Furthermore, it facilitates the accumulation of body fat and development of insulin resistance. Muscle adaptation to exercise is strongly influenced by anabolic endocrine hormones and local load-sensitive autocrine/paracrine growth factors. GH, IGF-I, and testosterone (T) are directly involved in muscle adaptation to exercise because they promote muscle protein synthesis, whereas T and locally expressed IGF-I have been reported to activate muscle stem cells. Although exercise programs improve physical function, in the long-term most older men fail to comply. The GH/IGF-I axis and T levels decline markedly with aging, whereas accumulating evidence supports their indispensable role in maintaining physical function integrity. Several studies have reported that the administration of T improves lean body mass and maximal voluntary strength in healthy older men. On the other hand, most studies have shown that administration of GH alone failed to improve muscle strength despite amelioration of the detrimental somatic changes of aging. Both GH and T are anabolic agents that promote muscle protein synthesis and hypertrophy but work through separate mechanisms, and the combined administration of GH and T, albeit in only a few studies, has resulted in greater efficacy than either hormone alone. Although it is clear that this combined approach is effective, this review concludes that further studies are needed to assess the long-term efficacy and safety of combined hormone replacement therapy in older men before the medical rationale of prescribing hormone replacement therapy for combating the sarcopenia of aging can be established

  17. Hormone replacement therapy and physical function in healthy older men. Time to talk hormones?

    Science.gov (United States)

    Giannoulis, Manthos G; Martin, Finbarr C; Nair, K Sreekumaran; Umpleby, A Margot; Sonksen, Peter

    2012-06-01

    Improving physical function and mobility in a continuously expanding elderly population emerges as a high priority of medicine today. Muscle mass, strength/power, and maximal exercise capacity are major determinants of physical function, and all decline with aging. This contributes to the incidence of frailty and disability observed in older men. Furthermore, it facilitates the accumulation of body fat and development of insulin resistance. Muscle adaptation to exercise is strongly influenced by anabolic endocrine hormones and local load-sensitive autocrine/paracrine growth factors. GH, IGF-I, and testosterone (T) are directly involved in muscle adaptation to exercise because they promote muscle protein synthesis, whereas T and locally expressed IGF-I have been reported to activate muscle stem cells. Although exercise programs improve physical function, in the long-term most older men fail to comply. The GH/IGF-I axis and T levels decline markedly with aging, whereas accumulating evidence supports their indispensable role in maintaining physical function integrity. Several studies have reported that the administration of T improves lean body mass and maximal voluntary strength in healthy older men. On the other hand, most studies have shown that administration of GH alone failed to improve muscle strength despite amelioration of the detrimental somatic changes of aging. Both GH and T are anabolic agents that promote muscle protein synthesis and hypertrophy but work through separate mechanisms, and the combined administration of GH and T, albeit in only a few studies, has resulted in greater efficacy than either hormone alone. Although it is clear that this combined approach is effective, this review concludes that further studies are needed to assess the long-term efficacy and safety of combined hormone replacement therapy in older men before the medical rationale of prescribing hormone replacement therapy for combating the sarcopenia of aging can be established.

  18. Primary prevention of cardiovascular disease with hormone replacement therapy

    DEFF Research Database (Denmark)

    Schierbeck, L

    2015-01-01

    Many peri- and postmenopausal women suffer from a reduced quality of life due to menopausal symptoms and preventable diseases. The importance of cardiovascular disease in women must be emphasized, as it is the leading cause of mortality and morbidity in women. It is well known that female hormones...... contribute to the later onset of cardiovascular disease in women. The effect of estrogens has for decades been understood from observational studies of postmenopausal women treated with hormone replacement therapy (HRT). Later, treatment with HRT was disregarded due to the fear of side......-effects and an ambiguity of the cardiovascular advantages. Accumulating knowledge from the large number of trials and studies has elucidated the cause for the disparity in results. In this paper, the beneficial effects of HRT, with emphasis on cardiovascular disease are explained, and the relative and absolute risks...

  19. Stroke in women - oral contraception, pregnancy, and hormone replacement therapy.

    Science.gov (United States)

    Rantanen, Kirsi; Tatlisumak, Turgut

    2013-01-01

    Stroke is a devastating disease affecting millions of people worldwide every year. Female stroke victims have higher mortality rates and they do not re-cover as well as men. Women's longevity and different vascular risk factor burden like a larger prevalence of atrial fibrillation play a role. Women also have unique risk factors such as oral contraception, pregnancy, estrogen decrease after the menopause and hormone replacement therapy, which should all be evaluated and taken into consideration in treatment decisions both in the acute phase of stroke and in secondary prevention. In this review, the evidence regarding these hormonal aspects and the risk of stroke in women are evaluated. The relevant guidelines are studied and research gaps identified. Future topics for research are recommended and current treatment possibilities and their risks discussed.

  20. Postmenopausal hormone therapy and the risk of breast cancer: a contrary thought.

    Science.gov (United States)

    Speroff, Leon

    2008-01-01

    The most important unanswered question regarding postmenopausal hormone therapy and the risk of breast cancer is whether hormone therapy initiates the growth of new breast cancers or whether the epidemiologic data reflect a hormonal impact on preexisting tumors. In this perspective I review the evidence favoring hormonal effects on preexisting tumors and suggest that exposure to combined estrogen and progestin is beneficial, causing greater differentiation and earlier detection of breast cancers.

  1. Effectiveness and adverse effects of hormonal therapy for prostate cancer: Japanese experience and perspective

    Institute of Scientific and Technical Information of China (English)

    Mikio Namiki; Satoru Ueno; Yasuhide Kitagawa; Takashi Fukagai; Hideyuki Akaza

    2012-01-01

    Recently,novel anti-androgens and inhibitors of androgen biosynthesis have been developed through the elucidation of mechanisms of castration resistance of prostate cancer.We believe that these new developments will improve hormonal therapy.On the other hand,there has been an increase in criticism of hormonal therapy,because hormonal therapy is supposed to induce adverse effects such as cardiovascular disease.In this review,we have introduced the Japanese experience of hormonal therapy,because we believe that there may be ethnic differences between Caucasians and Asian people in the efficacy and adverse effects of hormonal therapy.First,we showed that primary hormonal therapy can achieve long-term control of localized prostate cancer in some cases and that quality of life of patients receiving hormonal therapy is rather better than previously thought.Neoadjuvant and adjuvant hormonal therapy in cases undergoing radical prostatectomy or radiotherapy are very useful for high-risk or locally advanced prostate cancer.Further clinical trials are required to confirm the efficacy of neoadjuvant or adjuvant hormonal therapy.We showed that the death from cardiovascular diseases in Japanese patients receiving hormonal therapy was not higher than that in the general population.However,efforts should be made to decrease the adverse effects of hormonal therapy,because life-style change may increase the susceptibility to adverse effects by hormonal therapy even in Japan.Managements of endocrine and metabolic dysfunction,such as diabetes mellitus,are essential.New hormonal compounds such as selective androgen receptor modulators capable of specifically targeting prostate cancer are expected to be developed.

  2. Growth hormone therapy and craniofacial bones: a comprehensive review.

    Science.gov (United States)

    Litsas, G

    2013-09-01

    Growth hormone (GH) has significant effects on linear bone growth, bone mass and bone metabolism. The primary role of GH supplementation in children with GH deficiency, those born small for gestational age or with other types of disorders in somatic development is to increase linear growth. However, GH therapy seems to elicit varying responses in the craniofacial region. Whereas the effects of GH administration on somatic development are well documented, comparatively little is known of its effects on the craniofacial region. The purpose of this review was to search the literature and compile results from both animal and human studies related to the impact of GH on craniofacial growth.

  3. Long-term hormone therapy for perimenopausal and postmenopausal women.

    Science.gov (United States)

    Marjoribanks, Jane; Farquhar, Cindy; Roberts, Helen; Lethaby, Anne; Lee, Jasmine

    2017-01-17

    BACKGROUND: Hormone therapy (HT) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005. OBJECTIVES: To assess effects of long-term HT (at least 1 year's duration) on mortality, cardiovascular outcomes, cancer, gallbladder disease, fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment. SEARCH METHODS: We searched the following databases to September 2016: Cochrane Gynaecology and Fertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO. We searched the registers of ongoing trials and reference lists provided in previous studies and systematic reviews. SELECTION CRITERIA: We included randomised double-blinded studies of HT versus placebo, taken for at least 1 year by perimenopausal or postmenopausal women. HT included oestrogens, with or without progestogens, via the oral, transdermal, subcutaneous or intranasal route. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias and extracted data. We calculated risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, along with 95% confidence intervals (CIs). We assessed the quality of the evidence by using GRADE methods. MAIN RESULTS: We included 22 studies involving 43,637 women. We derived nearly 70% of the data from two well-conducted studies (HERS 1998; WHI 1998). Most participants were postmenopausal American women with at least some degree of comorbidity, and mean participant age in most studies was over 60 years. None of the studies focused on perimenopausal women.In relatively healthy postmenopausal women (i.e. generally fit, without overt disease), combined continuous HT increased the risk of a coronary event (after 1 year's use

  4. Magnetic resonance imaging in infantile spasms: effects of hormonal therapy.

    Science.gov (United States)

    Konishi, Y; Yasujima, M; Kuriyama, M; Konishi, K; Hayakawa, K; Fujii, Y; Ishii, Y; Sudo, M

    1992-01-01

    Magnetic resonance imaging (MRI) was performed on five patients with infantile spasms who were treated with relatively low doses of adrenocorticotrophic hormone (ACTH) to study the extent of brain shrinkage induced by ACTH therapy. MRI prior to ACTH therapy revealed periventricular hyperintensity (PVH) areas and poor myelination in four patients. In one case, MRI performed 2 days after initiation of ACTH therapy also showed PVH and poor myelination. Brain shrinkage was observed 2 weeks after initiation of ACTH therapy. The most impressive follow-up finding upon MRI was the decrease in PVH found in four patients. The differentiation between myelinated white matter and surrounding cortex became poorer in three cases. Cortical atrophy progressed in all patients but ventricular dilation progressed in only one patient. At the end of ACTH therapy, ventricular dilation progressed in all cases. These findings suggest that loss of water not only from periventricular white matter but also from cortex is the main etiological factor of brain shrinkage induced by ACTH.

  5. Postoperative pituitary hormonal disturbances and hormone replacement therapy time and dosage in children with craniopharyngiomas

    Institute of Scientific and Technical Information of China (English)

    LI Gui-mei; SUN Xiao-jun; SHAO Peng

    2008-01-01

    BackgroundThe proliferative activity and penetration into the hypothalamic structures in children craniopharyngiomas (CP) often make radical resection difficult. Therefore, complete resection of CP often results in permanent multiple pituitary hormone deficiency (MPHD). This study aimed to elucidate the postoperative pituitary hormonal disturbances, and hormone replacement therapy (HRT) time and dosage in children with CP.Methods Twenty patients with growth retardation and CP after resection, comprising 14 boys and 6 girls, with a mean age of (10.63 3.18) years (Group A) and 10 male patients of group A aged >10 years (Group B) were entailed. Thirty age-, sex- and Tanner stage-matched normal children (control Group A), and 44 male older children >10 years (control Group B) served as controls. The serum concentrations of insulin-like growth factor-1 (IGF-1), growth hormone (GH), free thyroxine (FT4), thyroid-stimulating hormone (TSH), adrenocorticortropic hormone (ACTH), cortisol (COR), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T) and estradiol (E2) were measured in the CP patients after resection and in controls. The appropriate time and dosage of HRT were investigated. Linear correlation analysis was made between levothyroxine (L-T4) dosage and primary FT4 in CP patients after resection. Results All cases had MPHD. The serum peak GH, IGF-1, FT4 and COR levels of Group A were significantly lower than that of the control Group A. The serum IGF-1 concentration increased to the normal level after 3 months of rhGH therapy; the serum FSH, LH, and T levels were significantly decreased (P <0.001); however, E2 and PRL were significantly increased (P <0.001) in Group B compared with the control Group B; 18 cases were found to have central diabetes insipidus (Dl) by water deprivation test and MRI. There was a significant negative linear regression (r= -0.8, P <0.001) between L-T4 and primary FT4 in Group A patients with CP

  6. Hormone replacement therapy and the risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sjögren, Lea; Mørch, Lina S; Løkkegaard, Ellen

    2016-01-01

    progestin therapy according to the risk of endometrial cancer, while considering both regimen and type of progestin. METHODS: PubMed, EMBASE and the Cochrane Library were searched, resulting in the identification of 527 published articles on menopausal women with intact uteri treated with estrogen only......BACKGROUND: In 1975, estrogen only was found to be associated with an increased risk of endometrial cancer. In November 2015, NICE guidelines on hormone therapy were published that did not take this risk into account. AIM: This systematic literature review assesses the safety of estrogen plus......, estrogen plus progestin or tibolone for a minimum of one year. Risk of endometrial cancer was compared to placebo or never users and measured as relative risk, hazard or odds ratio. RESULTS: 28 studies were included. The observational literature found an increased risk among users of estrogen alone...

  7. A retrospective study: osteoporosis and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    H. June Kuczynski

    1989-09-01

    Full Text Available The purpose of this stud y was to determine i f women who undergo hormone replacement therapy postmenopausally, will demonstrate less osteoporosis than women who do not undergo H R T. The osteoporosis subjects were 195 women who volunteered to participate in an NIHsponsored double-blind clinical trial entitled Safely and Efficacy of Fluoride Therapy in Osteoporosis. A convenience sample of 78 controls was obtained by inviting women seeking regular medical attention to join an epidemiological investigation of osteoporosis. The data were analyzed using Chisquare and Student’s t-ratio. The study concludes that future retrospective and prospective analyses appreciate the com plexity of the problem in terms of individual risk for osteoporosis.

  8. Fibromyalgic syndromes: could growth hormone therapy be beneficial?

    Science.gov (United States)

    Cuatrecasas, Guillem

    2009-06-01

    Fibromyalgia is a chronic, idiopathic condition in which patients experience pain, asthenia and fatigue. The pathogenesis of the condition is unknown, and numerous mechanisms have been postulated, including neural hypersensitivity and autoimmunity. Symptoms of fibromyalgia are broadly similar to those of growth hormone deficiency (GHD), and there is evidence of decreased GH secretion and functional GHD in a subset of patients with fibromyalgia. Use of GH therapy in this patient population therefore represents a rational treatment strategy. Preliminary placebo-controlled trials have shown that GH therapy can significantly improve signs and symptoms of fibromyalgia and quality of life in patients receiving the current standard of care. Despite the use of relatively high doses of GH in these patients, treatment is well tolerated. Several mechanisms of action for GH in fibromyalgia have been suggested, including both central and peripheral effects.

  9. Alzheimer's disease, apolipoprotein E and hormone replacement therapy.

    Science.gov (United States)

    Depypere, H; Vierin, A; Weyers, S; Sieben, A

    2016-12-01

    Alzheimer's disease is the most frequent cause of dementia in older patients. The prevalence is higher in women than in men. This may be the result of both the higher life expectancy of women and the loss of neuroprotective estrogen after menopause. Earlier age at menopause (spontaneous or surgical) is associated with an enhanced risk of developing Alzheimer's disease. Therefore, it is postulated that estrogen could be protective against it. If so, increasing exposure to estrogen through the use of postmenopausal hormone replacement could also be protective against Alzheimer's disease. The results of the clinical studies that have examined this hypothesis are inconclusive, however. One explanation for this is that estrogen treatment is protective only if it is initiated in the years immediately after menopause. Another possibility is that the neuroprotective effects of estrogen are negated by a particular genotype of apolipoprotein E. This protein plays an important role in cholesterol transport to the neurons. Studies that have examined the link between estrogen replacement therapy, Alzheimer's disease and the E4 allele of ApoE are inconclusive. This article reviews the literature on the influence of hormone replacement therapy on the incidence and progression of Alzheimer's disease.

  10. Risk of Breast Cancer in Relation to Combined Effects of Hormone Therapy, Body Mass Index, and Alcohol Use, by Hormone-receptor Status

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Tjonneland, Anne; Keiding, Niels;

    2015-01-01

    BACKGROUND: Alcohol consumption, increased body mass index (BMI), and hormone therapy are risk factors for postmenopausal breast cancer, but their combined effects are not well understood. Because hormone therapy is effective for the relief of menopausal symptoms, the identification of "high...... therapy users across all BMI strata (P for interaction = 0.003). A markedly higher risk of breast cancer was also observed for alcohol combined with hormone therapy use compared with abstinent nonusers (P for interaction = 0.02). These effects were primarily restricted to ER-positive cases. Combined...... effects of hormone therapy/high BMI and hormone therapy/alcohol on serum estradiol and testosterone supported the hypothesis of a hormonal pathway linking these exposures to breast cancer. CONCLUSION: These analyses suggest an increased risk of breast cancer associated with hormone therapy use-a risk...

  11. Menopausal Women's Access Path to Bioidentical Hormone Replacement Therapy: An Exploratory.

    Science.gov (United States)

    Moro, Doris; Young, Wendy; Stein, Richard; Isaac, Winston; Goodman, Deborah

    2010-01-01

    The objective of this exploratory qualitative study was to describe (1) the key factors affecting women's initial decision to explore the use of bioidentical hormone, (2) where women gather their information on bioidentical hormones, (3) the enablers and barriers to obtaining bioidentical hormones, and (4) how to improve the bioidentical hormone replacement therapy access path. The study was conducted in a compounding pharmacy located in a large urban area in southern Ontario, Canada. The participants included four postmenopausal women between the ages of 46 and 72 who self-identified as users of bioidentical hormone replacement therapy and with comprehensive provincial healthcare coverage. Participants were recruited at a compounding pharmacy with the use of tri-fold brochures, tear-sheets, and posters. The women participated in an audio-taped mini focus group. Discussion was guided by six open-ended questions. Verbatim quotes were analyzed using an affinity diagram. Participants identified three key factors related to their initial decision: (1) symptoms unalleviated by synthetic hormone replacement therapy, (2) side effects from synthetic hormone replacement therapy, and (3) personal preference. They obtained information and support from many sources, including: family/friends, publications, and specialists in menopausal health. Once participants had made a decision, they obtained a prescription and accessed bioidentical hormone replacement therapy at a compounding pharmacy. Knowledgeable primary care physicians and compounding pharmacists were seen as enablers. Lack of support/Information and costs were identifies as barriers. Improvements to bioidentical hormone replacement therapy access path were suggested. The results of this study suggest that there may be value in implementing strategies to further encourage family physicians and other specialists in menopausal health to discuss options regarding hormone replacement therapy with patients. For example, the

  12. Hormone therapy for postmenopausal women—An unanswered issue

    Directory of Open Access Journals (Sweden)

    Wen-Ling Lee

    2013-02-01

    Full Text Available Menopause is a biological and natural process that occurs as part of aging in women and is secondary to ovarian failure with resultant estrogen deficiency; therefore, menopause should not be considered as a disease. However, there is no doubt that estrogen deficiency induces general psychological and physical changes, and that postmenopausal women will experience many health-related issues and problems, including osteoporotic fractures, coronary heart disease (CHD, and most importantly for the quality of life (QOL and vasomotor symptoms (VMS such as hot flashes and night sweats. Hormone therapy (HT is very effective in the management of postmenopausal women with symptoms. With the large number of patients being treated with HT, especially the combination of estrogen and progestin therapy (EPT in the Women's Health Initiative (WHI study, clinicians now recognize the potential adverse effects of EPT. Although this concept is much clearer now, some women might still benefit from short-term HT, especially for young postmenopausal women. In this review, some health issues of postmenopausal women, especially alternative therapies are discussed.

  13. Bioidentical hormone therapy: An assessment of provider knowledge.

    Science.gov (United States)

    Files, Julia A; Kransdorf, Lisa N; Ko, Marcia; Kling, Juliana M; David, Paru S; Pruthi, Sandhya; Sood, Richa; Creedon, Douglas; Chang, Yu-Hui H; Mayer, Anita P

    2016-12-01

    Bioidentical hormone therapy (BHT) is available in the United States in formulations that have been approved by the Food and Drug Administration (FDA) but also in formulations that have not been so approved. The aim of this study was to evaluate the knowledge, beliefs, and prescribing practices of BHT among healthcare providers. A cross-sectional self-selected responder survey was conducted of health care providers attending primary care Continuing Medical Education (CME) conferences in the United States from May 2012 to April 2013. The questionnaire consisted of 26 items assessing knowledge, beliefs, and current practice around BHT. A total of 366 survey responses were analyzed. Though 69.8% of respondents accurately identified the definition of BHT, only 45.3% were aware that BHT is available in FDA-approved products and 34.2% of respondents incorrectly identified that BHT is available only in custom-compounded formulations. Of those who had prescribed CC-BHT, less than half agreed with the statement "I am comfortable prescribing BHT" (45.4%). Our study showed that many practitioners are unaware that bioidentical hormones are available in FDA-approved products. Knowledge gaps identified by this survey highlight the need for and importance of education to further dispel misinformation surrounding the topic. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. [Molecular-targeted therapy for hormone-refractory prostate cancer].

    Science.gov (United States)

    Nishimura, Kazuo; Takayama, Hitoshi; Nakayama, Masashi; Nonomura, Norio; Okuyama, Akihiko

    2006-06-01

    Molecular-targeted therapy is to treat pathologic pathways specifically in tumor cell or tumor microenvironment. Specific molecular-targeted therapeutic agents for hormone-refractory prostate cancer (HRPC) include endothelin-A receptor antagonist, EGF receptor (EGFR) inhibitor, platelet derived growth factor receptor (PDGFR) inhibitor, nuclear factor of kappaB (NF-kappaB) inhibitor, cyclooxygenase-2 (COX2) inhibitor, and active form of Vitamin D. These agents have been investigated in clinical trials. So far, none of the above-mentioned agent has shown a sufficient clinical efficacy alone. However, docetaxel-based combinations with thalidomide or calcitriol have promising clinical activities. Further investigations are needed to optimize the molecular-targeted agents in the combinations with chemotherapeutic agents for the treatment of HRPC.

  15. Safety and efficacy of growth hormone therapy in childhood.

    Science.gov (United States)

    Bowlby, Deborah A; Rapaport, Robert

    2004-11-01

    Growth hormone (GH) has been used for more than 40 years. GH improves height velocity in many conditions associated with impaired growth and corrects metabolic deficits attributable to GH deficiency (GHD). Many studies and surveillance programs exist to collect efficacy and safety data. GH has been demonstrated to have a relatively wide safety margin. Reported side effects, including pseudotumor cerebri, edema, slipped capital femoral epiphysis (SCFE), worsening of scoliosis, gynecomastia, and hyperglycemia require careful monitoring. Currently, there are no data suggesting that GH therapy increases the risk of developing de novo, recurrent, or secondary malignancies. Patients who have a high intrinsic risk factor for the development of an adverse event need more vigilant surveillance.

  16. Discontinuation of hormone replacement therapy after myocardial infarction and short term risk of adverse cardiovascular events

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Hansen, Peter Riis; Sørensen, Rikke;

    2012-01-01

    To assess the risk of adverse cardiovascular events in women who discontinue hormone replacement therapy after myocardial infarction compared with those who continue.......To assess the risk of adverse cardiovascular events in women who discontinue hormone replacement therapy after myocardial infarction compared with those who continue....

  17. Relation between hormone replacement therapy and ischaemic heart disease in women

    DEFF Research Database (Denmark)

    Løkkegaard, E; Pedersen, A T; Heitmann, B L

    2003-01-01

    To investigate the risk of ischaemic heart disease and myocardial infarction among women using hormone replacement therapy, especially the potential modifying effect of cardiovascular risk factors.......To investigate the risk of ischaemic heart disease and myocardial infarction among women using hormone replacement therapy, especially the potential modifying effect of cardiovascular risk factors....

  18. Experimental Benefits of Sex Hormones on Vascular Function and the Outcome of Hormone Therapy in Cardiovascular Disease

    OpenAIRE

    Ross, Reagan L.; Serock, Michelle R; Khalil, Raouf A.

    2008-01-01

    Cardiovascular disease (CVD) is more common in men and postmenopausal women than premenopausal women, suggesting vascular benefits of female sex hormones. Experimental data have shown beneficial vascular effects of estrogen including stimulation of endothelium-dependent nitric oxide, prostacyclin and hyperpolarizing factor-mediated vascular relaxation. However, the experimental evidence did not translate into vascular benefits of hormone replacement therapy (HRT) in postmenopausal women, and ...

  19. Effects of aerobic exercise on ectopic lipids in patients with growth hormone deficiency before and after growth hormone replacement therapy

    OpenAIRE

    2016-01-01

    Growth hormone replacement therapy (GHRT) increases exercise capacity and insulin resistance while it decreases fat mass in growth hormone-deficient patients (GHD). Ectopic lipids (intramyocellular (IMCL) and intrahepatocellular lipids (IHCL) are related to insulin resistance. The effect of GHRT on ectopic lipids is unknown. It is hypothesized that exercise-induced utilization of ectopic lipids is significantly decreased in GHD patients and normalized by GHRT. GHD (4 females, 6 males) and age...

  20. Effects of menopausal hormonal therapy on occult breast tumors.

    Science.gov (United States)

    Santen, Richard J; Song, Yan; Yue, Wei; Wang, Ji-Ping; Heitjan, Daniel F

    2013-09-01

    An estimated 7% of 40-80 year old women dying of unrelated causes harbor occult breast tumors at autopsy. These lesions are too small to be detected by mammography, a method which requires tumors to be approximately 1cm in diameter to be diagnosed. Tumor growth rates, as assessed by "effective doubling times" on serial mammography range from 10 to >700 days with a median of approximately 200 days. We previously reported two models, based on iterative analysis of these parameters, to describe the biologic behavior of undiagnosed, occult breast tumors. One of our models is biologically based and includes parameters of a 200 day effective doubling time, 7% prevalence of occult tumors in the 40-80 aged female population and a detection threshold of 1.16 cm and the other involves computer based projections based on age related breast cancer incidence. Our models facilitate interpretation of the Women's Health Initiative (WHI) and anti-estrogen prevention studies. The biologically based model suggests that menopausal hormone therapy with conjugated equine estrogens plus medroxyprogesterone acetate (MPA) in the WHI trial primarily promoted the growth of pre-existing, occult lesions and minimally initiated de novo tumors. The paradoxical reduction of breast cancer incidence in women receiving estrogen alone is consistent with a model that this hormone causes apoptosis in women deprived of estrogen long term as a result of the cessation of estrogen production after the menopause. Understanding of the kinetics of occult tumors suggests that breast cancer "prevention" with anti-estrogens or aromatase inhibitors represents early treatment rather than a reduction in de novo tumor formation. Our in vivo data suggest that the combination of a SERM, bazedoxifene (BZA), with conjugated equine estrogen (CEE) acts to block maturation of the mammary gland in oophorectomized, immature mice. This hormonal combination is defined by the generic term, tissue selective estrogen complex or

  1. Prescribing menopausal hormone therapy: an evidence-based approach

    Directory of Open Access Journals (Sweden)

    Sood R

    2014-01-01

    Full Text Available Richa Sood, Stephanie S Faubion, Carol S Kuhle, Jacqueline M Thielen, Lynne T Shuster Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic, Rochester, MN, USA Abstract: The constantly changing landscape regarding menopausal hormone therapy (MHT has been challenging for providers caring for menopausal women. After a decade of fear and uncertainty regarding MHT, reanalysis of the Women's Health Initiative data and the results of recent studies have provided some clarity regarding the balance of risks and benefits of systemic MHT. Age and years since menopause are now known to be important variables affecting the benefit-risk profile. For symptomatic menopausal women who are under 60 years of age or within 10 years of menopause, the benefits of MHT generally outweigh the risks. Systemic MHT initiated early in menopause appears to slow the progression of atherosclerotic disease, thereby reducing the risk of cardiovascular disease and mortality. During this window of opportunity, MHT might also provide protection against cognitive decline. In older women and women more than 10 years past menopause, the risk-benefit balance of MHT is less favorable, particularly with regard to cardiovascular risk and cognitive impairment. For women entering menopause prematurely (<40 years, MHT ameliorates the risk of cardiovascular disease, osteoporosis, and cognitive decline. Nonoral administration of estrogen offers advantages due to the lack of first-pass hepatic metabolism, which in turn avoids the increased hepatic synthesis of clotting proteins, C-reactive protein, triglycerides, and sex hormone-binding globulin. The duration of combined MHT use is ideally limited to less than 5 years because of the known increase in breast cancer risk after 3–5 years of use. Limitations to use of estrogen only MHT are less clear, since breast cancer risk does not appear to increase with use of estrogen alone. For women under the age of 60 years, or

  2. Growth hormone therapy in heart failure: a novel therapy worthy of further consideration?

    Science.gov (United States)

    Demers, Catherine; McKelvie, Robert S

    2005-08-01

    Despite the improvements in survival with angiotensin-converting enzyme inhibitors and beta-blockers, the clinical events for patients with heart failure remain elevated. New therapies for heart failure are required to improve the functional capacity, quality of life and prognosis. Growth hormone exerts both direct and indirect effects on cardiac structure and function. Experimental models of heart failure and small studies have demonstrated significant improvements in cardiac function, haemodynamical parameters, functional capacity and quality of life. The results from randomised controlled studies have been mixed with others showing benefit and some that do not. The randomised studies showing benefit consistently used growth hormone every other day. Further studies are needed to assess the potential role of this adjuvant therapy in patients with heart failure.

  3. Terapia hormonal y calidad del hueso Hormone therapy and bone quality

    Directory of Open Access Journals (Sweden)

    2005-08-01

    Full Text Available La osteoporosis se reconoce como uno de los problemas de salud de la población femenina posmenopáusica, y la terapia hormonal de reemplazo (THR como una de las medidas terapéuticas efectivas para evitar la fractura. Nos propusimos mostrar la experiencia acumulada en relación con el efecto de la terapia hormonal de reemplazo sobre la calidad del hueso. En un estudio retrospectivo realizado en 42 mujeres con edades entre 40 y 59 años que asistieron a la Clínica de Climaterio y Osteoporosis y a la consulta multidisciplinaria de climaterio del Hospital Ginecoobstétrico “Ramón González Coro” entre enero de 1997 y diciembre del año 2003, se determinó la calidad ósea mediante absorciometría dual de rayos X en región lumbar (L2-L4 o por ultrasonido del calcáneo (USCAL y recibieron tratamiento continuado con terapia estrogénica (E o con estrógenos progestagenos (EP durante no menos de un año (n = 30. Las mujeres que no pudieron recibir THR fueron agrupadas y evaluadas como grupo control (n =12. Durante el tiempo de observación promedio de 2 años, las mujeres que recibieron THR mejoraron su calidad ósea en el 16,8 %, mientras que las del grupo control empeoraron en el 8 % de los casos. Estos resultados iniciales, aunque son modestos, muestran la utilidad de la THR para mejorar la calidad del hueso y la necesidad de continuar estudios que permitan definir en nuestro medio la persistencia de la mejoría ósea, así como la magnitud de la osteoporosis posmenopáusica.Osteoporosis is recognized as one of the health problems of the female postmenopausic population and the replacement hormone therapy (RHT as one of the effective therapeutical measures to prevent fracture. We proposed ourselves to show the experience accumulated in relation to the effect of the replacement hormone therapy on the bone quality. In a retrospective study conducted among 42 women aged 30-59 that attended the Climacteric and Osteoporosis Clinic and the

  4. Advances in hormone replacement therapy: making the menopause manageable

    Directory of Open Access Journals (Sweden)

    Palacios Santiago

    2008-11-01

    Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.

  5. Hormone therapy and cardiovascular risk markers and disease

    DEFF Research Database (Denmark)

    Pedersen, Susan H; Lokkegaard, Ellen; Ottesen, Bent

    2006-01-01

    cardiovascular outcomes. Recent, large-scale, randomized clinical studies did not confirm a beneficial cardiovascular effect of HT. On the contrary, an increased risk was found with continuous combined estrogen-progestagen regimens. The progestagen used in these trials was medroxyprogesterone acetate and other...

  6. Enhanced Neuroactivation during Verbal Memory Processing in Postmenopausal Women Receiving Short Term Hormone Therapy

    Science.gov (United States)

    Persad, Carol C.; Zubieta, Jon-Kar; Love, Tiffany; Wang, Heng; Tkaczyk, Anne; Smith, Yolanda R.

    2012-01-01

    Capsule Using a randomized, double-blind placebo-controlled cross-over design, we showed that short-term hormone replacement therapy increases brain activation in parietal and prefrontal areas during verbal memory tasks in postmenopausal women. Objective To study the effects of hormone therapy on brain activation patterns during verbal memory in postmenopausal women. Design A randomized, double-blind placebo-controlled cross-over study was performed. Setting A tertiary care university medical center. Participants Ten healthy postmenopausal women (age range 50-60 years) were recruited from the local community. Interventions Women were randomized to the order they received combined hormone therapy, 5 ug ethinyl estradiol and 1 mg norethindrone acetate, and placebo. Volunteers received hormone therapy or placebo for 4 weeks, followed by a one month washout period, and then received the other treatment for 4 weeks. An fMRI was performed at the end of each 4 week treatment utilizing a verbal memory task. Main Outcome Measure Brain activation patterns were compared between hormone therapy and placebo. Results Hormone therapy was associated with increased activation in left middle/superior frontal cortex (BA 6,9), medial frontal cortex and dorsal anterior cingulate (BA 24,32), posterior cingulate (BA 6), and left inferior parietal (BA 40) during memory encoding. All regions were significant at p ≤ 0.05 with correction for multiple comparisons. Conclusions Hormone therapy increased neural activation in frontal and parietal areas in postmenopausal women during a verbal memory task. PMID:18692790

  7. Sexual healing in patients with prostate cancer on hormone therapy.

    Science.gov (United States)

    Schover, Leslie R

    2015-01-01

    Since prostate cancer becomes more common with age, at least one-third of men have sexual problems at diagnosis. All localized treatments for prostate cancer greatly increase the prevalence of sexual dysfunction, which include loss of desire, erectile dysfunction, and changes in orgasm. Even men on active surveillance have a higher rate of problems than matched peers without prostate cancer. However, men given androgen deprivation therapy (ADT) have the worst rates of sexual dysfunction. Even after 3 to 4 months of ADT, men's desire for sex is decreased and irreversible damage may occur to the erectile tissue in the penis. Erections do not recover in about one-half of men, even if ADT is discontinued. Although intermittent ADT allows some recovery of sexual function, serum testosterone requires 9 to 12 months off ADT to recover. Again, one-half of men have permanent erectile dysfunction. If ADT causes atrophy of the erectile tissue, blood leaks out of the venous system during erection. This syndrome is difficult to treat except with surgery to implant a penile prosthesis. Despite the high rate of sexual problems in men on ADT, a small group stays sexually active and is able to have reliable erections. To improve men's sexual satisfaction on ADT, it may be important to educate them about getting extra mental and physical sexual stimulation, as well as using penile rehabilitation during hormone therapy. Information on reaching orgasm and coping with problems such as dry orgasm, pain with orgasm, and urinary incontinence during sex also should be provided.

  8. Hormone replacement therapy diminishes hearing in peri-menopausal mice.

    Science.gov (United States)

    Price, Katharine; Zhu, Xiaoxia; Guimaraes, Patricia F; Vasilyeva, Olga N; Frisina, Robert D

    2009-06-01

    We recently discovered that progestin in hormone replacement therapy (HRT) for post-menopausal women has detrimental effects on the ear and central auditory system [Guimaraes, P., Frisina, S.T., Mapes, F., Tadros, S.F., Frisina, D.R., Frisina, R.D., 2006. Progestin negatively affects hearing in aged women. Proc. Natl. Acad. Sci. - PNAS 103, 14246-14249]. To start determining the generality and neural bases of these human findings, the present study examined the effects of combination HRT (estrogen+progestin) and estrogen alone on hearing in peri-menopausal mice. Specifically, auditory brainstem responses (ABRs-sensitivity of the auditory system) and distortion-product otoacoustic emissions (DPOAEs-cochlear outer hair cell system) were employed. Middle age female CBA mice received either a time-release, subcutaneous implanted pellet of estrogen+progestin, estrogen alone, or placebo. Longitudinal comparisons of ABR threshold data obtained at 4 months of treatment revealed statistically significant declines in auditory sensitivity over time for the combined estrogen+progestin treatment group, with the estrogen only group revealing milder changes at 3, 6 and 32 kHz. DPOAE testing revealed statistically significant differences for the estrogen+progestin treatment group in the high and middle frequency ranges (15-29 and 30-45 kHz) after as early as 2 months of treatment (p<0.01 and p<0.001, respectively). Statistically significant changes were also seen at 4 months of treatment across all frequencies for the combined HRT group. These data suggest that estrogen+progestin HRT therapy of 4 months duration impairs outer hair cell functioning and overall auditory sensitivity. These findings indicate that estrogen+progestin HRT may actually accelerate age-related hearing loss, relative to estrogen monotherapy; findings that are consistent with the clinical hearing loss observed in aging women that have taken combination HRT.

  9. Complete adrenocorticotropin deficiency after radiation therapy for brain tumor with a normal growth hormone reserve

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Haruna; Yoshioka, Katsunobu; Yamagami, Keiko [Osaka City General Hospital (Japan)] (and others)

    2002-06-01

    A 34-year-old man with neurofibromatosis type 1, who had received radiation therapy after the excision of a brain tumor 5 years earlier, was admitted to our hospital with vomiting and weight loss. Cortisol and adrenocorticotropin (ACTH) were undetectable before and after administration of 100 {mu}g corticotropin releasing hormone. The level of growth hormone without stimulation was 24.7 ng/ml. We diagnosed him to have complete ACTH deficiency attributable to radiation therapy. This is the first known case of a patient with complete ACTH deficiency after radiation therapy and a growth hormone reserve that remained normal. (author)

  10. Plant derived alternatives for hormone replacement therapy (HRT).

    Science.gov (United States)

    Seidlova-Wuttke, Dana; Jarry, Hubertus; Wuttke, Wolfgang

    2013-12-01

    Abstract Hormone replacement therapy (HRT) has undisputable positive effects on climacteric complaints, in the bone and on body weight but also several undesired side effects. Therefore, plant-derived alternatives are currently promoted. Phytoestrogens - primarily the isoflavones genistein, daidzein and coumestrol, stemming from soy (Glycine max) or red clover (Trifolium pratense) - were suggested to have the desired but not the undesired effects of estrogens. Most recently published placebo-controlled studies question the beneficial effects. When taken at the time of puberty however, phytoestrogens appear to protect against mammary cancer later in life. Extracts from the rhizome of Cimicifuga racemosa (black cohosh) have no estrogenic effects. In a narrow dose range they have beneficial effects on climacteric complaints, which are due to several compounds with dopaminergic, noradrenergic, serotoninergic and GABAergic actions that act together in the hypothalamus. Ecdysone is produced by several plants, including spinach (Spinacia oleracea) and was very early on shown to increase muscle mass. Later it became apparent that spinach extracts containing ecdysone decreased body fat load, thereby reducing secretion of proinflammatory cytokines by visceral adipocytes and oxidative stress. This had beneficial effects on body weight and serum lipids not only in obese postmenopausal but also in premenopausal women and in men. For the above-described plant extracts, solid placebo-controlled clinical trials are available. For other plant extracts claiming beneficial effects on climacteric complaints or postmenopausal diseases, no solid data are available.

  11. Low-dose hormone therapy in postmenopausal women in China.

    Science.gov (United States)

    Zang, H; Shi, H; Speroff, L

    2010-12-01

    To review the experience of menopausal symptoms and low-dose hormone therapy (HT) in postmenopausal women in China. Literature review and critical summaries of available prospective, clinical trials (randomized, controlled trials, RCTs). Chinese women experience menopausal symptoms less frequently compared with women in developed countries, and the prevalence of menopausal symptoms is less in women of southern China than in women of northern China. The majority of postmenopausal Chinese women lack knowledge about HT, and the usage rate of HT is low in these women compared to that in women of developed countries. Some RCTs investigated the efficacy and safety of low- or ultra-low-dose HT, including conjugated equine estrogen, estradiol valerate, transdermal estradiol, nylestriol alone or in combination with progesterone, and tibolone in postmenopausal Chinese women. These RCTs reported that low- or ultra-low-dose HT relieved menopausal symptoms and prevented bone loss as well as standard-dose HT and was less likely to induce side-effects, including irregular vaginal bleeding and breast tenderness; there may be dose-dependent effects of HT. No study evaluated the effects of low-dose HT on cardiovascular events or breast mammographic density/risk of breast cancer. More RCTs are required to confirm efficacy and to assess the safety of low- or ultra-low-dose HT for a long-term period in a large group of postmenopausal women.

  12. Successful Growth Hormone Therapy in Cornelia de Lange Syndrome.

    Science.gov (United States)

    de Graaf, Michael; Kant, Sarina G; Wit, Jan Maarten; Willem Redeker, Egbert Johan; Eduard Santen, Gijs Willem; Henriëtta Verkerk, Annemieke Johanna Maria; Uitterlinden, André Gerardus; Losekoot, Monique; Oostdijk, Wilma

    2017-06-07

    Cornelia de Lange Syndrome (CdLS) is a heterogeneous syndrome, both clinically and genetically, in its classical form characterised by distinctive facial features, intra-uterine growth retardation, short stature, developmental delay and anomalies in multiple organ systems. NIPBL, SMC1A, SMC3, RAD21 and HDAC8, all involved in the Cohesin pathway, have been identified to cause CdLS. Growth hormone (GH) secretion has been reported as normal, and to our knowledge there are no reports on the effect of recombinant human GH (r-hGH) treatment in CdLS patients. We present a patient born small for gestational age (SGA) with persistent severe growth retardation (height -3.4 SDS) and mild dysmorphic features, who was treated with GH from 4.3 years of age onward, and diagnosed 6 years later with CdLS using whole exome sequencing. Treatment led to a height gain of 1.6 standard deviation score (SDS) over 8 years. Treatment was interrupted shortly due to high serum IGF-1 serum values. We conclude that GH therapy appears effective and safe for short children with CdLS.

  13. Parathyroid Hormone-Related Protein Analogs as Osteoporosis Therapies.

    Science.gov (United States)

    Esbrit, Pedro; Herrera, Sabina; Portal-Núñez, Sergio; Nogués, Xavier; Díez-Pérez, Adolfo

    2016-04-01

    The only bone anabolic agent currently available for osteoporosis treatment is parathyroid hormone (PTH)-either its N-terminal 1-34 fragment or the whole molecule of 1-84 aminoacids-whose intermittent administration stimulates new bone formation by targeting osteoblastogenesis and osteoblast survival. PTH-related protein (PTHrP) is an abundant factor in bone which shows N-terminal homology with PTH and thus exhibits high affinity for the same PTH type 1 receptor in osteoblasts. Therefore, it is not surprising that intermittently administered N-terminal PTHrP peptides induce bone anabolism in animals and humans. Furthermore, the C-terminal region of PTHrP also elicits osteogenic features in vitro in osteoblastic cells and in various animal models of osteoporosis. In this review, we discuss the current concepts about the cellular and molecular mechanisms whereby PTHrP may induce anabolic actions in bone. Pre-clinical studies and clinical data using N-terminal PTHrP analogs are also summarized, pointing to PTHrP as a promising alternative to current bone anabolic therapies.

  14. Hormone replacement therapy and the prevention of postmenopausal osteoporosis.

    Science.gov (United States)

    Gambacciani, Marco; Levancini, Marco

    2014-09-01

    Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR), is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC), is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

  15. Effects of hormone therapy on cognition and mood.

    Science.gov (United States)

    Fischer, Barbara; Gleason, Carey; Asthana, Sanjay

    2014-04-01

    Results of the Women's Health Initiative (WHI) and Women's Health Initiative Memory Study (WHIMS) suggested that hormone therapy (HT) may be detrimental to cognitive health. This article reviews clinical studies that address issues relevant to those results. Literature review. A search of Pubmed and Web of Science was conducted using the search terms HT and cognition, HT and mood. Clinical and observational studies were selected if they were published after the year 2000. Theories of HT mechanisms of action, pharmacology, biology, and observational and clinical trials are discussed. Although observational and clinical trials show conflicting findings, methodologic considerations must be acknowledged. HT formulation and dose, route of administration, timing of initiation, length of treatment, and health of participants all contribute to inconsistencies in results. Transdermal estradiol and micronized progesterone administered at time of menopause are generally associated with cognitive and affective benefit. At the present time, results from existing studies are equivocal regarding the benefits of HT on cognition and affect. Future studies, such as the Kronos Early Estrogen Prevention Study (KEEPS), should address methodologic inconsistencies to provide clearer answers to this important question. Published by Elsevier Inc.

  16. Hormone replacement therapy: real concerns and false alarms.

    Science.gov (United States)

    Bluming, Avrum Z; Tavris, Carol

    2009-01-01

    From 2002 to 2008, reports from the Women's Health Initiative (WHI) claimed that hormone replacement therapy (HRT) significantly increased the risks of breast cancer development, cardiac events, Alzheimer disease, and stroke. These claims alarmed the public and health professionals alike, causing an almost immediate and sharp decline in the numbers of women receiving HRT. However, the actual data in the published WHI articles reveal that the findings reported in press releases and interviews of the principal investigators were often distorted, oversimplified, or wrong. This review highlights the history of research on HRT, including a timeline of studies that have or have not found a link between HRT and breast cancer; discusses how to distinguish important, robust findings from those that are trivial; closely examines the WHI findings on HRT and breast cancer, most of which are weak or statistically insignificant; reviews the current thinking about possible links of HRT with cardiovascular disease and cognitive functioning; and reports research on the benefits of HRT, notably relief of menopausal symptoms, that affect a woman's quality of life. On these complicated matters, physicians and the public must be cautious about accepting "findings by press release" in determining whether to prescribe or take HRT.

  17. Hormone replacement therapy and the prevention of postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    Marco Gambacciani

    2014-09-01

    Full Text Available Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT at different doses rapidly normalizes turnover, preserves bone mineral density (BMD at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR, is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC, is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

  18. Manufacturing heterosexuality: hormone replacement therapy and menopause in urban Oaxaca.

    Science.gov (United States)

    Ramirez, Michelle

    2006-01-01

    For several decades, hormone replacement therapies have been prescribed to women, not only to prevent disease but to improve the sexual functioning of menopausal women. The medical promotion of continued sexual activity in a woman's post-reproductive years is exported to locations outside of North America and Europe, which provides an opportunity to critically examine the cultural roots that have informed expert biomedical representations. This ethnographic study examined menopause and social class in Oaxaca de Juarez, Mexico using interviews, questionnaires, and textual analysis. The research found that biomedicine in conjunction with the pharmaceutical industry promoted culturally constructed gender hierarchies under the guise of optimal menopausal health. However, women's actual experience of gender and sexuality in mid-life diverged significantly from these expert representations. Themes that emerged in interviews and questionnaires included the importance of motherhood in old age, diminished sexual desire as not problematic, and greater sexual freedom at a post-reproductive age. Ultimately, biomedical discourse was not the sole arbiter of appropriate menopausal womanhood and femininity.

  19. Difference in signalling between various hormone therapies in endometrium, myometrium and upper part of the vagina

    NARCIS (Netherlands)

    P. Hanifi-Moghaddam (Payman); B. Boers-Sijmons (Bianca); A.H.A. Klaassens (Anet); F.H. van Wijk (Heidy); W.F.J. van IJcken (Wilfred); P.J. van der Spek (Peter); H.A.M. Verheul (Herman); H.J. Kloosterboer (Helenius); C.W. Burger (Curt); L.J. Blok (Leen)

    2008-01-01

    textabstractBACKGROUND: Combined hormone treatments in post-menopausal women have different clinical responses on uterus and vagina; therefore, we investigated differences in steroid signalling between various hormone therapies in these tissues. METHODS: A total of 30 post-menopausal women scheduled

  20. Hormones

    Science.gov (United States)

    Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work ... glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, ...

  1. Thyroid hormone therapy and procurement of livers from brain-dead donors.

    Science.gov (United States)

    Novitzky, Dimitri; Mi, Zhibao; Videla, Luis A; Collins, Joseph F; Cooper, David K C

    2016-08-01

    Hormonal therapy to brain-dead potential organ donors remains controversial. A retrospective study was carried out of hormonal therapy on procurement of organs in 63,593 donors in whom information on T3/T4 therapy was available. In 40,124 donors, T3/T4 and all other hormonal therapy was recorded. The percentages of all organs procured, except livers, were greater in T3/T4-treated donors. Nevertheless, if T3/T4 therapy had been administered to the donor, liver transplantation was associated with significantly increased graft and recipient survival at 1 month and 12 months. The potential reasons for the lack of effect of T3/T4 therapy on the number of livers procured are discussed.

  2. An automatic framework for assessing breast cancer risk due to various hormone replacement therapies (HRT)

    DEFF Research Database (Denmark)

    Karemore, Gopal; Brandt, Sami; Nielsen, Mads

    It is well known that menopausal hormone therapy increases mammographic density. Increase in breast density may relate to breast cancer risk. Several computer assisted automatic methods for assessing mammographic density have been suggested by J.W. Byng (1996), N. Karssemeijer (1998), J.M. Boone(...... features describing the local elongatedness or stripiness, especially trained to see the effect of HRT (Hormone Replacement Therapy ) thereby providing a non-subjective and reproducible measure and compare it to the BIRADS and percentage density measure....

  3. Current attitudes on self-use and prescription of hormone therapy among New York City gynaecologists

    DEFF Research Database (Denmark)

    Devi, Gayatri; Sugiguchi, Fumitaka; Pedersen, Anette Tønnes

    2013-01-01

    The results of the Women's Health Initiative studies dramatically altered hormone therapy use around the world. In countries outside the United States, self-use in physicians remained unaltered while prescription use declined, implying that physicians may not concur with the findings. We wished t...... to explore prevailing attitudes among American physicians by examining New York City obstetrician-gynaecologists' self-use and prescription use of hormone therapy....

  4. Quantitative liver functions in Turner syndrome with and without hormone replacement therapy

    DEFF Research Database (Denmark)

    Gravholt, Claus Højbjerg; Poulsen, Henrik Enghusen; Ott, Peter

    2007-01-01

    Studies have documented elevated levels of liver enzymes in many females with Turner syndrome (TS). Histology has shown a range of changes. Treatment with female hormone replacement therapy (HRT) reduces liver enzymes.......Studies have documented elevated levels of liver enzymes in many females with Turner syndrome (TS). Histology has shown a range of changes. Treatment with female hormone replacement therapy (HRT) reduces liver enzymes....

  5. Prescription drug coverage: implications for hormonal therapy adherence in women diagnosed with breast cancer.

    Science.gov (United States)

    Bradley, Cathy J; Dahman, Bassam; Jagsi, Reshma; Katz, Steven; Hawley, Sarah

    2015-11-01

    In spite of its demonstrated benefits, many women do not initiate hormonal therapy, and among those who do, many discontinue it prematurely. We examined whether differences in hormonal therapy adherence may be at least partially explained by the availability of prescription drug coverage. Women aged 20-79 years diagnosed with stage I-III breast cancer between June 2005 and February 2007 were enrolled in the study. Women completed a mailed survey, on average 9 months after diagnosis, and again approximately 4 years later (N = 712). Adjusted logistic regression was used to predict the likelihood of initiating hormonal therapy and hormonal therapy continuation. Women who had prescription drug coverage were more likely to initiate hormonal therapy relative to women without prescription drug coverage (OR 2.91, 95 % CI 1.24-6.84). Women with prescription drug coverage were also more likely to continue hormonal therapy (OR 2.23; 95 % CI 0.99-5.05, p = 0.0543). The lowest income women were also less likely to continue hormonal therapy relative to women with annual household income that exceeded $70,000 (OR 0.55; 95 % CI 0.29-1.04) with a borderline significance of (p = 0.08). This study demonstrates the critical role of prescription drug coverage in hormonal therapy initiation and continuation, independent of health insurance coverage. These findings add to the body of literature that addresses medication adherence. Financial factors must be considered along with behavioral factors that influence adherence, which is becoming increasingly relevant to oncology as treatments are shifted to oral medications, many of which are very expensive.

  6. Understanding Breast Cancer Survivors' Beliefs and Concerns About Adjuvant Hormonal Therapy: Promoting Adherence.

    Science.gov (United States)

    Hurtado-de-Mendoza, Alejandra; Jensen, Roxanne E; Jennings, Yvonne; Sheppard, Vanessa B

    2017-02-15

    Adjuvant hormonal therapy is recommended for women with hormone receptor (HR)-positive breast cancer. Though critical, many patients are non-adherent to this therapy. Few scales have been developed to specifically address beliefs about adjuvant hormonal therapy. This study explores the clarity and relevance of the Beliefs about Medicine Questionnaire (BMQ) in the context of adherence behaviors to hormonal therapy in Black and White breast cancer survivors. We recruited women diagnosed with HR-positive cancer from the Washington, DC, area. An interviewer administered a standardized survey and conducted a cognitive interview. Participants rated the BMQ across three areas: relevance, difficulty, and clarity. We coded whether the comments identified item level issues: limited applicability, unclear reference, unclear perspective, or wording or tone. In-depth interviews were conducted with women who prematurely discontinued hormone therapy. The sample (n = 30) was equally split between Black and White survivors. On average, women were 57.9 years old (SD = 9.0). Overall 77% rated scale as relevant. Cognitive interviews revealed areas of perceived limited acceptability such as the notion of becoming too dependent or the notion of becoming worse if not taking the medication. Women who discontinued hormonal therapy (n = 2) felt ambivalent towards hormonal therapy as they reported having both positive and negative beliefs about the medication. Our study findings suggest new areas for further research and instrument development to accurately measure self-reported beliefs about hormonal therapy by HR-positive breast cancer survivors.

  7. Postmenopausal hormone therapy and the risk of breast cancer. A clinician's view.

    Science.gov (United States)

    Speroff, Leon

    2004-09-24

    Reports from the Women's Health Initiative (WHI) and the Million Women Study have indicated that postmenopausal hormone therapy increases the risk of breast cancer. At this point in time, it is not certain whether these data reflect a small increase in risk or an impact of hormone therapy on pre-existing tumors. The purpose of this review is to provide an analysis of the epidemiologic data that can help the clinician inform patients and assist patients in their decision-making.

  8. Impact of hormone therapy on quality of life after menopause.

    Science.gov (United States)

    Utian, Wulf H; Woods, Nancy Fugate

    2013-10-01

    Given the complexity of the literature on quality of life (QOL) and hormone therapy (HT) among women in the menopausal transition and postmenopause, the purposes of this integrative review were to (1) define QOL as a multidimensional construct; (2) review validated instruments for measurement of QOL; (3) review results of HT and QOL clinical trials that have used validated instruments; and (4) assess the effectiveness of HT on QOL, including health-related QOL (HRQOL), menopause-specific QOL (MSQOL), and global QOL (GQOL). The literature on HT and QOL was searched for definitions of QOL and validated instruments for measuring QOL, and the results were summarized. The purposes of this integrative review were to evaluate the effects of HT on HRQOL, differentiating the effects of HT on GQOL, HRQOL, and MSQOL. As a basis for this review, we searched for published controlled clinical trials in which the effects of HT on QOL were studied using validated QOL instruments, in particular menopause-specific validated instruments. Clear definitions are elucidated. Validated instruments for the measurements of HRQOL, GQOL, and MSQOL are summarized, and the necessity of their incorporation into future research and clinical practice is emphasized. The published effects on QOL of estrogens and progestogens administered to symptomatic and nonsymptomatic women in the menopausal transition and beyond are reviewed. The impact of various health state-related symptoms on HRQOL and GQOL is now an integral component of contemporary health care. Effects of HT include GQOL and HRQOL and should be menopause-specific. There is clearly a need for further studies on menopause and menopause-related therapies using appropriate and validated instruments. Literature review shows that HT provides a significant benefit for MSQOL in midlife women, mainly through relief of symptoms, but treatment also may result in a global increase in sense of well-being (GQOL). HRQOL benefits are contingent on

  9. Growth Hormone Therapy in Children with Chronic Renal Failure

    OpenAIRE

    Cayir, Atilla; Kosan, Celalettin

    2014-01-01

    Growth is impaired in a chronic renal failure. Anemia, acidosis, reduced intake of calories and protein, decreased synthesis of vitamin D and increased parathyroid hormone levels, hyperphosphatemia, renal osteodystrophy and changes in growth hormone-insulin-like growth factor and the gonadotropin-gonadal axis are implicated in this study. Growth is adversely affected by immunosuppressives and corticosteroids after kidney transplantation. Treating metabolic disorders using the recombinant huma...

  10. Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use.

    Science.gov (United States)

    Martinelli, Ida; Lensing, Anthonie W A; Middeldorp, Saskia; Levi, Marcel; Beyer-Westendorf, Jan; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A; Cohen, Alexander T; Trajanovic, Mila; Gebel, Martin; Lam, Phuong; Wells, Philip S; Prins, Martin H

    2016-03-17

    Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration.

  11. Growth Hormone Therapy Is Safe and Effective in Patients with Lysinuric Protein Intolerance

    OpenAIRE

    Niinikoski, Harri; Lapatto, Risto; Nuutinen, Matti; Tanner, Laura; Simell, Olli; Näntö-Salonen, Kirsti

    2011-01-01

    Background: Lysinuric protein intolerance (LPI) is an autosomal recessive cationic amino acid transport defect characterized by episodes of postprandial hyperammonemias and spontaneous protein aversion. Subnormal growth is common in spite of appropriate nutritional therapy. Growth hormone (GH) therapy promotes appetite, protein synthesis and accretion, but its possible growth-promoting effects and safety in patients with LPI are poorly known.

  12. Postmenopausal hormone therapy and breast cancer: a clinician's message for patients.

    Science.gov (United States)

    Speroff, Leon

    2004-08-01

    The Women's Health Initiative agrees with some but not all case-control and cohort studies that current use of postmenopausal estrogen-progestin therapy is associated with a small increase in the risk of breast cancer. It is not known whether this is because of new tumor growth or an effect of hormonal therapy on preexisting tumors. Many studies indicate that women who develop breast cancer while using postmenopausal hormone therapy have a reduced risk of dying from breast cancer; this is consistent with an effect on preexisting tumors so that tumors appear at a less virulent and aggressive stage.

  13. Behavioral interventions to enhance adherence to hormonal therapy in breast cancer survivors: A systematic literature review

    Science.gov (United States)

    Hurtado-de-Mendoza, Alejandra; Cabling, Mark L.; Lobo, Tania; Dash, Chiranjeev; Sheppard, Vanessa B.

    2016-01-01

    Adjuvant hormonal therapy contributes to reductions in recurrence and mortality for women with hormone receptor positive breast cancer. However, adherence to hormonal therapy is suboptimal. This is the first systematic literature review examining interventions aimed at improving hormonal therapy adherence. Researchers followed the PRISMA guidelines. PubMed-Medline, CINAHL, PsychInfo, Ovid-Medline, and EMBASE were searched for behavioral interventions that aimed to enhance adherence to adjuvant hormonal therapy in breast cancer survivors. There were 376 manuscripts screened for eligibility. Five articles met criteria. All interventions presented adherence outcomes after one-year follow-up. None significantly enhanced adherence compared to the usual care in the primary analysis (OR ranged from 1.03 to 2.06 for adherence and from 1.11 – 1.18 for persistence). All targeted patients and three only included post-menopausal breast cancer patients. Three tested the same intervention consisting of educational materials. Only one was conducted in the US. Only one reported participants' ethnicity. Overall it was unclear whether the studies contained bias. The use of different terminology and operationalization of adherence made comparisons challenging. Interventions to improve adherence to adjuvant hormonal therapy in US breast cancer populations that includes survivors who are ethnically diverse, premenopausal, and taking tamoxifen are necessary to inform future interventions. Adoption of consistent adherence definitions/measurements will provide a clearer framework to consolidate aggregate findings. Given the limited efficacy of tested interventions, it is important to engage oncologists and academics to develop approaches that target different components associated with hormonal therapy adherence, such as doctor-patient communication or social support. PMID:27133733

  14. Psychosocial factors in adjuvant hormone therapy for breast cancer: an emerging context for adherence research.

    Science.gov (United States)

    Van Liew, Julia R; Christensen, Alan J; de Moor, Janet S

    2014-09-01

    For patients with hormone receptor positive breast cancer, survivorship entails prolonged self-management of adjuvant treatment in the form of daily hormone therapy. Although sustained daily adherence across the 5-year course of therapy is associated with improved recurrence-free survival outcomes, adherence is suboptimal and many women discontinue hormone therapy prematurely. Factors associated with breast cancer survivors' nonadherence and nonpersistence are not comprehensively understood. Furthermore, psychosocial variables have only received limited research attention, despite their documented relationships with adherence in other chronic illness populations. A systematic literature review identified 14 studies that analyzed relationships between psychosocial factors and breast cancer survivors' adherence and/or persistence with adjuvant hormone therapy. Although identified relationships were complex and at times inconsistent, salient conclusions emerged. Interpersonal factors, in the form of positive social support and patient-centered interactions with medical providers, as well as intrapersonal factors, such as anxiety and beliefs about the relative benefits of medication use, were reliably associated with better adherence and persistence. Depression did not demonstrate the negative impact on adherence that has been observed in other medical populations. No relationships between quality of life and adherence were identified. Adjuvant hormone therapy appears to be a unique context for medication adherence, which warrants further attention and more rigorous analysis in future research. Individual patients' psychosocial characteristics and health care preferences should be considered when striving to optimize medication adherence.

  15. Low dose hormone therapy in reproductive endocrinology in China

    Institute of Scientific and Technical Information of China (English)

    葛秦生; 肖碧莲; 乌毓明; 李晓红

    2003-01-01

    @@ The human endocrine system normally functions in a balanced physiological state. Any excess or deficiency will cause an endocrine imbalance and result in hyper-or hypo-function, requiring readjustment by hormone suppression or supplementation in order to reestablish a normal physiological balance.

  16. [Hormone therapy in prostate cancer; a pharmacotherapeutic challenge

    NARCIS (Netherlands)

    Westdorp, H.; Benoist, G.E.; Schers, H.J.; Erp, P.H. van; Gerritsen, W.R.; Mulders, P.F.A.; Kramers, C.

    2015-01-01

    Prostate cancer is the most common form of cancer in men in the Western world. One-third of the patients with localised prostate cancer will develop recurrent disease, localised disease spread or distant metastases. The presence of distant metastases is an indication for primary palliative hormone

  17. Effects of hormone replacement therapy on depressive and anxiety symptoms after oophorectomy

    Directory of Open Access Journals (Sweden)

    Danijela D. Ðoković

    2015-02-01

    Full Text Available Aim To assess the effect of hormone replacement therapy on postoperative depression and anxiety symptoms. Methods In observational prospective study 80 women divided into two groups were evaluated: women who received estrogen and androgen replacement therapy after hysterectomy with bilateral oophorectomy before onset of menopause (35-45 years old and a control group that consisted of perimenipausal women (45-55 years old. Hormone replacement therapy began one week after surgery. The severity of depression and anxiety was evaluated through the use of Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. Subjects from the study group were interviewed right after the surgical treatment, one, two and three months later. Subjects from the control group were interviewed only once. Results The women who underwent surgery had a statistically significantly higher score in Hamilton Depression Scale (p<0.001 and Hamilton Anxiety Scale (p=0.002 compared to the control perimenopausal women. There was a significant reduction of depressive and anxiety symptoms during hormone replacement therapy. Statistically significant difference in depressive score was found immediately after one month of hormone replacement therapy (first week/one month later: p=0.0057. Statistically significant difference in anxiety score appeared three months after the introduction of hormone therapy (first week/one month later: p=0.309; first week/two months later: p=0.046; first week/three months later: p<0.001. Level of serum luteinizing hormone was in correlation with depressive and anxiety score. Conclusion Estrogen-androgen replacement therapy may reduce the risk of psychiatric disorders developing in women with bilateral oophorectomy (indication for hysterectomy with oophorectomy was leiomyomata uteri.

  18. Risk of Stroke With Various Types of Menopausal Hormone Therapies: A National Cohort Study.

    Science.gov (United States)

    Løkkegaard, Ellen; Nielsen, Lars Hougaard; Keiding, Niels

    2017-08-01

    Double-blind randomized studies on the effects of oral postmenopausal hormone therapies were stopped mainly because of increased risk of stroke. We aimed to assess the risk of all strokes and various subtypes associated with hormone therapy and explore the influence of regimens and routes of administration. A national historical cohort of women aged 51 to 70 years from 1995 to 2010 was established by linking 5 Danish registries. The National Registry of Medicinal Product Statistics provided information on hormone therapy exposure and the National Patient or Cause of Death Registries supplied data regarding stroke diagnoses (ischemic/hemorrhagic/subarachnoid hemorrhage). Multiply adjusted rate ratios with time-varying covariates were fitted in Poisson regression models. Of the 980 003 included women, 20 199 suffered a stroke (78% ischemic, 12% hemorrhagic, and 10% subarachnoid hemorrhage). In total, 36% of women used hormone therapy. Current use conferred a relative rate of 1.16 (95% confidence interval, 1.12-1.22). Compared with never users, the increased rate ratio of all stroke with continuous, cyclic combined estrogen/progestin, and estrogen only oral therapies were 1.29 (95% confidence interval, 1.21-1.37), 1.11 (95% confidence interval, 1.04-1.20), and 1.18 (95% confidence interval, 1.10-1.26), respectively. The increased risk was because of ischemic stroke, but not hemorrhagic stroke. Transdermal application of hormone therapy was not associated with risk of stroke. Vaginal estrogen was associated with a decreased risk of stroke. In a national setting, we found an increased risk of stroke, based on ischemic stroke, with oral hormone therapies that was comparable to findings from randomized studies. We found no risk of stroke with transdermal application and a reduced risk with vaginal estrogen. © 2017 American Heart Association, Inc.

  19. Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.

    Science.gov (United States)

    Murphy, Caitlin C; Bartholomew, L Kay; Carpentier, Melissa Y; Bluethmann, Shirley M; Vernon, Sally W

    2012-07-01

    Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). This systematic review aims to: (1) determine the prevalence of adherence and persistence to adjuvant hormonal therapy among breast cancer survivors in clinical practice, and (2) identify correlates of adherence and persistence. We searched Medline, PubMed, PsycINFO, and CINAHL for studies that measured rates and/or correlates of adherence and/or persistence to adjuvant hormonal therapy. Studies were reviewed in a multi-step process: (1) the lead author screened titles and abstracts of all potentially eligible studies; (2) each coauthor reviewed a random 5 % sample of abstracts; and (3) two sets of coauthors each reviewed half of all "maybe" abstracts. Any disagreements were discussed until consensus was reached. Twenty-nine studies met inclusion criteria. Prevalence of adherence ranged from 41 to 72 % and discontinuation (i.e., nonpersistence) ranged from 31 to 73 %, measured at the end of 5 years of treatment. Extremes of age (older or younger), increasing out-of-pocket costs, follow-up care with a general practitioner (vs. oncologist), higher CYP2D6 activity, switching from one form of therapy to another, and treatment side effects were negatively associated with adherence and/or persistence. Taking more medications at baseline, referral to an oncologist, and earlier year at diagnosis were positively associated with adherence and/or persistence. Adherence and persistence to adjuvant hormonal therapy among breast cancer survivors is suboptimal. Many of the correlates of adherence and persistence studied to date are not modifiable. Our review reveals a critical need for further research on modifiable factors

  20. Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

    Directory of Open Access Journals (Sweden)

    Marco Antonio Botelho

    2014-02-01

    Full Text Available OBJECTIVE: To determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10% combined with estriol (0.1% + estradiol (0.25% for relieving postmenopausal symptoms. METHODS: A total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. RESULTS: An improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05 after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04±4.9 to 57.12±4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. CONCLUSION: The nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women.

  1. Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

    Energy Technology Data Exchange (ETDEWEB)

    Botelho, Marco Antonio; Queiroz, Dinalva Brito; Barros, Gisele; Guerreiro, Stela; Umbelino, Sonia; Lyra, Arao; Borges, Boniek; Freitas, Allan, E-mail: marcobotelho@pq.cnpq.br [Universidade Potiguar, Natal, RN (Brazil). Lab. de Nanotecnologia; Fechine, Pierre [Universidade Federal do Ceara (GQMAT/UFCE), Fortaleza, CE (Brazil). Dept. de Quimica Analitica. Grupo Avancado de Biomateriais em Quimica; Queiroz, Danilo Caldas de [Instituto Federal de Ciencia e Tecnologia (IFCT), Fortaleza, CE (Brazil). Lab. de Biotecnologia; Ruela, Ronaldo [Instituto de Biotecnologia Aplicada (INBIOS), Fortaleza, CE (Brazil); Almeida, Jackson Guedes [Universidade Federal do Vale de Sao Francisco (UNIVALE), Petrolina, PE (Brazil). Fac. de Ciencias Farmaceuticas; Quintans Junior, Lucindo [Universidade Federal de Sergipe (UFSE), Sao Cristovao, SE (Brazil). Dept. de Fisiologia

    2014-06-01

    Objective:to determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms. Methods: a total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. Results: an improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04 ± 4.9 to 57.12 ± 4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. Conclusion: the nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women. (author)

  2. Lipoproteína a, aterosclerosis y terapia hormonal de reemplazo Lipoprotein a, atherosclerosis and replacement hormone therapy

    Directory of Open Access Journals (Sweden)

    Miguel Lugones Botell

    2005-08-01

    Full Text Available Se realizó una revisión sobre la lipoproteína plasmática, Lp(a, cuyo papel fisiológico es poco conocido. Se ha descrito una asociación entre las concentraciones aumentadas de Lp(a y el proceso aterosclerótico. Además, su exceso podría inducir una disminución de la actividad fibrinolítica y, por tanto, favorecer la trombosis. También analizamos la terapia hormonal de reemplazo. En relación con los efectos positivos, mejora los síntomas climatéricos y previene la osteoporosis, aunque entre los efectos adversos en las mujeres que la siguen, se ha descrito un ligero aumento del riesgo del tromboembolismo venoso, y más recientemente, en estudios realizados en EE.UU. en los años 2002 y 2004, en el ya conocido estudio (Women´s Health Initiative Study, se reportó mayor incidencia de eventos cardiovasculares para la terapia combinada con estrógenos conjugados equinos y medroxiprogesterona, y de stroke para la terapia estrogénica. Estos estudios pusieron en su lugar los efectos de esta terapia, que no es totalmente inocua. Se precisan estudios más amplios para definir el papel de la terapia hormonal de reemplazo y otras medidas terapéuticas sobre el sistema hemostático, el metabolismo lipídico y la enfermedad cardiovascular.A review of plasmatic lipoprotein, Lp(a, whose physiological role is little known, was made. An association between the augmented concentrations of Lp(a and the atherosclerotic proccess has been described. Besides, its excess may lead to a reduction of the fibrinolytic activity and, therefore, favor thrombosis. The replacement hormone therapy was also analyzed. In relation to its positive effects, it improves the climacteric symptoms and prevents osteoporosis. Among its adverse effects, it has been observed a mild increase of the risk for venous thromboembolism and, more recently, in the aleady known Women's Health Initiative Study, it was reported a higher incidence of cardiovascular events for the combined

  3. Efeitos da terapia hormonal na menopausa sobre o sistema imune Effects of the menopause hormone therapy on the immune system

    Directory of Open Access Journals (Sweden)

    Sebastião Freitas de Medeiros

    2007-11-01

    be altered during pregnancy, gonadectomy, menopause and hormone therapy. Estrogen depresses the cellular immunity, suppresses the natural killer cell activity and increases the production of antibodies. Progesterone/progestogen suppresses the cellular immune system. Androgens, after metabolization in estrogens, might stimulate the humoral immune response. Hormone therapy is still broadly used in post-menopause women with the purpose of decreasing climacteric symptoms, as well as preventing genital atrophy and bone loss. Its use to attenuate the risk of cardiovascular and neurodegenerative diseases remains in debate. A few studies have been carried out to examine the effect of post-menopause hormone therapy on the immune system. There is evidence that the hypoestrogenic state, following menopause, could result in less resistance to infections. The present review examines the interaction between sexual steroids and the immune system and, based on epidemiological and clinical studies, evaluates the effects of hormone therapy on the immune responses. It was concluded that the hormone therapy normalizes the cellular immune response in post-menopausal women.

  4. The selection of hormonal therapy in prostate cancer: who, when, and for how long?

    Science.gov (United States)

    Ryan, Charles J; Small, Eric J

    2004-05-01

    Androgen deprivation is the foundation for the systemic therapy of advanced prostate cancer. Multiple trials have tested combined androgen blockade versus androgen deprivation alone in patients with advanced disease. These studies suggest a slight advantage to the combined approaches that contain flutamide and bicalutamide, but the lack of dramatic differences in outcome makes monotherapy reasonable, especially in patients with more indolent disease. Intermittent androgen deprivation is an alternative that may allow patients to reduce the total time on androgen suppression as well as possibly delay the onset of androgen independence. A number of secondary hormonal therapies, including deferred and secondary antiandrogens, ketoconazole, and estrogens have shown modest response proportions. Patients with less advanced disease such as a rising prostate-specific antigen have varied outcomes, and no standard approach exists. In this group, noncastrating forms of hormonal therapy are being evaluated. Patients undergoing definitive local therapy who have high-risk features may benefit from early, as opposed to deferred, androgen deprivation. This review examines the evidence for the current state of the art in hormonal therapy in patients with prostate cancer and focuses, in particular, on treatment composition and timing as well as the rationale for the use of hormonal therapy in early stage disease.

  5. Usefulness of MRI in evaluation of hormonal therapy for the ovarian chocolate cysts

    Energy Technology Data Exchange (ETDEWEB)

    Sugimura, Kazuro; Ishida, Tetsuya; Takemori, Masayuki; Kono, Michio; Yamasaki, Katsuhito.

    1988-09-01

    We evaluated the diagnostic capability of MRI in ovarian chocolate cysts treated by Danazol (analogue of testosterone). Both inversion recovery as T1-weighted image and long TE and TR spin echo as T2-weighted image were performed before and during hormonal therapy. Temporal change of signal intensity and size was evaluated in three ovarian chocolate cysts (stage II: 2 cases, stage III: 1 case by Beecham classification, 1966) using the 0.15-T MR system. The high intense signal from all of the cysts was seen on both T1 and T2 weighted images before treatment. There was marked decrease in size of the chocolate cysts during hormonal therapy, and they were of considerably lower signal intensity than initially on T2-weighted image. We concluded that MRI was useful to evaluate hormonal therapy for ovarian chocolate cysts.

  6. Efficacy of growth hormone therapy in adults with childhood-onset growth hormone deficiency

    OpenAIRE

    Kim, Ja Hye; Cho, Ja Hyang; Yoo, Han-Wook; Choi, Jin-Ho

    2014-01-01

    Purpose Growth hormone (GH) plays a key role in the regulation of body composition, lipid metabolism, and quality of life in adults with GH deficiency (GHD). This study investigated changes in laboratory findings and body composition after GH recommencement for adult GHD and analyzed correlation between GH interruption period and endocrine or anthropometric parameters. Methods A total of 45 patients (17 females and 28 males) diagnosed with childhood-onset GHD (CO-GHD) were investigated and al...

  7. Cognitive Deficits in Breast Cancer Survivors After Chemotherapy and Hormonal Therapy.

    Science.gov (United States)

    Frank, Jennifer Sandson; Vance, David E; Triebel, Kristen L; Meneses, Karen M

    2015-12-01

    Adjuvant treatments, specifically chemotherapy and hormonal therapy, have dramatically increased breast cancer survival, resulting in increased attention to the residual effects of treatment. Breast cancer survivors (BCS) frequently report that cognitive deficits are a particular source of distress, interfering with many aspects of quality of life. The literature on neuropsychological performance measures in BCS supports the reality of subtle cognitive deficits after both chemotherapy and hormonal therapy. This premise is supported by recent imaging studies, which reveal anatomical changes after chemotherapy as well as changes in patterns of neural activation while performing cognitive tasks. This review suggests that, even when performance on neuropsychological performance measures is within normal limits, BCS may be using increased cognitive resources in the face of reduced cognitive reserve. Potential interventions for cognitive deficits after adjuvant therapy include prescriptions for healthy living, pharmacotherapy, complementary therapy, and cognitive remediation therapy directed toward specific cognitive deficits or a combination of several strategies.

  8. Postoperative hormonal therapy prevents recovery of neurological damage after surgery in patients with breast cancer

    Science.gov (United States)

    Sekiguchi, Atsushi; Sato, Chiho; Matsudaira, Izumi; Kotozaki, Yuka; Nouchi, Rui; Takeuchi, Hikaru; Kawai, Masaaki; Tada, Hiroshi; Ishida, Takanori; Taki, Yasuyuki; Ohuchi, Noriaki; Kawashima, Ryuta

    2016-01-01

    Cancer survivors are exposed to several risk factors for cognitive dysfunction, such as general anesthesia, surgical trauma, and adjuvant therapies. In our recent study we showed that thalamic volume reduction and attentional dysfunction occurred shortly after surgery. Here, we examined the 6-month prognosis of the 20 patients with breast cancer who underwent surgery. Seven patients did not receive any adjuvant therapy after the surgery and 13 patients received a hormonal therapy after the surgery. We assessed their attentional functions, and thalamic volumes shortly after and 6 months after surgery. We found a significant group x time interaction in the attentional functions (p = 0.033) and the right thalamus (p <  0.05, small volume correction), suggesting the thalamic volume reduction and attentional dysfunction recovered in patients without adjuvant therapy. Our findings provide a better understanding of the potential role of hormonal therapy in relation to the cognitive dysfunction of cancer survivors. PMID:27708377

  9. Noonan syndrome and Turner syndrome patients respond similarly to 4 years' growth-hormone therapy

    DEFF Research Database (Denmark)

    Lee, Peter A; Ross, Judith L; Pedersen, Birgitte Tønnes

    2015-01-01

    BACKGROUND: Turner syndrome (TS) and Noonan syndrome (NS) are distinct syndromes associated with short stature and other similar phenotypic features. We compared the responses to growth hormone (GH) therapy of TS and NS patients enrolled in the NordiNet® International Outcome Study (IOS) or the A......BACKGROUND: Turner syndrome (TS) and Noonan syndrome (NS) are distinct syndromes associated with short stature and other similar phenotypic features. We compared the responses to growth hormone (GH) therapy of TS and NS patients enrolled in the NordiNet® International Outcome Study (IOS...

  10. Hormone Therapy Plus Chemotherapy for Metastatic Prostate Cancer

    Science.gov (United States)

    A trial of androgen deprivation therapy (ADT) plus six cycles of docetaxel versus ADT alone found that after a median follow-up of nearly 29 months, median overall survival was 13.6 months longer with the combination therapy than with ADT alone.

  11. Slipped Capital Femoral Epiphysis as a Complication of Growth Hormone Therapy

    Directory of Open Access Journals (Sweden)

    Shuo-Yu Wang

    2007-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a rare complication of growth hormone (GH therapy. Here, we report three patients who developed SCFE during GH therapy. The first two patients had hypopituitarism and had started GH therapy at the age of 15 years 6 months and 13 years 9 months, respectively. SCFE developed 4 years and 1 year after GH therapy, respectively. The third patient had Prader-Willi syndrome with obesity and hypogonadism and began GH therapy at the age of 12 years and 11 months. SCFE developed 2 months after starting GH therapy. Pain over the hip joints or over the knees is an early sign of SCFE. Despite recommendation, none of the three patients continued GH therapy. A high index of suspicion during GH therapy in patients at high risk of SCFE is important for early diagnosis and appropriate management. [J Formos Med Assoc 2007;106(2 Suppl:S46-S50

  12. Adjuvant Hormonal Therapy in Postmenopausal Women with Breast Cancer: Physician’s Choices

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    Asim Jamal Shaikh

    2012-01-01

    Full Text Available The choice of adjuvant hormonal therapy in postmenopausal women with hormone receptor positive breast cancer has remained a matter of controversy and debate. The variety of agents is available, with each claiming to be superior. This clinical survey was undertaken to get an impression of the physician’s first choice of therapy in an attempt to find out what questions still need to be answered in the making of “standard of care.” A web-based clinical survey was sent to the cancer physicians around the world, and 182 physicians responded to the survey. Most were medical oncologists in a tertiary care hospital. 36.3% preferred Anastrozole, 35.2% Tamoxifen, and 22.2% Letrozole as their first choice. Data support (67.8% and safety concerns (30% were given as the main reasons for the choice, 63.7% switched their therapy, and 24% had to switch because of side effects. 73.6% used 5 years of adjuvant hormonal therapy, 6.6% for 7 years, and 4.4% for 10 years. 61.5% follow their patients 3 times monthly, and 73.2% used laboratory and radiological assessment at each followup. Conclusion. Physicians show disagreement over the choice and duration of hormonal therapy in this patient population. Clinical trials leading to firm recommendations to set standards from which patients benefit the most are needed.

  13. Sequential hormonal therapy for metastatic breast cancer after adjuvant tamoxifen or anastrozole.

    Science.gov (United States)

    Carlson, Robert W; Henderson, I Craig

    2003-01-01

    The use of adjuvant endocrine therapy in the treatment of hormone receptor-positive, early breast cancer has become important in both pre- and postmenopausal women. Tamoxifen has been the principal adjuvant hormonal therapy in pre- and postmenopausal women with hormone receptor-positive breast cancer for nearly 20 years. Recent data in premenopausal women suggest benefit from ovarian ablation with or without tamoxifen. Early results from the 'Arimidex', Tamoxifen, Alone or in Combination (ATAC) trial have demonstrated that the third-generation, selective aromatase inhibitor (AI) anastrozole ('Arimidex') is a suitable alternative adjuvant therapy for postmenopausal women with hormone receptor-positive disease. After recurrence or relapse on adjuvant endocrine therapy, responses to the sequential use of additional endocrine agents are common. The increase in the number of options now available for adjuvant therapy will have important implications for the selection of the optimal sequence of endocrine agents in the treatment of recurrent breast cancer. Menopausal status is an important factor in determining the endocrine therapy that a patient receives. For premenopausal women, tamoxifen and/or a luteinizing hormone-releasing hormone agonist such as goserelin ('Zoladex') are both options for adjuvant endocrine treatment. After progression on adjuvant and first-line tamoxifen, ovarian ablation is an appropriate second-line therapy. For premenopausal women who have undergone ovarian ablation, the use of third-line therapy with an AI becomes possible. For postmenopausal women, a wide choice of endocrine treatment options is available and an optimal sequence has yet to be determined. Options for first-line therapy of metastatic disease include an AI for women who have received adjuvant tamoxifen or tamoxifen for patients who have received adjuvant anastrozole. In addition, data suggest that fulvestrant ('Faslodex'), a novel estrogen receptor (ER) antagonist that

  14. Is hormonal therapy associated with better quality of life in transsexuals? A cross-sectional study.

    Science.gov (United States)

    Gorin-Lazard, Audrey; Baumstarck, Karine; Boyer, Laurent; Maquigneau, Aurélie; Gebleux, Stéphanie; Penochet, Jean-Claude; Pringuey, Dominique; Albarel, Frédérique; Morange, Isabelle; Loundou, Anderson; Berbis, Julie; Auquier, Pascal; Lançon, Christophe; Bonierbale, Mireille

    2012-02-01

    Although the impact of sex reassignment surgery on the self-reported outcomes of transsexuals has been largely described, the data available regarding the impact of hormone therapy on the daily lives of these individuals are scarce. The objectives of this study were to assess the relationship between hormonal therapy and the self-reported quality of life (QoL) in transsexuals while taking into account the key confounding factors and to compare the QoL levels between transsexuals who have, vs. those who have not, undergone cross-sex hormone therapy as well as between transsexuals and the general population (French age- and sex-matched controls). This study incorporated a cross-sectional design that was conducted in three psychiatric departments of public university teaching hospitals in France. The inclusion criteria were as follows: 18 years or older, diagnosis of gender identity disorder (302.85) according to the Diagnostic and Statistical Manual, fourth edition text revision (DSM-IV TR), inclusion in a standardized sex reassignment procedure following the agreement of a multidisciplinary team, and pre-sex reassignment surgery. QoL was assessed using the Short Form 36 (SF-36). The mean age of the total sample was 34.7 years, and the sex ratio was 1:1. Forty-four (72.1%) of the participants received hormonal therapy. Hormonal therapy and depression were independent predictive factors of the SF-36 mental composite score. Hormonal therapy was significantly associated with a higher QoL, while depression was significantly associated with a lower QoL. Transsexuals' QoL, independently of hormonal status, did not differ from the French age- and sex-matched controls except for two subscales of the SF-36 questionnaire: role physical (lower scores in transsexuals) and general health (lower scores in controls). The present study suggests a positive effect of hormone therapy on transsexuals' QoL after accounting for confounding factors. These results will be useful for

  15. Influence of estrogen receptor alpha and progesterone receptor polymorphisms on the effects of hormone therapy on mammographic density.

    NARCIS (Netherlands)

    Duijnhoven, F.J.B. van; Peeters, P.H.; Warren, R.M.; Bingham, S.; Uitterlinden, A.G.; Noord, P.A.H. van; Monninkhof, E.M.; Grobbee, D.E.; Gils, C.H. van

    2006-01-01

    Postmenopausal hormone therapy increases mammographic density, a strong breast cancer risk factor, but effects vary across women. We investigated whether the effect of hormone therapy use is modified by polymorphisms in the estrogen receptor (ESR1) and progesterone receptor (PGR) genes in the Dutch

  16. Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

    DEFF Research Database (Denmark)

    Birch-Johansen, Fatima; Jensen, Allan; Olesen, Anne Braae

    2012-01-01

    We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women.......We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women....

  17. Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance).

    Science.gov (United States)

    Bluethmann, Shirley M; Alfano, Catherine M; Clapp, Jonathan D; Luta, George; Small, Brent J; Hurria, Arti; Cohen, Harvey J; Sugarman, Steven; B Muss, Hyman; Isaacs, Claudine; Mandelblatt, Jeanne S

    2017-06-26

    To investigate the effects of cognitive function on discontinuation of hormonal therapy in breast cancer survivors ages 65+ ("older"). Older breast cancer survivors with invasive, non-metastatic disease, and no reported cognitive difficulties were recruited from 78 Alliance sites between 2004 and 2011. Eligible survivors (n = 1280) completed baseline interviews; follow-up was conducted annually for up to 7 years. Survivors with estrogen-receptor-positive (ER+) cancers who initiated hormonal therapy (n = 990) were included. Self-reported cognitive function was measured using the EORTC-QLQ30 scale; a difference of eight points on the 0-100 scale was considered clinically significant. Based on varying rates of discontinuation over time, discontinuation was evaluated separately for three time periods: early (3-5 years). Cox models for each time period were used to evaluate the effects of cognition immediately preceding discontinuation, controlling for age, chemotherapy, and other covariates. Survivors were 65-91 years old (mean 72.6 years), and 79% had stages 1 or 2A disease. Overall, 43% discontinued hormonal therapy before 5 years. Survivors who reported lower cognitive function in the period before discontinuation had greater hazards of discontinuing therapy at the treatment midpoint (HR 1.22 per 8-point difference, CI 1.09-1.40, p cognition was not related to discontinuation in the other periods. Self-reported cognitive problems were a significant risk factor for discontinuation of hormonal therapy 1-3 years post-initiation. Additional research is needed on the temporality of cognitive effects and hormonal therapy to support survivorship care needs of older survivors.

  18. Estrogen receptor activation by tobacco smoke condensate in hormonal therapy-resistant breast cancer cells.

    Science.gov (United States)

    Niwa, Toshifumi; Shinagawa, Yuri; Asari, Yosuke; Suzuki, Kanae; Takanobu, Junko; Gohno, Tatsuyuki; Yamaguchi, Yuri; Hayashi, Shin-Ichi

    2017-01-01

    The relationship between tobacco smoke and breast cancer incidence has been studied for many years, but the effect of smoking on hormonal therapy has not been previously reported. We investigated the effect of smoking on hormonal therapy by performing in vitro experiments. We first prepared tobacco smoke condensate (TSC) and examined its effect on estrogen receptor (ER) activity. The ER activity was analyzed using MCF-7-E10 cells into which the estrogen-responsive element (ERE)-green fluorescent protein (GFP) reporter gene had been stably introduced (GFP assay) and performing an ERE-luciferase assay. TSC significantly activated ERs, and upregulated its endogenous target genes. This activation was inhibited by fulvestrant but more weakly by tamoxifen. These results suggest that the activation mechanism may be different from that for estrogen. Furthermore, using E10 estrogen depletion-resistant cells (EDR cells) established as a hormonal therapy-resistant model showing estrogen-independent ER activity, ER activation and induction of ER target genes were significantly higher following TSC treatment than by estradiol (E2). These responses were much higher than those of the parental E10 cells. In addition, the phosphorylation status of signaling factors (ERK1/2, Akt) and ER in the E10-EDR cells treated with TSC increased. The gene expression profile induced by estrogenic effects of TSC was characterized by microarray analysis. The findings suggested that TSC activates ER by both ligand-dependent and -independent mechanisms. Although TSC constituents will be metabolized in vivo, breast cancer tissues might be exposed for a long period along with hormonal therapy. Tobacco smoke may have a possibility to interfere with hormonal therapy for breast cancer, which may have important implications for the management of therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Raloxifene and hormone replacement therapy increase arachidonic acid and docosahexaenoic levels in postmenopausal women

    NARCIS (Netherlands)

    Giltay, E.J.; Duschek, E.J.J.; Katan, M.B.; Neele, S.J.; Netelenbos, J.C.; Zock, P.L.

    2004-01-01

    Estrogens may affect the essential n-6 and n-3 fatty acids arachidonic acid (AA; C20:4n-6) and docosahexaenoic acid (DHA; C22:6n-3). Therefore, we investigated the long-term effects of hormone replacement therapy and raloxifene, a selective estrogen-receptor modulator, in two randomized, double-blin

  20. Breast cancer incidence and use of hormone therapy in Denmark 1978-2007

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My

    2011-01-01

    Internationally, there have recently been reports of declining incidence rates for breast cancer. Decreased use of hormone therapy and decreased use of mammography has been put forward as possible reasons for this decline. The aim of this study was to analyse breast cancer incidence trends in Den...

  1. Hormone therapy affects plasma measures of factor VII-activating protease in younger postmenopausal women

    DEFF Research Database (Denmark)

    Mathiasen, Jørn Sidelmann; Skouby, S.O.; Vitzthum, F.;

    2010-01-01

    Objectives Current reviews indicate that hormone therapy (HT) has a protective role in coronary heart disease (CHD) in younger postmenopausal women, whereas HT contributes to CHD in older women Factor VII-activating protease (FSAP) is a serine protease that accumulates in unstable atherosclerotic...

  2. Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women

    DEFF Research Database (Denmark)

    Mosekilde, Leif; Beck-Nielsen, H.; Sørensen, O.H.

    2000-01-01

    OBJECTIVES: To study the fracture reducing potential of hormonal replacement therapy (HRT) in recent postmenopausal women in a primary preventive scenario. METHODS: Prospective controlled comprehensive cohort trial: 2016 healthy women aged 45-58 years, from three to 24 months past last menstrual...... and possibly the total number of fractures in recent postmenopausal women by use of HRT as primary prevention....

  3. Replacing hormone therapy-is the decline in prescribing sustained, and are nonhormonal drugs substituted?

    NARCIS (Netherlands)

    Vegter, Stefan; Kolling, Pieternel; Toben, Marjolijn; Visser, Sipke T.; de Jong-van den Berg, Lolkje T. W.

    2009-01-01

    Objectives: After two cautioning landmark studies in 2002 and 2003, a dramatic decrease in hormonal therapy (HT) prescribing for menopausal symptoms was seen. Our objectives were to (1) determine whether this decline in HT prescribing sustained until 2007 and (2) investigate nonhormonal drug prescri

  4. Attitude of German women towards hormone therapy : results of a lay survey

    NARCIS (Netherlands)

    Buhling, K. J.; Daniels, B.; Studnitz, F. S. G.; Eulenburg, C.; Mueck, A. O.

    2013-01-01

    Objective: Hormone therapy (HT) use has experienced a substantial change since publication of Women's Health Initiative (WHI) controlled trial. We aimed to investigate the attitude towards HT in German women aged 45-60 years. Study design: A questionnaire was sent to 9785 randomly selected women in

  5. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe

    DEFF Research Database (Denmark)

    Stahlberg, Claudia; Pedersen, Anette Tønnes; Lynge, Elsebeth

    2004-01-01

    Epidemiologic studies have shown an increased risk of breast cancer following hormone replacement therapy (HRT). The aim of this study was to investigate whether different treatment regimens or the androgenecity of progestins influence the risk of breast cancer differently. The Danish Nurse Cohort...

  6. Attitude of German women towards hormone therapy : results of a lay survey

    NARCIS (Netherlands)

    Buhling, K. J.; Daniels, B.; Studnitz, F. S. G.; Eulenburg, C.; Mueck, A. O.

    Objective: Hormone therapy (HT) use has experienced a substantial change since publication of Women's Health Initiative (WHI) controlled trial. We aimed to investigate the attitude towards HT in German women aged 45-60 years. Study design: A questionnaire was sent to 9785 randomly selected women in

  7. Use of postmenopausal hormone replacement therapy and risk of non-Hodgkin's lymphoma

    DEFF Research Database (Denmark)

    Nørgaard, M; Poulsen, A H; Pedersen, L;

    2006-01-01

    Use of postmenopausal hormone replacement therapy (HRT) has been hypothesised to be associated with a reduced risk of non-Hodgkin's lymphoma (NHL), but the epidemiologic evidence is conflicting. To examine the risk of NHL in HRT users aged 40 and older, we conducted a cohort study in the County...

  8. The validity of self-reported use of hormone replacement therapy among Danish nurses

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Johnsen, Søren Påske; Heitmann, Berit Lillienthal

    2004-01-01

    Recent findings from randomized clinical trials on the effects of hormone replacement therapy (HRT) among postmenopausal women contradict findings from observational studies indicating a protective effect on the development of cardiovascular disease. Most observational studies on HRT are based...... on self-reported data, although data on the validity of HRT in postmenopausal women are sparse....

  9. Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review

    NARCIS (Netherlands)

    Hemelaar, M.; Mooren, M.J. van der; Rad, M.; Kluft, C.; Kenemans, P.

    2008-01-01

    Objective: To review the effects of non-oral administration of postmenopausal hormone therapy (HT) on risk markers for atherosclerotic and venous thromboembolic disease.Non-oral postmenopausal HT appears not to increase venous thromboembolic risk, whereas the effect on coronary heart disease risk is

  10. The Miracle Drug : Hormone Replacement Therapy and Labor Market Behavior of Middle-Aged Women

    NARCIS (Netherlands)

    Meltem Daysal, N.; Orsini, C.

    2012-01-01

    Abstract: In an aging society, determining which factors contribute to the employment of older individuals is increasingly important. This paper sheds light on the impact of medical innovation in the form of Hormone Replacement Therapy (HRT) on employment of middle-aged women. HRT are drugs taken by

  11. Raloxifene and hormone replacement therapy increase arachidonic acid and docosahexaenoic levels in postmenopausal women

    NARCIS (Netherlands)

    Giltay, E.J.; Duschek, E.J.J.; Katan, M.B.; Neele, S.J.; Netelenbos, J.C.; Zock, P.L.

    2004-01-01

    Estrogens may affect the essential n-6 and n-3 fatty acids arachidonic acid (AA; C20:4n-6) and docosahexaenoic acid (DHA; C22:6n-3). Therefore, we investigated the long-term effects of hormone replacement therapy and raloxifene, a selective estrogen-receptor modulator, in two randomized,

  12. Should we start and continue growth hormone (GH) replacement therapy in adults with GH deficiency?

    NARCIS (Netherlands)

    ter Maaten, JC

    2000-01-01

    During the last decade, growth hormone deficiency (GHD) in adults has been described as a clinical syndrome. Central features of this entity include increased fat mass, reduced muscle and bone mass, as well as impaired exercise capacity and quality of life. GH replacement therapy has been initiated

  13. Hormone therapy and the risk of breast cancer in BRCA1 mutation carriers

    NARCIS (Netherlands)

    A. Eisen (Andrea); J. Lubinski (Jan); J. Gronwald (Jacek); P. Moller (Pal); H. Lynch (Henry); J.G.M. Klijn (Jan); C. Kim-Sing (Charmaine); S.L. Neuhausen (Susan); L. Gilbert (Lucy); P. Ghadirian (Parviz); S. Manoukian (Siranoush); G. Rennert (Gad); E. Friedman (Eitan); C. Isaacs (Claudine); B. Rosen (Barry); M.J. Daly (Mark); P. Sun (Ping); S. Narod (Steven); O.I. Olopade (Olofunmilayo); S. Cummings (Shelly); N. Tung (Nadine); F.J. Couch (Fergus); W.D. Foulkes (William); S.M. Domchek (Susan); D. Stoppa-Lyonnet (Dominique); R. Gershoni-Baruch (Ruth); D. Horsman (David); H. Saal (Howard); E. Warner (Ellen); W. Meschino (Wendy); K. Offit (Kenneth); A. Trivedi (Amber); M. Robson (Mark); M. Osborne (Michael); D. Gilchrist (Dawna); J.N. Weitzel (Jeffrey); W. McKinnon (Wendy); M. Wood (Marie); C. Maugard (Christine); B. Pasini (Barbara); T. Wagner (Teresa); K. Sweet; B. Pasche (Boris); T. Fallen (Taya); B.Y. Karlan (Beth); C. Eng (Charis); R.N. Kurz; S. Armel (Susan); A. Tulman (Anna); P.J. Ainsworth (Peter); E. Lemire (Edmond); J. McLennan; G. Evans (Gareth); T. Byrski (Tomas); T. Huzarski (Tomas); L. Shulman (Lee)

    2008-01-01

    textabstractBackground: Hormone therapy (HT) is commonly given to women to alleviate the climacteric symptoms associated with menopause. There is concern that this treatment may increase the risk of breast cancer. The potential association of HT and breast cancer risk is of particular interest to wo

  14. Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rosenfalck, A M; Højgaard, L

    2001-01-01

    OBJECTIVE: Menopause is linked to an increase in fat mass and a decrease in lean mass exceeding age-related changes, possibly related to reduced output of ovarian steroids. In this study we examined the effect of combined postmenopausal hormone replacement therapy (HRT) on the total and regional ......, which in turn, prevents disease in the elderly....

  15. The future of postmenopausal hormone therapy: It's time to move forward.

    Science.gov (United States)

    Speroff, Leon

    2007-05-20

    There are good reasons why the use of postmenopausal hormone therapy is at a contemporary low level. But an analysis of these factors provides explanations that offer a basis for appropriate and renewed use. A more optimistic position is supported by an up-to-date appraisal of clinical studies.

  16. The association between early menopause and risk of ischaemic heart disease: Influence of Hormone Therapy?

    DEFF Research Database (Denmark)

    Løkkegaard, E; Andersen, Zorana Jovanovic; Heitmann, B L

    2006-01-01

    Randomised clinical trials find no protection against development of ischaemic heart disease by use of Hormone Therapy (HT) after the age of 50 years. Observational studies suggest that early menopause is a risk factor for ischaemic heart disease. Yet, a clinical very relevant question is whether...... HT reduces this risk associated with early menopause....

  17. Carotid Artery Distensibility and Hormone Therapy and Menopause: The Los Angeles Atherosclerosis Study (LAAS)

    Science.gov (United States)

    Shufelt, Chrisandra; Elboudwarej, Omeed; Johnson, B. Delia; Mehta, Puja; Bittner, Vera; Braunstein, Glenn; Berga, Sarah; Stanczyk, Frank; Dwyer, Kathleen; Merz, C. Noel Bairey

    2015-01-01

    Objective Observational studies suggest that arterial distensibility decreases during menopause; however, the relation to hormone therapy use is controversial. We prospectively studied distensibility and hormone therapy use during different menopause stages. Methods 161 women between 42–61 years of age without cardiovascular disease had carotid artery measurements by ultrasound to calculate the distensibility index at baseline and 3 years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, and postmenopausal. Over 3 years of prospective observation, women were classified as remaining premenopausal, remaining postmenopausal, or transitioning, defined as change from premenopausal-to-perimenopausal, premenopausal-to-postmenopausal, perimenopausal-to-perimenopausal, or perimenopausal-to-postmenopausal. Results Distensibility declined over time in all menopause stages (pmenopause transition is associated with reduced vascular compliance. Hormone therapy is associated with better arterial distensibility only during menopause transition. Additional prospective studies are needed to confirm these findings and to determine if hormone therapy use beyond menopause transition is related to distensibility. PMID:26308234

  18. Genetic modifiers of menopausal hormone replacement therapy and breast cancer risk

    DEFF Research Database (Denmark)

    Rudolph, Anja; Hein, Rebecca; Lindström, Sara

    2013-01-01

    Women using menopausal hormone therapy (MHT) are at increased risk of developing breast cancer (BC). To detect genetic modifiers of the association between current use of MHT and BC risk, we conducted a meta-analysis of four genome-wide case-only studies followed by replication in 11 case...

  19. Radiation therapy alone for growth hormone-producing pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Plataniotis, G.A.; Kouvaris, J.R.; Vlahos, L.; Papavasiliou, C. [Athens Univ. (Greece). Dept. of Radiology

    1998-09-01

    We present our experience in the treatment of growth hormone (GH)-producing pituitary adenomas using irradiation alone. Between 1983 and 1991, 21 patients suffering from GH-secreting pituitary adenomas were treated with radiotherapy alone. Two bilateral opposing coaxial fields were used in 10 patients and in the remaining 11 a third frontovertex field was added. Treatment was given in 1.8-2 Gy daily fractions and total dose ranged between 45 and 54 Gy. Treatment was given using a cobalt unit. Four patients treated with somatostatin prior to and 14 patients treated after the end of radiotherapy experienced symptom relief for 6-28 weeks. The 5-year actuarial rate of disease control was 72%. Five out of six failed patients had macroadenomas. Hypopituitarism was observed in 5/21 (24%) patients. Whereas RT alone is effective in the treatment of microadenomas, this is not true for large infiltrative macroadenomas. (orig.)

  20. Growth hormones therapy in immune response against Trypanosoma cruzi.

    Science.gov (United States)

    Frare, Eduardo Osório; Santello, Fabricia Helena; Caetano, Leony Cristina; Caldeira, Jerri C; Toldo, Míriam Paula Alonso; Prado, José Clóvis do

    2010-04-01

    Growth hormone (GH) is an important hypophyseal hormone that is primarily involved in body growth and metabolism. In mammals, control of Trypanosoma cruzi parasitism during the acute phase of infection is considered to be critically dependent on direct macrophage activation by cytokines. To explore the possibility that GH might be effective in the treatment of Chagas' disease, we investigated its effects on the course of T. cruzi infection in rats, focusing our analyses on its influences on parasitemia, NO, TNF-alpha and IFN-gamma concentration and on histopathological alterations and parasite burden in heart tissue. T. cruzi-infected male Wistar rats were intraperitoneally treated with 5 ng/10 g body weight/day of GH. Animals treated with GH showed a significant reduction in the number of blood trypomastigotes during the acute phase of infection compared with untreated animals (P<0.05). For all experimental days (7, 14 and 21 post infection) of the acute phase, infected and GH treated animals reached higher concentrations of TNF-alpha, IFN-gamma and nitric oxide as compared to untreated and infected counterparts (P<0.05) Histopathological observations of heart tissue revealed that GH administration also resulted in fewer and smaller amastigote burdens, and less inflammatory infiltrate and tissue disorganization, indicating a reduced parasitism of this tissue. These results show that GH can be considered as an immunomodulator substance for controlling parasite replication and combined with the current drug used may represent in the future a new therapeutic tool to reduce the harmful effects of Chagas' disease.

  1. Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status : a large prospective cohort study

    NARCIS (Netherlands)

    Ritte, Rebecca; Lukanova, Annekatrin; Berrino, Franco; Dossus, Laure; Tjonneland, Anne; Olsen, Anja; Overvad, Thure Filskov; Overvad, Kim; Clavel-Chapelon, Francoise; Fournier, Agnes; Fagherazzi, Guy; Rohrmann, Sabine; Teucher, Birgit; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Ramon Quiros, Jose; Buckland, Genevieve; Sanchez, Maria-Jose; Amiano, Pilar; Chirlaque, Maria-Dolores; Ardanaz, Eva; Sund, Malin; Lenner, Per; Bueno-de-Mesquita, Bas; van Gils, Carla H.; Peeters, Petra H. M.; Krum-Hansen, Sanda; Gram, Inger Torhild; Lund, Eiliv; Khaw, Kay-Tee; Wareham, Nick; Allen, Naomi E.; Key, Timothy J.; Romieu, Isabelle; Rinaldi, Sabina; Siddiq, Afshan; Cox, David; Riboli, Elio; Kaaks, Rudolf

    2012-01-01

    Introduction: Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement

  2. Ductal carcinoma In-Situ in turner syndrome patient undergoing hormone replacement therapy: A case report

    Directory of Open Access Journals (Sweden)

    Rashmi Bawa

    2016-03-01

    Full Text Available Turner’s syndrome is a rare congenital disease which affects about 1 in every 2500-3000 live-born females. This happens due to chromosomal abnormalities in a phenotypic female, causing increased gonadotropin concentrations and low concentrations of estrogens from infancy. As a result, hormone replacement therapy is started in most adolescent Turner syndrome patients to initiate and sustain sexual maturation. Accordingly, most Turner’s syndrome patients undergo several decades of estrogen replacement therapy, from puberty to post-menopausal age. The highly publicized findings of the Women’s Health Initiative have called into question the appropriateness of hormone replacement therapy in adolescents with Turner’s syndrome. Those concerns were mostly theoretical extrapolations, as few prospective studies of cancer occurrence in women with Turner syndrome have been reported. Consequently, several recent publications have challenged those extrapolations, based on the assertion that the levels of hormone replacement in Turner syndrome patients are well below the physiologic levels observed in normal menstruating women, as well as the fact that these women are significantly younger than those studied by the Women’s Health Initiative. In discord to those reports, we present a case of ductal carcinoma in-situ in a 40-year-old Turner patient, who had undergone over two decades of combined hormone replacement therapy. The patient underwent an elective excisional biopsy for a palpable mass, with histopathology revealing a complex fibroadenoma with a nidus of ductal carcinoma in-situ. The lesion was noted to be estrogen receptor positive and progesterone receptor negative, with heavy staining for HER-2/Neu receptor. The patient was treated with tamoxifen. While a rare case, it is imperative for the astute clinician to keep in mind the consequences of long-term hormone replacement therapy in Turner’s syndrome patients in order to avoid missed

  3. Psychological functioning after growth hormone therapy in adult growth hormone deficient patients: endocrine and body composition correlates

    OpenAIRE

    Lašaitė, Lina; Bunevičius, Robertas; Lašienė, Danutė Teresė; Lašas, Liudvikas

    2004-01-01

    Growth hormone replacement in adult growth hormone deficient patients improves psychological well-being and the quality of life. The aim of this study was to investigate relationship between changes in mood, cognitive functioning, quality of life, changes in body composition and hormone concentration at baseline and six months after treatment with human recombinant growth hormone. Eighteen adult patients with growth hormone deficiency syndrome were recruited to the study. Growth hormone was a...

  4. Influence of hormone replacement therapy in postmenopausal women with type 2 diabetes and hyperlipidemia on lipid and glucose metabolism

    Directory of Open Access Journals (Sweden)

    Vuksanović Miljanka

    2006-01-01

    Full Text Available Introduction. Hormone replacement therapy (HRT is less frequently prescribed to postmenopausal women with diabetes type 2 who have poor lipid status despite well known favorable effect of HRT on lipid levels. Objective. The aim of this study was to assess the effect of oral HRT in postmenopausal women with type 2 diabetes and hyperlipidemia. Method. Continuously combined HRT, estradiol 2mg + norethisterone acetate 1mg was given to 30 women with diabetes type 2 and hyperlipidemia and two control groups of postmenopausal women (30 with hyperlipidemia only and 30 healthy women over a 6-month period. Total cholesterol (t- HOL, triglycerides, LDL-cholesterol, HDL-cholesterol, glycosylated hemoglobin A1c (HbA1c were evaluated in 3-month intervals. Fasting and postprandial glucose levels were evaluated monthly. Results. HRT significantly decreased levels of t-HOL (χ2 Friedman=11.712; p<0.01 and LDL-c (χ2 Friedman=10.403; p<0.01 in postmenopausal women with type 2 diabetes. However, the effect was more pronounced in two control groups. Triglycerides (χ2 Friedman=5.400; p≥0.05 and HDL-c (χ2 Friedman=1.113; p>0.05 did not change in postmenopausal women with type 2 diabetes. Six month of oral HRT significantly decreased HbA1c (F=44.693; p<0.01. Fasting and postprandial glycemia was decreased but not significantly (χ2 Friedman=6.527; p>0.05. Conclusion. Six-month application of HRT is effective in lowering the lipid levels and HbA1c in postmenopausal women with type 2 diabetes. However, target lipid levels were not achieved.

  5. Abiraterone acetate for prostate cancer: a new era of hormonal therapies

    Institute of Scientific and Technical Information of China (English)

    Emmanuel S Antonarakis

    2011-01-01

    @@ Therapies targeting the androgen receptor (AR) axis have constituted the Holy Grail in the management of advanced prostate cancer for seven decades.1 These hormonal therapies have traditionally taken two main forms: those that suppress gonadal androgen synthesis (e.g.,the gonadotropin releasing hormone agonists/antagonists,such as leuprolide),and those that inhibit the AR directly (e.g.,the anti-androgens,such asbicalutamide).However,although the vast majority of patients with prostate cancer initially respond favorably to androgen-ablative therapies (manifested by tumor regressions and symptomatic improvements),all patients will eventually develop further disease progression after a median of 18-24 months.This transformed disease state,known as castration-resistant prostate cancer (CRPC),is invariably fatal.

  6. Ovarian morphology and function during growth hormone therapy of short girls born small for gestational age

    DEFF Research Database (Denmark)

    Tinggaard, Jeanette; Jensen, Rikke; Sundberg, Karin

    2014-01-01

    OBJECTIVE: To study the effect of growth hormone (GH) treatment on ovarian and uterine morphology and function in short, prepubertal small-for-gestational-age (SGA) girls.DESIGN: A multinational, randomized controlled trial on safety and efficacy of GH therapy in short, prepubertal children born...... SGA.SETTING: Not applicable.PATIENT(S): A subgroup of 18 Danish girls born SGA included in North European SGA Study (NESGAS).INTERVENTION(S): One year of GH treatment (67 μg/kg/day) followed by 2 years of randomized GH treatment (67 μg/kg/day, 35 μg/kg/day, or IGF-I titrated).MAIN OUTCOME MEASURE...... normal reference ranges. Ovarian follicles became visible in 58% after 1 year compared with 28% before GH therapy. Anti-Müllerian hormone increased significantly during the 3 years of GH therapy but remained within the normal range. Precocious puberty was observed in one girl; another girl developed...

  7. Oral contraceptive use, hormone replacement therapy, reproductive history and risk of colorectal cancer in women.

    Science.gov (United States)

    Kabat, Geoffrey C; Miller, Anthony B; Rohan, Thomas E

    2008-02-01

    Evidence from epidemiologic studies suggests a possible role of exogenous and endogenous hormones in colorectal carcinogenesis in women. However, with respect to exogenous hormones, in contrast to hormone replacement therapy, few cohort studies have examined oral contraceptive use in relation to colorectal cancer risk. We used data from a large cohort study of Canadian women enrolled in a randomized controlled trial of breast cancer screening to assess the association of oral contraceptive use, hormone replacement therapy and reproductive factors with risk of colorectal cancer, overall and by subsite within the colorectum. Cancer incidence and mortality were ascertained by linkage to national databases. Among 89,835 women aged 40-59 at enrollment and followed for an average of 16.4 years, we identified 1,142 incident colorectal cancer cases. Proportional hazards models were used to estimate the associations between the exposures of interest and risk of colorectal cancer. Ever use of oral contraceptives at baseline was associated with a modest reduction in the risk of colorectal cancer (hazard ratio 0.83, 95% confidence interval 0.73-0.94), with similar effects for different subsites within the colorectum. No trend was seen in the hazard ratios with increasing duration of oral contraceptive use. No associations were seen with use of hormone replacement therapy (ever use or duration of use) or reproductive factors. Our results are suggestive of an inverse association between oral contraceptive use and colorectal carcinogenesis. However, given the lack of a dose-response relationship and the potential for confounding, studies with more complete assessment of exogenous hormone use throughout the life course are needed to clarify this association. (c) 2007 Wiley-Liss, Inc.

  8. Promotion and marketing of bioidentical hormone therapy on the internet: a content analysis of websites.

    Science.gov (United States)

    Yuksel, Nese; Treseng, Laetitia; Malik, Bushra; Ogbogu, Ubaka

    2017-10-01

    To evaluate the quality of information presented and claims made on websites offering bioidentical hormone therapy (BHT) products or services. A quantitative content analysis was completed on 100 websites promoting or offering BHT products or services. Websites were identified through Google search engine from September to October 2013. Search terms included "bioidentical hormone therapy" or "bioidentical progesterone," accompanied by "purchase or buy," "service," or "doctors." The Brief DISCERN instrument was used to determine the quality of the health information. Websites were from Canada (59%), United States (38%), and other countries (3%). Almost half of the websites originated from medical clinics (47%), and healthcare professionals offering BHT services included physicians (50%), pharmacists (19%), and naturopaths (16%). Majority of websites promoted BHT as custom-compounded formulations (62%), with only 27% indicating that BHT is also commercially available. Websites overall claimed that BHT had less risk compared with conventional hormone therapy (62%). BHT was described as having less breast cancer risk (40%), whereas over a quarter of websites described BHT as "protective" for breast cancer. Websites mainly targeted women (99%), with males mentioned in 62% of websites. Product descriptors used to promote BHT included individualization (77%), natural (70%), hormone imbalance (56%), and antiaging (50%). The mean Brief DISCERN score was 15, indicating lower quality of information. Claims made about BHT on the internet are misleading and not consistent with current professional organizations' recommendations. Understanding how BHT may be promoted on the internet can help healthcare professionals when educating patients.

  9. Hormonal changes during GnRH analogue therapy in children with central precocious puberty

    DEFF Research Database (Denmark)

    Müller, J; Juul, A; Andersson, A M

    2000-01-01

    Gonadotropin releasing hormone analogues (GnRHa) have been used for treatment of central precocious puberty (CPP) for more than 15 years. They are generally considered safe although data on potential long-term side effects are scarce. However, GnRHa therapy has profound effects on both the hypoth......Gonadotropin releasing hormone analogues (GnRHa) have been used for treatment of central precocious puberty (CPP) for more than 15 years. They are generally considered safe although data on potential long-term side effects are scarce. However, GnRHa therapy has profound effects on both...... the hypothalamopituitary-gonadal axis as well as on growth hormone (GH) secretion. Gonadal activity is increased in children with CPP; during GnRHa therapy secretion of gonadal hormones is suppressed as reflected by measurements of LH, FSH, and estradiol/testosterone. More recently, studies of levels of inhibin A and B...... as well as markers of androgen action such as SHBG and prostate specific antigen have demonstrated marked suppression of gonadal function possibly to infra-physiological levels. The possible long-term consequences of these observations have yet to be determined. Detailed analyses of the GH-IGF-I axis have...

  10. Breast cancer after hormone replacement therapy--does prognosis differ in perimenopausal and postmenopausal women?

    Science.gov (United States)

    Baumgärtner, A K; Häusler, A; Seifert-Klauss, V; Schuster, T; Schwarz-Boeger, U; Kiechle, M

    2011-10-01

    Hormone replacement therapy (HRT) has been associated with higher incidence of breast cancer in postmenopausal women, but it is unclear if breast cancers developing after HRT use have different prognosis. 1053 women with hormone receptor positive non-metastasized breast cancer were analyzed in a retrospective trial, stratifying by HRT use before diagnosis. Postmenopausal HRT users had significantly more early tumor stages (pprognosis in perimenopausal women only (TTP: HR=1.16; OS: HR=1.31). In this retrospective analysis postmenopausal HRT users seemed to have a better breast cancer prognosis. For perimenopausal HRT users however, a trend towards worse prognosis was found.

  11. Effects of aerobic exercise on ectopic lipids in patients with growth hormone deficiency before and after growth hormone replacement therapy.

    Science.gov (United States)

    Christ, Emanuel R; Egger, Andrea; Allemann, Sabin; Buehler, Tania; Kreis, Roland; Boesch, Chris

    2016-01-21

    Growth hormone replacement therapy (GHRT) increases exercise capacity and insulin resistance while it decreases fat mass in growth hormone-deficient patients (GHD). Ectopic lipids (intramyocellular (IMCL) and intrahepatocellular lipids (IHCL) are related to insulin resistance. The effect of GHRT on ectopic lipids is unknown. It is hypothesized that exercise-induced utilization of ectopic lipids is significantly decreased in GHD patients and normalized by GHRT. GHD (4 females, 6 males) and age/gender/waist-matched control subjects (CS) were studied. VO2max was assessed on a treadmill and insulin sensitivity determined by a two-step hyperinsulinaemic-euglycaemic clamp. Visceral (VAT) and subcutaneous (SAT) fat were quantified by MR-imaging. IHCL and IMCL were measured before and after a 2 h exercise at 50-60% of VO2max using MR-spectroscopy (∆IMCL, ∆IHCL). Identical investigations were performed after 6 months of GHRT. VO2max was similar in GHD and CS and significantly increased after GHRT; GHRT significantly decreased SAT and VAT. 2 h-exercise resulted in a decrease in IMCL (significant in CS and GHRT) and a significant increase in IHCL in CS and GHD pre and post GHRT. GHRT didn't significantly impact on ∆IMCL and ∆IHCL. We conclude that aerobic exercise affects ectopic lipids in patients and controls. GHRT increases exercise capacity without influencing ectopic lipids.

  12. The effect of continuous combined conjugated equine estrogen plus medroxyprogesterone acetate and tibolone on cardiovascular metabolic risk factors

    DEFF Research Database (Denmark)

    Skouby, S.O.; Sidelmann, J.J.; Nilas, L.;

    2008-01-01

    OBJECTIVES: Hormone treatment (HT) after the menopause affects lipid and carbohydrate metabolism and inflammation and may modify risk factors relevant for the clinical expression of the metabolic syndrome and cardiovascular disease. Tibolone has pharmacodynamic properties different from other...... hormone preparations. Here, we compare the effect of combined HT and tibolone on metabolic risk markers for the development of cardiovascular disease. METHODS: Postmenopausal women were randomly assigned to 1.25 or 2.5 mg/day of tibolone or oral continuous combined conjugated equine estrogen plus...

  13. Influence of modified transdermal hormone replacement therapy on the concentrations of hormones, growth factors, and bone mineral density in women with osteopenia.

    Science.gov (United States)

    Stanosz, Staniaław; Zochowska, Ewa; Safranow, Krzysztof; Sieja, Krzysztof; Stanosz, Małgorzta

    2009-01-01

    The metabolic and therapeutic action of estrogens depends on their type, dosage, form, route of administration, and treatment-free interval during the therapeutic cycle. Hormone therapy is generally subclassified into 2 forms that differ in the type of hormones. In hormonal replacement therapy (HRT), estrogens and progesterone components do not differ in chemical structure and molecular mass from those naturally produced by the female organism. In hormonal supplementary therapy (HST), the estrogen and progestagen components do differ from the natural hormones in structure and mass. The aim of the study was to compare 2 kinds of hormonal therapy in early postmenopausal women with osteopenia. These forms of therapy are modified transdermal HRT and orally given HST. The objective of this study was the estimation of sex hormone, insulin-like growth factor I (IGF-I), prolactin (PRL), osteocalcin, and procollagen concentration in serum as well as the degree of mineralization of the lumbar spine in women in the early postmenopausal period with osteopenia under different kinds of hormonal therapy. The study was conducted in 75 women with an average age of 52.4 +/- 3.5 years and with primary osteopenia, in the early postmenopausal period, who were randomly assigned to 3 groups depending on the form and route of administration of therapy: Group I (n = 25, control) was receiving placebo in the form of patches. Group II (n = 25) was treated with modified transdermal HRT. This group obtained micronized 17beta-estradiol at increasing-decreasing doses and progesterone in the second phase of the therapeutic cycle. Group III (n = 25) was receiving orally given HST and obtained Cyclo-Menorette (Wyeth, Munster, Germany). The therapeutic cycle in each group lasted 21 days, followed by a 7-day medication-free interval. Estradiol concentration in serum was increased 5-fold and estrone (E(1)) was increased about 11-fold in the group of women receiving orally given HST (P hormone was

  14. Transdermal hormone therapy in postmenopausal women: A review of metabolic effects and drug delivery technologies

    Directory of Open Access Journals (Sweden)

    Nathan W Kopper

    2008-10-01

    Full Text Available Nathan W Kopper, Jennifer Gudeman, Daniel J ThompsonKV Pharmaceutical, St. Louis, MO, USAAbstract: Vasomotor symptoms (VMS associated with menopause can cause significant discomfort and decrease the quality of life for women in the peri-menopausal and post-menopausal stages of life. Hormone therapy (HT is the mainstay of treatment for menopausal symptoms and is currently the only therapy proven effective for VMS. Numerous HT options are available to treat VMS, including estrogen-only and estrogen-progestogen combination products to meet the needs of both hysterectomized and nonhysterectomized women. In addition to selecting an appropriate estrogen or estrogen-progestogen combination, consideration should be given to the route of administration to best suit the needs of the patient. Delivery systems for hormone therapy include oral tablets, transdermal patches, transdermal topical (nonpatch products, and intravaginal preparations. Oral is currently the most commonly utilized route of administration in the United States. However, evidence suggests that oral delivery may lead to some undesirable physiologic effects caused by significant gut and hepatic metabolism. Transdermal drug delivery may mitigate some of these effects by avoiding gut and hepatic first-pass metabolism. Advantages of transdermal delivery include the ability to administer unmetabolized estradiol directly to the blood stream, administration of lower doses compared to oral products, and minimal stimulation of hepatic protein production. Several estradiol transdermal delivery technologies are available, including various types of patches, topical gels, and a transdermal spray.Keywords: estradiol, hormone therapy, menopause, transdermal drug delivery, vasomotor symptoms

  15. Impacto da terapia hormonal sobre o peso corpóreo Impact of hormone replacement therapy on body weight

    Directory of Open Access Journals (Sweden)

    Joana Palmira Martins Almeida

    2011-10-01

    Full Text Available OBJETIVO: avaliar o efeito da terapêutica hormonal (TH no peso de mulheres na peri-menopausa, assim como o efeito de diferentes regimes terapêuticos no referido parâmetro. MÉTODOS: estudo retrospectivo de 139 mulheres, com menopausa há menos de 2 anos, acompanhadas na consulta de climatério do nosso departamento. Obtiveram-se dois grupos: mulheres a quem se iniciou TH (n=89 e outro, grupo controle, sem terapia hormonal (n=50. Em cada grupo, foi avaliada a modificação ponderal no intervalo de 1 ano após a primeira consulta. Nas submetidas a TH, avaliou-se esse mesmo parâmetro em função de diferentes regimes terapêuticos preconizados: estrogênio isolado vs estroprogestagênio e dose standard vs baixa dosagem. A análise estatística foi realizada com recurso ao programa SPSS®, adotando-se como nível de significância valores pPURPOSE: to evaluate the effect of hormone replacement therapy (HT on the weight on perimenopausal women as well as the effect of different treatment regimens on this parameter. METHODS: a retrospective study of 139 women with menopause for less than 2 years, who were monitored with periodical visits in our department. We compared two groups: women who started HT (n=89 with women who had no hormonal treatment (n=50 and in the two groups, we evaluated the changes in body weight over a 1-year period. In the first group, we assessed the same parameter as a function of different treatment regimens: estrogen alone versus estrogen combined with progestin and standard dose versus low dose. The SPSS® program was used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the groups were similar with respect to demographic and baseline characteristics; weight gain was higher in the untreated group (434 vs 76 g, but the difference observed was not significant (p = 0.406; among HT users, those taking estrogen alone had an increased weight gain compared to women taking estrogen with progestin

  16. Phytoestrogens as alternative hormone replacement therapy in menopause: What is real, what is unknown.

    Science.gov (United States)

    Moreira, Ana C; Silva, Ana M; Santos, Maria S; Sardão, Vilma A

    2014-09-01

    Menopause is characterized by an altered hormonal status and by a decrease in life quality due to the appearance of uncomfortable symptoms. Nowadays, with increasing life span, women spend one-third of their lifetime under menopause. Understanding menopause-associated pathophysiology and developing new strategies to improve the treatment of menopausal-associated symptoms is an important topic in the clinic. This review describes physiological and hormone alterations observed during menopause and therapeutic strategies used during this period. We critically address the benefits and doubts associated with estrogen/progesterone-based hormone replacement therapy (HRT) and discuss the use of phytoestrogens (PEs) as a possible alternative. These relevant plant-derived compounds have structural similarities to estradiol, interacting with cell proteins and organelles, presenting several advantages and disadvantages versus traditional HRT in the context of menopause. However, a better assessment of PEs safety/efficacy would warrant a possible widespread clinical use.

  17. Premenstrual Exacerbation of Life-Threatening Asthma: Effect of Gonadotrophin Releasing Hormone Analogue Therapy

    Directory of Open Access Journals (Sweden)

    Alun L Edwards

    1996-01-01

    Full Text Available Variability in the severity of asthma during various phases of the menstrual cycle has been frequently suspected. However, the hormonal changes that might affect mediators of bronchospasm have yet to be elucidated. The case of a 41-year-old woman suffering from longstanding asthma with life-threatening exacerbations is reported. The patient was treated with buserelin, a gonadotropin releasing hormone (GnRH analogue, which created a temporary chemical menopause and thus permitted diagnosis of a premenstrual exacerbation of asthma and offered insight into potential therapy. GnRH analogues may therefore be of value in assessing women with severe asthma suspected to vary with the menstrual cycle. The addition of estrogens and progestins at the same time as treatment with GnRH analogue may be of value in determining the role of these hormones in the pathogenesis of menstrually related exacerbations of asthma.

  18. Promotional tone in reviews of menopausal hormone therapy after the Women's Health Initiative: an analysis of published articles.

    Directory of Open Access Journals (Sweden)

    Adriane Fugh-Berman

    2011-03-01

    Full Text Available BACKGROUND: Even after the Women's Health Initiative (WHI found that the risks of menopausal hormone therapy (hormone therapy outweighed benefit for asymptomatic women, about half of gynecologists in the United States continued to believe that hormones benefited women's health. The pharmaceutical industry has supported publication of articles in medical journals for marketing purposes. It is unknown whether author relationships with industry affect promotional tone in articles on hormone therapy. The goal of this study was to determine whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy and whether articles identified as promotional were more likely to have been authored by those with conflicts of interest with manufacturers of menopausal hormone therapy. METHODS AND FINDINGS: We analyzed tone in opinion pieces on hormone therapy published in the four years after the estrogen-progestin arm of the WHI was stopped. First, we identified the ten authors with four or more MEDLINE-indexed reviews, editorials, comments, or letters on hormone replacement therapy or menopausal hormone therapy published between July 2002 and June 2006. Next, we conducted an additional search using the names of these authors to identify other relevant articles. Finally, after author names and affiliations were removed, 50 articles were evaluated by three readers for scientific accuracy and for tone. Scientific accuracy was assessed based on whether or not the findings of the WHI were accurately reported using two criteria: (1 Acknowledgment or lack of denial of the risk of breast cancer diagnosis associated with hormone therapy, and (2 acknowledgment that hormone therapy did not benefit cardiovascular disease endpoints. Determination of promotional tone was based on the assessment by each reader of whether the article appeared to promote hormone therapy. Analysis of inter-rater consistency found moderate agreement

  19. Hepatic adenomatosis associated with hormone replacement therapy and hemosiderosis: A case report

    Institute of Scientific and Technical Information of China (English)

    Satoshi Hagiwara; Hiroyuki Kuwano; Masatomo Mori; Hitoshi Takagi; Daisuke Kanda; Naondo Sohara; Satoru Kakizaki; Kenji Katakai; Teruo Yoshinaga; Tsugio Higuchi; Kenichi Nomoto

    2006-01-01

    We have reported a case of hepatic adenomatosis associated with hormone replacement therapy (estrogen and progesterone) and hemosiderosis caused by excessive blood transfusion for the treatment of chronic myeloid leukemia. A 34-year-old woman was found to have several hepatic tumors on a routine medical examination. The general condition was good.Laboratory studies showed iron overload. Abdominal computed tomography and selective hepatic angiography showed several hypervascular tumors in the right lobe of the liver (up to 20 mm in diameter). Since hepatocellular carcinoma could not be ruled out, subsegmental hepatectomy was performed. Histopathological examination of the surgical specimen showed hepatic adenomatosis with hemosiderosis. Both hormone replacement therapy and iron overload could be the cause of hepatic adenomatosis.

  20. Use and discontinuation of hormone replacement therapy in women with myocardial infarction: a nationwide study

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Hansen, P. R.; Abildstrom, S. Z.

    2011-01-01

    center dot General use of hormone replacement therapy (HRT) dropped drastically after 2002 when pivotal randomized trials showed increased risk of coronary artery disease and other complications with HRT. center dot HRT is not recommended for primary or secondary prevention of coronary heart...... disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). center dot It is unknown whether women actually discontinue HRT after MI. WHAT THIS STUDY ADDS center dot Women who use HRT when they experience their MI generally continue using HRT. center dot We found a remarkably...... low increase in discontinuation after 2002, in contrast to the general drop in use of HRT. AIM To characterize the pattern of use and discontinuation of postmenopausal hormone replacement therapy (HRT) in women with myocardial infarction (MI) before and after 2002, where the general use of HRT dropped...

  1. How Should Physicians Help Gender-Transitioning Adolescents Consider Potential Iatrogenic Harms of Hormone Therapy?

    Science.gov (United States)

    Steensma, Thomas D; Wensing-Kruger, S Annelijn; Klink, Daniel T

    2017-08-01

    Counseling and treatment of transgender youth can be challenging for mental health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. Is a gender identity diagnosis helpful? What is the right time to treat, and should the adolescent's age matter in decision making? In this article, we discuss these questions in light of a case in which an adolescent wishes to pursue hormone therapy. Our analysis focuses on the importance of balanced decision making when counseling and treating adolescents with nonconforming gender identities. We argue that clinicians' communicating appropriate expectations about the effectiveness and limitations of hormone therapy and the risks of psychological and physical iatrogenic effects is critical. © 2017 American Medical Association. All Rights Reserved.

  2. Development of a growth-hormone-conjugated nanodiamond complex for cancer therapy.

    Science.gov (United States)

    Chu, Hsueh-Liang; Chen, Hung-Wei; Tseng, Shin-Hua; Hsu, Ming-Hua; Ho, Li-Ping; Chou, Fu-Hsuan; Li, Md Phd Hsing-Yuan; Chang, Yu-Chuan; Chen, Pei-Hsin; Tsai, Li-Yun; Chou, Ching-Chung; Chen, Jyh Shin; Cheng, Tsai-Mu; Chang, Chia-Ching

    2014-05-01

    It is highly desirable to develop a therapeutic, observable nanoparticle complex for specific targeting in cancer therapy. Growth hormone (GH) and its antagonists have been explored as cancer cell-targeting molecules for both imaging and therapeutic applications. In this study, a low toxicity, biocompatible, therapeutic, and observable GH-nanoparticle complex for specifically targeting growth hormone receptor (GHR) in cancer cells was synthesized by conjugating GH with green fluorescence protein and carboxylated nanodiamond. Moreover, we have shown that this complex can be triggered by laser irradiation to create a "nanoblast" and induce cell death in the A549 non-small-cell lung cancer cell line via the apoptotic pathway. This laser-mediated, cancer-targeting platform can be widely used in cancer therapy.

  3. Effect of electroconvulsive therapy without anticonvulsive premedication on serum growth hormone in man.

    Science.gov (United States)

    Vigas, M; Stowasserová, N; Németh, S; Jurcovicová, J

    1975-01-01

    Serum concentrations of human growth hormone (HGH) were measured in psychiatric patients during the first, third and sixth electroconvulsive therapy (ECT) without anticonvulsive premedication. Serum HGH increased 30 min after the application of current and no differences were found between responses to 1st, 3rd, or 6th ECT. Maximal increase of serum glucose was seen after the first ECT and gradual decreases after the 3rd and 6th ECT were observed

  4. Impact of recent studies on attitudes and use of hormone therapy among Scandinavian gynaecologists

    DEFF Research Database (Denmark)

    Pedersen, Anette Tønnes; Iversen, Ole-Erik; Løkkegaard, Ellen

    2007-01-01

    Climacteric medicine has been in focus during the last 2 decades, and an intensive debate has been ongoing regarding the positive and negative aspects of postmenopausal hormone therapy (HT). Recent randomised controlled studies have been unable to confirm data from observational studies of primar...... of the present study was to re-assess the same parameters concerning HT among Scandinavian gynaecologists in 2002-2003, and compare the results with the data collected in 1995-1997....

  5. The Miracle Drug : Hormone Replacement Therapy and Labor Market Behavior of Middle-Aged Women

    OpenAIRE

    Meltem Daysal, N.; Orsini, C.

    2012-01-01

    Abstract: In an aging society, determining which factors contribute to the employment of older individuals is increasingly important. This paper sheds light on the impact of medical innovation in the form of Hormone Replacement Therapy (HRT) on employment of middle-aged women. HRT are drugs taken by middle-aged women to soften symptoms related to menopause. Before 2002, HRT products were among the most popular prescription drugs in America. We use the timing of the release of information of t...

  6. Natural products and no-hormone therapy for the treatment of vasomotor symptoms affecting menopause women

    Directory of Open Access Journals (Sweden)

    Jaime Urdinola

    2005-08-01

    Full Text Available Among menopausal women receiving hormone therapy, whether combinedor with estrogens alone, there has always been a great worryabout the side effects or the potential development of cancer.This is especially true among women that have survived breastcancer, in the event the disease may reoccur. However there arealternatives for women not willing to take these standard therapiesfor their estrogen deficiency. This revision presents the up-to-dateevidence about the efficiency and safety of these compounds usedto treat this problem.

  7. Vaginal estrogen products in hormone receptor-positive breast cancer patients on aromatase inhibitor therapy.

    Science.gov (United States)

    Sulaica, Elisabeth; Han, Tiffany; Wang, Weiqun; Bhat, Raksha; Trivedi, Meghana V; Niravath, Polly

    2016-06-01

    Atrophic vaginitis represents a major barrier to compliance with aromatase inhibitor (AI) therapy in breast cancer (BC) survivors. While local estrogen therapy is effective for postmenopausal vaginal dryness, the efficacy of such therapies has not been evaluated systematically in hormone receptor-positive (HR+) BC patients on AI therapy. Furthermore, the potential risk of breast cancer recurrence with vaginal estrogen therapy represents a long-term safety concern for the patients with HR + BC. Unfortunately, there is no standardized assay to measure very low concentrations of estradiol (E2) in these women being treated with AI therapy. This makes it difficult to evaluate even indirectly the potential risk of BC recurrence with vaginal estrogen therapy in HR + BC patients on AI therapy. In this review, we describe available assays to measure very low concentrations of E2, discuss the Food and Drug Administration-approved vaginal estrogen products on the market, and summarize published and ongoing clinical trials evaluating the safety and efficacy of vaginal estrogen in HR + BC patients on AI therapy. In the absence of any randomized controlled clinical trials, this review serves as a summary of available clinical data and ongoing studies to aid clinicians in selecting the best available option for their patients.

  8. Growth hormone inhibition causes increased selenium levels in Duchenne muscular dystrophy: a possible new approach to therapy.

    Science.gov (United States)

    Collipp, P J; Kelemen, J; Chen, S Y; Castro-Magana, M; Angulo, M; Derenoncourt, A

    1984-08-01

    Nine children with Duchenne muscular dystrophy were given Sanorex (mazindol), a growth hormone inhibitor, daily for 6 months. There was no significant change in their muscle function, but there was a significant reduction in weight gain and in levels of growth hormone, somatomedin C, hair zinc, serum zinc, and serum LDH. Selenium and glutathione peroxidase in the serum increased significantly. Thirteen other children with growth hormone deficiency had a significant reduction in hair selenium following growth hormone administration. These results show a significant relationship between growth hormone and selenium nutritional status and confirm our previous reports indicating an effect of growth hormone on zinc nutritional status. It is possible that prolonged therapy with a growth hormone inhibitor would attenuate the course and improve the longevity of patients with muscular dystrophy.

  9. The effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy in postmenopausal women: an observational cohort study.

    Science.gov (United States)

    Ruiz, Andres D; Daniels, Kelly R

    2014-01-01

    Prior studies demonstrated improved menopausal symptom relief following treatment with compounded bioidentical hormone replacement therapy; however, clinical effectiveness studies evaluating different routes of bioidentical hormone replacement therapy administration are lacking. The objective of this study was to determine the effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy for the treatment of vasomotor, mood, and other quality-of-life symptoms in post-menopausal women. This was a prospective, observational cohort study of women > or = 18 years of age who received a compounded sublingual or topical bioidentical hormone replacement therapy preparation between January 1, 2003 and October 1, 2010 in a community pharmacy. Data collection included patient demographics, comorbidities, hormone regimens, and therapeutic outcomes. Patients rated their vasomotor, mood, and quality-of-life symptoms as absent, mild, moderate, or severe at baseline, at one to three months follow-up, and three to six months follow-up. Baseline characteristics were compared using the chi-square test for categorical variables and the Wilcoxon rank sum test for continuous variables. Symptom intensity between baseline and follow-up periods were compared using the Wilcoxon signed-rank test. A total of 200 patients met study criteria; 160 received topical bioidentical hormone replacement therapy, and 40 received sublingual bioidentical hormone replacement therapy. Most sublingually-treated patients (70%) received an estrogen combination and 100% received progesterone. Nearly half (43%) of the topically treated patients received an estrogen combination (43%) and 99% received progesterone. The percentage of sublingually treated patients reporting "moderate" or "severe" symptoms was significantly reduced at one to three months follow-up for the following target symptoms: hot flashes (31%, P = 0.04), night sweats (38%, P sublingual bioidentical hormone

  10. [Hormone replacement therapy among Norwegian women. Self-reported use and sales of estrogen preparations].

    Science.gov (United States)

    Søgaard, A J; Fønnebø, V; Magnus, J H; Tollan, A

    1998-02-10

    In order to analyse the use of hormone replacement therapy (HRT) and the predicting factors for its use, two random samples of Norwegian women (30-79 years) were interviewed by the Central Bureau of Statistics in 1994 (n = 565) and in 1996 (n = 470). The extent of use of HRT was compared with statistics for sales of oestrogen in Norway and the Nordic countries. In the age group 45-69 years the use of hormone replacement therapy increased from 16.3% in 1994 to 19.1% in 1996. The proportion of users did not increase with a higher level of education. In addition to information received, and after adjusting for other variables, attitudes towards oestrogen and knowledge about it were the most important contributing factors for using HRT. Sales figures show that the use of systemic oestrogen in Norway has increased more than 280% since 1990. None of the Nordic countries have had a corresponding increase, but the Norwegian figures are still low compared to most other Nordic countries. In 1996 14.5% of Norwegian women (50-79 years) used oestrogen for urogenital disorders. Norwegian women need to be better informed and more knowledgeable to enable them to make conscious choice regarding use of hormone replacement therapy.

  11. Second-line hormonal therapy with the enzalutamid in patients with castrate-resistant prostate cancer

    Directory of Open Access Journals (Sweden)

    B. Ya. Alekseev

    2016-01-01

    Full Text Available Prostate cancer (PC is an actual problem of modern oncourology due to the continuing high rates of this disease morbidity and mortality. Despite improvements in diagnostic techniques, incidence of common forms of the disease remain to be high. Metastatic castrate-resistant prostate cancer (mCRPC is a disease with an extremely poor prognosis, in which standard methods of hormonal treatment are ineffective. Heterogeneity of CRPC patient population requires differentiated approach to the administration of therapy based on the availability of various prognostic factors. Not so long ago chemotherapy with docetaxel was the main treatment for this group of patients. Second-line hormonal therapy was introduced into clinical practice in 2011 with the advent of new drugs aimed at the complete suppression of testosterone production. Enzalutamid, a new drug for second-line hormonal therapy, has essentially different mechanism of action. It is able to block androgen receptors selectively and disrupt translocation of the signal from the receptor into the cell and into the cell nucleus. Large randomized trials that studied the effectiveness of this drug allowed to register it for clinical use, including our country. An article presents a review of the literature on clinical trials devoted to the use of a drug in CRPC patients. 

  12. Alpha-adrenergic regulation of growth hormone release after electroconvulsive therapy in man.

    Science.gov (United States)

    Vigas, M; Wiedermann, V; Németh, S; Jurcovicová, J; Zigo, L

    1976-01-01

    When electroshcok therapy was administered to male psychiatric patients without anticonvulsive premedication, serum growth hormone (GH) increased; the increase was not prevented by an infusion of 20% glucose (5 ml per min) 20 min prior to electroshock. Therefore, the GH rise is not caused by muscle exercise during convulsions. Infusing 30 mg of phentolamine 40 min prior to electroshcok inhibited the GH response. Phentolamine's effect shows that the stress-induced GH release that follows electroconvulsive therapy is mediated by alpha-adrenergic neurons.

  13. The Role of Sex Hormone Replacement Therapy on Self-Perceived Competence in Adolescents with Delayed Puberty.

    Science.gov (United States)

    Schwab, Jacqueline; Kulin, Howard E.; Susman, Elizabeth J.; Finkelstein, Jordan W.; Chinchilli, Vernon M.; Kunselman, Susan J.; Liben, Lyye S.; D'Arcangelo, M. Rose; Demers, Lawrence M.

    2001-01-01

    Examined role of sex steroids in development of self-perceived competence among adolescents receiving hormone therapy for delayed puberty. Found that hormone treatments had a significant positive effect for both males and females in perceived job competence. Significant positive effects were also obtained for perceptions of romantic appeal and…

  14. Effects of growth hormone deficiency and recombinant growth hormone therapy on postprandial gallbladder motility and cholecystokinin release.

    NARCIS (Netherlands)

    Moschetta, A.; Twickler, M.; Rehfeld, J.F.; Ooteghem, N.A. van; Castro Cabezas, M.; Portincasa, P.; Berge-Henegouwen, G.P. van; Erpecum, K.J. van

    2004-01-01

    In addition to cholecystokinin, other hormones have been suggested to be involved in regulation of postprandial gallbladder contraction. We aimed to evaluate effects of growth hormone (GH) on gallbladder contractility and cholecystokinin release. Gallbladder and gastric emptying (by ultrasound) and

  15. The impact of hormone replacement therapy on menopausal symptoms in younger high-risk women after prophylactic salpingo-oophorectomy

    NARCIS (Netherlands)

    J.B. Madalinska; M. van Beurden; E.M.A. Bleiker; H.B. Valdimarsdottir; J. Hollenstein; L.F. Massuger; K.N. Gaarenstroom; M.J.E. Mourits; R.H.M. Verheijen; E.B.L. van Dorst; H. van der Putten; K. van der Velden; H. Boonstra; N.K. Aaronson

    2006-01-01

    Purpose Preventive health strategies for women at increased hereditary risk of ovarian cancer include gynecologic screening (GS) and/or prophylactic oophorectomy (PBSO). Hormone replacement therapy (HRT) is often prescribed to compensate for postsurgical endocrine deficiencies. This study examined t

  16. The impact of hormone replacement therapy on menopausal symptoms in younger high-risk women after prophylactic salpingo-oophorectomy.

    NARCIS (Netherlands)

    Madalinska, J.B.; Beurden, M. van; Bleiker, E.M.A.; Valdimarsdottir, H.B.; Hollenstein, J.; Massuger, L.F.A.G.; Gaarenstroom, K.N.; Mourits, M.J.E.; Verheijen, R.H.; Dorst, E.B.L. van; Putten, H. van der; Velden, K. van der; Boonstra, H.; Aaronson, N.K.

    2006-01-01

    PURPOSE: Preventive health strategies for women at increased hereditary risk of ovarian cancer include gynecologic screening (GS) and/or prophylactic oophorectomy (PBSO). Hormone replacement therapy (HRT) is often prescribed to compensate for postsurgical endocrine deficiencies. This study examined

  17. The impact of hormone replacement therapy on menopausal symptoms in younger high-risk women after prophylactic salpingo-oophorectomy.

    NARCIS (Netherlands)

    Madalinska, J.B.; Beurden, M. van; Bleiker, E.M.A.; Valdimarsdottir, H.B.; Hollenstein, J.; Massuger, L.F.A.G.; Gaarenstroom, K.N.; Mourits, M.J.E.; Verheijen, R.H.; Dorst, E.B.L. van; Putten, H. van der; Velden, K. van der; Boonstra, H.; Aaronson, N.K.

    2006-01-01

    PURPOSE: Preventive health strategies for women at increased hereditary risk of ovarian cancer include gynecologic screening (GS) and/or prophylactic oophorectomy (PBSO). Hormone replacement therapy (HRT) is often prescribed to compensate for postsurgical endocrine deficiencies. This study examined

  18. Estrogen, vascular estrogen receptor and hormone therapy in postmenopausal vascular disease.

    Science.gov (United States)

    Khalil, Raouf A

    2013-12-15

    Cardiovascular disease (CVD) is less common in premenopausal women than men of the same age or postmenopausal women, suggesting vascular benefits of estrogen. Estrogen activates estrogen receptors ERα, ERβ and GPR30 in endothelium and vascular smooth muscle (VSM), which trigger downstream signaling pathways and lead to genomic and non-genomic vascular effects such as vasodilation, decreased VSM contraction and growth and reduced vascular remodeling. However, randomized clinical trials (RCTs), such as the Women's Health Initiative (WHI) and Heart and Estrogen/progestin Replacement Study (HERS), have shown little vascular benefits and even adverse events with menopausal hormone therapy (MHT), likely due to factors related to the MHT used, ER profile, and RCT design. Some MHT forms, dose, combinations or route of administration may have inadequate vascular effects. Age-related changes in ER amount, distribution, integrity and post-ER signaling could alter the vascular response to MHT. The subject's age, preexisting CVD, and hormone environment could also reduce the effects of MHT. Further evaluation of natural and synthetic estrogens, phytoestrogens, and selective estrogen-receptor modulators (SERMs), and the design of appropriate MHT combinations, dose, route and 'timing' could improve the effectiveness of conventional MHT and provide alternative therapies in the peri-menopausal period. Targeting ER using specific ER agonists, localized MHT delivery, and activation of specific post-ER signaling pathways could counter age-related changes in ER. Examination of the hormone environment and conditions associated with hormone imbalance such as polycystic ovary syndrome may reveal the causes of abnormal hormone-receptor interactions. Consideration of these factors in new RCTs such as the Kronos Early Estrogen Prevention Study (KEEPS) could enhance the vascular benefits of estrogen in postmenopausal CVD. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Serum estrogen and SHBG levels and breast cancer incidence among users and never users of hormone replacement therapy

    DEFF Research Database (Denmark)

    Würtz, Anne Mette Lund; Tjønneland, Anne; Christensen, Jane Hvarregaard;

    2012-01-01

    Levels of endogenous estrogen and SHBG are associated with risk of breast cancer among women who have never used hormone replacement therapy (HRT). We investigated these associations in both never and baseline users of HRT.......Levels of endogenous estrogen and SHBG are associated with risk of breast cancer among women who have never used hormone replacement therapy (HRT). We investigated these associations in both never and baseline users of HRT....

  20. Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma: Influence of Gonadal Hormone Exposure.

    Science.gov (United States)

    Krul, Inge M; Opstal-van Winden, Annemieke W J; Aleman, Berthe M P; Janus, Cécile P M; van Eggermond, Anna M; De Bruin, Marie L; Hauptmann, Michael; Krol, Augustinus D G; Schaapveld, Michael; Broeks, Annegien; Kooijman, Karen R; Fase, Sandra; Lybeert, Marnix L; Zijlstra, Josée M; van der Maazen, Richard W M; Kesminiene, Ausrele; Diallo, Ibrahima; de Vathaire, Florent; Russell, Nicola S; van Leeuwen, Flora E

    2017-07-18

    Young women treated with chest radiation therapy (RT) for Hodgkin lymphoma (HL) experience a strongly increased risk of breast cancer (BC). It is unknown whether endogenous and exogenous gonadal hormones affect RT-associated BC risk. We conducted a nested case-control study among female 5-year HL survivors treated before age 41. Hormone exposure and HL treatment data were collected through medical records and questionnaires for 174 BC case patients and 466 control patients. Radiation dose to breast tumor location was estimated based on RT charts, simulation films, and mammography reports. We observed a linear radiation dose-response curve with an adjusted excess odds ratio (EOR) of 6.1%/Gy (95% confidence interval [CI]: 2.1%-15.4%). Women with menopause <30 years (caused by high-dose procarbazine or pelvic RT) had a lower BC risk (OR, 0.13; 95% CI, 0.03-0.51) than did women with menopause ≥50 years. BC risk increased by 6.4% per additional year of post-RT intact ovarian function (P<.001). Among women with early menopause (<45 years), hormone replacement therapy (HRT) use for ≥2 years did not increase BC risk (OR, 0.86; 95% CI, 0.32-2.32), whereas this risk was nonsignificantly increased among women without early menopause (OR, 3.69; 95% CI, 0.97-14.0; P for interaction: .06). Stratification by duration of post-RT intact ovarian function or HRT use did not statistically significantly modify the radiation dose-response curve. BC risk in female HL survivors increases linearly with radiation dose. HRT does not appear to increase BC risk for HL survivors with therapy-induced early menopause. There are no indications that endogenous and exogenous gonadal hormones affect the radiation dose-response relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Cutaneous adverse effects of hormonal adjuvant therapy for breast cancer: a case of localised urticarial vasculitis following anastrozole therapy and a review of the literature.

    Science.gov (United States)

    Bock, Vanessa L; Friedlander, Michael; Waring, Dale; Kossard, Steven; Wood, Glenda K

    2014-11-01

    Hormonal therapy with either tamoxifen or aromatase inhibitors is commonly used to treat women with breast cancer in both the adjuvant and recurrent disease setting. Cutaneous adverse reactions to these drugs have been rarely reported in the literature. We report an unusual case of urticarial vasculitis following the aromatase inhibitor anastrozole that localised to the unilateral trunk and mastectomy scar, and review the literature on the cutaneous adverse effects of hormonal therapy for breast cancer.

  2. An Epidemiologic Study of Genetic Variation in Hormonal Pathways in Relation to the Effect of Hormone Replacement Therapy on Breast Cancer Risk

    Science.gov (United States)

    2008-10-01

    hormone therapy in breast cancer risk.” Kerryn W. Reding, Chu Chen, Christopher I. Li, Christopher S. Carlson, Jasmine Wilkerson, Frederico M...therapy in breast cancer risk.” Kerryn W. Reding, Chu Chen, Christopher I. Li, Christopher S. Carlson, Jasmine Wilkerson, Frederico M. Farin, Kenneth E...Chen, Christopher I. Li, Christopher S. Carlson, Jasmine Wilkerson, Frederico M. Farin, Kenneth E. Thummel, Janet R. Daling, and Kathleen E. Malone

  3. Hormone replacement therapy and menopause%绝经期激素替代疗法

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    SUMMARY Hormone replacement therapy (HRT) was initiated almost half a century ago to treat menopausal symptoms. Initially, its use remained limited even among symptomatic women and the move toward postmenopausal hormone use for disease prevention came later. Improved treatment schedules and delivery systems expanded the use of HRT worldwide. However, large trials of postmenopausal hormones with disease outcomes were even later in coming and today HRT has become a specialized, multidisciplinary area of research. As the population continues to grow older, there has been an increased focus on the effects of ageing. HRT may affect length and quality of life through disease prevention. It may have possible beneficial effects on cognition, on the incidence of hip fracture, myocardial infarction and stroke, and adverse effects on the incidence of breast cancer, endometrial cancer, and venous thromboembolism.Today's attitudes about the hormonal treatments for the menopausal transition have moved from expansive optimism to contracting disappointment amidst safety concerns and equivocal results and faces greater skepticism and scrutiny. The health and well being of large numbers of women are at stake, and researchers, clinicians and the general public are watching and weighing the options.

  4. The role of hormone replacement therapy in the intensive care management of deceased organ donors: a primer for nurses.

    Science.gov (United States)

    Smetana, Keaton S; Kimmons, Lauren A; Jones, G Morgan

    2015-01-01

    Donation after brain death remains the primary contributor to the supply of organs available for transplantation in the United States. After brain death, both a surge of catecholamines and a dysregulation of the neurohormonal axis may result in hypotension, decreased organ perfusion, and reduced viability of organs to be transplanted. Hormone replacement therapy is widely used to maintain organ perfusion and has been shown to increase the number of organs procured. This article reviews the literature and mechanisms supporting the use of hormone replacement therapy in brain-dead organ donors and provides clinicians with information regarding the administration, monitoring, and preparation of thyroid hormone, arginine vasopressin, and corticosteroids.

  5. The effect of hormone therapy on women's quality of life in the first year of the Estonian Postmenopausal Hormone Therapy trial

    Directory of Open Access Journals (Sweden)

    Veerus Piret

    2012-04-01

    Full Text Available Abstract Background For postmenopausal women, the main reason to start hormone therapy (HT is to reduce menopausal symptoms and to improve quality of life (QOL. The aim of this study was to analyse the impact of HT on different aspects of symptom experience and QOL during a randomised trial. A total of 1823 postmenopausal women were recruited into the Estonian Postmenopausal Hormone Therapy (EPHT trial in 1999–2001. Women were randomised to blind HT, open-label HT, placebo or non-treatment arm. After one year in the trial, a questionnaire was mailed and 1359 women (75% responded, 686 in the HT arms and 673 in the non-HT arms. Mean age at filling in the questionnaire was 59.8 years. The questionnaire included Women's Health Questionnaire (WHQ to assess menopause specific QOL of middle-aged women together with a 17-item questionnaire on symptoms related to menopause, a question about painful intercourse, and a question about women's self-rated health. Results After one year in the trial, fewer women in the HT arms reported hot flashes, trouble sleeping, and sweating on the symptom questionnaire. According to WHQ, women in the HT arms had fewer vasomotor symptoms, sleep problems, and problems with sexual behaviour, but more menstrual symptoms; HT had no effect on depression, somatic symptoms, memory, attractiveness, or anxiety. A smaller proportion of women reported painful intercourse in the HT arms. There were no significant differences between the trial arms in women’s self-rated subjective health. Conclusions The results from the EPHT trial confirm that HT is not justified for treating symptoms, other than vasomotor symptoms, among postmenopausal women. WHQ proved to be a useful and sensitive tool to assess QOL in this age group of women.

  6. Progressive pituitary hormone deficiency following radiation therapy in adults; Deficiencia progressiva dos hormonios adeno-hipofisarios apos radioterapia em adultos

    Energy Technology Data Exchange (ETDEWEB)

    Loureiro, Rafaela A.; Vaisman, Mario [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia]. E-mail: rafaela_loureiro@hotmail.com

    2004-10-01

    Hypopituitarism can be caused by radiation therapy, even when it is not directly applied on the hypothalamic-pituitary axis, and can lead to anterior pituitary deficiency mainly due to hypothalamic damage. The progressive loss of the anterior pituitary hormones usually occurs in the following order: growth hormone, gonadotropin hormones, adrenocorticotropic hormone and thyroid-stimulating hormone. Although there are several different tests available to confirm anterior pituitary deficiency, this paper will focus on the gold standard tests for patients submitted to radiation therapy. We emphasize that the decline of anterior pituitary function is time- and dose-dependent with some variability among the different axes. Therefore, awareness of the need of a joint management by endocrinologists and oncologists is essential to improve treatment and quality of life of the patients. (author)

  7. What is the influence of hormone therapy on homocysteine and crp levels in postmenopausal women?

    Directory of Open Access Journals (Sweden)

    Eli Marcelo Lakryc

    2015-02-01

    Full Text Available OBJECTIVE: To evaluate the influence of estrogen therapy and estrogen-progestin therapy on homocysteine and C-reactive protein levels in postmenopausal women. METHODS: In total, 99 postmenopausal women were included in this double-blind, randomized clinical trial and divided into three groups: Group A used estrogen therapy alone (2.0 mg of 17β-estradiol, Group B received estrogen-progestin therapy (2.0 mg of 17 β-estradiol +1.0 mg of norethisterone acetate and Group C received a placebo (control. The length of treatment was six months. Serum measurements of homocysteine and C-reactive protein were carried out prior to the onset of treatment and following six months of therapy. RESULTS: After six months of treatment, there was a 20.7% reduction in homocysteine levels and a 100.5% increase in C-reactive protein levels in the group of women who used estrogen therapy. With respect to the estrogen-progestin group, there was a 12.2% decrease in homocysteine levels and a 93.5% increase in C-reactive protein levels. CONCLUSION: Our data suggested that hormone therapy (unopposed estrogen or estrogen associated with progestin may have a positive influence on decreasing cardiovascular risk due to a significant reduction in homocysteine levels.

  8. Prostate cancer: what are the news in hormonal therapy? The role of GnRH antagonists.

    Science.gov (United States)

    Zattoni, Filiberto

    2012-09-01

    The latest EAU guidelines on the evidence based-management of prostate cancer (P.Ca.), with regard to pharmacological androgen deprivation therapy (ADT), reiterate that the primary objective of hormonal therapy is to slow down the progression of the disease to the greatest possible extent. Degarelix a new product for the treatment of hormone-dependent P.Ca. has recently become available in Italy. This product is classified as a GnRH antagonist and provides safe and effective ADT. It completely blocks the synthesis and release of gonadotropins (LH and FSH), thus rapidly reducing the testosterone levels without causing clinical flare. The results of the clinical trials (36 months) demonstrate that degarelix, compared to high-dose leuprorelin (7.5 mg), suppresses levels of testosterone and PSA (Prostate-Specific Antigen) more rapidly and reduces levels of FSH and musculoskeletal events associated with treatment (pain, muscle weakness, spasms, oedema/joint stiffness, arthralgia, osteoporosis and osteopoenia) to a greater extent. In addition, these results demonstrate a significant increase in the probability of PSA progression-free survival, suggesting a possible delay in the onset of the "castration-resistant" stage. The information available to date supports the use of this new molecule as a valid alternative to GnRH agonists in the treatment of hormone-sensitive P.Ca.

  9. Long-term Effects on Cognitive Trajectories of Postmenopausal Hormone Therapy in Two Age Groups.

    Science.gov (United States)

    Espeland, Mark A; Rapp, Stephen R; Manson, JoAnn E; Goveas, Joseph S; Shumaker, Sally A; Hayden, Kathleen M; Weitlauf, Julie C; Gaussoin, Sarah A; Baker, Laura D; Padula, Claudia B; Hou, Lifang; Resnick, Susan M

    2017-06-01

    Postmenopausal hormone therapy may have long-term effects on cognitive function depending on women's age. Postintervention follow-up was conducted with annual cognitive assessments of two randomized controlled clinical trial cohorts, beginning an average of 6-7 years after study medications were terminated: 1,376 women who had enrolled in the Women's Health Initiative when aged 50-54 years and 2,880 who had enrolled when aged 65-79 years. Women had been randomly assigned to 0.625mg/d conjugated equine estrogens (CEE) for those with prior hysterectomy (mean 7.1 years), CEE with 2.5mg/d medroxyprogesterone acetate for those without prior hysterectomy (mean 5.4 years), or matching placebos. Hormone therapy, when prescribed to women aged 50-54 years, had no significant long-term posttreatment effects on cognitive function and on changes in cognitive function. When prescribed to older women, it was associated with long-term mean (SE) relative decrements (standard deviation units) in global cognitive function of 0.081 (0.029), working memory of 0.070 (0.025), and executive function of 0.054 (0.023), all p therapy regimen, prior use, or years from last menstrual period. Mean intervention effects were small; however, the largest were comparable in magnitude to those seen during the trial's active intervention phase. CEE-based hormone therapy delivered near the time of menopause provides neither cognitive benefit nor detriment. If administered in older women, it results in small decrements in several cognitive domains that remain for many years.

  10. Clinical relevance of "withdrawal therapy" as a form of hormonal manipulation for breast cancer

    Directory of Open Access Journals (Sweden)

    Robertson John FR

    2011-09-01

    Full Text Available Abstract Background It has been shown in in-vitro experiments that "withdrawal" of tamoxifen inhibits growth of tumor cells. However, evidence is scarce when this is extrapolated into clinical context. We report our experience to verify the clinical relevance of "withdrawal therapy". Methods Breast cancer patients since 1998 who fulfilled the following criteria were selected from the departmental database and the case-notes were retrospectively reviewed: (1 estrogen receptor positive, operable primary breast cancer in elderly (age > 70 years, locally advanced or metastatic breast cancer; (2 disease deemed suitable for treatment by hormonal manipulation; (3 disease assessable by UICC criteria; (4 received "withdrawal" from a prior endocrine agent as a form of therapy; (5 on "withdrawal therapy" for ≥ 6 months unless they progressed prior. Results Seventeen patients with median age of 84.3 (53.7-92.5 had "withdrawal therapy" as second to tenth line of treatment following prior endocrine therapy using tamoxifen (n = 10, an aromatase inhibitor (n = 5, megestrol acetate (n = 1 or fulvestrant (n = 1. Ten patients (58.8% had clinical benefit (CB (complete response/partial response/stable disease ≥ 6 months with a median duration of Clinical Benefit (DoCB of 10+ (7-27 months. Two patients remain on "withdrawal therapy" at the time of analysis. Conclusion "Withdrawal therapy" appears to produce sustained CB in a significant proportion of patients. This applies not only to "withdrawal" from tamoxifen, but also from other categories of endocrine agents. "Withdrawal" from endocrine therapy is, therefore, a viable intercalating option between endocrine agents to minimise resistance and provide additional line of therapy. It should be considered as part of the sequencing of endocrine therapy.

  11. Breast cancer with different prognostic characteristics developing in Danish women using hormone replacement therapy

    DEFF Research Database (Denmark)

    Stahlberg, Claudia; Pedersen, A T; Andersen, Zorana Jovanovic;

    2004-01-01

    The aim of this study is to investigate the risk of developing prognostic different types of breast cancer in women using hormone replacement therapy (HRT). A total of 10 874 postmenopausal Danish Nurses were followed since 1993. Incident breast cancer cases and histopathological information were...... retrieved through the National Danish registries. The follow-up ended on 31 December 1999. Breast cancer developed in 244 women, of whom 172 were invasive ductal carcinomas. Compared to never users, current users of HRT had an increased risk of a hormone receptor-positive breast cancer, but a neutral risk...... of receptor-negative breast cancer, relative risk (RR) 3.29 (95% confidence interval (CI): 2.27-4.77) and RR 0.99 (95% CI: 0.42-2.36), respectively (P for difference=0.013). The risk of being diagnosed with low histological malignancy grade was higher than high malignancy grade with RR 4.13 (95% CI: 2...

  12. Managing the menopause - British Menopause Society Council consensus statement on hormone replacement therapy.

    Science.gov (United States)

    Pitkin, Joan; Rees, Margaret C P; Gray, Sarah; Lumsden, Mary Ann; Stevenson, John; Williamson, Jennifer

    2003-09-01

    The British Menopause Society Council aims to aid health professionals to inform and advise women about the menopause. The oestrogen plus progestogen arm of the Women's Health Initiative was stopped in July 2002. This guidance regarding hormone replacement therapy (HRT) use responds to the results and analysis that have been published since then. Because there are few effective alternatives to HRT for vasomotor and urogenital symptoms, oestrogen-based treatments still have a major role. HRT is also most effective for prevention of osteoporosis. Unopposed oestrogens are contraindicated in women with an intact uterus, and hence a range of oestrogen and progestogen combinations, with differing routes of delivery, now exists under the title of "HRT". Treatment choice should be based on up to date information and targeted to individual women's needs. Hormone replacement still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination.

  13. An evidence-based approach to hormonal therapies for premenopausal women with fibroids.

    Science.gov (United States)

    Lethaby, Anne E; Vollenhoven, Beverley J

    2008-04-01

    Ovarian steroids, particularly oestrogen, are important factors for fibroid growth. This has provided a rationale for the investigation of hormonal therapies for women with fibroids. This chapter will assess the role of hormonal therapies for pre-menopausal women with fibroids. A comprehensive search of MEDLINE and EMBASE was undertaken in December 2006. Twenty-nine relevant randomized controlled trials and two systematic reviews were found. The included studies assessed gonadotrophin-releasing hormone analogues (GnRHa) alone, GnRHa plus add-back (with either progestagen, tibolone, combined oestrogen and progestagen, or raloxifene) and GnRHa given for at least 3 months prior to surgery for fibroids. Two trials assessed the effects of raloxifene alone. One trial assessed the effects of low-dose mifepristone, and a pilot study assessed the role of the selective progesterone receptor modulator, asoprisinil. GnRHa reduce fibroid and uterine volume and heavy bleeding but are associated with menopausal symptoms and bone loss, which limit long-term use. There is some evidence that add-back therapy, either progestagen, tibolone, combined oestrogen and progestagen, or raloxifene, can reduce the menopausal symptoms associated with GnRHa and/or loss of bone density, but there is insufficient good-quality research to make definitive conclusions. GnRHa given for at least 3 months before fibroid surgery improve pre-operative haemoglobin concentration and haematocrit, reduce uterine and pelvic symptoms, and reduce the rate of vertical incisions during laparotomy. Women undergoing hysterectomy are more likely to have a vaginal than an abdominal procedure. Limited evidence suggests that raloxifene may be useful in older premenopausal women with lower concentrations of background oestradiol. Limited short-term evidence of two progestogenic therapies indicates that low-dose mifepristone may improve quality of life and bleeding in the short term, and asoprisinil may improve bleeding

  14. Cardiovascular Disease Among Transgender Adults Receiving Hormone Therapy: A Narrative Review.

    Science.gov (United States)

    Streed, Carl G; Harfouch, Omar; Marvel, Francoise; Blumenthal, Roger S; Martin, Seth S; Mukherjee, Monica

    2017-08-15

    Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care. As with hormone therapy in cisgender persons (that is, those whose sex assigned at birth aligns with their gender identity), existing research in transgender populations suggests that CVD risk factors are altered by CSHT. Currently, systemic hormone replacement for cisgender adults requires a nuanced discussion based on baseline risk factors and age of administration of exogenous hormones because of concern regarding an increased risk for myocardial infarction and stroke. For transgender adults, CSHT has been associated with the potential for worsening CVD risk factors (such as blood pressure elevation, insulin resistance, and lipid derangements), although these changes have not been associated with increases in morbidity or mortality in transgender men receiving CSHT. For transgender women, CSHT has known thromboembolic risk, and lower-dose transdermal estrogen formulations are preferred over high-dose oral formulations. In addition, many studies of transgender adults focus predominantly on younger persons, limiting the generalizability of CSHT in older transgender adults. The lack of randomized controlled trials comparing various routes and formulations of CSHT, as well as the paucity of prospective cohort studies, limits knowledge of any associations between CSHT and CVD.

  15. Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy.

    Science.gov (United States)

    Planas, J; Celma, A; Placer, J; Maldonado, X; Trilla, E; Salvador, C; Lorente, D; Regis, L; Cuadras, M; Carles, J; Morote, J

    2016-11-01

    To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. 120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03). Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Radiotherapy combined with hormonal therapy in prostate cancer: the state of the art

    Directory of Open Access Journals (Sweden)

    Piotr Milecki

    2010-10-01

    Full Text Available Piotr Milecki1,2, Piotr Martenka1, Andrzej Antczak3, Zbigniew Kwias31Department of Radiotherapy, Greater Poland Cancer Center, Poznan, Poland; 2Department of Electroradiology, Medical University, Poznan, Poland; 3Chair of Urology, Medical University, Poznan, PolandAbstract: Androgen-deprivation therapy (ADT is used routinely in combination with definitive external beam radiation therapy (EBRT in patients with high-risk clinically localized or locally advanced disease. The combined treatment (ADT–EBRT also seems to play a significant role in improving treatment results in the intermediate-risk group of prostate cancer patients. On the other hand, there is a growing body of evidence that treatment with ADT can be associated with serious and lifelong adverse events including osteoporosis, cardiovascular disease, diabetes, and many others. Almost all ADT adverse events are time dependant and tend to increase in severity with prolongation of hormonal manipulation. Therefore, it is crucial to clearly state the optimal schedule for ADT in combination with EBRT, that maintaining the positive effect on treatment efficacy would keep the adverse events risk at reasonable level. To achieve this goal, treatment schedule may have to be highly individualized on the basis of the patient-specific potential vulnerability to adverse events. In this study, the concise and evidence-based review of current literature concerning the general rationales for combining radiotherapy and hormonal therapy, its mechanism, treatment results, and toxicity profile is presented.Keywords: prostate cancer, radiotherapy, androgen deprivation, combined treatment

  17. A Mathematical Model of Prostate Tumor Growth Under Hormone Therapy with Mutation Inhibitor

    Science.gov (United States)

    Tao, Youshan; Guo, Qian; Aihara, Kazuyuki

    2010-04-01

    This paper extends Jackson’s model describing the growth of a prostate tumor with hormone therapy to a new one with hypothetical mutation inhibitors. The new model not only considers the mutation by which androgen-dependent (AD) tumor cells mutate into androgen-independent (AI) ones but also introduces inhibition which is assumed to change the mutation rate. The tumor consists of two types of cells (AD and AI) whose proliferation and apoptosis rates are functions of androgen concentration. The mathematical model represents a free-boundary problem for a nonlinear system of parabolic equations, which describe the evolution of the populations of the above two types of tumor cells. The tumor surface is a free boundary, whose velocity is equal to the cell’s velocity there. Global existence and uniqueness of solutions of this model is proved. Furthermore, explicit formulae of tumor volume at any time t are found in androgen-deprived environment under the assumption of radial symmetry, and therefore the dynamics of tumor growth under androgen-deprived therapy could be predicted by these formulae. Qualitative analysis and numerical simulation show that controlling the mutation may improve the effect of hormone therapy or delay a tumor relapse.

  18. Radiotherapy combined with hormonal therapy in prostate cancer: the state of the art.

    Science.gov (United States)

    Milecki, Piotr; Martenka, Piotr; Antczak, Andrzej; Kwias, Zbigniew

    2010-10-11

    Androgen-deprivation therapy (ADT) is used routinely in combination with definitive external beam radiation therapy (EBRT) in patients with high-risk clinically localized or locally advanced disease. The combined treatment (ADT-EBRT) also seems to play a significant role in improving treatment results in the intermediate-risk group of prostate cancer patients. On the other hand, there is a growing body of evidence that treatment with ADT can be associated with serious and lifelong adverse events including osteoporosis, cardiovascular disease, diabetes, and many others. Almost all ADT adverse events are time dependant and tend to increase in severity with prolongation of hormonal manipulation. Therefore, it is crucial to clearly state the optimal schedule for ADT in combination with EBRT, that maintaining the positive effect on treatment efficacy would keep the adverse events risk at reasonable level. To achieve this goal, treatment schedule may have to be highly individualized on the basis of the patient-specific potential vulnerability to adverse events. In this study, the concise and evidence-based review of current literature concerning the general rationales for combining radiotherapy and hormonal therapy, its mechanism, treatment results, and toxicity profile is presented.

  19. Effects of substitution and high-dose thyroid hormone therapy on deiodination, sulfoconjugation, and tissue thyroid hormone levels in prolonged critically ill rabbits.

    Science.gov (United States)

    Debaveye, Yves; Ellger, Björn; Mebis, Liese; Visser, Theo J; Darras, Veerle M; Van den Berghe, Greet

    2008-08-01

    To delineate the metabolic fate of thyroid hormone in prolonged critically ill rabbits, we investigated the impact of two dose regimes of thyroid hormone on plasma 3,3'-diiodothyronine (T(2)) and T(4)S, deiodinase type 1 (D1) and D3 activity, and tissue iodothyronine levels in liver and kidney, as compared with saline and TRH. D2-expressing tissues were ignored. The regimens comprised either substitution dose or a 3- to 5- fold higher dose of T(4) and T(3), either alone or combined, targeted to achieve plasma thyroid hormone levels obtained by TRH. Compared with healthy animals, saline-treated ill rabbits revealed lower plasma T(3) (P=0.006), hepatic T(3) (P=0.02), and hepatic D1 activity (P=0.01). Substitution-dosed thyroid hormone therapy did not affect these changes except a further decline in plasma (P=0.0006) and tissue T(4) (P=0.04). High-dosed thyroid hormone therapy elevated plasma and tissue iodothyronine levels and hepatic D1 activity, as did TRH. Changes in iodothyronine tissue levels mimicked changes in plasma. Tissue T(3) and tissue T(3)/reverse T(3) ratio correlated with deiodinase activities. Neither substitution- nor high-dose treatment altered plasma T(2). Plasma T(4)S was increased only by T(4) in high dose. We conclude that in prolonged critically ill rabbits, low plasma T(3) levels were associated with low liver and kidney T(3) levels. Restoration of plasma and liver and kidney tissue iodothyronine levels was not achieved by thyroid hormone in substitution dose but instead required severalfold this dose. This indicates thyroid hormone hypermetabolism, which in this model of critical illness is not entirely explained by deiodination or by sulfoconjugation.

  20. Behavioral Interventions to Enhance Adherence to Hormone Therapy in Breast Cancer Survivors: A Systematic Literature Review.

    Science.gov (United States)

    Hurtado-de-Mendoza, Alejandra; Cabling, Mark L; Lobo, Tania; Dash, Chiranjeev; Sheppard, Vanessa B

    2016-08-01

    Adjuvant hormone therapy contributes to reductions in recurrence and mortality for women with hormone receptor-positive breast cancer. However, adherence to hormone therapy is suboptimal. This is the first systematic literature review examining interventions aimed at improving hormone therapy adherence. Researchers followed the PRISMA guidelines. PubMed-Medline, CINAHL, PsychInfo, Ovid-Medline, and EMBASE were searched for behavioral interventions that aimed to enhance adherence to adjuvant hormone therapy in breast cancer survivors. A total of 376 articles were screened for eligibility. Five articles met the study criteria. All interventions presented adherence outcomes after 1-year follow-up. None significantly enhanced adherence compared to the usual care in the primary analysis (odds ratios ranged from 1.03 to 2.06 for adherence and from 1.11 to 1.18 for persistence). All studies targeted patients, and only 3 studies included postmenopausal breast cancer patients. Three tested the same intervention consisting of educational materials. Only one was conducted in the United States. Only one reported participants' ethnicity. Overall, it was unclear whether the studies contained bias. The use of different terminology and operationalization of adherence made comparisons challenging. Interventions to improve adherence to adjuvant hormone therapy in US breast cancer populations that include survivors who are ethnically diverse, premenopausal, and receiving tamoxifen therapy are necessary to inform future interventions. Adoption of consistent adherence definitions/measurements will provide a clearer framework to consolidate aggregate findings. Given the limited efficacy of tested interventions, it is important to engage oncologists and researchers to develop approaches that target different components associated with hormone therapy adherence, such as doctor-patient communication or social support. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The relationship between breast density and bone mineral density in never users of postmenopausal hormone therapy.

    Science.gov (United States)

    Seckin, Berna; Pekcan, Meryem Kuru; Inal, Hasan Ali; Gulerman, Cavidan

    2017-06-01

    Estrogen is known to affect both mammographic breast density and bone mineral density (BMD), but there are inconsistent results about the association of these density measurements in postmenopausal women. Furthermore, there are scarce data on the relationship between breast density and BMD in never users of postmenopausal hormone therapy. In this study, we examined the relationship between mammographic breast density and BMD in postmenopausal women who were never hormone replacement therapy users. A total of 293 postmenopausal women were enrolled in this cross-sectional study. Mammograms and BMD measurements for screening purposes were obtained. Assessment of mammographic breast density was performed by using breast imaging reporting and data system classification. The BMD was measured using dual-energy X-ray absorptiometry of the lumbar spine and femoral neck. Grade 1 breast density was observed in 64 women (21.8 %), grade 2 in 113 women (38.6 %) and grades 3 and 4 in 116 (39.6 %) women. Breast density decreased with increasing age and body mass index (BMI). Meanwhile, no significant differences were detected in BMD measures of the hip (p = 0.14) and lumbar spine (p = 0.29) among the breast density categories. After adjusting for age and BMI, the differences in the mean BMD at the hip and lumbar spine across the breast density categories remained insignificant (p = 0.26 and 0.11, respectively). There is no evidence of a relationship between mammographic breast density and BMD in postmenopausal women who had never used hormone replacement therapy.

  2. Incremental value of hormonal therapy for deep vein thrombosis prediction: an adjusted Wells score for women.

    Science.gov (United States)

    Barros, Márcio Vinícius Lins de; Arancibia, Ana Elisa Loyola; Costa, Ana Paula; Bueno, Fernando Brito; Martins, Marcela Aparecida Corrêa; Magalhães, Maria Cláudia; Silva, José Luiz Padilha; Bastos, Marcos de

    2016-04-01

    Deep venous thrombosis (DVT) management includes prediction rule evaluation to define standard pretest DVT probabilities in symptomatic patients. The aim of this study was to evaluate the incremental usefulness of hormonal therapy to the Wells prediction rules for DVT in women. We studied women undertaking compressive ultrasound scanning for suspected DVT. We adjusted the Wells score for DVT, taking into account the β-coefficients of the logistic regression model. Data discrimination was evaluated by the receiver operating characteristic (ROC) curve. The adjusted score calibration was assessed graphically and by the Hosmer-Lemeshow test. Reclassification tables and the net reclassification index were used for the adjusted score comparison with the Wells score for DVT. We observed 461 women including 103 DVT events. The mean age was 56 years (±21 years). The adjusted logistic regression model included hormonal therapy and six Wells prediction rules for DVT. The adjusted score weights ranged from -4 to 4. Hosmer-Lemeshow test showed a nonsignificant P value (0.69) and the calibration graph showed no differences between the expected and the observed values. The area under the ROC curve was 0.92 [95% confidence interval (CI) 0.90-0.95] for the adjusted model and 0.87 (95% CI 0.84-0.91) for the Wells score for DVT (Delong test, P value < 0.01). Net reclassification index for the adjusted score was 0.22 (95% CI 0.11-0.33, P value < 0.01). Our results suggest an incremental usefulness of hormonal therapy as an independent DVT prediction rule in women compared with the Wells score for DVT. The adjusted score must be evaluated in different populations before clinical use.

  3. Influence of hormone substitution therapy on postmenopausal uterus; Einfluss einer Hormonsubstitution auf den postmenopausalen Uterus

    Energy Technology Data Exchange (ETDEWEB)

    Otte, A.; Ruedisueli, A.; Goetze, M.; Leibundgut, U.; Mueller-Brand, J. [Inst. fuer Nuklearmedizin, Kantonsspital, Universitaetskliniken, Basel (Switzerland); Nitzsche, E.U. [Abt. Nuklearmedizin, Radiologische Universitaetsklinik, Freiburg (Germany)

    1997-12-01

    In a 58-year-old postmenopausal woman blood flow and blood pool images of bone scintigraphy showed a focus of increased activity in the right pelvic region. Computed tomography and ultrasound exhibited no abnormalities in the abdomen; especially the uterus and ovaries were normal. Careful anamnestic evaluation revealed that the patient received a long-term peroral estrogen/gestagen replacement therapy for the prevention of osteoporosis, but did not have menstruation-like bleedings for the last twelve months of therapy. At time of admission, the patient was on day 25 of hormone replacement therapy, and the uterus wash, therefore, in a premenstrual stage. Hence, despite cessation of bleedings in postmenopausal women, one should think of hormone replacement therapy as an explanation for vascular pelvic tumors seen by the first two phases of bone scintigraphy, before further diagnostic steps are undertaken. (orig.) [Deutsch] Bei der Skelettszintigraphie einer 58jaehrigen postmenopausalen Frau erkannte man in der Perfusions- und Blood-pool-Phase einen unklaren Fokus erhoehter Aktivitaet im rechten Becken. Computertomographie und Sonographie des Abdomens, insbesondere des Uterus und der Ovarien, waren unauffaellig. Nach eingehender anamnestischer Befragung stellte sich heraus, dass die Patientin unter einer mehrjaehrigen peroralen Oestrogen-/Gestagen-Hormonsubstitutionstherapie zur Osteoporose-Prophylaxe stand, jedoch seit den letzten zwoelf Monaten der Therapie ueber keine menstruationsaehnlichen Abbruchblutungen mehr berichten konnte. Bei ihrer Zuweisung befand sich die Patientin am 25. Tag der Hormonsubstitutionstherapie und ihr Uterus somit in einem praemenstruellen Stadium. Trotz Ausbleibens der Blutung bei postmenopausalen Frauen sollte somit an die Moeglichkeit der Hormonsubstitution gedacht und danach gefragt werden, wenn in den ersten beiden Phasen der Skelettszintigraphie eine unklare, gut vaskularisierte Struktur im kleinen Becken gefunden wird, bevor weitere

  4. Hormone replacement therapy and risk of breast cancer: the role of progestins

    DEFF Research Database (Denmark)

    Stahlberg, Claudia Irene; Pederson, Anette Tønnes; Lynge, Elsebeth;

    2003-01-01

    Epidemiological studies have shown an increased risk of breast cancer associated with the use of hormone replacement therapy (HRT). This notion is mostly based on studies from the USA. During the last decades unopposed estrogen treatment has been used to a lesser extent, whereas the combined...... estrogen-progestin treatment regime is now prescribed worldwide. In the USA the predominant compounds are conjugated estrogens and medroxyprogesterone-acetate, whereas oestradiol combined with testosterone-like progestins is commonly used in Europe. These differences are largely the result of traditions...

  5. Long-term hormone replacement therapy preserves bone mineral density in Turner syndrome

    DEFF Research Database (Denmark)

    Cleemann, Line; Hjerrild, Britta E; Lauridsen, Anna L;

    2009-01-01

    at baseline and follow-up (5.9+/-0.7 years). SETTING: Tertiary hospital. PARTICIPANTS: Fifty-four women with TS (43.0+/-9.95 years). Interventions Hormone replacement therapy (HRT) and calcium and vitamin D supplementation. Main outcome measures BMD (g/cm(2)) measured at lumbar spine, hip, and the non.......010+/-0.144, PTestosterone, IGF1, and maximal oxygen uptake was significantly reduced in TS. CONCLUSION: Longitudinal changes in BMD in TS were slight. BMD can be maintained at most sites in well...

  6. A randomized, controlled pilot trial of hormone therapy for menopausal insomnia.

    Science.gov (United States)

    Silva, Betania Huber; Martinez, Denis; Wender, Maria Celeste Osório

    2011-12-01

    Insomnia is a frequent climacteric symptom. This pilot, double-blind, randomized placebo-controlled trial compared estradiol associated with trimegestone or placebo in 12 women with perimenopausal insomnia. The Pittsburgh Sleep Quality Index (PSQI) was administered, and polysomnography was performed at baseline and after 28 days. Sleep efficiency and median score of the PSQI improved significantly in the hormone therapy group (HT) (p=0.041 and p=0.027, respectively) and not in placebo group. Perimenopausal insomnia improved after short-term HT.

  7. Effects of hormone replacement therapy on endothelial function in menopausal women

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To observe the effects of hormone replacement therapy (HRT) on endothelial function in menopausal women. Methods A total of 30 menopausal women were treated with 2.5 mg of Tibolone (Livial) daily. At the same time,30 women with natural menopause without any treatment served as the control group. Endothelium-dependent (EDD),endothelium-independent (NID) vasodilatation function,and estradiol (E2) were examined by the non-invasive high-resolution ultrasonography before the treatment and at 12th,24th,...

  8. Medicare D Subsidies and Racial Disparities in Persistence and Adherence With Hormonal Therapy

    Science.gov (United States)

    Shi, Yushu; Charlson, John; Smith, Elizabeth C.; Smallwood, Alicia J.; Nattinger, Ann B.; Laud, Purushottam W.; Neuner, Joan M.

    2016-01-01

    Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially

  9. Managing the menopause: British Menopause Society Council consensus statement on hormone replacement therapy.

    Science.gov (United States)

    Pitkin, Joan; Rees, Margaret C P; Gray, Sarah; Lumsden, Mary Ann; Marsden, Jo; Stevenson, John; Williamson, Jennifer

    2005-12-01

    The British Menopause Society Council aims to help health professionals inform and advise women about the menopause. This guidance regarding estrogen-based hormone replacement therapy (HRT), including tibolone, which is classified in the British National Formulary as HRT, responds to the results and analysis of the randomized Women's Health Initiative studies and the observational Million Women Study. Treatment choice should be based on up-to-date information and targeted to individual women's needs. HRT still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination.

  10. Menopausia, hipertensión arterial y terapia de reemplazo hormonal Menopause, blood hypertension and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Daysi Navarro Despaigne

    2003-04-01

    Full Text Available Para evaluar la influencia de la terapia de reemplazo hormonal (THR sobre el síndrome climatérico (SC y los niveles de tensión arterial en mujeres posmenopáusicas con hipertensión arterial (HTA, se realizó un ensayo terapéutico abierto, el cual incluyó 45 mujeres no obesas con HTA ligera/moderada. En cada mujer se evaluó la evolución de los síntomas climatéricos y de los niveles de tensión arterial, así como los efectos indeseables a la THR. Como medicamento las pacientes recibieron Estradiol 2mg + Levonorgestrel 1 mg por día durante 12 meses. Durante la THR disminuyeron los síntomas climatéricos, en particular los vasomotores (de 86,6 a 10 % y los genitourinarios (de 56,7 a 15 %. En la totalidad de las mujeres existió estabilidad en los niveles de tensión arterial. En 5 mujeres hubo necesidad de incrementar la dosis de medicamentos antihipertensivos. En el resto esta se mantuvo o disminuyó. Como efectos indeseables se reportó sangramiento vaginal, mastodinia, cefalea, vasculitis e isquemia del quinto dedo del pie. Las dos últimas pacientes debieron suspender el tratamiento y se presentaron al sexto mes de haber iniciado la THR. En conclusión, en mujeres de edad mediana con hipertensión arterial la THR mejora el síndrome climatérico sin empeorar los niveles de tensión arterial.To evaluate the influence of hormone replacement therapy on the climateric syndrome (CS and the blood pressure values in postmenopausal women with hypertension, an open therapeutic assay was carried out, which included 45 non-obese women with slight/moderate hypertension. The course of the climateric symptoms and the blood pressure levels as well as the adverse effects of HRT were evaluated in every woman. The patients took Estradiol 2mg plus Levonorgestrel 1 mg per day for 12 months as drug therapy. During the application of the HRT, the climateric symptoms, particularly vasomotor (from 86,6 to 10% and genitourinary (from 56,7 to 15% decreased

  11. Use of Menopausal Hormone Therapy and Bioidentical Hormone Therapy in Australian Women 50 to 69 Years of Age: Results from a National, Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Louiza S Velentzis

    Full Text Available Menopausal Hormone Therapy (MHT use in Australia fell by 55% from 2001 to 2005, following the release of large-scale findings on its risks and benefits. Comprehensive national data, including information on overall prevalence of MHT use as well as information on duration of use in Australia have not been reported since the 2004-5 National Health Survey, when 11% of women aged 45+ years were estimated to be current MHT users. No national data are available on prevalence of use of "bioidentical" hormone therapy (BHT. The objective of this study was to determine recent prevalence of MHT and BHT use. A cross-sectional, national, age-stratified, population survey was conducted in 2013. Eligible women, aged 50-69 years, resident in Australia were randomly sampled in 5-year age groups from the Medicare enrolment database (Australia's universal health scheme. The response rate was 22% based on return of completed questionnaires, and analyses were restricted to 4,389 women within the specified age range. The estimated population-weighted prevalence of current use of MHT was 13% (95%CI 12-14, which was broadly similar to the previously reported national figures in 2004-5, suggesting that the use of MHT in Australia has largely stabilised over the past decade. A total of 39% and 20% of current-users with an intact uterus reported use of oestrogen-progestagen MHT and oestrogen-only MHT, respectively, whereas 77% of hysterectomised current-users used oestrogen-only MHT. Almost three-quarters of current-users [population-weighted prevalence 9% (95%CI 8-10] had used MHT for ≥5 years. In regard to BHT, estimated population-weighted prevalence of ever use was 6% (95%CI 6-7 and 2% (95%CI 2-3 for current use. The population-weighted prevalence of MHT and BHT combined, in current users in their fifties and sixties was 15% (95%CI 14-16. These data provide a recent national "snapshot" of Australian women's use of both conventional MHT and of BHT.

  12. European Code against Cancer 4th Edition: Medical exposures, including hormone therapy, and cancer.

    Science.gov (United States)

    Friis, Søren; Kesminiene, Ausrele; Espina, Carolina; Auvinen, Anssi; Straif, Kurt; Schüz, Joachim

    2015-12-01

    The 4th edition of the European Code against Cancer recommends limiting - or avoiding when possible - the use of hormone replacement therapy (HRT) because of the increased risk of cancer, nevertheless acknowledging that prescription of HRT may be indicated under certain medical conditions. Current evidence shows that HRT, generally prescribed as menopausal hormone therapy, is associated with an increased risk of cancers of the breast, endometrium, and ovary, with the risk pattern depending on factors such as the type of therapy (oestrogen-only or combined oestrogen-progestogen), duration of treatment, and initiation according to the time of menopause. Carcinogenicity has also been established for anti-neoplastic agents used in cancer therapy, immunosuppressants, oestrogen-progestogen contraceptives, and tamoxifen. Medical use of ionising radiation, an established carcinogen, can provide major health benefits; however, prudent practices need to be in place, with procedures and techniques providing the needed diagnostic information or therapeutic gain with the lowest possible radiation exposure. For pharmaceutical drugs and medical radiation exposure with convincing evidence on their carcinogenicity, health benefits have to be balanced against the risks; potential increases in long-term cancer risk should be considered in the context of the often substantial and immediate health benefits from diagnosis and/or treatment. Thus, apart from HRT, no general recommendations on reducing cancer risk were given for carcinogenic drugs and medical radiation in the 4th edition of European Code against Cancer. It is crucial that the application of these measures relies on medical expertise and thorough benefit-risk evaluation. This also pertains to cancer-preventive drugs, and self-medication with aspirin or other potential chemopreventive drugs is strongly discouraged because of the possibility of serious, potentially lethal, adverse events.

  13. Sources of information influencing the state-of-the-science gap in hormone replacement therapy usage.

    Science.gov (United States)

    Chew, Fiona; Wu, Xianwei

    2017-01-01

    Medical reviews and research comprise a key information source for news media stories on medical therapies and innovations as well as for physicians in updating their practice. The present study examined medical review journal articles, physician surveys and news media coverage of hormone replacement therapy (HT) to assess the relationship between the three information sources and whether/if they contributed to a state-of-the-science gap (a condition when the evaluation of a medical condition or therapy ascertained by the highest standards of investigation is incongruent with the science-in-practice such as physician recommendations and patient actions). We content-analyzed 177 randomly sampled HT medical reviews between 2002 and 2014, and HT news valence in three major TV networks, newspapers and magazines/internet sites in 2002-2003, 2008-2009 and 2012-14. The focus in both analyses was whether HT benefits outweighed risks, risks outweighed benefits or both risks and benefits were presented. We also qualitatively content-analyzed all 19 surveys of US physicians' HT recommendations from 2002 to 2009, and 2012 to 2014. Medical reviews yielded a mixed picture about HT (40.1% benefits, 26.0% risks, and 33.9% both benefits and risks). While a majority of physician surveys were pro-HT 10/19), eight showed varied attitudes and one was negative. Newspaper and television coverage reflected a pro and con balance while magazine stories were more positive in the later reporting period. Medical journal review articles, physicians, and media reports all provide varying view points towards hormone therapy use thus leading to limited knowledge about the actual risks and benefits of HT among peri- and menopausal women and a state-of-the-science gap.

  14. Sources of information influencing the state-of-the-science gap in hormone replacement therapy usage

    Science.gov (United States)

    Wu, Xianwei

    2017-01-01

    Objective Medical reviews and research comprise a key information source for news media stories on medical therapies and innovations as well as for physicians in updating their practice. The present study examined medical review journal articles, physician surveys and news media coverage of hormone replacement therapy (HT) to assess the relationship between the three information sources and whether/if they contributed to a state-of-the-science gap (a condition when the evaluation of a medical condition or therapy ascertained by the highest standards of investigation is incongruent with the science-in-practice such as physician recommendations and patient actions). Methods We content-analyzed 177 randomly sampled HT medical reviews between 2002 and 2014, and HT news valence in three major TV networks, newspapers and magazines/internet sites in 2002–2003, 2008–2009 and 2012–14. The focus in both analyses was whether HT benefits outweighed risks, risks outweighed benefits or both risks and benefits were presented. We also qualitatively content-analyzed all 19 surveys of US physicians’ HT recommendations from 2002 to 2009, and 2012 to 2014. Results Medical reviews yielded a mixed picture about HT (40.1% benefits, 26.0% risks, and 33.9% both benefits and risks). While a majority of physician surveys were pro-HT 10/19), eight showed varied attitudes and one was negative. Newspaper and television coverage reflected a pro and con balance while magazine stories were more positive in the later reporting period. Conclusion Medical journal review articles, physicians, and media reports all provide varying view points towards hormone therapy use thus leading to limited knowledge about the actual risks and benefits of HT among peri- and menopausal women and a state-of-the-science gap. PMID:28158240

  15. Efficacy of Drospirenone-Containing Hormone Replacement Therapy to Reduce Vasomotor Symptoms of Menopause

    Directory of Open Access Journals (Sweden)

    Dana A. Brown

    2013-10-01

    Full Text Available Hormone replacement therapy has been proven efficacious for controlling vasomotor symptoms such as hot flushes associated with menopause. Drospirenone is a progestin with antiandrogenic and antimineralocorticoid activity that may be used in combination with estrogen to control hot flushes and offers the potential benefit of minimizing breast tenderness, blood pressure elevations and weight gain. Six clinical trials were reviewed. Of these, four trials explicitly listed hot flushes as a primary outcome. Efficacy with regards to hot flushes was found to range from modest to large (i.e., 37.5% to 94.6%, and four of the studies utilized diary cards to assess hot flushes. Results from these studies must be interpreted cautiously as quite a few limitations existed such as small population sizes involving specific ethnic groups, lack of p values with regards to baseline characteristics lending question to homogeneity, and inclusion of mostly healthy participants. Additionally, while the studies were long enough to see an effect, the long term effects of drospirenone-containing hormone replacement therapy (HRT is unknown. The available data supports the use of drospirenone-containing HRT for the treatment of hot flushes associated with menopause.

  16. Management of acne vulgaris with hormonal therapies in adult female patients.

    Science.gov (United States)

    Husein-ElAhmed, Husein

    2015-01-01

    Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition. In particular, adult women with acne have been shown to be adversely impacted by the effect of acne on their quality of life. For the last four decades, dermatologists have used hormonal therapies for the management of acne vulgaris in adult women, which are considered a rational choice given the severity and chronicity of this condition in this group of patients. The aim of this work is to review the hormonal drugs for management of acne.

  17. RETRACTION: Challenges of combined everolimus/endocrine therapy in hormone receptor-positive metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Camillo Porta

    2014-06-01

    Full Text Available To our readers:With deep regrets, we inform our Readers that the article Challenges of combined everolimus/endocrine therapy in hormone receptor-positive metastatic breast cancer (DOI: http://dx.doi.org/10.4081/oncol.2014.236, which has been published Ahead of Print in the first issue of Oncology Reviews (2014, contains verbatim text plagiarized from another paper.1The manuscript must be considered as retracted. On behalf of the Editorial Board of Oncology Reviews, I apologize to the Author of the manuscript whose text was plagiarized by Y. Abubakr and Y. Albushra that this was not picked up in the peer review process. I also apologize to the affected journal for the violation of copyright due to plagiarism. Oncology Reviews is uncompromising in its commitment to scientific integrity. When credible evidence of misconduct is brought to our attention, our commitment to the scientific record and to our readership requires immediate notification. Oncology Reviews is increasingly employing sophisticated software to detect plagiarism. Other journals use similar tools. Authors should be aware that most journals routinely employ plagiarism detection software, and that any plagiarism is likely to be detected.Camillo Porta, Editor-in-Chief Oncology Reviews Reference 1. André F. Enhancing effectiveness of endocrine therapy in hormone receptor-positive advanced breast cancer. Medscape Education Oncology. CME Released: 05/24/2013; Valid for credit through 05/24/2014. http://www.medscape.org/viewarticle/804496

  18. Modification of blood pressure in postmenopausal women: role of hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Cannoletta M

    2014-08-01

    Full Text Available Marianna Cannoletta, Angelo Cagnacci Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences of the Mother, Child and Adult, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Emilia-Romagna, Italy Abstract: The rate of hypertension increases after menopause. Whether estrogen and progesterone deficiency associated with menopause play a role in determining a worst blood pressure (BP control is still controversial. Also, studies dealing with the administration of estrogens or hormone therapy (HT have reported conflicting evidence. In general it seems that, despite some negative data on subgroups of later postmenopausal women obtained with oral estrogens, in particular conjugated equine estrogens (CEE, most of the data indicate neutral or beneficial effects of estrogen or HT administration on BP control of both normotensive and hypertensive women. Data obtained with ambulatory BP monitoring and with transdermal estrogens are more convincing and concordant in defining positive effect on BP control of both normotensive and hypertensive postmenopausal women. Overall progestin adjunct does not hamper the effect of estrogens. Among progestins, drospirenone, a spironolactone-derived molecule, appears to be the molecule with the best antihypertensive properties. Keywords: hormone replacement therapy, estrogen, progestin, blood pressure, menopause, hypertension 

  19. Paraneoplastic Dermatomyositis with Cutaneous and Myopathic Disease Responsive to Adrenocorticotropic Hormone Therapy

    Science.gov (United States)

    Mancuso, Christopher; Lal, Karan; Dicostanzo, Damian; Gropper, Charles

    2017-01-01

    Dermatomyositis is a myopathic or amyopathic autoimmune connective tissue disease that presents with classic dermatologic findings ranging from: poikilodermatous photosensitivity (shawl sign), eyelid edema and violaceous-pigmentation (heliotrope sign), lichenoid eruptions on the knuckles and elbows (Gottron’s sign), periungual telangiectasias, and ragged cuticles (Samitz sign). Up to 30 percent of adult-onset cases of dermatomyositis may represent a paraneoplastic syndrome warranting a thorough work-up for malignancy. The authors present a case report of paraneoplastic dermatomyositis associated with triple negative, BRCA-1 positive, invasive intraductal carcinoma of the breast, whose myopathic and cuteanous symptoms were recalcitrant to high-dose corticosteroid therapy. Herein, the authors describe the first reported case of the use of an injectable adrenocorticotropic hormone agonist gel in a patient with myopathic paraneoplastic disease that achieved clinical resolution of both myopathic and cutaneous symptoms, but subseuqently developed significant hyperpigmentation of her face suspected to be secondary to a chemotherapeutic-induced pigmentary change which was augmented by adrenocorticotropic hormone therapy. PMID:28210382

  20. The 2017 hormone therapy position statement of The North American Menopause Society.

    Science.gov (United States)

    2017-06-22

    The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not

  1. The 2017 hormone therapy position statement of The North American Menopause Society.

    Science.gov (United States)

    2017-07-01

    The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not

  2. Using predictors of hormone therapy use to model the healthy user bias: how does healthy user status influence cognitive effects of hormone therapy?

    Science.gov (United States)

    Gleason, Carey E; Dowling, N Maritza; Friedman, Elliot; Wharton, Whitney; Asthana, Sanjay

    2012-05-01

    This study investigated the phenomenon known as the healthy user bias by equating hormone therapy (HT) use (past or current) with healthy user status. Data from the Survey of Midlife in the United States were used to identify the predictors of HT use. The unique Survey of Midlife in the United States data include psychological, demographic, health-related, and behavioral variables as well as history of HT use. Predictors of HT use were combined to derive propensity scores, describing the likelihood that a woman was an HT user, based on her psychological, demographic, physical, and behavioral profile (ie, likelihood of being a healthy user) as opposed to her actual use of HT. Finally, cognitive performance on an executive function test was examined in women stratified by propensity score. Using a multiple logistic regression model, nine variables emerged as predictors of HT use. The nine variables were used to estimate the propensity or conditional probability of using HT for each subject; resultant propensity scores were ranked and divided into tertiles. Women in the highest tertile demonstrated shorter median response latencies on a test of executive function than did women who did not use HT. From an array of psychological, medical, and behavioral variables, nine emerged as predictors of HT use. If validated, these features may serve as a means of estimating the phenomenon known as healthy user bias. Moreover, these data suggest that the degree to which a woman fits a model of a healthy user may influence cognitive response to HT.

  3. Sindrom pomanjkanja rastnega hormona pri odraslem - učinki nadomestnega zdravljenja: Syndrome of growth hormone deficiency in adults - effects of growth hormone replacement therapy:

    OpenAIRE

    Pfeifer, Marija

    2001-01-01

    Background. After the cessation of longitudinal growth, growth hormone (GH) continues to subserve an important role in the regulation of body metabolism (stimulation of lipolysis and lipid oxidation, protein synthesis, insulin antagonism, and sodium and water retention) to optimise body composition and function. Most patients with hypopituitarism exhibit the syndrome of GH deficiency with a number of abnormal features which can be reversed with recombinant GH replacement therapy. Conclusions....

  4. Risks and benefits of hormone replacement therapy in older men Riscos e benefícios da terapia de reposição hormonal em homens idosos

    Directory of Open Access Journals (Sweden)

    Fábio Firmbach Pasqualotto

    2004-02-01

    Full Text Available The use of testosterone in older men, known as male hormonal replacement therapy or androgen replacement therapy, has become of increasing interest to both the medical and lay communities over the past decade. Even though the knowledge of the potential benefits and risks of male Androgen Replacement Therapy has increased dramatically, there is still much that needs to be determined. Although there are a number of potential benefits of male Androgen Replacement Therapy and data concerning clinical effects of such replacement have accumulated, as yet there have not been any large multicenter randomized controlled trials of this therapy. It is the purpose of this article to review what is currently known about the possible risks and benefits of male Androgen Replacement Therapy by discussing the clinical trials to date.O uso da testosterona em homens idosos, conhecido como Terapia de Reposição Hormonal no homem ou Terapia de Reposição com Androgênios, têm aumentado o interesse para as comunidades médica e leiga na última década. Muito embora o conhecimento a respeito dos potenciais benefícios e riscos da Terapia de Reposição Hormonal nos homens tem aumentado dramaticamente, ainda existe muito que precisa ser determinado. Embora existam vários benefícios potenciais da Terapia de Reposição com Androgênios e dados clínicos relacionados com o uso de tal terapia, não existem ainda nenhum estudo controlado, randomizado e multicêntrico avaliando o uso de tal terapia. O objetivo deste artigo é revisar os aspectos atuais sobre os possíveis riscos e benefícios da Terapia de Reposição com Androgênios discutindo os estudos clínicos publicados sobre o assunto.

  5. Serum uric acid levels and hormone therapy type: a retrospective cohort study of postmenopausal women.

    Science.gov (United States)

    Jung, Jae H; Song, Gwan G; Lee, Young H; Kim, Jae-Hoon; Hyun, Myung H; Choi, Sung J

    2017-08-07

    Serum uric acid levels increase in postmenopausal women, but decrease when hormone therapy (HT) is administered. No study has, however, evaluated the effects of different types of HT on serum uric acid levels. We therefore examined whether estrogen therapy (ET), estrogen plus progestogen therapy (EPT), and tibolone use affected serum uric acid levels in this population. We performed a retrospective cohort study of postmenopausal women. From 2005 to 2015, postmenopausal women who had undergone blood uric acid-level testing at least twice were enrolled. Participants were grouped according to HT regimen: ET, EPT, or tibolone. The nonhormone therapy group did not receive HT. Differences in serum uric acid levels were examined in each group. Our analysis was adjusted to accommodate different follow-up intervals for individual participants. Multiple variables were adjusted using the Tukey-Kramer method. Age, body mass index, hypertension, diabetes mellitus, dyslipidemia, estimated glomerular filtration rate, alcohol consumption, smoking status, and comedications were also adjusted. After adjusting for multiple variables, the serum uric acid level increased to 0.87 ± 0.27 mg/dL (least squares mean ± standard error) in the nonhormone therapy group, and serum uric levels in the EPT group were found to be significantly lower (-0.38 ± 0.29 mg/dL, P uric acid levels in the ET and tibolone groups did not, however, differ significantly from the nonhormone therapy group level. We attribute our findings to the effects of progestogen, rather than estrogen.

  6. Transdermal hormone therapy and the risk of stroke and venous thrombosis.

    Science.gov (United States)

    Speroff, L

    2010-10-01

    Recent case-control and cohort studies have indicated that the transdermal administration of postmenopausal estrogen therapy is not associated with an increased risk of cardiovascular complications, specifically stroke and venous thrombosis. These studies have prompted the clinical promotion of transdermal treatment as 'safer'. There are reasons, however, to be cautious regarding postmenopausal transdermal hormone therapy, especially in regard to stroke. Previous reports linking postmenopausal estrogen therapy and the risk of stroke have not yielded consistent results, finding it difficult to adjust for all confounding factors, including compliance with treatment. Age of the population studies may be a critical issue. Notably, the risk of stroke with oral estrogen was not increased in the Women's Health Initiative when women with prior cardiovascular disease or those older than 60 years were excluded. There does appear to be a dose-response relationship with stroke, similar to that observed with estrogen-progestin contraceptives, and this may be a problem when studying standard doses of transdermal treatment, in that many women receiving transdermal estrogen display lower estrogen blood levels when compared with oral treatment. Clinicians should administer low doses of estrogen to women with risk factors for stroke, and the transdermal route of administration is indicated for women at high risk for venous thrombosis and for older postmenopausal women, especially for women with stroke risk factors. In a recent study, Renoux and colleagues from McGill University in Montreal performed a nested case-control study deriving the data from a cohort of women in the UK General Practice Research Database (GPRD). Current use of oral and transdermal hormone therapy, based on recorded prescriptions, was compared to no use in 15 710 cases and 59 958 controls. The adjusted rate ratio (RR) for stroke for current use of transdermal estrogens, with or without a progestin, was not

  7. Contracepção hormonal e anti-retrovirais em mulheres infectadas pelo HIV Hormonal contraception and antiretroviral therapy among HIV-infected women

    Directory of Open Access Journals (Sweden)

    Eliana Amaral

    2006-11-01

    Full Text Available Há controvérsia sobre a relação entre o uso de contraceptivos hormonais e o risco de adquirir o vírus da imunodeficiência humana (HIV, e pouco se sabe sobre os efeitos da contracepção hormonal em mulheres infectadas (efeitos colaterais, distúrbios menstruais, progressão da doença, interações com terapias anti-retrovirais. O objetivo deste artigo foi revisar os dados disponíveis quanto à vulnerabilidade ao HIV e à sua transmissibilidade na vigência do uso de contraceptivos hormonais bem como as conseqüências potenciais do uso desses contraceptivos por mulheres HIV-positivas sob terapia anti-retroviral (TARV, com ênfase nas interações medicamentosas. Concluiu-se que ainda não é possível elaborar recomendações, baseadas em evidências, sobre a contracepção hormonal em mulheres portadoras do HIV sob TARV. Assim, os infectologistas e os ginecologistas devem estar atentos às interações potenciais que possam representar aumento de efeitos adversos, individualizando a orientação sobre os esteróides contraceptivos, suas doses e vias de administração, considerando a TARV em uso.There is much controversy regarding the realtionship between the use of hormonal contraceptives and the risk of acquiring human immunodeficiency virus (HIV, and little is known about the effects of hormonal contraception in HIV-infected women (adverse events, menstrual disorders, disease progression, antiretroviral therapy interactions. The aim of the present study was to review available data regarding HIV vulnerability and transmission associated with hormonal contraceptives and the use of these contraceptives by women on antiretroviral therapy, with emphasis on drug interactions. In conclusion, it was not possible to offer evidence-based recommendations for the use of hormonal contraceptives among HIV-infected women under antiretroviral therapy. Infectious disease specialists and gynecologists providing care should be cautious about potential

  8. Standard and Low-dose Hormone Therapy for Postmenopausal Women—Focus on the Breast

    Directory of Open Access Journals (Sweden)

    Peng-Hui Wang

    2007-06-01

    Full Text Available Menopause occurs naturally when the ovary ceases folliculogenesis, or artificially by surgical and/or medical ablation of the ovarian function. Menopause is a hypoestrogenic state, which may adversely affect estrogen target tissues, such as the brain, skeleton and skin, as well as the cardiovascular and genitourinary systems, with resultant frequency and severity of climacteric symptoms. The climacteric symptoms, however, vary significantly among women. For decades, hormone therapy (HT has been the mainstay and is considered the most effective for managing menopausal symptoms. The prolonged use of either single estrogen therapy or a combination therapy of estrogen and progestogen (EPT might be associated with a slightly increased risk of breast cancer and many resultant adverse events, such as coronary heart disease, stroke and venous thromboembolism. Perhaps because the clear benefits are limited to these end points of HT in treating menopausal women, the relatively significant adverse event profiles of these women may not be enough to trigger primary care physicians to be more aggressive than they have been to date in treating climacteric symptoms of postmenopausal women. However, severe climacteric symptoms really disturb the woman's life. Some epidemiologic studies have shown that the increased risk for breast cancer after 5 years of combined EPT is similar in magnitude to other lifestyle variables, such as 10-year delayed menopause, fewer pregnancies and reduced breastfeeding, postmenopausal obesity, excessive alcohol or cigarette use, and lack of regular exercise. Furthermore, elevated serum concentrations of either endogenous or exogenous (replaced by HT sex hormone in either pre- or postmenopausal women are associated with an increased risk of breast cancer. Finally, the increased breast cancer risk diminishes soon after discontinuing hormones, and largely disappears by 5 years after cessation. Taken together, low-dose conventional HT

  9. Invited commentary: hormone therapy and risk of coronary heart disease why renew the focus on the early years of menopause?

    Science.gov (United States)

    Manson, JoAnn E; Bassuk, Shari S

    2007-09-01

    After the initial report from the Women's Health Initiative estrogen-progestin trial, which found that menopausal hormone therapy was associated with an increased risk of coronary heart disease in the overall cohort (age range: 50-79 years; mean age: 63 years), researchers took a closer look at the data from this and other studies, focusing on the timing of initiation of such therapy. The results suggest that hormone therapy may have a beneficial effect on the heart if started in early menopause, when a woman's arteries are still likely to be relatively healthy, but a harmful effect if started in late menopause, when advanced atherosclerosis may be present. The implication of the timing hypothesis for clinical practice is not that recently menopausal women be given hormone therapy for coronary heart disease prevention but rather that clinicians can be reassured about cardiac risks when considering short-term use of hormone therapy for vasomotor symptom relief in such women. The reduction in vasomotor symptoms must be weighed against other risks and benefits of treatment, but coronary disease is typically not a major factor in the equation for women who are recently menopausal.

  10. Effect of oxandrolone therapy on adult height in Turner syndrome patients treated with growth hormone: a meta-analysis.

    Science.gov (United States)

    Sheanon, Nicole M; Backeljauw, Philippe F

    2015-01-01

    Turner syndrome is a chromosomal abnormality in which there is complete or partial absence of the X chromosome. Turner syndrome effects 1 in every 2000 live births. Short stature is a cardinal feature of Turner Syndrome and the standard treatment is recombinant human growth hormone. When growth hormone is started at an early age a normal adult height can be achieved. With delayed diagnosis young women with Turner Syndrome may not reach a normal height. Adjuvant therapy with oxandrolone is used but there is no consensus on the optimal timing of treatment, the duration of treatment and the long term adverse effects of treatment. The objective of this review and meta-analysis is to examine the effect of oxandrolone on adult height in growth hormone treated Turner syndrome patients. Eligible trials were identified by a literature search using the terms: Turner syndrome, oxandrolone. The search was limited to English language randomized-controlled trials after 1980. Twenty-six articles were reviewed and four were included in the meta-analysis. A random effects model was used to calculate an effect size and confidence interval. The pooled effect size of 2.0759 (95 % CI 0.0988 to 4.0529) indicates that oxandrolone has a positive effect on adult height in Turner syndrome when combined with growth hormone therapy. In conclusion, the addition of oxandrolone to growth hormone therapy for treatment of short stature in Turner syndrome improves adult height. Further studies are warranted to investigate if there is a subset of Turner syndrome patients that would benefit most from growth hormone plus oxandrolone therapy, and to determine the optimal timing and duration of such therapy.

  11. Survival improvement in hormone-responsive young breast cancer patients with endocrine therapy.

    Science.gov (United States)

    Yoon, Tae In; Hwang, Ui-Kang; Kim, Eui Tae; Lee, SaeByul; Sohn, Guiyun; Ko, Beom Seok; Lee, Jong Won; Son, Byung Ho; Kim, Seonok; Ahn, Sei Hyun; Kim, Hee Jeong

    2017-09-01

    We investigated the oncologic outcomes by intrinsic subtype and age in young breast cancer patients and whether survival differences were related to treatment changes over time. A retrospective analysis was performed on 9633 invasive breast cancer patients treated at Asan Medical Center from January 1989 to December 2008. We also enrolled a matched cohort adjusting for tumor size, lymph node metastasis, subtypes, and tumor grade. Patients aged <35 years were included in the younger group (n = 602) and those aged ≥35 years were included in the older group (n = 3009). The younger patients showed a significantly higher T stage, a more frequent axillary node presentation, higher histologic grade, and higher incidence of triple-negative subtype tumors than older patients and also received more chemotherapy and were less likely to undergo hormone therapy. The younger patients with hormone receptor (HR)-positive tumors showed significantly poorer disease-free survival (DFS), loco-regional recurrence-free survival, distant metastasis-free survival, and breast cancer-specific survival outcomes than older patients. Younger patients with HR-positive and human epidermal growth factor receptor 2 (HER2)-negative tumor subtypes had a significantly improved DFS over time (p = 0.032). Within the HR-positive/Her2-negative subtype, more women received gonadotropin-releasing hormone agonist and tamoxifen treatment from 2003 to 2008 compared with 1989 to 2002 (p = 0.001 and p = 0.075, respectively). HR-positive young breast cancer patients have a poorer survival compared with older patients, even with more frequent chemotherapy, but more recent use of tamoxifen and ovarian suppression might improve this outcome in these patients.

  12. Low-dose growth hormone therapy reduces inflammation in HIV-infected patients

    DEFF Research Database (Denmark)

    Lindboe, Johanne Bjerre; Langkilde, Anne; Eugen-Olsen, Jesper

    2016-01-01

    BACKGROUND: Combination antiretroviral therapy (cART) has drastically increased the life expectancy of HIV-infected patients. However, HIV-infected patients exhibit increased inflammation and 33-58% exhibit a characteristic fat re-distribution termed HIV-associated lipodystrophy syndrome (HALS...... to investigate the impact of low-dose rhGH therapy on inflammation in HIV-infected patients. METHODS: Forty-six cART-treated HIV-infected men were included in the HIV-GH low-dose (HIGH/Low) study: a randomized, placebo-controlled, double-blinded trial. Subjects were randomized 3:2 to 0.7 mg/day rhGH, or placebo......). Recombinant human growth hormone (rhGH) has been tested as treatment of HALS. Low-dose rhGH therapy improves thymopoiesis and fat distribution in HIV-infected patients and appears to be well tolerated. However, since high-dose rhGH is associated with adverse events related to inflammation, we wanted...

  13. Pharmaceutical intervention in menopausal patients with hormone replacement therapy in a community pharmacy from Antofagasta

    Directory of Open Access Journals (Sweden)

    Alejandrina Alucema

    2015-02-01

    Full Text Available Context: Hormone replacement therapy (HRT is the most widely used treatment for controlling the effects of menopause. This type of therapy causes some drug-related problems (DRP, which requires monitoring to control the negative effects and ensure patient adherence to therapy. Aims: Perform a pharmacotherapeutic monitoring and educate to menopausal patients in HRT of a community pharmacy from the city of Antofagasta. Methods: A 98-menopausal patients underwent a pharmaceutical intervention to identify the PRM and its resolution. It was applied to them a survey before and after educational activities about this disease and HRT to determine the knowledge on the subject. Results: During the pharmacotherapeutic monitoring was determined that 55% of patients using combined HRT. 62 DRPs were detected, of which 43 were resolved (69%; the most were Patient-Pharmacist (73%. The better resolution DRP were DRP 4(b “frequency of inadequate administration” and DRP 2(a “no medical indication”. At baseline, 90% had an inadequate level of knowledge about the disease and THR, 8% intermediate, and only 2% adequate. After the implementation of the education strategy, the level of knowledge increased, achieving at the end of the study only intermediate (10% and adequate (90% levels. Conclusions: The results confirm the importance of pharmaceutical intervention for the identification and resolution of DRP and the requirement to establish educational strategies to increase the knowledge about menopause and HRT in menopausal patients.

  14. Menopausal hormone therapy and lung cancer-specific mortality following diagnosis: the California Teachers Study.

    Directory of Open Access Journals (Sweden)

    Jessica Clague

    Full Text Available Previous results from research on menopausal hormone therapy (MHT and lung cancer survival have been mixed and most have not studied women who used estrogen therapy (ET exclusively. We examined the associations between MHT use reported at baseline and lung cancer-specific mortality in the prospective California Teachers Study cohort. Among 727 postmenopausal women diagnosed with lung cancer from 1995 through 2007, 441 women died before January 1, 2008. Hazard Ratios (HR and 95% Confidence Intervals (CI for lung-cancer-specific mortality were obtained by fitting multivariable Cox proportional hazards regression models using age in days as the timescale. Among women who used ET exclusively, decreases in lung cancer mortality were observed (HR, 0.69; 95% CI, 0.52-0.93. No association was observed for estrogen plus progestin therapy use. Among former users, shorter duration (15 years was associated with a decreased risk (HR, 0.60; 95% CI, 0.38-0.95. Smoking status modified the associations with deceases in lung cancer mortality observed only among current smokers. Exclusive ET use was associated with decreased lung cancer mortality.

  15. Adherence to hormone therapy in women with breast cancer: a quantitative study.

    Science.gov (United States)

    Iacorossi, Laura; Gambalunga, Francesca; Fabi, Alessandra; Giannarelli, Diana; Facchinetti, Gabriella; Piredda, Michela; De Marinis, Maria Grazia

    2016-01-01

    The majority of patients with hormone receptor-positive breast cancer are treated with oral endocrine therapies, which are administered in periods ranging from 5 to 10 years. Adherence, ie the degree a subject's behavior corresponds to the agreed recommendations, then becomes a significant problem, which can also affect distress levels. The aim of this study is to evaluate the level of adherence to endocrine therapy and distress in a sample of Italian women. The study is a descriptive cross sectional survey. Adherence was measured with the Morisky Medication Adherence 8-item Scale and distress was measured by the Distress Thermometer. Socio-demographic and clinical data were also collected and then processed. Adherence measured with MMAS-8 items scored 6.18 corresponding to an average level of adherence in the 151 patients examined. The only factors affecting adherence signi- ficantly were: level of education, marital status and, among the side effects of therapy, poor concentration and memory. The data analysis obtained from the Distress Thermometer showed a degree of discomfort equal to 4.71,For example, in younger patients' levels of distress are greater in relationships, whereas in married/defacto women and workers distress levels are greater in practical areas. Results from this study can be useful to identify patients at risk for non-adhe- rence and distress, and consequently to help, the oncology team. Despite this, the study of adherence and related-factors needs further investigation.

  16. The 2012 Hormone Therapy Position Statement of The North American Menopause Society

    Science.gov (United States)

    2012-01-01

    Objective This position statement aimed to update the evidence-based position statement published by The North American Menopause Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset. Methods An Advisory Panel of expert clinicians and researchers in the field of women’s health was enlisted to review the 2010 NAMS position statement, evaluate new evidence, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. Results Current evidence supports the use of HT for perimenopausal and postmenopausal women when the balance of potential benefits and risks is favorable for the individual woman. This position statement reviews the effects of ET and EPT on many aspects of women’s health and recognizes the greater safety profile associated with ET. Conclusions Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years. PMID:22367731

  17. Estudo piloto dos efeitos da terapia hormonal sobre o tecido mamário normal de mulheres após a menopausa A pilot study of the effects of hormone therapy on normal breast tissue of postmenopausal women

    Directory of Open Access Journals (Sweden)

    Simone Elias

    2006-11-01

    Full Text Available OBJETIVOS: avaliou-se o tecido mamário de mulheres antes e depois de seis meses de terapia estroprogestativa combinada contínua (0,625 mg de estrogênios conjugados eqüinos associados a 2,5 mg de acetato de medroxiprogesterona. MÉTODOS: todas as pacientes foram avaliadas antes de se instituir o tratamento e consideradas aptas para este. Foram obtidos fragmentos de tecido mamário por meio de biópsia percutânea com agulha grossa (acoplada a um propulsor automático - "core-biópsia". O material foi fixado e os cortes corados por hematoxilina-eosina. Avaliou-se a densidade epitelial e o volume nuclear do epitélio mamário antes e após a terapia hormonal. Esses parâmetros morfométricos foram analisados graficamente com auxílio do programa Imagelab 2000 ®, após captura da imagem microscópica pelo sistema Vidcap 32. Esse programa permite que sejam selecionadas as áreas de interesse, possibilitando o cálculo de área, volume ou a relação da área ocupada entre diferentes estruturas. RESULTADOS: depois do uso da terapia, o volume nuclear nas mulheres em que o tratamento foi instituído em período mais tardio após a menopausa mostrou um aumento de cerca de 33% (de 103,6 para 138,1 µm³. A densidade epitelial não se modificou de forma significativa: o valor médio antes da terapia hormonal foi de 0,08 e após de 0,10. CONCLUSÕES: a terapia estroprogestativa combinada contínua empregada por seis meses induziu à alteração no volume nuclear das células epiteliais das mamas, sugerindo aumento de sua atividade metabólica. Provavelmente, esse evento precede outros que confirmariam o estímulo da proliferação celular por esses hormônios.PURPOSE: to analyze breast tissue of postmenopausal women before and after six months of continuous combined estrogen-progestin replacement therapy (0.625 mg conjugated equine estrogens associated with 2.5 mg medroxyprogesterone acetate. METHODS: all patients were evaluated before treatment and

  18. Hormone replacement therapy in morphine-induced hypogonadic male chronic pain patients

    Directory of Open Access Journals (Sweden)

    Ravaioli Laura

    2011-02-01

    Full Text Available Abstract Background In male patients suffering from chronic pain, opioid administration induces severe hypogonadism, leading to impaired physical and psychological conditions such as fatigue, anaemia and depression. Hormone replacement therapy is rarely considered for these hypogonadic patients, notwithstanding the various pharmacological solutions available. Methods To treat hypogonadism and to evaluate the consequent endocrine, physical and psychological changes in male chronic pain patients treated with morphine (epidural route, we tested the administration of testosterone via a gel formulation for one year. Hormonal (total testosterone, estradiol, free testosterone, DHT, cortisol, pain (VAS and other pain questionnaires, andrological (Ageing Males' Symptoms Scale - AMS and psychological (POMS, CES-D and SF-36 parameters were evaluated at baseline (T0 and after 3, 6 and 12 months (T3, T6, T12 respectively. Results The daily administration of testosterone increased total and free testosterone and DHT at T3, and the levels remained high until T12. Pain rating indexes (QUID progressively improved from T3 to T12 while the other pain parameters (VAS, Area% remained unchanged. The AMS sexual dimension and SF-36 Mental Index displayed a significant improvement over time. Conclusions In conclusion, our results suggest that a constant, long-term supply of testosterone can induce a general improvement of the male chronic pain patient's quality of life, an important clinical aspect of pain management.

  19. Effects of hormone replacement therapy on endothelial function in menopausal women

    Institute of Scientific and Technical Information of China (English)

    Jin-rn Yang; Fen Li

    2009-01-01

    Objective To observe the effects of hormone replacement therapy (HRT) on endothelial function in menopausal women. Methods A total of 30 menopausal women were treated with 2.5 mg of Tibolone (Livial) daily. At the same time, 30 women with natural menopause without any treatment served as the control group. Endothelium-dependent (EDD), endothelium-independent (NID) vasodilatation function, and estradiol (E2) were examined by the non-invasive high-resolution ultrasonography before the treatment and at 12th, 24th, 36th and 48th week of treatment, respectively. Results After hormone treatment, E2 increased significantly and EDD was improved significantly (P<0.05), and E2 was positively related with EDD (r=0.8092, P<0.001). No change of EDD was observed in the control group whereas a significant increase was observed in the treatment group. Conclusion Endothelium-dependent vasodilatation dysfunction is prominent in menopausal women. Tibolone can help improve the condition.

  20. Beliefs about bioidentical hormone therapy: a cross-sectional survey of pharmacists.

    Science.gov (United States)

    Siyam, Tasneem; Yuksel, Nesé

    2013-02-01

    The aim of this study was to assess pharmacists' beliefs about bioidentical hormone therapy (BHT) and to identify factors influencing these beliefs. This was a cross-sectional survey of pharmacists. An email invitation to participate in the online survey was sent to a random sample of 2000 pharmacists in Alberta. The survey was accessible for a six-week period from May to July, 2011. A 54-item questionnaire was used to capture knowledge and beliefs about, and confidence in BHT. Summary statistics and multivariate regression were used for analyses. Overall, 401 pharmacists completed the survey (response rate 20%). Respondents were mainly female (64%), above 30 years of age (81%) and in practice for more than 10 years (63%). Only 35% of respondents correctly classified BHT as including both compounding and commercial products. In regards to beliefs, 68% of respondents agreed that BHT is as effective as non-bioidentical hormones for vasomotor symptoms, while 60% agreed BHT had equal risk. Beliefs on estriol, progesterone, and saliva testing however, were more diverse with many "do not know" responses (40%). In multivariate analysis, pharmacists who worked in pharmacies that compounded BHT were more likely to believe in BHT safety (pBHT (pBHT. In addition, beliefs on the safety of BHT were associated with pharmacists' practice, specifically working in a pharmacy that compounds BHT. This study helps identify areas for targeted education. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Hormone replacement therapy: will it affect seizure control and AED levels?

    Science.gov (United States)

    Harden, Cynthia L

    2008-03-01

    Interest in the years of reproductive changes for women with epilepsy (WWE), specifically perimenopause, menopause and postmenopause has been emerging in the epilepsy community. This article discusses evidence for changes in seizure frequency during perimenopause and postmenopause. Further, a catamenial epilepsy pattern during the reproductive years may be a hallmark for the observed seizure frequency change during these years; that is, an increase at perimenopause but a decrease at menopause. This finding implies that a subset of WWE are particularly susceptible to endogenous reproductive hormonal changes. An adverse effect on seizure frequency with the use of hormone replacement therapy (HRT) during postmenopause for WWE was reported in questionnaires, and was later borne out in a clinical trial. The laboratory counterpart of this human trial, HRT in ovariectomized rodent seizure models, shows that estrogen and progesterone are neuroprotective and do not uniformly increase seizure frequency. Possible reasons for the discrepancy between "the lab and the clinic" are presented. Strategies for managing HRT in symptomatic postmenopausal WWE using estrogenic and progestogenic compounds that may be less likely to promote seizures are discussed.

  2. Effect of hormone therapy on exercise capacity in early postmenopausal women.

    Science.gov (United States)

    Mercuro, Giuseppe; Saiu, Francesca; Deidda, Martino; Mercuro, Silvia; Vitale, Cristiana; Rosano, Giuseppe M C

    2007-10-01

    To compare the exercise capacity of postmenopausal women with matched premenopausal controls, as well as postmenopausal women before and after 3 months of hormone therapy (HT). This study examined the response to strenuous isotonic exercise in 30 women with recently developed menopause (age, mean+/-standard deviation, 50.6+/-1.1 years) without cardiovascular risk factors or diseases. Thirty premenopausal subjects, matched one-to-one for age and biophysical characteristics, were the control group. Postmenopausal women underwent examination before (T(0)) and 3 months after (T(1)) HT (oral 0.625 mg conjugated estrogen and 2.5 mg medroxyprogesterone acetate/day) with high-resolution ultrasound determination of peripheral flow-mediated vasodilation and an integrative cardiopulmonary test. Postmenopausal women showed an impairment of flow-mediated vasodilation (Pexercise intolerance, and there are benefits in introducing HT.

  3. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors

    DEFF Research Database (Denmark)

    Rasmussen, Emma L Kaderly; Hannibal, Charlotte Gerd; Dehlendorff, Christian

    2017-01-01

    OBJECTIVE: Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. METHODS: This nationwide case-control study included all women with an SBT...... diagnosis in Denmark, 1978-2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy...... birth also decreased the SBT risk (p=0.03). An increased SBT risk was associated with infertility (OR=3.31; 95% CI: 2.44-4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR=1.32; 95% CI: 1.02-1.72), whereas OC use decreased the risk (OR=0.40; 95% CI: 0...

  4. Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients?

    Science.gov (United States)

    Lupo, Molly; Dains, Joyce E.; Madsen, Lydia T.

    2015-01-01

    Historically, randomized controlled trials (RCTs) have shown an increased risk of recurrence and mortality among women who have used primarily oral HRT after breast cancer. However, many of these studies have had design flaws that may impact the findings. Numerous investigators have concluded that additional RCTs should be performed, but because of ethical issues and logistic challenges, large-scale RCTs are unlikely. Thus, the authors conducted an integrative review investigating recurrence and mortality data among breast cancer survivors who have used hormone replacement therapy (HRT). They recommend a stepwise algorithm for treating vaginal symptoms in breast cancer survivors: (1) start with nonhormonal treatments; (2) progress to a detailed discussion among patients and health-care professionals about the current known risks and benefits of vaginal estrogen; and (3) conclude with mutual decision-making between health-care providers and patients regarding the use of vaginal estrogen treatment. PMID:26705493

  5. Changing pattern of thyroid and adrenal function in postmenopausal women after hormone replacement therapy

    Institute of Scientific and Technical Information of China (English)

    Lu Shu-lan; Yu Shan-shan; Cao Zuan-sun

    2005-01-01

    Objective:To investigate the changing pattern of thyroid and adrenal function in postmenopausal women; and the relationship between hormone replacement therapy (HRT) and thyroid and adrenal function. Methods:The levels of tT3, tT4, fT3, fT4, TSH and cortisol were measured in 60 postmenopausal women (30 cases in HRT group; 30 cases in control group) before and 12 months after HRT.Results:The serum levels of tT3, tT4, fT3, fT4, TSH and cortisol had no significant difference before and 12 months after HRT in postmenopausal women. The values of them were all in normal ranges.Conclusion:Changing pattern of thyroid and adrenal function was not as significant as that of gonads in postmenopausal women and the impact of HRT on it was not so significantly evident.

  6. Description of women's personality traits and psychological vulnerability prior to choosing hormone replacement therapy

    DEFF Research Database (Denmark)

    Loekkegaard, E; Eplov, L F; Køster, A

    2002-01-01

    INTRODUCTION: Data suggest that women using hormone replacement therapy (HRT) represent a special subgroup of the general population regarding, for instance, cardiovascular risk factors and education. OBJECTIVE: To analyse if women who choose HRT are characterised a priori by high neuroticism score...... included Eysencks personality questionnaire concerning intro/extroversion and neuroticism. At the age of 45, the re-examination of the women included a test for psychological vulnerability. The participants reported whether or not they used HRT at the age of 40, 45, 51 and 60 years. The analyses comprised...... "never users" of HRT and "future users", defined as women who started HRT subsequent to baseline registration during the observation period. The groups were compared by multivariate statistical methods to adjust for confounding factors. RESULTS: Women with high neuroticism score at the age of 40 were...

  7. The influence of hormone therapies on type I and II endometrial cancer

    DEFF Research Database (Denmark)

    Mørch, Lina S.; Kjær, Susanne K.; Keiding, Niels

    2016-01-01

    The influence of hormone therapy (HT) on risk for endometrial cancer is still casting which type of HT the clinicians recommend. It is unrevealed if HT has a differential influence on Type I versus Type II endometrial tumors, and little is known about the influence of, e.g., different routes...... of administration and about the influence of tibolone. We followed all Danish women aged 50–79 years without previous cancer or hysterectomy (n = 914,595) during 1995–2009. From the National Prescription Register, we computed HT exposures as time-dependent covariates. Incident endometrial cancers (n = 6,202) were...... identified from the National Cancer Registry: 4,972 Type I tumors and 500 Type II tumors. Incidence rate ratios (RRs) and 95% confidence intervals (Cls) were estimated by Poisson regression. Compared with women never on HT, the RR of endometrial cancer was increased with conjugated estrogen: 4.27 (1...

  8. Hormone replacement therapy and age-related brain shrinkage: regional effects.

    Science.gov (United States)

    Raz, Naftali; Rodrigue, Karen M; Kennedy, Kristen M; Acker, James D

    2004-11-15

    Neuroprotective properties of estrogen have been established in animal models, but clinical trials of hormone replacement therapy (HRT) produced contradictory results. We examined the impact of HRT on age-related regional changes in human brain volume. Six brain regions were measured twice, five years apart, in 12 healthy women who took HRT and in matched controls who did not. The controls showed a typical pattern of differential brain shrinkage in the association cortices and the hippocampus with no change in the primary visual cortex. In contrast, women who took HRT showed comparable shrinkage of the hippocampus but no significant shrinkage of the neocortex. Future large scale studies may benefit from applying regional rather than global measures in assessment of brain integrity.

  9. [Puberty-delaying hormone therapy in adolescents with gender identity disorder].

    Science.gov (United States)

    Nakatsuka, Mikiya

    2013-01-01

    The guideline for the treatment of people with gender identity disorder (GID) of the Japanese Society of Psychiatry and Neurology was revised in January 2012. The guideline eased restrictions for the endocrine treatment of transsexual adolescents. A medical specialist can start treating transsexual adolescents at the age of 15 after the diagnosis of GID. It recommends that transsexual adolescents (Tanner stage 2 [mainly 12-13 years of age]) are treated by endocrinologists to suppress puberty with gonadotropin-releasing hormone (GnRH) agonists until the age of 15 years old, after which cross-sex hormones may be given. Female-to-male transsexuals do not necessarily want to start androgen therapy before presenting female secondary sexual characteristics because androgen can easily stop menstruation, cause beard growth, and lower the voice. On the contrary, male-to-female transsexuals want to start estrogen therapy before presenting male secondary sexual characteristics because estrogen cannot alter the beard and low voice. It is important to identify children with gender dysphoria in school and help them receive medical advice. However, approximately half of school teachers think that children with gender dysphoria are very rare and they do not know of the notification from Ministry of Education, Culture, Sports, Science and Technology, JAPAN, which aims to help children with gender dysphoria. The revision of the guideline for the treatment of transsexual people and endocrine treatment of transsexual adolescents by medical specialists may prevent them from attempting suicide, being depressive, and refusing to attend school. Furthermore, the treatment may help avoid mental disorders, aid being employed with the desired sexuality, and, subsequently, getting married and having children.

  10. Accelerated cell aging in female APOE-ε4 carriers: implications for hormone therapy use.

    Directory of Open Access Journals (Sweden)

    Emily G Jacobs

    Full Text Available Apolipoprotein-ε4 (APOE-ε4 is a major genetic risk factor for cognitive decline, Alzheimer's disease (AD and early mortality. An accelerated rate of biological aging could contribute to this increased risk. Here, we determined whether APOE-ε4 status impacts leukocyte telomere length (TL and the rate of cellular senescence in healthy mid-life women and, further, whether hormone replacement therapy (HT modifies this association. Post-menopausal women (N = 63, Mean age = 57.7, all HT users for at least one year, were enrolled in a randomized longitudinal study. Half of the participants (N = 32 remained on their HT regimen and half (N = 31 went off HT for approximately two years (Mean  = 1.93 years. Participants included 24 APOE-ε4 carriers and 39 non-carrier controls. Leukocyte TL was measured at baseline and the end of year 2 using quantitative polymerase chain reaction. Logistic regression analysis indicated that the odds of an APOE-ε4 carrier exhibiting telomere shortening (versus maintenance/growth over the 2-year study were more than 6 (OR  = 6.26, 95% CI  = 1.02, 38.49 times higher than a non-carrier, adjusting for established risk factors and potential confounds. Despite the high-functioning, healthy mid-life status of study participants, APOE-ε4 carriers had marked telomere attrition during the 2-year study window, the equivalent of approximately one decade of additional aging compared to non-carriers. Further analyses revealed a modulatory effect of hormone therapy on the association between APOE status and telomere attrition. APOE-ε4 carriers who went off their HT regimen exhibited TL shortening, as predicted for the at-risk population. APOE-ε4 carriers who remained on HT, however, did not exhibit comparable signs of cell aging. The opposite pattern was found in non-carriers. The results suggest that hormone use might buffer against accelerated cell aging in mid-life women at risk for dementia

  11. Menopausal hormone therapy and breast cancer risk : impact of different treatments. The European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Bakken, Kjersti; Fournier, Agnes; Lund, Eiliv; Waaseth, Marit; Dumeaux, Vanessa; Clavel-Chapelon, Francoise; Fabre, Alban; Hemon, Bertrand; Rinaldi, Sabina; Chajes, Veronique; Slimani, Nadia; Allen, Naomi E.; Reeves, Gillian K.; Bingham, Sheila; Khaw, Kay-Tee; Olsen, Anja; Tjonneland, Anne; Rodriguez, Laudina; Sanchez, Maria-Jose; Amiano Etxezarreta, Pilar; Ardanaz, Eva; Tormo, Maria-Jose; Peeters, Petra H.; van Gils, Carla H.; Steffen, Annika; Schulz, Mandy; Chang-Claude, Jenny; Kaaks, Rudolf; Tumino, Rosario; Gallo, Valentina; Norat, Teresa; Riboli, Elio; Panico, Salvatore; Masala, Giovanna; Gonzalez, Carlos A.; Berrino, Franco

    2011-01-01

    Menopausal hormone therapy (MHT) is characterized by use of different constituents, regimens and routes of administration. We investigated the association between the use of different types of MHT and breast cancer risk in the EPIC cohort study. The analysis is based on data from 133,744 postmenopau

  12. Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women - results of the Danish Osteoporosis Prevention Study

    DEFF Research Database (Denmark)

    Mosekilde, Leif; Beck-Nielsen, H; Sørensen, O H

    2000-01-01

    OBJECTIVES: To study the fracture reducing potential of hormonal replacement therapy (HRT) in recent postmenopausal women in a primary preventive scenario. METHODS: Prospective controlled comprehensive cohort trial: 2016 healthy women aged 45-58 years, from three to 24 months past last menstrual ...

  13. Risk of low-energy hip, wrist, and upper arm fractures among current and previous users of hormone replacement therapy

    DEFF Research Database (Denmark)

    Hundrup, Yrsa Andersen; Høidrup, Susanne; Ekholm, Ola

    2004-01-01

    To examine the effect of oestrogen alone and in combination with progestin on the risk of low-energy, hip, wrist, and upper arm fractures. Additionally, to examine to what extent previous use, duration of use as well as recency of discontinuation of hormone replacement therapy (HRT) influences th...

  14. Hormone replacement therapy: changes in frequency and type of prescription by Dutch GPs during the last decade of the millenium.

    NARCIS (Netherlands)

    Donker, G.A.; Spreeuwenberg, P.; Bartelds, A.I.M.; Velden, K. van der; Foets, M.

    2000-01-01

    Objective: The present study was conducted in order to determine the change of frequency and type of hormone replacement therapy (HRT) regimen newly prescribed by Dutch GPs. Methods: A comparison was made of two data sets (multi-stage random samples) collected in 1987/88 and from 1995 to 1998 concer

  15. The growth hormone (GH)-insulin-like growth factor axis during testosterone replacement therapy in GH-treated hypopituitary males

    DEFF Research Database (Denmark)

    Fisker, Sidse; Nørrelund, Helene; Juul, A

    2001-01-01

    -independent effect on IGF-I and related parameters. Eight adult hypopituitary men (39.9 +/- 5.7 years) receiving growth hormone (GH) and testosterone replacement therapy (250 mg testosterone enantate every fourth week) participated in this prospective study. Frequent blood samples were drawn over a 5 week period...

  16. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

  17. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

  18. [Factors affecting adherence of breast cancer patients to adjuvant hormonal therapy and validation of the evaluation method].

    Science.gov (United States)

    Iwai, Masaru; Fuchikami, Hiromi; Mizuno, Yoshio; Takeda, Naoko; Inoue, Yuko; Seto, Hiroshi; Kudo, Takuya; Sato, Kazuhiko

    2014-07-01

    The long-term use of hormonal therapy is important for the treatment of patients with breast cancer. Therefore, we evaluated the methods used for measuring adherence and examined factors that influence compliance. Our goal was to improve overall adherence to the treatment. Retrospective analyses by using electronic medical records and questionnaires were performed on 294 patients with breast cancer. The patients were classified into 2 groups based on the mean number of days when a dose was missed over a period of 28 days: group A(range, 0-3 days, n=272)and group B (range, B4 days, n=22). Factors that may influence adherence, including age, duration of hormonal therapy, the drug administered in hormonal therapy, the surgical method, axillary lymph node dissection, and adjuvant chemotherapy, were compared between both groups. The adherence rates calculated from electronic medical records and questionnaires were similar. The proportion of patients younger than 50 years was 30% in group A and 50% in group B(pcancer-related procedures, such as breast conserving surgery, may also be linked to poor adherence. Young age and long duration of hormonal therapy are possibly related to poor adherence. Therefore, pharmacists should identify and manage these patients to increase adherence.

  19. Markers of bone metabolism are affected by renal function and growth hormone therapy in children with chronic kidney disease

    DEFF Research Database (Denmark)

    Doyon, Anke; Fischer, Dagmar Christiane; Bayazit, Aysun Karabay;

    2015-01-01

    Objectives: The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chro...

  20. Menopausal hormone therapy and breast cancer risk : impact of different treatments. The European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Bakken, Kjersti; Fournier, Agnes; Lund, Eiliv; Waaseth, Marit; Dumeaux, Vanessa; Clavel-Chapelon, Francoise; Fabre, Alban; Hemon, Bertrand; Rinaldi, Sabina; Chajes, Veronique; Slimani, Nadia; Allen, Naomi E.; Reeves, Gillian K.; Bingham, Sheila; Khaw, Kay-Tee; Olsen, Anja; Tjonneland, Anne; Rodriguez, Laudina; Sanchez, Maria-Jose; Amiano Etxezarreta, Pilar; Ardanaz, Eva; Tormo, Maria-Jose; Peeters, Petra H.; van Gils, Carla H.; Steffen, Annika; Schulz, Mandy; Chang-Claude, Jenny; Kaaks, Rudolf; Tumino, Rosario; Gallo, Valentina; Norat, Teresa; Riboli, Elio; Panico, Salvatore; Masala, Giovanna; Gonzalez, Carlos A.; Berrino, Franco

    2011-01-01

    Menopausal hormone therapy (MHT) is characterized by use of different constituents, regimens and routes of administration. We investigated the association between the use of different types of MHT and breast cancer risk in the EPIC cohort study. The analysis is based on data from 133,744

  1. Markers of bone metabolism are affected by renal function and growth hormone therapy in children with chronic kidney disease

    DEFF Research Database (Denmark)

    Doyon, Anke; Fischer, Dagmar Christiane; Bayazit, Aysun Karabay

    2015-01-01

    Objectives: The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chro...

  2. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy.

    Science.gov (United States)

    Baber, R J; Panay, N; Fenton, A

    2016-04-01

    The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.

  3. Effect of different hormonal therapies on thyroid function in surgical menopause: short-term results.

    Science.gov (United States)

    Erel, C Tamer; Gezer, Altay; Sentürk, Levent M; Somunkiran, Asli; Kaleli, Semih; Seyisoglu, Hakan

    2007-12-01

    To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an estrogen-only (n=20), tibolone (n=20) or calcium-only (n=19) group. On the 5th postoperative day and 4th and 12th weeks, serum E2, TSH, free T3 and free T4 levels were determined. Although the initial and week 4 serum E2, TSH, free T3 and free T4 levels were comparable, the week 12 serum E2 and TSH levels were different between the subjects on estrogen therapy and those receiving tibolone or calcium only (p=0.008 and 0.000, respectively). Serum E2 levels were higher and TSH levels lower in subjects receiving estrogen. Moreover, serum TSH levels correlated negatively with serum E2 levels in the 12th week of estrogen use (r=-0.354, p=0.006). TSH increased in the tibolone group as compared to the estrogen group but was still lower than in the calcium-only group; however, the differences were not statistically significant. Irrespective of different regimens, HRT does not have an important short-term effect on thyroid function in women with surgical menopause.

  4. Exercise training associated with estrogen therapy induced cardiovascular benefits after ovarian hormones deprivation.

    Science.gov (United States)

    Flues, Karin; Paulini, Janaina; Brito, Sebastião; Sanches, Iris Callado; Consolim-Colombo, Fernanda; Irigoyen, Maria-Cláudia; De Angelis, Kátia

    2010-03-01

    Menopause is recognized as a period of increased risk for coronary heart disease. Although the benefits of exercise training in lowering cardiovascular risk factors are well established, the risks and benefits of hormone therapy have been questioned. The purpose of the present study was to investigate the effects of estrogen therapy (HT) associated or not with exercise training (ET) in autonomic cardiovascular control in ovariectomized (OVX) rats. Female rats were divided into: control, OVX, OVX+HT, OVX+ET and OVX+HT+ET. HT was performed using a 0.25mg 8-weeks sustained release pellet. Trained groups were submitted to an 8-week exercise training protocol on treadmill. Baroreflex sensitivity (BRS) was evaluated by heart rate responses to arterial pressure (AP) changes, and vagal and sympathetic tonus by pharmacological blockade. Ovariectomy induced an AP increase (123+/-2mmHg vs. 108+/-2mmHg), BRS impairment ( approximately 69%), sympathetic activation ( approximately 100%) and vagal tonus reduction ( approximately 77%) compared to controls. HT or ET normalized the changes in parasympathetic tonus. However, only the association HT+ET was able to promote normalization of AP, BRS and sympathetic tonus, as compared to controls. These results indicate that ET induces cardiovascular and autonomic benefits in OVX rats under HT, suggesting a positive role of this association in the management of cardiovascular risk factor in postmenopausal women.

  5. Imbalance in the blood antioxidant system in growth hormone-deficient children before and after 1 year of recombinant growth hormone therapy

    Directory of Open Access Journals (Sweden)

    Maria S. Pankratova

    2015-06-01

    Full Text Available The aim of our study was to examine the effects of 12-month therapy with recombinant growth hormone (rGH on the blood antioxidant system in children with growth hormone deficiency (GHD. Total antioxidant capacity (TAC of plasma was measured by FRAP (ferric reducing antioxidant power or ferric reducing ability of plasma; activities of superoxide dismutase (SOD and catalase (CAT in erythrocytes were assessed; non-protein thiols (NT and ceruloplasmin (CP levels were also measured. These parameters were determined before and after 12 month of rGH treatment. Eleven treatment-naive prepubertal children with growth hormone deficiency were included in the study. Another 11 prepubertal children comprised a control group. Before rGH treatment, TAC of plasma and NT level in the control group were significantly lower (726 ± 196 vs. 525 ± 166 µmol/L, P = 0.0182 and 0.92 ± 0.18 vs. 0.70 ± 0.22 µmol/ml, P = 0.0319, before and after the therapy, respectively. The only parameter that significantly (19.6 ± 4.7 vs. 14.5 ± 3.4 Units/g Hb, P = 0.0396 exceeded the same in the control group after rGH therapy was SOD activity. However, none of the measured parameters of antioxidant system in GHD children, except for TAC (525 ± 166 vs. 658 ± 115 µmol/L, P = 0.0205, exhibited significant improvement toward the end of the 12-month treatment period, although non-significant changes in CAT activity and CP level were also observed. This work has demonstrated that some parameters of the blood antioxidant system are out of balance and even impaired in GHD children. A 12-month treatment with rGH resulted in a partial improvement of the antioxidant system.

  6. Pulmonary thrombosis associated with antidiuretic hormone replacement therapy due to secondary diabetes insipidus after traumatic brain injury: A case report

    Science.gov (United States)

    Naito, Kiyohito; Watari, Taiji; Yasunari, Eisuke; Yamano, Miki; Mogami, Atsuhiko; Obayashi, Osamu; Kaneko, Kazuo

    2012-01-01

    INTRODUCTION Diabetes insipidus is a well-recognized complication of traumatic brain injury. The majority of patients with post-traumatic diabetes insipidus will require antidiuretic hormone (ADH) replacement therapy and tend to show dehydration. On the other hand, some negative effects of ADH on blood coagulation, such as increased platelet cohesion and the promotion of von Willebrand factor release, have also been reported. However, the incidence of thrombosis during antidiuretic hormone replacement therapy is disputed. PRESENTATION OF CASE A case of pulmonary thrombosis associated with ADH replacement therapy due to secondary diabetes insipidus after traumatic brain injury is presented here. DISCUSSION In our case, there were three factors that may have contributed to the observed thrombosis (dehydration, bed rest for a long period and ADH replacement therapy). CONCLUSION We believe that controlling urinary output and monitoring urinary and serum osmotic pressure are necessary for the management for diabetes insipidus patients after traumatic brain injury. In particular, we must carefully monitor the management of such patients during antidiuretic hormone replacement therapy. PMID:23131855

  7. Pulmonary thrombosis associated with antidiuretic hormone replacement therapy due to secondary diabetes insipidus after traumatic brain injury: A case report.

    Science.gov (United States)

    Naito, Kiyohito; Watari, Taiji; Yasunari, Eisuke; Yamano, Miki; Mogami, Atsuhiko; Obayashi, Osamu; Kaneko, Kazuo

    2013-01-01

    Diabetes insipidus is a well-recognized complication of traumatic brain injury. The majority of patients with post-traumatic diabetes insipidus will require antidiuretic hormone (ADH) replacement therapy and tend to show dehydration. On the other hand, some negative effects of ADH on blood coagulation, such as increased platelet cohesion and the promotion of von Willebrand factor release, have also been reported. However, the incidence of thrombosis during antidiuretic hormone replacement therapy is disputed. A case of pulmonary thrombosis associated with ADH replacement therapy due to secondary diabetes insipidus after traumatic brain injury is presented here. In our case, there were three factors that may have contributed to the observed thrombosis (dehydration, bed rest for a long period and ADH replacement therapy). We believe that controlling urinary output and monitoring urinary and serum osmotic pressure are necessary for the management for diabetes insipidus patients after traumatic brain injury. In particular, we must carefully monitor the management of such patients during antidiuretic hormone replacement therapy. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Does menopausal hormone therapy reduce myocardial infarction risk if initiated early after menopause? A population-based case-control study.

    Science.gov (United States)

    Carrasquilla, Germán D; Berglund, Anita; Gigante, Bruna; Landgren, Britt-Marie; de Faire, Ulf; Hallqvist, Johan; Leander, Karin

    2015-06-01

    This study aims to assess whether the timing of menopausal hormone therapy initiation in relation to onset of menopause and hormone therapy duration is associated with myocardial infarction risk. This study was based on the Stockholm Heart Epidemiology Program, a population-based case-control study including 347 postmenopausal women who had experienced a nonfatal myocardial infarction and 499 female control individuals matched for age and residential area. Odds ratios (with 95% CIs) for myocardial infarction were calculated using logistic regression. Early initiation of hormone therapy (within 10 y of onset of menopause or before age 60 y), compared with never use, was associated with an odds ratio of 0.87 (95% CI, 0.58-1.30) after adjustments for lifestyle factors, body mass index, and socioeconomic status. For late initiation of hormone therapy, the corresponding odds ratio was 0.97 (95% CI, 0.53-1.76). For hormone therapy duration of 5 years or more, compared with never use, the adjusted odds ratio was 0.64 (95% CI, 0.35-1.18). For hormone therapy duration of less than 5 years, the odds ratio was 0.97 (95% CI, 0.63-1.48). Neither the timing of hormone therapy initiation nor the duration of therapy is significantly associated with myocardial infarction risk.

  9. Lichen planus-like drug reaction associated with recombinant human growth hormone therapy in a child patient with Turner syndrome.

    Science.gov (United States)

    Soares, Mariana Quirino Silveira; Mendonca, Elismauro Fancisco

    2016-01-01

    Turner syndrome (TS) is a genetic disease with an incidence rate of between 1:2000 and 1:5000 live female births. The treatment of TS differs according to age and Recombinant Human Growth Hormone (RHGH) therapy is usually given for the treatment of short stature in girls with TS in childhood. We describe the first case of a TS patient who presented with a clinical picture compatible with oral and palmoplantar lichen planus-like reaction during RHGH therapy; spontaneous remission occurred after therapy suspension.

  10. Effect of transdermal hormone therapy on platelet haemostasis in menopausal women

    Directory of Open Access Journals (Sweden)

    Grzegorz Stachowiak

    2015-02-01

    Full Text Available [b]Introduction[/b]. Despite the undeniably positive effect on the quality of life of menopausal women, menopausal hormone therapy (HT also has negative side-effects, which include, among others, thromboembolic complications. [b]objective[/b]. To assess the effect of a popular type of this therapy – transdermal HT on platelet hemostasis, which plays a significant role in intravascular coagulation. [b]Materials and method[/b]. The study group consisted of 92 postmenopausal women: 1 group G1 (n=30, treated with transdermal HT (17β-estradiol 50 μg/day plus NETA 170 μg/day; 2 group G2 (n=31, treated with the above transdermal HT and low dosage of acetylsalicylic acid (ASA; 3 control group P (n=31. All the women qualified for the study had two or more risk factors for arterial thrombosis, such as: smoking, hypertension, visceral obesity, hypercholesterolaemia, hypertriglyceridaemia, elevated levels of PAI-1, and increased fibrinogen, increased activity of coagulation factor VII. Results. After three months of therapy, in the G1 group there was a decrease in platelet count (p = 0.004 and a decrease in GP IIb/IIIa – a platelet receptor for fibrinogen (p = 0.022. In the G2 group, no changes in the tested parameters were observed. conclusions. 1 Transdermal HT in the form of combined, estrogen-progestogen patches favourably modifies platelets haemostasis, reversing the adverse effects that occur after menopause. 2 The use of low ASA doses as a thromboprophylaxis in short-term transdermal HT is not necessary.

  11. Risk of venous thromboembolic disease in postmenopausal women taking oral or transdermal hormone replacement therapy

    Institute of Scientific and Technical Information of China (English)

    Barbara RUSZKOWSKA; Gra(z)yna GADOMSKA; Liliana BIELIS; Marzena GRUSZKA; Barbara G(O)RALCZYK; Danuta RO(S)(C); Gra(z)yna ODROW(A)(Z)-SYPNIEWSKA

    2011-01-01

    Objective: The influence of hormone replacement therapy(HRT)on hemostasis processes depends on the type of hormone,the combination of doses,the time of taking HRT,and the route of administration(oral,transdermal,implanted).The aim of the current study was to assess some parameters of coagulation,especially tissue factor pathway inhibitor(TFPI)and tissue factor(TF)in postmenopausal women using oral or transdermal HRT.Methods: The study was conducted on 76 healthy women,including 46 women aged 44-58 years who were taking oral(26)or transdermal(20)HRT,and 30 women aged 44-54 years who did not take HRT as the control group.Plasma concentrations of TF,TFPI,thrombin-antithrombin complex(TAT),and D-dimer were performed by enzyme-linked immunosorbent assay(ELISA).Moreover,the concentration of fibrinogen and activity of protein C were measured by chromogenic and chronometric methods.Results: We observed a significantly higher concentration of TF and a significantly lower concentration of TFPI in women taking oral and transdermal HRT in comparison with the control group.We also found a significantly lower concentration of fibrinogen in women taking oral HRT vs.the control group.Moreover,no statistically significant changes in concentrations of TAT and D-dimer,or activity of protein C were noted.Conclusions: In this study,the occurrence of an increased TF concentration simultaneously with a decreased concentration of TFPI in women taking HRT indicates hypercoagulability.No significant modification of TAT or D-dimer occurred,and thus there may not be increased risk of thrombosis.

  12. Toward developing recombinant gonadotropin-based hormone therapies for increasing fertility in the flatfish Senegalese sole

    Science.gov (United States)

    Chauvigné, François; Ollé, Judith; González, Wendy; Duncan, Neil; Giménez, Ignacio

    2017-01-01

    Captive flatfishes, such as the Senegalese sole, typically produce very low volumes of sperm. This situation is particularly prevalent in the first generation (F1) of reared sole males, which limits the development of artificial fertilization methods and the implementation of selective breeding programs. In this study, we investigated whether combined treatments with homologous recombinant follicle-stimulating (rFsh) and luteinizing (rLh) hormones, produced in a mammalian host system, could stimulate spermatogenesis and enhance sperm production in Senegalese sole F1 males. In an initial autumn/winter experiment, weekly intramuscular injections with increasing doses of rFsh over 9 weeks resulted in the stimulation of gonad weight, androgen release, germ cell proliferation and entry into meiosis, and the expression of different spermatogenesis-related genes, whereas a subsequent single rLh injection potentiated spermatozoa differentiation. In a second late winter/spring trial corresponding to the sole’s natural prespawning and spawning periods, we tested the effect of repeated rLh injections on the amount and quality of sperm produced by males previously treated with rFsh for 4, 6, 8 or 10 weeks. These latter results showed that the combination of rFsh and rLh treatments could increase sperm production up to 7 times, and slightly improve the motility of the spermatozoa, although a high variability in the response was found. However, sustained administration of rFsh during spawning markedly diminished Leydig cell survival and the steroidogenic potential of the testis. These data suggest that in vivo application of rFsh and rLh is effective at stimulating spermatogenesis and sperm production in Senegalese sole F1 males, setting the basis for the future establishment of recombinant gonadotropin-based hormone therapies to ameliorate reproductive dysfunctions of this species. PMID:28329024

  13. Effects of hormone replacement therapy on magnetic resonance imaging of brain parenchyma hyperintensities in postmenopausal women

    Institute of Scientific and Technical Information of China (English)

    Yan-yong LIU; Qin-sheng GE; Ping-ping ZUO; Ling HU; Chao JI; Dong-wen CHEN; Xi SHEN; Nan YANG; Yun YUE; Jing-mei JIANG; Xia HONG

    2009-01-01

    Aim:To apply 3.0 magnetic resonance imaging (MRI) to study the effects of long-term,low dose hormone replacement therapy (HRT) on the brain parenchyma of postmenopausal women.Methods:A total of 155 postmenopausal healthy female medical staff members from Peking Union Medical College Hospital were enrolled.The HRT group was composed of 71 subjects who had been given a low dose of HRT for over 4 years,while 84 women who had never been given HRT were enrolled in the control group.The Mini-Mental State Examination (MMSE) was used to evaluate mental state,and an Enzyme-Linked ImmunoSorbent Assay (ELISA) was used to detect plasma levels of sex hormones.In addition,all participants were subjected to an MRI,including axial T2 weighted imaging (T2WI),fluid-attenuated inversion recovery (FLAIR),T1 weighted imaging (TIWI,oblique coronal,vertical to the hippocampus,slice thickness 3 mm without gaps),and a 3D image of the whole brain.Results:The ELISA showed that the plasma level of estradiol in the HRT group was significantly higher than that in the control group (P

  14. Benign Phyllodes Tumor Mimicking a Malignancy in a Turner Syndrome Woman with Hormone Replacement Therapy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Jae; Chong, Se Min; Pang, Jae Choon; Seo, Jae Seung; Byun, Jun Soo; Seok, Ju Won [Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul (Korea, Republic of); Shin, Hee Jung; Gong, Gyung Yub [Asan Medical Center, University of Ulsan College of Mdeicine, Seoul (Korea, Republic of)

    2010-12-15

    Phyllodes tumor of the breast is a relatively rare fibroepithelial tumor. Turner syndrome is a condition that affects approximately 50 per 100,000 females and includes total or partial absence of one X chromosome in all or part of the cells, reduced final height, absence of female sex hormone, and infertility. In this case report, we describe the first case of a benign phyllodes tumor mimicking a malignancy at breast US in a 26-year-old woman with Turner syndrome who had been undergoing hormone replacement therapy

  15. Changes in Newspaper Coverage About Hormone Therapy with the Release of New Medical Evidence

    Science.gov (United States)

    Haas, Jennifer S; Geller, Berta; Miglioretti, Diana L; Buist, Diana SM; Nelson, David E; Kerlikowske, Karla; Carney, Patricia A; Breslau, Erica S; Dash, Sarah; Canales, Mary K; Ballard-Barbash, Rachel

    2006-01-01

    BACKGROUND Results of 2 trials of postmenopausal hormone therapy (HT) challenged established practice patterns; 1 was not associated with changes in HT use, whereas the other was associated with substantial decline. Differential coverage by lay newspapers may have contributed to the differential impact. OBJECTIVE To examine newspaper coverage of HT before and after the publication of the Heart and Estrogen Replacement Study (HERS) in August 1998, and the main findings of the estrogen plus progestin therapy arm of the Women's Health Initiative (EPT-WHI) in July 2002. DESIGN Longitudinal review of newspaper articles, 1998 to 2003 (n=663). SETTING Twenty local and 6 regional/national newspapers. MEASUREMENTS Number and content of articles about HT. RESULTS The average number of articles about HT published during the month of the publication of the EPT-WHI was at least 8-fold greater than the number of articles published on the topic during any prior period. While the majority of articles in all periods presented information about the potential benefits of HT, information about harms became more common than information about benefits during the 2 months before the publication of the EPT-WHI, when the trial participants were notified of the early termination of the study. The presentation of specific health harms was more common after the publication of the EPT-WHI than after the publication of HERS. Few articles in any period used visual aids. CONCLUSIONS The publication of the EPT-WHI was associated with a change in both the volume and content of newspaper coverage about HT. PMID:16499542

  16. The effects of a novel hormonal breast cancer therapy, endoxifen, on the mouse skeleton.

    Directory of Open Access Journals (Sweden)

    Anne Gingery

    Full Text Available Endoxifen has recently been identified as the predominant active metabolite of tamoxifen and is currently being developed as a novel hormonal therapy for the treatment of endocrine sensitive breast cancer. Based on past studies in breast cancer cells and model systems, endoxifen classically functions as an anti-estrogenic compound. Since estrogen and estrogen receptors play critical roles in mediating bone homeostasis, and endoxifen is currently being implemented as a novel breast cancer therapy, we sought to comprehensively characterize the in vivo effects of endoxifen on the mouse skeleton. Two month old ovariectomized C57BL/6 mice were treated with vehicle or 50 mg/kg/day endoxifen hydrochloride via oral gavage for 45 days. Animals were analyzed by dual-energy x-ray absorptiometry, peripheral quantitative computed tomography, micro-computed tomography and histomorphometry. Serum from control and endoxifen treated mice was evaluated for bone resorption and bone formation markers. Gene expression changes were monitored in osteoblasts, osteoclasts and the cortical shells of long bones from endoxifen treated mice and in a human fetal osteoblast cell line. Endoxifen treatment led to significantly higher bone mineral density and bone mineral content throughout the skeleton relative to control animals. Endoxifen treatment also resulted in increased numbers of osteoblasts and osteoclasts per tissue area, which was corroborated by increased serum levels of bone formation and resorption markers. Finally, endoxifen induced the expression of osteoblast, osteoclast and osteocyte marker genes. These studies are the first to examine the in vivo and in vitro impacts of endoxifen on bone and our results demonstrate that endoxifen increases cancellous as well as cortical bone mass in ovariectomized mice, effects that may have implications for postmenopausal breast cancer patients.

  17. Occurrence of DNET and other brain tumors in Noonan syndrome warrants caution with growth hormone therapy.

    Science.gov (United States)

    McWilliams, Geoffrey D; SantaCruz, Karen; Hart, Blaine; Clericuzio, Carol

    2016-01-01

    Noonan syndrome (NS) is an autosomal dominant developmental disorder caused by mutations in the RAS-MAPK signaling pathway that is well known for its relationship with oncogenesis. An 8.1-fold increased risk of cancer in Noonan syndrome has been reported, including childhood leukemia and solid tumors. The same study found a patient with a dysembryoplastic neuroepithelial tumor (DNET) and suggested that DNET tumors are associated with NS. Herein we report an 8-year-old boy with genetically confirmed NS and a DNET. Literature review identified eight other reports, supporting the association between NS and DNETs. The review also ascertained 13 non-DNET brain tumors in individuals with NS, bringing to 22 the total number of NS patients with brain tumors. Tumor growth while receiving growth hormone (GH) occurred in our patient and one other patient. It is unknown whether the development or progression of tumors is augmented by GH therapy, however there is concern based on epidemiological, animal and in vitro studies. This issue was addressed in a 2015 Pediatric Endocrine Society report noting there is not enough data available to assess the safety of GH therapy in children with neoplasia-predisposition syndromes. The authors recommend that GH use in children with such disorders, including NS, be undertaken with appropriate surveillance for malignancies. Our case report and literature review underscore the association of NS with CNS tumors, particularly DNET, and call attention to the recommendation that clinicians treating NS patients with GH do so with awareness of the possibility of increased neoplasia risk.

  18. Hormone therapy after uterine cervical cancer treatment: a Swedish population-based study.

    Science.gov (United States)

    Everhov, Åsa Hallqvist; Nyberg, Tommy; Bergmark, Karin; Citarella, Anna; Rådestad, Angelique Flöter; Hirschberg, Angelica Lindén; Smedby, Karin E

    2015-06-01

    This study aims to assess use of hormone therapy (HT) after cervical cancer treatment in women of premenopause age. We identified 837 women aged 45 years or younger at diagnosis of cervical cancer in the Swedish Cancer Register from January 1, 2005 to September 30, 2009 with a minimal follow-up of 1.5 years. Information on cancer treatment (surgical operation, radiotherapy, and/or chemotherapy) was obtained through the National Patient Register. Use of HT was estimated through HT dispensing during follow-up as recorded in the Prescribed Drug Register. Percentage of recommended dose was assessed by frequency of HT dispensing at half-year intervals up to April 1, 2011 or a maximal age of 50 years. A total of 257 women (31%) received acute estrogen deprivation due to bilateral salpingo-oophorectomy and/or radiotherapy. Among these women, 171 (67%) of 257 had at least one dispensing of HT during the period 0.5 to 1 year after diagnosis, and 118 (46%) of 257 were dispensed 75% or more of the recommended dose. Proportion users decreased to 39% at 4.5 to 5 years after diagnosis (21% with ≥ 75% of the recommended dose). Women younger than 40 years had a higher prevalence of HT use at 0.5 to 1 year (79%), decreasing to 45% after 4.5 to 5 years. The results did not vary by cancer histology. Fewer than half of cervical cancer survivors with therapy-induced early menopause used HT at or close to the recommended dose, and the use decreased during follow-up. Increased awareness of the health benefits of HT for this patient group is needed among professionals and women.

  19. The 5th Conference on Asian Trends in Prostate Cancer Hormone Therapy.

    Science.gov (United States)

    Akaza, Hideyuki; Moore, Malcolm A; Chang, Shu-Jen; Cheng, Christopher; Choi, Han Yong; Esuvaranathan, Kesavan; Hinotsu, Shiro; Hong, Sung-Joon; Kim, Choung-Soo; Kim, Wun-Jae; Murai, Masaru; Naito, Seiji; Soebadi, Doddy; Song, Jae-Mann; Umbas, Rainy; Usami, Michiyuki; Xia, Shujie; Yang, Chi-Rei

    2007-01-01

    The Conference on Asian Trends in Prostate Cancer Hormone Therapy is an annual forum for Asian urologists now in its 5th year. The 2006 conference, held in Bali, Indonesia, was attended by 27 leading urologic oncologists from China, Indonesia, Japan, Korea, Singapore, and Taiwan and featured a packed program of presentations and discussions on a wide range of topics such as relationships among clinicians and the newly opened Asia Regional Office for Cancer Control of the International Union Against Cancer (UICC), detection rates of prostate cancer by biopsy in each of the 6 Asian countries, and favored treatment modalities for hormone-refractory prostate cancer (HRPC) in each country. The first session of the conference kicked off with a keynote lecture entitled "Activities of the UICC ARO". UICC's new office will be the nerve center for its activities in the Asia region. Along with the Asian Pacific Organization for Cancer Prevention (APOCP), UICC aims to shift the focus of attention to cancer control. As such APOCP's long-running publication the APJCP is to be re-launched as the Asian Pacific Journal of Cancer Control. Although UICC is primarily concerned with cancer, several risk factors for cancer are common also to other non-communicable diseases such as diabetes and heart disease, and an important strategy is to implement measures to control these various pathologic conditions as a whole. Apart from contributing to an Asian prostate cancer registry the UICC-ARO will provide training courses, working groups, and assistance in collecting and processing data. The keynote lecture was followed by a roundtable discussion on possible ways in which clinicians from each Asian country can work with UICC. A number of suggestions were put forth including better registration, epidemiology research, possible implementation of UICC prostate cancer guidelines, early detection and screening, and roles of diet and phytotherapy. The underlying reasons for the large but

  20. Testosterone Replacement Therapy Prevents Alterations of Coronary Vascular Reactivity Caused by Hormone Deficiency Induced by Castration.

    Science.gov (United States)

    Rouver, Wender Nascimento; Delgado, Nathalie Tristão Banhos; Menezes, Jussara Bezerra; Santos, Roger Lyrio; Moyses, Margareth Ribeiro

    2015-01-01

    The present study aimed to determine the effects of chronic treatment with different doses of testosterone on endothelium-dependent coronary vascular reactivity in male rats. Adult male rats were divided into four experimental groups: control (SHAM), castrated (CAST), castrated and immediately treated subcutaneously with a physiological dose (0.5 mg/kg/day, PHYSIO group) or supraphysiological dose (2.5 mg/kg/day, SUPRA group) of testosterone for 15 days. Systolic blood pressure (SBP) was assessed at the end of treatment through tail plethysmography. After euthanasia, the heart was removed and coronary vascular reactivity was assessed using the Langendorff retrograde perfusion technique. A dose-response curve for bradykinin (BK) was constructed, followed by inhibition with 100 μM L-NAME, 2.8 μM indomethacin (INDO), L-NAME + INDO, or L-NAME + INDO + 0.75 μM clotrimazole (CLOT). We observed significant endothelium-dependent, BK-induced coronary vasodilation, which was abolished in the castrated group and restored in the PHYSIO and SUPRA groups. Furthermore, castration modulated the lipid and hormonal profiles and decreased body weight, and testosterone therapy restored all of these parameters. Our results revealed an increase in SBP in the SUPRA group. In addition, our data led us to conclude that physiological concentrations of testosterone may play a beneficial role in the cardiovascular system by maintaining an environment that is favourable for the activity of an endothelium-dependent vasodilator without increasing SBP.

  1. Hormone Replacement Therapy and Risk of Breast Cancer in Korean Women: A Quantitative Systematic Review

    Science.gov (United States)

    Bae, Jong-Myon; Kim, Eun Hee

    2015-01-01

    Objectives: The epidemiological characteristics of breast cancer incidence by age group in Korean women are unique. This systematic review aimed to investigate the association between hormone replacement therapy (HRT) and breast cancer risk in Korean women. Methods: We searched electronic databases such as KoreaMed, KMbase, KISS, and RISS4U as well as PubMed for publications on Korean breast cancer patients. We also conducted manual searching based on references and citations in potential papers. All of the analytically epidemiologic studies that obtained individual data on HRT exposure and breast cancer occurrence in Korean women were selected. We restricted the inclusion of case-control studies to those that included age-matched controls. Estimates of summary odds ratio (SOR) with 95% confidence intervals (CIs) were calculated using random effect models. Results: One cohort and five case-control studies were finally selected. Based on the heterogeneity that existed among the six studies (I-squared=70.2%), a random effect model was applied. The summary effect size of HRT history from the six articles indicated no statistical significance in breast cancer risk (SOR, 0.983; 95% CI, 0.620 to 1.556). Conclusions: These facts support no significant effect of HRT history in the risk of breast cancer in Korean women. It is necessary to conduct a pooled analysis. PMID:26429288

  2. Insulin resistance and medial prefrontal gyrus metabolism in women receiving hormone therapy.

    Science.gov (United States)

    Rasgon, Natalie L; Kenna, Heather A; Wroolie, Tonita E; Williams, Katherine E; DeMuth, Bevin N; Silverman, Daniel H S

    2014-07-30

    Insulin resistance (IR) is a putative risk factor for cognitive decline and dementia, and has been shown to impede neuronal glucose metabolism in animal models. This post hoc study focused on metabolic changes in the medial prefrontal region, a brain region exhibiting decline years before documented cognitive changes, relative to high or low IR status in a cohort of postmenopausal women at risk for dementia who were randomized to continue or discontinue existing stable hormone therapy (HT) for 2 years. Subjects were dichotomized into high and low IR groups based on the homeostatic model assessment of insulin resistance, which was within clinically normal limits for the group as a whole at both baseline and 2-year follow-up. Results showed that high and low IR groups showed significant differences in metabolic decline of the medial prefrontal gyrus, regardless of HT randomization group. However, HT randomization was predictive of metabolic decline only in women with low HOMA (homeostatic assessment of insulin resistance). Performance in working memory was consistent with observed metabolic changes. These results suggest IR may be an independent moderator of regional metabolic changes, while protective metabolic effects of HT are most apparent in those at low-end range of IR. If replicated in future studies, these findings will help to better understand the interaction between putative risk and protective factors, and further delineate cohort postmenopausal women who may benefit from HT.

  3. Laser Printing of PCL/Progesterone Tablets for Drug Delivery Applications in Hormone Cancer Therapy

    Science.gov (United States)

    Salmoria, G. V.; Klauss, P.; Kanis, L. A.

    2017-09-01

    In this study, polycaprolactone (PCL) and progesterone (PG) tablets were produced by selective laser sintering (SLS) using different particle sizes and laser energy. The sintered PCL/PG tablets presented uniform morphology, coalescence of particles and interconnected pores distributed in the polymeric matrix. The EDS analysis confirmed the presence of progesterone recrystallized on the surface of the porous PCL matrix. The crystallinity values for the PCL/PG tablets were lower than that for the pure PCL, suggesting the interaction of components at the molecular level. The PCL/PG tablets fabricated with small particles and high laser energy presented a higher value for the flexural modulus compared with the other specimens. The glass transition temperature (Tg) was -37 °C for the PCL/PG tablet with a high degree of sintering. The fatigue test showed that the PCL/PG blend tablets have high fatigue strength. The drug release mechanism of all tablets studied followed a zero-order kinetics, and drug release rates were dependent on sintering degree and, consequently, on matrix erosion, showing a potential application to controlled drug delivery in hormone cancer therapy.

  4. Hormone therapy at early post-menopause increases cognitive control-related prefrontal activity

    Science.gov (United States)

    Girard, Romuald; Météreau, Elise; Thomas, Julie; Pugeat, Michel; Qu, Chen; Dreher, Jean-Claude

    2017-01-01

    Clinical data have been equivocal and controversial as to the benefits to the brain and cognition of hormone therapy (HT) in postmenopausal women. Recent reevaluation of the role of estrogens proposed that HT may effectively prevent the deleterious effects of aging on cognition, and reduces the risks of dementia, including Alzheimer’s disease, if initiated early at the beginning of menopause. Yet, little is known about the effects of HT on brain activation related to cognitive control, the ability to make flexible decisions in relation to internal goals. Here, we used fMRI to directly test for a modulation of sequential 17β estradiol (2 mg/day) plus oral progesterone (100 mg/day) on task switching-related brain activity in women at early postmenopause. The results showed that HT enhanced dorsolateral prefrontal cortex recruitment during task switching. Between-subjects correlation analyses revealed that women who engaged more the dorsolateral prefrontal cortex showed higher task switching performance after HT administration. These results suggest that HT, when taken early at the beginning of postmenopause, may have beneficial effect on cognitive control prefrontal mechanisms. Together, these findings demonstrate that HT can prevent the appearance of reduced prefrontal cortex activity, a neurophysiological measure observed both in healthy aging and early dementia.

  5. [HORMONALLY-GENETICALLY DEPENDENT THERAPY, USING VITAMIN K IN PATIENTS, SUFFERING THE ULCER HEMORRHAGE].

    Science.gov (United States)

    Duzhyi, I D; Kharchenko, S V

    2016-04-01

    Pathophysiological mechanisms of the vitamin K impact, including those in the gut with ulcerative affection, are studied still insufficiently. Investigations of pharmacogenomics of the vitamin K gives a new approach to therapy in patients, suffering gastro-intestinal hemorrhage. Possibilities of titration of the vitamin K3 (menadione) doses, depending on level of estrogenemia and genetic constitution, concerning genes-candidates ESR1 (rs2234693) and VKORC1 (rs9923231), were studied. There were examined 36 patients, who were treated for the ulcer hemorrhage. The blood serum concentration of estradiol was investigated in accordance to method of solid phase enzyme immunoassay, the genotyping procedure was performed in accordance to indices of polymerase chain reaction with analysis of the restrictional fragments length. The initial daily dose of menadione have constituted 20 mg. After a genotype determination made (first-second day after admittance to hospital) in patients with normoestrogenemia in genotypes CC/GG, CC/GA, CT/GG, CT/GA a vitaminotherapy was prolonged in daily dose of 20 mg, and in a conditionally-pathological variant of genotype the dose of vitamin K was enhanced up to 30 mg. Determination of hormones and the patients' genetic constitution makes possible to apply a personified approach for the vitamin K3 application in the ulcerative hemorrhage.

  6. Prevalence of hormone replacement therapy in a sample of middle-aged women

    DEFF Research Database (Denmark)

    Pedersen, S H; Jeune, B

    1988-01-01

    A survey based on a postal questionnaire sent to a random sample of Danish women aged 40-59 yr living on the island of Fünen (n = 401, response rate = 79%) revealed that the overall prevalence of the use of hormone replacement therapy (HRT) was 16%, the highest rate being in the 50-54 age group (21......%). Among post-menopausal women the rate was 21% and it was highest of all (37%) in those who had undergone an artificial menopause. The median age at the start of treatment was 44.3 yr among the artificial menopause and 48.9 yr among the natural menopause subjects. About half of the women were treated...... with natural oestrogen alone and over a third with cyclic natural oestrogen in combination with progestogens. Almost one-third of the women had consulted their doctor about climacteric complaints and two-thirds of these were current or past users of HRT. The women had ambiguous feelings towards HRT...

  7. Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype.

    Science.gov (United States)

    McCullough, Marjorie L; Patel, Alpa V; Patel, Roshni; Rodriguez, Carmen; Feigelson, Heather Spencer; Bandera, Elisa V; Gansler, Ted; Thun, Michael J; Calle, Eugenia E

    2008-01-01

    Epidemiologic studies unequivocally show that greater body mass increases the risk of endometrial cancer, but whether risk varies by use of postmenopausal hormone therapy (HT), location of fat deposition, or cancer subtype is still unclear. We examined these associations among 33,436 postmenopausal women in the Cancer Prevention Study II Nutrition Cohort, who completed questionnaires on diet, lifestyle, and medical history at baseline in 1992. A total of 318 cases were eligible through June 2003. Cox-proportional hazards analyses were used to estimate multivariate-adjusted rate ratios (RR). As expected, adult body mass index (BMI) was a strong predictor of risk [RR, 4.70; 95% confidence interval (CI), 3.12-7.07 for BMI 35+ versus 22.5-25.0, P trend or =35 versus 22.5-25.0, P trend or =30 versus <25.0) increased risk of both "type I" (classic estrogen pathway, RR, 4.22; 95% CI, 3.07-5.81) and "type II" (serous, clear cell, and all other high grade) cancers (RR, 2.87; 95% CI, 1.59-5.16). The increased risk of endometrial cancer across the range of BMI in women who never used postmenopausal HT stresses the need to prevent both overweight and obesity in women.

  8. Effects of hormone replacement therapy on platelet activation in postmenopausal women

    Institute of Scientific and Technical Information of China (English)

    古健; 杨冬梓; 王良岸; 尹松梅; 邝健全

    2003-01-01

    Objective To assess the effects of hormone replacement therapy (HRT) on platelet activation in postmenopausal women compared with premenopausal women. Methods The expressions of CD41 and CD62P in fifteen postmenopausal women before and after HRT were detected using flow cytometry (FCM), with fifteen premenopausal women with a mean age of 47 years as controls.Results The expressions of CD41 and CD62P in postmenopausal women were higher than those in the control group. CD62P(%), CD62P(I) and CD41 were reduced from 36.40±5.9, 37.75±5.8, and 470.11±74.0 to 27.97±5.6, 26.64±4.9, and 303.23±72.8 after six months of HRT (P<0.05). Conclusions Platelet activation in postmenopausal women was higher than in premenopausal women and was reduced significantly after six months of HRT. HRT may have a favorable effect on reduction of platelet activity.

  9. Reprint of "Use of medroxyprogesterone acetate for hormone therapy in postmenopausal women: Is it safe?".

    Science.gov (United States)

    Stanczyk, Frank Z; Bhavnani, Bhagu R

    2015-09-01

    Medroxyprogesterone acetate (MPA) has been in clinical use for over 30 years, and was generally considered to be safe until the results of long-term studies of postmenopausal hormone therapy (HT) using treatment with conjugated equine estrogens (CEE) combined with MPA and CEE alone suggested that MPA, and perhaps other progestogens, may play a role in the increased risk of breast cancer and cardiovascular diseases. This review examines critically the safety of MPA in terms of breast cancer and cardiovascular disease risk, and its effects on brain function. Research into mechanisms by which MPA might cause adverse effects in these areas, combined with the available clinical evidence, suggests a small increase in relative risk for breast cancer and stroke, and a decline in cognitive function, in older women using MPA with an estrogen for postmenopausal HT. However, short-term (less than 5 years) use of MPA with an estrogen in the years immediately after the onset of menopause for the management of vasomotor symptoms does not appear to be associated with any increased risk of these disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Testosterone Replacement Therapy Prevents Alterations of Coronary Vascular Reactivity Caused by Hormone Deficiency Induced by Castration.

    Directory of Open Access Journals (Sweden)

    Wender Nascimento Rouver

    Full Text Available The present study aimed to determine the effects of chronic treatment with different doses of testosterone on endothelium-dependent coronary vascular reactivity in male rats. Adult male rats were divided into four experimental groups: control (SHAM, castrated (CAST, castrated and immediately treated subcutaneously with a physiological dose (0.5 mg/kg/day, PHYSIO group or supraphysiological dose (2.5 mg/kg/day, SUPRA group of testosterone for 15 days. Systolic blood pressure (SBP was assessed at the end of treatment through tail plethysmography. After euthanasia, the heart was removed and coronary vascular reactivity was assessed using the Langendorff retrograde perfusion technique. A dose-response curve for bradykinin (BK was constructed, followed by inhibition with 100 μM L-NAME, 2.8 μM indomethacin (INDO, L-NAME + INDO, or L-NAME + INDO + 0.75 μM clotrimazole (CLOT. We observed significant endothelium-dependent, BK-induced coronary vasodilation, which was abolished in the castrated group and restored in the PHYSIO and SUPRA groups. Furthermore, castration modulated the lipid and hormonal profiles and decreased body weight, and testosterone therapy restored all of these parameters. Our results revealed an increase in SBP in the SUPRA group. In addition, our data led us to conclude that physiological concentrations of testosterone may play a beneficial role in the cardiovascular system by maintaining an environment that is favourable for the activity of an endothelium-dependent vasodilator without increasing SBP.

  11. Analysis of the Influence of Hormone Replacement Therapy on Osteocalcin Gene Expression in Postmenopausal Women.

    Science.gov (United States)

    Rahnama, Mansur; Jastrzębska-Jamrogiewicz, Izabela; Jamrogiewicz, Rafał; Trybek, Grzegorz

    2015-01-01

    Osteocalcin (OC) contributes to the process of bone mineralization. Present study was designed to investigate the changes in OC gene expression of postmenopausal women treated with hormone replacement therapy (HRT). Study was also designed to evaluate OC gene expression in cells which are not part of connective tissue. Research was carried out on 30 postmenopausal women not treated and 30 treated with HRT. Examination of OC gene expression was conducted on peripheral blood lymphocytes (PBL) and buccal epithelial lining (BEL). Densitometry was conducted on femur and mandible. Tests revealed OC gene expression in BEL and PBL. BMD was higher in groups treated with HRT. Assessment of correlation between the OC gene expression in BEL and BMD of mandible revealed significant positive relation. OC gene expression can be stated BEL and PBL. Analysis of correlation between OC gene expression in oral cavity and mandible BMD showed significant correlation between local OC expression and local bone metabolism. The relation between OC gene expression and bone metabolism is complex and further research is needed to clear all of the uncertainties.

  12. Loyalties in clinical research on drugs: the case of hormone replacement therapy.

    Science.gov (United States)

    Palmlund, Ingar

    2006-07-01

    In this study, physicians' loyalties toward patients and pharmaceutical companies in clinical drug research are explored, using Bourdieu's conceptual tools. The utilization of estrogen supplements in so-called hormone replacement therapy (HRT) for healthy menopausal and postmenopausal women is used as a case. For over 60 years a multitude of reports in medical journals have praised the benefits of HRT, even though some studies indicated hazards. Clinical studies and promotional campaigns resulted in prescriptions of HRT for millions of women. A large randomized controlled clinical trial known as the Women's Health Initiative (WHI) in 2002 demonstrated that many of the claims of benefits of HRT had been misguiding; the risks of cancer and heart disease had been proven higher than most purported benefits. I draw on Bourdieu's theories to emphasize that a more distinct demarcation line between those who dispose their economic capital in the interests of producing and promoting products for profit, and those who exchange their cultural capital for economic benefits, is needed to ensure trust in physicians' loyalty to patients is not eroded.

  13. Transgenic Studies with a Keratin Promoter-Driven Growth Hormone Transgene: Prospects for Gene Therapy

    Science.gov (United States)

    Wang, Xiaoming; Zinkel, Sandra; Polonsky, Kenneth; Fuchs, Elaine

    1997-01-01

    Keratinocytes are potentially appealing vehicles for the delivery of secreted gene products because they can be transferred to human skin by the relatively simple procedure of grafting. Adult human keratinocytes can be efficiently propagated in culture with sufficient proliferative capacity to produce enough epidermis to cover the body surface of an average adult. However, the feasibility of delivering secreted proteins through skin grafting rests upon (i) the strength of the promoter in keratinocytes and (ii) the efficiency of protein transport through the basement membrane of the stratified epithelium and into the bloodstream. In this paper, we use transgenic technology to demonstrate that the activity of the human keratin 14 promoter remains high in adult skin and that keratinocyte-derived human growth hormone (hGH) can be produced, secreted, and transported to the bloodstream of mice with efficiency that is sufficient to exceed by an order of magnitude the circulating hGH concentration in growing children. Transgenic skin grafts from these adults continue to produce and secrete hGH stably, at ≈ 1/10 physiological levels in the bloodstream of nontransgenic recipient mice. These studies underscore the utility of the keratin 14 promoter for expressing foreign transgenes in keratinocytes and demonstrate that keratinocytes can be used as effective vehicles for transporting factors to the bloodstream and for eliciting metabolic changes. These findings have important implications for considering the keratinocyte as a possible vehicle for gene therapy.

  14. Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis

    Science.gov (United States)

    Wang, Siqi; Wang, Yuqiong; Xu, Jinming; Chen, Yuxin

    2017-01-01

    Abstract Background: Association between exogenous estrogen intake and cholelithiasis risk has been reported in several epidemiological studies, including oral contraceptive (OC) and hormone replacement therapy (HRT), while the results were controversial. This study aimed to perform a comprehensive meta-analysis of this issue. Methods: PUBMED, EMBASE, and Cochrane library database were searched up to October 2016. Two reviewers independently extracted data from eligible studies, relative risks (RRs), and/or odds ratios (ORs) with 95% confidence intervals (95% CIs) for the highest versus lowest categories of intake were adopted. Either a fixed- or a random-effects model was adopted to estimate overall RRs or ORs. Besides, subgroup and publication bias analyses were applied to explain the heterogeneity. An original study was also conducted to verify our conclusion. Results: A total of 19 studies with approximately 556,620 participants were included in this meta-analysis. The pooled RR of cholelithiasis for the highest versus the lowest categories was 1.59 (95% CI: 1.44–1.75), indicating that exogenous estrogen was positive associated with the intake of exogenous estrogen. However, the pooled RR of OC intake and cholelithiasis risk was 1.19 (95% CI: 0.97–1.45), and the RR for HRT was 1.79 (95% CI: 1.61–2.00). Conclusion: The HRT was positively associated with the cholelithiasis risk, and the OC will not increase the risk of cholelithiasis. PMID:28383429

  15. Effects of Hormone Therapy on Oxidative Stress in Postmenopausal Women with Metabolic Syndrome

    Science.gov (United States)

    Sánchez-Rodríguez, Martha A.; Zacarías-Flores, Mariano; Castrejón-Delgado, Lizett; Ruiz-Rodríguez, Ana Karen; Mendoza-Núñez, Víctor Manuel

    2016-01-01

    The aim of this study was to determine the effect of oral hormone therapy (HT) on oxidative stress (OS) in postmenopausal women with metabolic syndrome (MetS). A randomized, double blind, placebo-controlled trial was carried out. We formed four groups of 25 women each; healthy (HW) and MetS women (MSW) were assigned to HT (1 mg/day of estradiol valerate plus 5 mg/10 day of medroxiprogesterone) or placebo. We measured plasma lipoperoxides, erythrocyte superoxide dismutase and glutathione peroxidase, total plasma antioxidant status and uric acid, as OS markers. Alternative cut-off values of each parameter were defined and a stress score (SS) ranging from 0 to 7 was used as total OS. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria. Participants were seen at baseline, 3 and 6 months. After 6 months, MetS decreased in MSW-HT (48%), their triglycerides and high-density lipoprotein cholesterol (HDL-c) improved; in the other groups no difference was found. SS in MSW-HT decreased (3.8 ± 0.3 to 1.7 ± 0.3, p < 0.05) and OS was also reduced (44%), this effect was evident since 3 mo. HW-HT with high OS also decreased (40%). In placebo groups there was no change. Our findings suggest that HT improve lipids and OS associated to MetS in postmenopausal women. PMID:27563883

  16. A decade post WHI, menopausal hormone therapy comes full circle--need for independent commission.

    Science.gov (United States)

    Utian, W H

    2012-08-01

    The sudden decision by the National Heart, Lung, and Blood Institute of the National Institutes of Health to terminate the estrogen-progestogen therapy arm of the Women's Health Initiative (WHI) Study a decade ago now begs two questions:--has women's health after menopause been helped or harmed as a result of the findings and the way in which they were presented, and, if harmed, what needs to be done to put things right? Time and multiple reviews of specific publications from the WHI lead to the serious question whether a project designed to be of benefit to women's health has boomeranged, and instead may have resulted in significant impairment to both the quality of life and physical health of postmenopausal women. It is therefore urgent to confirm whether this is so and whether corrective action needs be taken to prevent even more harm. There are two obvious and immediate actions to be called for: (1) The Food and Drug Administration (FDA) needs to revisit the black-box warnings on postmenopausal hormones. Specifically, there needs to be a separation of the advisories for estrogen alone from estrogen and progestogen combined usage. (2) Justification is given to call for an independent commission to scrutinize every major WHI paper to determine whether the data justified the conclusions drawn. Women progressing through and beyond menopause in the next decade need to be spared the unnecessary harm that may have been inflicted on their sisters of the previous decade.

  17. Effects of Hormone Therapy on Oxidative Stress in Postmenopausal Women with Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Martha A. Sánchez-Rodríguez

    2016-08-01

    Full Text Available The aim of this study was to determine the effect of oral hormone therapy (HT on oxidative stress (OS in postmenopausal women with metabolic syndrome (MetS. A randomized, double blind, placebo-controlled trial was carried out. We formed four groups of 25 women each; healthy (HW and MetS women (MSW were assigned to HT (1 mg/day of estradiol valerate plus 5 mg/10 day of medroxiprogesterone or placebo. We measured plasma lipoperoxides, erythrocyte superoxide dismutase and glutathione peroxidase, total plasma antioxidant status and uric acid, as OS markers. Alternative cut-off values of each parameter were defined and a stress score (SS ranging from 0 to 7 was used as total OS. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII criteria. Participants were seen at baseline, 3 and 6 months. After 6 months, MetS decreased in MSW-HT (48%, their triglycerides and high-density lipoprotein cholesterol (HDL-c improved; in the other groups no difference was found. SS in MSW-HT decreased (3.8 ± 0.3 to 1.7 ± 0.3, p < 0.05 and OS was also reduced (44%, this effect was evident since 3 mo. HW-HT with high OS also decreased (40%. In placebo groups there was no change. Our findings suggest that HT improve lipids and OS associated to MetS in postmenopausal women.

  18. Are women who are taking Hormone Replacement Therapy doing so with informed consent?

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, E.M

    2003-11-01

    Just over half the population in Britain today are women, and each is likely to spend over one-third of her life in the post menopausal state. The number of post-war 'Baby Boomers' is having a profound effect on interest in the menopause and increasing awareness of Hormone Replacement Therapy (HRT). Patients are no longer prepared to passively accept the advice of their doctor, and should make an informed decision over its use, after having been given up-to-date information. Some of the claimed benefits of taking HRT are not fully proven and the risks and disadvantages must be considered, notably the increased risk of breast cancer and the effect on the sensitivity and specificity of the mammographic image. The long-term benefits are still uncertain. Available information needs to be comprehensible, credible, and up to date. Whether to initiate the taking of HRT is one of the most important decisions a woman entering mid-life will make, so she needs to be given information she can understand in order to make an informed decision. HRT and informed consent are topics relevant to mammography, which was the rationale in writing this paper as part of a Post Graduate Certificate in Mammographic Studies.

  19. The use of 17β Estradiol gel and progestogen tablet for hormone replacement therapy (HRT in menopause

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2003-09-01

    Full Text Available The treatment and prevention of disease in menopausal women due to deficiency of estrogen hormone are done through the administration of estrogen hormone, known as hormone replacement therapy (HRT. The administration of HRT is commonly done through the administration of tablets. However, the administration of tablet will result in metabolism in the colon and liver. Tablets are usually used on a daily basis such that it may lead to boredom and results in gastrointestinal disorder. The administration of gel, on the other hand, is done by applying the gel to the body and therefore metabolism in the colon and liver can be prevented. In women with uterus, estrogen must be combined with progestogen. The type of progestogen recommended is the one with natural derivative and which possesses antimineralocorticoid properties, such that fluid retention can be avoided. One of the types of progestogen which does not result in fluid retention is nomogestrol acetate. Nomogestrol acetate will also inhibit 17β hydrosisteroiddehydrogency enzyme type 1, such that estradiol (E2 is prevented from being transformed into estron (E1. As a result, E2 level in the breast tissue is kept at minimum, thereby reducing the risk of breast cancer. (Med J Indones 2003; 12: 194-8 Keywords: 17β estradiol gel, hormone replacement therapy, progestogen, nomogestrol acetate, enzyme

  20. Is timing everything? A meeting report of the Society for Women's Health Research roundtable on menopausal hormone therapy.

    Science.gov (United States)

    Davies, Erika; Mangongi, Ngoda P; Carter, Christine L

    2013-04-01

    The Society for Women's Health Research (SWHR) is a national, nonprofit organization based in Washington DC that is dedicated to transforming women's health through science, advocacy, and education. For more than 10 years, women and the physicians who treat them have been concerned about the safety of menopausal hormone therapy, largely since the early termination of two large federally funded studies. Considerable confusion remains despite decades of accumulated evidence from observational studies, clinical trials, and meta-analyses. In November 2012, SWHR convened 18 of the foremost experts within the field for a roundtable event to discuss the collective evidence related to the risks and benefits of hormone therapy. This report includes a synopsis of those discussions, the clinical statements that were generated and agreed upon, and the research recommendations suggested by the assembled experts.

  1. EFFECT OF GROWTH HORMONE REPLACEMENT THERAPY ON THE QUALITY OF LIFE IN WOMEN WITH GROWTH HORMONE DEFICIENCY WHO HAVE A HISTORY OF ACROMEGALY VERSUS OTHER DISORDERS

    Science.gov (United States)

    Valassi, Elena; Brick, Danielle J.; Johnson, Jessica C.; Biller, Beverly M. K.; Klibanski, Anne; Miller, Karen K.

    2013-01-01

    Objective To compare the response in quality of life (QoL) to growth hormone (GH) replacement in women with GH deficiency (GHD) and a history of acromegaly with that in women with GHD of other causes. Methods Fifty-five women with GHD were studied: 17 with prior acromegaly and 38 with other causes of GHD. We compared two 6-month, randomized, placebo-controlled studies of GH therapy in women with hypopituitarism conducted with use of the same design—one in women with a history of acromegaly and one in women with no prior acromegaly. QoL was assessed with the following questionnaires: the QoL-Assessment of Growth Hormone deficiency in Adults (AGHDA), the Symptom Questionnaire, and the 36-Item Short-Form Health Survey (SF-36). Results The 2 groups had comparable mean pretreatment age, body mass index, and QoL scores and comparable mean GH dose at 6 months (0.61 ± 0.30 versus 0.67 ± 0.27 mg daily). After 6 months of GH replacement therapy, women with GHD and prior acromegaly demonstrated a greater improvement in AGHDA score, four SF-36 subscales (Role Limitations due to Physical Health, Energy or Fatigue, Emotional Well-Being, and Social Functioning), and the Somatic Symptoms subscale of the Symptom Questionnaire than did women with GHD of other causes. Poorer pretreatment QoL was associated with a greater improvement in QoL after administration of GH. Conclusion In this study, GH replacement therapy improved QoL in women with GHD and a history of acromegaly but not in women with GHD due to other hypothalamic and pituitary disorders. Further studies are needed to determine the long-term risks versus benefits of GH replacement in patients who develop GHD after definitive treatment for acromegaly. PMID:22440981

  2. Effects of different progestin regimens in hormone replacement therapy on blood coagulation factor VII and tissue factor pathway inhibitor

    DEFF Research Database (Denmark)

    Bladbjerg, E-M; Skouby, S O.; Andersen, L F;

    2002-01-01

    BACKGROUND: Long-term hormone replacement therapy (HRT) reduces cardiovascular risk, but an early increased risk was reported in women with coronary heart disease. In such women the arterial intima can express tissue factor, and changes in coagulation factor VII (factor VII) and tissue factor...... after progestin intake. The integrated response, AUC, for TFPI was significantly lower in the HRT groups compared with the reference group. CONCLUSION: The observed changes may increase the early thrombotic risk associated with HRT use. Udgivelsesdato: 2002-Dec...

  3. Favorable Impacts of Growth Hormone (GH) Replacement Therapy on Atherogenic Risks in Japanese Children with GH Deficiency

    OpenAIRE

    Kohno, Hitoshi; Tanaka, Toshiaki; Fujieda, Kenji; Chihara, Kazuo; Seino, Yoshiki; Irie, Minoru; Takano, Kazue

    2012-01-01

    Growth hormone (GH) affects body composition and atherogenic risk factors. Severe hyperlipidemia may develop in GH-deficient adults as a consequence of continuous GH deficiency. We investigated changes in lipid profiles in 158 Japanese children (103 boys and 55 girls) with GH deficiency who had been enrolled in the Pfizer International Growth Database Japan during 3 yr of GH replacement therapy to evaluate whether GH treatment has beneficial effects on atherogenic risk factors. Total choleste...

  4. Update on medical and regulatory issues pertaining to compounded and FDA-approved drugs, including hormone therapy

    OpenAIRE

    Pinkerton, JoAnn V; Pickar, James H.

    2016-01-01

    Abstract Objective: We review the historical regulation of drug compounding, concerns about widespread use of non-Food and Drug Admiistration (FDA)-approved compounded bioidentical hormone therapies (CBHTs), which do not have proper labeling and warnings, and anticipated impact of the 2013 Drug Quality and Security Act (DQSA) on compounding. Methods: US government websites were searched for documents concerning drug compounding regulation and oversight from 1938 (passage of Federal Food, Drug...

  5. Evolution of glycated haemoglobin in adults on growth hormone replacement therapy.

    Science.gov (United States)

    Andrea Parra R, Paola; Barquiel A, Beatriz; Fernández M, Alberto; Pérez F, Laura; Lecumberri S, Beatriz; Gaby Llaro C, Mary; Álvarez-Escolá, Cristina

    2015-05-01

    To evaluate the effects of GH replacement therapy (GHR) for 3 years on glycated haemoglobin (HbA1c) and on the presence of dysglycaemia at any time during follow-up in Spanish adult patients with growth hormone deficiency (GHD). A retrospective study of 41 patients with GHD was conducted using baseline and long-term data. Changes in HbA1c values during the first 3 years of GHR were studied in both the overall population and patients with or without dysglycaemia during follow-up. Dysglycaemia was defined as FPG ≥ 100 mg/dl and/or HbA1c ≥ 5.7%. Mean HbA1c value (5.4 ± 0.4% at baseline) increased during the first and second years of GHR (HbA1c 5.5 ± 0.4%, p=0.05, and 5.5 ± 0.4%, p=0.006 respectively). This increase was not maintained during the third year (HbA1c 5.4 ± 0.3%, p=0.107) of GHR. Twenty-eight patients (68.2%) had dysglycaemia during follow-up, 9 of them since baseline. In the 19 patients without baseline dysglycaemia, HbA1c increased during the first year and remained stable in the next 2 years (mean HbA1c 5.2 ± 0.4% at baseline; 5.5 ± 0.4% at 1 year, p<0.050; 5.4 ± 0.4% at 2 years, p=0.004, and 5.4 ± 0.4% at 3 years, p=0.016). In the 9 patients with baseline dysglycaemia, HbA1c did not significantly change during the 3 years of GHR therapy. HbA1c values increased during the first 2 years of GHR therapy. In patients with no dysglycaemia before treatment, HbA1c steadily increased over the 3 years. However, it did not change in patients with baseline dysglycaemia. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  6. Shared decision making and patient choice for growth hormone therapy: current perspectives

    OpenAIRE

    George B; Ayyar V

    2016-01-01

    Belinda George, Vageesh Ayyar Department of Endocrinology, St. John’s Medical College Hospital, Bangalore, Karnataka, India Abstract: Growth hormone has now been available in medical practice for close to 50 years. Its use has provided dramatic results in patients with growth hormone deficiency and it is associated with an overall favorable safety profile. Over the years, the utility of growth hormone has expanded to include treatment for short stature associated with condi...

  7. Is hormonal therapy effective in advanced endometrial cancer? A systematic review and meta-analysis.

    Science.gov (United States)

    Ethier, Josee-Lyne; Desautels, Danielle N; Amir, Eitan; MacKay, Helen

    2017-10-01

    Hormonal therapy (HT) is used commonly in the treatment of advanced endometrial cancer (EC). However, a 2010 Cochrane Review did not show a survival benefit for HT. Here, we quantify its effects and explore the influence of clinico-pathologic factors and hormone receptor (HR) status on overall response rates (ORR). A systematic search of electronic databases identified publications of HT in advanced EC. Data from individual studies reporting ORR, median progression-free (PFS) or overall survival (OS) were weighted by individual study sample size and pooled in a meta-analysis. Outcomes of estrogen (ER) and progesterone receptor (PgR) subgroups were collected. Studies of first- and second-line HT were analyzed independently. Mixed studies were included if subgroup data based on previous HT exposure were provided. Meta-regression was performed to evaluate the influence of clinico-pathologic factors on outcomes. Thirty-nine studies were included, with seven providing subgroup data based on HR status. First-line HT was associated with a mean ORR of 21.6% and clinical benefit rate (CBR) of 36.7%. Median PFS and OS were 2.8 and 10.2months respectively. ORR was 20.4% in clinical trials and 25.3% in observational studies. Magnitude of ORR was lower in older age, adenosquamous histology and high grade. ORR was higher in ER+ (26.5%) and PgR+ (35.5%) disease, and lower in ER- (9.2%) or PgR- (12.1%) tumors. Second-line ORR was 18.5%. CBR was 35.8%, but was significantly associated with timing of stable disease assessments in first- and second-line. Meta-regression performed in mixed and second-line studies showed an association between previous HT and greater ORR (β 0.561; p=0.024), suggesting potential confounding by indication (re-treatment of good responders to first-line HT). HT is associated with modest ORR in advanced EC, and is greatest in HR+ tumors. Response rates in second-line are likely dependent on response to previous HT. Copyright © 2017 Elsevier Inc. All

  8. Variation in the FGFR2 gene and the effects of postmenopausal hormone therapy on invasive breast cancer.

    Science.gov (United States)

    Prentice, Ross L; Huang, Ying; Hinds, David A; Peters, Ulrike; Pettinger, Mary; Cox, David R; Beilharz, Erica; Chlebowski, Rowan T; Rossouw, Jacques E; Caan, Bette; Ballinger, Dennis G

    2009-11-01

    Breast cancer concern is a major reason for the recent marked reduction in use of postmenopausal hormone therapy, although equally effective means of controlling menopausal symptoms are lacking. Single nucleotide polymorphisms (SNP) in the fibroblast growth factor receptor 2 (FGFR2) gene are substantially associated with postmenopausal breast cancer risk and could influence hormone therapy effects. We interrogated eight SNPs in intron 2 of the FGFR2 gene for 2,166 invasive breast cancer cases from the Women's Health Initiative clinical trial and one-to-one matched controls to confirm an association with breast cancer risk. We used case-only analyses to examine the dependence of estrogen plus progestin and estrogen-alone odds ratios on SNP genotype. Seven FGFR2 SNPs, including six in a single linkage disequilibrium region, were found to associate strongly (P rs3750817 (minor allele T with frequency 0.39) had an estimated per-minor-allele odds ratio of 0.78, and was not in such strong linkage disequilibrium with the other SNPs. The genotype of this SNP related significantly (P rs3750817 have a reduced breast cancer risk and seem to experience comparatively favorable effects of postmenopausal hormone therapy.

  9. Household net worth, racial disparities, and hormonal therapy adherence among women with early-stage breast cancer.

    Science.gov (United States)

    Hershman, Dawn L; Tsui, Jennifer; Wright, Jason D; Coromilas, Ellie J; Tsai, Wei Yann; Neugut, Alfred I

    2015-03-20

    Nonadherence to adjuvant hormonal therapy is common and is associated with increased prescription copayment amount and black race. Studies suggest that household wealth may partly explain racial disparities. We investigated the impact of net worth on disparities in adherence and discontinuation. We used the OptumInsight insurance claims database to identify women older than age 50 years diagnosed with early breast cancer, from January 1, 2007, to December 31, 2011, who were using hormonal therapy. Nonadherence was defined as a medication possession ratio of ≤ 80% of eligible days over a 2-year period. We evaluated the association of demographic and clinical characteristics, annual household income, household net worth ( $750,000), insurance type, and copayments ( $20) with adherence to hormonal therapy. Logistic regression analyses were conducted by sequentially adding sociodemographic and financial variables to race. We identified 10,302 patients; 2,473 (24%) were nonadherent. In the unadjusted analyses, adherence was negatively associated with black race (odds ratio [OR], 0.76; P Adherence was positively associated with medium (OR, 1.33; P adherence (OR, 0.76) was reduced by adding net worth to the model (OR, 0.84; P adherence (OR, 0.87; P = .08). The interaction between net worth and race was significant (P adherence. These results suggest that economic factors may contribute to disparities in the quality of care. © 2015 by American Society of Clinical Oncology.

  10. Transgender women, hormonal therapy and HIV treatment: a comprehensive review of the literature and recommendations for best practices

    Directory of Open Access Journals (Sweden)

    Asa Radix

    2016-07-01

    Full Text Available Introduction: Studies have shown that transgender women (TGW are disproportionately affected by HIV, with an estimated HIV prevalence of 19.1% among TGW worldwide. After receiving a diagnosis, HIV-positive TGW have challenges accessing effective HIV treatment, as demonstrated by lower rates of virologic suppression and higher HIV-related mortality. These adverse HIV outcomes have been attributed to the multiple sociocultural and structural barriers that negatively affect their engagement within the HIV care continuum. Guidelines for feminizing hormonal therapy among TGW recommend combinations of oestrogens and androgen blockers. Pharmacokinetic studies have shown that certain antiretroviral therapy (ART agents, such as protease inhibitors (PIs, non-nucleoside reverse transcriptase inhibitors (NNRTIs and cobicistat, interact with ethinyl estradiol, the key oestrogen component of oral contraceptives (OCPs. The goal of this article is to provide an overview of hormonal regimens used by TGW, to summarize the known drug-drug interactions (DDIs between feminizing hormonal regimens and ART, and to provide clinical care recommendations. Methods: The authors identified English language articles examining DDIs between oestrogen therapy, androgen blockers and ART published between 1995 and 2015 using PubMed, Cumulative Index to Nursing and Allied Health Literature and EBSCOhost. Results and Discussion: Published articles predominantly addressed interactions between ethinyl estradiol and NNRTIs and PIs. No studies examined interactions between ART and the types and doses of oestrogens found in feminizing regimens. DDIs that may have the potential to result in loss of virologic suppression included ethinyl estradiol and amprenavir, unboosted fosamprenavir and stavudine. No clinically significant DDIs were noted with other anti-retroviral agents or androgen blockers Conclusions: There are insufficient data to address DDIs between ART and feminizing hormone

  11. Transgender women, hormonal therapy and HIV treatment: a comprehensive review of the literature and recommendations for best practices

    Science.gov (United States)

    Radix, Asa; Sevelius, Jae; Deutsch, Madeline B

    2016-01-01

    Introduction Studies have shown that transgender women (TGW) are disproportionately affected by HIV, with an estimated HIV prevalence of 19.1% among TGW worldwide. After receiving a diagnosis, HIV-positive TGW have challenges accessing effective HIV treatment, as demonstrated by lower rates of virologic suppression and higher HIV-related mortality. These adverse HIV outcomes have been attributed to the multiple sociocultural and structural barriers that negatively affect their engagement within the HIV care continuum. Guidelines for feminizing hormonal therapy among TGW recommend combinations of oestrogens and androgen blockers. Pharmacokinetic studies have shown that certain antiretroviral therapy (ART) agents, such as protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and cobicistat, interact with ethinyl estradiol, the key oestrogen component of oral contraceptives (OCPs). The goal of this article is to provide an overview of hormonal regimens used by TGW, to summarize the known drug-drug interactions (DDIs) between feminizing hormonal regimens and ART, and to provide clinical care recommendations. Methods The authors identified English language articles examining DDIs between oestrogen therapy, androgen blockers and ART published between 1995 and 2015 using PubMed, Cumulative Index to Nursing and Allied Health Literature and EBSCOhost. Results and Discussion Published articles predominantly addressed interactions between ethinyl estradiol and NNRTIs and PIs. No studies examined interactions between ART and the types and doses of oestrogens found in feminizing regimens. DDIs that may have the potential to result in loss of virologic suppression included ethinyl estradiol and amprenavir, unboosted fosamprenavir and stavudine. No clinically significant DDIs were noted with other anti-retroviral agents or androgen blockers Conclusions There are insufficient data to address DDIs between ART and feminizing hormone regimens used by TGW

  12. Lifestyle influences on the association between pre-diagnostic hormone replacement therapy and breast cancer prognosis - results from The Danish 'Diet, Cancer and Health' prospective cohort

    DEFF Research Database (Denmark)

    Holm, Marianne; Olsen, Anja; Kroman, Niels

    2014-01-01

    OBJECTIVES: The association between pre-diagnostic hormone replacement therapy (HRT) and breast cancer specific mortality as well as potential influences from other lifestyle factors on the association was investigated. STUDY DESIGN: Female participants from the prospective cohort "Diet, Cancer...

  13. Dietary Boron and Hormone Replacement Therapy as Risk Factors for Lung Cancer in Women

    Science.gov (United States)

    Mahabir, S.; Spitz, M. R.; Barrera, S. L.; Dong, Y. Q.; Eastham, C.; Forman, M. R.

    2012-01-01

    Hormone replacement therapy (HRT) may reduce lung cancer risk. Dietary boron may have actions similar to those of HRT; however, no previous study has reported the associations between dietary boron intake and lung cancer risk or the joint effects of boron intake and HRT use on lung cancer risk. The authors examined the associations between boron intake and the joint effects of boron intake and HRT on lung cancer risk in women. In an ongoing case-control study in Houston, Texas (July 1995 through April 2005, end date for this analysis), 763 women were diagnosed with lung cancer, and 838 were matched healthy controls with data on both diet and HRT. Multiple logistic regression analyses were conducted to assess the associations between dietary boron and HRT with lung cancer risk. After adjustment for potential confounders, the odds ratios for lung cancer with decreasing quartiles of dietary boron intake were 1.0, 1.39 (95% confidence interval (CI): 1.02, 1.90), 1.64 (95% CI: 1.20, 2.24), and 1.95 (95% CI: 1.42, 2.68) mg/day, respectively, for all women (ptrend boron intake who used HRT, the odds ratio for lung cancer for low dietary boron intake and no HRT use was 2.07 (95% CI: 1.53, 2.81). Boron intake was inversely associated with lung cancer in women, whereas women who consumed low boron and did not use HRT were at substantial increased odds. PMID:18343880

  14. No Increase in Fractures After Stopping Hormone Therapy: Results From the Women's Health Initiative.

    Science.gov (United States)

    Watts, Nelson B; Cauley, Jane A; Jackson, Rebecca D; LaCroix, Andrea Z; Lewis, Cora E; Manson, JoAnn E; Neuner, Joan M; Phillips, Lawrence S; Stefanick, Marcia L; Wactawski-Wende, Jean; Crandall, Carolyn

    2017-01-01

    The Women's Health Initiative (WHI) hormone therapy (HT) trials showed protection against hip and total fractures, but a later observational report suggested loss of benefit and a rebound increased risk after cessation of HT. The purpose of this study was to examine fractures after discontinuation of HT. Two placebo-controlled randomized trials served as the study setting. Study patients included WHI participants (N = 15,187) who continued active HT or placebo through the intervention period and who did not take HT in the postintervention period. Trial interventions included conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) in naturally menopausal women and CEE alone in women with prior hysterectomy. Total fractures and hip fractures through 5 years after discontinuation of HT were recorded. Hip fractures were infrequent (∼2.5 per 1000 person-years); this finding was similar between trials and in former HT and placebo groups. There was no difference in total fractures in the CEE + MPA trial for former HT vs former placebo users (28.9 per 1000 person-years and 29.9 per 1000 person-years, respectively; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.87 to 1.09; P = 0.63); however, in the CEE-alone trial, total fractures were higher in former placebo users (36.9 per 1000 person-years) compared with the former active group (31.1 per 1000 person-years), a finding that was suggestive of a residual benefit of CEE against total fractures (HR, 0.85; 95% CI, 0.73 to 0.98; P = 0.03). We found no evidence for increased fracture risk, either sustained or transient, for former HT users compared with former placebo users after stopping HT. There was residual benefit for total fractures in former HT users from the CEE-alone study.

  15. Breast cancer risk by breast density, menopause, and postmenopausal hormone therapy use.

    Science.gov (United States)

    Kerlikowske, Karla; Cook, Andrea J; Buist, Diana S M; Cummings, Steve R; Vachon, Celine; Vacek, Pamela; Miglioretti, Diana L

    2010-08-20

    We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use. We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m(2). Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density. Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2). Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin.

  16. Prescribing of FDA-approved and compounded hormone therapy differs by specialty.

    Science.gov (United States)

    Constantine, Ginger D; Archer, David F; Graham, Shelli; Bernick, Brian A; Mirkin, Sebastian

    2016-10-01

    To determine the prescribing patterns of general practitioners (GPs), obstetrician/gynecologists (OB/GYNs), and wellness physicians (WPs) of menopausal hormone therapy (HT) for both compounded (CHT) and Food and Drug Administration (FDA)-approved products, using a survey of US physicians. Nine thousand one US physicians were invited to participate in a survey to report on their HT-prescribing patterns. Physicians were eligible if they prescribed HT for at least six patients per month. The survey was completed by 440 eligible physicians (893 responded of 9,001 invited) including 171 GPs, 170 OB/GYNs, and 84 WPs. Physicians prescribed HT for 15% to 30% of their female patients, with WPs numerically most likely to prescribe HT. Menopausal symptoms were the leading reason for HT prescriptions among all specialties. WPs seemed more likely to prescribe HT for general/cardiovascular health (28%), and for shorter durations, than other specialties. WPs prescribed proportionally more compounded (vs FDA-approved) estrogens/progestogens than GPs or OB/GYNs, but OB/GYNs seemed to prescribe more compounded dehydroepiandrosterone and testosterone (prescribed alone) than did others. OB/GYNs seemed least likely to consider CHT being more safe or effective than FDA-approved HT. Symptom relief was the main determinant of efficacy for all specialties; WPs also used blood (61%) or saliva testing (25%) for dose adjustment. Although all physician specialties surveyed prescribed HT, differences in prescribing CHT versus FDA-approved formulations by medical specialty/practice seemed to exist. Of those surveyed, OB/GYNs and GPs prescribed proportionally more FDA-approved HT, whereas WPs, similarly, prescribed more CHT. More discussion is needed concerning physicians' decisions to prescribe CHT versus FDA-approved formulations.

  17. Effects of hormone therapy on brain structure: A randomized controlled trial.

    Science.gov (United States)

    Kantarci, Kejal; Tosakulwong, Nirubol; Lesnick, Timothy G; Zuk, Samantha M; Gunter, Jeffrey L; Gleason, Carey E; Wharton, Whitney; Dowling, N Maritza; Vemuri, Prashanthi; Senjem, Matthew L; Shuster, Lynne T; Bailey, Kent R; Rocca, Walter A; Jack, Clifford R; Asthana, Sanjay; Miller, Virginia M

    2016-08-30

    To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Participants (aged 42-56 years, within 5-36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 μg/d transdermal 17β-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n = 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Higher rates of ventricular expansion were observed in both the CEE and the 17β-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p = 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r = -0.58; p ≤ 0.001) and with rates of increase in white matter hyperintensity volume (r = 0.27; p = 0.01) after adjusting for age. The changes were not different between the CEE and 17β-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. © 2016 American Academy of Neurology.

  18. Risks of nonadherence to hormone therapy in Asian women with breast cancer

    Directory of Open Access Journals (Sweden)

    Kun-Pin Hsieh

    2015-06-01

    Full Text Available The aim of this study was to quantify the hormone therapy (HT nonadherence patterns and to assess the associated risk factors in Asian women with breast cancer. This retrospective cohort study used the Taiwan Health Insurance Research Database from 2003 to 2011. Data from women with newly diagnosed primary breast cancer were identified, and persistence (without HT prescribing gap ≥ 180 days to HT was defined through records of dispensing prescriptions. Study cohorts were further classified as adjuvant and primary HT groups. Each individual's HT utilization patterns and the medication possession ratio at overall HT course were measured. The odds ratios (ORs of nonadherence (medication possession ratio, <80% in adjuvant and primary HT patients were estimated using logistic regressions with adjustment of potential confounding variables. These patients had 15.6% and 23.4% nonadherence rates to HT in adjuvant and primary HT groups, respectively. In the adjuvant HT group, older age groups (≥50 years and taking aromatase inhibitors were less likely to show nonadherence (p < 0.05. In the primary HT group, women older than 70 years were significantly less likely to exhibit nonadherence (OR = 0.53; 95% confidence interval, 0.28–0.99; however, women with presence of HT-related adverse events had significantly increased risk (OR = 1.44; 95% confidence interval, 1.02–2.03. Young age and experience of musculoskeletal and joint symptoms were identified as risk factors for nonadherence.

  19. Vascular effects of phytoestrogens and alternative menopausal hormone therapy in cardiovascular disease.

    Science.gov (United States)

    Gencel, V B; Benjamin, M M; Bahou, S N; Khalil, R A

    2012-02-01

    Phytoestrogens are estrogenic compounds of plant origin classified into different groups including isoflavones, lignans, coumestans and stilbenes. Isoflavones such as genistein and daidzein are the most studied and most potent phytoestrogens, and are found mainly in soy based foods. The effects of phytoestrogens are partly mediated via estrogen receptors (ERs): ERα, ERβ and possibly GPER. The interaction of phytoestrogens with ERs is thought to induce both genomic and non-genomic effects in many tissues including the vasculature. Some phytoestrogens such as genistein have additional non-ER-mediated effects involving signaling pathways such as tyrosine kinase. Experimental studies have shown beneficial effects of phytoestrogens on endothelial cells, vascular smooth muscle, and extracellular matrix. Phytoestrogens may also affect other pathophysiologic vascular processes such as lipid profile, angiogenesis, inflammation, tissue damage by reactive oxygen species, and these effects could delay the progression of atherosclerosis. As recent clinical trials showed no vascular benefits or even increased risk of cardiovascular disease (CVD) and CV events with conventional menopausal hormone therapy (MHT), phytoestrogens are being considered as alternatives to pharmacologic MHT. Epidemiological studies in the Far East population suggest that dietary intake of phytoestrogens may contribute to the decreased incidence of postmenopausal CVD and thromboembolic events. Also, the WHO-CARDIAC study supported that consumption of high soybean diet is associated with lower mortalities from coronary artery disease. However, as with estrogen, there has been some discrepancy between the experimental studies demonstrating the vascular benefits of phytoestrogens and the data from clinical trials. This is likely because the phytoestrogens clinical trials have been limited in many aspects including the number of participants enrolled, the clinical end points investigated, and the lack of

  20. The Benefit of Menopausal Hormone Therapy on Bone Density and Microarchitecture Persists After its Withdrawal.

    Science.gov (United States)

    Papadakis, Georgios; Hans, Didier; Gonzalez-Rodriguez, Elena; Vollenweider, Peter; Waeber, Gérard; Marques-Vidal, Pedro Manuel; Lamy, Olivier

    2016-12-01

    Menopausal hormone therapy (MHT) favorably affects bone mineral density (BMD). Whether MHT also affects bone microarchitecture, as assessed by trabecular bone score (TBS), has never been evaluated. Our objective was to assess the effect of MHT on TBS and BMD before and after its withdrawal. This was a cross-sectional study. This study included the general community. Data were collected from the OsteoLaus cohort (1500 women aged 50-80 years). After exclusion of women with bone-modulating treatments, 1279 women were categorized according to MHT status into current (CU), past (PU), and never (NU) users. Spine TBS and BMD at lumbar spine, femoral neck, and total hip were assessed by dual X-ray absorptiometry. Age- and body mass index-adjusted analysis showed higher TBS values in CU vs PU or NU (1.31 ± 0.01, 1.29 ± 0.01, and 1.27 ± 0.01, respectively; P < .001). All BMD values were significantly higher in CU vs PU or NU. Compared to NU, PU exhibited higher lumbar spine (0.94 ± 0.01 vs 0.91 ± 0.01 g/cm(2); P = .017) and total hip (0.86 ± 0.01 vs 0.84 ± 0.01 g/cm(2); P = .026) BMD and a trend for higher TBS (P = .066). The 10-year loss of TBS and BMD at lumbar spine and total hip was significantly lower for both CU and PU vs NU. MHT duration had no effect on bone parameters. In PU, the residual effect on TBS and BMD was significantly more prominent in early discontinuers (<2 years). MHT is associated with bone microarchitecture preservation, as assessed by TBS. The effect of MHT on TBS and BMD persists at least 2 years after withdrawal.

  1. Adherence to adjuvant hormonal therapy and its relationship to breast cancer recurrence and survival among low-income women.

    Science.gov (United States)

    Weaver, Kathryn E; Camacho, Fabian; Hwang, Wenke; Anderson, Roger; Kimmick, Gretchen

    2013-04-01

    Although clinical trials have demonstrated the benefit of adjuvant hormonal therapy for hormone receptor-positive breast cancer, it is not known whether poor medication adherence might impact outcomes, particularly in the context of a low-income population traditionally underrepresented in clinical trials. We explored the relationship between adherence to tamoxifen or selective aromatase inhibitors with cancer recurrence and death in a low-income, Medicaid-insured population. Using a Medicaid claims-tumor registry and National Death Index data, we evaluated adherence to adjuvant hormonal therapy [defined by the medication possession ratio (MPR)], cancer recurrence, and cancer-specific survival for female breast cancer diagnosed from 1998 to 2002, in North Carolina. Multivariate Cox proportional hazards models and logistic regression models were used to examine the role of adherence on cancer recurrence and survival. The sample consisted of 857 cases, mean age 67.7 years, 56.9% white, 60.9% local stage, with a mean follow-up of 4.4 years. Mean first-year MPR was 77%. MPR adherence was not significantly associated with cancer-related death [adjusted hazards ratio=1.18 (95% confidence interval, 0.54-2.59)], or recurrence [adjusted odds ratio=1.49 (95% confidence interval, 0.78-2.84)]. There was also no significant interaction between adherence and use of concurrent CYP2D6 enzyme inhibitors. Hormonal therapy adherence was not associated with breast cancer outcomes in this low-income population with relatively poor adherence. Although suboptimal adherence is considered to be an important clinical problem, its effects on breast cancer outcomes may be masked by patient genetic profiles, tumor characteristics, and behavioral factors.

  2. Melanoma Therapy with Rhenium-Cyclized Alpha Melanocyte Stimulating Hormone Peptide Analogs

    Energy Technology Data Exchange (ETDEWEB)

    Thomas P Quinn

    2005-11-22

    Malignant melanoma is the 6th most commonly diagnosed cancer with increasing incidence in the United States. It is estimated that 54,200 cases of malignant melanoma will be newly diagnosed and 7,600 cases of death will occur in the United States in the year 2003 (1). At the present time, more than 1.3% of Americans will develop malignant melanoma during their lifetime (2). The average survival for patients with metastatic melanoma is about 6-9 months (3). Moreover, metastatic melanoma deposits are resistant to conventional chemotherapy and external beam radiation therapy (3). Systematic chemotherapy is the primary therapeutic approach to treat patients with metastatic melanoma. Dacarbazine is the only single chemotherapy agent approved by FDA for metastatic melanoma treatment (5). However, the response rate to Dacarbazine is only approximately 20% (6). Therefore, there is a great need to develop novel treatment approaches for metastatic melanoma. The global goal of this research program is the rational design, characterization and validation of melanoma imaging and therapeutic radiopharmaceuticals. Significant progress has been made in the design and characterization of metal-cyclized radiolabeled alpha-melanocyte stimulating hormone peptides. Therapy studies with {sup 188}Re-CCMSH demonstrated the therapeutic efficacy of the receptor-targeted treatment in murine and human melanoma bearing mice (previous progress report). Dosimetry calculations, based on biodistribution data, indicated that a significant dose was delivered to the tumor. However, {sup 188}Re is a very energetic beta-particle emitter. The longer-range beta-particles theoretically would be better for larger tumors. In the treatment of melanoma, the larger primary tumor is usually surgically removed leaving metastatic disease as the focus of targeted radiotherapy. Isotopes with lower beta-energies and/or shorter particle lengths should be better suited for targeting metastases. The {sup 177}Lu

  3. Effect of growth hormone, hyperbaric oxygen and combined therapy on the gastric serosa

    Science.gov (United States)

    Adas, Gokhan; Adas, Mine; Arikan, Soykan; Sarvan, Ahu Kemik; Toklu, Akin Savas; Mert, Selva; Barut, Gul; Kamali, Sedat; Koc, Bora; Tutal, Firat

    2013-01-01

    AIM: To investigate the role of growth hormone (GH), hyperbaric oxygen therapy (HBOT) and combined therapy on the intestinal neomucosa formation of the gastric serosa. METHODS: Forty-eight male Wistar-albino rats, weighing 250-280 g, were used in this study. The rats were divided into four groups (n = 12): Group 1, control, gastric serosal patch; Group 2, gastric serosal patch + GH; Group 3, gastric serosal patch + HBOT; and Group 4, gastric serosal patch + GH + HBOT. Abdominal access was achieved through a midline incision, and after the 1-cm-long defect was created in the jejunum, a 1 cm × 1 cm patch of the gastric corpus was anastomosed to the jejunal defect. Venous blood samples were taken to determine the insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) basal levels. HBOT was performed in Groups 3 and 4. In Groups 2 and 4, human GH was given subcutaneously at a dose of 2 mg per kg/d for 28 d, beginning on the operation day. All animals were sacrificed 60 d after surgery. The jejunal segment and the gastric anastomotic area were excised for histological examination. The inflammatory process, granulation, collagen deposition and fibroblast activity at the neomucosa formation were studied and scored. Additionally, the villus density, villus height, and crypt depth were counted and recorded. The measurements of villus height and crypt depth were calculated with an ocular micrometer. New vessel growth was determined by calculatingeach new vessel in a 1 mm2 area. RESULTS: In the histological comparison of groups, no significant differences were observed between the control group and Groups 2 and 3 with respect to epithelialization, granulation, fibroblastic activity and the inflammatory process, but significant differences were present between the control group and all others groups (Groups 2-4) with respect to angiogenesis (P < 0.01) and collagen deposition (P < 0.05, P < 0.01). Significant differences between the

  4. Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial.

    Science.gov (United States)

    Haidar, Ahmad; Legault, Laurent; Messier, Virginie; Mitre, Tina Maria; Leroux, Catherine; Rabasa-Lhoret, Rémi

    2015-01-01

    The artificial pancreas is an emerging technology for the treatment of type 1 diabetes and two configurations have been proposed: single-hormone (insulin alone) and dual-hormone (insulin and glucagon). We aimed to delineate the usefulness of glucagon in the artificial pancreas system. We did a randomised crossover trial of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy (continuous subcutaneous insulin infusion) in participants aged 12 years or older with type 1 diabetes. Participants were assigned in a 1:1:1:1:1:1 ratio with blocked randomisation to the three interventions and attended a research facility for three 24-h study visits. During visits when the patient used the single-hormone artificial pancreas, insulin was delivered based on glucose sensor readings and a predictive dosing algorithm. During dual-hormone artificial pancreas visits, glucagon was also delivered during low or falling glucose. During conventional insulin pump therapy visits, patients received continuous subcutaneous insulin infusion. The study was not masked. The primary outcome was the time for which plasma glucose concentrations were in the target range (4·0-10·0 mmol/L for 2 h postprandially and 4·0-8·0 mmol/L otherwise). Hypoglycaemic events were defined as plasma glucose concentration of less than 3·3 mmol/L with symptoms or less than 3·0 mmol/L irrespective of symptoms. Analysis was by modified intention to treat, in which we included data for all patients who completed at least two visits. A p value of less than 0·0167 (0·05/3) was regarded as significant. This trial is registered with ClinicalTrials.gov, number NCT01754337. The mean proportion of time spent in the plasma glucose target range over 24 h was 62% (SD 18), 63% (18), and 51% (19) with single-hormone artificial pancreas, dual-hormone artificial pancreas, and conventional insulin pump therapy, respectively. The mean difference in time spent in the target

  5. Tolerability of Therapies Recommended for the Treatment of Hormone Receptor-Positive Locally Advanced or Metastatic Breast Cancer.

    Science.gov (United States)

    Ohno, Shinji

    2016-08-01

    For women with hormone receptor-positive advanced breast cancer, endocrine therapies, including the selective estrogen receptor modulator tamoxifen, the aromatase inhibitors anastrozole, letrozole, and exemestane, and the selective estrogen receptor degrader fulvestrant, are recommended in clinical guidelines. The addition of targeted agents such as everolimus or palbociclib to aromatase inhibitors are also recommended as treatment options. Chemotherapy remains an option, although clinical guidelines have recommended these agents be reserved for patients with immediately life-threatening disease or if resistance to endocrine therapy is known or suspected. The present review has consolidated the tolerability profiles of the agents approved for use in the treatment of hormone receptor-positive advanced or metastatic breast cancer based on phase III registration trial data. Endocrine therapies are generally well tolerated, although the addition of targeted therapies to aromatase inhibitors or fulvestrant appears to increase the proportion of patients experiencing adverse events, and palbociclib and chemotherapy appear to be more closely associated with serious adverse events, including neutropenia.

  6. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Sarah L.; Lawrence, Sarah [University of Ottawa, Division of Endocrinology, Children' s Hospital of Eastern Ontario, Ottawa (Canada); Laffan, Eoghan [Children' s University Hospital, Pediatric Radiology, Dublin 1 (Ireland)

    2012-07-15

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  7. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study

    Science.gov (United States)

    Hosadurga, Rajesh; Nabeel Althaf, M. S.; Hegde, Shashikanth; Rajesh, Kashyap S.; Arun Kumar, M. S.

    2016-01-01

    Background: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. Aim: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. Settings and Design: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. Materials and Methods: A pilot study was conducted on 21 adolescent patients between the age group of 13–19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal–lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. Results: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. Conclusion: Direct correlation between estradiol, testosterone, and gingival enlargement was seen. PMID:27994419

  8. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study

    Directory of Open Access Journals (Sweden)

    Rajesh Hosadurga

    2016-01-01

    Full Text Available Background: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. Aim: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. Settings and Design: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. Materials and Methods: A pilot study was conducted on 21 adolescent patients between the age group of 13–19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal–lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. Results: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. Conclusion: Direct correlation between estradiol, testosterone, and gingival enlargement was seen.

  9. Improved adipose tissue metabolism after 5-year growth hormone replacement therapy in growth hormone deficient adults: The role of zinc-α2-glycoprotein.

    Science.gov (United States)

    Balaž, Miroslav; Ukropcova, Barbara; Kurdiova, Timea; Vlcek, Miroslav; Surova, Martina; Krumpolec, Patrik; Vanuga, Peter; Gašperíková, Daniela; Klimeš, Iwar; Payer, Juraj; Wolfrum, Christian; Ukropec, Jozef

    2015-01-01

    Growth hormone (GH) supplementation therapy to adults with GH deficiency has beneficial effects on adipose tissue lipid metabolism, improving thus adipocyte functional morphology and insulin sensitivity. However, molecular nature of these effects remains unclear. We therefore tested the hypothesis that lipid-mobilizing adipokine zinc-α2-glycoprotein is causally linked to GH effects on adipose tissue lipid metabolism. Seventeen patients with severe GH deficiency examined before and after the 5-year GH replacement therapy were compared with age-, gender- and BMI-matched healthy controls. Euglycemic hyperinsulinemic clamp was used to assess whole-body and adipose tissue-specific insulin sensitivity. Glucose tolerance was determined by oGTT, visceral and subcutaneous abdominal adiposity by MRI, adipocyte size morphometrically after collagenase digestion, lipid accumulation and release was studied in differentiated human primary adipocytes in association with GH treatment and zinc-α2-glycoprotein gene silencing. Five-year GH replacement therapy improved glucose tolerance, adipose tissue insulin sensitivity and reduced adipocyte size without affecting adiposity and whole-body insulin sensitivity. Adipose tissue zinc-α2-glycoprotein expression was positively associated with whole-body and adipose tissue insulin sensitivity and negatively with adipocyte size. GH treatment to adipocytes in vitro increased zinc-α2-glycoprotein expression (>50%) and was paralleled by enhanced lipolysis and decreased triglyceride accumulation (>35%). Moreover, GH treatment improved antilipolytic action of insulin in cultured adipocytes. Most importantly, silencing zinc-α2-glycoprotein eliminated all of the GH effects on adipocyte lipid metabolism. Effects of 5-year GH supplementation therapy on adipose tissue lipid metabolism and insulin sensitivity are associated with zinc-α2-glycoprotein. Presence of this adipokine is required for the GH action on adipocyte lipid metabolism in vitro.

  10. Response to long-term growth hormone therapy in patients affected by RASopathies and growth hormone deficiency: Patterns of growth, puberty and final height data.

    Science.gov (United States)

    Tamburrino, Federica; Gibertoni, Dino; Rossi, Cesare; Scarano, Emanuela; Perri, Annamaria; Montanari, Francesca; Fantini, Maria Pia; Pession, Andrea; Tartaglia, Marco; Mazzanti, Laura

    2015-11-01

    RASopathies are developmental disorders caused by heterozygous germline mutations in genes encoding proteins in the RAS-MAPK signaling pathway. Reduced growth is a common feature. Several studies generated data on growth, final height (FH), and height velocity (HV) after growth hormone (GH) treatment in patients with these disorders, particularly in Noonan syndrome, the most common RASopathy. These studies, however, refer to heterogeneous cohorts in terms of molecular information, GH status, age at start and length of therapy, and GH dosage. This work reports growth data in 88 patients affected by RASopathies with molecularly confirmed diagnosis, together with statistics on body proportions, pubertal pattern, and FH in 33, including 16 treated with GH therapy for proven GH deficiency. Thirty-three patients showed GH deficiency after pharmacological tests, and were GH-treated for an average period of 6.8 ± 4.8 years. Before starting therapy, HV was -2.6 ± 1.3 SDS, and mean basal IGF1 levels were -2.0 ± 1.1 SDS. Long-term GH therapy, starting early during childhood, resulted in a positive height response compared with untreated patients (1.3 SDS in terms of height-gain), normalizing FH for Ranke standards but not for general population and Target Height. Pubertal timing negatively affected pubertal growth spurt and FH, with IGF1 standardized score increased from -2.43 to -0.27 SDS. During GH treatment, no significant change in bone age velocity, body proportions, or cardiovascular function was observed.

  11. Efecto de la terapia hormonal de reemplazo sobre la mamografía: nuestra experiencia Effect of replacement hormone therapy on mammography: our experience in this field

    Directory of Open Access Journals (Sweden)

    Daysi Navarro Despaigne

    2005-12-01

    Full Text Available Se realizó un estudio retrospectivo, cuyo objetivo fue describir el efecto de la terapia hormonal de reemplazo (THR sobre las mamografías de mujeres de edad mediana que asistieron a la Clínica de Climaterio y Osteoporosis (ClimOs entre enero de 1998 y diciembre de 2003. A cada mujer se le realizó mamografía (Mx inicial y durante el uso de la THR, las cuales fueron informadas como: 1 mamografías sin alteraciones, 2 con cambios menores [densidad irregular y microcalcificaciones] y 3 con cambios mayores [nódulos, quistes u otra alteración]. Como tratamiento recibieron estrógenos solos (E, estrógenos y progestagenos combinados continuos (EP y terapia no estrogénica (fitoestrógenos, tibolona. La muestra estuvo constituida por 112 mujeres, con edades entre 34 y 59 años. La Mx inicial mostró: no alteraciones en el 85,5 %, cambios menores en el 9,1 y cambios mayores en el 5,4. En la posTHR (tiempo promedio entre ambos estudios: 2,5 años, el 66 % continuó con mamografías normales, en el 29,0 hubo cambios menores (pA retrospective study was conducted, with the objective of describing the effect of hormone replacement therapy (HRT on mammography performed on middle-aged females, who had been seen at climacterics and osteoporosis clinics from January 1998 to December 2003. Mammography had been performed on each woman at the beginning and during the use of the HRT, being the results as follows: 1 mammography showing no changes; 2 mammography with slight changes irregular density and microcalcification and 3 mammography with major changes nodules, cysts or any other change . As a treatment, they received estrogen (E, continuos combined estrogen and progestagen (EP and nonestrogen therapy (phytoestrogen, tibolone. The sample was composed of 112 women aged 34 to 59 years. The initial Mx showed no changes in 85,5 %, slight changes in 9,1 and major changes in 5,4 of females. After the application of HRT (average time between both mammographic

  12. The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy.

    Science.gov (United States)

    Peppone, Luke J; Janelsins, Michelle C; Kamen, Charles; Mohile, Supriya G; Sprod, Lisa K; Gewandter, Jennifer S; Kirshner, Jeffrey J; Gaur, Rakesh; Ruzich, Janet; Esparaz, Benjamin T; Mustian, Karen M

    2015-04-01

    Up to 50% of breast cancer survivors on aromatase inhibitor therapy report musculoskeletal symptoms such as joint and muscle pain, significantly impacting treatment adherence and discontinuation rates. We conducted a secondary data analysis of a nationwide, multi-site, phase II/III randomized, controlled, clinical trial examining the efficacy of yoga for improving musculoskeletal symptoms among breast cancer survivors currently receiving hormone therapy (aromatase inhibitors [AI] or tamoxifen [TAM]). Breast cancer survivors currently receiving AI (N = 95) or TAM (N = 72) with no participation in yoga during the previous 3 months were randomized into 2 arms: (1) standard care monitoring and (2) standard care plus the 4-week yoga intervention (2x/week; 75 min/session) and included in this analysis. The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS©(®)) program consisting of breathing exercises, 18 gentle Hatha and restorative yoga postures, and meditation. Musculoskeletal symptoms were assessed pre- and post-intervention. At baseline, AI users reported higher levels of general pain, muscle aches, and total physical discomfort than TAM users (all P ≤ 0.05). Among all breast cancer survivors on hormonal therapy, participants in the yoga group demonstrated greater reductions in musculoskeletal symptoms such as general pain, muscle aches and total physical discomfort from pre- to post-intervention than the control group (all P ≤ 0.05). The severity of musculoskeletal symptoms was higher for AI users compared to TAM users. Among breast cancer survivors on hormone therapy, the brief community-based YOCAS©® intervention significantly reduced general pain, muscle aches, and physical discomfort.

  13. Vaccine Therapy and Pembrolizumab in Treating Patients With Hormone-Resistant, Metastatic Prostate Cancer

    Science.gov (United States)

    2016-06-22

    Hormone-Resistant Prostate Cancer; Metastatic Malignant Neoplasm in the Bone; Metastatic Malignant Neoplasm in the Soft Tissues; Metastatic Prostate Carcinoma; Prostate Adenocarcinoma; Recurrent Prostate Carcinoma; Stage IV Prostate Cancer

  14. Relationships between selenium, lipids, iron status and hormonal therapy in women of the SU.VI.M.AX cohort.

    Science.gov (United States)

    Arnaud, Josiane; Arnault, Nathalie; Roussel, Anne-Marie; Bertrais, Sandrine; Ruffieux, Daniel; Galan, Pilar; Favier, Alain; Hercberg, Serge

    2007-01-01

    Significant differences in serum selenium concentration according to contraceptive treatment and age have been evidenced in women of the SU.VI.M.AX cohort. This study aimed at verifying the physiopathological hypothesis that the observed increase in serum selenium concentration could be related to serum lipid increase and/or bleeding decrease. Women were divided into six groups: menopausal with or without hormonal replacement therapy; non-menopausal using contraceptive pills; intrauterine device; other contraceptive treatment or no contraceptive treatment. Adjusted linear regression indicated positive associations between selenium and apolipoprotein A1 (r(2) from 0.038 to 0.074, p<0.07 depending on groups) or ferritin in serum (r(2) from 0.032 to 0.075, p<0.07 depending on groups). These relationships could explain the differences observed according to hormonal treatment and age in the SU.VI.MAX study.

  15. Thyroid function in children with growth hormone (GH deficiency during the initial phase of GH replacement therapy - clinical implications

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    Smyczynska Joanna

    2010-03-01

    Full Text Available Abstract Background Normal thyroid hormone secretion or appropriate L-thyroxine (L-T4 substitution is necessary for the optimal effect of the growth hormone (GH administration on growth rate. The decrease of free thyroxine (FT4 levels at recombinant human GH (rhGH therapy onset has been reported in several studies. The aim of the present study was to evaluate the effect of rhGH administration on thyrotropin (TSH and FT4 serum concentrations in children with GH deficiency (GHD during the 1st year of therapy, as well as to assess potential indications to thyroid hormone supplementation in them. Patients and methods The analysis involved data of 75 children (59 boys, 16 girls with disorders of GH secretion (GHD, neurosecretory dysfunction - NSD and partial GH inactivity (inactGH, who were treated with rhGH for - at least - one year. In all the children, body height and height velocity (HV were assessed before and after 1 year of therapy, while TSH, FT4, IGF-I and IGFBP-3 before treatment and after 3-6 months and 1 year of treatment. In the patients, who revealed hypothyroidism (HypoT, an appropriate L-T4 substitution was introduced immediately. The incidence of HypoT, occurring during the initial phase of rhGH therapy, was assessed, as well as its influence on the therapy effectiveness. Results Before rhGH substitution, there were no significant differences in either auxological indices or TSH and FT4 secretion, or IGF-I concentration and its bioavailability among the groups of patients. During the initial 3-6 months of rhGH administration, a significant decrease of FT4 serum concentration, together with a significant increase of IGF-I SDS and IGF-I/IGFBP-3 molar ratio was observed in all the studied groups. In 17 children, HypoT was diagnosed and L-T4 substitution was administered. Despite similar IGF-I secretion increase, the improvement of HV presented significantly lower in children with HypoT than in those who remained euthyroid all the time

  16. Reproductive factors and menopausal hormone therapy and bladder cancer risk in the NIH-AARP Diet and Health Study.

    Science.gov (United States)

    Daugherty, Sarah E; Lacey, James V; Pfeiffer, Ruth M; Park, Yikyung; Hoover, Robert N; Silverman, Debra T

    2013-07-15

    The incidence of bladder cancer among women is at least one-third to one-fourth that observed among men in many countries. Even after accounting for known risk factors, the reason for this gender disparity remains unexplained. We conducted a comprehensive evaluation of reproductive factors and exogenous hormone use with a primary focus on menopausal hormone therapy use and risk of bladder cancer in women in the NIH-AARP Diet and Health Study. Reproductive and hormonal factors were ascertained on the baseline questionnaire in 1995-1996 among 201,492 females who were followed until December 31, 2006. During follow-up, 651 cases of bladder cancer were diagnosed. A subset of women provided detailed information on use of MHT in a second questionnaire in 1996-1997. In this analysis, 127,361 females were followed through June 30, 2002 and 198 incident bladder cancer cases were identified. Cox proportional hazard models, adjusted for smoking status, cigarettes per day and body mass index using age as the time metric, were used to obtain hazard ratios (HRs). A reduced risk was observed among parous women (HR=0.76; 95% CI 0.62-0.93) and women who reported late age at menarche (≥15 years) (HR=0.57; 95% CI 0.39-0.84). Women who reported ever using estrogen and progestin therapy had a decreased risk (HR=0.53; 95% CI: 0.34-0.83) compared with women who did not report MHT use. No association was observed for estrogen only users (HR=0.82; 95% CI: 0.58-1.15). Our results suggest a putative role for sex hormones in the etiology of bladder cancer among women.

  17. Systemic administration of mesenchymal stem cells combined with parathyroid hormone therapy synergistically regenerates multiple rib fractures.

    Science.gov (United States)

    Cohn Yakubovich, Doron; Sheyn, Dmitriy; Bez, Maxim; Schary, Yeshai; Yalon, Eran; Sirhan, Afeef; Amira, May; Yaya, Alin; De Mel, Sandra; Da, Xiaoyu; Ben-David, Shiran; Tawackoli, Wafa; Ley, Eric J; Gazit, Dan; Gazit, Zulma; Pelled, Gadi

    2017-03-09

    A devastating condition that leads to trauma-related morbidity, multiple rib fractures, remain a serious unmet clinical need. Systemic administration of mesenchymal stem cells (MSCs) has been shown to regenerate various tissues. We hypothesized that parathyroid hormone (PTH) therapy would enhance MSC homing and differentiation, ultimately leading to bone formation that would bridge rib fractures. The combination of human MSCs (hMSCs) and a clinically relevant PTH dose was studied using immunosuppressed rats. Segmental defects were created in animals' fifth and sixth ribs. The rats were divided into four groups: a negative control group, in which animals received vehicle alone; the PTH-only group, in which animals received daily subcutaneous injections of 4 μg/kg teriparatide, a pharmaceutical derivative of PTH; the hMSC-only group, in which each animal received five injections of 2 × 10(6) hMSCs; and the hMSC + PTH group, in which animals received both treatments. Longitudinal in vivo monitoring of bone formation was performed biweekly using micro-computed tomography (μCT), followed by histological analysis. Fluorescently-dyed hMSCs were counted using confocal microscopy imaging of histological samples harvested 8 weeks after surgery. PTH significantly augmented the number of hMSCs that homed to the fracture site. Immunofluorescence of osteogenic markers, osteocalcin and bone sialoprotein, showed that PTH induced cell differentiation in both exogenously administered cells and resident cells. μCT scans revealed a significant increase in bone volume only in the hMSC + PTH group, beginning by the 4(th) week after surgery. Eight weeks after surgery, 35% of ribs in the hMSC + PTH group had complete bone bridging, whereas there was complete bridging in only 6.25% of ribs (one rib) in the PTH-only group and in none of the ribs in the other groups. Based on the μCT scans, biomechanical analysis using the micro-finite element method demonstrated that

  18. Differences in Menopausal Hormone Therapy Use among Women in Germany between 1998 and 2003

    Directory of Open Access Journals (Sweden)

    Scheidt-Nave Christa

    2007-10-01

    Full Text Available Abstract Background To examine the differences in menopausal hormone therapy (MHT use and user profiles among women in Germany before and after the communication of the Women's Health Initiative (WHI trial and other study results concerning the risks and benefits of MHT. Methods Current MHT use was ascertained in two periodic German national health surveys conducted in 1997–1999 and 2003–2004. MHT prevalence and user profiles were assessed within each survey. The association of the survey period (2003–2004 vs. 1997–1999 with current MHT use was analyzed in weighted multivariable logistic regression (MLR models, pooling data from both surveys. Results The overall prevalence of current MHT use decreased by 40.2% from 16.9% of the sample in 1997–1999 to 10.1% in 2003–2004. The difference in prevalence between surveys varied with age decade with the smallest decreases among women 60–69 years of age (20.3% vs. 18.5%, compared to women of younger and older age groups (40–49: 10.7% vs. 3.9%; 50–59: 36.3% vs. 21.3%; 70–79: 5.7% vs. 3.2%. Variables independently associated with higher current MHT use in both health surveys included age category (curvilinear relationship with highest use among women 50–59 years and residence in West vs. East Germany. A higher social status, lower body mass index, and more health-conscious behaviour were significantly associated with higher current MHT use in the 1997–1999 survey, but these associations were not found in the later survey. MLR analyses confirmed a significant decline in MHT use between the 1997–1999 and 2003–2004 surveys, however, the effect was modified by social status and was not significant among lowest social-status women. Conclusion Current MHT use considerably declined among women in Germany between the pre- and post-WHI era. A convergence of current MHT use among women of higher social status with pre-existing patterns of use among lower social-status women suggests that

  19. Differential effects of oral and transdermal menopausal hormone therapy on prostacyclin and thromboxane in platelets.

    Science.gov (United States)

    Raz, Limor; Hunter, Larry W; Jayachandran, Muthuvel; Heit, John A; Miller, Virginia M

    2014-01-01

    Abstract Menopausal hormone therapies (MHT) may increase thrombotic risk but modulate endothelial function and reduce development of vascular lesions. This study compared effects of MHT on prostanoid-modulated adenosine triphosphate (ATP) secretion from platelets in relationship with endothelial reactive hyperemia (RH) index and carotid intima medial thickness (CIMT). Participants were healthy, recently menopausal women of the Kronos Early Estrogen Prevention Study (KEEPS) randomized to one of three treatments: oral conjugated equine estrogen (oCEE, 0.45 mg/day), transdermal 17β-estradiol (tE2, 50 μg/day) each with intermittent oral progesterone or placebo pills and patch (PL). Prostacyclin and thromboxane A2 were assessed by quantification of their stable metabolites (6-keto-prostaglandin F1α, 6-k-PGF1α; thromboxane B2, TXB2), using ELISA. Dense granule ATP secretion from activated platelets was determined by bioluminescence; RH and CIMT were determined by fingertip tonometry and ultrasound, respectively. After 48 months of treatment, platelet content of 6-k-PGF1α and TXB2 was significantly lower in oCEE compared to the PL. Inhibition of ATP secretion by exogenous activation of cAMP associated with platelet 6-k-PGF1α (r = -0.41, P = 0.04) and TXB2 (r = 0.71, P = 0.0005) only in the oCEE group. Serum and platelet content of 6-k-PGF1α and TXB2 associated positively in the PL and tE2 groups. Serum 6-k-PGF1α positively associated with RH in the oCEE group (r = 0.73, P = 0.02), while serum TXB2 positively associated with CIMT in the tE2 group (r = 0.64, P = 0.01). Thus, oCEE and tE2 differentially affect prostanoid-mediated platelet secretory pathways but alone would not account for an increased thrombotic risk for oral MHT. Furthermore, platelet-derived prostanoids may contribute to RH and vascular remodeling in healthy menopausal women.

  20. The effect of Hormone Replacement Therapy (HRT in the psychological well-being of menopausal women

    Directory of Open Access Journals (Sweden)

    Eugenia Vlachou

    2013-01-01

    Full Text Available The factors affecting the psychological situation of menopausal women have often been examined in the past. Aim: The purpose of the present study was to examine the psychological disorders that arise in menopausal women receiving Hormone Replacement Therapy (HRT in comparison to those not receiving HRT. Material and Method: The sample of the study included 216 menopausal women, 40-60 years old, divided into two groups and examined twice in a six months period apart. The first group included 100 women receiving HRT for at least three months period, while the second group included116 women not receiving HRT. A demographic inventory, the Greene Climacteric Scale, the Hamilton Anxiety Scale and the CES-D Depression Scale were used. Results: 46.3% of women were taking HRT while 53.7% were not. In the first interview the mean values of the Greene Scale were for the first group 13.21±9.61 and for the second one 25.33±12.25, (p<0.001, while at the second interview the mean values were 9.17±6.93 and 28.65±13.25 respectively, (p<0.001. In the Hamilton scale at the first interview the mean values of the first group were 5.74±8.29 and for the second one 19.28±11.90 (p<0.001, while at the second interview the mean values were 4.43±7.75 and 19.47±11.75 respectively (p<0.001 and were above the threshold of a clinically anxiety syndrome. The mean values of the CES-D in the first interview were 10.33±7.58 in the first group and 11.20±11.22 in the second one (p<0.001, while at the second interview were 8.61±6.25 and 11.82±11.59 respectively (p<0.001. Multiple linear regression analysis demonstrated that the education level interprets 49.4%, 28.4% and 17.1% of the variable, for Greene, Hamilton and CES-D scales respectively (Β=-4.563, p<0.001, Β=-3.012, p=0.005 και Β=-4.175, p<0.001 respectively. Conclusions: HRT seem to provide significant improvement in menopausal psychological symptoms. Further studies are needed in order to clarify relative

  1. The effects of an 'explicit' values clarification exercise in a woman's decision aid regarding postmenopausal hormone therapy.

    Science.gov (United States)

    O'Connor, Annette M.; Wells, George A.; Tugwell, Peter; Laupacis, Andreas; Elmslie, Tom; Drake, Elizabeth

    1999-03-01

    OBJECTIVE: To evaluate the incremental effect of a graphic weigh-scale values clarification exercise to explicitly consider the personal importance of the benefits versus the risks in a woman's decision aid regarding postmenopausal hormone therapy. DESIGN: Randomized controlled trial. Intervention Decision aid including information on options, benefits and risks, and their probabilities either followed by: (1) a graphic weigh-scale values clarification exercise to explicitly consider the personal importance of each benefit and risk; or (2) a summary of the main benefits and risks to implicitly consider benefits versus the risks. SAMPLE: Two-hundred and one women aged 50-69 years from Ottawa, Canada, who had never used hormone therapy. OUTCOME: Perceived clarity of values, a sub-scale of the decisional conflict scale; congruence between personal values of benefits and risks (measured on 0-10 importance rating scale) and choices (accept, decline, unsure regarding preventive hormone therapy [HRT]) using discriminant function analysis. RESULTS: There were no statistically significant differences between interventions in perceived clarity of values and overall congruence between values and choices. Amongst those choosing HRT, there was a trend in those exposed to the graphic weigh-scale exercise to have better congruence between values and choices compared to implicit values clarification (P = 0.06). CONCLUSION: The use of the graphic weigh-scale exercise in a decision aid conveys no overall short-term benefit. Further study is needed to specifically determine effects in those changing the status quo and on the quality of patient-practitioner communication and persistence with decisions.

  2. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Moon Z

    2017-02-01

    Full Text Available Zoe Moon, Rona Moss-Morris, Myra S Hunter, Sophie Carlisle, Lyndsay D Hughes Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Purpose: Nonadherence to hormone therapy in breast cancer survivors is common and associated with increased risk of mortality. Consistent predictors of nonadherence and nonpersistence are yet to be identified, and little research has examined psychosocial factors that may be amenable to change through intervention. This review aimed to identify predictors of nonadherence and nonpersistence to hormone therapy in breast cancer survivors in order to inform development of an intervention to increase adherence rates.Methods: Studies published up to April 2016 were identified through MEDLINE, Embase, Web of Science, PsycINFO, CINAHL and gray literature. Studies published in English measuring associations between adherence or persistence and any predictor variables were included. Eligible studies were assessed for methodological quality, data were extracted and a narrative synthesis was conducted.Results: Sixty-one eligible articles were identified. Most studies focused on clinical and demographic factors with inconsistent results. Some evidence suggested that receiving specialist care and social support were related to increased persistence, younger age and increased number of hospitalizations were associated with nonadherence, and good patient–physician relationship and self-efficacy for taking medication were associated with better adherence. A small amount of evidence suggested that medication beliefs were associated with adherence, but more high-quality research is needed to confirm this.Conclusion: Some psychosocial variables were associated with better adherence and persistence, but the results are currently tentative. Future high-quality research should be carried out to identify psychosocial determinants of nonadherence or

  3. Continuation of growth hormone (GH) therapy in GH-deficient patients during transition from childhood to adulthood

    DEFF Research Database (Denmark)

    Nørrelund, Helene; Vahl, N; Juul, A

    2000-01-01

    fat and increased fat-free mass [M-value (mg/kg x min), 5.1 +/- 0.7 (placebo) vs. 3.4 +/- 1.0 (open), P = 0.09]. In the group randomized to continued GH treatment almost all hormonal and metabolic parameters remained unchanged during the study. In conclusion, 1) discontinuation of GH therapy for 1 yr...... in adolescent patients induces fat accumulation without compromising insulin sensitivity; and 2) the beneficial effects of continued GH treatment on body composition in terms of decrease in fat mass and increase in fat-free mass does not fully balance the direct insulin antagonistic effects....

  4. Effect of Long-Term Hormonal Therapy (vs Short-Term Hormonal Therapy): A Secondary Analysis of Intermediate-Risk Prostate Cancer Patients Treated on NRG Oncology RTOG 9202.

    Science.gov (United States)

    Mirhadi, Amin J; Zhang, Qiang; Hanks, Gerald E; Lepor, Herbert; Grignon, David J; Peters, Christopher A; Rosenthal, Seth A; Zeitzer, Kenneth; Radwan, John S; Lawton, Colleen; Parliament, Matthew B; Reznik, Robert S; Sandler, Howard M

    2017-03-01

    NRG Oncology RTOG 9202 was a randomized trial testing long-term adjuvant androgen deprivation (LTAD) versus initial androgen deprivation only (STAD) with external beam radiation therapy (RT) in mostly high-risk and some intermediate-risk prostate cancer patients. RTOG 9408 found an overall survival (OS) advantage in patients with cT1b-T2b disease and prostate-specific antigen (PSA) terms of OS, DSS, or PSAF rates in the intermediate-risk subset in this study. Whereas the subset was relatively small, treatment assignment was randomly applied, and a trend in favor of LTAD would have been of interest. Given the small number of disease-specific deaths observed and lack of benefit with respect to our endpoints, this secondary analysis does not suggest that exploration of longer hormonal therapy is worth testing in the intermediate-risk prostate cancer subset. Copyright © 2016. Published by Elsevier Inc.

  5. Response to three years of growth hormone therapy in girls with Turner syndrome

    Science.gov (United States)

    Park, Hong Kyu; Lee, Hae Sang; Ko, Jung Hee; Hwang, Il Tae

    2013-01-01

    Purpose Short stature is the most common finding in patients with Turner syndrome. Improving the final adult height in these patients is a challenge both for the patients and physicians. We investigated the clinical response of patients to growth hormone treatment for height improvement over the period of three years. Methods Review of medical records from 27 patients with Turner syndrome treated with recombinant human growth hormone for more than 3 years was done. Differences in the changes of height standard deviation scores according to karyotype were measured and factors influencing the height changes were analyzed. Results The response to recombinant human growth hormone was an increase in the height of the subjects to a mean value of 1.1 standard deviation for subjects with Turner syndrome at the end of the 3-year treatment. The height increment in the first year was highest. The height standard deviation score in the third year was negatively correlated with the age at the beginning of the recombinant human growth hormone treatment. Different karyotypes in subjects did not seem to affect the height changes. Conclusion Early growth hormone administration in subjects with Turner syndrome is helpful to improve height response to the treatment. PMID:24904845

  6. Hormonal replacement therapy and aging: Asian practical recommendations on testosterone supplementation

    Institute of Scientific and Technical Information of China (English)

    YoungChanKim

    2003-01-01

    Profound and diffuse alterations in the production of gonadal and adrenal androgens as well as growth hormone are associated with aging. To convey this concept more appropriately, partial endocrine deficiency in the aging male (PEDAM) was introduced as a term for the phenomenon of hormonal alterations in the aging male.Hormones responsible for some of the manifestations associated with male aging are testosterone, growth hormone,dehydroepiansdrosterone (DHEA), melatonin, thyroid hormones and leptin. Of these, testosterone has been widely investigated and its beneficial and adverse effects on male bodily systems are relatively well established. However, a serious body of confusion and misunderstandings surrounding the diagnosis, treatment and monitoring of men suspected of having androgen deficiency has been raised. Therefore, it is timely to provide practical criteria for diagnosis and treatment to avoid misconception about the use of testosterone in the aging male. To provide an understanding and information of the issues, the following headings are summarized: (1) Important clinical consideration on testosterone supplementation in the aging male; (2) Asian practical recommendations on testosterone supplementation in the aging male.

  7. Growth Hormone and Insulin-like Growth Factor 1: New Endocrine Therapies in Cardiology?

    Science.gov (United States)

    Clark, R

    1997-10-01

    The hormones growth hormone (GH) and insulin-like growth factor 1 (IGF-1) play a dominant role in whole body growth and metabolism. This is reflected in the use of human GH (hGH) in GH-deficient children to stimulate growth and in GH-deficient adults to reduce visceral fat mass. Recent data suggest that hGH may improve cardiac function in patients with heart failure, so there is current interest in methods to raise GH-IGF levels, including the testing of agents that release GH from the pituitary, administering IGF-1, and most recently, long-acting formulations of hGH. It is hoped that this ongoing integration of cardiology and endocrinology will uncover the pathophysiology of some cardiovascular diseases and yield new treatments based on the hormones of the GH axis. (Trends Cardiovasc Med 1997;7:264-268). © 1997, Elsevier Science Inc.

  8. Growth hormone deficiency

    Science.gov (United States)

    ... dosage of the medicine. Serious side effects of growth hormone treatment are rare. Common side effects include: Headache Fluid ... years. The rate of growth then slowly decreases. Growth hormone therapy does not work for all children. Left untreated, ...

  9. Circulating levels of pegvisomant and endogenous growth hormone during prolonged pegvisomant therapy in patients with acromegaly

    DEFF Research Database (Denmark)

    Madsen, Michael; Fisker, Sanne; Feldt-Rasmussen, Ulla;

    2014-01-01

    OBJECTIVE: To investigate whether pegvisomant treatment in acromegaly induces gradual elevations in endogenous serum growth hormone (GH) levels and whether serum pegvisomant levels predict the therapeutic outcome. PATIENTS AND METHODS: Seventeen patients (6 women), mean age 46·3 years (range: 23...... correlated with baseline growth hormone levels, whereas no associations between serum pegvisomant and either dose, gender, age or body weight were found. CONCLUSIONS: (1) Serum GH levels increased initially, but remained stable during prolonged pegvisomant treatment in patients with acromegaly, (2) serum...

  10. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje;

    2000-01-01

    OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal changes...... in blood pressure (BP) by two measurement techniques during a cyclic hormone replacement regimen. DESIGN AND METHODS: Sixteen healthy and normotensive post-menopausal women (age 55 +/- 3 years) were studied in a placebo-controlled, randomized crossover study, and were randomized to 17beta-oestradiol plus...

  11. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje

    2000-01-01

    OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal changes...... in blood pressure (BP) by two measurement techniques during a cyclic hormone replacement regimen. DESIGN AND METHODS: Sixteen healthy and normotensive post-menopausal women (age 55 +/- 3 years) were studied in a placebo-controlled, randomized crossover study, and were randomized to 17beta-oestradiol plus...

  12. Outpatient overnight glucose control with dual-hormone artificial pancreas, single-hormone artificial pancreas, or conventional insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, randomised controlled trial.

    Science.gov (United States)

    Haidar, Ahmad; Legault, Laurent; Matteau-Pelletier, Laurence; Messier, Virginie; Dallaire, Maryse; Ladouceur, Martin; Rabasa-Lhoret, Rémi

    2015-08-01

    Additional benefits of the dual-hormone (insulin and glucagon) artificial pancreas compared with the single-hormone (insulin alone) artificial pancreas have not been assessed in young people in outpatient unrestricted conditions. We evaluated the efficacy of three systems for nocturnal glucose control in children and adolescents with type 1 diabetes. We did a randomised, three-way, crossover trial in children aged 9-17 years with type 1 diabetes attending a diabetes camp in Canada. With use of sealed envelopes, children were randomly assigned in a 1:1:1:1:1:1 ratio with blocks of six to different sequences of the three interventions (single-hormone artificial pancreas, dual-hormone artificial pancreas, and conventional continuous subcutaneous insulin pump therapy). Each intervention was applied for 3 consecutive nights. Participants, study staff, and endpoint assessors were not masked. The primary outcome was the percentage of time spent with glucose concentrations lower than 4·0 mmol/L from 2300 h to 0700 h. Analysis was by intention to treat. A p value of less than 0·0167 was regarded as significant. This study is registered with ClinicalTrials.gov, number NCT02189694. Between June 30, 2014, and Aug 9, 2014, we enrolled 33 children of mean age 13·3 years (SD 2·3; range 9-17). The time spent at a glucose concentration lower than 4·0 mmol/L was median 0% (IQR 0·0-2·4) during nights with the dual-hormone artificial pancreas, 3·1% (0·0-6·9) during nights with the single-hormone artificial pancreas (p=0·032), and 3·4% (0-11·0) during nights with conventional pump therapy (p=0·0048 compared with dual-hormone artificial pancreas and p=0·32 compared with single-hormone artificial pancreas). 15 hypoglycaemic events (pump therapy compared with four events with the single-hormone system and no events with the dual-hormone system. None of the assessed outcomes varied with the order in which children and young adults were assigned interventions. The dual-hormone

  13. Continuation of growth hormone (GH) therapy in GH-deficient patients during transition from childhood to adulthood

    DEFF Research Database (Denmark)

    Nørrelund, Helene; Vahl, N; Juul, A

    2000-01-01

    -controlled, parallel study. Measurements were made at baseline, where all patients were on their regular GH replacement, after 12 months of either continued GH (0.018 +/- 0.001 mg/kg day) or placebo, and finally after 12 months of open phase GH therapy (0.016 mg/kg x day). Before study entry GH deficiency...... fat and increased fat-free mass [M-value (mg/kg x min), 5.1 +/- 0.7 (placebo) vs. 3.4 +/- 1.0 (open), P = 0.09]. In the group randomized to continued GH treatment almost all hormonal and metabolic parameters remained unchanged during the study. In conclusion, 1) discontinuation of GH therapy for 1 yr...

  14. Less mammographic density after nasal versus oral administration of postmenopausal hormone therapy

    NARCIS (Netherlands)

    Dijck, J.A. van; Otten, J.D.M.; Karssemeijer, N.; Kenemans, P.; Verbeek, A.L.M.; Mooren, M.J. van der

    2011-01-01

    ABSTRACT Objective Nasal administration gives a more acute but shorter rise in serum hormone levels than oral administration and may therefore have less effect on the fibroglandular tissue in the breasts. We studied the change in mammographic breast density after nasal vs. oral administration of pos

  15. Growth hormone therapy, muscle thickness, and motor development in Prader-Willi Syndrome: An RCT

    NARCIS (Netherlands)

    Reus, L.; Pillen, S.; Pelzer, B.J.; Velden, J.A.M. van der; Hokken-Koelega, A.C.; Zwarts, M.; Otten, B.J.; Nijhuis-Van der Sanden, M.W.G.

    2014-01-01

    OBJECTIVE: To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS). METHODS: In a randomized controlled trial, 22 infants with PWS (12.9 +/- 7.1 mo

  16. Growth hormone therapy, muscle thickness, and motor development in Prader-Willi Syndrome: An RCT

    NARCIS (Netherlands)

    Reus, L.; Pillen, S.; Pelzer, B.J.; Alfen-van der Velden, A.A.E.M. van; Hokken-Koelega, A.C.S.; Zwarts, M.J.; Otten, B.J.; Nijhuis-Van der Sanden, M.W.G.

    2014-01-01

    OBJECTIVE: To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS). METHODS: In a randomized controlled trial, 22 infants with PWS (12.9 ± 7.1 mont

  17. Growth hormone therapy, muscle thickness, and motor development in Prader-Willi Syndrome: An RCT

    NARCIS (Netherlands)

    Reus, L.; Pillen, S.; Pelzer, B.J.; Velden, J.A.M. van der; Hokken-Koelega, A.C.; Zwarts, M.; Otten, B.J.; Nijhuis-Van der Sanden, M.W.G.

    2014-01-01

    OBJECTIVE: To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS). METHODS: In a randomized controlled trial, 22 infants with PWS (12.9 +/- 7.1

  18. Hormone replacement therapy increases levels of antibodies against heat shock protein 65 and certain species of oxidized low density lipoprotein

    Directory of Open Access Journals (Sweden)

    Uint L.

    2003-01-01

    Full Text Available Hormone replacement therapy (HRT reduces cardiovascular risks, although the initiation of therapy may be associated with transient adverse ischemic and thrombotic events. Antibodies against heat shock protein (Hsp and oxidized low density lipoprotein (LDL have been found in atherosclerotic lesions and plasma of patients with coronary artery disease and may play an important role in the pathogenesis of atherosclerosis. The aim of the present study was to assess the effects of HRT on the immune response by measuring plasma levels of antibodies against Hsp 65 and LDL with a low and high degree of copper-mediated oxidative modification of 20 postmenopausal women before and 90 days after receiving orally 0.625 mg equine conjugate estrogen plus 2.5 mg medroxyprogesterone acetate per day. HRT significantly increased antibodies against Hsp 65 (0.316 ± 0.03 vs 0.558 ± 0.11 and against LDL with a low degree of oxidative modification (0.100 ± 0.01 vs 0.217 ± 0.02 (P<0.05 and P<0.001, respectively, ANOVA. The hormone-mediated immune response may trigger an inflammatory response within the vessel wall and potentially increase plaque burden. Whether or not this immune response is temporary or sustained and deleterious requires further investigation.

  19. Analysis of the influence of hormone replacement therapy on TNF-alpha serum levels in menopausal women 

    Directory of Open Access Journals (Sweden)

    Mansur Rahnama

    2012-12-01

    Full Text Available Objective:The aim of the study was to investigate and compare levels of TNF-α in serum of menopausal women treated and not treated with hormone replacement therapy (HRT.Design:The study was designed to verify whether there is a correlation between the concentrations of this cytokine and bone mineral density (BMD.Material/Methods:The study was carried out on a group of 60 women during menopause – 30 untreated (control group and 30 treated with HRT (study group. Half of the patients were after natural menopause and the other half were after ovariectomy. Blood samples were collected. Densitometry was conducted on the vertebral column. To evaluate the results of densitometric examination the T-score index was calculated.Results:The T-score index of the control group reached values below –2. T-score results for the study group were significantly higher than in the control group. Hormone replacement therapy used by women from the study group caused a decrease in the TNF content in serum, compared with the control group.Conclusions:Beneficial effects of HRT on bone tissue may be exerted through decreased concentration of TNF-α in serum. The use of HRT allows constant bone mineral density to be maintained, which leads to prevention of osteoporotic changes. 

  20. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review

    Science.gov (United States)

    Moon, Zoe; Moss-Morris, Rona; Hunter, Myra S; Carlisle, Sophie; Hughes, Lyndsay D

    2017-01-01

    Purpose Nonadherence to hormone therapy in breast cancer survivors is common and associated with increased risk of mortality. Consistent predictors of nonadherence and nonpersistence are yet to be identified, and little research has examined psychosocial factors that may be amenable to change through intervention. This review aimed to identify predictors of nonadherence and nonpersistence to hormone therapy in breast cancer survivors in order to inform development of an intervention to increase adherence rates. Methods Studies published up to April 2016 were identified through MEDLINE, Embase, Web of Science, PsycINFO, CINAHL and gray literature. Studies published in English measuring associations between adherence or persistence and any predictor variables were included. Eligible studies were assessed for methodological quality, data were extracted and a narrative synthesis was conducted. Results Sixty-one eligible articles were identified. Most studies focused on clinical and demographic factors with inconsistent results. Some evidence suggested that receiving specialist care and social support were related to increased persistence, younger age and increased number of hospitalizations were associated with nonadherence, and good patient–physician relationship and self-efficacy for taking medication were associated with better adherence. A small amount of evidence suggested that medication beliefs were associated with adherence, but more high-quality research is needed to confirm this. Conclusion Some psychosocial variables were associated with better adherence and persistence, but the results are currently tentative. Future high-quality research should be carried out to identify psychosocial determinants of nonadherence or nonpersistence that are modifiable through intervention. PMID:28260867

  1. Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review.

    Science.gov (United States)

    Moon, Zoe; Moss-Morris, Rona; Hunter, Myra S; Carlisle, Sophie; Hughes, Lyndsay D

    2017-01-01

    Nonadherence to hormone therapy in breast cancer survivors is common and associated with increased risk of mortality. Consistent predictors of nonadherence and nonpersistence are yet to be identified, and little research has examined psychosocial factors that may be amenable to change through intervention. This review aimed to identify predictors of nonadherence and nonpersistence to hormone therapy in breast cancer survivors in order to inform development of an intervention to increase adherence rates. Studies published up to April 2016 were identified through MEDLINE, Embase, Web of Science, PsycINFO, CINAHL and gray literature. Studies published in English measuring associations between adherence or persistence and any predictor variables were included. Eligible studies were assessed for methodological quality, data were extracted and a narrative synthesis was conducted. Sixty-one eligible articles were identified. Most studies focused on clinical and demographic factors with inconsistent results. Some evidence suggested that receiving specialist care and social support were related to increased persistence, younger age and increased number of hospitalizations were associated with nonadherence, and good patient-physician relationship and self-efficacy for taking medication were associated with better adherence. A small amount of evidence suggested that medication beliefs were associated with adherence, but more high-quality research is needed to confirm this. Some psychosocial variables were associated with better adherence and persistence, but the results are currently tentative. Future high-quality research should be carried out to identify psychosocial determinants of nonadherence or nonpersistence that are modifiable through intervention.

  2. Changes in Plasma Prolactin and Growth Hormone Level and Visual Problem after radiation Therapy(RT) of Pituitary Adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sei Chul; Kwon, Hyung Chul; Oh, Yoon Kyeong; Bahk, Yong Whee; Son, Ho Young; Kang, Joon Ki; Song, Jin Un [Catholic Medical College, Seoul (Korea, Republic of)

    1985-06-15

    Twenty-four cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary Hospital, Catholic Medical College. Of 24 case of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analyzed the alteration of the endocrinological tests, neurologic abnormalities, major clinical symptoms, endocrinological changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra and para-sellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormonesecreting tumors, 3 ACTH-secreting tumors consisting of one Cushing disease and two Nelson syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but on lost case. 6. Two of 4 growth hormone-secreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.

  3. Impact of hormone replacement therapy on cardiac metabolic indicators in men with high cardiovascular risk and hypogonadism

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2014-12-01

    Full Text Available The paper evaluates the impact of hormone replacement therapy (HRT with androgens on cardiac metabolic indicators in men with high cardiovascular risk (CVR and androgen deficiency state. An open-label randomized clinical trial enrolled 52 men aged 30–64 years with high CVR and detected androgen-deficiency state. The men were randomized into 2 groups: a control group (CG (n = 26 continued to receive the pre-trial therapy; during the previous therapy, a study group (SG (n = 26 had daily applications of transdermal gel with testosterone (AndroGel in a daily dose of 50 mg of testosterone in 5 g of the gel. The trial lasted 180 days. The changes in the indicators under study were traced 90 days after treatment initiation at an intermediate visit and 180 days after the initiation of treatment – at the end of its treatment.At the end of the trial, HRT in men with androgen deficiency and high CVR led to normalization of testosterone levels in all the SG patients and to improvement in erectile function by 12 %. Androgen therapy caused a statistically significant reduction in blood pressure by 10 %; no changes were virtually observed in the CG. HRT promoted a slight, but significant weight loss (by an average of 2.8 kg and waist circumference (by an average of 1.7 cm. The therapy performed also lowered the concentration of total cholesterol by an average of 11 % and that of triglycerides by 22 %. During the therapy, there was a significant decrease in fasting insulin and glucose levels. Overall, the course therapy with transdermal gel in combination with testosterone resulted in a reduction in the expected total CVR by 30 %. Thus, HRT using testosterone preparations in men with hypogonadism and high CVR led to normalization of testosterone levels and major cardiac metabolic indicators and to improvement in erectile function.

  4. Impact of hormone replacement therapy on cardiac metabolic indicators in men with high cardiovascular risk and hypogonadism

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2014-01-01

    Full Text Available The paper evaluates the impact of hormone replacement therapy (HRT with androgens on cardiac metabolic indicators in men with high cardiovascular risk (CVR and androgen deficiency state. An open-label randomized clinical trial enrolled 52 men aged 30–64 years with high CVR and detected androgen-deficiency state. The men were randomized into 2 groups: a control group (CG (n = 26 continued to receive the pre-trial therapy; during the previous therapy, a study group (SG (n = 26 had daily applications of transdermal gel with testosterone (AndroGel in a daily dose of 50 mg of testosterone in 5 g of the gel. The trial lasted 180 days. The changes in the indicators under study were traced 90 days after treatment initiation at an intermediate visit and 180 days after the initiation of treatment – at the end of its treatment.At the end of the trial, HRT in men with androgen deficiency and high CVR led to normalization of testosterone levels in all the SG patients and to improvement in erectile function by 12 %. Androgen therapy caused a statistically significant reduction in blood pressure by 10 %; no changes were virtually observed in the CG. HRT promoted a slight, but significant weight loss (by an average of 2.8 kg and waist circumference (by an average of 1.7 cm. The therapy performed also lowered the concentration of total cholesterol by an average of 11 % and that of triglycerides by 22 %. During the therapy, there was a significant decrease in fasting insulin and glucose levels. Overall, the course therapy with transdermal gel in combination with testosterone resulted in a reduction in the expected total CVR by 30 %. Thus, HRT using testosterone preparations in men with hypogonadism and high CVR led to normalization of testosterone levels and major cardiac metabolic indicators and to improvement in erectile function.

  5. The presence and role of progesterone receptor in the ovaries of postmenopausal women who have not applied hormone replacement therapy.

    Directory of Open Access Journals (Sweden)

    Małgorzata Piasecka

    2008-12-01

    Full Text Available At present, not much is known about progesterone receptor (PR expression and localization in postmenopausal women ovaries. In the ovaries of reproductive age women, PR is localized in internal theca and granulosa cells, corpus luteum, ovary surface epithelium (OSE and in stroma. PR expression depends on the serum concentration of progesterone, estrogen, gonadotropin and androgen. The goal of the conducted studies was to examine PR localization and expression in the ovaries of postmenopausal women who have not applied hormone replacement therapy so far. Also, the correlation was examined between PR expression and localization in the ovaries, steroid and gonadotropin hormone serum concentrations, and influence of the time from the last menstruation. The material came from 50 postmenopausal women who had their ovaries removed due to non-neoplastic diseases. The women were divided into 3 groups (A, B, C depending on the time from the last menstruation. The follitropin (FSH, luteotropin (LH, estradiol (E2, testosterone (T, androstendione (A and dehydroepiandrosterone sulphate (DHEAS concentrations in blood plasma were measured. Monoclonal mouse anti-human PR antibody was used for immunohistochemical detection (examination involved 50 postmenopausal ovaries. Between particular groups, E2 serum concentrations did not differ, but FSH, LH, T, A, DHEAS serum concentrations were significantly different. Immunohistochemical nuclear localization of PR in postmenopausal women ovaries was observed. PR expression was similar in all three groups (A, B, C. PR expression was observed in OSE nuclei and invaginations cysts deriving from the isolation of invaginated epithelium and metaplastic columnar epithelium and in stroma. In the ovaries of postmenopausal women who have not applied hormone replacement therapy so far, PR was detected in all three groups. Its expression did not depend on the time from menopause and was similar in all examined groups. FSH, LH, T, A

  6. Comparison of health utility weights among elderly patients receiving breast-conserving surgery plus hormonal therapy with or without radiotherapy

    Science.gov (United States)

    Ali, Askal Ayalew; Xiao, Hong; Tawk, Rima; Campbell, Ellen; Semykina, Anastasia; Montero, Alberto J.; Diaby, Vakaramoko

    2017-01-01

    Background The selection of the most appropriate treatment combinations requires the balancing of benefits and harms of these treatment options as well as the patients’ preferences for the resulting outcomes. Objective This research aimed at estimating and comparing the utility weights between elderly women with early stage hormone receptor positive (HR+) breast cancer receiving a combination of radiotherapy and hormonal therapy after breast conserving surgery (BCS) and those receiving a combination of BCS and hormonal therapy. Methods The Surveillance, Epidemiology, and End Results (SEER) linked with Medicare Health Outcomes Survey (MHOS) was used as the data source. Health utility weights were derived from the VR-12 health-related quality of life instrument using a mapping algorithm. Descriptive statistics of the sample were provided. Two sample t-tests were performed to determine potential differences in mean health utility weights between the two groups after propensity score matching. Results The average age at diagnosis was 72 vs. 76 years for the treated and the untreated groups, respectively. The results showed an inverse relationship between the receipt of radiotherapy and age. Patients who received radiotherapy had, on average, a higher health utility weight (0.70; SD = 0.123) compared with those who did not receive radiotherapy (0.676; SD = 0.130). Only treated patients who had more than two comorbid conditions had significantly higher health utility weights compared with patients who were not treated. Conclusions The mean health utility weights estimated for the radiotherapy and no radiotherapy groups can be used to inform a comparative cost-effectiveness analysis of the treatment options. However, the results of this study may not be generalizable to those who are outside a managed care plan because MHOS data is collected on managed care beneficiaries. PMID:27819160

  7. Early report of randomized double blind clinical trial of hormonal therapy of carcinoma of prostate (CAP stage D2

    Directory of Open Access Journals (Sweden)

    Jagdeesh N Kulkarni

    2003-01-01

    Full Text Available Objectives: We herein report our experience of double blind randomized clinical trial comparing combined an-drogen blockade vs monotherapy in stage D2 CaP. Patients and Methods: Through June 1999 and May 2001, 100 patients of stage D2 CaP were randomized into placebo (44 and flutamide (42 group after orchiectomy in double blind fashion using the strictest criteria. All men and histological proof of CaP with bone metastasis dem-onstrated on imaging: bone scan and skeletal survey. These patients were further substratified according to number o f bony metastases into high volume disease (HVD>5 sites and low volume disease (LVD< 5 sites. The follow-up was at 3 month intervals. Criteria for decoding were clinical or serological progression and serious adverse effects. Results: Of the 100 patients recruited in the trial, 48 had HVD and 52 LVD. Treatmentwise they were almost equally distributed in flutamide group and placebo group. In the follow-up ranging front 6 to 24 months, 30 out of 100 patients (30% required decoding, reasons for decod-ing were progression of disease in 25 and serious adverse effects in remaining 5. These 25 patients were further analyzed according to treatment group, volume of metas-tasis pre -orchiectomy PSA and Gleason score. We observed that number of bony metastases had impact over the dura-tion of response to hormonal therapy. Discussion: We initiated this simple trial to address the issue of benefit of total androgen blockade over monotherapy in Indian population. In the initial analysis, we observed that treatment group did not make any impact over the response. While subset of prostate cancer with large number of bony metastases has higher propensity to convert into hormone refractory cancer Conclusions: Addition of flutamide did not provide ben-efit. We observed that large number of bony metastases had poor response to hormonal therapy, hence it requires large trial to substantiate this initial observation.

  8. Improving the outcome of established therapies for osteoporosis by adding the active D-hormone analog alfacalcidol.

    Science.gov (United States)

    Ringe, J D; Schacht, E

    2007-12-01

    While in other chronic diseases combined treatment regimens are the rule there is a lack of reported experience or study data on combining different specific drugs to treat osteoporosis. Significant differences in the mode of action (MOA) of the substances to be combined may be important for achieving optimal therapeutic results. Recognising that today bisphosphonates are the leading therapy for osteoporosis we suggest that the active D-hormone analog alfacalcidol with its completely different mechanisms of action could be an interesting combination to improve the therapeutic outcome of the pure antiresoptive action of bisphosphonates. Alfacalcidol is activated by the enzyme 25-hydroxylase in the liver for systemic and in osteoblasts for local D-hormone actions. It possesses a unique pattern of pleiotropic effects on, e.g. gut, bone, pararthyroids, muscle and brain. Alfacalcidol is superior to plain vitamin D (cholecalciferol) because the final kidney activation of the latter is regulated by a negative feedback mechanism. In vitamin D replete patients or patients with impaired kidney function no increased D-hormone action at the target tissues can be achieved. Animal studies and several trials in humans with alendronate plus calcitriol or alfacalcidol proved that the combination induced significantly higher increases of bone mineral density (BMD) than the respective mono-therapies. The results of the 2-year AAC-trial from our group indicate that the combination alendronate and alfacalcidol is also superior in terms of falls, fractures and back pain. From the review of the literature and the own new results we conclude that this combined therapeutic regimen is a very promising option for treating established osteoporosis and propose a differentiated use of alfacalcidol alone or the combination with alendronate in different stages and clinical situations of osteoporosis.

  9. Prospective assessment of pituitary size and shape on MR imaging after suppressive hormonal therapy in central precocious puberty

    Energy Technology Data Exchange (ETDEWEB)

    Beek, J.T. van; Sharafuddin, M.J.A.; Kao, S.C.S. [Department of Radiology-JPP 3889, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52246 (United States); Luisiri, A. [Cardinal Glennon Children' s Hospital, St. Louis, Missouri (United States); Garibaldi, L.R. [Children' s Hospital of New Jersey, Newark Beth Israel Medical Center, Newark, New Jersey (United States); St. Barnabas Medical Center, Livingston, New Jersey (United States)

    2000-07-01

    Objective. The diagnostic significance of an enlarged pituitary gland regarding both shape and size parameters on MR imaging has previously been demonstrated in children with central precocious puberty. This study was designed to assess changes in these parameters following successful suppressive therapy of central precocious puberty with the gonadotropin-releasing hormone (GnRH) analogue. Materials and methods. Twelve girls (mean age 7.3 years) with central precocious puberty were prospectively enrolled in our study protocol. Sagittal and coronal MR images of the pituitary region were obtained in all patients before treatment and after at least 6 months of GnRH analogue therapy (mean 18.0 months). Parameters measured included pituitary gland height, length, width, sagittal cross-sectional area, and volume. Results. All patients had excellent clinical response to treatment with arrest of secondary sexual development, normalization of serum estradiol levels, and complete obliteration of the LH response to diagnostic GnRH stimulation. No significant change occurred in any pituitary size or shape parameter following GnRH analogue therapy. Conclusion. Favorable clinical response to GnRH analogue therapy in central precocious puberty is not accompanied by significant a change in pituitary gland size and shape. (orig.)

  10. Collagen synthesis in postmenopausal women during therapy with anabolic steroid or female sex hormones

    DEFF Research Database (Denmark)

    Hassager, C; Jensen, L T; Pødenphant, J;

    1990-01-01

    The effect of anabolic steroid therapy and estrogen-progestogen substitution therapy on serum concentration of procollagen type III aminoterminal peptide (PIIINP), a measure of collagen synthesis, in postmenopausal women was studied in two double-blind studies: (1) 39 women allocated to treatment....... We conclude that anabolic steroids stimulate type III collagen synthesis in postmenopausal women, while estrogen-progestogen therapy may have such an effect, but only to a lesser degree....

  11. Effects of horseback riding exercise therapy on hormone levels in elderly persons

    Science.gov (United States)

    Cho, Sung-Hyoun; Kim, Jin-Woo; Kim, Seon-Rye; Cho, Byung-Jun

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of riding exercise on hormone levels in normal elderly people who were taught horseback riding for 8 weeks. [Subjects] Subjects were classified into an exercise group (n=10) and control group (n=10). [Methods] The two groups, horseback riding exercise group of 10 and control group of 10, were each tested for 15 minutes, 3 times, over 8 weeks. Post-exercise tests were implemented in both groups in the same way as pre-study tests. [Results] The horseback riding group showed a significant difference in the pre- and post-exercise serotonin and cortisol levels. Additionally, serotonin and cortisol levels showed significant differences between the two groups. [Conclusion] Serotonin and cortisol levels significantly increased in the experimental group, suggesting that horseback riding exercise is effective for improving the levels of these hormones. PMID:26311966

  12. Contraindications of postmenopausal hormone therapy%绝经后激素治疗禁忌证

    Institute of Scientific and Technical Information of China (English)

    田秦杰; 王含必

    2011-01-01

    为减少激素治疗(HT)的风险,使用HT需严格排除禁忌证,包括妊娠、原因不明的阴道出血、乳腺癌、性激素相关的恶性肿瘤、活动性静脉或动脉血栓栓塞性疾病、严重肝肾功能障碍和一些与性激素相关的少见疾病.%The usage of HT must exclude the contraindication in order to reduce the risk of HT, including pregnancy, unexplained vaginal bleeding,breast cancer, sex hormone related malignant tumors, active venous or arterial thromboembolism,severe hepatic-renal dysfunction and rare sex hormone related diseases.

  13. MANAGEMENT OF ENDOCRINE DISEASE: Growth and growth hormone therapy in short children born preterm.

    Science.gov (United States)

    Boguszewski, Margaret Cristina da Silva; Cardoso-Demartini, Adriane de Andre

    2017-03-01

    Approximately 15 million babies are born preterm across the world every year, with less than 37 completed weeks of gestation. Survival rates increased during the last decades with the improvement of neonatal care. With premature birth, babies are deprived of the intense intrauterine growth phase, and postnatal growth failure might occur. Some children born prematurely will remain short at later ages and adult life. The risk of short stature increases if the child is also born small for gestational age. In this review, the effects of being born preterm on childhood growth and adult height and the hormonal abnormalities possibly associated with growth restriction are discussed, followed by a review of current information on growth hormone treatment for those who remain with short stature during infancy and childhood.

  14. Comparison of Piascledine (Avocado and Soybean Oil) and Hormone Replacement Therapy in Menopausal-Induced Hot Flashing

    Science.gov (United States)

    Panahi, Yunes; Beiraghdar, Fatemeh; Kashani, Nafise; Baharie Javan, Nika; dadjo, yahya

    2011-01-01

    Different symptoms in Climacteric period, includes hot flash. Hormone replacement therapy (HRT) is common therapy for relief of menopausal symptoms but has possible contraindications and side effects. Recently Piascledine (combination of Avocado oil with Soybean oil) showed effects in reducing hot flash severity. Present study designed to compare the effects of HRT with Piascledine in treatment of hot flash. The cases of this study were sixty-six women at the age range of 40 to 70 years and complaints of menopause-induced hot flashing, whose last menstruation dated at least 6 months prior to the beginning of the study. The patients in this open label clinical trial, randomized to receive Piascledine capsule 1 mg or HRT (0.625 mg oral daily Conjugated Estrogen tablets, plus 2.5 mg continuous oral daily Medroxyprogesterone Acetate tablets) for 2 month. Hot flash property and severity was assessed via a daily check list and Visual analog scale. Climacteric symptom was measured before and after intervention using Greene Climacteric Scale (GCS) and Blatt-kupperman Menopausal Index (BKMI). Thirty-three eligible patients were allocated in each group. From the Piascledine group, one patient and from the HRT group, 16 patients weren›t willing to attend the study; therefore, 32 and 17 woman received treatment in Piascledine and HRT groups. 4 patients were withdrawn for vaginal bleeding and one for breast tenderness from HTR group. Hot flash severity in both groups decreased during the time similarly. With regard to GCS (p = 0.571) and BMKI (p = 0.891), the outcome was similar among the two groups. Due to low HRT compliance and its possible risks in long period of time and considering the same activity of soybean supplement and HRT in relieving the hot flash as menopausal symptoms in women, it seems that soybean supplements can be an alternative therapy to hormone. PMID:24250433

  15. The diversity of abnormal hormone receptors in adrenal Cushing's syndrome allows novel pharmacological therapies

    Directory of Open Access Journals (Sweden)

    Lacroix A.

    2000-01-01

    Full Text Available Recent studies from several groups have indicated that abnormal or ectopic expression and function of adrenal receptors for various hormones may regulate cortisol production in ACTH-independent hypercortisolism. Gastric inhibitory polypeptide (GIP-dependent Cushing's syndrome has been described in patients with either unilateral adenoma or bilateral macronodular adrenal hyperplasia; this syndrome results from the large adrenal overexpression of the GIP receptor without any activating mutation. We have conducted a systematic in vivo evaluation of patients with adrenal Cushing's syndrome in order to identify the presence of abnormal hormone receptors. In macronodular adrenal hyperplasia, we have identified, in addition to GIP-dependent Cushing's syndrome, other patients in whom cortisol production was regulated abnormally by vasopressin, ß-adrenergic receptor agonists, hCG/LH, or serotonin 5HT-4 receptor agonists. In patients with unilateral adrenal adenoma, the abnormal expression or function of GIP or vasopressin receptor has been found, but the presence of ectopic or abnormal hormone receptors appears to be less prevalent than in macronodular adrenal hyperplasia. The identification of the presence of an abnormal adrenal receptor offers the possibility of a new pharmacological approach to control hypercortisolism by suppressing the endogenous ligands or by using specific antagonists for the abnormal receptors.

  16. PSA Response to Lenalidomide Therapy in a Pre-Treated Patient with Metastatic Prostate Cancer Refractory to Hormones and Chemotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Joan Manel Gasent Blesa

    2012-04-01

    Full Text Available Hormone-resistant prostate cancer (HRPC occurs when prostate cancer is no longer responsive to hormone therapy. Treatment options are limited, and there is a clear necessity for therapies that improve outcome. Preclinical and clinical evidence supports the role of the immunomodulatory agent lenalidomide in HRPC. In this paper, we report that lenalidomide showed antitumoral activity in a patient with HRPC and bone metastases pre-treated with chemotherapy, decreased the PSA level and improved the patient’s health status for the first 5 months. It is important to emphasize that it was not associated with hematologic toxicity.

  17. Effects of substitution and high-dose thyroid hormone therapy on deiodination, sulfoconjugation, and tissue thyroid hormone levels in prolonged critically ill rabbits

    NARCIS (Netherlands)

    Y. Debaveye (Yves); B. Ellger (Björn); L. Mebis (Liese); T.J. Visser (Theo); V.M. Darras (Veerle); G. van den Berghe (Greet)

    2008-01-01

    textabstractTo delineate the metabolic fate of thyroid hormone in prolonged critically ill rabbits, we investigated the impact of two dose regimes of thyroid hormone on plasma 3,3′-diiodothyronine (T2) and T4S, deiodinase type 1 (D1) and D3 activity, and tissue iodothyronine levels in liver and kidn

  18. Age at menopause and hormone replacement therapy as risk factors for head and neck and oesophageal cancer (Review).

    Science.gov (United States)

    McCarthy, Caroline E; Field, John K; Marcus, Michael W

    2017-10-01

    There were ~986,000 cases of head and neck cancer (HNC) and oesophageal cancer diagnosed worldwide in 2012. The incidence of these types of cancer is much higher in males than females, although this disparity decreases in the elderly population, suggesting a role for hormones as a risk factor. This systematic review investigates the potential role of female hormones [age at menopause and use of hormone replacement therapy (HRT)] as risk factors for HNC/oesophageal squamous cell carcinoma (SCC). The electronic databases MEDLINE, Web of Science, EMBASE and Cochrane were searched. Only studies with at least 50 cases of HNC/oesophageal SCC, with data on age at menopause, smoking, alcohol, age and socioeconomic status or educational attainment, were included. The Newcastle Ottawa Scale was used for assessing risk of bias. Eight studies met the inclusion criteria (5 oesophageal SCC, 2 HNC and 1 combined oesophageal SCC and HNC). HRT was shown to reduce the risk of HNC (HR, 0.78; 95% CI, 0.61-0.99) in one study. Our results showed that earlier age at menopause is a risk factor for oesophageal SCC, with women entering menopause at 50 years. Similar, but less striking, results were observed for HNC. HRT was found to reduce the risk of HNC/oesophageal SCC, but the evidence is inconclusive. We, therefore, recommend that consideration should be given to collecting data on reproductive factors and exposure to HRT, as routine practice, in future epidemiological and clinical studies of these cancers. The concept of oestrogen deficiency as a risk for HNC/oesophageal SCC deserves further exploration in future laboratory and clinical studies.

  19. Estrogen metabolism genotypes, use of long-term hormone replacement therapy and risk of postmenopausal breast cancer.

    Science.gov (United States)

    Cerne, Jasmina Ziva; Novakovic, Srdjan; Frkovic-Grazio, Snjezana; Pohar-Perme, Maja; Stegel, Vida; Gersak, Ksenija

    2011-08-01

    Association between long-term hormone replacement therapy (HRT) use and increased risk of breast cancer is still under debate. Functionally relevant genetic variants within the estrogen metabolic pathway may alter exposure to exogenous sex hormones and affect the risk of postmenopausal breast cancer. We investigated the associations of common polymorphisms in 4 genes encoding key proteins of the estrogen metabolic pathway, duration of HRT use and their interactions with breast cancer risk. We studied 530 breast cancer cases and 270 controls of the same age and ethnicity participating in a case-control study of postmenopausal women. Duration of HRT use was ascertained through a postal questionnaire. Genotyping was conducted for CYP1B1 (rs1056836), COMT (rs4680), GSTP1 (rs1695) and MnSOD (rs4880) polymorphisms by PCR-based RFLP and TaqMan® allelic discrimination method. Adjusted odds ratios and 95% confidence intervals were calculated using logistic regression analysis. HRT use was significantly associated with decreased breast cancer risk (pC and HRT use (pinteraction=0.036); the risk of breast cancer associated with long-term vs. short-term HRT use was decreased in women homozygous for the wild-type allele and increased in women with at least one variant allele of the MnSOD 47T>C polymorphism. Our results suggest that MnSOD 47T>C polymorphism in interaction with long-term HRT use may modify the risk of breast cancer.

  20. Investigation of awareness rate and current situation in hormone replacement therapy in medical care personnel in Shanghai

    Institute of Scientific and Technical Information of China (English)

    Shao Hong-fang; Tao Min-fang; Sun Xun-yan; Jiang Li-zhen

    2012-01-01

    Objective: To survey the cognition and requirement of perimenopause health care in Shanghai women,and provide updated situation about hormone replacement therapy (HRT) for further improving the quality of perimenopause health care.Methods: A large survey among 480 medical care personnel at age of 40-60 years in 12 hospitals in Shanghai was launched.The designed questionnaires included the awareness rate,basic knowledge of HRT and request for the information of HRT etc.The data were analyzed.Results: Among the respondents,35.81% (169/472) believed that it is necessary to start HRT in perimenopause women; 16.10 % (76/472) knew about H RT at some extent; 43.22 % (204/472) requested for the training of HRT; and 14.19%(67/472)would like to recommend patients using the hormone to treat perimenopause syndrome.In addition,52.41% (76/145)of the medical care personnel who refused to use HRT were worried about the side effects.Conclusion: In Shanghai,the awareness rate of HRT among medical care personnel was relatively low.Only a few medical care personnel prefer to use HRT in perimenopause patients.The main reasons for that were lack of understanding in the treatment of HRT and concerned side effects.

  1. Hormonal Replacement Therapy and the Risk of Lung Cancer in Women: An Adaptive Meta-analysis of Cohort Studies.

    Science.gov (United States)

    Bae, Jong-Myon; Kim, Eun Hee

    2015-11-01

    Approximately 10% to 15% of lung cancer cases occur in never-smokers. Hormonal factors have been suggested to lead to an elevated risk of lung cancer in women. This systematic review (SR) aimed to investigate the association between hormonal replacement therapy (HRT) and the risk of lung cancer in women using cohort studies. We first obtained previous SR articles on this topic. Based on these studies we made a list of refereed, cited, and related articles using the PubMed and Scopus databases. All cohort studies that evaluated the relative risk of HRT exposure on lung cancer occurrence in women were selected. Estimate of summary effect size (sES) with 95% confidence intervals (CIs) were calculated. A total of 14 cohort studies were finally selected. A random effect model was applied due to heterogeneity (I-squared, 64.3%). The sES of the 14 articles evaluating the impact of HRT exposure on lung cancer occurrence in women indicated no statistically significant increase in lung cancer risk (sES, 0.99; 95% CI, 0.90 to 1.09). These results showed that HRT history had no effect on the risk of lung cancer in women, even though the sES of case-control studies described in previous SR articles indicated that HRT had a protective effect against lung cancer. It is necessary to conduct a pooled analysis of cohort studies.

  2. A Changing Landscape of Advanced Prostate Cancer: Understanding Mechanisms of Resistance to Potent Hormonal Therapies

    Science.gov (United States)

    2016-10-01

    ctDNA. Figure 7: Overview of copy number state of selected genes across study samples divided by levels of plasma tumor fraction. Overall...90203 Trial, “Immediate prostatectomy vs. neoadjuvant docetaxel and androgen deprivation therapy for men with high risk, localized prostate cancer...Halabi S, Gleave ME, Impact of therapy on gene expression in high-risk prostate cancer treated with neoadjuvant docetaxel and androgen deprivation

  3. Anophthalmia, hearing loss, abnormal pituitary development and response to growth hormone therapy in three children with microdeletions of 14q22q23.

    Science.gov (United States)

    Brisset, Sophie; Slamova, Zuzana; Dusatkova, Petra; Briand-Suleau, Audrey; Milcent, Karen; Metay, Corinne; Simandlova, Martina; Sumnik, Zdenek; Tosca, Lucie; Goossens, Michel; Labrune, Philippe; Zemankova, Elsa; Lebl, Jan; Tachdjian, Gerard; Sedlacek, Zdenek

    2014-02-28

    Microdeletions of 14q22q23 have been associated with eye abnormalities and pituitary defects. Other phenotypic features in deletion carriers including hearing loss and response to growth hormone therapy are less well recognized. We studied genotype and phenotype of three newly identified children with 14q22q23 deletions, two girls and one boy with bilateral anophthalmia, and compared them with previously published deletion patients and individuals with intragenic defects in genes residing in the region. The three deletions were de novo and ranged in size between 5.8 and 8.9 Mb. All three children lacked one copy of the OTX2 gene and in one of them the deletion involved also the BMP4 gene. All three patients presented partial conductive hearing loss which tended to improve with age. Analysis of endocrine and growth phenotypes showed undetectable anterior pituitary, growth hormone deficiency and progressive growth retardation in all three patients. Growth hormone therapy led to partial catch-up growth in two of the three patients but just prevented further height loss in the third. The pituitary hypoplasia, growth hormone deficiency and growth retardation associated with 14q22q23 microdeletions are very remarkable, and the latter appears to have an atypical response to growth hormone therapy in some of the cases.

  4. Postmenopausal hormone therapy and depression disorder%绝经后激素治疗与抑郁障碍

    Institute of Scientific and Technical Information of China (English)

    何方方

    2011-01-01

    围绝经妇女是抑郁障碍的高发人群,可能和这一时期特有的激素波动有关.妇产科医生在诊断绝经期综合征的同时要高度警惕抑郁障碍的存在.抗抑郁药物和激素治疗同时应用治疗围绝经期和绝经后抑郁症效果较好.%Depressive symptoms was common in the perimenopausal women. That maybe relate to unstable of estradiol level during the menopausal transition. Recognition of depression among women presenting with menopausal symptoms was very important, When gynecological doctors managed the climacteric symptoms of menopausal women. Hormone therapy plus anti-depressive treatment were much better for menopausal depression.

  5. The effect of hormone replacement therapy on mood and everyday memory in younger mid-life women.

    Science.gov (United States)

    Stephens, Christine; Pachana, Nancy A; Bristow, Virginia

    2006-11-01

    Research on the effect of hormone replacement therapy (HRT) on both mood and memory indicates that oestrogen may enhance verbal memory in younger mid-aged women. This study examined the effect of HRT on everyday memory, while accounting for mood changes, in women between ages 40 and 60. A within-subjects comparison of 17 women, showed that mood, everyday memory, working memory, and delayed verbal memory improved after 3 months of HRT use. The improvement in memory was not mediated by mood, but changes in mood were moderated by exercise habits. The results suggest that verbal memory in particular may be enhanced by HRT in this age group, and everyday memory is an important construct to consider in future research.

  6. Is Hormone Replacement Therapy Safe in Women With a BRCA Mutation?: A Systematic Review of the Contemporary Literature.

    Science.gov (United States)

    Birrer, Nicole; Chinchilla, Carolina; Del Carmen, Marcela; Dizon, Don S

    2016-02-02

    Women with a BRCA1 or BRCA2 mutation are recommended to undergo prophylactic (or risk reducing) bilateral salpingo-oophorectomy (BSO) before age 40, resulting in surgical menopause. Given the concerns of estrogen deprivation on overall health, hormone therapy (HT) is often discussed, yet safety concerns persist. We performed a systematic literature review of the safety of HT in women with a BRCA mutation undergoing prophylactic BSO. Although there remains a paucity of data on this topic, as evidenced by this systematic review of the contemporary literature, these patients do benefit from treatment, especially as it relates to menopausal symptoms without an apparently increased risk of breast cancer. Decisions regarding the use of HT in women who undergo BSO after detection of a BRCA mutation must be individualized based on careful consideration of the risks and benefits. However, the risks of a subsequent cancer diagnosis appear small, particularly in regards to the benefits of treatment afforded by HT.

  7. Effect of hormone replacement therapy on the bone mass and urinary excretion of pyridinium cross-links

    Directory of Open Access Journals (Sweden)

    Dolores Perovano Pardini

    2000-01-01

    Full Text Available CONTEXT: The menopause accelerates bone loss and is associated with an increased bone turnover. Bone formation may be evaluated by several biochemical markers. However, the establishment of an accurate marker for bone resorption has been more difficult to achieve. OBJECTIVE: To study the effect of hormone replacement therapy (HRT on bone mass and on the markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline. DESIGN: Cohort correlational study. SETTING: Academic referral center. SAMPLE: 53 post-menopausal women, aged 48-58 years. MAIN MEASUREMENTS: Urinary pyr and d-pyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography and corrected for creatinine excretion measured before treatment and after 1, 2, 4 and 12 months. Bone mineral density (BMD was measured by dual energy X-ray absorptiometry (DEXA before treatment and after 12 months of HRT. RESULTS: The BMD after HRT was about 4.7% (P < 0.0004; 2% (P < 0.002; and 3% (P < 0.01 higher than the basal values in lumbar spine, neck and trochanter respectively. There were no significant correlations between pyridinium cross-links and age, weight, menopause duration and BMD. The decrease in pyr and d-pyr was progressive after HRT, reaching 28.9% (P < 0.0002, and 42% (P < 0.0002 respectively after 1 year. CONCLUSIONS: Urinary pyridinoline and deoxypyridinoline excretion decreases early in hormone replacement therapy, reflecting a decrease in the bone resorption rate, and no correlation was observed with the bone mass evaluated by densitometry.

  8. Clinical Characteristics and Outcome of Gleason Score 10 Prostate Cancer on Core Biopsy Treated by External Radiotherapy and Hormone Therapy

    Institute of Scientific and Technical Information of China (English)

    Zhi-peng Mai; Wei-gang Yan; Han-zhong Li; Zhi-gang Ji; Fu-quan Zhang; Ke Hu; Yu Xiao

    2015-01-01

    Objective To evaluate the clinical characteristics and outcomes of patients with Gleason score 10 prostate cancer treated by external radiotherapy and hormone therapy. Methods From January 2003 to March 2014, 1832 patients with prostate cancer were treated, among which 9 patients (represented 0.49%) were identified as Gleason score 10 disease on prostate core biopsy without distant metastases when first diagnosed. All 9 patients were treated by whole pelvic external radiotherapy (The whole pelvic dose was 50.0 Gy and the boost dose ranged from 76.2 to 78.0 Gy) and long-term hormone therapy. We assessed the clinical characteristics, treatment outcomes and treatment toxicities. Survival curves were calculated using the Kaplan-Meier method. Results The median follow-up was 4.8 years. Six patients’ pre-treatment prostate-specific antigen (PSA) levels were lower than 20.0μg/L and three patients’ pre-treatment PSA levels were higher than 70.0μg/L. The median percentage of positive biopsy cores was 91%. Three, four and two cases were classified as T2c, T3a and T3b stage, respectively. Three cases were assessed as N1 stage. The 5-year biochemical failure-free survival, distant metastasis-free survival, cancer specific survival and overall survival rates were 28.6%, 57.1%, 66.7%and 57.1%, respectively. Five patients experienced grade 1-2 acute gastrointestinal toxicities and six patients complained of grade 1-2 acute genitourinary toxicities. No bone fracture or cardiovascular disease was detected. Conclusions Gleason score 10 prostate cancer on core biopsy is usually combined with other high risk factors. The pre-treatment PSA levels lie in two extremes. Timely and active treatments are urgent needed because unfavourable oncological outcomes are often presented.

  9. Safety of hormonal replacement therapy and oral contraceptives in systemic lupus erythematosus: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Adriana Rojas-Villarraga

    Full Text Available There is conflicting data regarding exogenous sex hormones [oral contraceptives (OC and hormonal replacement therapy (HRT] exposure and different outcomes on Systemic Lupus Erythematosus (SLE. The aim of this work is to determine, through a systematic review and meta-analysis the risks associated with estrogen use for women with SLE as well as the association of estrogen with developing SLE.MEDLINE, EMBASE, SciElo, BIREME and the Cochrane library (1982 to July 2012, were databases from which were selected and reviewed (PRISMA guidelines randomized controlled trials, cross-sectional, case-control and prospective or retrospective nonrandomized, comparative studies without language restrictions. Those were evaluated by two investigators who extracted information on study characteristics, outcomes of interest, risk of bias and summarized strength of evidence. A total of 6,879 articles were identified; 20 full-text articles were included. Thirty-two meta-analyses were developed. A significant association between HRT exposure (Random model and an increased risk of developing SLE was found (Rate Ratio: 1.96; 95%-CI: 1.51-2.56; P-value<0.001. One of eleven meta-analyses evaluating the risk for SLE associated with OC exposure had a marginally significant result. There were no associations between HRT or OC exposure and specific outcomes of SLE. It was not always possible to Meta-analyze all the available data. There was a wide heterogeneity of SLE outcome measurements and estrogen therapy administration.An association between HRT exposure and SLE causality was observed. No association was found when analyzing the risk for SLE among OC users, however since women with high disease activity/Thromboses or antiphospholipid-antibodies were excluded from most of the studies, caution should be exercised in interpreting the present results. To identify risk factors that predispose healthy individuals to the development of SLE who are planning to start HRT or OC

  10. Definitive conformation radiotherapy combined with chemo-hormonal therapy in the treatment of adenocarcinoma of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Karasawa, Katsuyuki; Kodaira, Takeshi [Tokyo Metropolitan Komagome Hospital (Japan); Nakagawa, Keiichi; Onogi, Yuzo; Hara, Hiroshi; Matsumoto, Hidetsugu; Sasaki, Yasuhito

    1996-12-01

    To ascertain the clinical benefits of photon conformation radiotherapy, since 1988 we have been conducting a clinical trial of photon conformation radiotherapy for adenocarcinoma of the prostate, and we have analyzed the findings thus far. Between 1988 and 1993, 33 evaluable patients with prostate cancer were treated with definitive radiotherapy at the Dept. of Radiology, Social Health Insurance Medical Center. Their ages ranged from 54 to 86, and averaged 69.3 y.o. (median 67). Their stages were as follows: 3 stage-B, 25 stage-C, and 5 stage-D cases. The minimum follow-up period was 1 year. Patients received 40 to 50 Gy (fraction dose ranged from 1.8 Gy to 2 Gy) to the pelvis using the AP-PA technique followed by a 20 to 30 Gy conformal boost (fraction dose 2 Gy) to the prostate gland. Total dose ranged from 68 Gy to 70.4 Gy, with an average of 70 Gy. Systemic multiagent chemotherapy with CDDP, ADR, MTX, 5FU, and CPM was administered concurrently and adjuvantly. Hormonal therapy was also adjuvantly administered. Overall survival rates at 3 years for stage B, C, and D were 100%, 100%, and 60%, respectively. and was 85% at 5 years for stage C. Relapse-free survival rates at 3 years for stage B and C were 100% and 96%, respectively, and was 61% at 5 years for stage C. Regarding stage C cases, the initial site of recurrence was bone in 5 cases. As for complications, there were 5 (15%) grade 1, 4 (12%) grade 2, and 1 (3%) grade 3 rectal complications. Although the number of cases is rather small and the follow-up period is rather short, definitive conformal radiotherapy with adjuvant chemo-hormonal therapy appears promising in the treatment of prostate cancer by improving survival rates with acceptable normal tissue toxicity. (author)

  11. Prevalence of right atrial non-pulmonary vein triggers in atrial fibrillation patients treated with thyroid hormone replacement therapy.

    Science.gov (United States)

    Kim, Ki-Hun; Mohanty, Sanghamitra; Mohanty, Prasant; Trivedi, Chintan; Morris, Eli Hamilton; Santangeli, Pasquale; Bai, Rong; Al-Ahmad, Amin; Burkhardt, John David; Gallinghouse, Joseph G; Horton, Rodney; Sanchez, Javier E; Bailey, Shane; Hranitzky, Patrick M; Zagrodzky, Jason; Kim, Soo G; Di Biase, Luigi; Natale, Andrea

    2017-08-01

    Thyroid hormone (TH) is known to enhance arrhythmogenicity, and high-normal thyroid function is related with an increased recurrence of atrial fibrillation (AF) after catheter ablation. However, the impact of thyroid hormone replacement (THR) on AF ablation is not well known. This study evaluated 1163 consecutive paroxysmal AF patients [160 (14%) on THR and 1003 (86%) without THR] undergoing their first catheter ablation. A total of 146 patients on THR and 146 controls were generated by propensity matching, based on calculated risk factor scores, using a logistic model (age, sex, body mass index, and left atrium size). The presence of non-pulmonary vein (PV) triggers was disclosed by a high-dose isoproterenol challenge (up to 30 μg/min) after PV isolation. Clinical characteristics were not different between the groups. When compared to the control, non-PV triggers were significantly greater in the THR patients [112 (77%) vs. 47 (32%), P right atrium (95 vs. 56%, P sources of non-PV triggers were the interatrial septum (25 vs. 11%, P = 0.002), coronary sinus (70 vs. 52%, P = 0.01), left atrial appendage (47 vs. 34%, P = 0.03), crista terminalis/superior vena cava (11 vs. 8%, P = 0.43), and mitral valve annulus (7 vs. 5%, P = 0.45) (THR vs. control), respectively. After mean follow-up of 14.7 ± 5.2 months, success rate was lower in patients on THR therapy [94 (64.4%)] compared to patients not receiving THR therapy [110 (75.3%), log-rank test value = 0.04]. Right atrial non-PV triggers were more prevalent in AF patients treated with THR. Elimination of non-PV triggers provided better arrhythmia-free survival in the non-THR group.

  12. The effects of GH and hormone replacement therapy on serum concentrations of mannan-binding lectin, surfactant protein D and vitamin D binding protein in Turner syndrome

    DEFF Research Database (Denmark)

    Gravholt, Claus Højbjerg; Leth-Larsen, Rikke; Lauridsen, Anna Lis

    2004-01-01

    function. In the present study we examined whether GH or hormone replacement therapy (HRT) in Turner syndrome (TS) influence the serum concentrations of MBL and two other proteins partaking in the innate immune defence, surfactant protein D (SP-D) and vitamin D binding protein (DBP). DESIGN: Study 1...

  13. The influence of hormone replacement therapy on the aging-related change in cognitive performance. Analysis based on a Danish cohort study

    DEFF Research Database (Denmark)

    Løkkegaard, E; Pedersen, A T; Laursen, P;

    2002-01-01

    A maintenance and/or improvement of cognitive performance with postmenopausal hormone replacement therapy (HRT) is biological plausible. The objectives of this study were to analyze the impact of HRT on aging-related changes in cognitive performances, and to assess whether women who choose HRT have...... better cognitive performance prior to HRT....

  14. Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [{sup 177}Lu-DOTA{sup 0},Tyr{sup 3}]octreotate

    Energy Technology Data Exchange (ETDEWEB)

    Keizer, Bart de; Kam, Boen L.R.; Essen, Martijn van; Krenning, Eric P.; Kwekkeboom, Dik J. [Erasmus Medical Center, Department of Nuclear Medicine, Rotterdam, P.O. Box 2040 (Netherlands); Aken, Maarten O. van; Feelders, Richard A.; Herder, Wouter W. de [Erasmus Medical Center, Section of Endocrinology, Department of Internal Medicine, Rotterdam (Netherlands)

    2008-04-15

    Receptor radionuclide therapy is a promising treatment modality for patients with neuroendocrine tumors for whom alternative treatments are limited. The aim of this study was to investigate the incidence of hormonal crises after therapy with the radiolabeled somatostatin analogue [{sup 177}Lu-DOTA{sup 0},Tyr{sup 3}]octreotate ({sup 177}Lu-octreotate). All {sup 177}Lu-octreotate treatments between January 2000 and January 2007 were investigated. Four hundred seventy-six patients with gastroenteropancreatic neuroendocrine tumors and three patients with metastatic pheochromocytoma were included for analysis. Four hundred seventy-nine patients received a total of 1,693 administrations of {sup 177}Lu-octreotate. Six of 479 patients (1%) developed severe symptoms because of massive release of bioactive substances after the first cycle of {sup 177}Lu-octreotate. One patient had a metastatic hormone-producing small intestinal carcinoid; two patients had metastatic, hormone-producing bronchial carcinoids; two patients had vasoactive intestinal polypeptide-producing pancreatic endocrine tumors (VIPomas); and one patient had a metastatic pheochromocytoma. With adequate treatment, all patients eventually recovered. Hormonal crises after {sup 177}Lu-octreotate therapy occur in 1% of patients. Generally, {sup 177}Lu-octreotate therapy is well tolerated. (orig.)

  15. EVALUATION OF THE EFFECTS OF HORMONAL SUBSTITUTION THERAPY UPON THE PERIODONTAL STATUS IN FEMALE PATIENTS DURING PRE- AND POST-MENOPAUSE

    Directory of Open Access Journals (Sweden)

    Irina Ursărescu

    2012-12-01

    Full Text Available Scope of the study. To evaluate the bone mass loss in women, during menopause and post-menopause (a period associated with a deficit of estrogen and the effect of the substitution hormonal therapy. Materials and method. The experimental group included 46 female subjects, evaluated in the beginning of menopause and also at post-menopause, with and without hormonal substitution therapy (in the moment of the consultation. The periodontal clinical (probing depth, CPITN, index of gingival recession, index of dental mobility, index of furcation involvement and radiological indices were evaluated, on following the evolution of the periodontal status from the first consultation in the 3 years. Results. It has been demonstrated that, in patients with periodontitis, early onset menopause and the estrogen deficit, the frequency of gingival bleeding on probing and the clinical loss of attachment were higher, comparatively with the patients having followed a hormonal substitution therapy. Discussion. Apparently, estrogen has a protecting effect upon the periodontium and also upon the severity of the periodontal disease. More than that, the alveolar bone that may be affected by osteoporosis also contributes to the benefic effects of HT, in preventing osteoporosis, the risk of suffering the negative effects of edentation in postmenopause women who receive HT being lower. Conclusions. The present study evidenced the increased incidence of both gingivitis and periodontal pathology, of the ratio of edentation in women at menopause, while the absence of the hormonal substitution therapy seems to be associated with the severity of the periodontal disease.

  16. 性激素,激素替代疗法与心血管疾病%Sexual hormones, hormonal replacement therapy and cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao-ping; Jane F.Reckelhoff; 曲浥晨

    2012-01-01

    Premenopausal women have a lower risk and incidence of cardiovascular disease (CVD) compared to age-matched men and this gender advantage for women gradually disappears after menopause, suggesting that sexual hormones, most likely estrogen, play a cardioprotective role in women. Observational studies have shown that postmenopausal on hormone replacement therapy (HRT) have a lower rate of CVD. However, randomized prospective primary or secondary prevention trials failed to confirm the beneficial cardiac effects of HRT. Both the Women's Health Initiative (WHI) and the Heart and Estrogen/Progestin Replacement Study (HERS Ⅰ and Ⅱ ) shown that HRT increase the risk and events of CVD in postmenopausal women. The reasons for this paradoxical characterization of HRT as both beneficial and detrimental remain unclear. This review highlights the factors that may contribute to this divergent outcome and could reveal why young or premenopausal women are protected from CVD and yet postmenopausal women do not benefit from HRT. Moreover, dosage, duration, the type of estrogen and route of administration all merit consideration when determining the outcome of HRT. In summary, the fact that young or premenopausal women are protected from cardiovascular disease and yet postmenopausal women do not benefit from HRT has made HRT one of the most controversial topics related to women's health. Future studies are necessary if we are to understand the divergent published findings regarding HRT and develop new therapeutic strategies to improve the quality of life for women.%绝经前女性的心血管疾病(CVD)风险及其发生率与同龄男性相比均较低,女性的这种性别优势却在绝经后逐渐消失,这表明,性激素,尤其是雌激素,在女性中具有心血管保护的作用.观察性研究显示女性绝经后接受激素替代疗法(HRT)可降低CVD的发病率.但是,随机前瞻性一级或二级预防试验未能证实HRT对心脏有积极影响.女性健康

  17. Terapia hormonal de reemplazo en prevención cardiovascular: ¿Dónde estamos parados? Hormone replacement therapy and cardiovascular prevention: Where are we now?

    Directory of Open Access Journals (Sweden)

    Jorge Lermna

    2008-06-01

    of physiological mechanisms suggesting that estrogens could be responsible for this cardiovascular protection, and retrospective analysis of clinical studies showed that post menopausal women who had used hormonal replacement therapy (HRT suffered less cardiovascular events. These observations stimulated the execution of several prospective, randomized clinical trials (some of them with a large number of patients and prolonged follow-up in post menopausal women, with the aim of proving the hypothesis that HRT could prevent major cardiovascular events. Such hypothesis could not be demonstrated in any of those studies because HRT was not beneficial, and in several cases it was even deleterious in some aspects. Criticism has arisen over some of the methodological aspects of those prospective trials, basically regarding the age of the included patients and the timing of the beginning of HRT. There are also biological reasons that can explain the contradiction. A new hypothesis, also based on experimental and clinical observations, suggests the possibility that beginning HRT in younger women and earlier after menopause could yield different results.

  18. Non-hormonal systemic therapy in men with hormone-refractory prostate cancer and metastases: a systematic review from the Cancer Care Ontario Program in Evidence-based Care's Genitourinary Cancer Disease Site Group

    Directory of Open Access Journals (Sweden)

    Hotte Sébastien

    2006-05-01

    Full Text Available Abstract Background Prostate cancer that has recurred after local therapy or disseminated distantly is usually treated with androgen deprivation therapy; however, most men will eventually experience disease progression within 12 to 20 months. New data emerging from randomized controlled trials (RCTs of chemotherapy provided the impetus for a systematic review addressing the following question: which non-hormonal systemic therapies are most beneficial for the treatment of men with hormone-refractory prostate cancer (HRPC and clinical evidence of metastases? Methods A systematic review was performed to identify RCTs or meta-analyses examining first-line non-hormonal systemic (cytotoxic and non-cytotoxic therapy in patients with HRPC and metastases that reported at least one of the following endpoints: overall survival, disease control, palliative response, quality of life, and toxicity. Excluded were RCTs of second-line hormonal therapies, bisphosphonates or radiopharmaceuticals, or randomized fewer than 50 patients per trial arm. MEDLINE, EMBASE, the Cochrane Library, and the conference proceedings of the American Society of Clinical Oncology were searched for relevant trials. Citations were screened for eligibility by four reviewers and discrepancies were handled by consensus. Results Of the 80 RCTs identified, 27 met the eligibility criteria. Two recent, large trials reported improved overall survival with docetaxel-based chemotherapy compared to mitoxantrone-prednisone. Improved progression-free survival and rates of palliative and objective response were also observed. Compared with mitoxantrone, docetaxel treatment was associated with more frequent mild toxicities, similar rates of serious toxicities, and better quality of life. More frequent serious toxicities were observed when docetaxel was combined with estramustine. Three trials reported improved time-to-disease progression, palliative response, and/or quality of life with mitoxatrone

  19. Iatrogenic Creutzfeldt-Jakob disease following human growth hormone therapy: case report

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    Caboclo Luís Otávio Sales Ferreira

    2002-01-01

    Full Text Available We report the case of a 41-year-old man with iatrogenic Creutzfeldt-Jakob disease (CJD acquired after the use of growth hormone (GH obtained from a number of pituitary glands sourced from autopsy material. The incubation period of the disease (from the midpoint of treatment to the onset of clinical symptoms was rather long (28 years. Besides the remarkable cerebellar and mental signs, the patient exhibited sleep disturbance (excessive somnolence from the onset of the symptoms, with striking alteration of the sleep architecture documented by polysomnography. 14-3-3 protein was detected in the CSF, and MRI revealed increased signal intensity bilaterally in the striatum, being most evident in diffusion-weighted (DW-MRI sequences. This is the second case of iatrogenic CJD associated with the use of GH reported in Brazil.

  20. Epigenetics of Estrogen Receptor Signaling: Role in Hormonal Cancer Progression and Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mann, Monica; Cortez, Valerie [Department of Cellular and Structural Biology, UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 (United States); Vadlamudi, Ratna K., E-mail: vadlamudi@uthscsa.edu [Department of Obstetrics and Gynecology, UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 (United States)

    2011-03-29

    Estrogen receptor (ERα) signaling plays a key role in hormonal cancer progression. ERα is a ligand-dependent transcription factor that modulates gene transcription via recruitment to the target gene chromatin. Emerging evidence suggests that ERα signaling has the potential to contribute to epigenetic changes. Estrogen stimulation is shown to induce several histone modifications at the ERα target gene promoters including acetylation, phosphorylation and methylation via dynamic interactions with histone modifying enzymes. Deregulation of enzymes involved in the ERα -mediated epigenetic pathway could play a vital role in ERα driven neoplastic processes. Unlike genetic alterations, epigenetic changes are reversible, and hence offer novel therapeutic opportunities to reverse ERα driven epigenetic changes. In this review, we summarize current knowledge on mechanisms by which ERα signaling potentiates epigenetic changes in cancer cells via histone modifications.

  1. Primary hypothyroidism mimicking a pituitary macroadenoma: regression after thyroid hormone replacement therapy

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Ki Seong; Kim, Jong Moon; Kim, Tae Young [Wonkwang University School of Medicine, Department of Neurosurgery, Iksan (Korea); See-Sung, Choi [Wonkwang University School of Medicine, Department of Radiology, Iksan (Korea); Kim, Jong Duck [Wonkwang University School of Medicine, Department of Pediatrics, Iksan (Korea)

    2009-02-15

    We report a 9-year-old girl with pituitary hyperplasia due to primary hypothyroidism. She presented with growth arrest, abnormal thyroid function studies, and a pituitary mass on MRI. With thyroxine therapy, the pituitary mass regressed and her symptoms resolved. Primary hypothyroidism should be considered in the differential diagnosis of solid mass lesions of the pituitary gland. (orig.)

  2. A Review of hormone-based therapies to treat adult acne vulgaris in women

    Directory of Open Access Journals (Sweden)

    M.K. Trivedi, BS, BA

    2017-03-01

    Combined oral contraceptive medications and spironolactone as adjuvant and monotherapies are safe and effective to treat women with adult acne. However, appropriate clinical examinations, screening, and individual risk assessments particularly for venous thromboembolism risk must be conducted prior to initiating therapy.

  3. Ketogenic Diet and Hormonal Therapy in Prevention of Evolution of West Syndrome to Lennox-Gastaut

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-08-01

    Full Text Available Medical records of 98 patients diagnosed with West syndrome and monitored at Sanggye Paik Hospital, Seoul, Korea, for at least 3 years were retrospectively reviewed to assess etiology, age at onset, value of various therapies, and the rate of evolution from West syndrome to Lennox-Gastaut syndrome.

  4. Compare the effects of electromagnetic therapy and exercises on estrogen hormone

    Directory of Open Access Journals (Sweden)

    Somayeh Kasharafi Fard

    2016-11-01

    Full Text Available Menopause is the passing phase from fertility to infertility for women. 40 Sprague dawley female rats in different phases of menstruation were randomly selected from Shiraz University of Medical Sciences Laboratory, they were anesthetized and their ovaries were removed. After 12 weeks of rest to reach menopause they were divided to 4 equal groups: control group (C, electromagnetic pulse therapy group (M, exercise group (E, and electromagnetic therapy – exercise group (ME, and continued their exercise program for 10 weeks. Exercise program which was executed for 3 times a week, on flatted treadmill. And subjects from group M were put inside the English made BTL magnet device model 5000, with 51 MT/10 intensity and 30 Hz frequency, 3 days in a week for 30 minutes. Also the subjects in group ME performed the programs from exercise and electromagnetic pulse group simultaneously. After 10 weeks of experimenting, all rats bleeding. The results showed that the average number of electromagnetic – exercise, electromagnetic, and exercise groups are significantly better that control group and this difference is meaningfully considered 95% approved (p<0.05. Moreover, the results show that there is a meaningful difference between electromagnetic – exercise group and exercise group (P= 0.042, SD= 0.756, M= 2.27 and these differences are 95% approved in a meaningful level (p<0.05. But other differences have no meaning. we can use electromagnetic therapy – exercise method, electromagnetic therapy method, and exercise method to increase estrogen and heal osteoporosis.

  5. Prevention and treatment of bone loss in patients with nonmetastatic breast or prostate cancer who receive hormonal ablation therapy.

    Science.gov (United States)

    Limburg, Connie; Maxwell, Cathy; Mautner, Beatrice

    2014-04-01

    Hormone ablation therapy is a mainstay in the treatment of breast and prostate cancers. However, aromatase inhibitors (AIs) used in postmenopausal women with breast cancer and androgen-deprivation therapy (ADT) used in men with prostate cancer contribute to substantial bone loss, thereby increasing the risk of osteoporotic fractures. Evidence-based guidelines, therefore, urge oncology practices to screen these patients for bone loss and, if needed, provide treatment to maintain bone health. In addition to lifestyle modification and calcium or vitamin D supplementation, bone protection strategies include treatment with bisphosphonates and denosumab, a monoclonal antibody against RANK ligand. Identification of patients at greater risk for bone loss and fracture and proper interventions can reduce fracture rates. Oncology nurses can play an important role in screening these patients. The purpose of this article is to inform oncology nurses about the effects of cancer treatment on bone health, review current prevention and treatment options for cancer treatment-induced bone loss, and discuss recommendations for identifying high-risk individuals.

  6. Effects of Growth Hormone Deficiency on Body Composition and Biomarkers of Cardiovascular Risk after Definitive Therapy for Acromegaly

    Science.gov (United States)

    Lin, E; Wexler, TL; Nachtigall, L; Tritos, N; Swearingen, B; Hemphill, L; Loeffler, J; Biller, BMK; Klibanski, A; Miller, KK

    2012-01-01

    Background Both growth hormone (GH) excess and GH deficiency are associated with body composition and biomarkers of cardiovascular risk in patients with pituitary disorders. However, the effects of developing GH deficiency after definitive treatment of acromegaly are largely unknown. Objective To determine whether development of GH deficiency after definitive therapy for acromegaly is associated with increased visceral adiposity and biomarkers of cardiovascular risk compared to GH sufficiency after definitive therapy for acromegaly. Design Cross-sectional Patients We studied three groups of subjects, all with a history of acromegaly (n=76): subjects with subsequent GH deficiency (GHD; n=31), subjects with subsequent GH sufficiency (GHS; n=25), and subjects with active acromegaly (AA; n=20). No study subjects were receiving somatostatin analogues, dopamine agonists or hGH. Measurements Body composition (by DXA), abdominal adipose tissue depots (by cross-sectional CT), total body water (by bioimpedance analysis) and carotid intima-media thickness (IMT) were measured. Fasting morning serum was collected for high-sensitivity C-reactive protein (hsCRP), lipids and lipoprotein levels. An oral glucose tolerance test was performed, and homeostasis model of assessment-insulin resistance (HOMA-IR) was calculated. Results Abdominal visceral adipose tissue, total adipose tissue, and total body fat were higher in subjects with GHD than GHS or AA (p acromegaly may adversely affect body composition and inflammatory biomarkers of cardiovascular risk but does not appear to adversely affect glucose homeostasis, lipids and lipoproteins, or other cardiovascular risk markers. PMID:22315983

  7. [The influence of balneo- and peloid therapy on the characteristics of the hormonal regulation in the women presenting with bacterial vaginosis].

    Science.gov (United States)

    Boldyreva, O A

    2015-01-01

    The objective of the present work was to study the influence of balneo- and peloid therapy on the characteristics of the hormonal regulation in the women presenting with bacterial vaginosis. The immunoenzymatic assay (ELISA) was used to study characteristics of hormonal regulation in 128 women presenting with bacterial vaginosis and normal prolactin level and 58 women with bacterial vaginosis and concomitant hyperprolactinemia. The study included the evaluation of dynamics of the clinical and laboratory parameters under the influence of peloidtherapy. The application of the sulfide-containing siltypeloids was shown to have positive clinical effect on the adrenal and ovarian function and to exert the modulating action on the levels of the pituitary and sex hormones in women with bacterial vaginosis and normal prolactin levels. In contrast, the same treatment of the women with bacterial vaginosis and hyperprolactinemia causes a further deterioration of hormonal imbalance, increases the initially elevated prolactin level, aggravates disorders in the pituitary and ovarian regulation, and decreases the effectiveness of the treatment. The results of the study suggest the necessity of the differential approach to the prescription of balneo- and peloid therapy to the patients with gynecological problems associated with hormonal disorders taking into account the level of prolactinemia.

  8. Dosage dependent hormonal counter regulation to combination therapy in patients with left ventricular dysfunction

    DEFF Research Database (Denmark)

    Galløe, A.M.; Skagen, K.; Christensen, N.J.

    2006-01-01

    The present study attempts to assess the efficacy combination therapy for heart failure. Genuine dose-response studies on combination therapy are not available and published studies involved adding one drug on top of 'usual treatment'. Sixteen different dosage combinations of trandolapril...... rate and plasma noradrenaline in a dose dependent manner. Doses of bumetanide of more than 0.5 mg, given twice daily significantly decreased the quality of life and increased diuresis. Weight loss was maximal on 0.5 mg bumetanide twice daily. Trandolapril significantly reduced systolic blood pressure...... of life and weight loss. Estimated by the reduction in systolic blood pressure the optimal dosage of Trandolapril appeared to be 0.5 mg once daily. CONCLUSIONS: It appears that patients should be given less than the usually recommended dosages. Patients may be treated with a low dose loop diuretic...

  9. Prospective randomized trial to assess effects of continuing hormone therapy on cerebral function in postmenopausal women at risk for dementia.

    Directory of Open Access Journals (Sweden)

    Natalie L Rasgon

    Full Text Available The objective of this study was to examine the effects of estrogen-based hormone therapy (HT on regional cerebral metabolism in postmenopausal women (mean age = 58, SD = 5 at risk for development of dementia. The prospective clinical trial design included pre- and post-intervention neuroimaging of women randomized to continue (HT+ or discontinue (HT- therapy following an average of 10 years of use. The primary outcome measure was change in brain metabolism during the subsequent two years, as assessed with fluorodeoxyglucose-18 positron emission tomography (FDG-PET. Longitudinal FDG-PET data were available for 45 study completers. Results showed that women randomized to continue HT experienced relative preservation of frontal and parietal cortical metabolism, compared with women randomized to discontinue HT. Women who discontinued 17-β estradiol (17βE-based HT, as well as women who continued conjugated equine estrogen (CEE-based HT, exhibited significant decline in metabolism of the precuneus/posterior cingulate cortical (PCC area. Significant decline in PCC metabolism was additionally seen in women taking concurrent progestins (with either 17βE or CEE. Together, these findings suggest that among postmenopausal subjects at risk for developing dementia, regional cerebral cortical metabolism is relatively preserved for at least two years in women randomized to continue HT, compared with women randomized to discontinue HT. In addition, continuing unopposed 17βE therapy is associated specifically with preservation of metabolism in PCC, known to undergo the most significant decline in the earliest stages of Alzheimer's disease.ClinicalTrials.gov NCT00097058.

  10. Effects of growth hormone and thyroxine replacement therapy on insulin signaling in Ames dwarf mice.

    Science.gov (United States)

    Louis, Audreen; Bartke, Andrzej; Masternak, Michal M

    2010-04-01

    Ames dwarf (Prop1(df), df/df) mice lack growth hormone (GH), prolactin, and thyrotropin and live remarkably longer than their normal siblings. Significance of reduced activity of the somatotropic and thyroid axes during development and adulthood on longevity are unknown. Because enhanced insulin sensitivity and reduced insulin levels are among likely mechanisms responsible for increased longevity in these mutants, we compared the effects of GH and thyroxine (T4) replacement on various parameters related to insulin signaling in young and old male df/df mice. The results suggest that altered plasma adiponectin and insulin-like growth factor-1 (IGF-1) and hepatic IGF-1, insulin receptor (IR), IR substrate-1, peroxisome proliferator-activated receptor (PPAR) gamma, and PPARgamma coactivator-1 alpha may contribute to increased insulin sensitivity in Ames dwarfs. The stimulatory effect of GH and T4 treatment on plasma insulin and inhibitory effect on expression of hepatic glucose transporter-2 were greater in old than in young dwarfs. These results indicate that GH and T4 treatment has differential impact on insulin signaling during development and adulthood.

  11. Growth hormone therapy, muscle thickness, and motor development in Prader-Willi syndrome: an RCT.

    Science.gov (United States)

    Reus, Linda; Pillen, Sigrid; Pelzer, Ben J; van Alfen-van der Velden, Janielle A A E M; Hokken-Koelega, Anita C S; Zwarts, Machiel; Otten, Barto J; Nijhuis-van der Sanden, Maria W G

    2014-12-01

    To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS). In a randomized controlled trial, 22 infants with PWS (12.9 ± 7.1 months) were followed over 2 years to compare a treatment group (n = 10) with a waiting-list control group (n = 12). Muscle thickness of 4 muscle groups was measured by using ultrasound. Muscle strength was evaluated by using the Infant Muscle Strength meter. Motor performance was measured with the Gross Motor Function Measurement. Analyses of variance were used to evaluate between-group effects of GH on muscle thickness at 6 months and to compare pre- and posttreatment (after 12 months of GH) values. Multilevel analyses were used to evaluate effects of GH on muscle thickness over time, and multilevel bivariate analyses were used to test relationships between muscle thickness, muscle strength, and motor performance. A significant positive effect of GH on muscle thickness (P muscle thickness and muscle strength (r = 0.61, P muscle thickness and motor performance (r = 0.81, P muscle strength and motor performance (r = 0.76, P muscle thickness, which was related to muscle strength and motor development in infants with PWS. Catch-up growth was faster in muscles that are most frequently used in early development. Because this effect was independent of GH, it suggests a training effect. Copyright © 2014 by the American Academy of Pediatrics.

  12. Pharmacokinetics of the first combination 17β-estradiol/progesterone capsule in clinical development for menopausal hormone therapy.

    Science.gov (United States)

    Pickar, James H; Bon, Charles; Amadio, Julia M; Mirkin, Sebastian; Bernick, Brian

    2015-12-01

    This study aims to compare the pharmacokinetics and oral bioavailability of a capsule combining 17β-estradiol and progesterone in a non-peanut oil-containing formulation with those of widely used and approved separate formulations of estradiol and progesterone coadministered to healthy postmenopausal women. This was an open-label, balanced, randomized, single-dose, two-treatment, three-period, three-sequence, cross-over, partial-replicate, reference-scaled study. Postmenopausal women (aged 40-65 y) were randomly assigned to one of three dosing sequences of test and reference products (TRR, RTR, or RRT, where T is the test drug and R is the coadministered reference product), with each of the three periods separated by a 14-day washout. The primary pharmacokinetic endpoints were Cmax, AUC(0-t), and AUC(0-inf) for the test and reference products, assessed for bioequivalence using the scaled average bioequivalence or unscaled average bioequivalence method. Safety was assessed by clinical observation, participant-reported adverse events, and laboratory data, including blood levels of hormones. Sixty-six women were randomly assigned, and 62 women (94.0%) completed all three study periods. All AUC and Cmax parameters met bioequivalence criteria for all analytes (estradiol, progesterone, and estrone), except Cmax for total estrone. The extent of estradiol and progesterone absorption was similar between the test product and the reference products. Four adverse events--all considered mild and unrelated to the study drugs--were reported. The combination 17β-estradiol/progesterone product demonstrates bioavailability similar to those of the respective reference products of estradiol and progesterone. If regulatory approval is obtained, this new hormone therapy would be the first treatment of menopause symptoms to combine progesterone with 17β-estradiol in an oral formulation.

  13. Examining the relationship between hormone therapy and dry-eye syndrome in postmenopausal women: a cross-sectional comparison study.

    Science.gov (United States)

    AlAwlaqi, Ahmed; Hammadeh, Mohamed

    2016-05-01

    To examine the relationship between hormone therapy (HT) and dry-eye syndrome (DES) in postmenopausal women. A cross-sectional study was performed on 360 postmenopausal women. They were grouped into two groups. Group 1 was the control group (n = 189) without DES symptoms and which did not receive HT. Group 2 (n = 177) consisted of women with DES symptoms. Group 2 was randomly grouped into two further categories-group 2A (n = 90) that received estrogen-only HT, and group 2B (n = 87) in which participants were treated with a combination of estrogen and progesterone HT. The severity of symptom levels was determined using the Ocular Surface Disease Index levels that identify the extent of the relationship between the sex hormones and DES. A further comparison of the severity of symptoms among women using HT and those not using HT was used to establish the relationship between HT and DES in postmenopausal women. There was a significant variation in the severity levels of DES across women not using HT and those who were using HT (group 2A and 2B) (F[2, 357] = 974.186, P 1 mg/d) across women using HT (group 2A and 2B) (F[2, 357] = 302.513, P women using HT (group 2A and 2B) (F[3, 356] = 218.266, P women. Instead, prolonged HT use seems to increase the risk of DES.

  14. Impact of hormonal therapy on the detection of promoter hypermethylation of the detoxifying glutathione-S-transferase P1 gene (GSTP1 in prostate cancer

    Directory of Open Access Journals (Sweden)

    Krause Hans

    2006-06-01

    Full Text Available Abstract Background In spite of excellent cure rates for prostate cancer patients with favorable tumor characteristics, patients with unfavorable characteristics after radical prostatectomy are still at a significantly increased risk of tumor progression. Early adjuvant hormonal therapy (AHT has been shown to be of prognostic benefit in these patients. Unfortunately initiation and duration of early AHT in the individual patient is based on statistic data. PSA, as the standard prostate marker is neither able to reliably indicate minimal residual tumor disease in the early postoperative phase, nor can it be used for therapy monitoring due to the suppressive effect of hormonal therapy on PSA production. Promoter hypermethylation of the detoxifying glutathione-S-transferase P1 gene (GSTP1-HM has been shown to be the most common DNA alteration of primary prostatic carcinoma which, when used as a marker, is supposed to be able to overcome some of the disadvantages of PSA. However until now information on the impact of hormonal therapy on the detection of GSTP1-HM is lacking. The purpose of our study was to assess the impact of endocrine therapy on the detection of GSTP1-HM by methylation-specific PCR (MSP in prostate cancer. Methods Paraffin embedded tumor samples from the radical prostatectomy (RP specimens from 15 patients after hormonal therapy (HT (mean 8 months were assessed by MSP. In 8 of the patients the GSTP-1 status of the tumors before HT was assessed on the corresponding initial diagnostic biopsies. Results Following HT MSP showed GSTP1-HM in 13/15 of the RP specimens. In two patients analysis of the RP specimens failed to show GSTP1-HM. All initial tumor samples (8/8 biopsy specimens showed GSTP1-HM, including both patients negative for GSTP1 HM in the corresponding RP specimen. Conclusion In most cases hormonal therapy appears to not alter GSTP1 HM detection. However the change from a positive to a negative GSTP1 HM status in a subset of

  15. Effects of recombinant human growth hormone therapy on carbohydrate, lipid and protein metabolisms of children with Turner syndrome

    Science.gov (United States)

    Qi, Weibin; Li, Shuxian; Shen, Qiong; Guo, Xiuxia; Rong, Huijuan

    2014-01-01

    Objective: To study the effect of recombinant human growth hormone (rhGH) therapy on carbohydrate, lipid and protein metabolisms of Turner syndrome (TS). Metho d s: Total 45 patients with TS admitted between Jul. 2008 and Jun. 2011 were involved in this study. All patients received the clinical evaluation of body fat, plasma lipids, proteins and oral glucose tolerance test (OGTT) before and after rhGH therapy. Results : Our results indicated a significant decrease of body fat (FAT%) from 23.56±4.21 to 18.71±2.23 but no obvious change on the level of fat mass (FM) (p>0.05) was observed after rhGH therapy. We also detected significant changes on plasma high-density lipoprotein cholesterol (HDL-C) from (1.65±0.58 mmol/L) to (2.20±0.65 mmol/L) and low-density lipoprotein cholesterol (LDH-C) from (2.55±0.55 mmol/L) to (2.10±0.54 mmol/L) after rhGH exposure. However, no statistical significance was detected on the level of plasma triglyceride (TG), cholesterol (CHO). Interestingly, the levels of plasma retinol binding protein (RbP) (32.55±4.28mg/L), transferrin (TRF) (2.95±0.40 mg/L), serum albumin (PRE) (250.00±45.50 mg/L) and albumin (propagated) (33.58±4.25 mg/L) were significantly increased. When it goes to the oral glucose tolerance test (OGTT) test, there were 10 impaired glucose tolerance (IGT) cases among all patients before and after rhGH therapy. No significant change was observed on homeostasis model assessment- insulin resistance (HOMA-IR) level during rhGH intervention. Conclusion : Abnormal lipid and protein metabolisms of the children with TS can be improved with rhGH therapy for 6 months. PMID:25097506

  16. Genetic polymorphisms of MC2R gene associated with responsiveness to adrenocorticotropic hormone therapy in infantile spasms

    Institute of Scientific and Technical Information of China (English)

    LIU Zhan-li; HE Bing; FANG Fang; TANG Cai-yun; ZOU Li-ping

    2008-01-01

    Background Infantile spasms is a severe epileptic encephalopathy,which is refractory to conventional antiepileptic drugs.Adrenocorticotropic hormone (ACTH) has been the major therapy for infantile spasms;however,ACTH therapy is ineffective for some patients.The variations in the receptor genes can contribute to antiepileptic drug resistance.This study was to elucidate the possible associations between the variations of the MC2R gene and ACTH responsiveness in patients with infantile spasms.Methods We screened for variations in the promoter and coding region of the MC2R gene in 91 Chinese patients with infantile spasms and 94 controls,using PCR and a direct sequencing method.The frequencies of the genotypes,alleles and reconstructed haplotypes were analyzed in the cases and controls.The association between ACTH responsiveness and genetic variations of the MC2R gene was also assessed.Results Four single nucleotide polymorphisms (SNPs) were identified in the MC2R promoter,one of which was a novel specimen at position-2 from the transcription start site ATT,-2T>C.Three SNPs (rs1893220,rs2186944 and -2T>C)showed a significant difference between the cases and controls (P<0.05 for all).The frequency of the common TCCT haplotype carrying four-SNP major alleles was significantly lower in the cases (39%) than in the controls (60%)(P=0.00003).The homozygous carriers of the TCCT haplotype had a much lower relative risk than the non-carriers (RR=0.42,95%CI 0.26-0.70,P=0.0001).ACTH responsiveness was strongly associated with the TCCT haplotype (P=0.000082).Compared with non-carriers of the TCCT haplotype,the homozygous and heterozygous carders were more responsive to ACTH therapy (P=0.0002;P=0.0003,respectively).Conclusions Our results indicated that the TCCT haplotype in the MC2R promoter is strongly associated with the responsiveness of the ACTH therapy performed on patients with infantile spasms.The polymorphisms of the MC2R promoter might be one important factor that

  17. Risk of hormone escape in a human prostate cancer model depends on therapy modalities and can be reduced by tyrosine kinase inhibitors.

    Directory of Open Access Journals (Sweden)

    Charlotte Guyader

    Full Text Available Almost all prostate cancers respond to androgen deprivation treatment but many recur. We postulated that risk of hormone escape--frequency and delay--are influenced by hormone therapy modalities. More, hormone therapies induce crucial biological changes involving androgen receptors; some might be targets for escape prevention. We investigated the relationship between the androgen deprivation treatment and the risk of recurrence using nude mice bearing the high grade, hormone-dependent human prostate cancer xenograft PAC120. Tumor-bearing mice were treated by Luteinizing-Hormone Releasing Hormone (LHRH antagonist alone, continuous or intermittent regimen, or combined with androgen receptor (AR antagonists (bicalutamide or flutamide. Tumor growth was monitored. Biological changes were studied as for genomic alterations, AR mutations and protein expression in a large series of recurrent tumors according to hormone therapy modalities. Therapies targeting Her-2 or AKT were tested in combination with castration. All statistical tests were two-sided. Tumor growth was inhibited by continuous administration of the LH-RH antagonist degarelix (castration, but 40% of tumors recurred. Intermittent castration or complete blockade induced by degarelix and antiandrogens combination, inhibited tumor growth but increased the risk of recurrence (RR as compared to continuous castration (RR(intermittent: 14.5, RR(complete blockade: 6.5 and 1.35. All recurrent tumors displayed new quantitative genetic alterations and AR mutations, whatever the treatment modalities. AR amplification was found after complete blockade. Increased expression of Her-2/neu with frequent ERK/AKT activation was detected in all variants. Combination of castration with a Her-2/neu inhibitor decreased recurrence risk (0.17 and combination with an mTOR inhibitor prevented it. Anti-hormone treatments influence risk of recurrence although tumor growth inhibition was initially similar. Recurrent

  18. Synthesis, characterization, and cytocompatibility of potential cockle shell aragonite nanocrystals for osteoporosis therapy and hormonal delivery

    Directory of Open Access Journals (Sweden)

    Jaji AZ

    2017-01-01

    Full Text Available Alhaji Zubair Jaji,1,2 Md Zuki Bin Abu Bakar,1,3 Rozi Mahmud,4 Mohamad Yusof Loqman,5 Mohamad Noor Mohamad Hezmee,1 Tijani Isa,3 Fu Wenliang,3 Nahidah Ibrahim Hammadi1 1Department of Veterinary Pre-Clinical Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 2Department of Veterinary Anatomy, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Kwara, Nigeria; 3Molecular Biomedicine Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 4Department of Imaging, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 5Department of Companion Animal Medicine and Surgery, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Abstract: Calcium carbonate is a porous inorganic nanomaterial with huge potential in biomedical applications and controlled drug delivery. This study aimed at evaluating the physicochemical properties and in vitro efficacy and safety of cockle shell aragonite calcium carbonate nanocrystals (ANC as a potential therapeutic and hormonal delivery vehicle for osteoporosis management. Free and human recombinant parathyroid hormone 1-34 (PTH 1-34-loaded cockle shell aragonite calcium carbonate nanocrystals (PTH-ANC were synthesized and evaluated using standard procedures. Transmission electron microscopy and field emission scanning electron microscopy results demonstrated highly homogenized spherical-shaped aragonite nanocrystals of 30±5 nm diameter. PTH-ANC had a zeta potential of −27.6 ± 8.9 mV. The encapsulation efficiency of the formulation was found to be directly proportional to the concentrations of the drug fed. The X-ray diffraction patterns revealed strong crystallizations with no positional change of peaks before and after PTH-ANC synthesis. Fourier transform infrared spectroscopy demonstrated no detectable interactions between micron-sized aragonite and surfactant at molecular level. PTH-ANC formulation was stabilized

  19. [Adult height of children with idiopathic short stature treated with growth hormone therapy].

    Science.gov (United States)

    Avilés Espinoza, Carolina; Bermúdez Melero, Carla; Martinez Aguayo, Alejandro; García Bruce, Hernán

    2016-01-01

    Idiopathic short stature (ISS) is defined as a height of < or = 2 standard deviations (SD) from the mean for age. The use of Growth Hormone (GH) in ISS is controversial, and there are not results for adult height (AH) in Chilean patients with ISS treated with GH. The objective of the study is to compare AH in patients treated with GH with the height prediction at beginning of treatment. AH was considered with bone age ≥ 17 in males and ≥15 in females. The height SD according to the NCHS curves at beginning and ending of treatment were used for the comparison. Height prediction (HP) was calculated by Bayley-Pinneau method. AH was reached by 18/47 patients with ISS treated with GH. Initial height -2.1 ± 0.85 SD (133.1±6.8 cm) and HP -1.94±0.86 SD, and were treated since 11.6 ± 1.2 years old. After one year of treatment their height was -1.64 ± 0.69 SD, and AH was -1.28 +/- 0.62 SD (163.76 +/- 7.22 cm). It is suggested that treatment with GH for ISS is effective to increase AH. Although with wide individual variability, a mean increase of 0.67±0.9 SD (+2.67 cm) was obtained in the AH. This is the first report on Adult Height in Chilean patients. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Differential effects of hormone therapy on serotonin, vascular function and mood in the KEEPS.

    Science.gov (United States)

    Raz, L; Hunter, L V; Dowling, N M; Wharton, W; Gleason, C E; Jayachandran, M; Anderson, L; Asthana, S; Miller, V M

    2016-01-01

    Serotonin (5-hydroxytryptamine, 5-HT) is modulated by sex steroid hormones and affects vascular function and mood. In the Kronos Early Estrogen Prevention Cognitive and Affective Ancillary Study (KEEPS-Cog), women randomized to oral conjugated equine estrogens (oCEE) showed greater benefit on affective mood states than women randomized to transdermal 17β-estradiol (tE2) or placebo (PL). This study examined the effect of these treatments on the platelet content of 5-HT as a surrogate measure of 5-HT synthesis and uptake in the brain. The following were measured in a subset (n = 79) of women enrolled in KEEPS-Cog: 5-HT by ELISA, carotid intima-medial thickness (CIMT) by ultrasound, endothelial function by reactive hyperemic index (RHI), and self-reported symptoms of affective mood states by the Profile of Mood States (POMS) questionnaire. Mean platelet content of 5-HT increased by 107.0%, 84.5% and 39.8%, in tE2, oCEE and PL groups, respectively. Platelet 5-HT positively correlated with estrone in the oCEE group and with 17β- estradiol in the tE2 group. Platelet 5-HT showed a positive association with RHI, but not CIMT, in the PL and oCEE groups. Reduction in mood scores for depression-dejection and anger-hostility was associated with elevations in platelet 5-HT only in the oCEE group (r = -0.5, p = 0.02). Effects of oCEE compared to tE2 on RHI and mood may be related to mechanisms involving platelet, and perhaps neuronal, uptake and release of 5-HT and reflect conversion of estrone to bioavailable 17β-estradiol in platelets and the brain.

  1. Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial

    Directory of Open Access Journals (Sweden)

    Rahu Mati

    2008-08-01

    Full Text Available Abstract Background Preventive drugs require long-term trials to show their effectiveness or harms and often a lot of changes occur during post-marketing studies. The purpose of this article is to describe the research process in a long-term randomized controlled trial and discuss the impact and consequences of changes in the research environment. Methods The Estonian Postmenopausal Hormone Therapy trial (EPHT, originally planned to continue for five years, was planned in co-operation with the Women's International Study of Long-Duration Oestrogen after Menopause (WISDOM in the UK. In addition to health outcomes, EPHT was specifically designed to study the impact of postmenopausal hormone therapy (HT on health services utilization. Results After EPHT recruited in 1999–2001 the Women's Health Initiative (WHI in the USA decided to stop the estrogen-progestin trial after a mean of 5.2 years in July 2002 because of increased risk of breast cancer and later in 2004 the estrogen-only trial because HT increased the risk of stroke, decreased the risk of hip fracture, and did not affect coronary heart disease incidence. WISDOM was halted in autumn 2002. These decisions had a major influence on EPHT. Conclusion Changes in Estonian society challenged EPHT to find a balance between the needs of achieving responses to the trial aims with a limited budget and simultaneously maintaining the safety of trial participants. Flexibility was the main key for success. Rapid changes are not limited only to transiting societies but are true also in developed countries and the risk must be included in planning all long-term trials. The role of ethical and data monitoring committees in situations with emerging new data from other studies needs specification. Longer funding for preventive trials and more flexibility in budgeting are mandatory. Who should prove the effectiveness of an (old drug for a new preventive indication? In preventive drug trials companies may

  2. Neoadjuvant hormone therapy following treatment with robotic-assisted radical prostatectomy achieved favorable in high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Hou CP

    2014-12-01

    Full Text Available Cheng-Pang Hou,1,2,* Wei-Chang Lee,1,2,* Yu-Hsiang Lin,1,2 Shao-Ming Chen,3 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2,4 Horng-Heng Juang,4,5 Ke-Hung Tsui1,2,4 1Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China; 2School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China; 3Hou-Pin Taipei Hospital, 4Bioinformation Center, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China; 5Department of Anatomy, School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China *These authors contributed equally to this work Purpose: Patients with a high risk of prostate carcinoma typically have higher rates of positive surgical margins and biochemical failure following radical prostatectomy and adjuvant hormone therapy. In this study, we assessed the effects of neoadjuvant hormone therapy (NHT on prostate carcinoma in high-risk patients following robotic-assisted radical prostatectomy (RARP. Methods: This retrospective study investigated the medical records of 28 patients who underwent RARP between January 2009 and October 2013. Twenty-two patients underwent NHT prior to RARP. Furthermore, six patients did not undergo NHT prior to RARP. Parameters including age, operating time, blood loss, blood transfusion status, and cancer stage were checked against anatomical correlations. Potential predictors of prolonged operating time and prolonged surgical procedures were assessed using multiple logistic regressions. Results: NHT was shown to be an independent predictor of prolonged total operating time. Tumor stage alterations did not appear to be associated with NHT followed by RARP. The patients who underwent NHT were not more likely to have positive surgical margins, and an increase in patients requiring blood transfusion was not seen. Conclusion: NHT appears to increase

  3. Papel de la terapia hormonal sustitutiva, en la prevención y tratamiento de la osteoporosis menopáusica Role of hormone replacement therapy in the prevention and treatment of menopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    M. C. Landa

    2003-01-01

    Full Text Available La terapia hormonal sustitutiva se ha venido utilizando como prevención y tratamiento de la osteoporosis postmenopáusica. En este trabajo se revisan los ensayos publicados recientemente, especialmente los estudios Heart and estrogen/progestin replacement study (HERS y Women´s Health Initiative (WHI, ensayos aleatorizados controlados de gran extensión. Se concluye que la terapia hormonal sustitutiva tiene un efecto de mejora de los síntomas vasomotores de la menopausia. Tiene un efecto positivo sobre la masa ósea con más intensidad sobre el hueso trabecular, pero este efecto sólo persiste durante el tratamiento hormonal y se recupera el balance negativo del recambio óseo al acabar el tratamiento. Se comprueba un efecto protector sobre las fracturas osteoporóticas (vértebra, fémur durante el tratamiento en mujeres mayores (60 años, pero no se comprueba esta acción a largo plazo por lo que su valor como terapia preventiva de la osteoporosis no es apoyada. Al finalizar se dan unas orientaciones que permitan ayudar en la práctica clínica.Hormone replacement therapy has been employed for the prevention and treatment of postmenopausal osteoporosis. This paper reviews recently published trials, especially the studies Heart and estrogen/progestin replacement study (HERS and Women´s Health Initiative (WHI, randomized controlled trials of wide scope. The conclusion reached is that hormone replacement therapy has the effect of improving the vasomotor symptoms of menopause. It has a positive effect on the bone mass with more intensity on the trabecular bone, but this effect only persists during the hormonal treatment and the negative balance of bone exchange is recovered when treatment stops. A protective effect is found on osteoporotic fractures (vertebra, femur during the treatment of older women (above 60 years, but this action is not found in the long term, which is why its value as a preventive therapy for osteoporosis is not supported

  4. Effectiveness and safety of growth hormone replacement therapy in adults with growth hormone deficiency%生长激素替代治疗成人生长激素缺乏症的有效性与安全性

    Institute of Scientific and Technical Information of China (English)

    林晨红; 宋筱筱; 徐小红

    2015-01-01

    成人生长激素缺乏症可致机体组分改变、糖、脂代谢紊乱、骨代谢异常、心血管疾病风险增加及生活质量下降等,生长激素替代治疗可有效改善以上情况.但生长激素广泛的生理作用使其安全性备受争议,近几年大部分文献提示生长激素替代治疗不增加糖尿病的发生、肿瘤复发、新发恶性肿瘤及心血管事件等,但仍缺乏大量随机、对照研究,故在生长激素治疗时应严密监测血清胰岛素样生长因子-1水平、血脂、血压、血糖、骨密度、肿瘤标志物及生活质量等指标.%Adult growth hormone deficiency causes a series of abnormities including abnormal body composition,impaired glucose and lipid metabolism,abnormal bone metabolism,as well as increased cardiovascular risk and decreased living quality.Growth hormone replacement therapy can effectively improve those abnormalities.However,the safety of growth hormone is controversial since growth hormone has extensively physiological functions.In recent years,most of the studies revealed that the incidence of diabetes mellitus,tumor recurrence,second neoplasms and cardiovascular events in growth hormone replacement therapy did not increase,although large randomized controlled studies are needed to reach the conclusion.Serum insulin-like growth factor-1 level,serum lipids,blood pressure,plasma glucose,bone mineral density,cancer biomarkers and living quality should be closely monitored during the period of growth hormone replacement therapy.

  5. Growth hormone therapy in a girl with Turner syndrome and diabetes type 1 - case report.

    Science.gov (United States)

    Obara-Moszynska, Monika; Banaszak, Magdalena; Niedziela, Marek

    2015-01-01

    Wstęp. Badania wskazują na złożoną etiologię nieprawidłowego metabolizmu węglowodanów w zespole Turnera (ZT). W związku z tymi zaburzeniami leczenie rekombinowanym hormonem wzrostu (rGH ) w ZT może być związane z powikłaniami, szczególnie że hormon wzrostu ma działanie diabetogenne. Opis przypadku. Wywiad okołoporodowy jest nieznany (pacjent adoptowany w wieku 4 lat). W wieku 11 lat ze względu na typowy fenotyp rozpoznano ZT. Kariotyp: 45,X[43]/46,X,i(X)(q10)[7]. W tym samym wieku rozpoznano cukrzycę insulinozależną na podstawie wyników laboratoryjnych. Rozpoczęto konwencjonalną insulinoterapię. W trakcie hospitalizacji, w wieku 12 lat, wzrost wynosił 123,5 cm (- 4,4 SD), W tym samym wieku rozpoczęto leczenie rGH w dawce 0,045 mg/kg mc/dobę. Po 3 miesiącach tempo wzrastania zwiększyło się do 8,2 cm/rok. W wieku 13 lat zainicjowano terapię preparatem 17β-estradiolu. Po upływie 3 lat i 4 miesięcy leczenie rGH przerwano z powodu niskiego tempa wzrastania. Wzrost dziewczynki wynosił 140 cm (-4SD). Dwa lata po zakończeniu leczenia rGH wzrost wynosił 141,2 cm. Po zakończeniu leczenia rGH zapotrzebowanie dzienne na insulinę zmniejszyło się z 50–60 jm./dobę do 38–44 jm./dobę. Wnioski. Decyzja włączenia terapii rGH w ZTz cukrzycą jest z pewnością trudna. W momencie rozpoczęcia lecze­nia rGH klinicysta musi mieć na uwadze ryzyko powikłań metabolicznych, ale także świadomość, że daje pacjen­towi szansę na poprawę wzrostu końcowego. Z punktu widzenia prawidłowego rozwoju psychoemocjonalnego zmniejszenie deficytu wzrostu jest bardzo ważne.

  6. Testicular radiation dose after multimodal curative therapy for locally advanced rectal cancer. Influence on hormone levels, quality of life, and sexual functioning

    Energy Technology Data Exchange (ETDEWEB)

    Hennies, S.; Wolff, H.A.; Rave-Fraenk, M.; Hess, C.F. [University Medicine Goettingen (Germany). Dept. of Radiotherapy; Jung, K. [University Medicine Goettingen (Germany). Dept. of Medical Statistics; Gaedcke, J.; Ghadimi, M.; Becker, H. [University Medicine Goettingen (Germany). Dept. of General Surgery; Hermann, R.M. [University Medicine Goettingen (Germany). Dept. of Radiotherapy; Aerztehaus an der Ammerlandklinik, Westerstede (Germany). Radiotherapy; Christiansen, H. [University Medicine Goettingen (Germany). Dept. of Radiotherapy; Hannover Medical School (Germany). Dept. of Radiotherapy

    2012-10-15

    Purpose: The purpose of the current work was to prospectively measure the influence of testicular radiation dose on hormone levels, quality of life (QoL), and sexual functioning following multimodal therapy (neoadjuvant radiochemotherapy, surgery, and adjuvant chemotherapy) for rectal cancer. Patients and methods: From November 2007 to November 2009, 83 male patients were treated at the University of Goettingen with radiochemotherapy (RCT) for locally advanced rectal cancer [total dose 50.4 Gy, concomitant chemotherapy with two cycles of 5-fluorouracil (FU) or 5-FU and oxaliplatin]. Testicular radiation doses were analyzed and correlated with hormone levels [luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone and free androgen index (FAI) serum levels], QoL, and sexual functioning, which were determined before and up to 1 year after RCT. Results: Mean dose at the testes was 3.9 Gy (range 0.28-11.98 Gy). It was higher for tumors located < 6 cm from the anocutaneous line (p < 0.05). One year after therapy, testosterone, the testosterone/LH ratio, and the FAI/LH ratio were significantly decreased (3.5-3.0 {mu}g/l, 0.9-0.4, 7.9-4.5, respectively) while LH and FSH (4.2-8.5 IU/l, 6.0-21.9 IU/l) were increased. QoL and sexual functioning were significantly impaired. However, there was no statistical correlation between testicular radiation dose and changes in hormone levels, QoL, or sexual functioning. Conclusion: Multimodal treatment for rectal cancer including RCT leads to hormone level changes and to impaired QoL and sexual functioning. However, because there was no apparent correlation between the analyzed parameters, QoL is probably also influenced by other factors, e.g., psychosocial aspects. (orig.)

  7. Hormonal therapy with estradiol and drospirenone improves endothelium-dependent vasodilation in the coronary bed of ovariectomized spontaneously hypertensive rats.

    Science.gov (United States)

    Borgo, M V; Claudio, E R G; Silva, F B; Romero, W G; Gouvea, S A; Moysés, M R; Santos, R L; Almeida, S A; Podratz, P L; Graceli, J B; Abreu, G R

    2016-01-01

    Drospirenone (DRSP) is a progestin with anti-aldosterone properties and it reduces blood pressure in hypertensive women. However, the effects of DRSP on endothelium-dependent coronary vasodilation have not been evaluated. This study investigated the effects of combined therapy with estrogen (E2) and DRSP on endothelium-dependent vasodilation of the coronary bed of ovariectomized (OVX) spontaneously hypertensive rats. Female spontaneously hypertensive rats (n=87) at 12 weeks of age were randomly divided into sham operated (Sham), OVX, OVX treated with E2 (E2), and OVX treated with E2 and DRSP (E2+DRSP) groups. Hemodynamic parameters were directly evaluated by catheter insertion into the femoral artery. Endothelium-dependent vasodilation in response to bradykinin in the coronary arterial bed was assessed using isolated hearts according to a modified Langendorff method. Coronary protein expression of endothelial nitric oxide synthase and estrogen receptor alpha (ER-α) was assessed by Western blotting. Histological slices of coronary arteries were stained with hematoxylin and eosin, and morphometric parameters were analyzed. Oxidative stress was assessed in situ by dihydroethidium fluorescence. Ovariectomy increased systolic blood pressure, which was only prevented by E2+DRSP treatment. Estrogen deficiency caused endothelial dysfunction, which was prevented by both treatments. However, the vasodilator response in the E2+DRSP group was significantly higher at the three highest concentrations compared with the OVX group. Reduced ER-α expression in OVX rats was restored by both treatments. Morphometric parameters and oxidative stress were augmented by OVX and reduced by E2 and E2+DRSP treatments. Hormonal therapy with E2 and DRSP may be an important therapeutic option in the prevention of coronary heart disease in hypertensive post-menopausal women.

  8. Does hormonal therapy for fertility preservation affect the survival of young women with early-stage endometrial cancer?

    Science.gov (United States)

    Greenwald, Zoë R; Huang, Lina N; Wissing, Michel D; Franco, Eduardo L; Gotlieb, Walter H

    2017-05-01

    The incidence of endometrial cancer among young women is increasing. Some patients with low-grade endometrial cancer receive hormone therapy (HT) before surgery to preserve fertility. It is unclear whether this adversely affects survival. Patients with localized, low-grade endometrial cancer who were aged Cancer-specific and overall survival were measured using Kaplan-Meier methods. Hazard ratios and 95% confidence intervals (95% CIs) were estimated using Cox models adjusted for age, period of diagnosis, marital status, race, tumor grade, morphology, and previous radiotherapy. A total of 6339 women were included in the current study cohort, 161 of whom initially received HT and 6178 of whom received primary surgery. After 15 years of follow-up, all-cause mortality did not differ between the groups (HT group: 14.1% [95% CI, 6.7%-28.4%] and propensity score-matched primary surgery group: 9.3% [95% CI, 4.1%-20.5%]). Cancer-specific mortality appeared higher in patients treated with HT compared with those treated with primary surgery (9.2% [95% CI, 3.4%-24.0%] vs 2.1% [95% CI, 1.5%-2.8%]). However, this difference was driven by 3 late deaths in the HT group. Sensitivity analyses using a broader definition of cancer-specific mortality provided no statistical evidence of a survival difference between the treatment groups. The hazard ratio for the overall risk of death was 1.45 (95% CI, 0.44-4.74). Based on this population-based cohort, young patients with low-grade endometrial cancer appear to have excellent survival, regardless of the primary therapy chosen (HT vs primary surgery). The current selection of patients for HT to preserve fertility, which is managed carefully by experienced clinicians, does not appear to significantly worsen clinical outcomes. Cancer 2017;123:1545-1554. © 2017 American Cancer Society. © 2016 American Cancer Society.

  9. Hormonal therapy with estradiol and drospirenone improves endothelium-dependent vasodilation in the coronary bed of ovariectomized spontaneously hypertensive rats

    Energy Technology Data Exchange (ETDEWEB)

    Borgo, M.V.; Claudio, E.R.G.; Silva, F.B.; Romero, W.G.; Gouvea, S.A.; Moysés, M.R.; Santos, R.L.; Almeida, S.A. [Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES (Brazil); Podratz, P.L.; Graceli, J.B. [Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Abreu, G.R. [Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES (Brazil)

    2015-11-17

    Drospirenone (DRSP) is a progestin with anti-aldosterone properties and it reduces blood pressure in hypertensive women. However, the effects of DRSP on endothelium-dependent coronary vasodilation have not been evaluated. This study investigated the effects of combined therapy with estrogen (E2) and DRSP on endothelium-dependent vasodilation of the coronary bed of ovariectomized (OVX) spontaneously hypertensive rats. Female spontaneously hypertensive rats (n=87) at 12 weeks of age were randomly divided into sham operated (Sham), OVX, OVX treated with E2 (E2), and OVX treated with E2 and DRSP (E2+DRSP) groups. Hemodynamic parameters were directly evaluated by catheter insertion into the femoral artery. Endothelium-dependent vasodilation in response to bradykinin in the coronary arterial bed was assessed using isolated hearts according to a modified Langendorff method. Coronary protein expression of endothelial nitric oxide synthase and estrogen receptor alpha (ER-α) was assessed by Western blotting. Histological slices of coronary arteries were stained with hematoxylin and eosin, and morphometric parameters were analyzed. Oxidative stress was assessed in situ by dihydroethidium fluorescence. Ovariectomy increased systolic blood pressure, which was only prevented by E2+DRSP treatment. Estrogen deficiency caused endothelial dysfunction, which was prevented by both treatments. However, the vasodilator response in the E2+DRSP group was significantly higher at the three highest concentrations compared with the OVX group. Reduced ER-α expression in OVX rats was restored by both treatments. Morphometric parameters and oxidative stress were augmented by OVX and reduced by E2 and E2+DRSP treatments. Hormonal therapy with E2 and DRSP may be an important therapeutic option in the prevention of coronary heart disease in hypertensive post-menopausal women.

  10. Assessment of the Effects of Zoledronic Acid Therapy on Bone Metabolic Indicators in Hormone-Resistant Prostate Cancer Patients with Bone Metastatasis

    Science.gov (United States)

    Demirtas, Abdullah; Sahin, Nurettin; Caniklioglu, Mehmet; Kula, Mustafa; Ekmekcioglu, Oguz; Tatlisen, Atila

    2011-01-01

    Purpose. Assessment of effects of zoledronic acid therapy on bone metabolic indicators in hormone-resistant prostate cancer patients with bone metastasis. Material and Methods. Hormone-resistant prostate cancer patients who were identified to have metastases in their bone scintigraphy were taken to trial group. Before administration of zoledronic acid, routine tests for serum calcium, total alkalen phosphates were studied. Sample sera for bone metabolic indicators BALP, PINP, and ICTP were collected. Bone pain was assessed via visual analogue scale and performance via Karnofsky performance scale. Four mg zoledronic acid was administered intravenously once a month. Results. When serum levels of bone forming indicators PINP; BALP were compared before and after therapy, there were insignificant decreases (P = .33, P = .21, resp.). Serum levels of bone destruction indicator ICTP was compared, and there was a significant decrease after zoledronic acid therapy (P = .04). When performances of the patients were compared during therapy period, performances decreased significantly due to progress of illness (P = .01). All patients had ostalgia caused by bone metastases at various degrees. Significant decrease in pain scores was observed (P < .01). Conclusion. Zoledronic acid therapy decreased bone destruction and was effective in palliation of pain in patient with bone metastasis. Using bone metabolic indicators during followup of zoledronic acid therapy might be useful. PMID:22084798

  11. Intra-articular injection of parathyroid hormone in the temporomandibular joint as a novel therapy for mandibular asymmetry.

    Science.gov (United States)

    Wan, Qilong; Li, Zu-Bing

    2010-04-01

    Mandibular asymmetry (MA) is one of the most common craniofacial malformations. However, there is no optimal technique for this malformation nowadays. A novel technique for both children and adults with less disadvantages is a must. Parathyroid hormone (PTH) is a straight-chain polypeptide secreted by the parathyroid gland that regulates calcium metabolism. PTH has both anabolic and catabolic effects on bone formation, depending on its mode of administration. Furthermore, the mandible is characterized by the most delayed growth and the most postnatal growth of all the facial bones. The condyle, the major growth site of mandible, grows by proliferation of cartilage in the condylar head and endochondral bone formation. Condylar cartilage is present throughout postnatal life, taking part in endochondral ossification and having a special multidirectional capacity for growth potential and remodeling throughout life. Based on the double effects of PTH on bone formation and characters of mandibular development and growth, it is hypothesized that intermittent or/and continuous intra-articular injection of PTH in the temporomandibular joint be a novel therapy for mandibular asymmetry for both children and adults. It can achieve early treatment of MA to avoid many secondary deformities and keep away from many complications resulting from current techniques or systematic administration of PTH.

  12. Declining incidence of breast cancer after decreased use of hormone-replacement therapy: magnitude and time lags in different countries.

    Science.gov (United States)

    Zbuk, Kevin; Anand, Sonia S

    2012-01-01

    Throughout the latter half of the 20th century, hormone-replacement therapy (HRT) use steadily increased in the Western world. In 2002, the early termination of the Women's Health Initiative trial due to an excess of adverse events attributable to HRT, led to a precipitous decline in its use. Breast cancer incidence began to decline soon thereafter in the USA and several other countries. However, the magnitude of the decline in breast cancer incidence, and its timing with respect to HRT cessation, shows considerable variability between nations. The impact of HRT cessation appears most significant and immediate in countries with the largest absolute decline in HRT use. In countries in which peak prevalence of HRT use was high, several studies have convincingly excluded decreasing rates of mammographic screening as an explanation for the decline in breast cancer incidence. Conversely, in some countries, no decline in breast cancer incidence is apparent that can be readily attributed to declining trends in HRT use. In such cases, declines in breast cancer incidence may be related instead to saturation or decreased utilisation of mammographic screening programmes. In other cases, it is difficult to disentangle the respective influence of trends in HRT use, and the influence of changes relating to mammographic screening. However, irrespective of time lags and varying magnitudes of effect, the data convincingly support a direct association between decreasing HRT use and declining breast cancer incidence.

  13. Decline in breast cancer incidence in the Flemish region of Belgium after a decline in hormonal replacement therapy.

    Science.gov (United States)

    Renard, F; Vankrunkelsven, P; Van Eycken, L; Henau, K; Boniol, M; Autier, P

    2010-12-01

    Breast cancer incidence rate in Belgian women was as high as 152.7 for 100 000 in 2003 (adjusted on European population). We made an estimation of the contribution of hormone replacement therapy (HRT) on breast cancer incidence from 1999 to 2005 in women aged 50-69 years in Flanders. Breast cancer data were extracted from the Belgium Cancer Registry. Drug consumption was computed from drug sales data. The fraction of breast cancers attributable to HRT was calculated by year, using the relative risks of the Million Women Study in the UK. The proportion of women aged 50-69 years using HRT in Flanders increased since 1992, peaked at 20% in 2001, then decreased to 8% in 2008. The incidence of breast cancer in 100 000 women aged 50-69 years in Flanders increased from 332.8 in 1999 to 407.9 in 2003, then decreased to 366.1 in 2005; the variations were mostly noticeable for tumors <20 mm in size. The fraction of breast cancers attributed to HRT peaked at 11% in 2001 and decreased afterward. The high level of breast cancer observed in the years 2001-2003 in Flanders can be partly attributed to the use of HRT. Since participation to mammography screening of Flemish women aged 50-69 years was still on the rise in 2003 and never exceeds 62%, the decrease in breast cancer incidence was likely to be due to the decrease in HRT use and not to screening saturation.

  14. Efficacy and safety of drospirenone 2 mg/17β-estradiol 1 mg hormone therapy in Korean postmenopausal women

    Science.gov (United States)

    Park, Bo Ra; Park, Hye Na; Jung, Ji Back; Kim, Jeong Sig; Choi, Gyu Yeon; Lee, Jeong Jae; Lee, Im Soon

    2017-01-01

    This regulatory post-marketing surveillance study aimed to evaluate the therapeutic efficacy and safety of drospirenone (DRSP) 2 mg/estradiol (E2) 1 mg tablet in Korean postmenopausal women. A total of 4,149 patients were enrolled and the study was conducted at 207 clinical research centers. The patients' source data was collected between November 2006 and November 2012. More than 85% of patients experienced improvement of menopausal symptoms. The most frequently reported adverse events were vaginal bleeding and breast pain; most of the women suffering from these symptoms fully recovered. The incidence of adverse event was higher in patients of younger age (20 to 39 years), in patients with concomitant diseases, previous hormone replacement therapy in medical history, those treated with DRSP 2 mg/E2 1 mg for shorter duration (3 years or less) and in patients using concomitant medication. In conclusion, the results from this large post-marketing surveillance study confirm the efficacy and safety of DRSP 2 mg/E2 1 mg tablet in Korean postmenopausal women.

  15. [Phytoestrogens--whether can they be an alternative to hormone replacement therapy for women during menopause period?].

    Science.gov (United States)

    Dittfeld, Anna; Koszowska, Aneta; Brończyk, Anna Puzoń; Nowak, Justyna; Gwizdek, Katarzyna; Zubelewicz-Szkodzińska, Barbara

    2015-01-01

    Menopause is a turning point in a woman's life. Decreasing of secretion of estrogens can cause appearing of many health problems, which make that life is becoming harder in each partof life. Hormonal ReplacementTherapy (HRT) is using for relieving the symptoms of menopause, however, because of the possibility of adverse reactions cannot be used by all women. Alternative for HTC are phytoestrogens--compounds naturally occurring in plants, structurally similar to endogenous estrogen, so that they have an affinity for estrogen receptors, and in this way they can modulate functions of endocrine system. Phytoestrogens can play an important role in symptoms of menopause, but their positive impacts are being described for cardiovascular system, especially for lipid metabolism, bone metabolism. Moreover consumption of phytoestrogens could relieve as symptoms as: fatigue, insomnia, problems with concentrations and depression symptoms. Phytoestrogens are acting as antioxidants against free radicals, and reactive oxygen forms which are known as carcinogenic factors. Article is a review of the most important information about phitoestrogens and their influence on women organism during menopausal period.

  16. Surgery Should Complement Endocrine Therapy for Elderly Postmenopausal Women with Hormone Receptor-Positive Early-Stage Breast Cancer

    Directory of Open Access Journals (Sweden)

    Olivier Nguyen

    2012-01-01

    Full Text Available Introduction. Endocrine therapy (ET is an integral part of breast cancer (BC treatment with surgical resection remaining the cornerstone of curative treatment. The objective of this study is to compare the survival of elderly postmenopausal women with hormone receptor-positive early-stage BC treated with ET alone, without radiation or chemotherapy, versus ET plus surgery. Materials and Methods. This is a retrospective study based on a prospective database. The medical records of postmenopausal BC patients referred to the surgical oncology service of two hospitals during an 8-year period were reviewed. All patients were to receive ET for a minimum of four months before undergoing any surgery. Results. Fifty-one patients were included and divided in two groups, ET alone and ET plus surgery. At last follow-up in exclusive ET patients (n=28, 39% had stable disease or complete response, 22% had progressive disease, of which 18% died of breast cancer, and 39% died of other causes. In surgical patients (n=23, 78% were disease-free, 9% died of recurrent breast cancer, and 13% died of other causes. Conclusions. These results suggest that surgical resection is beneficial in this group and should be considered, even for patients previously deemed ineligible for surgery.

  17. Hormone-replacement therapy influences gene expression profiles and is associated with breast-cancer prognosis: a cohort study

    Directory of Open Access Journals (Sweden)

    Skoog Lambert

    2006-06-01

    Full Text Available Abstract Background Postmenopausal hormone-replacement therapy (HRT increases breast-cancer risk. The influence of HRT on the biology of the primary tumor, however, is not well understood. Methods We obtained breast-cancer gene expression profiles using Affymetrix human genome U133A arrays. We examined the relationship between HRT-regulated gene profiles, tumor characteristics, and recurrence-free survival in 72 postmenopausal women. Results HRT use in patients with estrogen receptor (ER protein positive tumors (n = 72 was associated with an altered regulation of 276 genes. Expression profiles based on these genes clustered ER-positive tumors into two molecular subclasses, one of which was associated with HRT use and had significantly better recurrence free survival despite lower ER levels. A comparison with external data suggested that gene regulation in tumors associated with HRT was negatively correlated with gene regulation induced by short-term estrogen exposure, but positively correlated with the effect of tamoxifen. Conclusion Our findings suggest that post-menopausal HRT use is associated with a distinct gene expression profile related to better recurrence-free survival and lower ER protein levels. Tentatively, HRT-associated gene expression in tumors resembles the effect of tamoxifen exposure on MCF-7 cells.

  18. Hormone replacement therapy and oral contraceptives and risk of oesophageal adenocarcinoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Lagergren, Katarina; Lagergren, Jesper; Brusselaers, Nele

    2014-11-01

    There is an unexplained strong male predominance in the aetiology of oesophageal adenocarcinoma (OAC). The hypothesis that oestrogens are protective, deserves attention. A potential protective influence of exogenous oestrogen exposure, that is, hormone replacement therapy (HRT) and oral contraceptives (OC) has been addressed only in studies of limited statistical power, and the individual studies have not provided conclusive results. We conducted a systematic literature search and meta-analysis on HRT and OC and the risk of OAC. We used the databases PubMed and the Web of Science. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the Mantel-Haenszel random-effect method. A total of five studies were included. Compared to never users, ever users of HRT had a statistically significantly decreased risk of OAC (pooled OR = 0.75; 95% CI: 0.58-0.98), and ever users of OC had a borderline significantly decreased risk of this cancer (pooled OR = 0.76; 95% CI: 0.57-1.00). In conclusion, HRT and OC use seems to be associated with a decreased risk of OAC. However, further research is warranted.

  19. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Rui-Yi Wu; Guo-Min Wang; Lei Xu; Bo-Heng Zhang; Ye-Qing Xu; Zhao-Chong Zeng; Bing Chen

    2011-01-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P=0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P=0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety.

  20. Growth Hormone Deficiency in Adults

    Science.gov (United States)

    ... mass and strength Mild bone loss Thinning skin Sleep problems Decreased exercise performance Decreased energy Decreased well-being, mild depression, or moodiness What are the benefits of growth hormone therapy? Growth hormone treatment involves injections (shots) ...

  1. Genetic variation in estrogen receptor, C-reactive protein and fibrinogen does not predict the plasma levels of inflammation markers after longterm hormone replacement therapy

    DEFF Research Database (Denmark)

    de Maat, Moniek P M; Madsen, Jonna Skov; Langdahl, Bente Lomholt;

    2007-01-01

    Markers of inflammation, such as C-reactive protein (CRP) and fibrinogen, are associated with the risk of atherothrombosis. Plasma levels of these markers of inflammation are affected by hormone replacement therapy (HRT) and modulated by smoking. We studied whether genetic variation in the estrogen...... receptor- 1 (ESR1), CRP and fibrinogen-beta genes influences the plasma levels of inflammation markers after HRT. Plasma CRP and fibrinogen were measured after five years follow-up in healthy postmenopausal women (per-protocol group) who were randomised to hormone therapy (n=187) or no treatment (n=249......). The effect of HRT, smoking and genetic variations in ESR1 (PvuII and XbaI), CRP (1444C/T) and fibrinogen-beta (FGB, -455G/A) were determined. The plasma concentration of CRP was higher in the HRT group than in the control group (2.03 mg/l and 1.41 mg/l, respectively; p

  2. Variação no Índice de Massa Corporal em Usuárias de Terapia de Reposição Hormonal Variations in the Body Mass Index in Users of Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    José Alaércio de Toledo Lima-Junior

    2000-05-01

    Full Text Available Objetivo: avaliar os efeitos da terapia de reposição hormonal sobre o índice de massa corporal de mulheres na pós-menopausa. Casuística e Métodos: foram avaliadas retrospectivamente, por um período de três anos, 166 usuárias e 136 não-usuárias de reposição hormonal, acompanhadas no Ambulatório de Menopausa do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, avaliando-se a variação desse parâmetro ao final de cada ano em relação ao inicial. A análise dos dados foi realizada usando-se o testechi², o teste t de Student e o teste de Mann-Whitney para amostras independentes. Resultados: não foram observadas variações significativas no índice de massa corporal, quando se compararam as usuárias e não-usuárias durante os três anos de observação. Conclusão: a terapia de reposição hormonal não produziu alterações no índice de massa corporal em mulheres adequadamente acompanhadas durante o seu uso.Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.

  3. Growth hormone therapy in calcium-loaded rats with renal failure.

    Science.gov (United States)

    Sanchez, Cheryl P; He, Yu-Zhu

    2004-07-01

    GH increases linear growth in children with chronic renal failure, but the response remains suboptimal in some patients. Some of the factors that may explain the poor response to GH include high doses of calcitriol and exogenous calcium loading to prevent hyperphosphatemia. High doses of exogenous calcium adversely affect chondrocyte proliferation and delay mineralization in the growth plate of rats with renal failure; bone histomorphometric changes in these animals are comparable to adynamic bone. To evaluate GH effects on adynamic bone in renal failure, 48 weanling rats underwent sham nephrectomy (Intact-Control) or 5/6 nephrectomy (Nx). Nx animals were fed a high-calcium diet (Nx-Ca(2+)) to induce adynamic bone. After 4 wk, the Nx-Ca(2+) animals were treated with GH (Nx-Ca(2+) + GH), calcitriol (Nx-Ca(2+) + D), or a combination of GH and calcitriol (Nx-Ca(2+)GH + D) for 2 wk. Serum intact PTH and IGF-I levels did not differ among all nephrectomized groups given high calcium. GH did not increase body length or tibial length at the end of study period. In the proximal tibia, the width of the growth plate and the growth plate architecture did not improve with GH. There was a decline in histone-4 expression, IGF-I protein, IGF binding protein-3, and bone morphogenetic protein-7 staining and a mild increase in IGF-I receptor, GH receptor, and gelatinase B expression in the Nx-Ca(2+) + GH group when compared with the Intact-Control group. Calcitriol blunted some of the mitogenic effects of GH in the growth plate. Thus, there was a poor response to GH therapy in calcium-loaded animals with renal failure.

  4. Effects of parathyroid hormone alone or in combination with antiresorptive therapy on bone mineral density and fracture risk--a meta-analysis

    DEFF Research Database (Denmark)

    Vestergaard, P; Jørgensen, Niklas R; Mosekilde, L

    2007-01-01

    AIM: The effects of parathyroid hormone (PTH) alone or in combination with antiresorptive therapy on changes in bone mineral density (BMD) and fracture risk were studied. MATERIALS AND METHODS: Randomised placebo controlled trials were retrieved from the PubMed, Web of Science or Embase databases....... RESULTS: PTH alone or in combination with antiresorptive drugs reduced vertebral [relative risk (RR)=0.36, 95% confidence interval (CI): 0.28-0.47, 2p

  5. Epigenetic reactivation of estrogen receptor-α (ERα by genistein enhances hormonal therapy sensitivity in ERα-negative breast cancer

    Directory of Open Access Journals (Sweden)

    Li Yuanyuan

    2013-02-01

    soybean product and anti-hormone therapy in refractory ERα-negative breast cancer which will provide more effective options in breast cancer therapy.

  6. Altered Nutrition State in the Severe Multiple Trauma Patients Undergoing Adjuvant Recombinant Human Growth Hormone Nutritional Support Therapy

    Institute of Scientific and Technical Information of China (English)

    GUO Yanqing; BAI Xiangjun; LIN Guanyu; TANG Zhaohui

    2007-01-01

    In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS>25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg·d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and compared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were - 1.28±3.19, 5.45±2.00 and -0.18±2.55, 6.11±1.60, respectively,which were significantly higher than those in the control group (-5.17±1.68 and -1.08±3.31, P<0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19±27.15, 194.44±50.82 and 194.94±29.65, 194.11±16.17, respectively, which were significantly higher than those in the control group (117.42±19.10 and 135.63±28.31, P<0.01). There was no significant difference between the rhGH 0.2 U/(kg·d) group and rhGH 0.4 U/(kg·d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg·d).

  7. Thyroid stimulating hormone suppression post-therapy in patients with Graves' disease: a systematic review of pathophysiology and clinical data.

    Science.gov (United States)

    Yu, Huan; Farahani, Pendar

    2015-04-08

    Post-treatment hypothyroidism is common in Graves' disease, and clinical guidelines recommend monitoring for it; however, thyroid stimulating hormone (TSH) can remain suppressed in these patients following treatment. The objectives of this study were to explore the proposed pathophysiology behind the phenomenon of post-therapy TSH suppression and to systematically review existing clinical data on post-therapy TSH suppression in patients with Graves' disease. A systematic literature search was performed using EMBASE and PubMed databases, with several combinations of MeSH terms. Bibliography mining was also done on relevant articles to be as inclusive as possible. A total of 18 articles described possible mechanisms for post-therapy TSH suppression. Several of the studies demonstrate evidence of thyrotroph atrophy and hypothesize that this contributes to the ongoing suppression. TSH receptors have been identified in folliculo-stellate cells of the pituitary as well as astroglial cells of the hypothalamus, mediating paracrine feedback. A few studies have demonstrated inverse correlation between autoantibody titres and TSH levels, suggestive of their role in mediating ongoing TSH suppression in patients with Graves' disease. In addition, five studies were identified that provided clinical data on the duration of TSH suppression. Combined data show that 45.5% of patients recover TSH by 3 months after treatment, increasing to 69.3% by 6 months, and plateauing to 73.8% by 12 months (p>0.0001). Sub-analysis also shows that for patients who are TBII negative, 80.7% recover their TSH by 6 months compared with only 58.7% in those who are TBII positive (p= 0.003). Clinical data suggests that TSH recovery is most likely to occur within the first 6 months after treatment, with recovery plateauing at approximately 70% of patients, suggesting that reliance on this assay for monitoring can be very misleading. Furthermore, TBII positivity is associated with lower likelihood of TSH

  8. Growth hormone inhibition causes increased selenium levels in Duchenne muscular dystrophy: a possible new approach to therapy.

    OpenAIRE

    Collipp, P. J.; Kelemen, J.; Chen, S. Y.; Castro-Magana, M; Angulo, M.; Derenoncourt, A

    1984-01-01

    Nine children with Duchenne muscular dystrophy were given Sanorex (mazindol), a growth hormone inhibitor, daily for 6 months. There was no significant change in their muscle function, but there was a significant reduction in weight gain and in levels of growth hormone, somatomedin C, hair zinc, serum zinc, and serum LDH. Selenium and glutathione peroxidase in the serum increased significantly. Thirteen other children with growth hormone deficiency had a significant reduction in hair selenium ...

  9. Racial differences in receipt of adjuvant hormonal therapy among Medicaid enrollees in South Carolina diagnosed with breast cancer.

    Science.gov (United States)

    Felder, Tisha M; Do, D Phuong; Lu, Z Kevin; Lal, Lincy S; Heiney, Sue P; Bennett, Charles L

    2016-05-01

    Several factors contribute to the pervasive Black-White disparity in breast cancer mortality in the U.S., such as tumor biology, access to care, and treatments received including adjuvant hormonal therapy (AHT), which significantly improves survival for hormone receptor-positive breast cancers (HR+). We analyzed South Carolina Central Cancer Registry-Medicaid linked data to determine if, in an equal access health care system, racial differences in the receipt of AHT exist. We evaluated 494 study-eligible, Black (n = 255) and White women (n = 269) who were under 65 years old and diagnosed with stages I-III, HR+ breast cancers between 2004 and 2007. Bivariate and multivariate analyses were conducted to assess receipt of ≥1 AHT prescriptions at any point in time following (ever-use) or within 12 months of (early-use) breast cancer diagnosis. Seventy-two percent of the participants were ever-users (70 % Black, 74 % White) and 68 % were early-users (65 % Black, 71 % White) of AHT. Neither ever-use (adjusted OR (AOR) = 0.75, 95 % CI 0.48-1.17) nor early-use (AOR = 0.70, 95 % CI 0.46-1.06) of AHT differed by race. However, receipt of other breast cancer-specific treatments was independently associated with ever-use and early-use of AHT [ever-use: receipt of surgery (AOR = 2.15, 95 % CI 1.35-3.44); chemotherapy (AOR = 1.97, 95 % CI 1.22-3.20); radiation (AOR = 2.33, 95 % CI 1.50-3.63); early-use: receipt of surgery (AOR = 2.03, 95 % CI 1.30-3.17); chemotherapy (AOR = 1.90, 95 % CI 1.20-3.03); radiation (AOR = 1.73, 95 % CI 1.14-2.63)]. No racial variations in use of AHT among women with HR+ breast cancers insured by Medicaid in South Carolina were identified, but overall rates of AHT use by these women is low. Strategies to improve overall use of AHT should include targeting breast cancer patients who do not receive adjuvant chemotherapy and/or radiation.

  10. Hormone replacement therapy and risk for coronary heart disease. Data from the CORA-study--a case-control study on women with incident coronary heart disease.

    Science.gov (United States)

    Windler, Eberhard; Zyriax, Birgit-Christiane; Eidenmüller, Britta; Boeing, Heiner

    2007-07-20

    Hormone replacement therapy (HRT) has been suggested to prevent cardiovascular disease, while some intervention studies have shed doubt on this concept. Thus, uncertainty remains whether current HRT use is beneficial as to cardiovascular disease or may even be harmful. This research investigates the association of hormone replacement therapy, risk factors and lifestyle characteristics with the manifestation of coronary heart disease in current HRT users versus never users. The coronary risk factors for atherosclerosis in women study (CORA-study) provide clinical and biochemical parameters and data on lifestyle in 200 consecutive pre- and postmenopausal women with incident coronary heart disease compared to 255 age-matched population-based controls, of which 87.9% were postmenopausal. Significantly more controls than cases used currently HRT for a median of 9.5 years (32.9% versus 20.2%), while 50.0% of cases and 42.5% of controls had never used HRT (pCORA-study are not compatible with an adverse impact of hormone replacement therapy on cardiovascular disease, rather support the notion of beneficial effects of HRT on weight, central adiposity, insulin sensitivity and blood pressure. Yet, the data do not support the presumption of a general healthy user effect in women on HRT either. Rather, in some women adverse lifestyle habits, especially intense smoking, appear to counteract possible beneficial effects of HRT.

  11. Comparative proteomic analysis in children with idiopathic short stature (ISS) before and after short-term recombinant human growth hormone (rhGH) therapy.

    Science.gov (United States)

    Heo, Sun Hee; Choi, Jin-Ho; Kim, Yoo-Mi; Jung, Chang-Woo; Lee, Jin; Jin, Hye Young; Kim, Gu-Hwan; Lee, Beom Hee; Shin, Choong Ho; Yoo, Han-Wook

    2013-04-01

    This study was undertaken to identify growth hormone (GH) responsive proteins and protein expression patterns by short-term recombinant human growth hormone (rhGH) therapy in patients with idiopathic short stature (ISS) using proteomic analysis. Seventeen children (14 males and three females) with ISS were included. They were treated with rhGH at a dose of 0.31 ± 0.078 mg/kg/week for 3 months. Immunodepletion of six highly-abundant serum proteins followed by 2D DIGE analysis, and subsequent MALDI TOF MS, were employed to generate a panel of proteins differentially expressed after short-term rhGH therapy and verify the differences in serum levels of specific proteins by rhGH therapy. Fourteen spots were differentially expressed after rhGH treatment. Among them, apo E and apo L-1 expression were consistently enhanced, whereas serum amyloid A was reduced after rhGH therapy. The differential expressions of these proteins were subsequently verified by Western blot analysis using sera of the before and after rhGH treatment. This study suggests that rhGH therapy influences lipoprotein metabolism and enhances apo L-1 protein expression in ISS patients. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. HORMONE THERAPY IN ADVANCED ER+/HER2- NEGATIVE BREAST CANCER WITH PI3K INHIBITORS: A REVIEW OF THE LITERATURE

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