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Sample records for term hormone replacement

  1. Effect of long-term Hormone Replacement Therapy on Plasma Homocysteine in Postmenopausal Women

    DEFF Research Database (Denmark)

    Madsen, Jonna S; Kristensen, Søren R; Klitgaard, Niels A

    2002-01-01

    OBJECTIVE: The purpose of this study was to investigate the long-term effect of hormone replacement therapy on total homocysteine and to study whether there was any difference in effect between opposed and unopposed hormone replacement therapy or whether the methylenetetrahydrofolate reductase C677......T polymorphism was associated with the effect of hormone replacement therapy on total homocysteine. STUDY DESIGN: Two hundred nine healthy postmenopausal women were randomized to hormone replacement therapy (n = 103) or no substitution (n = 106) 5 to 7 years earlier. RESULTS: Women who received...... hormone replacement therapy had significantly lower total homocysteine concentrations than women in the control group; median total homocysteine values were 8.6 micromol/L and 9.7 micromol/L, respectively, in a per-protocol analysis (P =.02). The effect was comparable in all methylenetetrahydrofolate...

  2. 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....

  3. Hormone Replacement Therapy and Your Heart

    Science.gov (United States)

    Hormone replacement therapy and your heart Are you taking — or considering — hormone therapy to treat bothersome menopausal symptoms? Understand ... for you. By Mayo Clinic Staff Long-term hormone replacement therapy used to be routinely prescribed for postmenopausal women ...

  4. 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

  5. Thyroiditis de Quervain. Are there predictive factors for long-term hormone-replacement?

    Science.gov (United States)

    Schenke, S; Klett, R; Braun, S; Zimny, M

    2013-01-01

    Subacute thyroiditis is a usually self-limiting disease of the thyroid. However, approximately 0.5-15% of the patients require permanent thyroxine substitution. Aim was to determine predictive factors for the necessity of long-term hormone-replacement (LTH). We retrospectively reviewed the records of 72 patients with subacute thyroiditis. Morphological and serological parameters as well as type of therapy were tested as predictive factors of consecutive hypothyroidism. Mean age was 49 ± 11 years, f/m-ratio was 4.5 : 1. Thyroid pain and signs of hyperthyroidism were leading symptoms. Initial subclinical or overt hyperthyroidism was found in 20% and 37%, respectively. Within six months after onset 15% and 1.3% of the patients developed subclinical or overt hypothyroidism, respectively. At latest follow-up 26% were classified as liable to LTH. At onset the thyroid was enlarged in 64%, and at latest follow-up in 8.3%, with a significant reduction of the thyroid volume after three months. At the endpoint the thyroid volume was less in patients in the LTH group compared with the non-LTH group (41.7% vs. 57.2% of sex-adjusted upper norm, p = 0.041). Characteristic ultrasonographic features occurred in 74% of the patients in both lobes. Serological and morphological parameters as well as type of therapy were not related with the need of LTH. In this study the proportion of patients who received LTH was 26%. At the endpoint these patients had a lower thyroid volume compared with euthyroid patients. No predictive factors for LTH were found.

  6. 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......-dominant forearm. Bone formation and resorption markers, sex hormones, IGF1, and maximal oxygen uptake. RESULTS: At follow-up, forearm BMD, radius ultradistal BMD, and hip BMD remained unchanged, radius 1/3 BMD declined (0.601+/-0.059 vs 0.592+/-0.059, P=0.03), while spine BMD increased (0.972+/-0.139 vs 1.......010+/-0.144, Poxygen uptake was significantly reduced in TS. CONCLUSION: Longitudinal changes in BMD in TS were slight. BMD can be maintained at most sites in well...

  7. Estrogen and Progestin (Hormone Replacement Therapy)

    Science.gov (United States)

    ... Estrogen and progestin are two female sex hormones. Hormone replacement therapy works by replacing estrogen hormone that is no ... menopausal women. Progestin is added to estrogen in hormone replacement therapy to reduce the risk of uterine cancer in ...

  8. Incidences of breast cancer throughout long-term hormone replacement therapy.

    Science.gov (United States)

    Cortés-Prieto, J; Juez-Martel, P

    2007-05-01

    To report the main incidences related to diagnosis of breast cancer in a randomly selected cohort population of women treated with conjugated equine estrogens (CEE), always in conjunction with the opposed progestin, medroxy progesterone acetate (MPA) throughout prolonged oral administration. One hundred and seventy-eight women were subsequently studied before and during the treatment (cohort study). The profile of studied patients included family and personal histories, gynecological and breast examinations, basal hormonal levels, bone mass concentration (BMC) as well as total cholesterol levels and their fractions. The usual clinical cut off age was applied at the beginning of treatment according to following criteria: (a) women less than 60 years old (91.60%), and (b) women more than 60 years old (8.40%), by assuming that a primary protective effect of HRT might be lost or diminished after surpassing this age threshold. In all the treated women were thoroughly advised about the importance of diet, exercises and self-determination. Both oral CEE 0.625 mg/daily and either 2.5 mg/daily or 5 mg/daily of MPA were administrated in accordance with The American Fertility Society Meeting after 1995 (Seattle) recommendations, following two patterns: (1) cycles or perimenopausal women: from days 1 to 25, and (2) postmenopausal women, from Monday to Friday. No other specific treatments were prescribed. Statistical analysis was performed by using SPSS 12.0 and G-stat 2.0. Evaluation of basal hormonal levels, BMC, cholesterol levels and their fractions were not included in the current study. Data from the statistical analysis of 178 treated women were as follow: mean duration of treatment 8.06 years for all women; in the younger age group 7.97, and in the older age group 9.04. Total of 1405.5 woman-years of follow-up, 119 women for more than 5 years (66.85%), and more times (68.18%) with CEE plus MPA 5 mg/daily regime. Dropouts occurred in 34 women (19.10%). Main incidences

  9. Effects of Long-term Growth Hormone Replacement in Adults With Growth Hormone Deficiency Following Cure of Acromegaly

    DEFF Research Database (Denmark)

    Tritos, Nicholas A; Johannsson, Gudmundur; Korbonits, Márta

    2014-01-01

    CONTEXT: GH deficiency (GHD) may occur in adults with cured acromegaly (acroGHD). OBJECTIVE: Our objective was to examine the effectiveness and safety of GH replacement in acroGHD. DESIGN: This study was a retrospective analysis of data from KIMS (Pfizer International Metabolic Database). SETTING....../expected = 0.58 [0.48-0.70]) in comparison with the general population. There was no difference in incidence of all cancers, benign or malignant brain tumors, or diabetes mellitus between acroGHD and NFPA. CONCLUSIONS: GH replacement has comparable effects on quality of life and lipids in acroGHD and NFPA...

  10. Long-term effects of growth hormone (GH) replacement in men with childhood-onset GH deficiency

    NARCIS (Netherlands)

    ter Maaten, JC; De Boer, H; Kamp, O; Stuurman, L; Van der Veen, EA

    Short term GH replacement therapy has been shown to improve body composition and exercise capacity. It is not yet known whether GH replacement remains beneficial over the long term. We assessed the effects of long term GH replacement on body composition, bone mineral density, and cardiac function.

  11. 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.

  12. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women

    DEFF Research Database (Denmark)

    Schierbeck, Louise Lind; Rejnmark, Lars; Tofteng, Charlotte Landbo

    2012-01-01

    To investigate the long term effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women.......To investigate the long term effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women....

  13. Alternatives to hormone replacement for menopause.

    Science.gov (United States)

    Soffa, V M

    1996-03-01

    This paper examines the controversy over estrogen therapies and shows how lifestyle interventions can be offered as a safe way to promote prevention and good health, without the risks and long-term side effects associated with hormone replacement drugs. Some researchers show that estrogen therapy may decrease osteoporosis and heart disease. Preventing these diseases has become the primary justification for recommending hormones to most menopausal women, whether the loss of estrogen is induced by surgical removal of the ovaries, hysterectomy, ovary radiation, chemotherapy, or is a result of the natural aging process. Prevention is the foremost reason that many clinicians tell their patients that the benefits outweigh the risks, and the reason women are advised to use this therapy for decades. More women may be requesting alternatives to the widely prescribed hormone replacement drugs as concern about the long-term risks and public understanding about the drug-free options for prevention grow. Beginning with providing information about the risks associated with both estrogen and the combination of estrogen and progestogen, this paper examines "natural" approaches to conditions commonly associated with menopause.

  14. IMPLANT WITH RISELLE IN HORMONE REPLACEMENT THERAPY

    Directory of Open Access Journals (Sweden)

    Daniela Badoi

    2012-06-01

    Full Text Available One of the most important roles of hormone replacement therapy is to remove the symptoms of menopause, especially the vaso-motor and urogenital tract appeared immediately after oophorectomy. The decreased risks of cardiovascular diseases are the long-term benefits. The cardiovascular protective effect of estrogen occurs by different mechanisms, all leading to reduction or slowing atherosclerotic processes and this improves cardiovascular performance. After 2 years of treatment no patient in group 1 interrupted therapy.

  15. Two to three years of hormone replacement treatment in healthy women have long-term preventive effects on bone mass and osteoporotic fractures: the PERF study

    DEFF Research Database (Denmark)

    Bagger, Yu Z; Tankó, László B; Alexandersen, Peter

    2004-01-01

    Hormone replacement therapy (HRT) is often prescribed for a few years to suppress menopausal symptoms. Although its long-term use of HRT for the primary prevention of osteoporosis is not currently recommended, the long-term skeletal benefits of the limited therapy are of great interest. To determ......Hormone replacement therapy (HRT) is often prescribed for a few years to suppress menopausal symptoms. Although its long-term use of HRT for the primary prevention of osteoporosis is not currently recommended, the long-term skeletal benefits of the limited therapy are of great interest...... density (BMD) at the spine (L1-L4) and bone mineral content (BMC) in the forearm were measured at baseline, the end of the trials, and follow-up. At follow-up, we assessed the radiological presence of vertebral fracture and collected information on the new incidence of nonvertebral fractures. Compared...... by a significantly reduced risk of all osteoporotic fractures as compared with the placebo group [OR = 0.48 (95% CI, 0.26-0.88)]. 'Fast losers' on placebo had more than a 4-fold higher risk of fractures than had the women on limited HRT with a normal rate of bone loss after withdrawal. In conclusion, limited HRT...

  16. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

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

    1994-01-01

    . This review is based on the English-language literature on the effect of estrogen therapy and estrogen plus progestin therapy on postmenopausal women. The advantages of hormone replacement therapy are regulation of dysfunctional uterine bleeding, relief of hot flushes, and prevention of atrophic changes......The menopause is defined as cessation of menstruation, ending the fertile period. The hormonal changes are a decrease in progesterone level, followed by a marked decrease in estrogen production. Symptoms associated with these hormonal changes may advocate for hormonal replacement therapy...... 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...

  17. Hormone replacement therapy in menopause

    National Research Council Canada - National Science Library

    Pardini, Dolores

    2014-01-01

    Although estrogen has been clinically available for more than six decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (HT), estrogen therapy (ET...

  18. Long-term effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity in healthy postmenopausal women

    NARCIS (Netherlands)

    Baal, W.M. van; Kenemans, P.; Emeis, J.J.; Schalkwijk, C.G.; Mijatovic, V.; Mooren, M.J. van der; Vischer, U.M.; Stehouwer, C.D.A.

    1999-01-01

    Objective: To study the effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity. Design: Prospective, randomized, controlled study. Setting: Academic hospital. Patient(s): Healthy postmenopausal women with an intact uterus. Intervention(s): For

  19. Alternatives for optimal hormone replacement therapy.

    Science.gov (United States)

    Sitruk-Ware, R

    2003-08-01

    To satisfy the needs of women with a wide variety of different medical histories and preferences, a wide choice of various forms of hormone replacement therapy (HRT) is desirable. The potential long-term benefits of HRT, in terms of osteoporosis, cardiovascular disease and dementia, require good compliance, which in turn requires an HRT formulation that is highly acceptable. An absence of weight gain and lack of androgenic effects are of great importance, as are predictable bleeding and positive effects on postmenopausal symptoms and quality of life. HRT should be tailored to each woman's needs by the choice of appropriate estrogens and particularly a progestogen with a suitable pharmacological profile. An ideal progestogen should be targeted at preventing endometrial hyperplasia without opposing the effects of estrogen on the vessels. Several new progestogens have been synthesized in recent years. Dienogest, the progestogenic component of a new hormone replacement therapy with estradiol valerate, has many desirable features, including antiandrogenic properties; in this respect, it is unique amongst progestogens derived from testosterone. Tailored HRT should treat symptoms, minimize risk factors, meet personal preferences and lifestyle needs, and not be contraindicated for concomitant diseases. During the next decade, optimal HRT must match a number of trends, including an aging population, and is likely to be influenced by the outcome of major trials such as the Women's Health Initiative trial whose negative results will impact the prescriptions, the advent of new compounds--particularly the selective estrogen receptor modulators and progestogen receptor modulators--and the introduction of new methods of delivery, including vaginal rings and medicated intrauterine systems.

  20. 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 ... www.mayoclinic.org/diseases-conditions/menopause/expert-answers/hormone-replacement-therapy/FAQ-20058499 . Mayo Clinic Footer Legal Conditions and ...

  1. HORMONE REPLACEMENT THERAPY AND CANCER

    Directory of Open Access Journals (Sweden)

    Marjetka Uršič Vrščaj

    2003-12-01

    Full Text Available Background. Sex steroids are not known to damage DNA directly. They can stimulate or inhibit cell proliferation, and thus can modulate tumor developmental progression.Results. Sex steroids-related tumors in women are represented by breast cancer and endometrial cancer, and a possible relationship exists between sex steroids and both ovarian and colon cancer. Among current ERT users or those who stopped use 1–4 years previously, the relative risk of having breast cancer diagnosed is low, increases by factor of 1.023 for each year of hormone use. An appropriate combination of estrogen and progestin does not appear to increase, and may even decrease, the risk of endometrial cancer. Studies on HRT and risk of epithelial ovarian cancer have produced conflicting results but most data seem to exclude a strong assotiation. It is important that available data suggest a reduced risk of benign colorectal adenoma and colon cancer for 30–40%.Conclusions. After breast cancer, endometrial cancer, melanoma or epithelial ovarian cancer HRT is not absolute contraindication. Low-grade endometrial stromal sarcoma should be considered to be a contraindication to HRT.

  2. [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.

  3. 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...

  4. 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....

  5. Sex hormone replacement in Turner syndrome

    DEFF Research Database (Denmark)

    Trolle, Christian; Hjerrild, Britta; Cleemann, Line Hartvig

    2012-01-01

    osteoporosis seen in Turner syndrome. But sex hormone insufficiency is also involved in the increased cardiovascular risk, state of physical fitness, insulin resistance, body composition, and may play a role in the increased incidence of autoimmunity. Severe morbidity and mortality affects females with Turner...... syndrome. Recent research emphasizes the need for proper sex hormone replacement therapy (HRT) during the entire lifespan of females with TS and new hypotheses concerning estrogen receptors, genetics and the timing of HRT offers valuable new information. In this review, we will discuss the effects...

  6. Effect of long-term hormone replacement therapy on tissue factor pathway inhibitor and thrombin activatable fibrinolysis inhibitor in healthy postmenopausal women

    DEFF Research Database (Denmark)

    Bladbjerg, Else-Marie; Madsen, Jonna Skov; Kristensen, Søren Risom

    2003-01-01

    It was recently reported from the Women's Health Initiative that healthy women using combined hormone replacement therapy (HRT) for 5 years have an increased cardiovascular risk. We hypothesize that the increased risk is confined to subgroups of atherosclerotic women. Such women may have higher...... polymorphism. Overall, concentrations of TAFI did not differ between the two groups but were reduced by hormone therapy in homozygotes for the rare TAFI -438 A allele (P .... The observed decrease in TFPI may contribute to the increased cardiovascular risk associated with HRT. Udgivelsesdato: 2003-Jun...

  7. Hormone replacement therapy and mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A

    2002-07-01

    The benefits of hormone replacement therapy (HRT) with oestrogen are well known and have led to widespread usage of HRT in post-menopausal women. There is an increased relative risk of breast cancer with prolonged HRT use of 1.7 at worst and this does not warrant more frequent screening. HRT itself makes mammographic screening less effective by adversely affecting both the sensitivity and specificity of screening mammography. A number of large studies have shown a reduction in the sensitivity of screening mammography of between 7% and 21% in current HRT users. This reduction in sensitivity is seen only in women over the age of 50 and is more marked when using single view mammography. The reduction in sensitivity is largely confined to those women who have a dense mammographic background pattern while on HRT. HRT use is also associated with a reduction in specificity of between 12% and almost 50%. This reduction in specificity is mainly found at incident screens. What can be done to minimize the adverse effects of HRT on mammographic screening? The imminent introduction of two views at all screens within the National Health Breast Screening Programme will be helpful. Short-term cessation of HRT use may deter attendance for screening by HRT users and is unproven. Combined oestrogen and progesterone preparations taken continuously appear to be particularly associated with adverse breast screening performance, while tibolone may have little effect on mammographic density. Manipulation of the type of HRT preparations used may allow the adverse effects of HRT on breast screening to be reduced. Evans, A. (2002)

  8. Hormonal replacement therapy after gynaecological cancer.

    Science.gov (United States)

    Biglia, Nicoletta; Mariani, Luca; Marenco, Davide; Robba, Claudio; Peano, Elisa; Kubatzki, Franziska; Sismondi, Piero

    2006-01-01

    Thousands of women are treated each year for gynaecological cancers; many of these are already in menopause, while other younger patients will go into early menopause due to surgery, chemotherapy and/or radiotherapy to the pelvic region. The aim of this paper is to review the biological and clinical evidence in favour and against hormone replacement therapy (HRT) use after gynaecological cancers. With the exception of breast and endometrial cancer, there is no biological evidence that HRT may increase the recurrence risk. In women with previous endometrial cancer, HRT use is not supported by univocal and conclusive data to formulate specific recommendations, whereas most authors suggest that oestrogens may be used after adequate information about risks and benefits. The use of HRT in breast cancer patients is, at present, considered contra-indicated, even if results of clinical trials are not concordant. Therapeutic non-hormonal alternatives may be proposed to these patients.

  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. Positive impact of hormone replacement therapy on the fibrinolytic system: a long-term randomized controlled study in healthy postmenopausal women

    DEFF Research Database (Denmark)

    Madsen, J S; Kristensen, S R; Gram, J

    2003-01-01

    BACKGROUND: The mechanisms by which postmenopausal hormone replacement therapy (HRT) may influence risk of cardiovascular disease are still unclear. Impaired fibrinolytic function is associated with an enhanced risk of cardiovascular disease and therefore the effect of HRT on fibrinolysis may...... be of importance. OBJECTIVES: To investigate the prolonged effect of HRT on the fibrinolytic system and to determine whether two common polymorphisms in the plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) genes modulate this effect. Methods: Healthy postmenopausal women (n...

  11. Therapy of Hypoparathyroidism by Replacement with Parathyroid Hormone

    Directory of Open Access Journals (Sweden)

    Lars Rejnmark

    2014-01-01

    Full Text Available 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 (QoL 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, nevertheless, a number of challenges. If PTH is injected only once a day, fluctuations in calcium levels may occur resulting in hypercalcemia in the hours following an injection. Twice-a-day injections seem to cause less fluctuation in plasma calcium but do stimulate bone turnover to above normal. Most recently, continuous delivery of PTH by pump has appeared as a feasible alternative to injections. Plasma calcium levels do not fluctuate, urinary calcium is lowered, and bone turnover is only stimulated modestly (into the normal range. Further studies are needed to assess the long-term effects. If beneficial, it seems likely that standard treatment of HypoPT in the future will change into replacement therapy with the missing hormone.

  12. 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....

  13. Hormone replacement therapy increases the risk of cranial meningioma

    DEFF Research Database (Denmark)

    Andersen, Lene; Friis, Søren; Hallas, Jesper

    2013-01-01

    We investigated the influence of hormone replacement therapy (HRT) use on the risk of meningioma in a population-based setting.......We investigated the influence of hormone replacement therapy (HRT) use on the risk of meningioma in a population-based setting....

  14. [Risk discourse in Hormone Replacement Therapy].

    Science.gov (United States)

    Lu, Zxy-Yann Jane; Chen, Hai-Chiao; Juan, Yueh-Ching

    2006-02-01

    The medical world has used Hormone Replacement Therapy (HRT) on menopausal women for over 70 years, but controversy surrounding the treatment remains. Findings reported by the NIH, U.S.A. in July 2002 indicated that HRT might cause cardiovascular and cancer risks, and resulted in serious concern among menopausal women using HRT in Taiwan. One after the other, members of the medical profession in Taiwan have argued that the medicine used in the research was different (from that used in Taiwan) and that the constitutions of western women are different from those of Taiwanese women, attempting to limit the negative impact of this research. HRT is one of the most widely used, but also one of the most controversial of medical technologies. The technico-scientific and sociocultural perspectives are two major approaches to the conceptualization of risk in relation to technology. Based on cognitive science, the technico-scientific discourse of risk emphasizes human forecasting of harmful events and scientific measures for preventing risk. The sociocultural perspective emphasizes that the risk is socially constructed and applies to control deviance. In addition, surveillance and regulated measures are applied to high-risk populations, as normalizing technology with moral implications. This paper suggests that health care professionals examine how HRT users interpret the meanings of risk. Reflection on the process and criteria for identifying high-risk populations is also suggested. Partnership with and empowerment of HRT users is advocated in preference to the use of regulating and normalizing measures.

  15. The replacement of serum by hormones in cell culture media.

    Science.gov (United States)

    Sato, G; Hayashi, I

    1976-12-01

    The replacement of serum by hormones in cell culture media. (Reemplazo del suero por hormonas en el medio de cultivo de células). Arch. Biol. Med. Exper. 10: 120-121, 1976. The serum used in cell culture media can be replaced by a mixture of hormones and some accesory blood factors. The pituitary cell line GH3 can be grown in a medium in which serum is replaced by triiodothyronine, transferrin, parathormone, tyrotrophin releasing hormone and somatomedins. Hela and BHK cell strains can also be grown in serum free medium supplemented with hormones. Each cell type appears to have different hormonal requirements yet it may found that some hormones are required for most cell types.

  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. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

  18. Breast parenchymal change on mammography following postmenopausal hormone replacement therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Pyoung; Kim, Sun Jung; Kim, Hee Soo; Na, Jae Beom; Won, Jong Yoon; Won, Jae Whan [College of Medicine, Yonsei University, Seoul (Korea, Republic of); Min, Yong Gi; Cho, Byung Jae; Lee, Kyung Sang [Cheil General Hospital, Seoul (Korea, Republic of)

    1994-11-15

    To determine the frequency and distribution of parenchymal changes on mammography before and after hormone replacement therapy. Mammograms of 100 postmenopausal women who underwent hormone replacement therapy without breast disease were evaluated. Mammograms obtained annually after hormone replacement were analysed and compared with that of pretreatment. In addition, mammograms of control group and treatment group were compared. An increase in density of breast parenchyma was seen on the mammogram of 20 women(20%) receiving therapy. The mammograms from the control group showed no change. Mammographic changes were detected at first year in 13 women, 2nd year in 4 women, 3rd year in 2 women, and 4th year in 1 woman (average, 19 months). We conclude that increase in mammographic density following postmenopausal hormone replacement therapy is not uncommon(20%)

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    these systems as biological mediators of hormonal influences on the brain. More, hormonal replacement appears to increase cerebral blood flow in several cortical regions. On the other hand, studies on emotion processing in postmenopausal women are lacking. These results call for well-powered randomized...

  20. Press coverage of hormone replacement therapy and menopause.

    Science.gov (United States)

    Colombo, Cinzia; Mosconi, Paola; Buratti, Maria Grazia; Liberati, Alessandro; Donati, Serena; Mele, Alfonso; Satolli, Roberto

    2010-11-01

    To evaluate the information reported by Italian press articles about hormone replacement therapy (HRT) and menopause, in terms of completeness, clarity of language and transparency. In the framework of the Consensus Conference Informing women about hormone replacement therapy, 225 articles published from 2000 to 2007 in Italian lay press were evaluated. Health magazines, weekly news magazines, newspapers, women's magazines and medical practitioners' journals were selected. A form covering graphic layout, completeness of information, clarity of language and transparency was applied to each article by a reviewer. The form was tested in a pilot phase. HRT was recommended to treat menopausal symptoms in more than half of articles (56%) and was described as a preventive measure in almost half (48%). Risks related to HRT were under-reported (58% of the articles). Information on conflicts of interest was lacking (88%). Opinions of experts were the main source of information cited in the articles (66%). The information reported by the articles is lacking in several aspects. Many women are likely to receive unbalanced information from the press. Qualified sources of information delivered on the scientific knowledge available are needed, reporting advantages and disadvantages of HRT, pharmacological and non-pharmacological alternative treatments and their effectiveness. Scientific journalism needs to grow through training. The role of researchers and clinicians is discussed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Informing women about hormone replacement therapy: the consensus conference statement.

    Science.gov (United States)

    Mosconi, Paola; Donati, Serena; Colombo, Cinzia; Mele, Alfonso; Liberati, Alessandro; Satolli, Roberto

    2009-05-29

    The risks/benefits balance of hormone replacement therapy is controversial. Information can influence consumers' knowledge and behavior; research findings about hormone replacement therapy are uncertain and the messages provided by the media are of poor quality and incomplete, preventing a fully informed decision making process. We therefore felt that an explicit, rigorous and structured assessment of the information needs on this issue was urgent and we opted for the organisation of a national consensus conference (CC) to assess the current status of the quality of information on hormone replacement therapy (HRT) and re-visit recent research findings on its risks/benefits. We chose a structured approach based on the traditional CC method combined with a structured preparatory work supervised by an organising committee (OC) and a scientific board (SB). The OC and SB chose the members of the CC's jury and appointed three multidisciplinary working groups (MWG) which were asked to review clinical issues and different aspects of the quality of information. Before the CC, the three MWGs carried out: a literature review on the risk/benefit profile of HRT and two surveys on the quality of information on lay press and booklets targeted to women. A population survey on women's knowledge, attitude and practice was also carried out. The jury received the documents in advance, listened the presentations during the two-day meeting of the CCs, met immediately after in a closed-door meeting and prepared the final document. Participants were researchers, clinicians, journalists as well as consumers' representatives. Key messages in the CC's deliberation were: a) women need to be fully informed about the transient nature of menopausal symptoms, about HRT risks and benefits and about the availability of non-pharmacological interventions; b) HRT is not recommended to prevent menopausal symptoms; c) the term "HRT" is misleading and "post menopausal hormone therapy" should be the

  2. Informing women about hormone replacement therapy: the consensus conference statement

    Directory of Open Access Journals (Sweden)

    Liberati Alessandro

    2009-05-01

    Full Text Available Abstract Background The risks/benefits balance of hormone replacement therapy is controversial. Information can influence consumers' knowledge and behavior; research findings about hormone replacement therapy are uncertain and the messages provided by the media are of poor quality and incomplete, preventing a fully informed decision making process. We therefore felt that an explicit, rigorous and structured assessment of the information needs on this issue was urgent and we opted for the organisation of a national consensus conference (CC to assess the current status of the quality of information on hormone replacement therapy (HRT and re-visit recent research findings on its risks/benefits. Methods We chose a structured approach based on the traditional CC method combined with a structured preparatory work supervised by an organising committee (OC and a scientific board (SB. The OC and SB chose the members of the CC's jury and appointed three multidisciplinary working groups (MWG which were asked to review clinical issues and different aspects of the quality of information. Before the CC, the three MWGs carried out: a literature review on the risk/benefit profile of HRT and two surveys on the quality of information on lay press and booklets targeted to women. A population survey on women's knowledge, attitude and practice was also carried out. The jury received the documents in advance, listened the presentations during the two-day meeting of the CCs, met immediately after in a closed-door meeting and prepared the final document. Participants were researchers, clinicians, journalists as well as consumers' representatives. Results Key messages in the CC's deliberation were: a women need to be fully informed about the transient nature of menopausal symptoms, about HRT risks and benefits and about the availability of non-pharmacological interventions; b HRT is not recommended to prevent menopausal symptoms; c the term "HRT" is misleading and "post

  3. 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.

  4. Hormone replacement therapy in cancer survivors.

    Science.gov (United States)

    Biglia, Nicoletta; Gadducci, Angelo; Ponzone, Riccardo; Roagna, Riccardo; Sismondi, Piero

    2004-08-20

    Thousands of women are treated each year for cancer; many of these are already in menopause, while other younger patients will go into early menopause due to surgery, or chemotherapy, or the need for radiotherapy to the pelvic region. In most cases the oncologist and the gynaecologist would advise these women against the use of HRT. The purpose of this paper is to review biological and clinical evidences in favour and against HRT use in the different tumours and to propose an algorithm that can help choosing the treatment for the single woman. We performed a systematic literature review through April 2002 concerning: (1) biological basis of hormonal modulation of tumour growth; (2) epidemiological data on the impact of HRT on different cancers risk in healthy women; (3) safety of HRT use in cancer survivors; (4) alternatives to HRT. With the exception of meningioma, breast and endometrial cancer, there is no biological evidence that HRT may increase recurrence risk. In women with previous breast and endometrial cancer HRT is potentially hazardous on a biological basis, even if published data do not show any worsening of prognosis. Even if a cautious approach to hormonal-dependent neoplasias is fully comprehensible and the available alternative treatment should be taken into greater consideration, the reticence to prescribe HRT in women previously treated for other non hormone-related tumours has neither a biological nor a clinical basis. An algorithm based on present knowledge is proposed.

  5. 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

  6. [Effects of growth hormone replacement therapy on bone metabolism].

    Science.gov (United States)

    Yamamoto, Masahiro; Sugimoto, Toshitsugu

    2014-06-01

    Growth hormone (GH) as well as insulin like growth factor-1 (IGF-1) are essential hormones to maintain homeostasis of bone turnover by activating osteoblastogenesis and osteoclastogenesis. Results from GH replacement therapy for primary osteoporosis and adult-onset GH deficiency (AGHD) suggest that one year or more treatment period by this agent is required to gain bone mineral density (BMD) over the basal level after compensating BMD loss caused by dominant increase in bone resorption which was observed at early phase of GH treatment. A recent meta-analysis demonstrates the efficacy of GH replacement therapy on increases in BMD in male patients with AGHD. Additional analyses are needed to draw firm conclusions in female patients with AGHD, because insufficient amounts of GH might be administrated to them without considerations of influence of estrogen replacement therapy on IGF-1 production. Further observational studies are needed to clarify whether GH replacement therapy prevent fracture risk in these patients.

  7. QUALITY OF LIFE, COUNSELLING AND HORMONE REPLACEMENT THERAPY

    Directory of Open Access Journals (Sweden)

    Nena Kopčavar Guček

    2008-12-01

    Quality of life in menopause is a result of many factors and therefore it is very individual.Hormone replacement therapy is one of the possibilities of improvement. Therefore, it isessential that a woman is adequately informed about all the advantages and risks of thehormonal replacement therapy. Only an informed patient can be a partner in shareddecision making about the improvement of quality of life

  8. The Language of Journalism in Treatments of Hormone Replacement News

    Science.gov (United States)

    MacDonald, Susan Peck

    2005-01-01

    Researchers studying science communication have criticized the sensationalism that often appears in journalistic accounts of science news. This article looks at the linguistic sources of that sensationalism by analyzing the journalistic coverage of the Women's Health Initiative (WHI) study of hormone replacement research, which was abruptly…

  9. [Alternatives to hormone replacement therapy for menopause: an epidemiological evaluation].

    Science.gov (United States)

    Ringa, V

    2004-05-01

    Recent results put into question the risks/benefits ratio of hormone replacement therapy and emphasize the importance of precise knowledge of the effects of other treatments that exist for postmenopausal symptoms or diseases. Our aim is to analyze their effect. A review of randomized trials or epidemiological studies was undertaken. Bisphophonates, calcitonin, parathormone, strontium ranelate, calcium and vitamin D have specific effects on bone. The efficacy of bisphophonates for prevention and treatment of osteoporosis has been proven and parathormone and strontium ranelate seem promising. These treatments are useful for women at high risk of osteoporosis who do not suffer from menopausal symptoms. Tibolone, SERMs and phytoestrogens exert effects on various tissues. SERMs are very promising, but they do not improve climacteric symptoms and their long term effects are still unknown. Tibolone has beneficial effects on climacteric symptoms and on bone loss, but recent results concerning its effects on the risk of breast cancer call into question its interest. The beneficial effects of phytoestrogens on bone and on vasomotor symptoms need to be confirmed. At this time, none of the existing treatments for postmenopausal symptoms or diseases is ideal. The existence of several options for treatments of symptoms or diseases of the postmenopause is helpful as it affords several choices for physicians and for women who sometimes need to be treated for many years. However several questions remain unanswered concerning the long term effects of these treatments.

  10. 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).......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...

  11. Adult growth hormone deficiency – benefits, side effects, and risks of growth hormone replacement

    Directory of Open Access Journals (Sweden)

    Mary Lim Reed

    2013-06-01

    Full Text Available Deficiency of growth hormone (GH in adults results in a syndrome characterized by decreased muscle mass and exercise capacity, increased visceral fat, impaired quality of life, unfavorable alterations in lipid profile and markers of cardiovascular risk, decrease in bone mass and integrity and increased mortality. When dosed appropriately, GH replacement therapy (GHRT is well tolerated, with a low incidence of side effects, and improves most of the alterations observed in GH deficiency (GHD; beneficial effects on mortality, cardiovascular events and fracture rates, however, remain to be conclusively demonstrated. The potential of GH to act as a mitogen has resulted in concern over the possibility of increased de novo tumors or recurrence of pre-existing malignancies in individuals treated with GH. Though studies of adults who received GHRT in childhood have produced conflicting reports in this regard, long term surveillance of adult GHRT has not demonstrated increased cancer risk or mortality.

  12. 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,

  13. Primary prevention of cardiovascular disease with hormone replacement therapy

    DEFF Research Database (Denmark)

    Schierbeck, L

    2015-01-01

    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......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...

  14. Thyroid dysfunction, thyroid hormone replacement and colorectal cancer risk.

    Science.gov (United States)

    Boursi, Ben; Haynes, Kevin; Mamtani, Ronac; Yang, Yu-Xiao

    2015-06-01

    Current screening guidelines for colorectal cancer (CRC) do not consider thyroid dysfunction as a risk factor for disease development. We sought to determine the risk of developing CRC in patients with thyroid dysfunction, with and without thyroid hormone replacement (THR). We conducted a nested case-control study using a large population-based medical records database from the United Kingdom. Study case patients were defined as those with any medical code of CRC. Subjects with familial colorectal cancer syndromes or inflammatory bowel disease (IBD) were excluded. For every case patient, four eligible control patients matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence density sampling. Exposure was THR therapy before index date. We further divided the THR unexposed group into patients with hypothyroidism (TSH > 4 mg/dl), patients with hyperthyroidism (TSH CRC were estimated using conditional logistic regression. All statistical tests were two-sided. We identified 20990 CRC patients and 82054 control patients. The adjusted odds ratio for CRC associated with THR was 0.88 (95% CI = 0.79 to 0.99, P = .03) and 0.68 (95% CI = 0.55 to 0.83, P CRC. Long-term THR is associated with a decreased risk of CRC. Hyperthyroidism and untreated hypothyroidism are associated with modestly elevated risk of CRC. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Hypoparathyroidism: clinical features, skeletal microstructure and parathyroid hormone replacement

    OpenAIRE

    Rubin, Mishaela R.; Bilezikian, John P.

    2010-01-01

    OBJECTIVE: Hypoparathyroidism is a disorder in which parathyroid hormone is deficient in the circulation due most often to immunological destruction of the parathyroids or to their surgical removal. The objective of this work was to define the abnormalities in skeletal microstructure as well as to establish the potential efficacy of PTH(1-84) replacement in this disorder. SUBJECTS AND METHODS: Standard histomorphometric and µCT analyses were performed on iliac crest bone biopsies obtained fro...

  16. 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

  17. Polycythaemia Secondary to Hormone Replacement Therapy with Tibolone

    Directory of Open Access Journals (Sweden)

    Laura Staples

    2017-01-01

    Full Text Available We present the case report of a patient with severe polycythaemia associated with tibolone. In our 65-year-old postmenopausal patient who initially presented with haemoglobin 203 g/L [115–160] and haematocrit 0.63 [0.32–0.47], the cessation of tibolone, a synthetic hormone replacement therapy, led to a dramatic and sustained resolution of this patient’s polycythaemia to normal haematological values. Tibolone possesses oestrogenic, androgenic, and progestogenic properties. Tibolone therapy may be an infrequently recognized contributor towards polycythaemia in postmenopausal patients presenting to haematology clinics.

  18. 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...... therapy and non-fatal subarachnoid haemorrhage (odds ratio 0.52 [95% CI 0.23-1.22]), intracerebral haemorrhage (0.15 [0.02-1.09]), or thromboembolic infarction (1.16 [0.86-1.58]), respectively, compared with never use. Current use of combined oestrogen-progestagen replacement therapy had no significant...

  19. 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.

  20. Hormone Replacement Therapy, Likely Neither Angel Nor Demon.

    Directory of Open Access Journals (Sweden)

    Mitchell S Wachtel

    Full Text Available A decline in breast cancer incidence has been attributed to the reduction in hormone replacement therapy (HRT prescriptions since the publication of the landmark WHIT paper in 2003. Concurrently, a relationship between HRT and cerebrovascular disease incidence has also been suggested. No generalized analysis of HRT prescription rates and breast cancer incidence rates that included more than seven years of data. We hypothesized that detailed analysis of SEER data would clarify the relationship between HRT use and breast cancer incidence. Given the large decline in HRT prescription rates uncovered, analyses of potential complications were also conducted, with the understanding that a small effect or one limited to a subpopulation, such as a single race, might not be detected.Incidence rates (per 100,000 women and standard errors for ductal and lobular breast carcinomas, and endometrioid /endometrial carcinomas in women over 50 years were obtained from the Surveillance, Epidemiology, and End Results (SEER database 1992-2012. From the Medical Expenditure Panel Survey 1996-2012 weighted counts and standard errors of hormone replacement therapy (HRT prescriptions for women over 50 years were obtained. Using the National Hospital Discharge Survey (NHDS, 1996-2010 weighted counts and standard errors of femoral neck fractures, total hip replacements, acute myocardial infarctions, and cerebral infarctions were obtained for 50+ year men and women. Weighted counts and standard errors were divided by US census figures and multiplied by 100,000. Joinpoint regression was used to analyze rates.Beginning 2001, HRT prescription rates dropped dramatically, 2001-2012 AAPC -14.9 (95% CI -17.4, -12.4. Breast cancer rates, which began to decline in 1999, increased after 2003; 2012 rates were similar to those seen in 2001 for both ductal, AAPC 0.1 (-0.4, 0.6 and lobular, AAPC 0.5 (-0.4, 1.5, carcinoma. Endometrial carcinoma rates increased, 2001-2012 AAPC 3.5 (3.1, 3

  1. Headache and hormone replacement therapy in the postmenopausal woman.

    Science.gov (United States)

    MacGregor, E Anne

    2009-01-01

    Headache and migraine are common symptoms of the menopause, often associated with irregular periods, hot flashes, and night sweats. Perimenopausal women should routinely be asked about headache and migraine, so that they can be offered appropriate advice. If attacks are infrequent, it may be sufficient to optimize acute treatment strategies. Lifestyle changes, alone or combined with a nonprescription treatment such as isoflavones, may be considered, although evidence of efficacy is limited. In women with migraine and more severe menopause symptoms, continuous hormone replacement therapy should be considered, using a nonoral route and the lowest dose effective in controlling symptoms. For women who have contraindications to estrogen therapy or do not wish to use it, compounds that inhibit serotonin reuptake, such as venlafaxine, fluoxetine, and paroxetine, have all shown efficacy for the control of hot flashes and prevention of migraine. Gabapentin is another nonhormonal option that has clinical trial evidence of effectiveness in treating hot flashes and reducing the frequency and severity of migraine attacks. Although clonidine is licensed in several countries for migraine prophylaxis and treatment of vasomotor symptoms, any benefit from treatment is often offset by adverse events. There is evidence that hysterectomy can increase the frequency of migraine and menopause symptoms, with added morbidity and risk of mortality. Therapy should regularly be evaluated to assess its ongoing need, as hormonal triggers are self-limiting and abate after menopause.

  2. 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.

  3. Hormone replacement therapy leads to increased plasma levels of platelet derived microparticles in postmenopausal women

    NARCIS (Netherlands)

    Rank, Andreas; Nieuwland, Rienk; Nikolajek, Katharina; Rösner, Sabine; Wallwiener, Lisa-Maria; Hiller, Erhard; Toth, Bettina

    2012-01-01

    Whereas prevention of cardiovascular diseases by hormonal replacement therapy is still part of an ongoing debate, well-defined data are available relating hormonal replacement therapy to an elevated risk of venous thrombosis and embolism. Although it seems that venous thrombosis in patients treated

  4. 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....

  5. Hormone Replacement Therapy and Risk for Neurodegenerative Diseases

    Directory of Open Access Journals (Sweden)

    Richelin V. Dye

    2012-01-01

    Full Text Available Over the past two decades, there has been a significant amount of research investigating the risks and benefits of hormone replacement therapy (HRT with regards to neurodegenerative disease. Here, we review basic science studies, randomized clinical trials, and epidemiological studies, and discuss the putative neuroprotective effects of HRT in the context of Alzheimer’s disease, Parkinson’s disease, frontotemporal dementia, and HIV-associated neurocognitive disorder. Findings to date suggest a reduced risk of Alzheimer’s disease and improved cognitive functioning of postmenopausal women who use 17β-estradiol. With regards to Parkinson’s disease, there is consistent evidence from basic science studies for a neuroprotective effect of 17β-estradiol; however, results of clinical and epidemiological studies are inconclusive at this time, and there is a paucity of research examining the association between HRT and Parkinson’s-related neurocognitive impairment. Even less understood are the effects of HRT on risk for frontotemporal dementia and HIV-associated neurocognitive disorder. Limits to the existing research are discussed, along with proposed future directions for the investigation of HRT and neurodegenerative diseases.

  6. 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.

  7. 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.

  8. Mammographic changes in postmenopausal women : comparative effects between continuous combined hormone and single estrogen replacement therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Sug; Choi, Jong Tae; Jung, Kyoon Soon; Jung, Seung Hye [Jeil Women' s Hospital, Seoul (Korea, Republic of)

    1997-06-01

    As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-setional study analyzed the effects of different hormone therapies on mammographic density. Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625mg, plus continuous medroxyprogesterone acetate, 2.5mg (n=48), Group II : continuous conjugated equine estrogen 0.625mg (n=19). The mammograms were read by two radiologists. With regard to the radiologists involved, interobserver reliabillity (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously.

  9. 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...

  10. Progestational effects of combinations of gestodene on the postmenopausal endometrium during hormone replacement therapy.

    Science.gov (United States)

    Byrjalsen, I; Bjarnason, N H; Christiansen, C

    1999-03-01

    The aim of the study was to assess the dose-response effects on the postmenopausal endometrium of 3 sequential combined hormone replacement regimens and 1 continuous combined hormone replacement regimen of estradiol and gestodene. In this 2-year double-blind, placebo-controlled study, 278 healthy postmenopausal women received either 2 mg estradiol sequentially combined with 50 microg or 25 microg gestodene, 1 mg estradiol sequentially or continuously combined with 25 microg gestodene, or placebo. All 4 hormone treatment regimens produced a safe endometrial histologic appearance. The regimens that were based on the lower dose of 1 mg estradiol was associated with less uterine bleeding than were those that were based on 2 mg estradiol. For sequentially opposing the 2 mg dose of estradiol, the dose of 25 microg gestodene was less efficient in producing secretory activity than was the dose of 50 microg gestodene. The measurement of placental protein 14 in serum reflected the secretory transformation of the endometrial buildup. The reduction in bleeding episodes associated with regimens with lower estradiol doses may lead to improved long-term therapy compliance by menopausal women. The potency of progestogens can be assessed by measuring the serum concentration of placental protein 14.

  11. Supplemental and complementary alternatives to hormone replacement therapy.

    Science.gov (United States)

    Keller, C; Fullerton, J; Mobley, C

    1999-05-01

    Tables 1 and 2 offer a summary of information currently available on the sources, dosages, and proposed health benefits of the supplemental and complementary nutritional therapies that can be suggested as alternatives to hormone replacement therapy. These therapies have the additional benefit of being broadly available to women of all socioeconomic strata, and should be acceptable to women of various ethnicities and cultures. Adequate intakes (AI) of vitamins are recommended based on observational or experimentally determined approximations of the average nutrient intake, by a defined population or group, that appears to sustain a defined nutritional state (Food and Nutrition Boar, Institute of Medicine, 1997). Reviewing the empirical evidence concerning the use of vitamin supplements leads to the conclusion that doses higher than AI or recommended daily requirements is not warranted. For those individuals who choose to supplement, counseling should be provided to caution about tolerable upper limits, those maximum levels of nutrient intake judged unlikely to pose a risk for adverse health effects (Food and Nutrition Boar, Institute of Medicine). Supplemental and complementary therapy directed at ameliorating symptoms or reducing the risk of menopause related illness (osteoporosis and CHD) becomes a decision balance of the woman's preferences, risk and health history, and personal and financial resources. There appears to be some protection of morbidity and mortality from CHD with antioxidant dietary intake. Osteoporosis appears to be delayed with calcium supplementation. Menopausal symptoms, CHD risk, and osteoporosis risk appears to be reduced with phytoestrogen supplementation, although doses have not been established. Research concerning the safety and efficacy of these therapies continues. Findings from current clinical trials, such as the Women's Health Initiative may render these and additional alternative therapies to HRT more precise in the near future.

  12. Effect of hormone replacement therapy on lipids and coagulation factors in postmenopausal women smokers

    Directory of Open Access Journals (Sweden)

    Tatović-Babić Danijela

    2002-01-01

    Full Text Available Postmenopause and smoking impair lipid profile, induce hypercoagulability and reduce fibrinolytic capacity [1, 2]. Postmenopause induced lipid changes can be reversed by oestrogen replacement [3]. Oestrogens also reduce fibrino-gen level [4] and have beneficial effects on endothelium [5]. Although several studies showed that hormone replacement therapy may increase the risk of thromboembolic diseases, procoagulant oestrogen activity has not clearly been demonstrated. It is well known that smoking accelerates oestrogen metabolism [6, 7], which may attenuate its beneficial effects. The present study was undertaken to determine if there is difference in beneficial effects of oestrogens between smokers and non-smokers in terms of coagulation process and lipids. The examination was a longitudinal one-year, before/after therapeutic study, which included healthy postmenopausal women (FSH levels at least 40 U/l, 30 smokers and 32 non-smokers who were under 55 years of age and postmenopausal period shorter than 5 years. Women with surgically induced menopause received unopposed oral oestrogens, while those with spontaneous menopause were treated with combined oral oestrogen/progestogen therapy. Before entering the study and in three-months intervals total LDL, HDL cholesterol, triglycérides and VLDL were determined, as well School of Medicine, Belgrade as plasma fibrinogen prothrombin time, and activated partial thromboplastin time. Neither beneficial nor adverse effects of oestrogens on lipids and coagulation were observed during one-year follow-up in smokers, although subjects with longer smoking history had higher triglycérides levels after 12 months of therapy. On the contrary, oestrogen replacement reduced total and LDL cholesterol and increased HDL cholesterol in non-smokers, with no change in triglycérides and VLDL level. A decrease in fibrinogen levels and coagulation activity, expressed by protrombin time and partial thromboplastin time, were

  13. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

    Directory of Open Access Journals (Sweden)

    Mi Z

    2014-12-01

    Full Text Available Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA, are statistically conservative. Hsu’s multiple comparisons with the best (MCB – adapted from the Dunnett’s multiple comparisons with control (MCC – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM or generalized linear mixed models (GLMM, and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS, among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

  14. Temporal changes in cardiac function and cerebral blood flow during sequential postmenopausal hormone replacement

    DEFF Research Database (Denmark)

    Sørensen, M B; Fritz-Hansen, T; Jensen, H H

    2001-01-01

    and placebo in two 12-week periods. Temporal changes were measured by magnetic resonance flow mapping 8 times. RESULTS: Systemic vascular resistance was reduced during estradiol (-6.9%; P ... (maximum increase, 5.2%; P hormone replacement therapy (-37 mL/min; P =.01) but increased to baseline after...... the addition of norethindrone acetate. CONCLUSIONS: Sequential hormone replacement therapy is associated with changes in cardiac function, which are of therapeutic potential in cardiovascular disorders. Sequential hormone replacement therapy exhibits an overall neutral effect on cerebral blood flow....

  15. Effects of hormone replacement therapy on postmenopausal uterine myoma.

    Science.gov (United States)

    Colacurci, N; De Franciscis, P; Cobellis, L; Nazzaro, G; De Placido, G

    2000-05-29

    To evaluate the effects of sequential continuous hormone replacement therapy (HRT) on myoma size and on pulsatility index (PI) of uterine arteries and to verify the correlation between uterine artery flow impedance and the growth rate of myoma in women receiving HRT. In a prospective 1-year study 60 postmenopausal women were enrolled into three study-groups to receive continuous transdermal 17beta-oestradiol 0.05 mg/day plus nomegestrolo acetate 5 mg/day sequentially added: 20 patients (group A) unaffected by uterine myomas, 20 patients (group B) with single asymptomatic myoma 3 cm/14 cm3. The changes in myoma volume and in PI were assessed by means of transvaginal ultrasonographic scan every 3 months. The patients with myoma were divided into two subgroups: quiescent myoma (B1, C1) and growing myoma (B2, C2). No significant increase of uterine fibroids volume was found after 1-year HRT (24.14+/-20.02-->28.81+/-30.02 cm3). Six out of eight myomas growing during HRT belonged to group C. The uterine artery basal PI value of group A was significantly higher (P1.88+/-0.16) and C (1.59+/-0.28-->1.92+/-0.21). The baseline PI values in group B1 and C1 were significantly higher than the baseline values observed in group B2 and C2 (1.76+/-0.17 vs. 1.32+/-0.02, 1.76+/-0.16 vs. 1.24+/-0.08) and significantly lower than those observed in group A (2.39+/-0.47). After 3 months of HRT, the PI values were not significantly higher than the baseline values in groups B1 and C2 (1.76+/-0.17-->1.90+/-0.17; 1.24+/-0.08-->1.74+/-0.16), while they were significantly higher in group C1 (1.76+/-0.16-->2.01+/-0.17). Sequential continuous HRT does not increase the volume of the uterine myoma. The findings of very low resistance index in the uterine arteries of women with growing myoma may indicate the risk of growth of the neoplasia during HRT. The assessment of PI in the uterine arteries could be helpful in predicting the growth rate of the myomas before starting HRT.

  16. 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...

  17. Hormone replacement therapy and intima-media thickness of the common carotid artery: the Rotterdam study

    NARCIS (Netherlands)

    I.C.D. Westendorp (Iris); B.A. in 't Veld; M.L. Bots (Michiel); J.M. Akkerhuis (Jurgen); D.E. Grobbee (Diederick); J.C.M. Witteman (Jacqueline); A. Hofman (Albert)

    1999-01-01

    textabstractBACKGROUND AND PURPOSE: Observational data suggest that hormone replacement therapy (HRT) reduces morbidity and mortality from cardiovascular disease in healthy postmenopausal women. The mechanisms underlying this protection are not entirely clear but may

  18. Oral contraceptive use and hormone replacement therapy are associated with microalbuminuria

    NARCIS (Netherlands)

    Monster, TBM; Janssen, WMT; de Jong, PE; de Jong-van den Berg, LTW

    2001-01-01

    Background: Controversy exists regarding the adverse and beneficial effects of oral contraceptive use and hormone replacement therapy. Microalbuminuria is associated with increased risk of renal and cardiovascular disease. Objective: To examine the association between oral contraceptive use or

  19. TLR-4 mediated brain inflammation halts neurogenesis: Impact of hormonal replacement therapy

    National Research Council Canada - National Science Library

    Abdeslam eMouihate

    2014-01-01

    ...-estradiol is also endowed with proinflammatory properties. The aim of the present study is to assess the effect of hormonal replacement therapies on LPS-induced brain inflammation and its consequent effect on newly born...

  20. 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....

  1. 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.

  2. EFFECTS OF GROWTH HORMONE REPLACEMENT THERAPY ON THYROID FUNCTION TESTS IN GROWTH HORMONE DEFICIENT CHILDREN

    Directory of Open Access Journals (Sweden)

    H Moayeri

    2008-12-01

    Full Text Available "nThere are numerous, often contradictory reports on the effect of growth hormone (GH therapy on thyroid function. These reports prompted us to evaluate the impact of GH therapy on thyroid function in previously euthyroid children with GH deficiency. Twenty five clinically and biochemically euthyroid children with GH deficiency were studied. A thyroid profile (T4, Free T4, T3 and TSH was performed at baseline and 3, 6 and 12 months after GH therapy in 21 children with idiopathic growth hormone deficiency (group A and 4 children with organic GH deficiency (group B. We observed a significant reduction in serum T4 and free T4 concentrations during GH therapy in both groups (P < 0.01. No patient in group A had free T4 levels fell into the hypothyroid range, while in one of four patients in group B, free T4 value fell into the hypothyroid range during GH therapy. In both groups, no significant variation in serum TSH and T3 was recorded at any time. Our data suggest that GH therapy can introduce changes in thyroid function and so confirm the need of a careful monitoring of thyroid function in particular in children with organic GH deficiency during long-term GH therapy.

  3. Hormone Replacement Therapy and Menopause: A Review of Randomized, Double-Blind, Placebo-Controlled Trials

    Directory of Open Access Journals (Sweden)

    Chueh Chang

    2003-06-01

    Full Text Available Hormone replacement therapy (HRT is frequently prescribed to healthy women to ameliorate menopausal symptoms. HRT is used long term (≥ 1 year to prevent chronic disease in older women. The objective of this study was to review the benefits and risks of HRT and studies of menopause or HRT in Taiwan via a MEDLINE search. Recommendations are provided for future HRT research in Taiwan. Randomized, double-blind, placebo-controlled clinical trials are considered the gold standard of scientific evidence. A MEDLINE literature search (January 1966-July 2002 identified 23 papers on trials (≥ 1 year that met the inclusion criteria. The results showed that various HRT regimens used for more than 1 year caused more harm than good in healthy menopausal women and that there was no benefit for women with coronary artery disease, Alzheimer's disease, hysterectomy, hysterosalpingooophorectomy, and ischemic stroke. None of this research was conducted in Taiwan. A MEDLINE search using the key words “estrogen replacement therapy and menopause in Taiwan” identified 16 studies. There was only one, short-term, HRT trial. No evidence suggested benefits from long-term HRT in menopausal women in Taiwan.

  4. One year growth hormone replacement therapy does not alter colonic epithelial cell proliferation in growth hormone deficient adults

    NARCIS (Netherlands)

    Beentjes, JAM; van Gorkom, BAP; Sluiter, WJ; de Vries, Emma; Kleibeuker, JH; Dullaart, RPF

    OBJECTIVE Increased colonic epithelial cell proliferation has been found in various conditions associated with increased risk of colorectal cancer including acromegaly. In a placebo-controlled study we determined the effect of growth hormone (GH) replacement therapy in GH deficient adults on the

  5. [Pituitary functional recovery and hormone replacement therapy of patients with pituitary adenoma surgery].

    Science.gov (United States)

    Fu, Xiao-Hong; Xue, Xin-Cheng; Zhou, Pei-Zhi; Yin, Sen-Lin; Jiang, Shu

    2013-05-01

    To study the pituitary functional recovery of patients with pituitary adenoma surgery and to identify appropriate dosages of hormone replacement for those patients. Serum hormone levels of 187 patients with pituitary adenoma were detected before and after surgery. The lowest serum hormone levels were detected on the 3rd day after surgery (P pituitary adenoma experienced hypopituitarism shortly after surgery, especially for the elderly who recovered more slowly. Low dosage of hormone replacement therapy based on their symptoms can help the patients reach a stable level of hormone within three months. As a result, the 90th day after surgery can be regarded as a cut-off time for measuring functional recovery of glandula pituitaria.

  6. Menopause and hormone replacement therapy. The 2017 recommendations of the Italian Menopause Society.

    Science.gov (United States)

    Gambacciani, Marco; Biglia, Nicoletta; Cagnacci, Angelo; DI Carlo, Costantino; Caruso, Salvatore; Cicinelli, Ettore; DE Leo, Vincenzo; Farris, Manuela; Gambera, Alessandro; Guaschino, Secondo; Lanzone, Antonio; Paoletti, Anna M; Russo, Novella; Vicariotto, Franco; Villa, Paola; Volpe, Annibale

    2017-10-03

    In the last decade the risk benefits ratio of HRT has been reevaluated mainly in tens of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausel Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these Recommendations is to provide a simple and updated reference on postmenopausal HRT. The term HRT typically includes estrogen replacement therapy (ERT) and estrogen- progestogen therapy (EPT). EPT can be sequential (Seq) when progestogen is added to ERT for 10-14 days a month, or continuous combined (CC) when progestogen is administered continuously every day along with a fixed amount of estrogen, In the everyday language, HRT includes also Tibolone and the Tissue Selective Estrogen Complex (TSEC).

  7. Hormone replacement therapy and women with premature menopause--a cancer survivorship issue.

    Science.gov (United States)

    King, Judy; Wynne, Catherine Harper; Assersohn, Laura; Jones, Alison

    2011-07-01

    The importance of addressing survivorship issues has been emphasised in recent years. As cancer therapies improve there is a growing population of cancer survivors, which includes many women with premature menopause. Women who are premenopausal at the time of their cancer diagnosis may have specific survivorship issues to be addressed, including infertility, early menopause and sexual dysfunction. These factors can continue have a significant impact on the quality of life of these patients at long term follow up. Data for this Review were identified by searches of MEDLINE, PubMed, and references from relevant articles using the search terms 'HRT', 'women/female cancer/tumour', 'menopause' and 'survivorship'. Abstracts and reports from meetings were excluded. Only papers published in English between 1980 and 2010 were included. The aims of this review are to: • Address the hormonal factors which impact on cancer survivorship for premenopausal women • Review the debate for the role of hormone replacement therapy (HRT) in cancer survivors • Provide information for physicians and patients regarding the management of hormonally driven survivorship issues (for different tumour types), based on current evidence The recommendations for practice are that HRT may be offered for the alleviation of vasomotor symptoms in cancer survivors who undergo premature menopause up to the age of natural menopause (51 years in the UK). HRT (including vaginal oestrogen preparations) is contraindicated in survivors of oestrogen receptor positive breast cancer and low grade endometrial leiomyosarcoma, where non-HRT alternatives should be considered to alleviate symptoms. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  8. 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.

  9. 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.

  10. Hormone replacement therapy and the risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sjögren, Lea L; Mørch, Lina Steinrud; Løkkegaard, Ellen

    2016-01-01

    , 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......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...... 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...

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

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Hansen, Peter Riis; Abildstrøm, Steen Zabell

    2011-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: 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. HRT is not recommended for primary or secondary prevention of...... of coronary heart disease and guidelines recommend discontinuation of HRT after myocardial infarction (MI). It is unknown whether women actually discontinue HRT after MI.......WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: 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. HRT is not recommended for primary or secondary prevention...

  12. A case report of spontaneous pregnancy during hormonal replacement therapy for premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Mahbod Ebrahimi

    2011-01-01

    Full Text Available Background: Premature ovarian failure (POF is a common condition; its incidence is estimated to be as great as 1 in 100 by the age of 40 years. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function and pregnancy may occur rarely in women with POF. We report a case of POF who conceived during hormone replacement therapy.Case: A 30 years-old woman with confirmed POF after pelvic surgery and sever emotional stress conceived spontaneously.Conclusion: Return of ovarian function and achievement of pregnancy is possible in women with POF.

  13. 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...

  14. 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)

  15. 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.

  16. Allopathic and complementary alternatives to hormone replacement therapy.

    Science.gov (United States)

    Eichholz, Amy C; Mahavni, Vikas; Sood, Anil K

    2002-07-01

    Management of the menopause is a rapidly growing concern due to the ageing human population. The overall female lifespan has increased over the last century and up to a third of a woman's life is now spent in menopause. To that end, significant attention has been placed on maximising the quantity and quality of life in the menopausal years. The optimal management strategies are ones that are highly flexible and sensitive to an individual's expectations and concerns. Thus, while traditional oestrogen replacement therapy has been in place for > 20 years, there is now a greater interest in alternatives to this modality for those women who cannot or will not use it. This article reviews some of the alternative therapies that are being incorporated both in the allopathic and complementary medicine arenas.

  17. Therapy of hypoparathyroidism by replacement with parathyroid hormone

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Underbjerg, Line; Sikjaer, Tanja

    2014-01-01

    recently, continuous delivery of PTH by pump has appeared as a feasible alternative to injections. Plasma calcium levels do not fluctuate, urinary calcium is lowered, and bone turnover is only stimulated modestly (into the normal range). Further studies are needed to assess the long-term effects...

  18. 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

  19. Changes in the profile of lipoprotein subfractions associated with hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Vieira José Luiz da Costa

    2001-01-01

    Full Text Available OBJECTIVE: To report the effects of 2 regimens of hormone replacement therapy during the postmenopausal period on the profile of the major lipoprotein subfractions (HDL, LDL, and VLDL. METHODS: We carried out a cohort study in 38 postmenopausal patients who were starting their hormone replacement therapy due to gynecological indications, for a period of 12 weeks. Analysis of lipoprotein subclasses was performed through nuclear magnetic resonance spectroscopy. RESULTS: Hormone replacement therapy cause an increase in the proportion of larger subfractions of VLDL and HDL (p=0.008 and 0.03, respectively and in the proportion of larger particles of VLDL due to a 36% increase in the levels of larger particles (p=0.004, concomitantly with a 15% reduction in the levels of smaller particles (p=0.04. In regard to HDL, the increase occurred only a 17% increase in the levels of larger particles (p=0.002. No significant change occurred in the distribution pattern of LDL subfractions. CONCLUSION: The proportion of larger subfractions of VLDL and HDL increases after hormone replacement therapy. The increase in the proportion of larger particles of VLDL occurs due to an increase in the levels of the larger subclasses concomitantly with a reduction in the smaller particles. However, an increase in the proportion of larger particles of HDL occurs only due to an increase in the levels of the larger subfractions.

  20. 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...

  1. Hormone replacement therapy and risk of hip fracture: population based case-control study

    Science.gov (United States)

    Michaëlsson, Karl; Baron, John A; Farahmand, Bahman Y; Johnell, Olof; Magnusson, Cecilia; Persson, Per-Gunnar; Persson, Ingemar; Ljunghall, Sverker

    1998-01-01

    Objective: To determine the relative risk of hip fracture associated with postmenopausal hormone replacement therapy including the effect of duration and recency of treatment, the addition of progestins, route of administration, and dose. Design: Population based case-control study. Setting: Six counties in Sweden. Subjects: 1327 women aged 50-81 years with hip fracture and 3262 randomly selected controls. Main outcome measure: Use of hormone replacement therapy. Results: Compared with women who had never used hormone replacement therapy, current users had an odds ratio of 0.35 (95 % confidence interval 0.24 to 0.53) for hip fracture and former users had an odds ratio of 0.76 (0.57 to 1.01). For every year of therapy, the overall risk decreased by 6% (3% to 9%): 4% (1% to 8%) for regimens without progestin and 11% (6% to 16%) for those with progestin. Last use between one and five years previously, with a duration of use more than five years, was associated with an odds ratio of 0.27 (0.08 to 0.94). After five years without hormone replacement therapy the protective effect was substantially diminished (−7% to 48%). With current use, an initiation of therapy nine or more years after the menopause gave equally strong reduction in risk for hip fracture as an earlier start. Oestrogen treatment with skin patches gave similar risk estimates as oral regimens. Conclusions: Recent use of hormone replacement therapy is required for optimum fracture protection, but therapy can be started several years after the menopause. The protective effect increases with duration of use, and an oestrogen-sparing effect is achieved when progestins are included in the regimen. Key messages Hormone replacement therapy should be continued for long periods for optimal protection of hip fracture No overall substantial hip fracture protection remains after five years without hormone replacement therapy Therapy can be initiated several years after menopause without loss of fracture protection

  2. Growth hormone replacement delays the progression of chronic heart failure combined with growth hormone deficiency: an extension of a randomized controlled single-blind study.

    Science.gov (United States)

    Cittadini, Antonio; Marra, Alberto M; Arcopinto, Michele; Bobbio, Emanuele; Salzano, Andrea; Sirico, Domenico; Napoli, Raffaele; Colao, Annamaria; Longobardi, Salvatore; Baliga, Ragavendra R; Bossone, Eduardo; Saccà, Luigi

    2013-08-01

    This study sought to evaluate the efficacy and safety of long-term growth hormone (GH) replacement therapy in GH-deficient patients with chronic heart failure (CHF). Recent evidence indicates that growth hormone deficiency (GHD) affects as many as 40% of patients with CHF, and short-term GH replacement causes functional benefit. Whether long-term GH replacement also affects CHF progression is unknown. The study is an extension of a previous randomized, controlled single-blind trial that screened 158 consecutive CHF patients (New York Heart Association classes II to IV) and identified 63 who had GHD by the growth hormone releasing hormone plus arginine test. Fifty-six patients were randomized to receive either GH therapy or standard CHF therapy. Patients were evaluated at baseline and after a 4-year follow-up. The primary endpoint was peak oxygen consumption (VO2). Secondary endpoints included left ventricular (LV) ejection fraction and volumes, serum amino terminal fragment of the pro-hormone brain-type natriuretic peptide, quality of life, and safety. Seventeen patients in the GH group and 14 in the control group completed the study. In the GH group, peak VO2 improved over the 4-year follow-up. The treatment effect was 7.1 ± 0.7 ml/kg/min versus -1.8 ± 0.5 ml/kg/min in the GH and control groups, respectively. At 4 years, LV ejection fraction increased by 10 ± 3% in the GH group, whereas it decreased by 2 ± 5% in control patients. The treatment effect on LV end-systolic volume index was -22 ± 6 ml and 8 ± 3 ml/m(2) in the GH and control groups, respectively (all p < 0.001). No major adverse events were reported in the patients who received GH. Although this is a preliminary study, the finding suggests a new therapeutic approach to a large proportion of GHD patients with CHF. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. 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....

  4. Hormone replacement therapy and risk of new-onset atrial fibrillation after myocardial infarction - a nationwide cohort study

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Hansen, Peter Riis; Lindhardsen, Jesper

    2012-01-01

    Our aim was to assess the association between use of hormone replacement therapy (HRT) and risk of new-onset atrial fibrillation (AF) after myocardial infarction.......Our aim was to assess the association between use of hormone replacement therapy (HRT) and risk of new-onset atrial fibrillation (AF) after myocardial infarction....

  5. The effect of hormone replacement therapy on serum homocysteine levels in perimenopausal women : a randomized controlled trial

    NARCIS (Netherlands)

    Hak, AE; Bak, AAA; Lindemans, J; Planellas, J; Bennink, HJTC; Hofman, A; Grobbee, DE; Witteman, JCM

    2001-01-01

    Serum homocysteine levels may be lowered by hormone replacement therapy, but randomized controlled trial data are scarce. We performed a single center randomized placebo-controlled trial to assess the 6 months effect of hormone replacement therapy compared with placebo on fasting serum homocysteine

  6. Selective modulation of postmenopausal women: cutting the Gordian knot of hormone replacement therapy with breast carcinoma.

    Science.gov (United States)

    Diamanti-Kandarakis, Evanthia; Sykiotis, Gerasimos P; Papavassiliou, Athanasios G

    2003-01-01

    Hormone replacement therapy (HRT) has proven and presumable benefits for women desiring postmenopausal health preservation. Among HRT-associated risks, the fear of breast carcinoma intimidates women and physicians contemplating hormonal treatment and limits long-term compliance. Identifying effective alternative medications that are not associated with breast carcinoma or that even may prevent its development would be a major advance. This article discusses the clinical perspective of HRT and selective estrogen receptor modulators (SERMs) in light of the molecular and cellular mechanisms of estrogen and progesterone action on the breast. Emphasis is placed on the potential of selective receptor modulation as the future of postmenopausal treatment. Current epidemiologic evidence suggests that HRT is associated with a small but substantial increase in the risk of breast carcinoma, and combined estrogen-progesterone regimens further increase this hazard. Ample biologic data support this clinical association and propose multiple molecular mechanisms for the effects of estrogen and progesterone on breast cells. SERMs are a novel class of drugs that demonstrate estrogen agonistic and antagonistic actions in a tissue specific manner. SERMs act by binding the estrogen receptor and selectively modulating its effect on gene transcription at target tissues. SERMs offer an alternative to HRT that can successfully circumvent the intimidating side-effect of breast carcinoma. Further insight into the molecular mechanisms of SERM action may enable the development of agents with improved target-tissue selectivity. Identifying selective modulators with unique pharmacologic properties would facilitate the creation of individualized treatment for the postmenopausal woman according to her particular predisposition for menopause-related morbidities and her overall clinical profile. Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11049

  7. Dramatic change in prescribing of hormone replacement therapy in the Netherlands after publication of the Million Women Study : a follow-up study

    NARCIS (Netherlands)

    Faber, A; Bouvy, ML; Loskamp, L; van de Berg, PB; Egberts, TCG; de Jong-van den Berg, LTW

    2005-01-01

    Aims To estimate the diffusion of new safety information concerning postmenopausal hormonal replacement therapy (HRT) into prescribing practice in the Netherlands and to assess the impact of revised guidelines on the long-term treatment of HRT. Design Cross-sectional study. Setting Community

  8. Hormone replacement therapy may reduce the return of endogenous lead from bone to the circulation

    Energy Technology Data Exchange (ETDEWEB)

    Webber, C.E.; Beaumont, L.F.; Gordon, C.L. [McMaaster Univ., Hamilton, Ontario (Canada)] [and others

    1995-12-01

    Hormone replacement therapy (HRT) in postmenopausal women suppress the increase in bone resorption expected as circulating levels of endogenous estrogen decline. We tested the hypothesis that bone lead content might remain elevated in women on HRT. Fifty-six women who at recruitment were on average 3.5 years postmenopausal were placed on calcium supplementations. Six months later, 33 of these women were prescribed either low dose or moderate dose hormone replacement in addition to the calcium supplementation. After approximately 4 years of hormone replacement, lead content was measured at the tibia and calcaneus by in vivo fluorescence excitation, and lead concentrations were measured in serum, whole blood, and urine. Women not taking hormones had significantly lower lead concentrations in cortical bone compared to all women on HRT (p=0.007). Tibia lead content (mean {plus_minus} SD) for women on calcium only was 11.13 {plus_minus}6.22 {mu}g/g bone mineral. For women on HRT, tibia bone lead was 19.37 {plus_minus}8.62 {mu}g/g bone mineral on low-dose HRT and 16.87 {plus_minus} 11.68 {mu}g/g bone mineral on moderate-dose HRT. There were no differences between groups for lead concentrations measured in trabecular bone, whole blood, serum, or urine. Hormone replacement maintains cortical bone lead content. In women not on HRT, there will be a perimenopausal release of lead from bone. 27 refs., 1 fig., 1 tab.

  9. Growth hormone replacement normalizes impaired fibrinolysis: new insights into endothelial dysfunction in patients with hypopituitarism and growth hormone deficiency.

    Science.gov (United States)

    Miljic, D; Miljic, P; Doknic, M; Pekic, S; Stojanovic, M; Cvijovic, G; Micic, D; Popovic, V

    2013-12-01

    Cardiovascular morbidity in adult patients with growth hormone deficiency (GHD) and hypopituitarism is increased. Clustering of cardiovascular risk factors leading to endothelial dysfunction and impaired fibrinolysis has also been reported and may account for progression to overt vascular changes in these patients. However, effect of long lasting GH replacement therapy on fibrinolytic capacity in GH deficient patients has not been investigated so far. To investigate fibrinolysis before and after challenge with venous occlusion in GHD patients with hypopituitarism before and during one year of growth hormone replacement. Hospital based, interventional, prospective study. Twenty one patient with GHD and fourteen healthy control subjects matched for age, sex and body mass index (BMI). Anthropometric, metabolic and fibrinolytic parameters were measured at the start and after three, six and twelve months of treatment with human recombinant GH. At baseline GHD patients had significantly impaired fibrinolysis compared to healthy persons. During treatment with GH, significant changes were observed in insulin like growth factor 1(IGF-1) [from baseline 6.9(2.4-13.5) to 22.0(9.0-33.0) nmol/l after one month of treatment; pfibrinolysis. Improvement in fibrinolysis was mostly attributed to improvement of stimulated endothelial tissue plasminogen activator (t-PA) release in response to venous occlusion [from baseline 1.1(0.4-2.6) to 1.9(0.5-8.8) after one year of treatment; p<0.01]. Growth hormone replacement therapy has favorable effects on t-PA release from endothelium and net fibrinolytic capacity in GHD adults, which may contribute to decrease their risk of vascular complications. © 2013.

  10. 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.

  11. 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......, approximately one third reporting a positive and one-third a negative attitude....

  12. Doubling in the use of thyroid hormone replacement therapy in Denmark: association to iodization of salt?

    DEFF Research Database (Denmark)

    Cerqueira, Charlotte; Knudsen, Nils; Ovesen, Lars

    2011-01-01

    of salt was initiated in 1998 because of mild-to-moderate iodine deficiency. The aim of this study was to evaluate the effect of the raised iodine intake on the nationwide incident use of thyroid hormone replacement therapy (levothyroxine) to treat hypothyroidism. Data on all use of levothyroxine...... for caution when initiating iodine fortification programs to keep the intake within the optimal range, and the need for continuous monitoring....

  13. Medium term results of Avon patellofemoral joint replacement

    Directory of Open Access Journals (Sweden)

    Praveen K Sarda

    2011-01-01

    Conclusion: The Avon patellofemoral joint replacement provides predictably good results and excellent survivorship in the medium term, for isolated patellofemoral arthritis. However, progression of tibiofemoral arthritis remains unpredictable and therefore patient selection is crucial to ensure success. Clicking remains a potential problem and can compromise the postoperative results in upto 15% of the cases.

  14. Regaining lost youth: the controversial and colorful beginnings of hormone replacement therapy in aging.

    Science.gov (United States)

    Kahn, Arnold

    2005-02-01

    The quest for regaining lost youth seems to have existed since the beginning of recorded history and has taken many forms. One strategy that began in earnest in the latter part of the 19th century and continues to have enormous momentum today is based on the notion that by replacing internally secreted substances, that is, hormones, that decline with age, the vitality and physical attributes associated with youth can be regained. Although the approach remains highly controversial as, for example, in "anti-aging medicine," it is no more controversial than it was many years ago when the work of three high profile investigators, Charles Eduoard Brown-Séquard, Eugen Steinach, and Serge Voronoff set the basis for using this strategy. In the case of all three individuals, the therapies they developed received widespread attention (including ridicule) in the popular press, were spread rapidly by practitioners of questionable training and ethical motivation, and finally and relatively quickly disappeared from common use. However, and ultimately more importantly, in the process of developing and promoting their therapies, these individuals made important contributions to the origins of endocrinology, the biology of sex, and establishment of hormone replacement therapy. It remains to be seen whether contemporary efforts using hormone replacement therapy to blunt and reverse aging have the same fate as their predecessors and make comparable important contributions to biology and medicine.

  15. Growth hormone replacement therapy in adults with growth hormone deficiency; thrice weekly low dose administration.

    Science.gov (United States)

    Chung, Y. S.; Lee, H. C.; Hwang, S. K.; Paik, I. K.; Lee, J. H.; Huh, K. B.

    1994-01-01

    Recent reports on growth hormone (GH) therapy have shown that GH has various beneficial effects in GH deficient adults. In most of these studies, GH was administered daily. Because GH is still expensive and has to be delivered by subcutaneous injection, we studied the 6-month therapeutic effects of thrice weekly GH injection therapy and compared it with daily therapy. Twenty eight adult patients with GH deficiency were randomly assigned into group 1 (ten cases, thrice weekly injections of GH), group 2 (nine cases, daily injections), and group 3 (nine cases, placebo injections). Lean body mass, serum basal GH levels, and insulin-like growth factor 1 levels significantly increased after six months of GH therapy in both groups 1 and 2. According to computed tomography, the mean mid-thigh muscle mass significantly increased in group 1, while the visceral fat mass significantly decreased in group 2. GH levels significantly increased exercise rate-pressure product and hand grip strength only in group 1. These results suggest that thrice weekly injections of GH are as effective as daily injections in GH deficient adults. PMID:7986392

  16. 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

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

    NARCIS (Netherlands)

    Madalinska, Joanna B.; van Beurden, Marc; Bleiker, Eveline M. A.; Valdimarsdottir, Heiddis B.; Hollenstein, Judith; Massuger, Leon F.; Gaarenstroom, Katja N.; Mourits, Marian J. E.; Verheijen, Rene H. M.; van Dorst, Eleonora B. L.; van der Putten, Hans; van der Velden, Ko; Boonstra, Henk; Aaronson, Neil 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. 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

  19. Attitudes toward postmenopausal long-term hormone therapy.

    Science.gov (United States)

    Kolip, Petra; Hoefling-Engels, Nicole; Schmacke, Norbert

    2009-02-01

    In this article we address the question of why postmenopausal women undergo hormone therapy. Thirty-five women aged 46 to 75 years living in Bremen (Germany) and taking postmenopausal hormones for at least 12 months were interviewed. Following Fritz Schütze, the interviews were analyzed according to a reconstructive analytical procedure. Five different types of users were identified. They differed from each other in terms of their reasons for using hormones, their expectations of this type of therapy, and their personal habits and circumstances, including an integrity-preserving attitude, a performance-oriented attitude, a searching attitude, a faith-in-medicine attitude, and a benefit-generalizing attitude. The interviews show that there is a need for target-oriented counseling, taking into account the individual attitudes toward menopause and postmenopausal hormone therapy.

  20. Sleep architecture in Sheehan's syndrome before and 6 months after growth hormone replacement therapy.

    Science.gov (United States)

    Ismailogullari, Sevda; Tanriverdi, Fatih; Kelestimur, Fahrettin; Aksu, Murat

    2009-02-01

    To characterize the sleep parameters in patients with growth hormone (GH) deficiency in Sheehan's syndrome adults and to assess the effects of 6-month GH replacement therapy (GHRT). Twenty-two women with Sheehan's syndrome, (mean age; 49.1+/-2.2 years), and 12 women with similar age (mean age; 51.3+/-3.8 years) and body mass index as control subjects were included in the study. Under baseline conditions, women received adequate hormone replacement therapy for all hormonal deficiencies other than GH. Twelve patients received recombinant GH (Genotropin; Pfizer Stockholm, Sweden) (treatment group) and eight patients received placebo (placebo group) for 6 months. Two patients had only baseline evaluation and were not followed up prospectively. Two polysomnography (PSG) recordings were performed on the patients group, one in the baseline period and the other at the sixth month of treatment (either GH or placebo). Control group had only baseline PSG. GH deficient females with Sheehan's syndrome have more NREM (95.9+/-1.5% and 88.6+/-0.9%, respectively; psyndrome patients under baseline conditions.

  1. 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....

  2. Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Close Helen

    2012-05-01

    Full Text Available Abstract Background Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT. Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. Methods 51,182 menopausal women were identified using the UK General Practice Research Database between 1995–2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs were calculated for GORD and proton-pump inhibitor (PPI use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. Results In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18–1.89. Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03–1.74. Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01–2.22. Conclusions This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance.

  3. Book review of The Estrogen Elixir: A History of Hormone Replacement Therapy in America by Elizabeth Siegel Watkins

    Directory of Open Access Journals (Sweden)

    Sonnenschein Carlos

    2008-01-01

    Full Text Available Abstract The Estrogen Elixir: A History of Hormone Replacement Therapy in America by Elizabeth Siegel Watkins is a thoroughly documented cautionary tale of the information and advice offered to women in the perimenopausal period of their life, and the consequences of exposure to sexual hormones on their health and wellbeing.

  4. Obesity, type 2 diabetes and hormone replacement therapy vs. colorectal tumors in the elderly

    OpenAIRE

    Szamocka, Małgorzata; Ameryk, Monika; Meder, Agnieszka; Sokup, Alina; Świątkowski, Maciej

    2017-01-01

    Szamocka Małgorzata, Ameryk Monika, Meder Agnieszka, Sokup Alina, Świątkowski Maciej. Obesity, type 2 diabetes and hormone replacement therapy vs. colorectal tumors in the elderly. Journal of Education, Health and Sport. 2017;7(6):230-243. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.804629 http://ojs.ukw.edu.pl/index.php/johs/article/view/4530         The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1...

  5. 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.......04) and abdominal fat decreased (-185 g vs. +253 g, p = 0.04) during HRT compared with placebo. DISCUSSION: HRT is linked to the reversal of both menopause-related obesity and loss of lean mass, without overall change in body weight. The increase in lean body mass during HRT is likely explained by muscle anabolism...

  6. 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

  7. Receptors for thyrotropin-releasing hormone, thyroid-stimulating hormone, and thyroid hormones in the macaque uterus: effects of long-term sex hormone treatment.

    Science.gov (United States)

    Hulchiy, Mariana; Zhang, Hua; Cline, J Mark; Hirschberg, Angelica Lindén; Sahlin, Lena

    2012-11-01

    Thyroid gland dysfunction is associated with menstrual cycle disturbances, infertility, and increased risk of miscarriage, but the mechanisms are poorly understood. However, little is known about the regulation of these receptors in the uterus. The aim of this study was to determine the effects of long-term treatment with steroid hormones on the expression, distribution, and regulation of the receptors for thyrotropin-releasing hormone (TRHR) and thyroid-stimulating hormone (TSHR), thyroid hormone receptor α1/α2 (THRα1/α2), and THRβ1 in the uterus of surgically menopausal monkeys. Eighty-eight cynomolgus macaques were ovariectomized and treated orally with conjugated equine estrogens (CEE; n = 20), a combination of CEE and medroxyprogesterone acetate (MPA; n = 20), or tibolone (n = 28) for 2 years. The control group (OvxC; n = 20) received no treatment. Immunohistochemistry was used to evaluate the protein expression and distribution of the receptors in luminal epithelium, glands, stroma, and myometrium of the uterus. Immunostaining of TRHR, TSHR, and THRs was detected in all uterine compartments. Epithelial immunostaining of TRHR was down-regulated in the CEE + MPA group, whereas in stroma, both TRHR and TSHR were increased by CEE + MPA treatment as compared with OvxC. TRHR immunoreactivity was up-regulated, but THRα and THRβ were down-regulated, in the myometrium of the CEE and CEE + MPA groups. The thyroid-stimulating hormone level was higher in the CEE and tibolone groups as compared with OvxC, but the level of free thyroxin did not differ between groups. All receptors involved in thyroid hormone function are expressed in monkey uterus, and they are all regulated by long-term steroid hormone treatment. These findings suggest that there is a possibility of direct actions of thyroid hormones, thyroid-stimulating hormone and thyrotropin-releasing hormone on uterine function.

  8. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement.

    Science.gov (United States)

    Jonklaas, Jacqueline; Bianco, Antonio C; Bauer, Andrew J; Burman, Kenneth D; Cappola, Anne R; Celi, Francesco S; Cooper, David S; Kim, Brian W; Peeters, Robin P; Rosenthal, M Sara; Sawka, Anna M

    2014-12-01

    A number of recent advances in our understanding of thyroid physiology may shed light on why some patients feel unwell while taking levothyroxine monotherapy. The purpose of this task force was to review the goals of levothyroxine therapy, the optimal prescription of conventional levothyroxine therapy, the sources of dissatisfaction with levothyroxine therapy, the evidence on treatment alternatives, and the relevant knowledge gaps. We wished to determine whether there are sufficient new data generated by well-designed studies to provide reason to pursue such therapies and change the current standard of care. This document is intended to inform clinical decision-making on thyroid hormone replacement therapy; it is not a replacement for individualized clinical judgment. Task force members identified 24 questions relevant to the treatment of hypothyroidism. The clinical literature relating to each question was then reviewed. Clinical reviews were supplemented, when relevant, with related mechanistic and bench research literature reviews, performed by our team of translational scientists. Ethics reviews were provided, when relevant, by a bioethicist. The responses to questions were formatted, when possible, in the form of a formal clinical recommendation statement. When responses were not suitable for a formal clinical recommendation, a summary response statement without a formal clinical recommendation was developed. For clinical recommendations, the supporting evidence was appraised, and the strength of each clinical recommendation was assessed, using the American College of Physicians system. The final document was organized so that each topic is introduced with a question, followed by a formal clinical recommendation. Stakeholder input was received at a national meeting, with some subsequent refinement of the clinical questions addressed in the document. Consensus was achieved for all recommendations by the task force. We reviewed the following therapeutic

  9. Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement

    Science.gov (United States)

    Bianco, Antonio C.; Bauer, Andrew J.; Burman, Kenneth D.; Cappola, Anne R.; Celi, Francesco S.; Cooper, David S.; Kim, Brian W.; Peeters, Robin P.; Rosenthal, M. Sara; Sawka, Anna M.

    2014-01-01

    Background: A number of recent advances in our understanding of thyroid physiology may shed light on why some patients feel unwell while taking levothyroxine monotherapy. The purpose of this task force was to review the goals of levothyroxine therapy, the optimal prescription of conventional levothyroxine therapy, the sources of dissatisfaction with levothyroxine therapy, the evidence on treatment alternatives, and the relevant knowledge gaps. We wished to determine whether there are sufficient new data generated by well-designed studies to provide reason to pursue such therapies and change the current standard of care. This document is intended to inform clinical decision-making on thyroid hormone replacement therapy; it is not a replacement for individualized clinical judgment. Methods: Task force members identified 24 questions relevant to the treatment of hypothyroidism. The clinical literature relating to each question was then reviewed. Clinical reviews were supplemented, when relevant, with related mechanistic and bench research literature reviews, performed by our team of translational scientists. Ethics reviews were provided, when relevant, by a bioethicist. The responses to questions were formatted, when possible, in the form of a formal clinical recommendation statement. When responses were not suitable for a formal clinical recommendation, a summary response statement without a formal clinical recommendation was developed. For clinical recommendations, the supporting evidence was appraised, and the strength of each clinical recommendation was assessed, using the American College of Physicians system. The final document was organized so that each topic is introduced with a question, followed by a formal clinical recommendation. Stakeholder input was received at a national meeting, with some subsequent refinement of the clinical questions addressed in the document. Consensus was achieved for all recommendations by the task force. Results: We reviewed the

  10. Breast Cancer Suspicion in a Transgender Male-to-Female Patient on Hormone Replacement Therapy Presenting with Right Breast Mass: Breast Cancer Risk Assessment and Presentation of a Rare Lesion

    Directory of Open Access Journals (Sweden)

    Krystina Tongson

    2017-01-01

    Full Text Available There has been an increasing use of hormonal therapy among male-to-female (MtF transgender individuals. This long-term hormone replacement therapy (HRT renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy. The patient additionally had a strong family history of breast cancer. Final pathology revealed lobular hyperplasia in the setting of gynecomastia and pseudoangiomatous stromal hyperplasia (PASH. Both pathology findings are rare in biological females, let alone in the setting of hormone replacement therapy in a MtF individual. While the number of reported cases of suspicious breast lesions in this population remains scarce, it presents both a diagnostic and therapeutic challenge due to the nature of the treatment course and the lack of research in this recently growing subgroup of patients.

  11. The effect of hormone replacement on physical performance in community-dwelling elderly women.

    Science.gov (United States)

    Greenspan, Susan L; Resnick, Neil M; Parker, Robert A

    2005-11-01

    Our aim was to determine the effect of hormone replacement on physical performance measures, functional ability, physical activity, falls, and cognitive function in elderly women. Following a 3-month, open-label, run-in phase, we randomized 373 community-dwelling women aged 65 years and older to receive conjugated equine estrogen 0.625 mg/day plus or minus medroxyprogesterone 2.5 mg/day vs placebo for 3 years in a double-blind fashion. We assessed time to rise from a chair, timed walking, balance, Instrumental Activities of Daily Living, Physical Activity Scale of the Elderly, Folstein Mini-Mental State Examination, and falls. Over 3 years, except for balance scores, performance measures declined significantly (all PActivities of Daily Living (0.1, -0.1 to 0.3 points), Physical Activity Scale of the Elderly (-3, -15 to 8 points), Folstein Mini-Mental State Examination (-0.1, -0.3 to 0.3 points), or the proportion of participants reporting falls (-1, -11 to 9%). In elderly women, hormone replacement had no statistically significant effect on cognition or balance, nor did it prevent the age-related decline in physical measures of mobility, ability to rise from a chair, self-reported activities of daily living, physical activity scores, or falls.

  12. Effectiveness of Compounded Bioidentical Hormone Replacement Therapy: An Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    Daniels Kelly R

    2011-06-01

    Full Text Available Abstract Background Bioidentical Hormone Replacement Therapy (BHRT is believed it to be a safer and equally effective alternative to Conventional Hormone Therapy for the relief of menopausal symptoms; however, data are needed to support these claims. The objective of this study is to evaluate the effectiveness of compounded BHRT provided in six community pharmacies. Methods This was an observational cohort study of women between the ages of 18-89 who received a compounded BHRT product from January 1, 2003 to April 30, 2010 in six community pharmacies. Data included patient demographics, comorbidities, therapeutic outcomes, and hormone therapies. Women self-rated menopausal symptoms as absent, mild, moderate, or severe. Descriptive statistics were used to characterize the patient population, BHRT use, and adverse events. Patient symptom severity was compared at baseline and 3 to 6 months follow-up using the Wilcoxon signed-rank test. Results Women (n = 296 receiving BHRT at Oakdell Pharmacy had a mean (standard deviation age of 52 (9 years. The most common BHRT dosage forms utilized were topical (71% and oral (43%. Compounded BHRT regimens were generally initiated at low doses regardless of route. Women experienced a 25% decrease in emotional lability (p Conclusions This study demonstrates that compounded BHRT improves mood symptoms. Larger studies are needed to examine the impact on vasomotor symptoms, myocardial infarction and breast cancer.

  13. [Menopause in 2004: "hormone replacement therapy" is not what it used to be anymore].

    Science.gov (United States)

    Azoulay, C

    2004-11-01

    The data concerning post-menopausal hormone replacement therapy (HRT) were recently completely modified. The aim of this review is to present the last studies about post-menopausal HRT and to describe new alternatives to this treatment. In May 2002, the women's health initiative (WHI) trial of post-menopausal HRT was interrupted earlier than expected. The studied hormonal formulation in this arm of the WHI trial was the association of conjugated equine estrogens and medroxyprogesterone. The reason for termination was an increased risk of breast cancer and myocardial infarction in the hormone-therapy group. Later, reports confirmed that this type of HRT could not be used any more for the primary prevention of coronary heart disease even if the absolute risk remained low. There is an increased risk for venous thromboembolism with post-menopausal estroprogestative replacement. This risk does not seem to exist with transdermal estrogens. The other WHI findings concerned the lack of protection against dementia and cognitive decline. On the contrary, osteoporotic hip fractures and colorectal cancers were reduced in the treated group. In April 2004, the estrogen only arm of the same WHI study was also prematurely interrupted because of an increase in the incidence of stroke. The risk of breast cancer was on the contrary not increased after 6.8 years, raising the question of the eventual role of progestins. The impact of the WHI trial on clinical practice was very important since then. The "Agence Francaise de sécurité sanitaire des produits de santé" (AFSSAPS) edited in May 2004 a public recommendation limiting indication for HRT to patients with severe climacteric symptoms. The treatment must now be prescribed for the shortest time and at the minimal dose. The patient has to be precisely informed about the risks with HRT and the practitioner has to re-evaluate his prescription annually. Hormonal or non-hormonal alternatives have also to be considered as phytoestrogens

  14. Abnormal imaging findings of the breast related to hormone replacement therapy: analysis of surgically excised cases

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Woo Kyung; Cha, Joo Hee; Cho, Kyung Soo; Choi, Een Wan; Lee, Yu Jin; Im, Jung Gi [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Kim, Hyung Seok [Wooridul Spine Hospital, Seoul (Korea, Republic of); Chung, Sun Yang [Bundang CHA General Hospital, Sungnam (Korea, Republic of); Cho, Nariya [Gil Medical Center, Incheon (Korea, Republic of)

    2004-02-01

    To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between to two groups. Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcifications, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p<0.001), smaller (17 mm vs 24 mm, p<0.01), showed microcalcification only (20% vs 13%; p<0.05), and were intraductal (20% vs 7%; p<0.01). In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with

  15. 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.

  16. Effect of growth hormone replacement therapy on plasma lecithin : cholesterol acyltransferase and lipid transfer protein activities in growth hormone-deficient adults

    NARCIS (Netherlands)

    Beentjes, JAM; van Tol, A; Sluiter, WJ; Dullaart, RPF

    The effects of growth hormone (GH) replacement on plasma lecithin:cholesterol acyltransferase (LCAT), cholesteryl ester transfer protein (CETP), and phospholipid transfer protein (PLTP), factors involved in high density lipoprotein (HDL) metabolism, We unknown. We carried out a 6 mouths study in 24

  17. The effect of growth hormone replacement on the thyroid axis in patients with hypopituitarism: in vivo and ex vivo studies.

    Science.gov (United States)

    Glynn, Nigel; Kenny, Helena; Quisenberry, Leah; Halsall, David J; Cook, Paul; Kyaw Tun, Tommy; McDermott, John H; Smith, Diarmuid; Thompson, Christopher J; O'Gorman, Donal J; Boelen, Anita; Lado-Abeal, Joaquin; Agha, Amar

    2017-05-01

    Alterations in the hypothalamic-pituitary-thyroid axis have been reported following growth hormone (GH) replacement. The aim was to examine the relationship between changes in serum concentration of thyroid hormones and deiodinase activity in subcutaneous adipose tissue, before and after GH replacement. A prospective, observational study of patients receiving GH replacement as part of routine clinical care. Twenty adult hypopituitary men. Serum TSH, thyroid hormones - free and total thyroxine (T4) and triiodothyronine (T3) and reverse T3, thyroglobulin and thyroid-binding globulin (TBG) levels were measured before and after GH substitution. Changes in serum hormone levels were compared to the activity of deiodinase isoenzymes (DIO1, DIO2 and DIO3) in subcutaneous adipose tissue. The mean daily dose of growth hormone (GH) was 0·34 ± 0·11 mg (range 0·15-0·5 mg). Following GH replacement, mean free T4 levels declined (-1·09 ± 1·99 pmol/l, P = 0·02). Reverse T3 levels also fell (-3·44 ± 1·42 ng/dl, P = 0·03) and free T3 levels increased significantly (+0·34 ± 0·15 pmol/l, P = 0·03). In subcutaneous fat, DIO2 enzyme activity declined; DIO1 and DIO3 activities remained unchanged following GH substitution. Serum TSH, thyroglobulin and TBG levels were unaltered by GH therapy. In vitro analysis of subcutaneous adipose tissue from hypopituitary human subjects demonstrates that GH replacement is associated with significant changes in deiodinase isoenzyme activity. However, the observed variation in enzyme activity does not explain the changes in the circulating concentration of thyroid hormones induced by GH replacement. It is possible that deiodinase isoenzymes are differentially regulated by GH in other tissues including liver and muscle. © 2016 John Wiley & Sons Ltd.

  18. Alternatives to hormone replacement therapy: a multi-method study of women's experiences.

    Science.gov (United States)

    Wathen, C Nadine

    2006-09-01

    To explore women's decision-making regarding use of complementary and alternative medicines (CAM) during menopause. Qualitative interviews were conducted with 20 women who were currently or had previously used hormone replacement therapy (HRT), including questions about their experiences with alternatives to HRT. This was followed by a non-random questionnaire survey of 285 demographically representative Canadian women aged 45-65 who were current or former HRT users. Fifty-seven percent (57%, n = 162) of women reported either having used or considered a CAM approach for menopause. Women who had tried or considered CAM were significantly younger (mean age = 54.9 years versus 56.8 years; t(280) = 3.4, p menopause-specific symptoms than those who had not, and these women also reported a worse experience of menopause overall. : A majority of menopausal women in the current study considered or tried CAM alternatives to HRT.

  19. 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

    . Recent studies originating from both the USA and Europe suggest that the combined treatment regimens with estrogen and progestin increase the risk of breast cancer beyond the risk following the use of unopposed estrogen. At present it is not known if progestins with different androgenicity influence......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...

  20. 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...... was established in 1993, where all female nurses aged 45 years and above received a mailed questionnaire (n = 23,178). A total of 19,898 women returned the questionnaire (86%). The questionnaire included information on HRT types and regimens, reproductive history and lifestyle-related factors. Breast cancer cases...... performed using Cox proportional hazards model. A total of 244 women developed breast cancer during follow-up. After adjustment for confounding factors, an increased risk of breast cancer was found for the current use of estrogen only (RR = 1.96; 95% CI = 1.16-3.35), for the combined use of estrogen...

  1. 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...... bleeding were recruited from a random sample of the background population. Mean age was 50. 8+/-2.8 years, and the number of person years followed was 9335.3. There were two main study arms: a randomised arm (randomised to HRT; n=502, or not; n=504) and a non-randomised arm (on HRT; n=221, or not; n=789...... by own choice). First line HRT was oral sequential oestradiol/norethisterone in women with intact uterus and oral continuous oestradiol in hysterectomised women. RESULTS: After five years, a total of 156 fractures were sustained by 140 women. There were 51 forearm fractures in 51 women. By intention...

  2. Regional-specific effects of ovarian hormone loss on synaptic plasticity in adult human APOE targeted replacement mice.

    Directory of Open Access Journals (Sweden)

    Rebecca C Klein

    Full Text Available The human apolipoprotein ε4 allele (APOE4 has been implicated as one of the strongest genetic risk factors associated with Alzheimer's disease (AD and in influencing normal cognitive functioning. Previous studies have demonstrated that mice expressing human apoE4 display deficits in behavioral and neurophysiological outcomes compared to those with apoE3. Ovarian hormones have also been shown to be important in modulating synaptic processes underlying cognitive function, yet little is known about how their effects are influenced by apoE. In the current study, female adult human APOE targeted replacement (TR mice were utilized to examine the effects of human APOE genotype and long-term ovarian hormone loss on synaptic plasticity in limbic regions by measuring dendritic spine density and electrophysiological function. No significant genotype differences were observed on any outcomes within intact mice. However, there was a significant main effect of genotype on total spine density in apical dendrites in the hippocampus, with post-hoc t-tests revealing a significant reduction in spine density in apoE3 ovariectomized (OVX mice compared to sham operated mice. There was also a significant main effect of OVX on the magnitude of LTP, with post-hoc t-tests revealing a decrease in apoE3 OVX mice relative to sham. In contrast, apoE4 OVX mice showed increased synaptic activity relative to sham. In the lateral amygdala, there was a significant increase in total spine density in apoE4 OVX mice relative to sham. This increase in spine density was consistent with a significant increase in spontaneous excitatory activity in apoE4 OVX mice. These findings suggest that ovarian hormones differentially modulate synaptic integrity in an apoE-dependent manner within brain regions that are susceptible to neurophysiological dysfunction associated with AD.

  3. Influences of hormone replacement therapy on olfactory and cognitive function in postmenopausal women.

    Science.gov (United States)

    Doty, Richard L; Tourbier, Isabelle; Ng, Victoria; Neff, Jessica; Armstrong, Deborah; Battistini, Michelle; Sammel, Mary D; Gettes, David; Evans, Dwight L; Mirza, Natasha; Moberg, Paul J; Connolly, Tim; Sondheimer, Steven J

    2015-06-01

    Olfactory dysfunction can be an early sign of Alzheimer's disease. Since hormone replacement therapy (HRT) may protect against Alzheimer's disease in postmenopausal women, the question arises as to whether it also protects against olfactory dysfunction in such women. A total of three olfactory and 12 neurocognitive tests were administered to 432 healthy postmenopausal women with varied HRT histories. Serum levels of reproductive hormones were obtained for all subjects; APOE-ε4 haplotype was determined for 77 women. National Adult Reading Test and Odor Memory/Discrimination Test scores were positively influenced by HRT. Odor Identification and Odor Memory/Discrimination Test scores were lower for women who scored poorly on a delayed recall test, a surrogate for mild cognitive impairment. The Wechsler Adult Intelligence Scale, Revised, as a Neuropsychological Instrument Spatial Span Backwards Test scores were higher in women receiving estrogen and progestin HRT and directly correlated with serum testosterone levels, the latter implying a positive effect of testosterone on spatial memory. APOE-ε4 was associated with poorer odor threshold test scores. These data suggest that HRT positively influences a limited number of olfactory and cognitive measures during menopause. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. INFLUENCES OF HORMONE REPLACEMENT THERAPY ON OLFACTORY AND COGNITIVE FUNCTION IN THE MENOPAUSE

    Science.gov (United States)

    Doty, Richard L.; Tourbier, Isabelle; Ng, Victoria; Neff, Jessica; Armstrong, Deborah; Battistini, Michelle; Sammel, Mary D.; Gettes, David; Evans, Dwight L.; Mirza, Natasha; Moberg, Paul J.; Connolly, Tim; Sondheimer, Steven J.

    2015-01-01

    Olfactory dysfunction can be an early sign of Alzheimer’s disease (AD). Since hormone replacement therapy (HRT) may protect against developing AD in postmenopausal women, the question arises as to whether it also protects against olfactory dysfunction in such women. Three olfactory and 12 neurocognitive tests were administered to 432 healthy postmenopausal women with varied HRT histories. Serum levels of reproductive hormones were obtained for all subjects; APOE-ε4 haplotype was determined for 77. National Adult Reading Test and Odor Memory/Discrimination Test (OMT) scores were positively influenced by HRT. Odor identification and OMT test scores were lower for women who scored poorly on a delayed recall test, a surrogate for mild cognitive impairment. WAIS-R NI Spatial Span Backwards Test scores were higher in women receiving estrogen plus progestin HRT and directly correlated with serum testosterone levels, the latter implying a positive effect of testosterone on spatial memory. APOE-ε4 was associated with poorer odor threshold test scores. These data suggest that HRT positively influences a limited number of olfactory and cognitive measures in the menopause. PMID:25850354

  5. 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 

  6. Differential effects of raloxifene and estrogen on body composition in growth hormone-replaced hypopituitary women.

    LENUS (Irish Health Repository)

    Birzniece, Vita

    2012-03-01

    GH deficiency causes reduction in muscle and bone mass and an increase in fat mass (FM), the changes reversed by GH replacement. The beneficial effects of GH on fat oxidation and protein anabolism are attenuated more markedly by raloxifene, a selective estrogen receptor modulator, compared with 17β-estradiol. Whether this translates to a long-term detrimental effect on body composition is unknown.

  7. The effect of growth hormone (GH) replacement on muscle strength in patients with GH-deficiency: a meta-analysis.

    LENUS (Irish Health Repository)

    Widdowson, W Matthew

    2012-02-01

    CONTEXT\\/OBJECTIVES: GH replacement increases muscle mass and reduces body fat in growth hormone deficiency (GHD) adults. A recent meta-analysis has demonstrated that this improvement in body composition is associated with improved exercise performance. The current meta-analysis was carried out to determine whether high-quality evidence exists to support a beneficial effect of GH replacement on strength. DESIGN\\/METHODS: An extensive Medline search\\/literature review identified eight studies with utilizable, robust data, involving 231 patients in nine cohorts. Previously unpublished data were sought from authors and obtained in two cases. All studies included were randomized, double-blind, placebo-controlled, of parallel or cross-over design and of an average 6.7 months duration. Information was retrieved in uniform format, with data pertaining to patient numbers, study-design, GH-dose, mean age, IGF-I levels and muscle strength measurements (isometric or isokinetic quadriceps strength) recorded. Data were analysed using a fixed-effects model, utilizing continuous data measured on different scales. A summary effect measure (d(s)) was derived for individual strength variables, whereas an overall summary effect was derived from the sum of all studies incorporating different variables; 95% CIs were calculated from the weighted variances of individual study effects. RESULTS: Analysis revealed no significant improvement, neither when all studies were combined (d(s) = +0.01 +\\/- 0.26) nor when measured individually (isometric quadriceps strength, d(s) = +0.02 +\\/- 0.32 and isokinetic quadriceps strength, d(s) = 0.00 +\\/- 0.45). CONCLUSIONS: Evidence from short-term controlled studies fails to support a benefit on muscle strength of GH replacement in GHD patients, which is likely to occur over a longer time-course, as seen in open-label studies.

  8. 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...... the fracture risk....

  9. 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

  10. Progestins used in hormonal replacement therapy display different effects in coronary arteries from New Zealand white rabbits

    DEFF Research Database (Denmark)

    Pedersen, Nina G; Pedersen, Susan H; Dalsgaard, Tórur

    2004-01-01

    OBJECTIVES: The aim of this study was in an animal model to assess the vascular effects of different progestins commonly used in hormonal replacement treatment. METHODS: Fifty-six non-atherosclerotic, ovariectomized New Zealand white rabbits were randomized into seven groups: (1) medroxyprogester......OBJECTIVES: The aim of this study was in an animal model to assess the vascular effects of different progestins commonly used in hormonal replacement treatment. METHODS: Fifty-six non-atherosclerotic, ovariectomized New Zealand white rabbits were randomized into seven groups: (1......) medroxyprogesterone acetate (MPA), (2) norethisterone acetate (NETA), (3) conjugated equine estrogens (CEE), (4) 17-beta-estradiol (E2), (5) MPA+CEE , (6) NETA+E2 , (7) or placebo (n=8) and given hormonal treatment through the diet for 4 weeks. Ring segments from the left proximal coronary artery and from the distal...

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

    Directory of Open Access Journals (Sweden)

    Fiona Chew

    Full Text Available 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.

  12. 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.

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

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    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.

  14. When is it safe to switch from oral contraceptives to hormonal replacement therapy?

    Science.gov (United States)

    Castracane, V D; Gimpel, T; Goldzieher, J W

    1995-12-01

    Women may continue to use oral contraceptives (OCs) into their 40's and 50's, but to date no method has been evaluated to ascertain their ovarian status, i.e., whether fertility and estrogen production have diminished sufficiently so they could be safely switched to hormonal replacement therapy. A group of 12 postmenopausal women who had been, for long periods of time, on a regimen of 3 back-to-back packages (i.e., 63 days on, 7 days off) of low-dose oral contraceptives have been studied. Secondly, a group of 9 perimenopausal women aged 36 to 47 were examined in the same manner. The third group consisted of early reproductive age women (arbitrarily divided into subsets aged 17-25 and 26-35 using low-dose OCs in the customary regimen) as normal controls. Blood samples were obtained on the last day of a pill cycle and at 7 days off the pill. In some menopausal women, blood samples were obtained at both 7 and 14 days off OCs. Serum was assayed by RIA for estradiol, FSH and LH. As expected in the young reproductive age women, estradiol levels increase at one week off the pill, together with a rebound in FSH and LH to follicular phase levels. In the perimenopausal group, there was a sharp distinction based on age. The women over 40 showed a more marked rise in FSH while those aged 36-40 showed a distinctly lesser response. Estradiol levels were variable, but tended to show some age grouping. Little diagnostic separation was observed for LH. In postmenopausal women, FSH levels were not always elevated at one week post-pill, and even in a second trial with sampling at one and two weeks off the OC, not all postmenopausal women showed a "menopausal" increase in FSH. The more uniform feature was that estradiol levels never increased above basal values. The study found that serum estradiol levels increase after a week off the pill in controls, but are unchanged at one and two weeks in the menopausal group. FSH levels rebound normally in reproductive age women and usually, but

  15. Effect of hormone replacement therapy on cardiovascular outcomes: a meta-analysis of randomized controlled trials.

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    Dicheng Yang

    Full Text Available BACKGROUND: Hormone replacement therapy (HRT is widely used to controlling menopausal symptoms and prevent adverse cardiovascular events. However, the benefit and risk of HRT on cardiovascular outcomes remains controversial. METHODOLOGY AND PRINCIPAL FINDINGS: We systematically searched the PubMed, EmBase, and Cochrane Central Register of Controlled Trials databases for obtaining relevant literature. All eligible trials reported on the effects of HRT on cardiovascular outcomes. We did a random effects meta-analysis to obtain summary effect estimates for the clinical outcomes with use of relative risks calculated from the raw data of included trials. Of 1903 identified studies, we included 10 trials reporting data on 38908 postmenopausal women. Overall, we noted that estrogen combined with medroxyprogesterone acetate therapy as compared to placebo had no effect on coronary events (RR, 1.07; 95%CI: 0.91-1.26; P = 0.41, myocardial infarction (RR, 1.09; 95%CI: 0.85-1.41; P = 0.48, stroke (RR, 1.21; 95%CI: 1.00-1.46; P = 0.06, cardiac death (RR, 1.19; 95%CI: 0.91-1.56; P = 0.21, total death (RR, 1.06; 95%CI: 0.81-1.39; P = 0.66, and revascularization (RR, 0.95; 95%CI: 0.83-1.08; P = 0.43. In addition, estrogen therapy alone had no effect on coronary events (RR, 0.93; 95%CI: 0.80-1.08; P = 0.33, myocardial infarction (RR, 0.95; 95%CI: 0.78-1.15; P = 0.57, cardiac death (RR, 0.86; 95%CI: 0.65-1.13; P = 0.27, total mortality (RR, 1.02; 95%CI: 0.89-1.18; P = 0.73, and revascularization (RR, 0.77; 95%CI: 0.45-1.31; P = 0.34, but associated with a 27% increased risk for incident stroke (RR, 1.27; 95%CI: 1.06-1.53; P = 0.01. CONCLUSION/SIGNIFICANCE: Hormone replacement therapy does not effect on the incidence of coronary events, myocardial infarction, cardiac death, total mortality or revascularization. However, it might contributed an important role on the risk of incident stroke.

  16. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma

    Science.gov (United States)

    Lee, Cheng-Chi; Chen, Chung-Ming; Lee, Shih-Tseng; Wei, Kuo-Chen; Pai, Ping-Ching; Toh, Cheng-Hong; Chuang, Chi-Cheng

    2015-01-01

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective study. All patients underwent transsphenoidal surgery. Hypogonadism was defined as total serum testosterone levels of operative magnetic resonance images. We prescribed testosterone to patients with defined hypogonadism or clinical symptoms of hypogonadism. Hormone replacement for longer than 1 year was considered as long-term therapy. The need for long-term post-operative testosterone replacement was significantly associated with larger pre-operative tumor volume (p = 0.0067), and lower pre-operative testosterone level (p = 0.0101). There was no significant difference between the gross total tumor resection and subtotal resection groups (p = 0.1059). The pre-operative tumor volume and testosterone level impact post-operative hypogonadism. By measuring the tumor volume and the testosterone level and by performing adequate tumor resection, surgeons will be able to predict post-operative hypogonadism and the need for long-term hormone replacement. PMID:26537232

  17. Effects of hormone replacement therapy on cognitive performance in elderly women.

    Science.gov (United States)

    Binder, E F; Schechtman, K B; Birge, S J; Williams, D B; Kohrt, W M

    2001-04-20

    To determine the effects of 9 months of hormone replacement therapy (HRT) on cognitive performance in women aged 75 years and older. A 9-month randomized, double-blinded, placebo-controlled parallel trial. Fifty-two elderly postmenopausal women (age range 75-91 years) without known contraindications to HRT or evidence of dementia or depression were enrolled. Participants were randomly assigned in a 1:2 ratio to placebo or conjugated estrogens at 0.625 mg/d plus trimonthly medroxyprogesterone acetate at 5 mg/d for 13 days (HRT). Main outcome measures were change from baseline and rate of change from baseline for the following psychometric tests: Verbal Fluency Test, Weschler Paired Associate Learning and 20 min Delayed Recall, Trailmaking A and B Tests, Cancellation Random Letter and Random Form Tests. At baseline, women in the HRT group reported a younger age of onset of menopause and a higher prevalence of hysterectomy, but otherwise did not differ from women in the placebo group. After 9 months of treatment, there were no significant group differences for any of the cognitive performance measures. The lack of an observed group-by-time difference for all cognitive tests remained after controlling for age of onset of menopause, education, and previous hysterectomy. Although conclusions are limited by small sample size and the relatively short duration of treatment, results suggest that 9 months of estrogen replacement in combination with trimonthly progestin does not improve cognitive performance in women over 75 years who do not have dementia or depression.

  18. Hormone replacement therapy after breast cancer: attitudes of women eligible in a randomized trial.

    Science.gov (United States)

    Wallberg, B; von Schoultz, E; Bolund, C; Bergh, J; Wilking, N

    2009-12-01

    Objectives To investigate the attitudes of breast cancer patients who accepted or declined participation in a randomized trial with hormone replacement therapy that might increase their risk of recurrence (the Stockholm trial). Methods A total of 115 patients free from breast cancer recurrence were interviewed; 57 were participants and 58 were non-participants in the Stockholm trial. Patients answered five questionnaires regarding information needs (two), attitudes to participation in trials (two) and patient role in treatment decisions (one). Results Participants in the Stockholm trial had a lower risk of breast cancer recurrence (measured by node-positive disease and tumor size) and were older than non-participants. Their information needs were the same. Participants in the trial were more prepared to accept uncertainty, to have an altruistic attitude, to accept risks including an increased risk of recurrence of breast cancer, if their quality of life or general health was improved. Most patients preferred a collaborative role in relation to their physician but participants often wanted more influence than they had in treatment decisions. Conclusion A patient's decision to accept or decline participation in the Stockholm trial was influenced by her objective risk of breast cancer recurrence and reflected her attitude to risk, uncertainty and preference to be active in treatment decisions.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Jong-Myon Bae

    2015-09-01

    Full Text Available 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.

  1. Quantification of apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT).

    Science.gov (United States)

    Terzea, Dana; Iosif, Cristina; Vasilescu, Florina; Andrei, F; Dobrea, Camelia; Nicolae, Alina; Georgescu, Alina; Mircea, F; Ceauşu, M; Vişan, Ariana; Mihai, Mihaela; Ardeleanu, Carmen

    2007-01-01

    To quantify the apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT). The study lot consisted of 30 endometrial biopsies on which we studied the apoptotic phenomenon through morphological and molecular biology techniques (TUNEL reaction). Examination of endometrial biopsies before and post-therapeutically has been made. From morphological point of view, pre-therapeutically, endometrial biopsies presented apoptotic changes in about 1-3% of cells and under TSH there have been observed apoptotic changes in about 1-2% of cells. In female reproductive system, we found out a raised rate of cellular proliferation and concurrently a raised rate of apoptosis. Apoptotic phenomenon can be observed in endometrium at every menstrual cycle. In proliferative endometrium apoptosis rate is low, but in endometrial carcinoma apoptosis rate grow up. Bcl2 and Bax are expressing in normal and hyperplastic endometrium, but in endometrial carcinoma Bcl2/Bax ratio decline. Quantification of apoptosis, using morphological and TUNEL reaction methods, on endometrial biopsies in postmenopausal patients before and after therapy indicate a low rate of apoptotic phenomenon.

  2. 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.

  3. PERİODONTAL TREATMENT OUTCOMES IN POST MENOPAUSAL WOMEN RECEIVING HORMONE REPLACEMENT THERAPY

    Directory of Open Access Journals (Sweden)

    Ali ÇEKİCİ

    2015-10-01

    Full Text Available Purpose: To evaluate the effect of hormone replacement therapy(HRT on periodontal treatment outcomes in a group of postmenopausal women with periodontitis. Materials and Methods: 23 post-menopausal chronic periodontitis patients were included in this study. The test group(n=11 consisted of women who started HRT with this study and received conjugated estrogen and medroxyprogesteron. The control group(n=12 was women not taking any HRT or supplement therapy. Study groups received the same periodontal treatment. All subjects examiend by recording the following: plaque index (PI, sulcus bleeding index (SBI, periodontal pocket depth (PD and relative attachment level (RAL from 6 sites in each tooth. Measurements were recorded at the baseline, 1 month, 3 months, and 6 months following periodontal treatment. Serum estrogene level and bone mineral density was recorded at baseline and 6 months following periodontal treatment. Results: The GI change was greater in the control group. There wasn’t significant difference by means of PD, the attachment gain was significantly greater in the HRT receiving group. Conclusion: HRT seems to have a positive effect on periodontal treatment outcomes.

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

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    Mansur Rahnama

    2015-01-01

    Full Text Available Background. 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. Material and Methods. 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. Results. 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. Conclusions. 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.

  5. Beneficial Effects on Pregnancy Outcomes of Thyroid Hormone Replacement for Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Norman J. Blumenthal

    2017-01-01

    Full Text Available Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH (serum TSH > 2.5 mIU/L and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2.5 mIU/L. Study Design. This prospective observational study was undertaken between 2013 and 2016. Blood samples were taken from 1025 women at presentation for thyroid stimulating hormone (TSH, anti-thyroglobulin antibodies (TGAb, and thyroid peroxidase antibodies (TPOAb. Those with a TSH > 2.5 mIU/L were treated with thyroxine and managed appropriately to ensure that the TSH was maintained ≤2.5 mIU/L. Outcomes in these patients were compared to those in euthyroid patients. Maternal antenatal complications and perinatal outcomes were recorded. Results. There were a total of 1025 patients of whom 382 (37.5% were nulliparous. 10.1% had a TSH level > 2.5 mIU/L and 18.2% had at least one raised thyroid antibody level. No differences in adverse outcomes of pregnancy were evident in women treated for SCH or overt hypothyroidism compared to the euthyroid group. There was also no association between raised thyroid antibodies and adverse pregnancy outcomes in either group. Conclusion. There were no adverse outcomes of pregnancy found in pregnant women who had been diagnosed and treated with thyroxine for SCH at the time of presentation when compared to euthyroid patients. There was also no relationship with thyroid antibodies and adverse pregnancy

  6. 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

  7. Hormonal Replacement Therapy and the Risk of Lung Cancer in Women: An Adaptive Meta-analysis of Cohort Studies

    OpenAIRE

    Bae, Jong-Myon; Kim, Eun Hee

    2015-01-01

    Objectives: 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. Methods: 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...

  8. 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.

  9. Tetrac can replace thyroid hormone during brain development in mouse mutants deficient in the thyroid hormone transporter Mct8

    NARCIS (Netherlands)

    S. Horn (Sigrun); S. Kersseboom (Simone); S. Mayerl (Steffen); J. Müller (Julia); C. Groba (Claudia); M. Trajkovic-Arsic (Marija); T. Ackermann (Tobias); T.J. Visser (Theo); H. Heuer (Heike)

    2013-01-01

    textabstractThe monocarboxylate transporter 8 (MCT8) plays a critical role in mediating the uptake of thyroid hormones (THs) into the brain. In patients, inactivating mutations in the MCT8 gene are associated with a severe form of psychomotor retardation and abnormal serum TH levels. Here, we

  10. The effects of hormone replacement therapy on echocardiographic basic cardiac functions in postmenopausal women.

    Science.gov (United States)

    Taskin, O; Gökdeniz, R; Muderrisoglu, H; Korkmaz, M E; Uryan, I; Atmaca, R; Kafkasli, A

    1998-09-01

    This prospective study was designed to investigate the effects of hormone replacement therapy (HRT) on systolic and diastolic functions. Twenty-eight non-smoking, healthy postmenopausal women who had not received any kind of HRT for at least three years within the onset of menopause were included in the study. All patients received 0.625 mg conjugated oestrogens and 2.5 mg medroxyprogesterone acetate as daily HRT regimen. Their basic systolic and diastolic functions were investigated echocardiographically using standard positions and windows before and 6 months after initiation of HRT. The means of age, weight and length of postmenopausal period were 49.3 +/- 5.8 years, 63.5 +/- 8.7 kg and 46.3 +/- 7.1 months, respectively. Heart rate and systolic and diastolic pressures were similar during the pre- and post-treatment periods. After 6 months of HRT, the mean left ventricular end-systolic and end-diastolic volumes were decreased significantly (71.3 +/- 16.4 versus 56.3 +/- 22.8 ml, 144.5 +/- 26.1 versus 111.7 +/- 24.0 ml, respectively, P function was significant compared with the pretreatment period (E/A 0.90 +/- 0.2 versus 1.10 +/- 0.4, deceleration time 238 +/- 36.8 versus 201 +/- 24.2 ms, respectively, P < 0.05). Based on our preliminary results, we conclude that besides the known favourable effects on women's lives, HRT may also improve cardiac performance and age-related dysfunctions. The present results further suggest that oestrogens exert many direct effects on the cardiovascular system, other than the metabolic changes related to lipoproteins.

  11. 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

  12. [Utilization of hormone replacement therapy in Spain: Trends in the period 2000-2014].

    Science.gov (United States)

    Baladé Martínez, Laura; Montero Corominas, Dolores; Macías Saint-Gerons, Diego

    2016-10-07

    The objective of the study was to describe the trends of utilization, supply and prevalence of hormone replacement therapy (HRT) in Spain during the period 2000-2014. Annual prevalence of HRT use including the 95% CI was calculated for women aged≥40 using individual data from the national population-based database BIFAP. Annual and total-period consumptions were expressed in defined daily doses (DDD) per 1,000 inhabitants per day and were obtained from the databases of medications dispensed in community pharmacies and charged through official prescriptions to the Spanish National Health System. In the year 2000, overall HRT consumption was 33.12 DDDs/1000 inhabitans/day: 19.81 for oestrogen only, 6.88 for tibolone and 6.44 for combined oestrogen and progestagen. In 2014 overall HRT consumption was 5.32 DDDs/1000 inhabitans/day: 1.08 for oestrogen only, 1.61 for tibolone and 2.62 for combinations of oestrogen and progestagen. The marketed presentations of HRT decreased by 46.9%. Prevalence of HRT use in women aged≥40 in BIFAP was 7.19% (95% CI 6.97-7.40) in 2001 and 0.21% (95% CI 0.20-0.22) in 2014. Women aged 40-45 registered the highest prevalence of use in 2014: 0.71% (95% CI 0.66-0.76). A sharp decline in the consumption and prevalence of HRT has been observed in Spain since the publication of the Women's Health Initiative and Million Women Study and the regulatory measures taken restricting conditions of use, showing a similar trend to that of other western countries. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. The effects of hormone replacement therapy on myocardial performance in early postmenopausal women.

    Science.gov (United States)

    Duzenli, M A; Ozdemir, K; Sokmen, A; Gezginc, K; Soylu, A; Celik, C; Altunkeser, B B; Tokac, M

    2010-04-01

    The results of the studies in which the effect of hormone replacement therapy (HRT) on cardiac function have been evaluated are rather disputable. In these studies, cardiac function was evaluated with conventional echocardiographic methods. This study was planned in order to investigate the effects of HRT on myocardial velocities and myocardial performance index (MPI) in healthy early postmenopausal women. In a prospective, controlled study, 60 healthy postmenopausal women were assigned to two groups (32 in the HRT group and 28 in the control group). After conventional echocardiographic parameters were measured, tissue Doppler echocardiography recordings were obtained from the mitral and tricuspid annulus. Systolic myocardial velocity (Sm), early and late diastolic myocardial velocities (Em and Am) and time intervals were measured and MPI was calculated. Then the symptom-limited exercise stress test using the Bruce protocol was performed. After 3 and 6 months of HRT (oral 0.625 mg conjugated estrogen + 2.5 mg medroxyprogesterone acetate/day), the same examinations were repeated. The effects of HRT on myocardial velocities, MPI and exercise time were evaluated at the 3rd and 6th months. The parameters of the control group remained statistically unchanged during the study. HRT did not have any effect on segmental and mean left ventricular (LV) Sm or right ventricular (RV) Sm. However, LV Em/Am and RV Em/Am ratios significantly increased at the 6th month of HRT, and LV and RV MPI values were observed to decrease significantly as compared to basal values. Additionally, a significant increase was observed in exercise duration and metabolic equivalent values after 3 months of HRT, and this increase continued at the 6th month as well. The favorable changes in all parameters in the HRT group were significantly different from those of the control group. Data obtained in this study suggest that HRT is not only effective for treating menopausal complaints but also increases

  14. Changes in elderly women's health-related quality of life following discontinuation of hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Pringle Kristine E

    2005-05-01

    Full Text Available Abstract Background Many women have discontinued hormone replacement therapy (HRT in view of recent findings. The goal of this study was to determine if HRT discontinuation is associated with changes in health-related quality of life (HRQOL in elderly women. Methods We studied women enrolled in Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE program, linking prescription claims with data from a longitudinal mail survey. HRQOL measures included the number of days out of the last 30 that physical health was not good and analogous measures for mental health, pain, and interference with activities, as well as a composite "healthy days" measure developed by CDC. Longitudinal analyses focused on 2,357 women who completed surveys in both 2002 and 2003, and who used HRT at baseline (mean age = 75.5, range = 65–102. Propensity scores were used to match HRT continuers and discontinuers according to HRT type, demographics, and baseline HRQOL. Analysis of covariance was used to compare HRQOL change in continuers and discontinuers. Results Between 2002 and 2003, 43% of HRT users discontinued therapy. Analysis of covariance to examine HRQOL change revealed complex interactions with age. Discontinuers aged 65–74 reported greater increases in days in which mental health was not good (p Conclusions These results suggest that there are substantial age differences in response to HRT discontinuation. While women aged 65–74 experienced apparent declines in HRQOL following HRT cessation, women aged 85 and older experienced relative improvements. The HRQOL declines observed among younger women underscore the importance of communication between clinicians and patients throughout the discontinuation process. These results also demonstrate the value of HRQOL surveillance as a component of health program administration.

  15. TLR-4 mediated brain inflammation halts neurogenesis: Impact of hormonal replacement therapy.

    Directory of Open Access Journals (Sweden)

    Abdeslam eMouihate

    2014-05-01

    Full Text Available Experimental and epidemiological data show that the severity and the duration of brain inflammation are attenuated in females compared to males. This attenuated brain inflammation is ascribed to 17β-estradiol. However, several studies suggest that 17β-estradiol is also endowed with proinflammatory properties. The aim of the present study is to assess the effect of hormonal replacement therapies on LPS-induced brain inflammation and its consequent effect on newly born neurons.Bilaterally ovariectomized rats received intrastriatal injection of lipopolysaccharide (LPS, 250 ng/µl and subsequently were given daily subcutaneous injections of either vehicle, 17β-estradiol (25 µg/kg or 17β-estradiol and progesterone (5mg/kg. Microglial activation and newly-born neurons in the rostral migratory stream were monitored using double immunofluorescence. Nuclear factor κB (NFκB signaling pathway and its target inflammatory proteins were assessed by either western blot (cyclooxygenase-2 (COX-2 and interleukin-6 (IL-6 or ELISA (Tumor Necrosis Factor-α (TNFα.LPS induced activation of microglia, promoted NFκB signaling pathway and enhanced production of the pro-inflammatory proteins (TNFα and COX-2. These proinflammatory responses were not attenuated by 17β-estradiol-injection. Supplementation of 17β-estradiol with progesterone significantly dampened these pro-inflammatory processes. Interestingly, LPS-induced brain inflammation dampened the number of newly born neuron in the rostral migratory stream. Administration of combined 17β-estradiol and progesterone resulted in a significantly higher number of newly born neurons when compared to those seen in rats given either vehicle or 17β-estradiol alone. These data strongly suggest that combined 17β-estradiol and progesterone, and not 17β-estradiol alone, rescues neurogenesis from the deleterious effect of brain inflammation likely via the inhibition of the signaling pathways leading to the pro

  16. Hormone-replacement therapy influences gene expression profiles and is associated with breast-cancer prognosis: a cohort study

    OpenAIRE

    Skoog Lambert; Shaw Peter; Pawitan Yudi; Nordgren Hans; Miller Lance D; Liu Edison T; Lin Chin-Yo; Huang Fei; Bjöhle Judith; Ploner Alexander; Hall Per; Smeds Johanna; Wedrén Sara; Öhd John; Bergh Jonas

    2006-01-01

    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) pr...

  17. Hormone replacement therapy use and plasma levels of sex hormones in the Norwegian Women and Cancer Postgenome Cohort – a cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Olsen Karina S

    2008-01-01

    Full Text Available Abstract Background Hormone replacement therapy use (HRT is associated with increased breast cancer risk. Our primary objective was to explore hormone levels in plasma according to HRT use, body mass index (BMI and menopausal status. A secondary objective was to validate self-reported questionnaire information on menstruation and HRT use in the Norwegian Women and Cancer postgenome cohort (NOWAC. Methods We conducted a cross-sectional study of sex hormone levels among 445 women aged 48–62 who answered an eight-page questionnaire in 2004 and agreed to donate a blood sample. The samples were drawn at the women's local general physician's offices in the spring of 2005 and sent by mail to NOWAC, Tromsø, together with a two-page questionnaire. Plasma levels of sex hormones and Sex Hormone Binding Globulin (SHBG were measured by immunometry. 20 samples were excluded, leaving 425 hormone measurements. Results 20% of postmenopausal women were HRT users. The plasma levels of estradiol (E2 increased with an increased E2 dose, and use of systemic E2-containing HRT suppressed the level of Follicle Stimulating Hormone (FSH. SHBG levels increased mainly among users of oral E2 preparations. Vaginal E2 application did not influence hormone levels. There was no difference in BMI between HRT users and non-users. Increased BMI was associated with increased E2 and decreased FSH and SHBG levels among non-users. Menopausal status defined by the two-page questionnaire showed 92% sensitivity (95% CI 89–96% and 73% specificity (95% CI 64–82%, while the eight-page questionnaire showed 88% sensitivity (95% CI 84–92% and 87% specificity (95% CI 80–94%. Current HRT use showed 100% specificity and 88% of the HRT-users had plasma E2 levels above the 95% CI of non-users. Conclusion Users of systemic E2-containing HRT preparations have plasma E2 and FSH levels comparable to premenopausal women. BMI has an influence on hormone levels among non-users. NOWAC

  18. HORMONE REPLACEMENT AND STRENGTH TRAINING POSITIVELY INFLUENCE BALANCE DURING GAIT IN POST-MENOPAUSAL FEMALES: A PILOT STUDY

    Directory of Open Access Journals (Sweden)

    Stephen D. Perry

    2005-12-01

    Full Text Available This study examined the effects of hormone replacement combined with strength training on improving dynamic balance control in post-menopausal women. Thirty one participating post-menopausal women were divided into three groups (hormone replacement (HR, non-hormone replacement (NR and control (CR group. HR and NR groups were tested for muscle strength and balance control during gait, prior to training and following a six week lower body strength training program. Quadriceps muscle strength was evaluated as isokinetic peak torque (60°·sec-1 using a CYBEX NORM and balance control was evaluated by center of mass - base of support relationships and ground reaction forces during gait perturbations. Only the HR group showed significantly (p < 0.05 improved balance control during the initial phase of unexpected gait termination and single stance periods while walking across uneven terrain following training. The strength gains in the HR group tended to be greater than in the NR group over the six week training program, although neither group showed statistically significant increases. The CR group showed no significant differences between testing times. HR in post-menopausal females may enhance dynamic balance control when combined with a strength training program, even if no statistically significant gains in strength are achieved

  19. Resolution of non-alcoholic steatohepatitis after growth hormone replacement in a pediatric liver transplant patient with panhypopituitarism

    DEFF Research Database (Denmark)

    Gilliland, Thomas; Dufour, Sylvie; Shulman, Gerald I.

    2016-01-01

    . Pediatric patients with NASH cirrhosis secondary to panhypopituitarism can be good candidates for liver transplantation, but hormone deficiencies predispose to recurrence after transplant. High-dose GH replacement should be considered in pediatric patients with GH deficiency and recurrent disease...... in the pediatric population often results from craniopharyngioma or pituitary adenoma and the sequelae of treatment, causing hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, and GH deficiency. Refractory NAFLD in panhypopituitarism may be amenable to GH replacement. Here, we report a pediatric...... case of NASH secondary to panhypopituitarism from craniopharyngioma, which recurred by 11 months after LDLT. Despite low-dose GH replacement, the patient remained GH deficient. Pubertal dosed GH therapy led to rapid and complete resolution of hepatic steatosis, which we tracked using serial (1) H MRS...

  20. Effect of Combined Hormonal Replacement Therapy on the Aldosterone/Renin Ratio in Postmenopausal Women.

    Science.gov (United States)

    Ahmed, Ashraf H; Gordon, Richard D; Ward, Gregory; Wolley, Martin; McWhinney, Brett C; Ungerer, Jacobus P; Stowasser, Michael

    2017-07-01

    Plasma aldosterone/renin ratio (ARR) is the most popular screening test for primary aldosteronism (PA). Because both estrogen and progesterone (including in oral contraceptive agents) affect aldosterone and renin levels, we studied the effects of combined hormonal replacement therapy (HRT) on ARR; renin was measured as both direct renin concentration (DRC) and plasma renin activity (PRA). Fifteen normotensive, healthy postmenopausal women underwent measurement (seated, midmorning) of plasma aldosterone, DRC, PRA, electrolytes, and creatinine and urinary aldosterone, cortisol, electrolytes, and creatinine at baseline and after 2 weeks and 6 weeks of treatment with combined HRT (conjugated estrogens 0.625 mg and medroxyprogesterone 2.5 mg daily). Combined HRT was associated with statistically significant increases in aldosterone [median (range): baseline, 150 (85 to 600); 2 weeks, 230 (129 to 790); 6 weeks, 434 (200 to 1200) pmol/L; P < 0.001 (Friedman test)] and PRA [2.3 (1.2 to 4.3), 3.8 (1.4 to 7.0), 5.1 (1.4 to 10.8) ng/mL/h, respectively; P < 0.001] but decreases in DRC [21 (10 to 31), 21 (10 to 39), and 14 (8.0 to 30) mU/L, respectively; P < 0.01], leading to increases in ARR calculated by DRC [7.8 (3.6 to 34.8), 11.4 (5.4 to 48.5), and 30.4 (10.5 to 90.2), respectively; P < 0.001]. The ARR calculated by DRC exceeded the cutoff value (70) in three patients after 6 weeks. There were no significant changes in ARR calculated by PRA [79 (26 to 184), 91 (23 to 166), and 88 (50 to 230), respectively; P = 0.282], plasma electrolytes and creatinine, or any urinary measurements. The combined oral HRT used in this study is capable of significantly increasing ARR with a risk of false-positive results during screening for PA but only if DRC (and not PRA) is used to calculate the ratio.

  1. Replacement

    Directory of Open Access Journals (Sweden)

    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  2. The effects of growth hormone deficiency and growth hormone replacement therapy on intellectual ability, personality and adjustment in children.

    Science.gov (United States)

    Puga González, B; Ferrández Longás, A; Oyarzábal, M; Nosas, R

    2010-06-01

    Traditionally, it has been assumed that intellectual development in children with growth hormone deficiency (GHD) is distributed between ranges of a normal population based on the observation that it does not differ substantially from that of children of the same age. Nevertheless, few studies have investigated this assumption. This Spanish Collaborative study was prospectively planned with two main purposes: to study a possible influence of GHD on intelligence quotient (IQ), personality traits and adaptative capacity and to study the evolution of these parameters during substitution therapy with growth hormone (GH). Although the overall intellectual ability of children with GHD is comparable to that of a normal reference population, some areas such the motor-component scale (evaluated by McCarthy test) and performance IQ (evaluated by WISC-R) were below the mean at the beginning of the study, showing significant improvement during therapy. Emotional adjustment (normal at study start) also improved significantly during treatment. Females showed better adjustment capacity before and during GH therapy. Longer studies with an increased number of cases are needed to confirm these effects of GHD and its treatment in children.

  3. Interactive effect of genetic susceptibility with height, body mass index, and hormone replacement therapy on the risk of breast cancer

    Directory of Open Access Journals (Sweden)

    Harlid Sophia

    2012-06-01

    Full Text Available Abstract Background Breast cancer today has many established risk factors, both genetic and environmental, but these risk factors by themselves explain only part of the total cancer incidence. We have investigated potential interactions between certain known genetic and phenotypic risk factors, specifically nine single nucleotide polymorphisms (SNPs and height, body mass index (BMI and hormone replacement therapy (HRT. Methods We analyzed samples from three different study populations: two prospectively followed Swedish cohorts and one Icelandic case–control study. Totally 2884 invasive breast cancer cases and 4508 controls were analysed in the study. Genotypes were determined using Mass spectrometry-Maldi-TOF and phenotypic variables were derived from measurements and/or questionnaires. Odds Ratios and 95% confidence intervals were calculated using unconditional logistic regression with the inclusion of an interaction term in the logistic regression model. Results One SNP (rs851987 in ESR1 tended to interact with height, with an increasingly protective effect of the major allele in taller women (p = 0.007 and rs13281615 (on 8q24 tended to confer risk only in non users of HRT (p-for interaction = 0.03. There were no significant interactions after correction for multiple testing. Conclusions We conclude that much larger sample sets would be necessary to demonstrate interactions between low-risk genetic polymorphisms and the phenotypic variables height, BMI and HRT on the risk for breast cancer. However the present hypothesis-generating study has identified tendencies that would be of interest to evaluate for gene-environment interactions in independent materials.

  4. Being a long-term user of nicotine replacement therapy

    DEFF Research Database (Denmark)

    Borup, Gitte; Nørgaard, Lotte Stig; Tønnesen, Philip

    , regarding long-term NRT users’ experiences with continuing the use of NRT. Results from a survey study among long-term NRT-users, who had used NRT for 12 months or more, found that out of 92 former smokers 88 % wished to quit using NRT. The primary causes stated for wishing to quit were being tired...... of feeling addicted, cost of NRT products and fear of adverse health consequences. Aim of study • To get a thorough understanding of the lived experiences of nicotine dependent long-term NRT users. • To investigate what motivates or discourages quitting NRT. Method Semi-structured interviews with long...

  5. Hormonal consequences, replacement therapy, and lost workdays after cervical cancer treatment

    OpenAIRE

    Hallqvist Everhov, Åsa

    2015-01-01

    Background: Uterine cervical cancer affects women of all ages and has a generally favorable prognosis. Many survivors live long with the consequences of the disease and its treatment, and therefore it is important to characterize potential treatment-induced morbidity. Aims: To investigate different hormonal aspects and work loss among cervical cancer survivors, by treatment modality. Methods: In a pilot study, we analyzed serum levels of anti-Müllerian hormone (AMH) and follicle-stimu...

  6. Effects of 1-year growth hormone replacement therapy on thyroid volume and function of the children and adolescents with idiopathic growth hormone deficiency.

    Science.gov (United States)

    Keskin, Meliksah; Bayramoglu, Elvan; Aycan, Zehra

    2017-10-17

    There are different opinions about the effects of growth hormone replacement therapy (GHRT) on thyroid function and volume. This study aimed to assess the effects of GHRT on thyroid volume and function in the children and adolescents with growth hormone (GH) deficiency. A total of 29 patients diagnosed with GH deficiency were enrolled in the study. The control group consisted of 29 cases matched for age, gender and pubertal period with the patients. Thyroid function tests and insulin-like growth factor levels were measured, simultaneously thyroid volumes were assessed by ultrasonography at the initiation period and at the end of GHRT. Thyroid volumes of the patient group was -0.55±1.1 standard deviations (SDs) initially; whereas at the end of 1 year it was found to be -0.29±1.29 SDs and both SDs of thyroid volumes did not differ significantly. The SDs of thyroid volume of the control group was -0.85±1.03 SDs initially and -0.72±0.85 SDs at the end of 1 year; and they did not differ significantly. On the other hand, after GHRT of 1 year, thyroid stimulating hormone (TSH) and free thyroxine (T4) levels decreased. It was observed that SDs of thyroid gland volumes did not change in GH deficient children and adolescents after GHRT.

  7. Effect of growth hormone replacement therapy in a boy with Dent's disease: a case report.

    Science.gov (United States)

    Samardzic, Mira; Pavicevic, Snezana; Ludwig, Michael; Bogdanovic, Radovan

    2011-08-22

    Dent's disease is an X-linked recessive proximal tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure. To the best of our knowledge, this is only the third report on the use of growth hormone therapy in a child with poor growth associated with Dent's disease. We report on a 7-year-old Montenegrin boy with proteinuria, hypercalciuria, nephrocalcinosis, rickets and short stature with unimpaired growth hormone secretion. A molecular genetic analysis showed S244L substitution on the CLCN5 gene. After two years of conventional treatment with hydrochlorothiazide, laboratory tests revealed more prominent proteinuria, mild hypophosphatemia, increased values of alkaline phosphatase and features of rickets. Phosphate salts, calcitriol, potassium citrate and growth hormone were included in the therapy. After three years of therapy, his adjusted parental stature was 1.53 standard deviations higher than at the initiation of growth hormone therapy. His global kidney functions and levels of proteinuria and calciuria remained relatively stable. In spite of the growth hormone therapy, his tubular reabsorption of phosphate deteriorated. Treatment with recombinant human growth hormone may have a positive effect on final height in poorly growing children with Dent's disease and hypophosphatemic rickets. However, it is not possible to reach definite conclusions due to the small sample within the literature and the brief duration of the therapy.

  8. Effect of growth hormone replacement therapy in a boy with Dent's disease: a case report

    Directory of Open Access Journals (Sweden)

    Ludwig Michael

    2011-08-01

    Full Text Available Abstract Introduction Dent's disease is an X-linked recessive proximal tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure. To the best of our knowledge, this is only the third report on the use of growth hormone therapy in a child with poor growth associated with Dent's disease. Case presentation We report on a 7-year-old Montenegrin boy with proteinuria, hypercalciuria, nephrocalcinosis, rickets and short stature with unimpaired growth hormone secretion. A molecular genetic analysis showed S244L substitution on the CLCN5 gene. After two years of conventional treatment with hydrochlorothiazide, laboratory tests revealed more prominent proteinuria, mild hypophosphatemia, increased values of alkaline phosphatase and features of rickets. Phosphate salts, calcitriol, potassium citrate and growth hormone were included in the therapy. After three years of therapy, his adjusted parental stature was 1.53 standard deviations higher than at the initiation of growth hormone therapy. His global kidney functions and levels of proteinuria and calciuria remained relatively stable. In spite of the growth hormone therapy, his tubular reabsorption of phosphate deteriorated. Conclusion Treatment with recombinant human growth hormone may have a positive effect on final height in poorly growing children with Dent's disease and hypophosphatemic rickets. However, it is not possible to reach definite conclusions due to the small sample within the literature and the brief duration of the therapy.

  9. A pooled analysis of case-control studies of thyroid cancer - III. Oral contraceptives, menopausal replacement therapy and other female hormones

    NARCIS (Netherlands)

    La Vecchia, C; Ron, E; Franceschi, S; Dal Maso, L; Mark, SD; Chatenoud, L; Braga, C; Preston-Martin, S; McTiernan, A; Kolonel, L; Mabuchi, K; Jin, F; Wingren, G; Galanti, MR; Hallquist, A; Lund, E; Levi, F; Linos, D; Negri, E

    Objective: The relations between oral contraceptives (OC), hormone replacement therapy (HRT) for menopause, and other female hormone use and thyroid cancer risk was analyzed using the original data from 13 studies from North America, Asia and Europe. Methods: Based on 2,132 cases and 3,301 controls,

  10. Physical activity, hormone replacement therapy, and the presence of coronary calcium in midlife women.

    Science.gov (United States)

    Weinberg, Nicole; Young, Amelia; Hunter, Carol J; Agrawal, Nisha; Mao, Songshou; Budoff, Matthew J

    2012-01-01

    Atherosclerotic calcification is a risk factor for cardiovascular events, independent of other traditional risk factors. Studies of the relation of menopausal hormone therapy to cardiovascular events have had inconsistent results, and often have been confounded by lifestyle behaviors and the "healthy user" effect. The authors evaluated the cross-sectional association of hormone therapy use with the presence and severity of atherosclerosis in postmenopausal women, independent of lifestyle factors, including diet and physical activity levels. The authors consecutively enrolled postmenopausal asymptomatic women who were referred for coronary artery calcium scanning to measure cardiovascular risk. After consent was obtained, women were interviewed prior to their cardiac scan about cardiac risk factors, hormone therapy use, menopausal status, diet, and physical activity. Coronary artery calcium prevalence was defined as any calcification present (score >0). Of the 544 enrolled women aged 50-80 years, 252 (46.3%) were hormone therapy users. Hormone therapy users had a significantly lower prevalence of any coronary artery calcium (defined as coronary artery calcium score >0; 37%), than non-users (50%, p = 0.04), as well as significantly lower mean calcium scores (p = 0.02). Multiple logistic regression models demonstrated a significantly reduced odds of coronary artery calcium in hormone therapy users compared to non-users with an adjusted odds ratio of 0.58 (p = 0.04), adjusting for traditional cardiac risk factors and body mass index. Women who reported consuming a vegetarian or a high-protein diet had almost two-fold odds of coronary artery calcium compared with women who reported regular, mixed, or low-fat, low-salt diets (OR = 1.78, p = 0.02). Severity of coronary artery calcium was less with increasing levels of physical activity, and a significant association was observed between physical activity and hormone therapy use (adjusted OR = 4.05, p = 0.03), independent

  11. 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, ...

  12. Types of hormone therapy

    Science.gov (United States)

    ... your doctor for regular checkups when taking HT. Alternative Names HRT- types; Estrogen replacement therapy - types; ERT- types of hormone therapy; Hormone replacement therapy - types; Menopause - types of hormone therapy; HT - types; Menopausal hormone ...

  13. Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions.

    Science.gov (United States)

    Ouyang, Pamela; Michos, Erin D; Karas, Richard H

    2006-05-02

    Cardiovascular disease is the leading cause of death among women in the U.S., exceeding breast cancer mortality in women of all ages. Women present with cardiovascular disease a decade after men, and this has been attributed to the protective effect of female ovarian sex hormones that is lost after menopause. Animal and observational studies have shown beneficial effects of hormone therapy when it is initiated early in the perimenopausal period or before the development of significant atherosclerosis. However, randomized, placebo-controlled trials in older women have not shown any benefit in either primary prevention or secondary prevention of cardiovascular events, with a concerning trend toward harm. This review outlines the lessons learned from the basic science, animal, observational, and randomized trials, and then summarizes yet-unanswered questions of hormone therapy and cardiovascular risk.

  14. 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-control...

  15. [Hot flashes resistant to hormone replacement in menopausal women: panic disorder?].

    Science.gov (United States)

    van der Feltz-Cornelis, C M

    1999-02-06

    Of two women aged 52 and 49, the first one was treated with increasingly high doses of oestrogens to reduce menopausal complaints and the second suffered from menopausal complaints while receiving antiepileptic treatment following surgical removal of a meningioma. The women had hot flushes refractive to hormone supplementation. The first one even developed addictive symptoms, demanding more and more hormone supplementation from her gynaecologist as her symptoms would not subside. Ultimately a panic disorder was diagnosed in both women. Symptoms of panic disorder can be disguised as or comorbid with menopausal complaints such as hot flushes. As patients with these complaints present themselves generally to their general practitioner or gynaecologist, the panic disorder may easily be overlooked. Both women reacted well to reattribution of their complaints, explanation that they had developed a panic disorder, behaviour therapy and treatment with clomipramine. Clues for diagnosis are lack of reaction to hormonal supplementation, worsening of symptoms after hormonal supplementation, as well as a positive history for anxiety symptoms and somatizing behaviour.

  16. 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. 

  17. “I AM HOT, IRRITABLE AND FEELING LOW; WHAT ALTERNATIVES DO I HAVE BESIDES HORMONE REPLACEMENT THERAPY?”

    Directory of Open Access Journals (Sweden)

    ZAINURASHID Z

    2010-01-01

    Full Text Available Women at the end of their reproductive age often complain of climacteric symptoms which can be quite debilitating at times. Physiological changes due to deficient oestrogen have received global attention in the search for an acceptable and safe measure to improve quality of life for women with these complaints. Hormone replacement therapy (HRT used to be the main treatment for menopausal symptoms. Lately there are concerns about its possible adverse effects of increasing risks of breast malignancy, heart diseases, etc. Complementary Alternative Medicine (CAM plays a significant role in relieving these climacteric symptoms especially in women with contraindications to hormonal therapy and in those who are worried of its adverse effects. It is important for women to be aware of these CAM to provide them with options to improve their quality oflife. This paper explores other pharmacological and non-pharmacological measures as alternatives to hormone replacementtherapy (HRT, to assess how useful and reliable they are according to available scientific evidence.

  18. Testosterone Replacement Therapy: Long-Term Safety and Efficacy

    Directory of Open Access Journals (Sweden)

    Giovanni Corona

    2017-08-01

    Full Text Available Recent position statements and guidelines have raised the distinction between a true and false, age-related hypogonadism (HG or late-onset hypogonadism (LOH. The former is the consequence of congenital or acquired “organic” damage of the brain centers or of the testis. The latter is mainly secondary to age-related comorbidities and does not require testosterone (T therapy (TTh. In addition, concerns related to cardiovascular (CV safety have further increased the scepticism related to TTh. In this paper, we reviewed the available evidence supporting the efficacy of TTh in non-organic HG and its long term safety. A large amount of evidence has documented that sexual symptoms are the most specific correlates of T deficiency. TTh is able to improve all aspects of sexual function independent of the pathogenetic origin of the disease supporting the scientific demonstration that LOH does exist according to an “ex-juvantibus” criterion. Although the presence of metabolic derangements could mitigate the efficacy of TTh on erectile dysfunction, the positive effect of TTh on body composition and insulin sensitivity might counterbalance the lower efficacy. CV safety concerns related to TTh are essentially based on a limited number of observational and randomized controlled trials which present important methodological flaws. When HG is properly diagnosed and TTh correctly performed no CV and prostate risk have been documented.

  19. Comparative effects of conventional hormone replacement therapy and tibolone on climacteric symptoms and sexual dysfunction in postmenopausal women.

    Science.gov (United States)

    Ziaei, S; Moghasemi, M; Faghihzadeh, S

    2010-04-01

    To compare the effects of tibolone with those of conventional hormone replacement therapy on climacteric symptoms and sexual function in postmenopausal women. In a randomized, controlled trial, 140 postmenopausal women were allocated into three groups. Of the subjects included, 47 women received 2.5 mg tibolone + one Cal+D tablet (500 mg calcium and 200 IU vitamin D) daily; 46 women received 0.625 mg conjugated equine estrogen + 2.5 mg medroxyprogesterone (CEE/MPA) + one Cal+D tablet daily; and 47 women received only one Cal+D tablet as the control group. The Greene Climacteric Scale (GCS) questionnaire was used to detect the efficacy of treatment on climacteric symptoms. Rosen's Female Sexual Function Index (FSFI) was used for sexual function evaluation. Sex hormone binding globulin (SHBG), free estradiol index (FEI) and free testosterone index (FTI) were measured before and after treatment. The women were followed up for 6 months After treatment, all subscores in the GCS improved in the tibolone and CEE/MPA groups (p < 0.01), except the sexual subscore in the CEE/MPA group, compared with baseline. There were significant differences in the FSFI in the tibolone and CEE/MPA groups in comparison to the control group after treatment. Tibolone, in comparison to CEE/MPA, significantly lowered SHBG levels and increased the FTI and FEI and improved the desire, arousal and orgasm sexual domains of the FSFI (p < 0.001). Tibolone may be an alternative to conventional hormone replacement therapy in the treatment of climacteric symptoms and sexual dysfunction in postmenopausal women.

  20. Hormone replacement therapy and Parkinson’s disease risk in women: a meta-analysis of 14 observational studies

    Directory of Open Access Journals (Sweden)

    Wang P

    2014-12-01

    Full Text Available Peifu Wang, Jilai Li, Shi Qiu, Honfeng Wen, Jichen DuDepartment of Neurology, Aerospace Center Hospital, Peking University Aerospace Clinical College, Beijing, People’s Republic of ChinaBackground and purpose: Published data on the relationship of hormone replacement therapy (HRT with Parkinson’s disease (PD were inconclusive. Thus, a systematic meta-analysis of observational studies was performed to clarify this topic.Methods: The databases of PubMed and EMBASE were searched for case–control or cohort studies published up till June 2, 2014. Meta-analysis of the relative risks (RRs with 95% confidence intervals (CIs was estimated using random-effects models.Results: A final total of ten case–control and four cohort studies were included in our meta-analysis. The overall combined RR of PD for ever users versus never users of HRT was 1.00 (95% CI: 0.84–1.20. Limited to those subjects who only use estrogen, a similar trend was detected (RR: 0.95, 95% CI: 0.69–1.30. In the subgroup analysis by study design, no significant association was observed in case–control studies (RR: 0.79, 95% CI: 0.62–1.02, whereas a positive association was found in cohort studies (RR: 1.24, 95% CI: 1.10–1.40. In further analysis according to study quality, an inverse association was found in the low-quality group (RR: 0.58, 95% CI: 0.40–0.82, whereas a positive association was found in the high-quality group (RR: 1.16, 95% CI: 1.02–1.31.Conclusion: In summary, our results of meta-analysis do not support a protective role of HRT in female PD development.Keywords: Parkinson’s disease, hormone replacement therapy, hormone meta-analysis

  1. 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

  2. Study protocol; Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Stott, David J.; Gussekloo, Jacobijn; Kearney, Patricia M.

    2017-01-01

    BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large...... in the placebo group. The primary outcomes are changes in two domains (hypothyroid symptoms and fatigue / vitality) on the thyroid-related quality of life questionnaire (ThyPRO) at one year. The study has 80% power (at p = 0.025, 2-tailed) to detect a change with levothyroxine treatment of 3.......0% on the hypothyroid scale and 4.1% on the fatigue / vitality scale with a total target sample size of 750 patients. Secondary outcomes include general health-related quality of life (EuroQol), fatal and non-fatal cardiovascular events, handgrip strength, executive cognitive function (Letter Digit Coding Test), basic...

  3. Effect of growth hormone replacement therapy in a boy with Dent's disease: a case report

    OpenAIRE

    Ludwig Michael; Pavicevic Snezana; Samardzic Mira; Bogdanovic Radovan

    2011-01-01

    Abstract Introduction Dent's disease is an X-linked recessive proximal tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure. To the best of our knowledge, this is only the third report on the use of growth hormone therapy in a child with poor growth associated with Dent's disease. Case presentation We report on a 7-year-old Montenegrin boy with proteinuria, hypercalciuria, nephrocalcinosis, rickets and s...

  4. Hormone Replacement Therapy advertising: sense and nonsense on the web pages of the best-selling pharmaceuticals in Spain

    Directory of Open Access Journals (Sweden)

    Cantero María

    2010-03-01

    Full Text Available Abstract Background The balance of the benefits and risks of long term use of hormone replacement therapy (HRT have been a matter of debate for decades. In Europe, HRT requires medical prescription and its advertising is only permitted when aimed at health professionals (direct to consumer advertising is allowed in some non European countries. The objective of this study is to analyse the appropriateness and quality of Internet advertising about HRT in Spain. Methods A search was carried out on the Internet (January 2009 using the eight best-selling HRT drugs in Spain. The brand name of each drug was entered into Google's search engine. The web sites appearing on the first page of results and the corresponding companies were analysed using the European Code of Good Practice as the reference point. Results Five corporate web pages: none of them included bibliographic references or measures to ensure that the advertising was only accessible by health professionals. Regarding non-corporate web pages (n = 27: 41% did not include the company name or address, 44% made no distinction between patient and health professional information, 7% contained bibliographic references, 26% provided unspecific information for the use of HRT for osteoporosis and 19% included menstrual cycle regulation or boosting feminity as an indication. Two online pharmacies sold HRT drugs which could be bought online in Spain, did not include the name or contact details of the registered company, nor did they stipulate the need for a medical prescription or differentiate between patient and health professional information. Conclusions Even though pharmaceutical companies have committed themselves to compliance with codes of good practice, deficiencies were observed regarding the identification, information and promotion of HRT medications on their web pages. Unaffected by legislation, non-corporate web pages are an ideal place for indirect HRT advertising, but they often contain

  5. Hormone replacement therapy advertising: sense and nonsense on the web pages of the best-selling pharmaceuticals in Spain.

    Science.gov (United States)

    Chilet-Rosell, Elisa; Martín Llaguno, Marta; Ruiz Cantero, María Teresa; Alonso-Coello, Pablo

    2010-03-16

    The balance of the benefits and risks of long term use of hormone replacement therapy (HRT) have been a matter of debate for decades. In Europe, HRT requires medical prescription and its advertising is only permitted when aimed at health professionals (direct to consumer advertising is allowed in some non European countries). The objective of this study is to analyse the appropriateness and quality of Internet advertising about HRT in Spain. A search was carried out on the Internet (January 2009) using the eight best-selling HRT drugs in Spain. The brand name of each drug was entered into Google's search engine. The web sites appearing on the first page of results and the corresponding companies were analysed using the European Code of Good Practice as the reference point. Five corporate web pages: none of them included bibliographic references or measures to ensure that the advertising was only accessible by health professionals. Regarding non-corporate web pages (n = 27): 41% did not include the company name or address, 44% made no distinction between patient and health professional information, 7% contained bibliographic references, 26% provided unspecific information for the use of HRT for osteoporosis and 19% included menstrual cycle regulation or boosting feminity as an indication. Two online pharmacies sold HRT drugs which could be bought online in Spain, did not include the name or contact details of the registered company, nor did they stipulate the need for a medical prescription or differentiate between patient and health professional information. Even though pharmaceutical companies have committed themselves to compliance with codes of good practice, deficiencies were observed regarding the identification, information and promotion of HRT medications on their web pages. Unaffected by legislation, non-corporate web pages are an ideal place for indirect HRT advertising, but they often contain misleading information. HRT can be bought online from Spain

  6. BENEFITS AND RISKS OF HORMONE REPLACEMENT ON THE DISTURBANCE ANDROGENIC MALE AGEING: A REVIEW OF THE LITERATURE

    Directory of Open Access Journals (Sweden)

    José Simão Rodrigues Filho

    2014-10-01

    Full Text Available The aging man is accompanied by a progressive decline in testosterone production. This slow decrease causes a series of signs and symptoms can often interfere with the quality of man life. The purpose of this article is to review the current issues about the possible risks and benefits of androgen replacement therapy, discussing the clinical studies published on the subject. This is a review of scientific articles, and the identification and analysis of the articles were made through a search in the PUBMED database and SCIELO the period July to October 2013 This set of changes from affecting the musculoskeletal system to damage the scope psychobehavioral called Androgen Dysfunction Male Aging, which affects over 20% of men over 60 years worldwide. It was found in this work that replacement with androgens exerts beneficial effects on the ystem and psycho-behavioral, reflecting improved quality of life. In the other hand, the potential risks refer to the cardiovascular effects of metabolism and worsening of prostate cancer. Although knowledge about the potential risks and benefits of hormone replacement in men has evolved, there is still much that needs to be determined.

  7. Benefits and risks of hormone replacement on the disturbance androgenic male ageing: A review of the literature

    Directory of Open Access Journals (Sweden)

    José Simão Rodrigues Filho

    2014-07-01

    Full Text Available The aging man is accompanied by a progressive decline in testosterone production. This slow decrease causes a series of signs and symptoms can often interfere with the quality of man life. The purpose of this article is to review the current issues about the possible risks and benefits of androgen replacement therapy, discussing the clinical studies published on the subject. This is a review of scientific articles, and the identification and analysis of the articles were made through a search in the PUBMED database and SCIELO the period July to October 2013 This set of changes from affecting the musculoskeletal system to damage the scope psycho-behavioral called Androgen Dysfunction Male Aging, which affects over 20% of men over 60 years worldwide. It was found in this work that replacement with androgens exerts beneficial effects on the musculoskeletal system and psycho-behavioral, reflecting improved quality of life. In the other hand, the potential risks refer to the cardiovascular effects of metabolism and worsening of prostate cancer. Although knowledge about the potential risks and benefits of hormone replacement in men has evolved, there is still much that needs to be determined.

  8. Hormonal changes during a long term isolation (SFINCSS-99 project)

    Science.gov (United States)

    Larina, I.; Custaud, M.; Gauquelin-Koch, G.; Gharib, C.; Grigoriev, A.; Nichiporuk, I.

    Long duration of space mission and functioning in Earth's orbit of the International Space Station make humans put up with spatial constraint for many months. From previous studies, it appears that confinement and inactivity can induce great psychological and physiological modifications by social and sensory deprivation. SFINCSS-99 experiment had the goal to determine the cardiovascular and the hormonal pattern of blood volume regulating hormones responses. Simulation experiments were performed in pressurized chambers outfitted with technical infrastructure including the systems for air regeneration, thermal and humidity air control, power supply, communications, TV monitoring, gas analysis and local electronic network. Three groups of test-subjects were functioning in parallel in adjacent modules, which mocked the ISS Russian and others segments. One33 crew (group I) occupied the 100 m module and the others the 200 m module (II &III). They could communicate and work together. Group I consisted from Russian males- volunteers aged of 37 to 48 who spent 240 days in chamber. Group II included 4 males (one German and three Russians) aged from 27 to 45, spent 110 days in isolation. In blood samples, drawing before, during and after isolation's period hormones were determined, in urine samples - excretion of hormones, electrolytes, nitrites, nitrates, and osmolality. The increase of plasma volume (hematocrit decrease in Group I was 13,2%: 42,7+/-0,5 vs 39,2+/-1,2; p< 0,05; in Group II - 4,1%: 44,3+/-1,0 vs 43,3+/-2,6) in association with a tendency to decrease in plasma renin activity (in Group I 13,1+/-3,5 vs 27,8+/-6,0) was likely to be due to decreased sympathetic activity, this do agree with the changes in urinary catecholamine (CA) during confinement. Urinary CA were significantly higher during the recovery period than during confinement (in Group I 341+/-44 vs 240+/-19, p< 0,05). This suggests that the sympathoadrenal system was activated, and agrees with the

  9. Hormonal replacement therapy with HCG and HU-FSH in thalassaemic patients affected by hypogonadotropic hypogonadism.

    Science.gov (United States)

    Cisternino, M; Manzoni, S M; Coslovich, E; Autelli, M

    1998-01-01

    Gonadotropin (Gn) replacement therapy using HCG plus HU-FSH was administered to 24 patients affected by beta-thalassaemia major with hypogonadotropic hypogonadism aged 18-40 years (25.2 +/- 5.4 yr, m +/- SEM). The age range at the start of treatment was 14.5-24.5 years (16.7 +/- 2.6 yr); the mean duration of Gn treatment was 8.6 +/- 3.9 years (range 1-15.2 yr). Gn therapy was begun with HCG alone, the dosage being initially 500 IU twice a week and then increased to a maximum of 3000 IU twice a week, according to the individual serum testosterone levels obtained. HU-FSH (75 IU twice a week) was added to initiate spermatogenesis in all cases when the HCG-induced testosterone serum levels normalized. The duration of HU-FSH treatment ranged from 1-2 years and then therapy was continued with HCG alone. In nine patients Gn therapy was discontinued after 6-14 years and was replaced by testosterone depot therapy, 75-100 mg i.m. twice a month, for a period ranging from 1-1.5 years. Using Gn therapy, the testosterone levels normalized. The compliant patients obtained good virilization and normal sexual function; testicular volume increased within the normal adult range and spermatogenesis was achieved. When Gn therapy was replaced by testosterone-depot therapy, a marked decrease in testicular volume and sperm count was observed, but the patients complied better and showed a slight increase in coarse hair. In conclusion gonadotropins are an effective replacement therapy for male hypogonadism in thalassaemic patients. If we consider the advantages and disadvantages of this therapy, the former seem to outweigh the latter. Finally, it should be emphasized that physicians caring for these patients must foster compliance during frequent check-ups and examinations.

  10. Kidney growth and renal functions under the growth hormone replacement therapy in children.

    Science.gov (United States)

    Ece, Aydın; Çetinkaya, Semra; Ekşioğlu, Seçil; Şenel, Saliha; Özkasap, Serdar; Giniş, Tayfur; Sen, Velat; Şahin, Cahit

    2014-05-01

    The aim of this study was to investigate the kidney growth and renal functions in children receiving recombinant human growth hormone (rhGH) treatment. A total of 37 children who received rhGH for 1.5 years before the study was started and 48 healthy controls were included at first evaluation. Hormone levels were determined and kidney sizes were measured by ultrasound. Kidney functions were assessed by serum creatinine and estimated glomerular filtration rate (eGFR). After 3 years of first evaluation, 23 patients were re-assessed. Kidney sizes were found to be lower in rhGH received children compared with controls at first evaluation (pchildren (p0.05). Although no abnormal renal function test results were found at first and second evaluations; rhGH received children had significantly lower eGFR, at first evaluation, compared with controls; however, renal functions significantly increased after 3 years of follow-up (pgrowth is parallel to growth in body height and other visceral organs. A 3-years rhGH treatment resulted in significant increases in renal functions.

  11. Hormone replacement therapy in menopause as a risk factor for developing breast cancer

    Directory of Open Access Journals (Sweden)

    Natasha Firmino Souto

    2014-07-01

    Full Text Available Objetivo: Analisar a produção científica envolvendo o uso da terapia de reposição hormonal no climatério como um fator de risco para desenvolvimento de câncer de mama. Método: Realizou-se uma revisão integrativa da literatura. Utilizamos as bases de dados BDENF, LILACS e SciELO. Identificamos 71 artigos, dos quais 24 compuseram nossa amostra. Resultados: Observamos que o Brasil foi o país com mais publicações e o idioma mais requisitado foi o português. Em relação à escolha do delineamento do estudo, 50% dos estudos possuíam abordagem metodológica do tipo qualitativa e o método de coleta de dados por meio de documentos foi o mais utilizado. Conclusão: A enfermagem como profissional da saúde deve orientar as mulheres em idade perimenopausa sobre os riscos e benefícios do uso da terapia de reposição hormonal a fim de auxiliá-las na adesão ou não a esse tratamento.

  12. Impact of Hormone Replacement Therapy on stroke, and dementia due to Alzheimer’s disease on menopausal women

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2002-12-01

    Full Text Available As a result of estrogen deficiency in menopausal women various health problems occur. Disorders of central nervous system such as stroke and dementia due to Alzheimer’s disease are frequently encountered in menopausal women. Estrogen plays an important role in the maintenance of the dense network of neural fibres connecting one nerve cell to another, and in the synaptic activity facilitating cognitive thought and memory. Hormone replacement therapy (HRT reduced the risk of stroke by 30 % and a reduction of 60 % in risk of stroke mortality. The HRT influence cognitive functioning in menopausal women and may reduce the risk of developing dementia. Women who received HRT performed better on several tests of memory and logical reasoning than women taking placebo. Vaginal bleeding episodes constitute the major cause of women’s dissatisfaction with combined HRT. (Med J Indones 2002; 11: 246-9. Keywords: HRT, menopause, memory, cognitive function, vaginal bleeding

  13. 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.

  14. An Automatic Framework for Assessing Breast Cancer Risk Due to Various Hormone Replacement Therapies (HRT)

    DEFF Research Database (Denmark)

    Karemore, Gopal Raghunath; Brandt, Sami; Nielsen, Mads

    Background: 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...... measurements of breast density changes related to HRT. 2) To investigate whether transdermal low dose estradiol treatment induces changes in mammographic density compared to raloxifene and if these findings indicate elevation of breast cancer risk by treatment. Material and Methods: Digitised mammographies...... of 2x135 completers of a two year, randomised, trial formed the base of the present analysis. Active treatments were transdermal estradiol releasing 0.014mg E2/week and orally administered raloxifene hydrochloride, 60mg/day respectively. Influence of the therapies on breast density was assessed...

  15. 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.

  16. Effects of continuous Hormone Replacement Therapy (HRT on FSH, lipid profiles, blood chemistry, and skin thickness in menopausal women

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2002-06-01

    Full Text Available This study was aimed to observe the effect of hormone replacement therapy (HRT of estradiol 2 mg + 1 mg acetate noretisterone administered continuously on FSH hormone, lipid profile, blood chemistry, and skin thickness in menopausal women. The duration of HRT administration was 6 months. The subjects of the study were 35 menopausal women. The study was conducted from January 2001 to June 2001. After HRT administration of 6 months, a significant decrease of FSH was observed. No effect of HRT was found in bilirubin level; however, there was a slight increase of alkali phosphatase enzyme, and a signifcant increase in SGOT and SGPT. HRT caused a decrease of total cholesterol level and triglyceride level. In addition, a slight increase of LDL level and significant decrease of HDL level were observed. HRT administration with progesterone synthetic noretisterone showed an increase of skin collagen synthesis, which was indicated by the significant increase of skin thickness. (Med J Indones 2002; 11: 97-103Keywords: HRT, FSH, menopause, lipid profile, blood chemistry, skin thickness

  17. 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.

  18. 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

    2015-01-01

    Objectives: 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. Methods: 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. Results: 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). Conclusions: 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. PMID:26639742

  19. Terapia de reposição hormonal e o câncer do endométrio Hormone replacement therapy and endometrial cancer

    Directory of Open Access Journals (Sweden)

    Naidilton Lantyer Cordeiro de Araújo Júnior

    2007-11-01

    Full Text Available A reposição hormonal para alívio dos sintomas menopausais é amplamente utilizada em todo o mundo. A evolução do conhecimento sobre os riscos deste tratamento sempre foi mais lenta do que sua aplicação na prática clínica. Na década de 70, um aumento de incidência de câncer do endométrio ocorreu nos países desenvolvidos sendo que a terapia de estrógenos exógenos na menopausa foi o principal fator relacionado. Nas décadas de 80 e 90, a combinação entre estrógenos e progestínicos passou a ser largamente utilizada com base na premissa de que apresentava efeitos benéficos sobre os sistemas cardiovascular e osteoarticular, sem aumento no risco de câncer uterino. Entretanto, relatos recentes novamente questionam a segurança da reposição hormonal e, desta vez, apontam para o risco maior de câncer total e doença cardiovascular nos esquemas combinados. Concluímos neste trabalho que os riscos recentemente relacionados à terapia combinada têm grande potencial de impacto na Saúde Pública, e este esquema não é indicado para proteção do risco de carcinoma endometrial uma vez que seus riscos superam os benefícios.Hormone replacement therapy (HRT has been used worldwide to relieve menopausal symptoms. The evolution in clinical knowledge of its risks has lagged persistently behind its application in clinical practice. In the 1970s, endometrial cancer incidence increased in developed countries, and exogenous estrogen therapy in postmenopausal women was the most important factor. In the 1980s and 90s, combined estrogen-progesterone therapy was prescribed on a large scale, based on its potential beneficial effects on the musculoskeletal and cardiovascular systems without increasing the risk of endometrial carcinoma. However, once again, recent reports argue against the safety of HRT, and the most important issues are now the increased risk of cardiovascular disease and total cancer in combined formulations. We conclude that the

  20. Modulation of cortisol metabolism by low-dose growth hormone replacement in elderly hypopituitary patients.

    Science.gov (United States)

    Toogood, A A; Taylor, N F; Shalet, S M; Monson, J P

    2000-04-01

    11 beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) functions as a net reductase converting cortisone to cortisol. GH inhibits 11beta-HSD1, resulting in a shift in cortisol metabolism favoring cortisone, an observation that may have significance in patients with ACTH deficiency who are unable to compensate for such changes. We have studied the effect of three doses of GH replacement (0.17, 0.33, and 0.5 mg each given for 12 weeks in ascending order) on cortisol metabolism in nine patients, aged 62-70 yr, with hypopituitarism who were receiving fixed doses of oral hydrocortisone. Serum insulin-like growth factor I levels rose in a dose-dependent manner over the course of the study. Fat mass decreased significantly at 24 weeks (P = 0.02), a change that was maintained at 36 weeks. Fasting serum insulin levels did not change significantly over the course of the study. The ratio of urine cortisol to cortisone metabolites (Fm/Em) fell significantly at 12 weeks (GH dose, 0.17 mg/day) from 1.32 (0.91-2.20) at baseline to 1.08 (0.89-2.11) (P cortisol replacement is suboptimal, may be at risk of the clinical manifestations of cortisol deficiency when they are commenced on GH therapy.

  1. The effect of the deterioration of insulin sensitivity on beta-cell function in growth-hormone-deficient adults following 4-month growth hormone replacement therapy

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Fisker, S; Hilsted, J

    1999-01-01

    .07). One patient developed impaired glucose tolerance. Short-term GH replacement therapy in a dose of about 2 IU/m2 daily in GHD adults induces a reduction in insulin sensitivity, despite favourable changes in body composition, and an inadequate enhancement of insulin secretion........017 +/- 0.005 and after 0.015 +/- 0.006 min-1, NS). Insulin secretion was enhanced during GH therapy, but insufficiently to match the changes in SI, resulting in a higher blood glucose level during an OGTT. Blood glucose at 120 min was 5.5 and 6.3 mmol/l before and after GH treatment, respectively (P = 0...

  2. 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.

  3. Prevention of cardiovascular events in early menopause: a possible role for hormone replacement therapy.

    Science.gov (United States)

    Antonicelli, Roberto; Olivieri, Fabiola; Morichi, Valeria; Urbani, Elisa; Mais, Valerio

    2008-11-12

    Heart disease is a major cause of illness and death in women. It is well known that there is an increase in cardiovascular disease and cardiovascular risk factors after the menopause, but it is still unclear whether the change in risk factors after the menopause is only related to the aging process or is principally due to estrogen deprivation. Observational studies suggest a protective role for estrogens, whereas recent randomized controlled trials report a negative effect of oral estrogens on primary and secondary prevention of cardiovascular events. The role of inflammation in the process of atherogenesis and in determining the cardiovascular disease risk in postmenopausal women has been focused only recently as well as the role of the estrogen receptor system in different tissues and the role of genetic susceptibility to adverse events during estrogen therapy. The objective of this work was to review the current understanding of the relationships between cardiovascular disease risk factors and hormonal age-related changes in postmenopausal women and particularly in early and surgical postmenopausal women, for a more appropriate evaluation of the expected effects of therapy with exogenous estrogens in a specific sample of the large population of postmenopausal women.

  4. 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

  5. Long-term evaluation of cross-sex hormone treatment in transsexual persons.

    Science.gov (United States)

    Wierckx, Katrien; Mueller, Sven; Weyers, Steven; Van Caenegem, Eva; Roef, Greet; Heylens, Gunter; T'Sjoen, Guy

    2012-10-01

    Long-term effects and side effects of cross-sex hormone treatment in transsexual persons are not well known. The aim of this study is to describe the effects and side effects of cross-sex hormone therapy in both transsexual men and women. Hormone levels were measured by immunoassays. Physical health was assessed by physical examination and questionnaires on general health and specific side effects, areal bone parameters by dual energy X-ray absorptiometry. Single center cross-sectional study in 100 transsexual persons post-sex reassignment surgery and on average 10 years on cross-sex hormone therapy. Transsexual men did not experience important side effects such as cardiovascular events, hormone-related cancers, or osteoporosis. In contrast, a quarter of the transsexual women had osteoporosis at the lumbar spine and radius. Moreover, 6% of transsexual women experienced a thromboembolic event and another 6% experienced other cardiovascular problems after on average 11.3 hormone treatment years. None of the transsexual women experienced a hormone-related cancer during treatment. Cross-sex hormone treatment appears to be safe in transsexual men. On the other hand, a substantial number of transsexual women suffered from osteoporosis at the lumbar spine and distal arm. Twelve percent of transsexual women experienced thromboembolic and/or other cardiovascular events during hormone treatment, possibly related to older age, estrogen treatment, and lifestyle factors. In order to decrease cardiovascular morbidity, more attention should be paid to decrease cardiovascular risk factors during hormone therapy management. © 2012 International Society for Sexual Medicine.

  6. Beyond hormone replacement: quality of life in women with congenital hypogonadotropic hypogonadism

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    Shota Dzemaili

    2017-08-01

    Full Text Available Objective: Little is known about how women with isolated GnRH deficiency cope with their condition. This study aimed to examine the health and informational needs of women with congenital hypogonadotropic hypogonadism (CHH and evaluate if their experiences differ from women with more common forms of infertility. Design: Cross-sectional, multiple methods study using web-based data collection to reach dispersed rare disease patients. Methods: A community-based participatory research framework was employed to develop an online survey and collect quantitative and qualitative data. Adult women diagnosed with CHH who had received at least one year of hormonal treatment completed the Morisky Medication Adherence Scale, Revised Illness Perception Questionnaire and Zung Self-Rating Depression Scale. Information on health care experiences, treatment outcomes and patient-reported challenges were also collected. Results: Women (n = 55 were often diagnosed late (20.7 ± 7.4, range: 10–48 years and 16/20 patients receiving fertility treatment conceived. Poor adherence was frequently observed (34/55 while more than half (27/49 reported a gap in treatment exceeding a year. Low adherence correlated with depressive symptoms (r = 0.3, P > 0.05. Negative illness perceptions were pervasive and 30/55 exhibited some depressive symptoms – significantly greater than women with common female factor infertility (P < 0.01. Symptoms were underappreciated by providers as only 15 of 55 patients had discussions about psychological services. Women identified isolation, need for information and finding expert care as challenges to living with CHH. Conclusions: Despite being a treatable form of female infertility, the presumable availability of treatment does not necessarily ensure adequate quality of life for women with isolated GnRH deficiency.

  7. Beyond hormone replacement: quality of life in women with congenital hypogonadotropic hypogonadism.

    Science.gov (United States)

    Dzemaili, Shota; Tiemensma, Jitske; Quinton, Richard; Pitteloud, Nelly; Morin, Diane; Dwyer, Andrew A

    2017-08-01

    Little is known about how women with isolated GnRH deficiency cope with their condition. This study aimed to examine the health and informational needs of women with congenital hypogonadotropic hypogonadism (CHH) and evaluate if their experiences differ from women with more common forms of infertility. Cross-sectional, multiple methods study using web-based data collection to reach dispersed rare disease patients. A community-based participatory research framework was employed to develop an online survey and collect quantitative and qualitative data. Adult women diagnosed with CHH who had received at least one year of hormonal treatment completed the Morisky Medication Adherence Scale, Revised Illness Perception Questionnaire and Zung Self-Rating Depression Scale. Information on health care experiences, treatment outcomes and patient-reported challenges were also collected. Women (n = 55) were often diagnosed late (20.7 ± 7.4, range: 10-48 years) and 16/20 patients receiving fertility treatment conceived. Poor adherence was frequently observed (34/55) while more than half (27/49) reported a gap in treatment exceeding a year. Low adherence correlated with depressive symptoms (r = 0.3, P > 0.05). Negative illness perceptions were pervasive and 30/55 exhibited some depressive symptoms - significantly greater than women with common female factor infertility (P < 0.01). Symptoms were underappreciated by providers as only 15 of 55 patients had discussions about psychological services. Women identified isolation, need for information and finding expert care as challenges to living with CHH. Despite being a treatable form of female infertility, the presumable availability of treatment does not necessarily ensure adequate quality of life for women with isolated GnRH deficiency. © 2017 The authors.

  8. Designing long-term disability plans: tax efficiency vs. maximizing wage replacement.

    Science.gov (United States)

    Luecke, Randall W; Blair, Dennis T

    2003-01-01

    The tax treatment of long-term disability plans raises difficult questions for employers and employees, as it necessitates a tradeoff between tax efficiency and maximizing wage replacement for disabled workers. By using simplified case examples, this article illustrates the advantages and disadvantages of different plan design choices. The authors conclude that, in most cases, long-term disability coverage should be mandatory but that employees should be given the choice to decide whether their coverage is taxable.

  9. 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

    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 estrog...

  10. 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...

  11. 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...

  12. Long-term estrogen replacement is associated with improved nonverbal memory and attentional measures in postmenopausal women.

    Science.gov (United States)

    Smith, Y R; Giordani, B; Lajiness-O'Neill, R; Zubieta, J K

    2001-12-01

    To determine the cognitive domains improved or preserved by long-term hormone replacement therapy (HRT). A comprehensive neuropsychological test battery was administered to healthy postmenopausal women who had been treated or not treated with long-term HRT without interruption since menopause. Women were recruited by advertisement from a university town and surrounding areas. Women 60 years or older were studied who were treated (n = 16) or not treated (n = 13) with HRT. Neuropsychological testing included tests of memory, verbal fluency, executive functions, attention and concentration, and psychomotor function. Tests of intellectual function, depressive symptoms, and emotional functioning assessed general functions and comparability of the groups. Neuropsychological testing scores were compared between groups. No statistically significant differences between the groups were found for general demographic, intellectual, and psychological measures. Scores from both the Weschler Memory Scale Visual Reproduction (delayed recall) and the Digit Vigilance Test (attention) showed statistically significant better performance and fewer errors in the group of women on HRT. Long-term postmenopausal HRT is associated with higher scores in tests of nonverbal memory and attention.

  13. Effects of replacement therapy on sleep architecture in children with growth hormone deficiency.

    Science.gov (United States)

    Verrillo, Elisabetta; Bizzarri, Carla; Bruni, Oliviero; Ferri, Raffaele; Pavone, Martino; Cappa, Marco; Cutrera, Renato

    2012-05-01

    Children with GH deficiency (GHD) show a general decrease in electroencephalographic (EEG) arousability represented by a significant global decrease in Cyclic Alternating Pattern (CAP). The aim of the present study was to evaluate if sleep structure is influenced by GH substitutive therapy by analyzing the classical sleep architecture parameters and sleep microstructure by means of CAP. Laboratory polysomnographic sleep recordings were obtained from five children affected by GHD (two girls and three boys; mean age: 4.6 ± 3.1 years), at baseline and after GH therapy, and from 10 normal healthy children (four girls and six boys, mean age: 5.6 ± 2.2 years). Compared to controls, GHD subjects showed a reduced total sleep time with increased wakefulness and a consequent decrease in sleep efficiency; GH therapy was associated with an increase of the awakenings/hour and a large effect size was evident for sleep latency, sleep efficiency, and stage N3, which were decreased, and for stage W, which was increased. CAP appeared to be globally reduced and all phase A subtypes and CAP cycle showed a longer duration in GHD children vs. controls. GH substitutive treatment was followed by an increase in CAP rate (total, in N2, and in N3); additionally, A1 index was also significantly increased, especially during stage N3, with a very large effect size. On the other hand, A2 and A3 index and CAP cycle mean duration were reduced. Sleep stage architecture seems to be influenced by the GH status, but the analysis of sleep microstructure by means of CAP reveals an enhancement of EEG slow oscillations in GHD patients (demonstrated by an increase in CAP rate and A1 index during N3) after the start of GH replacement therapy. These findings deserve to be verified in a larger trial. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. 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

  15. 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.

  16. 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.

  17. Surfactant replacement therapy for preterm and term neonates with respiratory distress.

    Science.gov (United States)

    Polin, Richard A; Carlo, Waldemar A

    2014-01-01

    Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in preterm infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This statement summarizes the evidence regarding indications, administration, formulations, and outcomes for surfactant-replacement therapy. The clinical strategy of intubation, surfactant administration, and extubation to continuous positive airway pressure and the effect of continuous positive airway pressure on outcomes and surfactant use in preterm infants are also reviewed.

  18. Acupuncture provides short-term pain relief for patients in a total joint replacement program.

    Science.gov (United States)

    Crespin, Daniel J; Griffin, Kristen H; Johnson, Jill R; Miller, Cynthia; Finch, Michael D; Rivard, Rachael L; Anseth, Scott; Dusek, Jeffery A

    2015-06-01

    Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain. A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management. The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012. Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients. Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10). Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture. Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR. Wiley Periodicals, Inc.

  19. Behavioural and hormonal effects of member replacement in captive groups of blue-fronted amazon parrots (Amazona aestiva).

    Science.gov (United States)

    Silva de Souza Matos, Laerciana; Palme, Rupert; Silva Vasconcellos, Angélica

    2017-05-01

    Social species in captivity may face allostatic overload due to artificial grouping and other social constraints. In rescue centres, groups of psittacines are constantly mixed due to the arrival and/or release of individuals; this procedure is potentially harmful to animal welfare. This study aimed at evaluating the possible impacts of mate replacement on the stress levels of captive blue-fronted amazon parrots (Amazona aestiva). During five weeks, we recorded agonistic interactions and dropping-glucocorticoid metabolites (GCM) concentrations of individuals allocated in a group whose members were kept constant and in a group subjected to frequent member replacement. In both groups, non-linear hierarchies developed, without sex differences regarding aggression or hierarchical positions. The replacement of individuals had no effect on the number of agonistic interactions or on the animals' stress levels. In both groups, higher-ranking individuals had higher stress loads than subordinates. Our study, the first to investigate the social dynamics of A. aestiva, indicated that introducing or removing individuals in captive groups does not seem to affect the welfare of the birds in the short term. This information favours release and reintroduction programs and is relevant for conservation management of this, and possibly other parrot species with similar environmental requirements. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The Effect of Hormone Replacement Therapy on Dry Eye Syndrome Evaluated with Schirmer Test and Break-Up Time.

    Science.gov (United States)

    Feng, Yanhong; Feng, Gang; Peng, Shuli; Li, Hui

    2015-01-01

    Hormone replacement therapy (HRT) for dry eye syndrome (DES) is controversial in clinical practice. The goal of this study was to review relevant studies and analyze the pooled data to determine whether HRT is effective for DES. In this study, a literature search of PubMed, Embase, and Cochrane databases up to May 2015 was performed, with the search restricted to English language publications. The studies were screened after reading the abstract and full text. Only studies related to the effect of HRT on DES were included in the meta-analysis. Results of Schirmer tests with and without anesthetics and tear break-up time (BUT) values data were extracted and entered into RevMan software to meta-analyze the overall effect of HRT on DES. A total of 43 studies were identified, and 21 of these studies were found to be related to the effect of HRT on DES. Ultimately, 5 studies were included in the final meta-analysis. The pooled results revealed that HRT can affect Schirmer test results without anesthetics but does not affect Schirmer test results with anesthetics and BUT. The results indicate that HRT might improve DES symptoms when measuring basal tear production without anesthesia.

  1. Hormone replacement therapy dissociates fat mass and bone mass, and tends to reduce weight gain in early postmenopausal women

    DEFF Research Database (Denmark)

    Jensen, L B; Vestergaard, P; Hermann, A P

    2003-01-01

    The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design. A total of 2016 women ages 45-58 years from 3 months to 2 years past last...... menstrual bleeding were included. One thousand were randomly assigned to HRT or no HRT in an open trial, whereas the others were allocated according to their preferences. All were followed for 5 years for body weight, bone mass, and body composition measurements. Body weight increased less over the 5 years...... in women randomized to HRT (1.94 +/- 4.86 kg) than in women randomized to no HRT (2.57 +/- 4.63, p = 0.046). A similar pattern was seen in the group receiving HRT or not by their own choice. The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat. The main determinant...

  2. Physical and social characteristics and support needs of adult female childhood cancer survivors who underwent hormone replacement therapy.

    Science.gov (United States)

    Tomioka, Akiko; Maru, Mitsue; Kashimada, Kenichi; Sakakibara, Hideya

    2017-08-01

    Female childhood cancer survivors who develop gonadal dysfunction require female hormone replacement therapy (HRT) from puberty until menopause. However, the support provided in such cases has not been studied. We investigated the physical and social characteristics and support needs of adult female childhood cancer survivors who underwent HRT. Forty-nine adult female childhood cancer survivors completed self-administered questionnaires. We compared the clinical characteristics, health status, and social conditions between a group that underwent HRT and a group that did not, and we surveyed support needs of the group that underwent HRT. The median age of the subjects was 25.0 years (range 20-41). Twenty subjects (40.8%) underwent HRT. A significantly high number of those who underwent HRT also underwent radiation therapy (p social characteristics between the groups. Those who experienced anxiety regarding fertility required information about HRT, a platform to share their concerns, and psychological support and cooperation among healthcare providers. Although the subjects of this survey exhibited good social adjustment regardless of whether or not they underwent HRT, they were anxious about fertility. It is important to understand the concerns and anxieties unique to female childhood cancer survivors and to enhance psychological support in addition to providing educational support so that HRT can be administered.

  3. The Effect of Hormone Replacement Therapy on Dry Eye Syndrome Evaluated with Schirmer Test and Break-Up Time

    Directory of Open Access Journals (Sweden)

    Yanhong Feng

    2015-01-01

    Full Text Available Hormone replacement therapy (HRT for dry eye syndrome (DES is controversial in clinical practice. The goal of this study was to review relevant studies and analyze the pooled data to determine whether HRT is effective for DES. In this study, a literature search of PubMed, Embase, and Cochrane databases up to May 2015 was performed, with the search restricted to English language publications. The studies were screened after reading the abstract and full text. Only studies related to the effect of HRT on DES were included in the meta-analysis. Results of Schirmer tests with and without anesthetics and tear break-up time (BUT values data were extracted and entered into RevMan software to meta-analyze the overall effect of HRT on DES. A total of 43 studies were identified, and 21 of these studies were found to be related to the effect of HRT on DES. Ultimately, 5 studies were included in the final meta-analysis. The pooled results revealed that HRT can affect Schirmer test results without anesthetics but does not affect Schirmer test results with anesthetics and BUT. The results indicate that HRT might improve DES symptoms when measuring basal tear production without anesthesia.

  4. Effect of long term use of Bovine Somatotropic Hormone (bST) on ...

    African Journals Online (AJOL)

    2007-va-512

    E-mail: agrotech@brain.net.pk. Introduction ... ascertain the effect of the long-term use of the bovine somatotropic hormone on the reproductive ... Table 1 Ingredient and chemical composition of the concentrate component of the diet. Composition. Ingredients. Maize grains (%). 10. Rice polishing (%). 8. Wheat bran (%). 22.

  5. Short-term effects of recombinant human growth hormone and feeding on gluconeogenesis in humans

    Science.gov (United States)

    After a short-term fast, lactating women have increased rates of glucose production but not gluconeogenesis (GNG) despite relative hypoinsulinemia. We explored the effects of non-insulin-dependent increase in glucose utilization and recombinant human growth hormone (rhGH) on glucose production, glyc...

  6. 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.

  7. Conocimientos de las mujeres menopáusicas respecto a la terapia hormonal sustitutiva Knowledge of hormone replacement therapy among menopausal women

    Directory of Open Access Journals (Sweden)

    Isabel Ruiz

    2004-02-01

    Full Text Available Objetivos: Analizar la información que tienen las mujeres sobre la terapia hormonal sustitutiva (THS, de quién proviene esta información y cómo se relaciona con la prescripción. Métodos: Estudio descriptivo transversal mediante encuesta telefónica. En relación con la THS, se recogió información sobre su prescripción, el conocimiento sobre la misma y las fuentes de información, sus beneficios y riesgos para la salud y el tipo y fuente de información sobre éstos. Resultados: Se realizaron 371 entrevistas (el 80% de la muestra seleccionada originalmente. El 66% de las mujeres refería conocer los beneficios y el 42% los conocía a través de los profesionales sanitarios. El 36% de las encuestadas creía que la THS tenía riesgos para la salud. El 91% de las mujeres a las que se les prescribe este tratamiento refiere conocer sus beneficios, frente a sólo el 57% de las mujeres a las que no se les prescribe (odds ratio [OR] = 7,32; intervalo de confianza [IC] del 95%, 2,86-18,74. Los profesionales sanitarios son la principal fuente de información de estos beneficios entre las mujeres que reciben la prescripción (93% (OR = 83,47; IC del 95%, 26,83-278,63. El 57% de las mujeres a las que se les prescribe este tratamiento refieren conocer sus riesgos, frente al 28% de las mujeres a las que no se les prescribe (OR = 3,11; IC del 95%, 1,59-6,05. Conclusiones: Las mujeres a las que se les prescribe THS tienen un nivel de información superior. La inmensa mayoría de las usuarias menciona algún beneficio, pero un 43% refiere desconocer los riesgos que implica su uso. En cuanto a la fuente de información, los aspectos beneficiosos del tratamiento se conocen mayoritariamente a través de los profesionales sanitarios, mientras que los riesgos se conocen tanto a partir de los profesionales sanitarios como de los medios de comunicación.Objectives: To analyze the information that women have on hormone replacement therapy (HRT, the sources of

  8. A mouse model to study the effects of hormone replacement therapy on normal mammary gland during menopause: enhanced proliferative response to estrogen in late postmenopausal mice.

    Science.gov (United States)

    Raafat, A M; Hofseth, L J; Li, S; Bennett, J M; Haslam, S Z

    1999-06-01

    Hormone replacement therapy (HRT) with estrogen alleviates menopausal symptoms and is effective in reducing osteoporosis and cardiovascular disease when taken in early postmenopause. Older, late postmenopausal women who never previously received HRT are also believed to benefit from estrogen treatment. On the other hand, increased lifetime exposure of the mammary gland to estrogen may increase the risk of breast cancer. The development of suitable experimental animal model systems can advance our understanding of the effects of estrogen and the timing of HRT on the postmenopausal breast. Toward this end, early and late postmenopausal states were induced in mice by short vs. long term ovariectomy (1 vs. 5 weeks), and the effects of 17beta-estradiol (E) on mammary gland morphology, cell proliferation, and progesterone receptor (PR) levels were investigated. We report that in late postmenopausal mice, E caused a pronounced enlargement of duct ends and 6.5- and 4-fold greater mitogenic responses in the duct end epithelium and adjacent stromal cells, respectively, compared with the response in early postmenopausal mice. Furthermore, after long term, daily treatment with E, steady state levels of proliferation remained 2-fold higher than those of similarly treated, early postmenopausal mice. E failed to increase mammary PR levels in late postmenopausal, but not in early postmenopausal mice. Stimulation of duct ends by E and lack of PR inducibility are characteristics of the immature pubertal mammary gland and indicate that the late postmenopausal mammary gland resembled the immature state. In contrast, minimal E-induced proliferation and increased PR inducibility, characteristics of the adult, sexually mature mammary gland, were retained in early postmenopausal mice. The lack of difference in the numbers of estrogen receptor-positive epithelial or stromal cells or in estrogen receptor cellular concentration after short vs. long term ovariectomy indicates that the

  9. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

    NARCIS (Netherlands)

    Asscheman, H.; Giltay, E.J.; Megens, J.A.J.; de Ronde, W.; van Trotsenburg, M.A.A.; Gooren, L.J.G.

    2011-01-01

    Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones. Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic.

  10. Physiology: Capacity for Hormone Production of Cultured Trophoblast Cells Obtained from Placentae at Term and in Early Pregnancy

    OpenAIRE

    Malek, Antoine; Willi, Amara; Müller, Jürg; Sager, Ruth; Hänggi, Willy; Bersinger, Nick

    2001-01-01

    Problem: There is an increased doubt about the identity of isolated cytotrophoblast cells at term. Therefore, we compared pregnancy serum levels of three hormones [human placental lactogen (hPL), human chorionic gonadotropin (hCG), and leptin] with the capacity for hormone production of early placentae [EP; 8–13 weeks of gestation (WG)] and term placentae (TP; 38–42 WG).

  11. A three-part intervention to change the use of hormone replacement therapy in response to new evidence.

    Science.gov (United States)

    Roumie, Christianne L; Grogan, Eric L; Falbe, William; Awad, Joseph; Speroff, Theodore; Dittus, Robert S; Elasy, Tom A

    2004-07-20

    Slow adaptation of new information by providers may result in suboptimal care. To evaluate changes in prescriptions for combination hormone replacement therapy (HRT) after a multicomponent intervention to deliver new information to patients and providers. Quasi-experimental study with multiple baselines. Veterans Affairs Tennessee Valley Healthcare System (VA-TVHS). Female veterans age 50 to 79 years who had a prescription filled at the VA-TVHS for combination HRT between 1 January 2002 and 1 July 2002. Discontinuation of HRT. A 3-part intervention consisted of 1) notifying patients who were using combination HRT of the results of the Women's Health Initiative study (patient education component), 2) sending all providers an e-mail with the Women's Health Initiative study results (provider education component), and 3) placing an electronic alert in each eligible patient's chart (provider care component). The alert asked providers to reevaluate the need for combination HRT. The intervention was implemented at different VA-TVHS sites in a stepwise fashion to differentiate intervention effect from media effect. Study follow-up continued through 31 December 2002. The total rate of discontinuation of combination HRT was 70.3% in 2002. The proportion of discontinuation from time of media release until intervention was 23.3%. After initiation of the intervention, an additional 43% of the original cohort discontinued use of HRT; this percentage represents a 59% relative decrease in HRT use among patients. After adjustment for time, the discontinuation rate per day was 4.9 times higher after the multifacted intervention than after the media release (95% CI, 1.8 to 13.1). A true control group is lacking. A multifaceted approach in an integrated health care system with standardized methods of communication is an effective way to implement patient-centered, effective, and timely care with changing medical knowledge.

  12. Effects of menopause and hormone replacement therapy on serum levels of coenzyme Q10 and other lipid-soluble antioxidants.

    Science.gov (United States)

    Palan, Prabhudas R; Connell, Kathleen; Ramirez, Elizabeth; Inegbenijie, Christian; Gavara, Rachana Y; Ouseph, Jacob A; Mikhail, Magdy S

    2005-01-01

    The present study examines the influence of menopause and hormone replacement therapy (HRT) on serum levels of coenzyme Q(10) and other lipid-soluble antioxidants in normal women. Serum levels of coenzyme Q(10), alpha-tocopherol, gamma-tocopherol, beta-carotene and lycopene in 50 premenopausal women (not using oral contraceptives), 33 healthy postmenopausal and 15 postmenopausal women on HRT ("Prempo"; combination of 0.625 mg conjugated estrogen and 2.5 mg medroxyprogesterone acetate) were measured by high-pressure liquid chromatography. Lipid profiles were also analyzed. Significantly higher serum coenzyme Q(10) and alpha-tocopherol levels were detected in postmenopausal compared with premenopausal women (P < 0.05, and < 0.001); whereas, in postmenopausal subjects on HRT, we detected a significant decrease in coenzyme Q(10) and gamma-tocopherol levels (P < 0.001, and < 0.05) and increased alpha-tocopherol levels (P < 0.05). Serum levels of beta-carotene, lycopene, LDL, HDL, cholesterol and triglyceride were comparable among the study groups. Coenzyme Q(10) is postulated to be involved in preventing cardiovascular disease (CVD) because of its bioenergetics role in the mitochondrial respiratory chain and its antioxidant properties at the mitochondrial and extramitochondrial levels. The decrease in serum concentrations of coenzyme Q(10), produced by HRT, may promote oxygen free radical-induced membrane damage and may, thus alter cardiovascular risk in postmenopausal women. HRT-induced reductions in lipid-soluble antioxidant(s) levels, and its potential consequences on CVD, needs to be further investigated.

  13. Combination of raloxifene, aspirin and estrogen as novel paradigm of hormone replacement therapy in rabbit model of menopause

    Science.gov (United States)

    Yang, Fa-lin; Hu, Ke-qing; Wang, Xin; Liu, Zi-mo; Hu, Qin; Li, Ji-fu; He, Hong

    2011-01-01

    Aim: To assess a novel hormone replacement therapy (HRT) paradigm using raloxifene, aspirin combined with estrogen in rabbit model of menopause. Methods: Female New Zealand white rabbits were ovariectomized or sham-operated. The ovariectomized rabbits were divided into 7 groups: estradiol valerate (E2), raloxifene, aspirin, E2 /raloxifene, E2/aspirin, E2 /raloxifene/aspirin and vehicle. Two weeks after the operation, the rabbits were administered the above drugs for 12 weeks. Then, the mammary glands were examined histologically, uterus was weighted, and blood sample was collected for analyzing the levels of estrogen, serum lipids and monocyte chemoattractant protein (MCP)-1, and platelet aggregation. The aortic tissue was examined morphometrically. Results: Compared with E2 0.1 mg·kg−1·d−1 treatment alone, the pairing of raloxifene 10 mg·kg−1·d−1 with E2 significantly decreased the extent of mammary gland branches and ducts (5.53%±1.23% vs 15.4%±2.17%, Praloxifene or E2 alone treatment significantly stimulated platelet aggregation relative to vehicle group. Addition of aspirin 5 mg·kg−1·d−1 reduced platelet aggregation to almost the same level as the vehicle group. E2 treatment exerted a positive effect on serum lipids and MCP-1, and a regression in aortic intimal plaque size compared to the vehicle. Raloxifene reinforced the positive effects of E2. Conclusion: The combination of raloxifene, aspirin and E2 exhibits positive lipid, MCP-1 and atherosclerotic responses with minimal stimulation of breast and uterine tissues as well as platelet aggregation in a rabbit model of the menopause. PMID:21765446

  14. Volumetric quantification of the effect of aging and hormone replacement therapy on breast composition from digital mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Hammann-Kloss, J.S., E-mail: sophie.hammann-kloss@egzb.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Ärztlicher Dienst, Evangelisches Geriatriezentrum Berlin gGmbH, Reinickendorfer Straße 61, 13347 Berlin (Germany); Bick, U., E-mail: ulrich.bick@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Fallenberg, E., E-mail: eva.fallenberg@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Engelken, F., E-mail: florian.engelken@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany)

    2014-07-15

    Objective: To assess the physiological changes in breast composition with aging using volumetric breast composition measurement from digital mammograms and to assess the effect of hormone replacement therapy (HRT). Methods: A total of 764 consecutive mammograms of 208 non-HRT using women and 508 mammograms of 134 HRT-using women were analyzed using a volumetric breast composition assessment software (Quantra™, Hologic Inc.). Fibroglandular tissue volume (FTV), breast volume (BV), and percent density (PD) were measured. For statistical analysis, women were divided into a premenopausal (<46 years), a perimenopausal (46–55 years), and a postmenopausal (>55 years) age group. More detailed graphical analysis was performed using smaller age brackets. Women using HRT were compared to age-matched controls not using HRT. Results: Women in the postmenopausal age group had a significantly lower FTV and PD and a significantly higher BV than women in the premenopausal age group (FTV: 77 vs. 120 cm{sup 3}, respectively; PD: 16% vs. 28%, respectively; BV 478 vs. 406 cm{sup 3}, respectively; p < 0.01 for all). Median FTV was nearly stable in consecutive mammograms in the premenopausal and postmenopausal age groups, but declined at a rate of 3.9% per year in the perimenopausal period. Median PD was constant in the premenopausal and postmenopausal age groups and declined at a rate of 0.57% per year in the perimenopausal age group. BV continuously increased with age. Women using HRT throughout the study had a 5% higher PD than women not using HRT (22% vs. 17%, respectively; p < 0.001). Conclusions: Accurate knowledge of normal changes in breast composition are of particular interest nowadays due to the importance of breast density for breast cancer risk evaluation. FTV and PD change significantly during the perimenopausal period but remain relatively constant before and thereafter. Median total breast volume consistently increases with age and further contributes to changes in

  15. Polymorphisms in Th1/Th2 cytokine Genes, hormone replacement therapy, and risk of non-Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Gongjian eZhu

    2011-07-01

    Full Text Available AbstractWe conducted a population-based case-control study in Connecticut women to test the hypothesis that genetic variations in Th1 and Th2 cytokine genes modify the relationship between hormone replacement therapy (HRT and risk of non-Hodgkin lymphoma (NHL. Compared to women without a history of HRT use, women with a history of HRT use had a significantly decreased risk of NHL if they carried IFNGR2 (rs1059293 CT/TT genotypes (OR=0.5, 95%CI: 0.3-0.9, IL13 (rs20541 GG genotype (OR=0.6, 95%CI: 0.4-0.9 and IL13 (rs1295686 CC genotype (OR=0.6, 95%CI: 0.4-0.8, but not among women who carried IFNGR2 CC, IL13 AG /AA and IL13 CT/TT genotypes. A similar pattern was also observed for B-cell lymphoma but not for T-cell lymphoma. A statistically significant interaction was observed for IFNGR2 (rs1059293 Pforinteraction=0.024, IL13 (rs20541 Pforinteraction=0.005, IL13 (rs1295686 Pforinteraction=0.008 and IL15RA (rs2296135 Pforinteraction=0.049 for NHL overall; IL13 (rs20541 Pforinteraction=0.0009, IL13 (rs1295686 Pforinteraction=0.0002, and IL15RA (rs2296135 Pforinteraction=0.041 for B-cell lymphoma. The results suggest that common genetic variation in Th1/Th2 pathway genes may modify the association between HRT and NHL risk.

  16. Hormone replacement therapy and risk of new-onset atrial fibrillation after myocardial infarction--a nationwide cohort study.

    Directory of Open Access Journals (Sweden)

    Ditte-Marie Bretler

    Full Text Available OBJECTIVES: Our aim was to assess the association between use of hormone replacement therapy (HRT and risk of new-onset atrial fibrillation (AF after myocardial infarction. DESIGN, SETTING AND PARTICIPANTS: We used Danish nationwide registers of hospitalizations and prescriptions to identify all women admitted with myocardial infarction in the period 1997 to 2009 and with no known diagnosis of AF. Their use of overall HRT and HRT categories was assessed. Multivariable Cox proportional hazards analysis was used to calculate the risk of new-onset AF first year after discharge, comparing use of HRT to no use. MAIN OUTCOME MEASURES: New-onset atrial fibrillation. RESULTS: In the period 1997 to 2009, 32 925 women were discharged alive after MI. In the first year after MI, new-onset AF was diagnosed in 1381 women (4.2%. Unadjusted incidence rates of AF decreased with use of HRT (incidence rate 37.4 for use of overall HRT and 53.7 for no use. Overall HRT was associated with a decreased risk of AF (HR 0.82, 95% confidence interval [CI] 0.68-1.00. The lowest risk of AF was found in women ≥80 years old for use of overall HRT and vaginal estrogen (HR 0.63, CI 0.42-0.94, and HR 0.58, CI 0.34-0.99, respectively. Decreased risk of AF with use of overall HRT and HRT categories was also found in other age groups. CONCLUSIONS: Use of HRT is associated with a decreased risk of new-onset AF in women with myocardial infarction first year after discharge. The underlying mechanisms remain to be determined. Unmeasured confounding might be one of them.

  17. 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.

  18. Comparing the Effects of Continuous Hormone Replacement Therapy and Tibolone on the Genital Tract of Menopausal Women; A Randomized Controlled Trial

    OpenAIRE

    Ziaei, Saeideh; Masoumi, Raziyeh; Faghihzadeh, Soghrat

    2010-01-01

    Introduction Many postmenopausal women who are on hormone replacement therapy discontinue medications due to vaginal bleeding. Tibolone, a synthetic steroid, has minimal stimulatory effect on the endometrium. The aim of this study was to assess the effects of continuous HRT regimen and tibolone on the onset of vaginal bleeding and vaginal maturation value. Materials and Methods A total of 150 healthy women in postmenopausal period were randomly enrolled in this controlled clinical trial. Pati...

  19. Remarkable change in age-specific breast cancer incidence in the Swiss canton of Geneva and its possible relation with the use of hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Wespi Yves

    2006-03-01

    Full Text Available Abstract Background This article aims to explain the reasons for the remarkable change in age of breast cancer occurrence in the Swiss canton of Geneva. Methods We used population-based data from the Geneva cancer registry, which collects information on method of detection, stage and tumour characteristics since 1975. For patients diagnosed between 1997–2003, we obtained additional information on use of hormone replacement therapy from a large prospective study on breast cancer. Using generalized log linear regression analysis, we compared age-specific incidence rates with respect to period, stage, oestrogen receptor status, method of detection and use of hormone replacement therapy. Results In the periods 1975–1979 and 1985–1989, breast cancer risk increased with age, showing the highest incidence rates among women aged ≥ 85 years. From 1997, the age-specific incidence curve changed completely (p Conclusion The increasing prevalence of hormone replacement therapy use during the 1990s could explain the important change in age-specific breast cancer incidence, not only by increasing breast cancer risk, but also by revealing breast cancer at an earlier age.

  20. Low use of long-term hormone replacement therapy in Denmark

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Steffensen, Flemming Hald; Sørensen, Henrik Toft

    1999-01-01

    .8% during the study period, and the therapeutic intensity (DDD/1000 women/day) increased from 20.6 to 32.0. The mean DDD sum of systemic HRT per user was 73.4 in 1991; it and the proportion of users who received less than 90 DDD per year (83.4% in 1991) remained almost constant during the study period....... The amount of oestrogen unopposed by progestin was high, 28.1% of all prescriptions. Conclusions Less than one-fifth of the study population used HRT for more than 3 months per year, and only 32.8% of the women who were new users of HRT in 1992 continued this therapy throughout the study period....

  1. Policies for replacing long-term indwelling urinary catheters in adults.

    Science.gov (United States)

    Cooper, Fergus P M; Alexander, Cameron Edwin; Sinha, Sanjay; Omar, Muhammad Imran

    2016-07-26

    Long-term indwelling catheters are used commonly in people with lower urinary tract problems in home, hospital and specialised health-care settings. There are many potential complications and adverse effects associated with long-term catheter use. The effect of health-care policies related to the replacement of long-term urinary catheters on patient outcomes is unclear. To determine the effectiveness of different policies for replacing long-term indwelling urinary catheters in adults. We searched the Cochrane Incontinence Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 19 May 2016), and the reference lists of relevant articles. All randomised controlled trials investigating policies for replacing long-term indwelling urinary catheters in adults were included. At least two review authors independently performed data extraction and assessed risk of bias of all the included trials. Quality of evidence was assessed by adopting the GRADE approach. Any discrepancies were resolved by discussion between the review authors or an independent arbitrator. We contacted the authors of included trials to seek clarification where required. Three trials met the inclusion criteria, with a total of 107 participants in three different health-care settings: A USA veterans administration nursing home; a geriatric centre in Israel; and a community nursing service in Hong Kong. Data were available for three of the pre-stated comparisons. Priefer and colleagues evaluated different time intervals between catheter replacement (n = 17); Firestein and colleagues evaluated the use of antibiotic prophylaxis at the time of replacement (n = 70); and Cheung and colleagues compared two different types of cleaning solutions (n = 20).All the included trials were

  2. 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…

  3. Cardiac function in growth hormone deficient patients before and after 1 year with replacement therapy: a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens Oscar; Kjær, Andreas

    2011-01-01

    Assessed by conventional echocardiography the influence of growth hormone deficiency (GHD) and effects of replacement therapy on left ventricle (LV) function and mass (LVM) have shown inconsistent results. We aimed to evaluate cardiac function before and during replacement therapy employing...... and after 1 year of GH replacement therapy. IGF-I, B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) were measured after 0, 1, 2, 3, 6 and 12 months of treatment. IGF-I Z-score increased from (median (IQR)) -2.3 (-3.8 to -1.4) to 0.5 (-0.3 to 1.7). LVM index (LVMI), ejection fraction...

  4. Variação da Pressão Arterial em Usuárias de Terapia de Reposição Hormonal Variation of Blood Pressure in Users of Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    José Alaércio de Toledo Lima-Junior

    2000-06-01

    Full Text Available Objetivo: avaliar os efeitos da terapia de reposição hormonal sobre a pressão arterial sistólica e diastólica de mulheres na pós-menopausa. Casuística e Métodos: foram avaliadas retrospectivamente 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 por um período de três anos. Avaliamos a variação desses parâmetros em relação aos valores iniciais. A análise dos dados foi realizada usando-se o teste t de Student, o Teste de Mann-Whitney e o teste não-paramétrico de Wilcoxon. Resultados: observou-se que a pressão arterial sistólica das usuárias de terapia de reposição hormonal foi menor ao final do terceiro ano de uso quando comparada com os valores iniciais (p = 0,01. Não houve diferença significativa na pressão arterial diastólica entre as usuárias e as não-usuárias. Conclusão: a terapia de reposição hormonal não produziu alterações nos parâmetros estudados em mulheres adequadamente acompanhadas durante o seu uso.Purpose: to evaluate the effects of hormone replacement therapy (HRT on the systolic and diastolic blood pressure of postmenopausal women. Methods: a total of 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 of these parameters were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through Student's t test, Mann-Whitney test, and the Wilcoxon nonparametric test. Results: we observed that the systolic blood pressure of HRT users was statistically lower at the end of the third year of use, compared to the initial values (p = 0.01. There was no significant difference in the diastolic blood pressure between users and non-users. Conclusion: hormone

  5. Long-term Safety of Testosterone and Growth Hormone Supplementation: A Retrospective Study of Metabolic, Cardiovascular, and Oncologic Outcomes

    OpenAIRE

    Ginzburg, Enrique; Klimas, Nancy; Parvus, Chad; Life, Jeff; Willix, Robert; Barber, Michale J.; Lin, Alvin; Comite, Florence

    2010-01-01

    Background Clinical research into the effects of hormonal supplementation has tended to focus on beneficial changes in anthropometric measures. There are fewer data on long-term safety with extended hormonal supplementation. Methods As part of a retrospective database survey, clinical outcomes were tabulated among patients who received at least 1 year of testosterone and/or growth hormone (GH) supplementation. In patients who were treated for at least 2 years, changes in markers of glucose an...

  6. A randomized clinical trial of cusp-replacing resin composite restorations: efficiency and short-term effectiveness.

    NARCIS (Netherlands)

    Kuijs, R.H.; Fennis, W.M.M.; Kreulen, C.M.; Roeters, F.J.M.; Creugers, N.H.J.; Burgersdijk, R.C.W.

    2006-01-01

    PURPOSE: This study aimed to assess the efficacy and short-term effectiveness of the morphology and function of direct and indirect cusp-replacing resin composite restorations. MATERIALS AND METHODS: In 94 patients, 106 cusp-replacing restorations for maxillary premolars were fabricated to restore

  7. Ascending aortic remodelling in Fabry disease after long-term enzyme replacement therapy.

    Science.gov (United States)

    Monney, Pierre; Qanadli, Salah Dine; Hajdu, Steven; Tran, Christel; Schwitter, Juerg; Dormond, Olivier; Barbey, Frédéric

    2017-11-09

    Previous cross-sectional studies reported a high prevalence of ascending aorta dilations/aneurysms in male adults with Fabry disease, independently of cardiovascular risk factors. To characterise the remodelling of the ascending aorta in classic Fabry disease under long-term enzyme replacement therapy. Diameter of the ascending aorta was measured with magnetic resonance imaging at the sino-tubular junction (STJ), and proximal (pAsAo), and distal ascending aorta (dAsAo) at baseline, and after 5 and 10 years of enzyme replacement therapy in 15 adult Fabry patients (10 males; 5 females). Over a mean follow-up of 9.5 years, the annual expansion rates measured in 10 males with Fabry disease were 0.41 ± 0.16, 0.36 ± 0.25 and 0.41 ± 0.26 mm/y at the STJ, pAsAo and dAsAo, respectively. Expansion rate at the pAsAo level in male patients was significantly higher than the expected expansion projected from theoretical normal values: 0.36 ± 0.25 vs 0.13 ± 0.05, p = 0.017. In 5 females, the annual expansion rates at the STJ, pAsAo and dAsAo were 0.14 ± 0.11, 0.21 ± 0.18 and 0.26 ± 0.24 mm/y, respectively. There was no significant difference from the projected normal expansion rate at the level of the pAsAo: 0.21 ± 0.18 vs 0.13 ± 0.04, p = 0.39. Our data suggest that the remodelling of the ascending aorta is more pronounced in male patients with Fabry disease under long-term enzyme replacement therapy compared with the progression observed in a large population study.

  8. Pros and Cons of Long-Term use of Nicotine Replacement Therapies: A Qualitative Study

    DEFF Research Database (Denmark)

    Borup, Gitte; Kaae, Susanne; Nørgaard, Lotte Stig

    2016-01-01

    In the last decade, harm reduction has been increasingly suggested as a method to reduce the harm caused by smoking in smokers who are unable or unwilling to quit all nicotine products. One of these methods includes long-term substitution of tobacco with nicotine replacement therapies (NRTs......, including perceived pros and cons of using NRTs, the risk of relapse to smoking and their motivation to quit using NRTs. The results identified five major themes that entailed pros and cons of the long-term use of NRTs. These were the non-nicotinic factors of NRTs, health risks of NRTs vs. smoking......, intrapersonal processes, the social environment of smoking vs. NRTs and finances. None of the ex-smokers feared to relapse to smoking, and few were motivated to quit NRTs. Non-nicotinic factors were found to have an important role in developing an addiction to NRTs. The use of NRTs yields some of the expected...

  9. Hormone Replacement Therapy Dissociates Fat Mass and Bone Mass, and Tends to Reduce Weight Gain in Early Postmenopausal Women: A Randomized Controlled 5‐Year Clinical Trial of the Danish Osteoporosis Prevention Study

    National Research Council Canada - National Science Library

    Jensen, LB; Vestergaard, P; Hermann, AP; Gram, J; Eiken, P; Abrahamsen, B; Brot, C; Kolthoff, N; Sørensen, OH; Beck‐Nielsen, H; Nielsen, S Pors; Charles, P; Mosekilde, L

    2003-01-01

    The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design...

  10. The effect of long-term prednisone treatment on growth hormone and insulin-like growth factor-1

    NARCIS (Netherlands)

    Prummel, M. F.; Wiersinga, W. M.; Oosting, H.; Endert, E.

    1996-01-01

    Due to a lack of longitudinal data the precise effect of long-term corticosteroid treatment on serum levels of the anabolic hormones Growth Hormone (GH) and Insulin-like Growth Factor-1 (IGF-1) is unknown. Therefore, we prospectively followed GH and IGF-1 levels over a six month period in 18

  11. Modelling Gaucher disease progression: long-term enzyme replacement therapy reduces the incidence of splenectomy and bone complications

    NARCIS (Netherlands)

    van Dussen, Laura; Biegstraaten, Marieke; Dijkgraaf, Marcel Gw; Hollak, Carla Em

    2014-01-01

    Long-term complications and associated conditions of type 1 Gaucher Disease (GD) can include splenectomy, bone complications, pulmonary hypertension, Parkinson disease and malignancies. Enzyme replacement therapy (ERT) reverses cytopenia and reduces organomegaly. To study the effects of ERT on

  12. 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.

  13. Deciding about hormone therapy

    Science.gov (United States)

    ... to continue seeing your doctor for regular checkups. Alternative Names HRT - deciding; Estrogen replacement therapy - deciding; ERT- deciding; Hormone replacement therapy - deciding; Menopause - deciding; HT - deciding; Menopausal hormone therapy - deciding; MHT - ...

  14. Prosthesis-Patient Mismatch After Aortic Valve Replacement: Effect on Long-Term Survival.

    Science.gov (United States)

    Swinkels, Ben M; de Mol, Bas A; Kelder, Johannes C; Vermeulen, Freddy E; ten Berg, Jurriën M

    2016-04-01

    Mean follow-up in previous studies on the effect of prosthesis-patient mismatch on long-term survival after aortic valve replacement (AVR) is confined to a maximum of one decade. This retrospective longitudinal cohort study was performed to determine the effect on long-term survival of prosthesis-patient mismatch after AVR with a mean follow-up of almost two decades. Kaplan-Meier survival analysis was used to determine long-term survival after AVR in a cohort of 673 consecutive patients, divided into 163 patients (24.2%) with prosthesis-patient mismatch (indexed effective orifice area ≤ 0.85 cm(2)/m(2)) and 510 patients (75.8%) without prosthesis-patient mismatch (indexed effective orifice area >0.85 cm(2)/m(2)). Effective orifice area values of the prosthetic valves were retrieved from the literature or obtained from the charts of the prosthetic valve manufacturers. Cox multiple regression analysis was used to identify possible independent predictors, including prosthesis-patient mismatch, of decreased long-term survival. Median sizes of the implanted mechanical (n = 430) and biologic (n = 243) prostheses were 25 and 23 mm, respectively. Mean follow-up after AVR was 17.8 ± 1.8 years. Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival (hazard ratio, 0.828; 95% confidence interval, 0.669 to 1.025; p = 0.083). Severe prosthesis-patient mismatch (indexed effective orifice area ≤ 0.65 cm(2)/m(2)), occurring in only 17 patients (2.5%), showed an insignificant trend toward decreased long-term survival (hazard ratio, 1.68; 95% confidence interval, 0.97 to 2.91; p = 0.066). Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival after AVR. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. 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

  16. [The influence of the hormonal replacement therapy on the amount and stability of the tear film among peri- and postmenopausal women].

    Science.gov (United States)

    Okoń, A; Jurowski, P; Goś, R

    2001-01-01

    To estimate the amount of the tear-film and its stability among women treated due to endocrinological or gynecological indications with hormone replacement therapy. 60 women treated with hormonal replacement therapy (HRT) were divided into 3 groups of examination: group 1 (20 women), treated with HRT after up to 1 year of menopausal symptoms, group 2 (20 women) treated with HRT between 1-5 years of menopausal symptoms, group 3 (20 women) treated with HRT after more than 5 years of menopausal symptoms. The secretion of the tear-film was measured using Schirmer I test and lisozyme test. The stability of the tear-film was measured with respect to the break-up time (BUT). The examinations were performed 3, 6, 12 months after HRT treatment. The values obtained before HRT treatment served as control. Before HRT treatment we observed significantly decreased tear secretion and lower stability in group 2 and group 3 as compared with group 1. We noticed the negative correlation between the secretion of the tear film as compared to age of examined women. HRT made the tear secretion significantly increased in group 2 and group 3 after 6, 12 and 3, 6, 12 months of HRT treatment respectively. We assessed a significant improvement of the tear film stability with respect to BUT in group 2 and 3 in all months of HRT treatment. We found significant correlation between modified Schirmer I test and lisozyme test (p film stability among peri and postmenopausal women. HRT treatment has beneficial influence on the tear film secretion and tear stabilization. Our results suggest that hormonal replacement therapy can be suitable for the treatment of the postmenopausal dry eye syndrome.

  17. The effect of a high-protein, high-sodium diet on calcium and bone metabolism in postmenopausal women stratified by hormone replacement therapy use

    DEFF Research Database (Denmark)

    Harrington, M.; Bennett, T.; Jakobsen, Jette

    2004-01-01

    randomly assigned to a diet high in protein ( 90 g/day) and sodium (180 mmol/day) ( calciuric diet) or a diet moderate in protein ( 70 g/day) and low in sodium ( 65 mmol/day) for 4 weeks followed by crossover to alternative dietary regimen for a further 4 weeks. The calciuric diet significantly (P......The objective of this study was to investigate the influence of a high-sodium, high-protein diet on bone metabolism in postmenopausal women ( aged 49 - 60 y) stratified by hormone replacement therapy (HRT) use. In a crossover trial, 18 women (n = 8 HRT users (+HRT) and n = 10 nonusers (-HRT)) were...

  18. 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.

  19. [Long-term outcomes of children treated with continuous renal replacement therapy].

    Science.gov (United States)

    Almarza, S; Bialobrzeska, K; Casellas, M M; Santiago, M J; López-Herce, J; Toledo, B; Carrillo, Á

    2015-12-01

    The objective of this study is to analyze long-term outcomes and kidney function in children requiring continuous renal replacement therapy (CRRT) after an acute kidney injury episode. A retrospective observational study was performed using a prospective database of 128 patients who required CRRT admitted to the pediatric intensive care unit between years 2006 and 2012. The subsequent outcomes were assessed in those surviving at hospital discharge. Of the 128 children who required RRT in the pediatric intensive care unit, 71 survived at hospital discharge (54.4%), of whom 66 (92.9%) were followed up. Three patients had chronic renal failure prior to admission to the NICU. Of the 63 remaining patients, 6 had prolonged or relapses of renal function disturbances, but only one patient with atypical Hemolytic Uremic Syndrome developed end-stage renal failure. The rest had normal kidney function at the last check-up. Most of surviving children that required CRRT have a positive outcome later on, presenting low mortality rates and recovery of kidney function in the medium term. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  20. Long-term benefit of enzyme replacement therapy in Pompe disease: A 5-year prospective study.

    Science.gov (United States)

    Kuperus, Esther; Kruijshaar, Michelle E; Wens, Stephan C A; de Vries, Juna M; Favejee, Marein M; van der Meijden, Jan C; Rizopoulos, Dimitris; Brusse, Esther; van Doorn, Pieter A; van der Ploeg, Ans T; van der Beek, Nadine A M E

    2017-12-05

    To determine the effect of enzyme replacement therapy (ERT) after 5 years and to identify predictors for a favorable response because few data are available on the long-term efficacy of ERT in Pompe disease. We included 102 adult patients with Pompe disease in a nationwide, prospective cohort study. We assessed muscle strength (manual muscle testing with Medical Research Council [MRC] grading, handheld dynamometry [HHD]), muscle function (6-minute walk test, Quick Motor Function Test), daily life activities (Rasch-Built Pompe-Specific Activity [R-PAct] Scale), and pulmonary function (forced vital capacity [FVC] in upright and supine positions, maximum inspiratory and expiratory pressures) at 3- to 6-month intervals before and after the start of ERT. Data were analyzed with linear mixed-effects models for repeated measurements. Median follow-up duration was 6.1 years (range 0.4-7.9 years), of which 5.0 years (range 0.2-7.3 years) were during ERT. Treated patients had better muscle strength (MRC sum score +6.6 percentage points [pp]; HHD sum score +9.6 pp, both p Pompe disease, with a peak effect at ≈2 to 3 years of treatment. This study provides Class IV evidence that for patients with Pompe disease, long-term ERT positively affects muscle strength, pulmonary function, and daily life activities. © 2017 American Academy of Neurology.

  1. Effect of Hormone Replacement Therapy (HRT and low-dose combined oral pill on skin thickness, lipid profile and blood chemistry of menopausal women

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2003-12-01

    Full Text Available This study to evaluate the effect of hormone replacement therapy ( HRT and low-dose combinated oral pill on skin thickness , lipid profile and blood chemistry on menopausal woman.This study was carried out in one year randomized prospective study. 36 women were divided into 18 women receiving HRT and the other 18 receiving low-dose oral pill. The result of this study showed an increase in skin thickness (collagen in both groups. But Those received low dose oral pill showed more . The increase of the skin thickness can prevent osteoporosis. The administration of HRT or low-dose oral pill could cause allteration in blood lipip profile and blood chemistry. But The changes were still within in normal limit. The administration of low-dose oral pill can be considered in postmeno-pausal women. (Med J Indones 2003; 12: 224-8Keywords: Hormone replacement therapy, low-dose oral pill, menopausal women, skin thickness, lipid profile, blood chemistry.

  2. New-onset postoperative atrial fibrillation after aortic valve replacement: Effect on long-term survival.

    Science.gov (United States)

    Swinkels, Ben M; de Mol, Bas A; Kelder, Johannes C; Vermeulen, Freddy E; Ten Berg, Jurriën M

    2017-08-01

    There is a paucity of data on long-term survival of new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Also, mean follow-up in previous studies is confined to a maximum of one decade. This retrospective, longitudinal cohort study was performed to determine the effect on long-term survival of new-onset POAF after aortic valve replacement (AVR) over a mean follow-up of almost 2 decades. Kaplan-Meier survival analysis was used to determine long-term survival after AVR, performed between January 1, 1990, and January 1, 1994, in 569 consecutive patients without a history of atrial fibrillation, divided into 241 patients (42.4%) with and 328 patients (57.6%) without new-onset POAF. New-onset POAF was considered in multivariable analysis for decreased long-term survival. After AVR, patients with new-onset POAF were treated with the aim to restore sinus rhythm within 24 to 48 hours from onset by medication and when medication failed by direct-current cardioversion before discharge home. Mean follow-up after AVR was 17.8 ± 1.9 years. Incidence of new-onset POAF was 42.4%. Kaplan-Meier overall cumulative survival rates at 15 years of follow-up were similar in the patients with new-onset POAF versus those without: 41.5% (95% confidence interval [CI], 35.2-47.7) versus 41.3% (95% CI, 36.0-46.7), respectively. New-onset POAF was not an independent risk factor for decreased long-term survival (hazard ratio 0.815; 95% CI, 0.663-1.001; P = .052). New-onset POAF after AVR does not affect long-term survival when treatment is aimed to restore sinus rhythm before discharge home. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  3. Subjective Sleep Quality and hormonal modulation in long-term yoga practitioners.

    Science.gov (United States)

    Vera, Francisca M; Manzaneque, Juan M; Maldonado, Enrique F; Carranque, Gabriel A; Rodriguez, Francisco M; Blanca, Maria J; Morell, Miguel

    2009-07-01

    Yoga represents a fascinating mind-body approach, wherein body movements (asana), breathing exercises (pranayama) and meditation are integrated into a single multidimensional practice. Numerous beneficial mental and physical effects have been classically ascribed to this holistic ancient method. The purpose of the present study has been to examine the effects of long-term yoga practice on Subjective Sleep Quality (SSQ) and on several hormonal parameters of the hypothalamus-pituitary-adrenal (HPA) axis. Twenty-six subjects (16 experimental and 10 controls) were recruited to be part of the study. Experimental subjects were regular yoga practitioners with a minimum of 3 years of practice. Blood samples for the quantification of adrenocorticotropic hormone (ACTH), cortisol and dehydroepiandrosterone sulphate (DHEA-S) were drawn from all subjects. Likewise, the Pittsburgh Sleep Quality Index (PSQI) was employed to assess SSQ. As statistical analysis, Mann-Whitney U-test was performed. The yoga group displayed lower PSQI scores and higher blood cortisol levels than control subjects. Therefore, it can be concluded that long-term yoga practice is associated with significant psycho-biological differences, including better sleep quality as well as a modulatory action on the levels of cortisol. These preliminary results suggest interesting clinical implications which should be further researched.

  4. Association Between Vitamin D and Carboxy-Terminal Cross-Linked Telopeptide of Type I Collagen in Children During Growth Hormone Replacement Therapy.

    Science.gov (United States)

    Witkowska-Sędek, Ewelina; Stelmaszczyk-Emmel, Anna; Kucharska, Anna; Demkow, Urszula; Pyrżak, Beata

    2017-09-22

    Growth hormone and insulin-like growth factor-1 (IGF-1) play a crucial role in the regulation of bone turnover. Adequate vitamin D status supports proper bone remodeling, leading to normal longitudinal bone growth and normal peak bone mass. The aim of this study was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] and carboxy-terminal cross-linked telopeptide of type I collagen (ICTP) in children and adolescents with growth hormone deficiency at baseline and during recombinant human growth hormone (rhGH) replacement therapy. The study was prospective and included 30 children and adolescents aged 5 to 17 years. Concentrations of 25(OH)D, ICTP, and IGF-1 were measured at baseline and during the first year of rhGH therapy. Baseline serum 25(OH)D concentration correlated with ICTP concentrations during the first trimester of rhGH therapy (r = 0.38, p < 0.050); the correlation was stronger in the second trimester of therapy (r = 0.6, p = 0.002). We conclude that proper vitamin D status is important in reaching the adequate dynamics of bone remodeling during growth, which is essential to achieve a catch-up growth during rhGH therapy.

  5. Beneficial Effects of Long-Term Growth Hormone Treatment on Adaptive Functioning in Infants With Prader-Willi Syndrome.

    Science.gov (United States)

    Lo, Sin T; Festen, Dederieke A M; Tummers-de Lind van Wijngaarden, Roderick F A; Collin, Philippe J L; Hokken-Koelega, Anita C S

    2015-07-01

    The aim of this study was to investigate the effect of growth hormone treatment on adaptive functioning in children with Prader-Willi syndrome. Vineland Adaptive Behavior Scale (VABS) was assessed during a randomized controlled trial (RCT) and after 7 years of growth hormone treatment. In the RCT, 75 children (42 infants and 33 prepubertal children) with Prader-Willi syndrome were included. Subsequently, 53 children were treated with long-term growth hormone. Our study demonstrates a marked delay in adaptive functioning in infants and children with Prader-Willi syndrome, which was associated with older age and lower intelligence. Results of the repeated measurements show that the earlier growth hormone treatment was started during infancy, the better the adaptive skills were on the long-term.

  6. Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Evgeniy Viktorovich Mikhalev

    2015-03-01

    Full Text Available The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM.The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes.

  7. The AES total ankle replacement: A mid-term analysis of 93 cases.

    Science.gov (United States)

    Henricson, Anders; Knutson, Kaj; Lindahl, Johan; Rydholm, Urban

    2010-06-01

    There are few studies concerning specific total ankle arthroplasties. This study reports mid-term survival data for the AES prosthesis. Ninety-three AES ankle arthroplasties were performed by the senior authors. The mean follow-up was 3.5 years. The 5-year survivorship and also the number of simultaneous procedures, reoperations, additional procedures and revisions are analyzed. The 5-year survivorship with revision for any reason as end-point was 90%. Simultaneous procedures were performed in 25 patients, deltoid release and subtalar fusion being the most common. There were seven revisions, one due to loosening, and two due to infection, instability and fractures, respectively. Twenty-seven reoperations or additional procedures were performed in 23 patients with a procedure for malleolar impingement being the most common reoperation, and correction of hindfoot varus being the most common reason for an additional procedure. The AES total ankle replacement seems to be a reasonably safe procedure in experienced hands. Copyright 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  8. Response to long-term enzyme replacement treatment in dogs with exocrine pancreatic insufficiency.

    Science.gov (United States)

    Wiberg, M E; Lautala, H M; Westermarck, E

    1998-07-01

    To study response to long-term enzyme replacement treatment in dogs with exocrine pancreatic insufficiency (EPI). Cross-sectional study. 76 German Shepherd Dogs or rough-coated Collies with EPI and 145 clinically normal dogs of the same breeds. Questionnaires were sent to owners of dogs with EPI and owners of clinically normal dogs. Dogs with EPI had been given dietary enzyme supplements for at least 4 months. Relative frequency distributions of gastrointestinal tract and dermatologic signs, prevalences of typical signs of EPI (e.g., weight loss, ravenous appetite, yellow and pulpy feces, high fecal volume), feeding regimens, and dietary intolerances were compared between dogs with EPI and clinically normal dogs. Gastrointestinal tract signs considered typical for dogs with EPI were almost completely controlled with dietary enzyme supplements in half of the dogs with EPI, and their general health was similar to that of clinically normal dogs. A poor treatment response was found in a fifth of dogs with EPI that had several signs that were typical of EPI. Signs most often persisting were high fecal volume, yellow and pulpy feces, and flatulence. Dermatologic problems were common, especially in German Shepherd Dogs with EPI. Treatment response was irrespective of breed. Nonenteric-coated enzyme supplements, powdered enzyme, and raw chopped pancreas were equally effective in controlling clinical signs. Although dietary sensitivities were common, use of adjunctive dietary treatment was minimal. Antibiotics were occasionally administered to half of the dogs with EPI. Results of this study indicate that, with basically similar treatment regimens, response to long-term enzyme treatment in dogs with EPI varied considerably.

  9. High rate of osteolytic lesions in medium-term followup after the AES total ankle replacement.

    Science.gov (United States)

    Kokkonen, Ari; Ikävalko, Mikko; Tiihonen, Raine; Kautiainen, Hannu; Belt, Eero A

    2011-02-01

    Some previous studies have shown a high percentage of early-onset and rapidly progressing osteolysis associated with total ankle arthroplasty (TAA) by the Ankle Evolutive System (AES). The purpose of our study was to analyze medium-term results at our institution. Altogether 38 TAAs using AES prostheses were carried out between 2003 and 2007. Diagnoses were rheumatoid arthritis (71%), post-traumatic and idiopathic osteoarthritis (29%). The mean age was 54 years, followup 28 months. Tibial and talar components had hydroxyapatite coating on metal (Co-Cr) components (HA-coated). Since 2005 the design was changed and components were porous coated with titanium and hydroxyapatite (dual-coated). Two-year survival was 79% (95% CI: 56 to 98). At followup 34 (89%) primary tibial and talar components were preserved. In 19 (50%) TAAs osteolysis (more than or equal to 2 mm) occurred in the periprosthetic bone area and in nine (24%) comprised large "cyst-like osteolysis''. In HA-coated prostheses radiolucent lines (less than or equal to 2 mm) or osteolysis (more than or equal to 2 mm) were detected in 11 (100%) cases and in dual-coated prostheses in 19 (74%) (p = 0.08). On the other hand there was more large "cyst-like osteolysis'' around the dual-coated prosthesis and lesions were larger (p = 0.017). In rheumatoid arthritis osteolysis was detected in 14 (52%) and large "cyst-like osteolysis'' in seven (26%) prostheses and in the group of traumatic and idiopathic osteoarthritis in six (55%) and two (18%), respectively. This study showed a high frequency of osteolysis in medium-term followup after the AES ankle replacement. The outcome was not sufficiently beneficial and we have discontinued use of this prosthesis.

  10. Progestins used in hormonal replacement therapy display different effects in coronary arteries from New Zealand white rabbits

    DEFF Research Database (Denmark)

    Pedersen, Nina G; Pedersen, Susan H; Dalsgaard, Tórur

    2004-01-01

    ) medroxyprogesterone acetate (MPA), (2) norethisterone acetate (NETA), (3) conjugated equine estrogens (CEE), (4) 17-beta-estradiol (E2), (5) MPA+CEE , (6) NETA+E2 , (7) or placebo (n=8) and given hormonal treatment through the diet for 4 weeks. Ring segments from the left proximal coronary artery and from the distal...... part of the left anterior descending coronary artery were microdissected and mounted for isometric tension recordings in a myograph. The vasoconstrictory responses induced by potassium, endothelin-1, calcium and Nw-nitro-L-arginine methyl ester, and the vasodilatory response induced by acetylcholine...

  11. Thyroid function in children with growth hormone (GH deficiency during the initial phase of GH replacement therapy - clinical implications

    Directory of Open Access Journals (Sweden)

    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

  12. Can anti-Mullerian hormone replace ultrasonographic evaluation in polycystic ovary syndrome? A review of current progress

    Directory of Open Access Journals (Sweden)

    Awadhesh Kumar Singh

    2015-01-01

    Full Text Available Several studies over the past decade have now consistently indicated that the serum anti-Mullerian hormone (AMH levels are at least 2–3-fold higher in the patients with polycystic ovary syndrome (PCOS, which also corresponds to the increased number of AMH producing preantral and small antral follicles. Moreover, AMH levels have been found to be associated in direct proportion to the follicle numbers per ovary or antral follicular count, assessed by the transvaginal ultrasound (TVS. Furthermore, AMH correlates directly with the rising serum testosterone and luteinizing hormone levels in PCOS. Hence, serum AMH in women with oligo-anovulation and/or hyperandrogenemia could indicate the presence of underlying PCOS, when reliable TVS is not feasible, or not acceptable, either due to the virginal status or psycho-social issue. In addition, the imaging quality of abdominal ultrasound is often impaired by obesity, which typically occurs in PCOS women. Indeed, PCOS occurs most commonly in young females who cannot be subjected to invasive TVS for various reasons; therefore, a desirable alternative to TVS is urgently required to diagnose the most prevalent endocrine abnormality of young women. This review will analyze the currently available evidence regarding the role of AMH in the diagnosis of PCOS.

  13. Impact of Prosthesis-Patient Mismatch on Long-term Functional Capacity After Mechanical Aortic Valve Replacement

    NARCIS (Netherlands)

    Petit-Eisenmann, H.; Epailly, E.; Velten, M.; Radojevic, J.; Eisenmann, B.; Kremer, H.; Kindo, M.

    2016-01-01

    BACKGROUND: The impact of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) for aortic stenosis on exercise capacity remains controversial. The aim of this study was to analyze the long-term impact of PPM after mechanical AVR on maximal oxygen uptake (VO2max). METHODS: The study

  14. Patient-reported outcome of hip resurfacing arthroplasty and standard total hip replacement after short-term follow-up

    DEFF Research Database (Denmark)

    Nissen, Nina; Douw, Karla; Overgaard, Søren

    2011-01-01

    The purpose of this study was to investigate patientreported outcome in terms of satisfaction in two study groups that had undergone hip resurfacing arthro-plasty (HRA) or total hip replacement (THR). The procedure consists of placing a hollow, mushroom-shaped metal cap over the femoral head while...

  15. Weight Changes in Patients with Differentiated Thyroid Carcinoma during Postoperative Long-Term Follow-up under Thyroid Stimulating Hormone Suppression

    Directory of Open Access Journals (Sweden)

    Seo Young Sohn

    2015-09-01

    Full Text Available BackgroundThere are limited data about whether patients who receive initial treatment for differentiated thyroid cancer (DTC gain or lose weight during long-term follow-up under thyroid stimulating hormone (TSH suppression. This study was aimed to evaluate whether DTC patients under TSH suppression experience long-term weight gain after initial treatment. We also examined the impact of the radioactive iodine ablation therapy (RAIT preparation method on changes of weight, comparing thyroid hormone withdrawal (THW and recombinant human TSH (rhTSH.MethodsWe retrospectively reviewed 700 DTC patients who underwent a total thyroidectomy followed by either RAIT and levothyroxine (T4 replacement or T4 replacement alone. The control group included 350 age-matched patients with benign thyroid nodules followed during same period. Anthropometric data were measured at baseline, 1 to 2 years, and 3 to 4 years after thyroidectomy. Comparisons were made between weight and body mass index (BMI at baseline and follow-up.ResultsSignificant gains in weight and BMI were observed 3 to 4 years after initial treatment for female DTC but not in male patients. These gains among female DTC patients were also significant compared to age-matched control. Women in the THW group gained a significant amount of weight and BMI compared to baseline, while there was no increase in weight or BMI in the rhTSH group. There were no changes in weight and BMI in men according to RAIT preparation methods.ConclusionFemale DTC patients showed significant gains in weight and BMI during long-term follow-up after initial treatment. These changes were seen only in patients who underwent THW for RAIT.

  16. 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

    , and Health" diagnosed with breast cancer (BC) were identified and their pre-diagnostic HRT use evaluated for association with tumour biology and breast cancer outcome in multivariate analysis. MAIN OUTCOME MEASURE: Breast cancer specific mortality. RESULTS: Of the 1212 patients originally considered 1064......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...... were included. Of these, 105 women died from breast cancer during a median follow-up of 6.3 years (range 0.2-14.3 years). In multivariate analyses women who used HRT at enrolment into the cohort study had 47% lower risk of dying from breast cancer as compared to women who had previously or never used...

  17. Parallel assessment of the impact of different hormone replacement therapies on breast density by radiologist-and computer-based analyses of mammograms

    DEFF Research Database (Denmark)

    Pettersen, P.C.; Raundahl, Jakob; Loog, M.

    2008-01-01

    OBJECTIVES: First, to compare the impact of nasally and orally dosed estradiol on breast density; second, to investigate the utility of computer-based automated approaches to the assessment of breast density with reference to traditional methods. METHODS: Digitized images from two 2-year, randomi......OBJECTIVES: First, to compare the impact of nasally and orally dosed estradiol on breast density; second, to investigate the utility of computer-based automated approaches to the assessment of breast density with reference to traditional methods. METHODS: Digitized images from two 2-year......, randomized, placebo-controlled trials formed the basis of the present post hoc analysis. Active treatments were 1 mg estradiol continuously combined with 0.125 mg trimegestone (oral hormone replacement therapy, HRT) or low-dose (150 or 300 microg estradiol) nasal estradiol cyclically combined with 200 mg...

  18. Preoperative Quadriceps Strength as a Predictor for Short-Term Functional Outcome After Total Hip Replacement

    NARCIS (Netherlands)

    Holstege, Marije S.; Lindeboom, Robert; Lucas, Cees

    2011-01-01

    Objective: To determine the preoperative strength of the muscle group of the lower extremity that is most important in predicting functional recovery after primary unilateral total hip replacement (THR). Design: Prospective observational study with inception cohort. Settings: Joint care program

  19. Serum Thyroid-Stimulating Hormone Levels and Body Mass Index Percentiles in Children with Primary Hypothyroidism on Levothyroxine Replacement.

    Science.gov (United States)

    Shaoba, Asma; Basu, Sanjib; Mantis, Stelios; Minutti, Carla

    2017-12-15

    To determine the association, if any, between thyroid-stimulating hormone (TSH) levels and body mass index (BMI) percentiles in children with primary hypothyroidism who are chemically euthyroid and on treatment with levothyroxine. This retrospective cross-sectional study consisted of a review of medical records from RUSH Medical Center and Stroger Hospital, Chicago, USA of children with primary hypothyroidism who were seen in the clinic from 2008 to 2014 and who were chemically euthyroid and on treatment with levothyroxine for at least 6 months. The patients were divided into two groups based on their TSH levels (0.34-hypothyroidism who are chemically euthyroid on treatment with levothyroxine, there is a positive association between higher TSH levels and higher BMI percentiles. However, it is difficult to establish if the higher TSH levels are a direct cause or a consequence of the obesity. Further studies are needed to establish causation beyond significant association.

  20. Comparative study between the effects of replacement therapy with liquid and tablet formulations of levothyroxine on mood states, self-perceived psychological well-being and thyroid hormone profile in recently thyroidectomized patients.

    Science.gov (United States)

    Lombardi, Celestino Pio; Bocale, Raffaella; Barini, Angelina; Barini, Antonella; D'Amore, Annamaria; Boscherini, Mauro; Bellantone, Rocco

    2017-01-01

    Following thyroid surgery, levothyroxine therapy is used to replace deficient thyroid hormones and prevent postoperative thyroid hypofunction. We compared the effects of replacement therapy with either liquid or tablet formulation of levothyroxine on mood states, self-perceived mental well-being and thyroid hormone profile in recently thyroidectomized patients. Profile of mood states, General Heath Questionnaire 12-items and thyroid hormone profile were assessed in recently (5-7 days) thyroidectomized patients at baseline and 2 months after randomization to replacement therapy with either liquid (n = 77) or tablet (n = 78) formulation of levothyroxine. After 2 months under levothyroxine replacement treatment, significant improvements of Positive Affect Scale (p Negative Affect Scale (p mood states, as well as of General Heath Questionnaire 12-items (p Positive Affect Scale of Profile of mood states, p = 0.030; Negative Affect Scale of Profile of mood states, p mood states and self-perception of mental well-being and thyroid hormone profile after 2 months of replacement therapy in recently thyroidectomized patients.

  1. Effect of long-term treatment with steroid hormones or tamoxifen on the progesterone receptor and androgen receptor in the endometrium of ovariectomized cynomolgus macaques

    Directory of Open Access Journals (Sweden)

    Cline J Mark

    2003-02-01

    Full Text Available Abstract The progesterone receptor (PR and androgen receptor (AR belong to the nuclear receptor superfamily. Two isoforms of PR (A and B have been identified with different functions. The expression of AR, each isoform of PR and their involvement in long-term effects on the endometrium after hormonal replacement therapy (HRT or tamoxifen (TAM treatment is not known. The aims of this study were to determine PR(A+B, PRB and AR distribution by immunohistochemistry in the macaque (Macaca fascicularis endometrium. Ovariectomized (OVX animals were orally treated continuously for 35 months with either conjugated equine estrogens (CEE; medroxyprogesterone acetate (MPA; the combination of CEE/MPA; or TAM. Treatment with CEE/MPA tended to down-regulate PR in the superficial glands, but increased it in the stroma. TAM treatment increased both the PR and PRB levels in the stroma. Overall, less than 20% of the cells were positive for the PRB isoform and less variation was observed after steroid treatment. AR was found in the stroma, mainly distributed in the basal layer of the endometrium in the OVX and steroid treated groups, but was absent in the TAM treated group. No AR was found in the glandular epithelium. The present data show that long-term hormone treatment affects the PR level, and also the ratio between PRA and PRB in the endometrium.

  2. Documented short-term continuation rates for combined hormonal contraceptives in an indigent population with ready access to contraceptive supplies.

    Science.gov (United States)

    Nelson, Anita L; Pietersz, Dannelle; Nelson, LeRoy E; Aguilera, Lucy

    2007-06-01

    One problem women have successfully using combined hormonal contraception is the limited supplies they are dispensed. Patients at the Women's Health Care Clinic at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center have virtually no barriers to method switching, so it is possible to estimate the impacts that more generous prescribing policies have on short-term continuation rates. Anonymous chart review of all women who initiated hormonal contraception between Jan. 1 and June 30, 2005. Only 40.4% of women had documented use for at least 3 months. Women dispensed supplies for 3 or more cycles at the initial visit were more likely to continue use for 3 months (47.8%) than were women dispensed fewer cycles (31.9%) (P hormonal contraceptive product, but they significantly increase at least intermediate term use of those methods.

  3. 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

    in relation to two testosterone injections. Mean baseline IGF-I levels were 352 +/- 135 microg/L, and they remained unaltered during the study period (analysis of variance (ANOVA), P = 0.88). Free IGF-I levels did not change either (ANOVA, P = 0.35). Serum IGF binding protein-3 (IGFBP-3) and acid...... (ANOVA, P = 0.08). Prostate-specific antigen tended slightly to increase after each testosterone injection (ANOVA, P = 0.08, post hoc, NS). We conclude that major changes in total IGF-I are not induced during conventional intramuscular testosterone replacement in GH-treated hypopituitary males......, suggesting that testosterone effects on IGF-I are likely to be secondary to a stimulation of endogenous GH release....

  4. Effect of estrogen receptor-alpha (ESR1 gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    N.C. Nogueira-de-Souza

    2009-12-01

    Full Text Available Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT. A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1 gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029. Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032. No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.

  5. The metabolic syndrome and disturbances in hormone levels in long-term survivors of disseminated testicular cancer

    NARCIS (Netherlands)

    Nuver, J; Smit, AJ; Wolffenbuttel, BHR; Sluiter, WJ; Hoekstra, HJ; Sleifer, DT; Gietema, JA

    2005-01-01

    Purpose The metabolic syndrome may be an important risk factor for cardiovascular disease in long-term survivors of testicular cancer (TC). We investigated the associations between hormone levels and the metabolic syndrome in these men. Patients and Methods We included TC patients cured by

  6. Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model

    NARCIS (Netherlands)

    Vrancken, A.C.T.; Madej, W.; Hannink, G.; Verdonschot, N.J.; Tienen, T.G. van; Buma, P.

    2015-01-01

    PURPOSE: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on

  7. Short term evaluation of an anatomically shaped polycarbonate urethane total meniscus replacement in a goat model

    NARCIS (Netherlands)

    Vrancken, A.C.T.; Madej, W.; Hannink, G.; Verdonschot, Nicolaas Jacobus Joseph; van Tienen, T.G.; Buma, P.

    2015-01-01

    Purpose: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on

  8. Long-term Lentil Green-manure Replacement for Fallow in the Semiarid Northern Great Plains

    Science.gov (United States)

    Summer fallow results in inefficient precipitation use and could potentially be replaced with a green manure (GM) crop that reduces fertilizer N application. A 12-year study near Culbertson, MT on a Williams loam (fine-loamy, mixed Typic Argiboroll) determined GM impacts on soil-N fertility, soil or...

  9. The Effect of Long Term Starvation on Galanin, Leptin, Thyroid Hormones, Insulin, Prolactin, Growth Hormone, Ghrelin and Factors Involved in Energy Metabolism in Adult Goats

    Directory of Open Access Journals (Sweden)

    Neda ESKANDARZADE

    2015-07-01

    Full Text Available Some hormonal disturbances have been demonstrated in starvation, but in ruminants such as goats, the role of galanin in adaptation to starvation or endocrine functions is not well studied. The present study was conducted to assess the effect of long term starvation on galanin, leptin, thyroid hormones, insulin, prolactin, growth hormone, ghrelin and factors involved in energy metabolism including HDL, Cholesterol, β-hydroxybutyrate, glucose, NEFA, TG and VLDL concentrations in adult goats. Eight non-lactating non-pregnant goats aged 4-5 years and BCS 3 were randomly divided to control and test groups. The animals were trained to eat their daily forage ration during a 10 day period. The experimental procedure was applied for 20 days, during which control group received 120% of maintenance energy, while the test group was supplied with 80% of maintenance energy for the first 10 days and with 40% of maintenance energy for another 10 days. Blood samples were collected at day 10 of training and 2, 4, 10, 12, 14 and 20 days after beginning of starvation. Blood parameters were measured according to standard procedures. No significant difference was observed in the concentrations of cholesterol, fT3, T4, T3, growth hormone, NEFA, insulin and ghrelin between control and test groups (P=0.05. There was significant difference in galanin, leptin, fT4, HDL, glucose, TG, VLDL and prolactin concentrations between control and test groups (P=0.05. Control of energy balance and the role of galanin in adaptation to long starvation or endocrine functions in goat are different from other species.

  10. Thyroid hormones and iodide in the near-term pregnant rat

    NARCIS (Netherlands)

    Versloot, P.

    1998-01-01

    Thyroid hormones, thyroxine (T4) and 3,5,3'-triiodothyronine (T3), are produced by the thyroid gland. To synthesize thyroid hormones the thyroid needs iodide. The uptake of iodide as well as the production and secretion of T4 and T3 by the thyroid gland is regulated by thyrotropin (TSH),

  11. Gender influences short-term growth hormone treatment response in children

    DEFF Research Database (Denmark)

    Sävendahl, Lars; Blankenstein, Oliver; Oliver, Isabelle

    2012-01-01

    Gender may affect growth hormone (GH) treatment outcome. This study assessed gender-related differences in change from baseline height standard deviation scores (ΔHSDS) after 2 years' GH treatment.......Gender may affect growth hormone (GH) treatment outcome. This study assessed gender-related differences in change from baseline height standard deviation scores (ΔHSDS) after 2 years' GH treatment....

  12. [Alteration of thyroid hormone secretion after long-term exposure to low doses of endocrine disruptor DDT].

    Science.gov (United States)

    Iaglova, N V; Iaglov, V V

    2014-01-01

    Endocrine disruptors are exogenous substances that exhibit hormone-like action and consequently disrupt homeostatic action of endogenous hormones. DDT is the most common disruptor. The objective was to evaluate changes in thyroid hormone secretion after long-term exposure to low doses of DDT. The experiment was performed on male Wistar rats. The rats were given DDT at doses of 1.89±0.86 мg/kg/day and 7.77±0.17 мg/kg/day for 6 and 10 weeks. Dose dependent increase of serum total thyroxine, total triiodthyronine, and thyroid peroxidase was revealed after 6 weeks exposure. After 10 weeks free thyroxine secretion was reduced. Such alterations of the thyroid status are typical for iodine deficient goiter. The data obtained indicate that the main mechanism of DDT action includes disruption of thyroxine secretion by thyrocytes, but not inhibition of deiodinase activity and decrease of blood thyroid binding proteins.

  13. Effects of recombinant growth hormone (GH replacement and psychomotor and cognitive stimulation in the neurodevelopment of GH-deficient (GHD children with cerebral palsy: a pilot study

    Directory of Open Access Journals (Sweden)

    Devesa J

    2011-05-01

    Full Text Available Jesús Devesa1,2, Begoña Alonso1, Nerea Casteleiro1, Paula Couto1, Beatriz Castañón1, Eva Zas1, Pedro Reimunde1,21Medical Center “Proyecto Foltra”, Cacheiras (Teo, A Coruña, Spain; 2Department of Physiology, School of Medicine, University of Santiago de Compostela, SpainAbstract: Cerebral palsy (CP is the main cause of physical disability in childhood and is an important health issue that has a strong socioeconomic impact. There is no effective treatment for CP and therapeutic approaches report only partial benefits for affected people. In this study we assessed the effects of growth hormone (GH treatment combined with psychomotor and cognitive stimulation in the neurodevelopment of children with CP and GH deficiency (GHD. The study was carried out in 11 patients (7 boys and 4 girls; 4.12 ± 1.31 years with GHD and CP who were treated with recombinant GH (rGH and psychomotor and cognitive stimulation during 2 months. Battelle Developmental Inventory Screening Test (BDIST was performed 2 months before commencing GH treatment, just before commencing GH administration, and after 2 months of combined treatment involving GH and cognitive stimulation. Psychomotor and cognitive status did not change during the period in which only cognitive stimulation was performed; however, significant improvements in personal and social skills, adaptive behavior, gross motor skills and total psychomotor abilities, receptive and total communication, cognitive skills and in the total score of the test (P < 0.01, and in fine motor skills and expressive communication (P < 0.02 were observed after the combined treatment period. Therefore, GH replacement together with psychomotor and cognitive stimulation seem to be useful for the appropriate neurodevelopment of children with GHD and CP.Keywords: growth hormone, cerebral palsy, cognitive functions, Battelle’s test, neurodevelopment

  14. Immediate and long term evolution of valve replacement in children less than 12 years old

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    Atik Fernando Antibas

    1999-01-01

    Full Text Available OBJECTIVE: The aim of this work was the follow-up and evaluation of valve replacement in children under 12 years of age. METHODS: Forty-four children less than 12 years old were underwent valve replacement at INCOR-HCFMUSP between January 1986 and December 1992. Forty (91% were rheumatic, 39 (88.7% were in functional classes II or IV, 19 (43.2% were operated upon on an emergency basis, and 6 (13.6% had atrial fibrillation. Biological prostheses (BP were employed in 26 patients (59.1%, and mechanical prostheses (MP in 18 (40.9%. Mitral valves were replaced in 30 (68.7%, aortic valves in 8 (18.2%, a tricuspid valve in 1 (2.3%, and double (aortic and mitral valves in 5 (11.4 of the patients. RESULTS: Hospital mortality was of 4.5% (2 cases. The mean follow-up period was 5.8 years. Re-operations occurred in 63.3% of the patients with BP and in 12.5% of those with MP (p=0.002. Infectious endocarditis was present in 26.3% of the BP, but in none of the cases of MP (p=0.049. Thrombosis occurred in 2 (12.5% and hemorrhage in one (6.5% of the patients with a MP. Delayed mortality occurred in 5 (11.9% of the patients over a mean period of 2.6 years; four had had BP and one had a MP (NS. Actuarial survival and re-operation-free curves after 10 years were respectively, 82.5±7.7 (SD% and 20.6±15.9%. CONCLUSION: Patients with MP required fewer re-operation, had less infectious endocarditis and lower late mortality rates compared with patients with bioprostheses. The former, therefore, appear to be the best valve replacement for pediatric patients.

  15. Short-term outcome of 1,465 computer-navigated primary total knee replacements 2005-2008.

    Science.gov (United States)

    Gøthesen, Oystein; Espehaug, Birgitte; Havelin, Leif; Petursson, Gunnar; Furnes, Ove

    2011-06-01

    and purpose Improvement of positioning and alignment by the use of computer-assisted surgery (CAS) might improve longevity and function in total knee replacements, but there is little evidence. In this study, we evaluated the short-term results of computer-navigated knee replacements based on data from the Norwegian Arthroplasty Register. Primary total knee replacements without patella resurfacing, reported to the Norwegian Arthroplasty Register during the years 2005-2008, were evaluated. The 5 most common implants and the 3 most common navigation systems were selected. Cemented, uncemented, and hybrid knees were included. With the risk of revision for any cause as the primary endpoint and intraoperative complications and operating time as secondary outcomes, 1,465 computer-navigated knee replacements (CAS) and 8,214 conventionally operated knee replacements (CON) were compared. Kaplan-Meier survival analysis and Cox regression analysis with adjustment for age, sex, prosthesis brand, fixation method, previous knee surgery, preoperative diagnosis, and ASA category were used. Kaplan-Meier estimated survival at 2 years was 98% (95% CI: 97.5-98.3) in the CON group and 96% (95% CI: 95.0-97.8) in the CAS group. The adjusted Cox regression analysis showed a higher risk of revision in the CAS group (RR = 1.7, 95% CI: 1.1-2.5; p = 0.02). The LCS Complete knee had a higher risk of revision with CAS than with CON (RR = 2.1, 95% CI: 1.3-3.4; p = 0.004)). The differences were not statistically significant for the other prosthesis brands. Mean operating time was 15 min longer in the CAS group. With the introduction of computer-navigated knee replacement surgery in Norway, the short-term risk of revision has increased for computer-navigated replacement with the LCS Complete. The mechanisms of failure of these implantations should be explored in greater depth, and in this study we have not been able to draw conclusions regarding causation.

  16. Accurate long-term prediction of height during the first four years of growth hormone treatment in prepubertal children with growth hormone deficiency or Turner Syndrome.

    Science.gov (United States)

    Ranke, Michael B; Lindberg, Anders; Brosz, Mathias; Kaspers, Stefan; Loftus, Jane; Wollmann, Hartmut; Kołtowska-Haggstrom, Maria; Roelants, Mathieu

    2012-01-01

    The study aim was to develop and validate models for long-term prediction of growth in prepubertal children with idiopathic growth hormone deficiency (GHD) or Turner syndrome (TS) for optimal, cost-effective growth hormone (GH) therapy. Height was predicted by sequential application of annual prediction algorithms for height velocity in cohorts of GHD (n = 664) and TS (n = 607) as documented within KIGS (Pfizer International Growth Database). As height prediction models also require an estimate of weight, new algorithms for weight increase during the first to fourth prepubertal years on GH were developed. When height was predicted from the start of GH treatment, the predicted and observed mean (SD) gain over 4 years was 30.4 (3.4) cm and 30.1 (4.9) cm, respectively, in GHD patients, and 27.2 (2.2) cm and 26.6 (3.5) cm, respectively, in TS patients. For all 4 years, gains of weight SD scores (SDS) were accurately described as a function of weight SDS and observed gain in height SDS (R(2) > 0.89). In GHD and TS patients treated with GH, an accurate prepubertal long-term prediction of height development in groups is possible. Based on this, an optimal individual height outcome could be simulated. Copyright © 2012 S. Karger AG, Basel.

  17. Efeitos da terapia de reposição hormonal na cicatrização de anastomoses de cólon Effects of hormonal replacement therapy on colon anastomosis healing in rats

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Pessole Biondo-Simões

    2005-06-01

    Full Text Available OBJETIVO: Existe coincidência entre os sintomas do climatério e o aparecimento acentuado dos sinais de envelhecimento da pele. Estudos, em modelos animais, mostraram que o estrógeno é uma espécie de mediador crítico na cicatrização de feridas. Os autores apresentam um estudo da influência da terapia de reposição hormonal (TRH em anastomoses de cólon, feitas em ratas. MÉTODOS: Utilizam 3 grupos de ratas Wistar, um grupo de ooforectomizadas com TRH feita com 50mg de estrógeno e 2 mg de acetato de medroxiprogesterona, um de ooforectomizadas e sem TRH e um de ratas laparotomizadas e não ooforectomizadas. Realizaram a ooforectomia e a confirmação da condição hormonal após 28 dias. Em seguida instituíram a TRH ou de solução fisiológica, diariamente. Após 2 meses fizeram uma colotomia esquerda com anastomose término-terminal e estudaram a resistência e a densidade de colágeno com 7 e 14 dias. RESULTADOS: As anastomoses dos cólons das ratas sem TRH eram menos resistentes do que as do grupo controle tanto no 7.º dia (p=0,0488 como no 14.º dia (p=0,0115. A densidade de colágeno foi menor no 7.º dia (p=0,0210 com menor presença de colágeno I (p=0,0023 e de colágeno III (p=0,0470. No 14.º dia estas diferenças permaneceram significantes. Nas anastomoses dos cólons das ratas com TRH as diferenças, em relação ao grupo controle, não foram significantes. CONCLUSÃO: A falta dos hormônios ovarianos leva à menor resistência e atrasa a maturação de anastomoses do cólon, em ratas e estas deficiências são compensadas pela TRH.PURPOSE: The symptoms of the climacteric coincide with the marked appearance of signs of skin aging. Studies on animal models have shown that estrogen is a critical mediator in wound healing. The authors report a study of the influence of hormonal replacement therapy (HRT on colon anastomoses performed in female rats. METHODS: Three groups of Wistar rats were used: one submitted to oophorectomy

  18. Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model.

    Directory of Open Access Journals (Sweden)

    A C T Vrancken

    Full Text Available Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU, total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on the implant location in the joint, geometrical integrity of the implant and the effect of the implant on synovial membrane and articular cartilage histopathological condition.The right medial meniscus of seven Saanen goats was replaced by the implant. Sham surgery (transection of the MCL, arthrotomy and MCL suturing was performed in six animals. The contralateral knee joints of both groups served as control groups. After three months follow-up the following aspects of implant performance were evaluated: implant position, implant deformation and the histopathological condition of the synovium and cartilage.Implant geometry was well maintained during the three month implantation period. No signs of PCU wear were found and the implant did not induce an inflammatory response in the knee joint. In all animals, implant fixation was compromised due to suture breakage, wear or elongation, likely causing the increase in extrusion observed in the implant group. Both the femoral cartilage and tibial cartilage in direct contact with the implant showed increased damage compared to the sham and sham-control groups.This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading. Failure of the fixation sutures may have increased implant mobility, which probably induced implant extrusion and potentially stimulated cartilage degeneration. Evidently, redesigning the fixation method is necessary. Future animal studies should evaluate the improved fixation method and compare implant performance to current treatment standards, such as allografts.

  19. Preweaning milk replacer intake and effects on long-term productivity of dairy calves.

    Science.gov (United States)

    Soberon, F; Raffrenato, E; Everett, R W; Van Amburgh, M E

    2012-02-01

    The preweaning management of dairy calves over the last 30 yr has focused on mortality, early weaning, and rumen development. Recent studies suggest that nutrient intake from milk or milk replacer during the preweaning period alters the phenotypic expression for milk yield. The objective of this study was to investigate the relationship between nutrient intake from milk replacer and pre- and postweaning growth rate with lactation performance in the Cornell dairy herd and a commercial dairy farm. The analysis was conducted using traditional 305-d first-lactation milk yield and residual lactation yield estimates from a test-day model (TDM) to analyze the lactation records over multiple lactations. The overall objective of the calf nutrition program in both herds was to double the birth weight of calves by weaning through increased milk replacer and starter intake. First-lactation 305-d milk yield and residuals from the TDM were generated from 1,244 and 624 heifers from the Cornell herd and from the commercial farm, respectively. The TDM was used to generate lactation residuals after accounting for the effects of test day, calving season, days in milk, days pregnant, lactation number, and year. In addition, lactation residuals were generated for cattle with multiple lactations to determine if the effect of preweaning nutrition could be associated with lifetime milk yield. Factors such as preweaning average daily gain (ADG), energy intake from milk replacer as a multiple of maintenance, and other growth outcomes and management variables were regressed on TDM milk yield data. In the Cornell herd, preweaning ADG, ranged from 0.10 to 1.58 kg, and was significantly correlated with first-lactation yield; for every 1 kg of preweaning ADG, heifers, on average, produced 850 kg more milk during their first lactation and 235 kg more milk for every Mcal of metabolizable energy intake above maintenance. In the commercial herd, for every 1 kg of preweaning ADG, milk yield increased

  20. Effects of long-term fasting on female hormone levels: Ramadan model.

    Science.gov (United States)

    Cağlayan, E K; Göçmen, A Y; Delibas, N

    2014-01-01

    Ramadan fasting is a special model of hunger and particularly affects metabolic processes, including carbohydrate and lipid levels. Endocrine changes induced by Ramadan fasting are not well known. The aim of this article was to evaluate the changes in hormone levels in women before and after the special Muslim fasting period of Ramadan. This study was performed in 30 healthy women in Obstetrics and Gynecology department during the Ramadan month of2011. Patients during and after the first menstrual period had menstrual cycles fasting blood samples taken on the same days. Luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone, and prolactin (PRL) levels were determined. Before and during fasting LH, FSH, E2, testosterone and PRL levels were not statistically different. Despite the limited available studies on these subjects in women, effect of Ramadan fasting on hormone levels were found to be within the normal limits.

  1. Long-term functional outcomes after replacement of the esophagus in pediatric patients: A systematic literature review.

    Science.gov (United States)

    Garritano, Stefano; Irino, Tomoyuki; Scandavini, Chiara Maria; Tsekrekos, Andrianos; Lundell, Lars; Rouvelas, Ioannis

    2017-09-01

    The indications of esophageal replacement (ER) in pediatric patients include long gap esophageal atresia (LGEA), intractable post-corrosive esophageal strictures (PCES), and some rare esophageal diseases. Various conduits and procedures are currently used worldwide with a lack of consensus regarding the ideal substitute to replace the esophagus replacement. The short-term outcomes of these advanced procedures are well known; there are few data available describing long-term functional outcomes of these patients with long life expectancy. The objective of this study is to investigate the long-term functional outcomes of the most widely used techniques for ER in pediatric patients based on a comprehensive literature search covering the last 10years. Eligible were all clinical studies reporting outcomes after esophagectomy in pediatric patients, which contained information on at least 3years of follow-up after the operation. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic web-based search using MEDLINE, the Cochrane Library and EMBASE databases was performed, reviewing all medical literature published between January 2006 and December 2015. The scientific quality of the data was generally poor, converging toward only 14 full-text articles for the final analysis. The stomach was the preferred organ for esophageal replacement, where the tubulization of the stomach resulted in significant gastroesophageal reflux. Dysphagia symptoms were more seldom reported, but several authors presented growing figures with the length of follow-up. Dumping syndrome and delayed gastric emptying were only scarcely reported upon. Following colonic graft, chronic gastrocolic reflux affects these patients, in the range of 35-70.8%, while 4 studies reported any dysphagia from 2.7% to 50% of the children. Only one study reported the outcome of the use of a long jejunal segment, where presence

  2. Women's knowledge, attitude and practice towards menopause and hormone replacement therapy: a facility based study in Al-Ain, United Arab Emirates.

    Science.gov (United States)

    Hamid, Saima; Al-Ghufli, Fatma Rashid; Raeesi, Hanan Ali; Al-Dliufairi, Khawla Mohammed; Al-Dhaheri, Noura Salem; Al-Maskari, Fatma; Blair, Iain; Shah, Syed Mahboob

    2014-01-01

    Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms like vasomotor symptoms, sleep disturbances, mood alteration, depression, urinary tract infection, vaginal atrophy and increased health risks for osteoporosis, cardiovascular diseases and loss of cognitive function. This study was conducted to determine knowledge, attitude and practice toward menopause among women in UAE. A clinic-based cross-sectional study was carried out among women of age 40 and above. Study subjects were recruited from four Primary Health Care centres in Al Ain city. The participants were administered a questionnaire in Arabic and English, which included 33 items; socio-demographic variables, and questions related to knowledge, attitude and practices regarding menopause and HRT. Out of 177 study subjected selected, 150 (85%) completed the survey. Almost half of the participants (51%) had already experienced menopause. A substantial number of women had poor know knowledge about menopause (67%) and HRT (73%). Sixty percent of women had positive attitude towards menopause. Of the fifty three percent of women with symptoms, 35% of them did not use anything to relieve their symptoms. Knowledge about menopause varied significantly (pattitude towards menopause and HRT was found to be statistically significant. Women with reported symptoms that were bothersome had positive attitude towards HRT uptake. The study indicated that there is poor knowledge about menopause and HRT among the participants. Level of knowledge was associated with the level of education. There was a positive attitude towards menopause, with women suffering the most from menopausal symptoms showing positive attitude towards HRT.

  3. Successful pregnancies after combined pentoxifylline-tocopherol treatment in women with premature ovarian failure who are resistant to hormone replacement therapy.

    Science.gov (United States)

    Letur-Konirsch, Hélène; Delanian, Sylvie

    2003-02-01

    To determine whether treatment with combined pentoxifylline (PTX) and tocopherol (Vit.E) can improve uterine parameters in hormonal replacement therapy (HRT)-resistant women with premature ovarian failure (POF), for whom the outcome of assisted reproductive technology is usually negative. We previously reported that uterine radiation-induced fibrosis is reversible by combined PTX-Vit.E treatment. Case report. Volunteer participants in an oocyte donation (OD) program in a French public hospital. Three women with POF (ages 36 +/- 2 years) using HRT exhibited uterine hormonoresistance, although they had high E(2) plasma levels. Their mean endometrial thickness was 4.9 mm, and they had an echogenic endometrium and thin uterine crosses. Between May 1998 and April 1999, treatment consisted of 800 mg of PTX combined with 1,000 IU of Vit.E daily for at least 9 months. Endometrial thickness, echogenicity, and pulsatility index of the uterine arteries, assessed by ultrasound and Doppler before and after treatment, and embryo implantation by IVF-OD. PTX-Vit.E treatment was well tolerated and induced improvements, as mean edematous endometrial thickness increased to 7.4 mm, with nice uterine crosses. Three frozen-thawed ETs resulted in two viable pregnancies. In women with POF and uterine resistance to HRT, combined PTX-Vit.E reduces fibroatrophic uterine lesions and improves the uterine response to HRT, thus allowing embryo implantation and ongoing pregnancy.

  4. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Shan, Leonard; Shan, Bernard; Suzuki, Arnold; Nouh, Fred; Saxena, Akshat

    2015-01-21

    Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  5. Long-term Safety of Testosterone and Growth Hormone Supplementation: A Retrospective Study of Metabolic, Cardiovascular, and Oncologic Outcomes.

    Science.gov (United States)

    Ginzburg, Enrique; Klimas, Nancy; Parvus, Chad; Life, Jeff; Willix, Robert; Barber, Michale J; Lin, Alvin; Comite, Florence

    2010-08-18

    Clinical research into the effects of hormonal supplementation has tended to focus on beneficial changes in anthropometric measures. There are fewer data on long-term safety with extended hormonal supplementation. As part of a retrospective database survey, clinical outcomes were tabulated among patients who received at least 1 year of testosterone and/or growth hormone (GH) supplementation. In patients who were treated for at least 2 years, changes in markers of glucose and lipid metabolism were analyzed with and without concomitant use of oral hypoglycemics and statins. In 263 patients (mean age 56) treated for at least 2 years, the only statistically significant effect on markers of glucose metabolism was an increase in glycated hemoglobin (still within normal limits) in patients receiving GH alone or in combination with testosterone but without oral hypoglycemics; with or without hypoglycemics, insulin levels showed no significant change. The only significant effects on markers of lipid metabolism were decreases in total cholesterol and low-density lipoprotein (LDL) in patients receiving combined testosterone and GH without statins. Decreases in LDL were significant in both the statin and non-statin groups; decreases in triglycerides were significant only in the statin group. In 531 patients treated for at least 1 year (mean age 54), the overall incidence of adverse clinical outcomes (prostate disease, diabetes, cardiovascular disease, cancer) was 1.3%. In this retrospective survey, extended testosterone and/or GH supplementation did not adversely affect metabolic markers or clinical outcomes. Safety; Testosterone; Growth hormone; Supplementation.

  6. Long-term in vitro culture of bovine preantral follicles: Effect of base medium and medium replacement methods.

    Science.gov (United States)

    Araújo, V R; Gastal, M O; Wischral, A; Figueiredo, J R; Gastal, E L

    2015-10-01

    Two culture media and replacement methods were compared during long-term in vitro culture of secondary follicles of cattle using α-MEM(+) or TCM-199(+) as base media. The medium replacement methods were: Conventional - removal and subsequent addition of the same amount (60μl) in a 100μl aliquot (MEM-C and TCM-C), and Small Supplementation - addition of 5μl of fresh medium to an initial small aliquot (50μl), resulting in a final volume of 125μl on the last day of culture (MEM-S and TCM-S). A total of 207 secondary follicles were cultured individually for 32 days at 38.5°C in 5% CO2 and medium replacement was performed every other day. The MEM-S treatment resulted in a larger (P0.05) the follicular and estradiol end points for TCM-199(+). The expression of the FSHR gene was greater (Pculture of preantral follicles of cattle if progressive addition of medium is used for medium change. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Short-term effect of recombinant human growth hormone in patients with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Becker, U; Grønbaek, M

    1994-01-01

    , and liver function. Twenty consecutive patients with cirrhosis were randomized to recombinant human growth hormone (Norditropin, 4 I.U. twice daily) subcutaneously for 6 weeks (n = 10) or conventional medical treatment (n = 10). The serum concentrations of insulin-like growth factor-I in the recombinant...... human growth hormone group increased after 3 (p group. The change in insulin-like growth factor-I during the treatment period was expressed as area under the curve (AUC). The AUCIGF-I was significantly larger...... in the recombinant human growth hormone group (median AUCIGF-I: 12.1, range: 0.0-54.7 weeks.nmol/l) than in the control group (median AUCIGF-I: 0.2, range: -10.6-9.9 weeks.nmol/l) (p

  8. Exploratory survey study of long-term users of nicotine replacement therapy in Danish consumers

    DEFF Research Database (Denmark)

    Borup, Gitte; Lyngby Mikkelsen, Kim; Tønnesen, Philip

    2015-01-01

    is scarce. The aim of this study was to collect information on the characteristics of long-term NRT users, having used NRT for at least 12 months, reasons for, and contentment with, their continued use of NRT including reasons for wishing to quit or sustain use and an estimation of their degree of nicotine...... used per day gives reason to believe the validity of the modified HSI. Further studies are required for confirmation. Better counselling of long-term users on the benefits of using NRT compared to smoking should be provided, for those who are chronically dependent, as well as support to stop long...... dependence. Method: Through advertisements in three national Danish newspapers, long-term NRT users were recruited to answer a short questionnaire about basic characteristics, health status and satisfaction with using NRT. A modified version of the Heaviness of Smoking Index (HSI) questionnaire was applied...

  9. Exploratory survey study of long-term users of nicotine replacement therapy in Danish consumers

    DEFF Research Database (Denmark)

    Borup, Gitte; Christrup, Lona Louring; Lyngby Mikkelsen, Kim

    is scarce. The aim of this study was to collect information on the characteristics of long-term NRT users, having used NRT for at least 12 months, reasons for, and contentment with, their continued use of NRT including reasons for wishing to quit or sustain use and an estimation of their degree of nicotine...... used per day gives reason to believe the validity of the modified HSI. Further studies are required for confirmation. Better counselling of long-term users on the benefits of using NRT compared to smoking should be provided, for those who are chronically dependent, as well as support to stop long...... dependence. Method Through advertisements in three national Danish newspapers, long-term NRT users were recruited to answer a short questionnaire about basic characteristics, health status and satisfaction with using NRT. A modified version of the Heaviness of Smoking Index (HSI) questionnaire was applied...

  10. Transcatheter aortic valve replacement has improved short-term but similar midterm outcomes in isolated aortic valve replacement after prior coronary artery bypass grafting.

    Science.gov (United States)

    Nguyen, Tom C; Babaliaros, Vasilis C; Razavi, Seyed Amirhossein; Kilgo, Patrick D; Devireddy, Chandan M; Leshnower, Brad G; Mavromatis, Kreton; Guyton, Robert A; Kanitkar, Mihir; Lerakis, Stam; Merlino, John; Chen, Edward P; Thourani, Vinod H

    2014-10-01

    An increasing number of patients with prior coronary artery bypass grafting (CABG) now present with severe aortic stenosis. The proposed benefit of surgical (SAVR) vs transcatheter aortic valve replacement (TAVR) is unknown. The objective of this study was to compare short-term and midterm outcomes of patients undergoing isolated SAVR vs TAVR in those with prior CABG. A retrospective analysis was performed of 255 patients who underwent isolated SAVR after prior CABG from January 2002 to February 2013 at Emory University. Outcomes of 148 patients undergoing SAVR (2002 to 2013) and 107 undergoing TAVR (2007 to 2013) were compared using multivariable logistic regression and analysis of variance techniques, adjusting for The Society of Thoracic Surgeons (STS) risk score. Kaplan-Meier plots were used to determine survival rates, and midterm survival between groups was compared using the Cox proportional hazards model. TAVR patients were older (79.8 ± 7.9 years vs 72.5 ± 8.8 years, p < 0.001) but were gender equivalent (female: 24% vs 22%, p = 0.61). The preoperative ejection fraction was similar between groups (TAVR: 0.433 ± 0.131 vs SAVR: 0.469 ± 0.148%, p = 0.60). The TAVR group had a significantly higher the STS risk scores (11.8% vs 7.1%, p < 0.001). All-cause 30-day mortality was 1.9% for TAVR and 4.1% for SAVR (p = 0.32), a result that marginally favors TAVR after risk adjustment (adjusted odds ratio, 0.19; p = 0.07). Postoperative morbidity and resource utilization was significantly higher in the SAVR patients. Midterm survival was similar between the two groups after adjustment (adjusted hazard ratio, 0.78, p = 0.46). Excellent outcomes can be achieved in SAVR or TAVR after prior CABG. Although TAVR improves short-term outcomes and resource utilization compared with SAVR, midterm mortality outcomes are similar. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. OSTEOPOROSIS AND HORMONE REPLACEMENT THERAPY

    Directory of Open Access Journals (Sweden)

    Tomaž Kocjan

    2008-12-01

    As older women are those who sustain the majority of osteoporotic fractures, HRT isleaving its main role in osteoporosis prevention and treatment to other drugs, first of all tobisphosphonates and strontium ranelate

  12. Replacement of dopaminergic medication with subthalamic nucleus stimulation in Parkinson's disease: long-term observation

    NARCIS (Netherlands)

    Romito, Luigi M.; Contarino, Maria Fiorella; Vanacore, Nicola; Bentivoglio, Anna Rita; Scerrati, Massimo; Albanese, Alberto

    2009-01-01

    Stimulation of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson's disease (PD), but the medication requirements after implant are poorly known. We performed a long-term prospective evaluation of 20 patients maintained at stable dopaminergic therapy for 5 years after

  13. Evolution of Long-Term Adjuvant Anti-hormone Therapy: Consequences and Opportunities. The St. Gallen Prize Lecture

    Science.gov (United States)

    Jordan, V. Craig; Obiorah, Ifeyinwa; Fan, Ping; Kim, Helen R.; Ariazi, Eric; Cunliffe, Heather; Brauch, Hiltrud

    2012-01-01

    The successful translation of the scientific principles of targeting the breast tumour oestrogen receptor (ER) with the nonsteroidal anti-oestrogen tamoxifen and using extended durations (at least 5-years) of adjuvant therapy, dramatically increased patient survivorship and significantly enhanced a drop in national mortality rates from breast cancer. The principles are the same for the validation of aromatase inhibitors to treat post-menopausal patients but tamoxifen remains a cheap, life-saving medicine for the pre-menopausal patient. Results from the Oxford Overview Analysis illustrate the scientific principle of “longer is better” for adjuvant therapy in pre-menopausal patients. One-year of adjuvant therapy is ineffective at preventing disease recurrence or reducing mortality, whereas five-years of adjuvant tamoxifen reduces recurrence by 50% which is maintained for a further ten-years after treatment stops. Mortality is reduced but the magnitude continues to increase to 30% over a 15-year period. With this clinical database, it is now possible to implement simple solutions to enhance survivorship. Compliance with long-term anti-hormone adjuvant therapy is critical. In this regard, the use of selective serotonin reuptake inhibitors (SSRIs) to reduce severe menopausal side effects may be inappropriate. It is known that SSRIs block the CYP2D6 enzyme that metabolically activates tamoxifen to its potent anti-oestrogenic metabolite, endoxifen. The selective nor-epinephrine reuptake inhibitor, venlafaxine, does not block CYP2D6, and may be a better choice. Nevertheless, even with perfect compliance, the relentless drive of the breast cancer cell to acquire resistance to therapy persists. The clinical application of long-term anti-hormonal therapy for the early treatment and prevention of breast cancer, focused laboratory research on the discovery of mechanisms involved in acquired anti-hormone resistance. Decades of laboratory study to reproduce clinical

  14. The St. Gallen Prize Lecture 2011: evolution of long-term adjuvant anti-hormone therapy: consequences and opportunities.

    Science.gov (United States)

    Jordan, V Craig; Obiorah, Ifeyinwa; Fan, Ping; Kim, Helen R; Ariazi, Eric; Cunliffe, Heather; Brauch, Hiltrud

    2011-10-01

    The successful translation of the scientific principles of targeting the breast tumour oestrogen receptor (ER) with the nonsteroidal anti-oestrogen tamoxifen and using extended durations (at least 5 years) of adjuvant therapy, dramatically increased patient survivorship and significantly enhanced a drop in national mortality rates from breast cancer. The principles are the same for the validation of aromatase inhibitors to treat post-menopausal patients but tamoxifen remains a cheap, life-saving medicine for the pre-menopausal patient. Results from the Oxford Overview Analysis illustrate the scientific principle of "longer is better" for adjuvant therapy in pre-menopausal patients. One year of adjuvant therapy is ineffective at preventing disease recurrence or reducing mortality, whereas five years of adjuvant tamoxifen reduces recurrence by 50% which is maintained for a further ten years after treatment stops. Mortality is reduced but the magnitude continues to increase to 30% over a 15-year period. With this clinical database, it is now possible to implement simple solutions to enhance survivorship. Compliance with long-term anti-hormone adjuvant therapy is critical. In this regard, the use of selective serotonin reuptake inhibitors (SSRIs) to reduce severe menopausal side effects may be inappropriate. It is known that SSRIs block the CYP2D6 enzyme that metabolically activates tamoxifen to its potent anti-oestrogenic metabolite, endoxifen. The selective norepinephrine reuptake inhibitor, venlafaxine, does not block CYP2D6, and may be a better choice. Nevertheless, even with perfect compliance, the relentless drive of the breast cancer cell to acquire resistance to therapy persists. The clinical application of long-term anti-hormonal therapy for the early treatment and prevention of breast cancer, focused laboratory research on the discovery of mechanisms involved in acquired anti-hormone resistance. Decades of laboratory study to reproduce clinical experience

  15. Effects of short-term testosterone replacement on areal bone mineral density and bone turnover in young hypogonadal males

    Directory of Open Access Journals (Sweden)

    Prasun Deb

    2012-01-01

    Full Text Available Context: Effect of parenteral testosterone esters administration on bone-mineral density (BMD and bone turnover in young age onset male hypogonadism is not studied in Indian subjects. Aims: To prospectively study the effect of short-term (6 months replacement therapy with parenteral testosterone enanthate-propionate combination on BMD and bone turnover markers in hypogonadal adult patients. Settings and Design: Prospective, tertiary care academic center. Materials and Methods: Thirteen young, otherwise healthy hypogonadal males (age 25.5 ± 4.9 yrs, serum testosterone 2.56 ± 4.29 nmol/l were subjected to BMD measurements (DXA and estimation of urinary Crosslaps™ and serum osteocalcin at baseline. Twelve healthy age and BMI-matched males served as controls for BMD measurements. The hypogonadal patients were administered parenteral testosterone esters (as mixed enanthate and propionate 250 mg i.m. every 2-3 weeks, and prospectively followed for 6 months. BMD and bone markers were studied at the end of 6 months. Statistical Analysis Used: Mann-Whitney nonparametric test, paired t-test and Pearson′s test of two-tail significance. Results: At baseline, BMD was significantly lower in hypogonadal males as compared to that in controls. With testosterone replacement, there was significant improvement in BMD, both at trabecular and cortical sites, There was a decline in bone turnover with treatment (Ur Crosslaps™:creatinine ratio: pretreatment 72.8 ± 40.4, post-treatment 35.5 ± 23.8 μg/mmol, P = 0.098; serum osteocalcin: pre-treatment 41.0 ± 16.8, post-treatment 31.7 ± 2.1 ng/ml, P = 0.393. Conclusions: Short-term parenteral testosterone replacement significantly improves BMD at the hip, lumbar spine and forearm in hypogonadal young males.

  16. 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.

    Science.gov (United States)

    Holm, Marianne; Olsen, Anja; Kroman, Niels; Tjønneland, Anne

    2014-12-01

    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. Female participants from the prospective cohort "Diet, Cancer, and Health" diagnosed with breast cancer (BC) were identified and their pre-diagnostic HRT use evaluated for association with tumour biology and breast cancer outcome in multivariate analysis. Breast cancer specific mortality. Of the 1212 patients originally considered 1064 were included. Of these, 105 women died from breast cancer during a median follow-up of 6.3 years (range 0.2-14.3 years). In multivariate analyses women who used HRT at enrolment into the cohort study had 47% lower risk of dying from breast cancer as compared to women who had previously or never used HRT (adjusted HR: 0.53; 95% CI, 0.37-0.85). Pre-diagnostic HRT use was associated with smaller tumour size at the time of diagnosis and a higher frequency of receptor positive breast cancer. Paradoxically, a high pre-diagnostic intake of vitamin D supplements was associated with HRT use but also with a higher BC specific mortality (HR: 1.47; 95% CI, 1.07-2.00) CONCLUSIONS: HRT use at enrolment was associated with breast tumours of smaller size at the time of diagnosis and positive receptor status, and with a lower BC mortality. The found association between vitamin D from supplements and higher BC mortality warrants further exploration. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. KRAS rs61764370 is associated with HER2-overexpressed and poorly-differentiated breast cancer in hormone replacement therapy users: a case control study

    Directory of Open Access Journals (Sweden)

    Cerne Jasmina-Ziva

    2012-03-01

    Full Text Available Abstract Background A single nucleotide polymorphism located in the 3'-untranslated region of the KRAS oncogene (KRAS variant; rs61764370 disrupts a let-7 miRNA binding and was recently reported to act as a genetic marker for increased risk of developing human cancers. We aimed to investigate an association of the KRAS variant with sporadic and familial breast cancer and breast tumor characteristics. Methods Genotyping was accomplished in 530 sporadic postmenopausal breast cancer cases, 165 familial breast cancer cases (including N = 29, who test positive for BRCA1/2 mutations and 270 postmenopausal control women using the flurogenic 5' nuclease assay. Information on hormone replacement therapy (HRT use and tumor characteristics in sporadic breast cancer cases was ascertained from a postal questionnaire and pathology reports, respectively. Associations between the KRAS genotype and breast cancer or breast tumor characteristics were assessed using chi-square test and logistic regression models. Results No evidence of association was observed between the KRAS variant and risk of sporadic and familial breast cancer - either among BRCA carriers or non-BRCA carriers. The KRAS variant was statistically significantly more often associated with human epidermal growth factor receptor 2 (HER2 - positive tumors and tumors of higher histopathologic grade. However, both associations were detected only in HRT users. Conclusion Our data do not support the hypothesis that the KRAS variant rs61764370 is implicated in the aetiology of sporadic or of familial breast cancer. In postmenopausal women using HRT, the KRAS variant might lead to HER2 overexpressed and poorly-differentiated breast tumors, both indicators of a worse prognosis.

  18. Association of postmenopausal hormone replacement therapy with carotid atherosclerosis and soluble thrombomodulin: the vascular aging (EVA) study. Etude du Vieillissement Artériel.

    Science.gov (United States)

    Petit, Laure; van Oort, Floor V A; Le Gal, Grégoire; Mennen, Louise I; Alhenc-Gelas, Martine; Touboul, Pierre-Jean; Zureik, Mahmoud; Scarabin, Pierre-Yves

    2002-02-15

    Hormone replacement therapy (HRT) may reduce atherosclerosis among postmenopausal women, partly by reducing vascular endothelium damage. We have tested this hypothesis by evaluating the association of HRT with firstly, carotid intima media thickness (IMT) and plaques, and secondly, with endothelial cell damage, indicated by soluble thrombomodulin (sTM). Then, we tested the association between the two markers of atherosclerosis and the levels of sTM. Among 747 postmenopausal women included into the EVA study, we compared 154 HRT users (including 80% transdermal treatment) with 593 never users. Carotid IMT and plaques were measured with B-mode ultrasonography and sTM with ELISA. At least one plaque was detected among 13.6% of HRT users and 27.3% of never users. After adjustment for confounding factors, the odds ratio for the presence of plaque was 0.45 (95% confidence interval, 0.25-0.78, P=0.005) in HRT users in comparison with nonusers. HRT users had a slightly lower crude mean IMT than nonusers, but the difference was not significant. sTM was positively associated with mean IMT (P for trend=0.001) but not with plaques. Finally, estrogen users had a lower sTM level than nonusers (difference 0.14 ng/ml, P=0.03). As HRT was associated with sTM and plaques, but not with IMT, while sTM was only associated with IMT, our hypothesis was not confirmed. This suggests that the possible beneficial effects of HRT on atherosclerosis may not go through the endothelial cell damage assessed by plasma thrombomodulin.

  19. Media coverage of women's health issues: is there a bias in the reporting of an association between hormone replacement therapy and breast cancer?

    Science.gov (United States)

    Whiteman, M K; Cui, Y; Flaws, J A; Langenberg, P; Bush, T L

    2001-01-01

    Media coverage of scientific research plays a major role in shaping public opinion and influencing medical practice. When an association is controversial, such as with hormone replacement therapy (HRT) and breast cancer, it is important that a balanced picture of the scientific literature be reported. The objective of this study was to assess whether scientific publications that do and do not support an HRT/breast cancer association were cited in the media in proportions similar to those with which they appear in the scientific literature. Scientific publications reporting on the HRT/breast cancer association published from January 1, 1995, to June 30, 2000, were identified through a systematic Medline search. Media reports from newspapers, magazines, television, and radio that reported on HRT and breast cancer were retrieved from an online database. Investigators independently recorded characteristics of the scientific publications and media reports. A total of 32 scientific publications were identified: 20 (62.5%) concluded there was an increased risk of breast cancer associated with HRT (positive publications), and 12 (37.5%) concluded there was no evidence for an association (null publications). Nearly half (47%) of the scientific publications were not cited by the media. There were 203 media citations of scientific publications: 82% were of positive publications and 18% were of null publications, representing a significant excess of citations of positive publications (p Media coverage of this controversial issue is based on a limited sample of the scientific publications. Moreover, the excess of media citations for positive scientific publications suggests a bias against null scientific publications.

  20. Association of the Joint Effect of Menopause and Hormone Replacement Therapy and Cancer in African American Women: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Daniel Sarpong

    2011-06-01

    Full Text Available Cancer is the second leading cause of death in the US and in Mississippi. Breast cancer (BC is the most common cancer among women, and the underlying pathophysiology remains unknown, especially among African American (AA women. The study purpose was to examine the joint effect of menopause status (MS and hormone replacement therapy (HRT on the association with cancers, particularly BC using data from the Jackson Heart Study. The analytic sample consisted of 3202 women between 35 and 84 years of which 73.7% and 22.6% were postmenopausal and on HRT, respectively. There were a total of 190 prevalent cancer cases (5.9% in the sample with 22.6% breast cancer cases. Menopause (p < 0.0001, but not HRT (p = 0.6402, was independently associated with cancer. Similar results were obtained for BC. BC, cancer, hypertension, type 2 diabetes, prevalent cardiovascular disease, physical activity and certain dietary practices were all significantly associated with the joint effect of menopause and HRT in the unadjusted analyses. The family history of cancer was the only covariate that was significantly associated with cancer in the age-adjusted models. In examining the association of cancer and the joint effect of menopause and HRT, AA women who were menopausal and were not on HRT had a 1.97 (95% CI: 1.15, 3.38 times odds of having cancer compared to pre-menopausal women after adjusting for age; which was attenuated after further adjusting for family history of cancer. Given that the cancer and BC cases were small and key significant associations were attenuated after adjusting for the above mentioned covariates, these findings warrant further investigation in studies with larger sample sizes of cancer (and BC cases.

  1. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study.

    Science.gov (United States)

    Rasmussen, Emma L Kaderly; Hannibal, Charlotte Gerd; Dehlendorff, Christian; Baandrup, Louise; Junge, Jette; Vang, Russell; Kurman, Robert J; Kjaer, Susanne K

    2017-03-01

    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. 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 or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p<0.01). Older age at first 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: 0.26-0.62). Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Preoperative quadriceps strength as a predictor for short-term functional outcome after total hip replacement.

    Science.gov (United States)

    Holstege, Marije S; Lindeboom, Robert; Lucas, Cees

    2011-02-01

    To determine the preoperative strength of the muscle group of the lower extremity that is most important in predicting functional recovery after primary unilateral total hip replacement (THR). Prospective observational study with inception cohort. Joint care program (hospital care/clinical division of a nursing home/outpatient physical therapy). Patients (N=55) undergoing primary unilateral THR. Not applicable. Baseline measures within 2 weeks preoperative and follow-up at 6 and 12 weeks postoperative included isometric strength measurement of the hip (flexors, extensors, abductors, adductors) and knee (flexors, extensors) musculature using a handheld dynamometer. Functional outcome was tested using performance-based (Timed Up and Go Test, 6-Minute Walk Test) and self-report measures (Western Ontario and McMaster Universities Osteoarthritis Index, subscale Physical Function [WOMAC PF], 36-Item Short Form Health Survey subscale Mental Health, visual analog scale for pain). Of the patients (N=55; mean age, 72.7±6.8y; 41 women) included; 18 dropped out, leaving 37 patients for analyses. After correction for WOMAC PF score at baseline, body mass index, sex, and age, the preoperative knee extensors strength measure of the operated site was the only muscle group showing a significant effect on functional outcome measured by using the WOMAC PF at 12 weeks postoperatively (R(2)=.355; β=-.105; P for β=.004). Preoperative greater knee extensor strength of the operated site is associated with better physical function, measured by using the WOMAC PF at 12 weeks postoperative. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Social representation of Hansen's disease thirty years after the term 'leprosy' was replaced in Brazil

    Directory of Open Access Journals (Sweden)

    Oliveira Maria Leide Wand-del-Rey de

    2003-01-01

    Full Text Available Based on the theories of social representation (SC and Central Core (CC, a structural study was undertaken regarding the neologism hanseníase (Hansen's disease, the term adopted by Brazil's Ministry of Health in the 1970s. Carried out during 2001, this study interviewed eight hundred housewives residing in the Rio de Janeiro and Duque de Caxias municipalities. It found that Hansen's disease is part of a process of modernization of common thinking, anchored in the traditional representation of leprosy. This finding is understandable from the perspective that the central structure of a social representation has a historical determination, so short- and middle-term changes are not to be expected. Furthermore, there has been no ongoing investment in social marketing to make the new terminology more widely known. The authors discuss the relation between social representation and the concept of the history of mentalities.

  4. Efectos de la terapia de reemplazo hormonal sobre la función autonómica en mujeres postmenopáusicas Effects of estrogen replacement therapy on autonomic function of post-menopausal women

    Directory of Open Access Journals (Sweden)

    Juan C Guzmán

    2007-02-01

    para mejorar los síntomas de la menopausia durante un tiempo corto, principalmente en mujeres postmenopáusicas jóvenes no hipertensas.Background: estrogen deficit during menopause may be related to cardiac autonomic function imbalance, reducing the cardiovagal reflex response that could potentially increase cardiovascular risk. The physiological mechanisms that lead to this alteration in postmenopausal women remain unclear. In this article, the effect of hormonal replacement therapy on autonomic function in women submitted to hysterectomy is discussed. Methods: Fifty women with a previous hysterectomy and amenorrhea for 1 year prior to surgery were enrolled in a prospective randomized crossover double-blind placebo controlled trial. Either oral estrogen replacement therapy (ERT conjugated estrogens 0.625 mg once a day or placebo, were randomly administered in a crossover design during 12 weeks with a 2 week washout period. Cardiovagal autonomic function was assessed by conventional techniques and through venous occlusion plethysmography in order to evaluate vascular autonomic function calculating forearm blood flow (FBF and peripheral vascular resistance (PVR at baseline, and during head-up tilt (HUT and a non-hypotensive stimuli (-10mmHg lower-body negative pressure (LBNP. Results: No differences were found in cardiovagal autonomic function comparing ERT vs. placebo at baseline resting conditions, nor during HUT and LBNP. A significant difference was identified in supine FBF [1.9(0.5 vs. 1.5(0.5, p=0.02] as well as in PVR [53.5(18.2 vs. 68.6(34, p=0.02] comparing ERT vs. placebo interventions. Conclusions: Short term ERT did not improve cardiovascular autonomic reflex responses in postmenopausal women, but increased vascular relaxation primarily by reducing peripheral vascular resistance. Hormone replacement therapy can be used under adequate supervision in order to improve menopausal symptoms during a short period of time, mainly in young non-hypertensive post

  5. Stability of selected serum hormones and lipids after long-term storage in the Janus Serum Bank.

    Science.gov (United States)

    Gislefoss, Randi E; Grimsrud, Tom K; Mørkrid, Lars

    2015-04-01

    The potential value of a biobank depends on the quality of the samples, i.e. how well they reflect the biological or biochemical state of the donors at the time of sampling. Documentation of sample quality has become a particularly important issue for researchers and users of biobank studies. The aim of this study was to investigate the long-term stability of selected components: cholesterol, high density cholesterol (HDLC), low density cholesterol (LDLC), apolipoprotein A1 (apo-A1), apolipoprotein B (apo B), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH) and free thyroxin (FT4). Samples, stored at -25°C, from 520 men aged 40-49 years at blood sampling distributed in equally sized groups (n=130) according to length of storage, 0, 4, 17 and 29 years, respectively, were used in a cross sectional design. The freshly collected serum samples were used as a reference group to calculate storage related changes. The differences between fresh samples and samples stored for 29 years were substantial for apo-A1 (+12%), apo-B (+22.3%), HDLC (-69.2%), LDLC (+31.3%), and PRL (-33.5%), while total cholesterol, FSH, LH, TSH and FT4 did not show any significant difference. The study showed large differences in serum level of the selected components. The lipids and apolipoproteins were all changed except for total cholesterol. Most hormones investigated (FSH, LH, TSH and FT4) proved to be stable after 29 years of storage while PRL showed sign of degradation. The observed differences are probably due to long-term storage effects and/or external factors (i.e. diet and smoking). Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  6. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients

    National Research Council Canada - National Science Library

    Beswick, Andrew David; Wylde, Vikki; Gooberman-Hill, Rachael; Blom, Ashley; Dieppe, Paul

    2012-01-01

    .... However, some people experience long-term pain. To review published studies in representative populations with total hip or knee replacement for the treatment of osteoarthritis reporting proportions of people by pain intensity...

  7. Effect of long term glucocorticoid treatment on human growth hormone secretion in children and adolescents and the safety and effectiveness of recombinant human growth hormone treatment.

    Science.gov (United States)

    Kang, Li; Dian-Chi, Zhang; Qi-Yong, Wu; Hui-Juan, Zhu; Feng-Yang, Gong; Hui, Pan; Zi-meng, Jin; Jie-ying, Deng; Yi-fan, Shi

    2011-02-01

    Long term glucocorticoid (prednisolone) treatment on human growth hormone (hGH) secretion in children and adolescents and to investigate the effectiveness and safety of the recombinant human growth hormone (rhGH) treatment. Twelve patients (age: 10.4∓1.2 years) who were treated in Peking Union Medical College Hospital from September 1999 to November 2009 were enrolled in this study. All of them had taken prednisolone with a dose of 0.5∓2.0 mg/(kg.d) for 6~18 months. Two different hGH stimulating tests was done and their growth and development was evaluated at regular intervals. Seven patients were given rhGH with a dose of 0.1 U/(kg.d) for 6~12 months to improve their growth and development after half a year of prednisolone withdrawal when their disease conditions were improved. The growth speed of these 12 children decreased significantly during prednisolone treatment compared with before prednisolone treatment (1.2∓0.3cm/year vs.3.7∓1.2 cm/year,P12 months than those with a 6~12 months course (P0.05). The growth speed of seven children who received rhGH therapy for half a year were increased from 2.2∓0.1cm/year to 7.8∓0.5cm/year (Pgrowth and development in these children after their primary diseases are improved and glucocorticoids are withdrawn.

  8. Medium-term evaluation of total knee arthroplasty without patellar replacement

    Directory of Open Access Journals (Sweden)

    José Wanderley Vasconcelos

    2013-06-01

    Full Text Available OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26% had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64% showed deviation between 0° and 4° varus. Thirty-nine (75.49% knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation.

  9. Short-term chemical pretreatment cannot replace curettage in photodynamic therapy

    DEFF Research Database (Denmark)

    Nissen, Christoffer V; Wiegell, Stine Regin; Philipsen, Peter Alshede

    2016-01-01

    pretreatment with curettage and two combination ointments containing calcipotriol/betamethasone and salicylic acid/betamethasone affect PpIX fluorescence after the application of methyl aminolevulinate MAL and 5-aminolevulinic acid (BF-200 ALA). METHODS: Four fields on the forearms of 30 healthy volunteers...... were pretreated with curettage or short-term application of calcipotriol/betamethasone or salicylic acid/betamethasone for 20 min. Two fields were not pretreated, thus serving as reference. After pretreatment, MAL or BF-200 ALA was applied for 24 h, and PpIX fluorescence was measured hourly from 1 to 5...... h and after 18, 21 and 24 h. RESULTS: Curettage significantly enhanced PpIX fluorescence for MAL from 1 to 21 h (P salicylic acid...

  10. In situ replacement of infected vascular prosthesis with fresh arterial homograft: Early and long-term results in 18 patients

    Directory of Open Access Journals (Sweden)

    Pejkić Siniša

    2013-01-01

    Full Text Available Introduction. Graft infection is rightly considered one of the severest complications of vascular reconstruction. Treatment is non­standardized and associated with high mortality and morbidity rates. The choice of therapeutic modality depends upon variety of factors. One increasingly used option is in situ replacement of the infected prosthesis with the arterial allograft. Objective. The aim of this prospective nonrandomized study was to evaluate the effectiveness and durability of fresh arterial allograft as in situ substitute for the infected vascular prosthesis. Methods. During period of 2002-2005, 18 patients with the synthetic vascular graft infection underwent partial or complete prosthesis removal and secondary in situ reconstruction using the fresh arterial allograft, preserved under hypothermic conditions in buffered saline solution with an addition of antibiotics. Results. In 14 male and 4 female patients, meanaged 62 years, 8 aortic and 10 peripheral arterial infected prostheses were partially or completely replaced with the allograft. Operative mortality was 27.8% and amputation rate was 22.2%. Systemic sepsis at initial presentation and highly virulent nature of causative microorganisms were identified as significant negative prognostic factors (χ² test, p<0.05. During the long­term follow­up (mean 47 months, allograft aneurysm developed in three patients, requiring allograft explantation, followed in two cases by tertiary prosthetic reconstruction. Conclusion. Substitution of the infected prosthesis with the arterial allograft could be successful if used selectively - for less virulent and localized infections of extracavitary grafts. Close follow­up is mandatory for timely diagnosis of late homograft lesions and its eventual replacement with more durable prosthetic material.

  11. The effect of short-term cortisol changes on growth hormone responses to the pyridostigmine-growth-hormone-releasing-hormone test in healthy adults and patients with suspected growth hormone deficiency

    DEFF Research Database (Denmark)

    Andersen, M; Støving, R K; Hangaard, J

    1998-01-01

    BACKGROUND AND AIMS: The interaction between cortisol and growth hormone (GH)-levels may significantly influence GH-responses to a stimulation test. In order to systematically analyse the interaction in a paired design, it is necessary to use a test, which has been proven safe and reliable such a...... nor by conventional HC therapy itself. However, our results also demonstrated that a GH-stimulation test should not be performed on patients, suffering from acute stress....... such as the pyridostigmine-growth-hormone-releasing-hormone (PD-GHRH) test. Three groups of subjects with a different GH-secretory capacity were included. STUDY A: Eight healthy adults were tested seven times, once with placebo throughout the examination and six times with the PD-GHRH test following no glucocorticoid......-responses to a PD-GHRH test were reduced in all individuals during acute stress-appropriate cortisol levels and the percentage reduction in GH-levels was independent of the GH-secretory capacity. Clinically, we found that peak GH-responses were not significantly affected by a short break in conventional HC therapy...

  12. Histological and ultrastructural alterations of rat thyroid gland after short-term treatment with high doses of thyroid hormones.

    Science.gov (United States)

    Ali Rajab, Njia M; Ukropina, Mirela; Cakic-Milosevic, Maja

    2017-09-01

    The aim of the present study was to investigate histological alterations of rat thyroid gland after short-term treatment with supraphysiological doses of thyroid hormones. Rats from experimental groups were treated with triiodothyronine (T3) or thyroxine (T4) during five days. In both treated groups, thyrocyte height was reduced and follicular lumens were distended. Progressive involutive changes of the thyroid parenchyma were apparent, including follicular remodeling (fusion) and death of thyrocytes. Morphological changes confirmed by quantitative analysis were more pronounced in the T4-treated group. Our results demonstrate that thyrotoxicosis, whether induced by T3 or T4, leads to different grades of thyroid tissue injury, including some irreversible damages. These changes might be explained at least in part by lack of trophic and cytoprotective effects of the thyroid stimulating hormone. Since the period required for morphophysiological recovery may be unpredictable, findings presented here should be taken into consideration in cases where the thyroid hormones are used as a treatment for thyroid and non-thyroid related conditions.

  13. Short- and Long-Term Mortality Rates of Elderly Acute Kidney Injury Patients Who Underwent Continuous Renal Replacement Therapy.

    Directory of Open Access Journals (Sweden)

    Harin Rhee

    Full Text Available The world's population is aging faster and the incidence of acute kidney injury (AKI needing continuous renal replacement therapy (CRRT is increasing in elderly population. The outcome of AKI needing CRRT in elderly patients is known to be poor. However, the definitions of elderly used in the previous literatures were diverse and, there were few data that compared the long-term mortality rates of these patients with middle aged patients. This study was aimed to evaluate this issue.This study was a single-center, retrospective cohort study of patients who underwent CRRT from January 2013 to December 2015. The patients were divided into the following four age cohorts: middle-aged (55-64, young-old (65-74, middle-old (75-84, and old-old (≥85. The short- and long-term mortality rates for each age cohort were compared.A total of 562 patients met the inclusion criteria. The short-term mortality rate was 57.3% in the entire cohort. Compared with the middle-aged cohort, the middle-old cohort (HR 1.48 (1.09-2.02, p = 0.012 and the old-old cohort (HR 2.33 (1.30-4.19, p = 0.005 showed an increased short-term mortality rate along with an increased SOFA score, acidemia and a prolonged prothrombin time. When we analyzed the long-term mortality rate of the 238 survived patients, the middle-old cohort (HR 3.76 (1.84-7.68, p<0.001, the old-old cohort (HR 4.40(1.20-16.10, p = 0.025, a lower BMI, the presence of liver cirrhosis, the presence of congestive heart failure and a history of sepsis were independent risk factors for the prediction of long-term mortality.Compared with the middle-aged cohort, the middle-old and the old-old cohort showed an increased short-term and long-term mortality rate. However, in the young-old cohort, neither the short-term nor the long-term mortality rate was increased.

  14. Perioperative growth hormone treatment increases nitrogen and fluid balance and results in short-term and long-term conservation of lean tissue mass

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Kissmeyer-Nielsen, Peter; Laurberg, Søren

    1998-01-01

    The surgical procedure for forming an ileoanal anastomosis with a J pouch (IAA) usually involves a temporary ileostomy; patients undergoing IAA surgery thus need to recover quickly because they return for ileostomy closure 3 mo later. We evaluated the effects of perioperative biosynthetic growth...... hormone (GH) treatment on short- and long-term changes in body composition and on nutritional intake. Patients with ulcerative colitis undergoing IAA surgery were randomly assigned to double-blind treatment with placebo (n=12) or 6 IU GH twice daily (n=12) from 2 d before to 7 d after the operation...

  15. Qualidade de vida em usuárias e não usuárias de terapia de reposição hormonal Quality of life in users and non-users of hormone replacement therapy

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    Sílvia E. V. Zahar

    2005-06-01

    Full Text Available OBJETIVO: Comparar a qualidade de vida de mulheres após a menopausa usuárias e não usuárias de terapia de reposição hormonal (TRH. MÉTODOS: Realizou-se um estudo de corte transversal com mulheres na pós-menopausa, com idade entre 40 e 65 anos, menopausadas há no máximo 15 anos. Consideraram-se como usuárias de TRH aquelas que faziam uso dessa terapia há pelo menos seis meses, e não usuárias aquelas que não fizeram uso dessa terapia nos últimos seis meses. Foram incluídas no estudo 207 mulheres: 106 usuárias e 101 não usuárias de TRH. Avaliaram-se as características sociodemográficas, clínicas e comportamentais. Aplicou-se o Índice de Kupperman para avaliar a intensidade dos sintomas climatéricos, e o questionário Medical Outcomes Study 36-item Short-Form Health Survey (SF-36 para avaliação da qualidade de vida. Na análise dos dados utilizaram-se os testes t de student, Qui-quadrado, exato de Fisher e Mann-Whitney. RESULTADOS: As usuárias de TRH apresentaram média etária de 52,6±4,9 anos e as não usuárias de 54,3±4,7 anos (p=0,01. Houve diferença estatisticamente significativa em relação ao estado marital (p=0,04. As usuárias relataram menor freqüência de sintomas climatéricos de intensidade moderada e acentuada (p=0,001. Dos oito domínios de qualidade de vida avaliados, apenas a vitalidade apresentou escore abaixo de 50 (45 para os dois grupos. Não houve diferenças entre os grupos em relação aos componentes do SF-36. CONCLUSÕES: As mulheres na pós-menopausa usuárias e não usuárias de TRH apresentaram boa qualidade de vida. Não houve diferenças entre usuárias e não usuárias de terapia hormonal.OBJECTIVE: To compare the quality of life in postmenopausal women who were users and non-users of hormone replacement therapy (HRT. METHODS: A cross-sectional study was conducted on postmenopausal women aged between 40 and 65 years, who had been menopausal for up to 15 years. Women considered HRT

  16. Cambios en el uso de la terapia hormonal sustitutiva tras una intervención informativa dirigida a mujeres y prescriptores Changes in the use of hormone replacement therapy after an educational intervention aimed at women and prescribers

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    Carmen Mosquera Tenreiro

    2009-04-01

    Full Text Available Objetivos: Describir las acciones desarrolladas en Asturias en 2004 y 2005 a partir de las recomendaciones de la Agencia Española del Medicamento (AEM sobre el uso de la terapia hormonal sustitutiva (THS después de la publicación del Women's Health Initiative y del Million Women Study. Métodos: Estudio casi experimental sin grupo control. Los datos utilizados fueron las ventas de THS entre 1996 y 2003, previamente a la intervención. En 2004-2005 se analizaron las ventas anuales de THS y el porcentaje estimado de mujeres que usaban este tratamiento respecto a la población de 50-59 años de edad. Para el análisis de la evolución de los costes se tomaron los precios de cada especialidad en pesetas hasta el año 2001 y en euros a partir de entonces. Resultados: Hubo un incremento de las ventas hasta el año 2001. A partir de entonces cambió la tendencia, con un descenso hasta 2005 del 73,6%. El descenso observado en el período 2004-2005 (49,1% fue el doble del producido durante 2002-2003 (24,5%. El porcentaje estimado de mujeres usuarias de THS entre 50 y 59 años habría sido de un 17,2% en 2001 y de un 4,1% en 2005. El gasto total de la THS experimentó un descenso similar, aunque Boltin® (tibolona duplicó sus ventas. Conclusiones: Las acciones para proporcionar una información sistemática e independiente a los profesionales y la población general son necesarias y eficaces. Es preciso investigar en el ámbito nacional la «epidemia» de la THS y sus costes en la salud, así como el uso de tibolona y sus efectos adversos.Objective: To describe changes in prescription of hormone replacement therapy (HRT in Asturias (Spain after the publication of the results of the Women's Health Initiative and the Million Women Study and following the recommendations of the Spanish Drugs Agency to women and prescribers (2004-2005. Methods: We performed a quasiexperimental study with no control group. The data used consisted of sales of HRT products

  17. Bone marrow involvement in Gaucher disease at MRI: what long-term evolution can we expect under enzyme replacement therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Fedida, Benjamin; Touraine, Sebastien; Laredo, Jean-Denis [Hopital Lariboisiere, AP-HP, Department of Musculoskeletal Imaging, Paris (France); Stirnemann, Jerome [Universite Paris-Diderot Hopital Bichat, AP-HP, Department of Biostatistics and Medical Data Processing, INSERM UMR 738, Paris (France); Geneva University Hospital, Division of General Internal Medicine, Faculty of Medicine, Geneva (Switzerland); Belmatoug, Nadia [Hopital Beaujon, AP-HP, Referral Center for Lysosomal Diseases (RCLD), Clichy (France); Hopital Beaujon, AP-HP, Department of Internal Medicine, Clichy (France); Petrover, David [Hopital Lariboisiere, AP-HP, Department of Musculoskeletal Imaging, Paris (France); Hopital Beaujon, AP-HP, Referral Center for Lysosomal Diseases (RCLD), Clichy (France)

    2015-10-15

    To study the long-term evolution of the bone marrow burden (BMB) score at MRI in patients with Gaucher disease (GD) under enzyme replacement therapy (ERT). Forty patients treated for GD were retrospectively studied in a referral centre. BMB scores were assessed on spine and femur MR examinations performed between January 2003 and June 2014. The long-term evolution of the BMB scores was analyzed using a linear mixed model. A total of 121 MRI examinations were performed during the study period with a mean follow-up of 7.1 years ± 5.6, an average rate of 3.1 MR examinations ± 1.7 per patient and an interval of 2.3 years ± 1.1 between examinations. Patients had received ERT during 12 years on average ± 6.7. The trend of BMB scores with time decreased significantly by 15 % (P = 0.008) during the total study period and 39 % (P = 0.01) during the first 5 years of treatment. No changes in BMB scores were observed after five years of treatment. In Gaucher patients, the trend of MRI BMB scores with time decreased significantly under ERT the first 5 years of treatment before a long-term stabilization. (orig.)

  18. Retrospective study of long-term outcomes of enzyme replacement therapy in Fabry disease: Analysis of prognostic factors

    NARCIS (Netherlands)

    Arends, Maarten; Biegstraaten, Marieke; Hughes, Derralynn A.; Mehta, Atul; Elliott, Perry M.; Oder, Daniel; Watkinson, Oliver T.; Vaz, Frédéric M.; van Kuilenburg, André B. P.; Wanner, Christoph; Hollak, Carla E. M.

    2017-01-01

    Despite enzyme replacement therapy, disease progression is observed in patients with Fabry disease. Identification of factors that predict disease progression is needed to refine guidelines on initiation and cessation of enzyme replacement therapy. To study the association of potential biochemical

  19. Long-term hormonal contraceptive use is associated with a reversible suppression of antral follicle count and a break from hormonal contraception may improve oocyte yield.

    Science.gov (United States)

    Letourneau, Joseph M; Cakmak, Hakan; Quinn, Molly; Sinha, Nikita; I Cedars, Marcelle; Rosen, Mitchell P

    2017-07-01

    Unlike infertility, patients presenting for fertility preservation (FP) are often using combined hormonal contraceptives (CHC). We studied whether long-term (≥6 months) CHC use is associated with reversible suppression of antral follicle count (AFC). This is a longitudinal study of FP cycles from 2012 to 2016. We studied three groups: those without CHC exposure (NO CHC), those with CHC usage with a CHC break (BREAK), and without a break (NO BREAK) prior to ovarian stimulation. We assessed ovarian reserve by AFC at initial consultation and discussed the possibility of CHC suppression of AFC. Patients chose between ovarian stimulation with no CHC break versus ovarian stimulation after a CHC break. AFC was measured serially in the BREAK group. We assessed whether AFC suppression was reversed in the BREAK group. Total oocyte yield was compared among the NO CHC, BREAK, and NO BREAK groups. T tests, ANOVA, and linear/logistic regressions were used. Seven hundred forty-three women underwent FP. Twenty-one percent (n = 154) were taking long-term CHC (≥6 months). AFC suppression was more likely with CHC use (OR 1.6, 95% CI 1.1-2.4, P = 0.011). The BREAK group (n = 79) stopped CHC for an average of 4 months. AFC improvement started at 1 month and plateaued at approximately 6- to 7-month break. The BREAK group had approximately twice as many oocytes per initial AFC as NO BREAK (2.8 ± 3.8 vs. 1.4 ± 0.9, P break of several months is associated with an increase in AFC and a potential improvement in overall egg yield.

  20. Densidade mamográfica em mulheres climatéricas em uso de terapia de reposição hormonal Mammographic parenchymal pattern in climacteric women receiving hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Herberth Régis de Araújo

    2004-01-01

    ênica.PURPOSE: to measure changes and predictors of changes in mammographic density of climacteric women, before and one year after hormone replacement therapy. METHODS: seventy climacteric women of 45 years or more participated in the study. They were followed-up at a Climacteric Outpatient Service. All of them used regularly either estrogenic or estroprogestative HRT for one year. They were submitted to one basal mammography and another at the end of the first year. HRT schedules could be different from each other, although with the same bioequivalence. Mammographic density was evaluated blindly at the beginning and at the end of the treatment. Age, ovarian function, time since menopause, body mass index, waist/hip ratio, age at menarche, age at first pregnancy, and smoking were evaluated as well. Mammographic density was classified according to the American College of Radiology BI-RADS system into one of the following four parenchymal patterns: A entirely liposubstituted breasts, B liposubstituted breasts with disperse glandular parenchyma, C heterogeneously dense breasts, and D extremely dense breasts. We proposed a subdivision of each category in to A e A1, B e B1, C and C1, D and D1 in order to identify smaller variations in mammographic density. Therefore, we attributed initial and final scores of 1-8 to each of the patients according to the mammographic density before and after HRT, corresponding to categories A to D1. The proportions of women that presented increase, decrease and no variation in mammographic density after 1 year of HRT were calculated. In addition, we estimated initial to final score variation using the paired t-test of the Statistical Package for Social Sciences (SPSS. RESULTS: mammographic density increased in 22.9%, decreased in 7.1% and did not change in 70% of the studied cases. A significant difference was observed between the score means before (2.2±1.82 and after HRT (2.5±1.9 (p=0.019. The androgenic distribution of body fat was associated with a

  1. Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

    Directory of Open Access Journals (Sweden)

    Renate Kruschitz

    2017-04-01

    Full Text Available Objective: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria according to the currently applicable guidelines. Methods: Data of overweight and obese individuals (n = 70 who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0 as well as after 1, 3, 6, 12, 24, and 36 (T1-T36 months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Results: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. Conclusion: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

  2. Kidney function in normal man during short-term growth hormone infusion

    DEFF Research Database (Denmark)

    Parving, H H; Noer, I; Mogensen, C E

    1978-01-01

    Kidney function was studied in 9 normal males before and during a 2 h growth hormone (GH) infusion of 50 ng/kg/min. The following variables were measured during each 20 min clearance period: glomerular filtration rate, GFR, effective renal plasma flow, RPF (steady state infusion technique...... with urinary collections using [125I]iothalamate and [131I]iodohippurate), and urinary albumin and beta2-microglobulin excretion rates (radioimmunoassays). The GH infusion resulted in a 10-fold increase in plasma GH concentration. All the above mentioned variables remained practically unchanged during...... the infusion except for a small (-5%) but significant decrease in renal plasma flow (P less than 0.01). Our negative results contrast to the findings of increased GFR and RPF during prolonged GH administration and suggest that GH requires several hours or days for its renal effects to become manifest....

  3. Hormone replacement therapy and the risk of breast cancer: assessment of therapy acceptance in a cohort of previously treated breast cancer patients Terapia de reposição hormonal e o risco de câncer de mama: avaliação de atitudes em pacientes previamente tratadas por câncer de mama

    Directory of Open Access Journals (Sweden)

    Agnaldo Anelli

    2003-01-01

    Full Text Available INTRODUCTION: In the postmenopausal period, an average of 25% of women will present symptomatic ovarian failure requiring hormonal replacement therapy. Estrogen can relieve vasomotor symptoms. Hormonal replacement therapy is generally not recommended for breast cancer patients due to the potential risk of tumor recurrence. To answer the questions about the safety of hormonal replacement therapy in this subgroup of women, it is necessary to establish the acceptance of treatment. METHODS: Between September 1998 and February 2001, a cohort of 216 breast cancer patients were asked to complete a questionnaire. All patients had completed their treatment and were informed about survival rates after breast cancer and hormonal replacement therapy. RESULTS: Among the 216 patients, 134 (62% would refuse hormonal replacement therapy. A hundred patients were afraid of relapse (74.6%. Adjuvant tamoxifen therapy was the only statistically significant variable (70.3% versus 29.7% p=0.003. Understanding clinical stage (p= 0.045 and type of medical assistance (private versus public , p=0.033 also seemed to influence the decision. Early stage disease (p= 0.22, type of surgical procedure (radical versus conservative, p=0.67, adjuvant chemotherapy (p=0.082 or marital status (p=0.98 were not statistically significant in decision making. Several patients submitted to adjuvant chemotherapy (41.6% would accept hormonal replacement therapy under medical supervision, as did most of advanced clinical stage patients (58.3%; p=0.022. CONCLUSION: There is a high level of rejection for hormonal replacement therapy among breast cancer patients when current data on tumor cure rates, and potential risks of estrogen use is available. Adverse effects of tamoxifen in the adjuvant setting may be the reason for refusal of hormonal replacement therapy .INTRODUÇÃO: Cerca de 25% das mulheres apresentarão deficiência estrogênica sintomática necessitando terapia de reposi

  4. Uncemented Total Hip Replacement Stem Loosening after Long Term Compressive Stress Application: A Simulated FEA Study of Cortical Bone Remodeling

    Science.gov (United States)

    Jung, Duk-Young; Tsutsumi, Sadami; Nakai, Ryusuke; Ikeuchi, Ken; Sekel, Ron

    The purpose of this study is to predict with the use of FEA, the differing predisposition to cortical bone resorption and subsequent distal migration of an un-cemented femoral hip replacement stem subjected to long term biomechanical high compressive stresses, while varying the load angles, the material properties of the stem, and the stem length. A two-dimensional hip model was constructed to estimate the minimum principle stresses (P3) and migration magnitudes. Bone remodeling at the interface between the bone and the prosthesis was performed by comparison of the local compressive stress to physiological stress values governing bone resorption. With respect to load angles, migrations of the hip prosthesis did not occur with load angles between 63° and 74° load angle in relation to the longitudinal axis of the bony femur, as the compressive stress generated on the cortical bone was under the criteria threshold for bone resorption (-50MPa). In addition, the magnitude of migration (17%decrease) was relatively more sensitive to changes in stem length than those (92%decrease) of changes of material properties. In conclusion, using an FEA model for bone remodeling, based on the high compressive stresses exerted on distal cortical bone, it is possible to estimate migration magnitudes of cementless hip prostheses in the long term. The load angles have been shown to be an important parameter affecting the migration magnitudes and furthermore, it can be demonstrated that the stiffer materials and reduction of stem length can decrease the migration of cementless hip prosthesis in the long term.

  5. Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type: 7 case reports.

    Science.gov (United States)

    Ohkura, T; Isse, K; Akazawa, K; Hamamoto, M; Yaoi, Y; Hagino, N

    1995-01-01

    Seven female patients with mild to moderate dementia of the Alzheimer type (DAT) were treated with long-term, low-dose estrogen replacement therapy (ERT) over a period of 5-45 months. Five of the 7 patients were cases who had responded well to short-term ERT with 1.25 mg/day of conjugated equine estrogens (CEE) for 6 weeks. The 7 patients from 56 to 77 years of age received 0.625 mg/day of CEE for 21 days, followed by a pause of 7 days. A 28-day cycle of low-dose ERT was performed repeatedly. In 4 cases, these patients received 5 mg/day of medroxyprogesterone acetate (MPA) during the last 10-12 days of estrogen treatment. Therapeutic efficacy of estrogen was evaluated by psychometric assessments such as the Mini-Mental State Examination (MMSE) and the Hasegawa Dementia Scale (HDS) and a behavior rating scale of the Gottfries-Bråne-Steen geriatric rating scale (GBS). The MMSE and HDS evaluations were performed principally once in 2-4 weeks. In 4 out of the 7 patients, the MMSE and HDS scores were elevated above the pretreatment levels during ERT. The termination of ERT resulted in a decrease in both scores. Furthermore, the GBS scores and daily activities of the same 4 patients were improved during ERT. In these 4 patients cognitive functions were markedly improved throughout the treatment period, while the other 2 patients responded moderately well and another patient did not respond at all. These observations suggest that long-term, low-dose ERT improves cognitive functions, dementia symptoms and daily activities in women with mild to moderate DAT.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Differences in preterm and term milk fatty acid compositions may be caused by the different hormonal milieu of early parturition.

    Science.gov (United States)

    Kuipers, Remko S; Luxwolda, Martine F; Dijck-Brouwer, D A Janneke; Muskiet, Frits A J

    2011-12-01

    The hormonal milieus of pregnancy and lactation are driving forces of nutrient fluxes supporting infant growth and development. The decrease of insulin sensitivity with compensatory hyperinsulinemia with advancing gestation, causes adipose tissue lipolysis and hepatic de novo lipogenesis (DNL). We compared fatty acid (FA) contents and FA-indices for enzyme activities between preterm (28-36 weeks) and term (37-42) milks, and between colostrum (2-5 days), transitional (6-15) and mature (16-56) milks. We interpreted FA differences between preterm and term milks, and their changes with lactation, in terms of the well known decrease of insulin sensitivity during gestation and its subsequent postpartum restoration, respectively. Compared with term colostrum, preterm colostrum contained higher indices of DNL in the breast (DNL-breast) and medium chain saturated-FA (MCSAFA), and lower DNL-liver and monounsaturated-FA (MUFA). Preterm milk also had higher docosahexaenoic acid (DHA) in colostrum and transitional milk and higher arachidonic acid (AA) in mature milk. Most preterm-term differences vanished with advancing lactation. In both preterm and term milks, DNL-breast and MCSAFA increased with advancing lactation, while DNL-liver, MUFA, long chain SAFA and AA decreased. DHA decreased in term milk. MUFA was inversely related to MCSAFA in all samples, correlated inversely with PUFA in colostrum and transitional milks, but positively in mature milk. MCSAFA correlated inversely with PUFA in mature milk. Higher maternal insulin sensitivity at preterm birth may be the cause of lower MUFA (a proxy for DNL-liver) and higher MCSAFA (a proxy for DNL-breast) in preterm colostrum, compared with term colostrum. Restoring insulin sensitivity after delivery may be an important driving force for milk FA-changes in early lactation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Robotic mitral valve replacement: A single center, medium-long term follow-up of 43 cases

    Directory of Open Access Journals (Sweden)

    Guo-peng LIU

    2017-08-01

    Full Text Available Objective To summarize the surgical experience gained from robotic mitral valve replacement (MVR, and demonstrate the long-term clinical follow-up results. Methods From Jan. 2007 to Jan. 2015, more than 700 patients underwent various types of robotic cardiac surgery in the Department the authors served in, and of them 43 patients underwent robotic MVR with da Vinci Surgical System (Intuitive Surgical, USA. Among the 43 patients, the average age was 47±11 years (ranged 19-65 years, and sex ratio (female to male was 0.8:1. Six patients were with heart function of NYHA class Ⅰ, 30 patients were of NYHA class Ⅱ and 7 patients were of NYHA class Ⅲ. The left ventricular ejection fraction (LVEF were 54%-78% (64.0%±7.1%, and 20 patients had atrial fibrillation on admission, and 35 patients were with rheumatic mitral stenosis (MS. Atrial septal defect (0.7cm in size co-existed in 1 case and 1 patient had mild aortic regurgitation. Mechanical or bioprosthetic mitral valve was replaced via left atriotomy by using da Vinci robotic surgical system after cardiopulmonary bypass (CPB set-up. Radiopaque titan clips was employed by Cor-Knot knot-tying device (LSI Solutions, Inc, Victor, NY to anchor the prosthetic valve. Trans-esophageal echocardiography (TEE was performed before and after surgery. The operative data were collected and patients were followed up at outpatient clinic regularly up to 6 years. Results All cases were performed successfully with the same surgery. No conversion to median sternotomy or operative mortality occurred. The average operation time was 292±62 minutes (ranged 140-450 minutes with CPB time of 124±26 minutes and aortic occlusion time of 88±21 minutes. The postoperative mechanical ventilation support time was continued for 15±6 hours, and the average staying length in critical care unit was 4±1 days. No myocardial infarction, ventricular tachycardia or excessive bleeding was complicated. All patients were successfully

  8. Histochemical studies on genetical control of hormonal enzyme inducibility in the mouse. VI. Effects of short term castration

    DEFF Research Database (Denmark)

    Kjaer, K; Kirkeby, S; Blecher, S R

    1983-01-01

    to survive long-term castration. The possibility of an androgen binding protein, as described in the rat and rabbit, is suggested on morphological grounds. The epididymal body appears to contain a class of highly androgen sensitive cells that degenerate rapidly following castration and a second class......The regional histology and esterase activity of the mouse epididymis after 24, 48, and 72 hr castration is reported. Differential sensitivity to androgen deprivation among the various epithelial cell types is described, allowing of positive identification of the cell types previously observed...... that survive from which regeneration occurs on testosterone replacement....

  9. Effects of growth hormone replacement therapy on IGF-related parameters and on the pituitary-gonadal axis in GH-deficient males. A double-blind, placebo-controlled crossover study

    DEFF Research Database (Denmark)

    Juul, A; Andersson, A M; Pedersen, S A

    1998-01-01

    It has been suggested that growth hormone (GH) may play a regulatory role in male reproductive function. To express full anabolic effect in immature boys testosterone apparently requires the presence of GH. In GH-deficient adults, GH replacement therapy exerts a variety of anabolic actions, some...... of which are similar to the effects of gonadal steroids. However, little is known about the potential effects of GH on gonadal steroids and on dynamic tests of pituitary-gonadal function in adults with GH deficiency. We evaluated the pituitary-gonadal axis in a 4-month double-blind, placebo-controlled GH...

  10. Hormone Replacement Therapy Appears to Be Safe After Prophylactic Adnexectomy in Premenopausal BRCA1/BRCA2 Mutation Carriers. Reaction to the 'Letter to readers' in Hereditary Cancer in Clinical Practice, 2005, 3 (2

    Directory of Open Access Journals (Sweden)

    Lubiński Jan

    2005-09-01

    Full Text Available In writing the letter to readers of our journal three months ago I was asking about opinions concerning the use of hormone replacement therapy (HRT in BRCA1/2 carriers after prophylactic adnexectomy, because at that time it was practically impossible to present evidence-based recommendations. Actually, most of the responses we have received have been opinions. It is important to recognise that the situation is now much clearer with studies performed by Tim Rebbeck et al which are to be published in the Journal of Clinical Oncology. The following responses have been received:

  11. Genetic deletion of melanin-concentrating hormone neurons impairs hippocampal short-term synaptic plasticity and hippocampal-dependent forms of short-term memory.

    Science.gov (United States)

    Le Barillier, Léa; Léger, Lucienne; Luppi, Pierre-Hervé; Fort, Patrice; Malleret, Gaël; Salin, Paul-Antoine

    2015-11-01

    The cognitive role of melanin-concentrating hormone (MCH) neurons, a neuronal population located in the mammalian postero-lateral hypothalamus sending projections to all cortical areas, remains poorly understood. Mainly activated during paradoxical sleep (PS), MCH neurons have been implicated in sleep regulation. The genetic deletion of the only known MCH receptor in rodent leads to an impairment of hippocampal dependent forms of memory and to an alteration of hippocampal long-term synaptic plasticity. By using MCH/ataxin3 mice, a genetic model characterized by a selective deletion of MCH neurons in the adult, we investigated the role of MCH neurons in hippocampal synaptic plasticity and hippocampal-dependent forms of memory. MCH/ataxin3 mice exhibited a deficit in the early part of both long-term potentiation and depression in the CA1 area of the hippocampus. Post-tetanic potentiation (PTP) was diminished while synaptic depression induced by repetitive stimulation was enhanced suggesting an alteration of pre-synaptic forms of short-term plasticity in these mice. Behaviorally, MCH/ataxin3 mice spent more time and showed a higher level of hesitation as compared to their controls in performing a short-term memory T-maze task, displayed retardation in acquiring a reference memory task in a Morris water maze, and showed a habituation deficit in an open field task. Deletion of MCH neurons could thus alter spatial short-term memory by impairing short-term plasticity in the hippocampus. Altogether, these findings could provide a cellular mechanism by which PS may facilitate memory encoding. Via MCH neuron activation, PS could prepare the day's learning by increasing and modulating short-term synaptic plasticity in the hippocampus. © 2015 Wiley Periodicals, Inc.

  12. Long-term functional outcomes after replacement of the esophagus with gastric, colonic, or jejunal conduits: a systematic literature review.

    Science.gov (United States)

    Irino, T; Tsekrekos, A; Coppola, A; Scandavini, C M; Shetye, A; Lundell, L; Rouvelas, I

    2017-12-01

    It is generally recognized that in patients with an intact stomach diagnosed with esophageal cancer, gastric tubulization and pull-up shall always be the preferred technique for reconstruction after an esophageal resection. However, in cases with extensive gastroesophageal junction (GEJ) cancer with aboral spread and after previous gastric surgery, alternative methods for reconstruction have to be pursued. Moreover, in benign cases as well as in those with early neoplastic lesions of the esophagus and the GEJ that are associated with long survival, it is basically unclear which conduit should be recommended. The aim of this study is to determine the long-term functional outcomes of different conduits used for esophageal replacement, based on a comprehensive literature review. Eligible were all clinical studies reporting outcomes after esophagectomy, which contained information on at least three years of follow-up after the operation in patients who were older than 18 years of age at the time of the operation. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic web-based search using MEDLINE, the Cochrane Library, and EMBASE databases was performed, reviewing medical literature published between January 2006 and December 2015. The scientific quality of the data was generally low, which allowed us to incorporate only 16 full text articles for the final analyses. After a gastric pull-up, the proportion of patients who suffered from dysphagia varied substantially but seemed to decrease over time with a mild dysphagia remaining during long-term follow-up. When reflux-related symptoms and complications were addressed, roughly two third of patients experienced mild to moderate reflux symptoms a long time after the resection. Following an isoperistaltic colonic graft, the functional long-term outcomes regarding swallowing difficulties were sparsely reported, while three studies

  13. An Analysis of Differences in Terms of Professional Interests Based on the Project to Replace IAS 39

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    Cláudia Daniela Ferreira da Mota Carvalho

    2015-08-01

    Full Text Available The professional interests of the various stakeholders groups are often seen as obstacles to full accounting harmonization. Studying different professional interests in the accounting domain is significant for organizations involved in the international accounting harmonization process, insofar as it enables them to identify the main obstacles to face in order to achieve full harmonization. Thus, this article is aimed at analyzing the differences in terms of professional interests by addressing the participation of various stakeholders groups in the process of issuing/modifying standards of the International Accounting Standards Board (IASB. Based on content analysis, we examined the comment letters sent to the IASB in the context of the first part of the first phase of the project to replace the International Accounting Standard (IAS 39, entitled "Financial Instruments - Recognition and Measurement", by the International Financial Reporting Standard (IFRS 9, on its turn entitled "Financial Instruments". Respondents were identified according to the stakeholders group, and, later, the collected data underwent a nonparametric chi-square test. The results of this study indicate there are significant differences between the answers obtained from the various stakeholders groups involved in the process of issuing or reviewing a standard of the IASB, above all made clear between the group of financial preparers and the regulatory and/or standard-setting agencies and the professional associations related to accounting.

  14. Long term end-stage renal disease and death following acute renal replacement therapy in the ICU

    DEFF Research Database (Denmark)

    Lohse, R.; Damholt, M. B.; Wiis, J.

    2016-01-01

    INTRODUCTION: In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors. METHODS: Retrospective analysis of all adult patients...... admitted to a general, university hospital ICU 2005-2012, excluding chronic dialysis patients. ESRD was defined as need of RRT > 90 days or kidney transplant. RESULTS: Of 5766 patients included, 1004 (16%) received acute RRT; their 30-day mortality was 42% vs. 16% for those not requiring acute RRT...... (adjusted hazard ratio (HR) 1.13 (0.96-1.32)). The 90-day mortality was 55% for patients receiving acute RRT vs. 22% for those who did not (adjusted HR 1.32 (1.15-1.51)) and 1-year mortality was 63% vs. 30%, respectively, (adjusted HR 1.31 (1.16-1.48)). The 7-year risk of ESRD for ICU patients surviving 90...

  15. The Ross Procedure in Adults: Long-Term Results of Homografts and Stentless Xenografts for Pulmonary Valve Replacement.

    Science.gov (United States)

    Christ, Torsten; Claus, Benjamin; Woythal, Nadine; Dushe, Simon; Falk, Volkmar; Grubitzsch, Herko

    2017-12-01

    Background The Ross procedure is an established method to treat aortic valve disease, offering excellent hemodynamic characteristics, growth potential, low risk of thromboembolism and no need for anticoagulation. Limitation of homograft quality and availability led to the use of different stentless xenografts. Long-term outcome and implications are yet to be addressed. Methods Forty five adult patients (mean age 38.8 ± 9.6 years) with aortic valve stenosis and/or insufficiency, who underwent the Ross procedure between 1995 and 2002 were identified for long-term evaluation. Patients younger than 18 years, with previous heart surgery and endocarditis were excluded. Stentless xenografts were used in 22 cases (Group X) and homografts in 23 cases (Group H). After review of the patients' history, morbidity and mortality were analyzed and risk stratification was performed. Results Between groups, baseline characteristics and operative data did not differ significantly. Total follow-up was 621.0 patient-years and 98.8% complete. Overall freedom from reoperation at 15 years was 68.4 ± 10.6% in group X and 85. ±  7.9% in group H (p = 0.09), respectively. Freedom from aortic valve reoperation at 15 years was comparable (83.9 ± 8.5% in group X and 85.3 ± 7.9% in group H, p = 0.61), whereas freedom from pulmonary valve reoperation at 15 years was significantly lower in group X (78.9 ± 9.4% versus 100%, p = 0.02). Long-term survival at 15 years was 79.7 ± 9.3% in group X and 94.4 ± 5.4% in group H (p = 0.07), respectively. Conclusions Stentless xenografts used as pulmonary valve substitute in the Ross procedure led to lower freedom from pulmonary valve reoperation compared with homografts. Additionally, there was a trend to inferior long-term survival with xenografts. Therefore, homografts should remain the preferred option for pulmonary valve replacement in the Ross procedure. Georg Thieme Verlag KG Stuttgart

  16. Long-term results of growth hormone treatment in France in children of short stature: population, register based study.

    OpenAIRE

    Coste, J.; Letrait, M.; Carel, J C; Tresca, J. P.; Chatelain, P; Rochiccioli, P.; Chaussain, J. L.; Job, J. C.

    1997-01-01

    OBJECTIVES: To describe the growth of children treated with growth hormone and to evaluate the prognostic factors for height at the end of treatment. DESIGN: Register based cohort study. SETTING: French national register of all children treated with growth hormone. SUBJECTS: 3233 short stature children (3165 of whom were deficient in growth hormone) who were treated with growth hormone (excluding children with Turner's syndrome) and whose treatment started between 1973 and 1989, last data bei...

  17. Long-term Efficacy and Safety of Enzalutamide Monotherapy in Hormone-naïve Prostate Cancer

    DEFF Research Database (Denmark)

    Tombal, Bertrand; Borre, Michael; Rathenborg, Per

    2015-01-01

    patients with metastases at baseline, 13 (50%) had a complete and four (15.4%) had a partial response as best overall tumor response up to 97 wk on treatment. There was overall maintenance of total-body bone mineral density (BMD) and moderate changes in lean and fat body mass at 49 and 97 wk. The most......BACKGROUND: Enzalutamide is an androgen receptor inhibitor with a demonstrated overall survival benefit in metastatic castration-resistant prostate cancer. A phase 2 study of enzalutamide monotherapy in patients with hormone-naïve prostate cancer (HNPC) showed a high response rate...... for the prespecified primary endpoint (ie, prostate-specific antigen [PSA] response at week 25), regardless of metastases at baseline, and favorable tolerability. OBJECTIVE: To determine the long-term efficacy and safety of enzalutamide monotherapy at 1 and 2 yr. DESIGN, SETTING, AND PARTICIPANTS: Open-label, single...

  18. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms

    DEFF Research Database (Denmark)

    Johnsen, S.P.; Sørensen, H.T.; Lucht, Ulf

    2006-01-01

    replacement, an age of 80 years or more and hip replacement undertaken as a sequela of trauma, for avascular necrosis or paediatric conditions, were associated with an increased risk of failure. However, during six months to 8.6 years after surgery, being less than 60 years old was associated...

  19. Estradiol attenuates ischemia-induced death of hippocampal neurons and enhances synaptic transmission in aged, long-term hormone-deprived female rats.

    Directory of Open Access Journals (Sweden)

    Tomoko Inagaki

    Full Text Available Transient global forebrain ischemia causes selective, delayed death of hippocampal CA1 pyramidal neurons, and the ovarian hormone 17β-estradiol (E2 reduces neuronal loss in young and middle-aged females. The neuroprotective efficacy of E2 after a prolonged period of hormone deprivation is controversial, and few studies examine this issue in aged animals given E2 treatment after induction of ischemia.The present study investigated the neuroprotective effects of E2 administered immediately after global ischemia in aged female rats (15-18 months after 6 months of hormone deprivation. We also used electrophysiological methods to assess whether CA1 synapses in the aging hippocampus remain responsive to E2 after prolonged hormone withdrawal. Animals were ovariohysterectomized and underwent 10 min global ischemia 6 months later. A single dose of E2 (2.25 µg infused intraventricularly after reperfusion significantly increased cell survival, with 45% of CA1 neurons surviving vs 15% in controls. Ischemia also induced moderate loss of CA3/CA4 pyramidal cells. Bath application of 1 nM E2 onto brain slices derived from non-ischemic aged females after 6 months of hormone withdrawal significantly enhanced excitatory transmission at CA1 synapses evoked by Schaffer collateral stimulation, and normal long-term potentiation (LTP was induced. The magnitude of LTP and of E2 enhancement of field excitatory postsynaptic potentials was indistinguishable from that recorded in slices from young rats.The data demonstrate that 1 acute post-ischemic infusion of E2 into the brain ventricles is neuroprotective in aged rats after 6 months of hormone deprivation; and 2 E2 enhances synaptic transmission in CA1 pyramidal neurons of aged long-term hormone deprived females. These findings provide evidence that the aging hippocampus remains responsive to E2 administered either in vivo or in vitro even after prolonged periods of hormone withdrawal.

  20. Chronic Kidney Disease After Acute Kidney Injury Requiring Continuous Renal Replacement Therapy and Its Impact on Long-Term Outcomes: A Multicenter Retrospective Cohort Study in Korea.

    Science.gov (United States)

    An, Jung Nam; Hwang, Jin Ho; Kim, Dong Ki; Lee, Hajeong; Ahn, Shin Young; Kim, Sejoong; Park, Jung Tak; Kang, Shin-Wook; Oh, Yun Kyu; Kim, Yon Su; Lim, Chun Soo; Oh, Hyung Jung; Lee, Jung Pyo

    2017-01-01

    Severe acute kidney injury requiring continuous renal replacement therapy is associated with a high risk of early mortality. Our objectives were to identify a cohort of early survivors and to follow their renal progress and long-term mortality. Multicenter, observational, retrospective cohort study. ICUs in tertiary academic hospitals in Korea. From 2009 to 2013, we identified 1,764 severe acute kidney injury patients who were started on continuous renal replacement therapy at four hospitals. Of these, we identified 331 survivors for whom we could identify renal function at baseline and at 3 months. None. The 331 patients were separated into two groups based on their renal function at 3 months after the start of continuous renal replacement therapy. Those who displayed significant deterioration in renal function compared to baseline, defined as greater than or equal to 50% increase in serum creatinine or greater than or equal to 35% decrease in the estimated glomerular filtration rate, or those who continued to receive renal replacement therapy were designated as a "3-month chronic kidney disease progression" group. Those with a return to baseline, less than 50% increase in serum creatinine or less than 35% decrease in the estimated glomerular filtration rate, were designated as a "3-month chronic kidney disease nonprogression" group. The acute kidney injury patients requiring continuous renal replacement therapy showed a higher risk of progression to end-stage renal disease compared to that of stage 3 chronic kidney disease patients who did not undergo an acute kidney injury episode, even if the acute kidney injury was recovered at 3 months after continuous renal replacement therapy initiation. Furthermore, "3-month chronic kidney disease progression" was associated with a high risk of progression to end-stage renal disease and long-term mortality over a median follow-up period of 12.7 (3.8-33.2) and 20.4 (7.5-39.7) months, respectively. Older age, higher baseline

  1. Hormones and Hypertension

    Science.gov (United States)

    Fact Sheet Hormones and Hypertension What is hypertension? Hypertension, or chronic (long-term) high blood pressure, is a main cause of ... tobacco, alcohol, and certain medications play a part. Hormones made in the kidneys and in blood vessels ...

  2. Long-term, hormone-responsive organoid cultures of human endometrium in a chemically defined medium

    OpenAIRE

    Turco, Margherita Yayoi; Gardner, L.; Hughes, J.; Cindrova-Davies, Tereza; Gomez, MJ; Farrell, L; Hollinshead, M; Marsh, SGE; Brosens, JJ; Critchley, HO; Simons, Benjamin David; Hemberger, M; Koo, Bonkyoung; Moffett, Ashley; Burton, Graham James

    2017-01-01

    In humans, the endometrium, the uterine mucosal lining, undergoes dynamic changes throughout the menstrual cycle and pregnancy. Despite the importance of the endometrium as the site of implantation and nutritional support for the conceptus, there are no long-term culture systems that recapitulate endometrial function in vitro. We adapted conditions used to establish human adult stem-cell-derived organoid cultures to generate three-dimensional cultures of normal and decidualized human endometr...

  3. Long-term rescue of cone photoreceptor degeneration in retinitis pigmentosa 2 (RP2)-knockout mice by gene replacement therapy.

    Science.gov (United States)

    Mookherjee, Suddhasil; Hiriyanna, Suja; Kaneshiro, Kayleigh; Li, Linjing; Li, Yichao; Li, Wei; Qian, Haohua; Li, Tiansen; Khanna, Hemant; Colosi, Peter; Swaroop, Anand; Wu, Zhijian

    2015-11-15

    Retinal neurodegenerative diseases are especially attractive targets for gene replacement therapy, which appears to be clinically effective for several monogenic diseases. X-linked forms of retinitis pigmentosa (XLRP) are relatively severe blinding disorders, resulting from progressive photoreceptor dysfunction primarily caused by mutations in RPGR or RP2 gene. With a goal to develop gene therapy for the XLRP-RP2 disease, we first performed detailed characterization of the Rp2-knockout (Rp2-KO) mice and observed early-onset cone dysfunction, which was followed by progressive cone degeneration, mimicking cone vision impairment in XLRP patients. The mice also exhibited distinct and significantly delayed falling phase of photopic b-wave of electroretinogram (ERG). Concurrently, we generated a self-complementary adeno-associated viral (AAV) vector carrying human RP2-coding sequence and demonstrated its ability to mediate stable RP2 protein expression in mouse photoreceptors. A long-term efficacy study was then conducted in Rp2-KO mice following AAV-RP2 vector administration. Preservation of cone function was achieved with a wide dose range over 18-month duration, as evidenced by photopic ERG and optomotor tests. The slower b-wave kinetics was also completely restored. Morphologically, the treatment preserved cone viability, corrected mis-trafficking of M-cone opsin and restored cone PDE6 expression. The therapeutic effect was achieved even in mice that received treatment at an advanced disease stage. The highest AAV-RP2 dose group demonstrated retinal toxicity, highlighting the importance of careful vector dosing in designing future human trials. The wide range of effective dose, a broad treatment window and long-lasting therapeutic effects should make the RP2 gene therapy attractive for clinical development. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Severe acute kidney injury following cardiac surgery: short-term outcomes in patients undergoing continuous renal replacement therapy (CRRT).

    Science.gov (United States)

    Pistolesi, Valentina; Di Napoli, Anteo; Fiaccadori, Enrico; Zeppilli, Laura; Polistena, Francesca; Sacco, Maria Itala; Regolisti, Giuseppe; Tritapepe, Luigi; Pierucci, Alessandro; Morabito, Santo

    2016-04-01

    Acute kidney injury (AKI) represents a major complication of cardiac surgery. Our aim was to evaluate, in patients undergoing continuous renal replacement therapy (CRRT) for cardiac surgery-associated AKI (CS-AKI), prognostic factors related to in-hospital survival and renal function recovery to independence from RRT. We conducted a retrospective analysis in patients with severe CS-AKI who underwent CRRT for at least 48 h. The sequential organ failure assessment (SOFA) score was calculated on a daily basis to evaluate illness severity throughout the intensive care unit (ICU) stay. In 264 patients (age 66.4 ± 11.7 years, 192 males), 30-day survival was 57.6 % while survival to discharge from the hospital was 40.5 %. Renal function recovery occurred in 96.3 % of survivors and in 13.4 % of non-survivors (p CRRT (SOFA-max) as independent prognostic factors for failure to recover renal function. Female gender was associated with a higher probability of survival, while higher serum creatinine at the start of CRRT, oliguria, sepsis and SOFA-max were independently associated with mortality. The subgroup of patients with a day-1 SOFA score above the median (≥10) showed a lower probability of survival and a lower cumulative incidence of renal function recovery. In a selected population of patients with severe CS-AKI requiring RRT, short-term outcomes appear strongly associated with the worst grade of illness severity during the first week of CRRT, thus reflecting the sequential occurrence of additional major complications during ICU stay. Renal function recovery and in-hospital survival appear mutually linked, sharing oliguria, sepsis and SOFA score as the main determinants of both outcomes.

  5. Mid-term changes in blood metal ion levels after Articular Surface Replacement arthroplasty of the hip.

    Science.gov (United States)

    Galea, V P; Laaksonen, I; Matuszak, S J; Connelly, J W; Muratoglu, O; Malchau, H

    2017-04-01

    Our first aim was to determine whether there are significant changes in the level of metal ions in the blood at mid-term follow-up, in patients with an Articular Surface Replacement (ASR) arthroplasty. Secondly, we sought to identify risk factors for any increases. The study involved 435 patients who underwent unilateral, metal-on-metal (MoM) hip resurfacing (HRA) or total hip arthroplasty (THA). These patients all had one measurement of the level of metal ions in the blood before seven years had passed post-operatively (early evaluation) and one after seven years had passed post-operatively (mid-term evaluation). Changes in ion levels were tested using a Wilcoxon signed-rank test. We identified subgroups at the highest risk of increase using a multivariable linear logistic regression model. There were significant increases in the levels of metal ions for patients who underwent both MoM HRA (Chromium (Cr): 0.5 parts per billion (ppb); Cobalt (Co): 1.1 ppb) and MoM THA (Cr: 0.5 ppb; Co: 0.7 ppb). In a multivariable model considering MoM HRAs, the change in the levels of metal ions was influenced by female gender (Co: Odds Ratio (OR) 1.42; p = 0.002 and Cr: OR 1.08; p = 0.006). The change was found to be irrespective of the initial level for the MoM HRAs, whereas there was a negative relationship between the initial level and the change in the level for those with a MoM THA (Co: OR -0.43; p MoM HRA and those with a MoM THA. We recommend that the levels of metal ions be measured most frequently for women with a MoM HRA. While those with a MoM THA appear to stabilise at a certain level, the accuracy of this trend is not yet clear. Vigilant follow-up is still recommended. Cite this article: Bone Joint J 2017;99-B(4 Supple B):33-40. ©2017 Galea et al.

  6. Oestrogen replacement in postmenopausal women.

    Science.gov (United States)

    Sassarini, Jenifer; Lumsden, Mary Ann

    2015-07-01

    Menopausal symptoms can disrupt a woman's personal and social life. Vasomotor symptoms (hot flushes and night sweats) are the most common symptoms and can be treated very effectively with oestrogen-based hormone therapy. The decision to use oestrogen (often simply termed hormone therapy or hormone replacement therapy or HT) therapy involves balancing the potential benefits against the potential risks. Most agree that short-term oestrogen therapy, using the lowest effective dose, is a reasonable option for recently menopausal women with moderate-to-severe symptoms who are in good cardiovascular health (Martin and Manson. 2008. J. Clin. Endocrinol. Metab. 93, 4567-75). Whilst effective and safe in most instances, HT is not suitable for all women or for all menopause-related symptoms when alternatives are available. The role of HRT in chronic disease prevention is also discussed. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. 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

  8. [Long-term use of combined hormonal contraception--myths and reality].

    Science.gov (United States)

    Novotná, M; Huvar, I; Bláha, O

    2002-09-01

    To assess relationship of long-term use of combined oral contraception (COC) and women health, discussion about myths connected with use of COC. Review of literature. Department of Obstetrics and Gynaecology, Hospital of Merciful Brothers, Brno, Czech Republic. Identification of studies able to address the topic using Medline database search. Besides reliable control of fertility COC protect women against dysmenorrhea, iron deficiency anemia, ovarian cysts and uterine fibroids. COC plays very important role in gynecologic endocrinology suppressing effectively hyperandrogenism, which has not only cosmetic effect but brings also improvement in cardiovascular health of affected perimenopausal women. Premenopausal using of COC could help preserve bone mineral density and can reduce the risk of developing Alzheimer's disease. The most important feature is protective effect against endometrial (by 70%) and ovarian (by 50%) cancer which increases with duration of COC use and is long lasting and may be observed 15 to 20 years after stopping use. Association of use COC with increased risk neither of cervical cancer nor breast cancer has not been confirmed. Controversy still persists over the association of long-term (longer than 8 years) COC use by young nulliparas and breast cancer. The risk in this group of users is probably slightly increased. But no authorities recommended any restriction of COC's prescription. Some studies have suggested an inverse relationship between use of COC and risk of colorectal cancer. The only established evidence of direct association between OC use and cancer risk is the increased risk for hepatocellular carcinoma in the absence of hepatitis B (but maximum by 4 cases per 1,000,000 users per year). Most non-contraceptive health benefits of COC are still not widely appreciated in spite of much evidence. The final decision of contraception method is upon well and adequate informed user by well educated doctor.

  9. Impairment of Host Liver Repopulation by Transplanted Hepatocytes in Aged Rats and the Release by Short-Term Growth Hormone Treatment.

    Science.gov (United States)

    Stock, Peggy; Bielohuby, Maximilian; Staege, Martin S; Hsu, Mei-Ju; Bidlingmaier, Martin; Christ, Bruno

    2017-03-01

    Hepatocyte transplantation is an alternative to whole liver transplantation. Yet, efficient liver repopulation by transplanted hepatocytes is low in livers of old animals. This restraint might be because of the poor proliferative capacity of aged donor hepatocytes or the regenerative impairment of the recipient livers. The age-dependent liver repopulation by transplanted wild-type hepatocytes was investigated in juvenile and senescent rats deficient in dipeptidyl-peptidase IV. Repopulation was quantified by flow cytometry and histochemical estimation of dipeptidyl-peptidase IV enzyme activity of donor cells in the negative host liver. As a potential pathway involved, expression of cell cycle proteins was assessed. Irrespective of the age of the donor hepatocytes, large cell clusters appeared in juvenile, but only small clusters in senescent host livers. Because juvenile and senescent donor hepatocytes were likewise functional, host-derived factor(s) impaired senescent host liver repopulation. Growth hormone levels were significantly higher in juvenile than in senescent rats, suggesting that growth hormone might promote host liver repopulation. Indeed, short-term treatment with growth hormone augmented senescent host liver repopulation involving the growth hormone-mediated release of the transcriptional blockade of genes associated with cell cycle progression. Short-term growth hormone substitution might improve liver repopulation by transplanted hepatocytes, thus augmenting the therapeutic benefit of clinical hepatocyte transplantation in older patients. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  10. 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) risk patients. It was still unknown whether intermediate-risk patients would experience an additional survival benefit with LTAD; thus, we performed a secondary analysis to explore whether LTAD had any incremental benefit beyond STAD among the intermediate-risk subset of RTOG 9202. The study endpoints were OS, disease-specific survival (DSS), and PSA failure (PSAF). An analysis was performed for all patients enrolled in RTOG 9202 defined as intermediate-risk (cT2 disease, PSArisk 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.

  11. Avoidable cancers in the Nordic countries. Exogenous hormones

    DEFF Research Database (Denmark)

    Winther, J F; Dreyer, L; Tryggvadottir, L

    1997-01-01

    The well-described influence of several aspects of reproductive life on the risk for cancer in the reproductive organs has raised concern regarding the safety of exogenous hormones, particularly since sex hormones have become one of the most widely used drugs among women in the western world....... The major areas of application include oral contraception and hormone replacement therapy in women with menopausal symptoms. Since the introduction of oral contraceptives onto the Nordic market in the late 1960s, the number of users has grown steadily, to reach proportions of long-term users among women...... years) of hormone replacement therapy among Nordic women aged 40-69 in 1995 was estimated to be 10-11%, which on the basis of an associated relative risk for breast cancer ranging from 1.2-1.5 suggests than an annual total of 260 cases of breast cancer could be avoided in the Nordic countries around...

  12. Long-Term Intake of a High-Protein Diet Affects Body Phenotype, Metabolism, and Plasma Hormones in Mice.

    Science.gov (United States)

    Vu, John P; Luong, Leon; Parsons, William F; Oh, Suwan; Sanford, Daniel; Gabalski, Arielle; Lighton, John Rb; Pisegna, Joseph R; Germano, Patrizia M

    2017-12-01

    Background: High-protein diets (HPDs) recently have been used to obtain body weight and fat mass loss and expand muscle mass. Several studies have documented that HPDs reduce appetite and food intake.Objective: Our goal was to determine the long-term effects of an HPD on body weight, energy intake and expenditure, and metabolic hormones.Methods: Male C57BL/6 mice (8 wk old) were fed either an HPD (60% of energy as protein) or a control diet (CD; 20% of energy as protein) for 12 wk. Body composition and food intakes were determined, and plasma hormone concentrations were measured in mice after being fed and after overnight feed deprivation at several time points.Results: HPD mice had significantly lower body weight (in means ± SEMs; 25.73 ± 1.49 compared with 32.5 ± 1.31 g; P = 0.003) and fat mass (9.55% ± 1.24% compared with 15.78% ± 2.07%; P = 0.05) during the first 6 wk compared with CD mice, and higher lean mass throughout the study starting at week 2 (85.45% ± 2.25% compared with 75.29% ± 1.90%; P = 0.0001). Energy intake, total energy expenditure, and respiratory quotient were significantly lower in HPD compared with CD mice as shown by cumulative energy intake and eating rate. Water vapor was significantly higher in HPD mice during both dark and light phases. In HPD mice, concentrations of leptin [feed-deprived: 41.31 ± 11.60 compared with 3041 ± 683 pg/mL (P = 0.0004); postprandial: 112.5 ± 102.0 compared with 8273 ± 1415 pg/mL (P weight and fat mass loss, but throughout the study preserved body lean mass and significantly reduced energy intake and expenditure as well as leptin and GLP-1 concentrations while elevating postprandial glucagon concentrations. This study suggests that long-term use of HPDs may be an effective strategy to decrease energy intake and expenditure and to maintain body lean mass. © 2017 American Society for Nutrition.

  13. Avoidable cancers in the Nordic countries. Exogenous hormones

    DEFF Research Database (Denmark)

    Winther, J F; Dreyer, L; Tryggvadottir, L

    1997-01-01

    . The major areas of application include oral contraception and hormone replacement therapy in women with menopausal symptoms. Since the introduction of oral contraceptives onto the Nordic market in the late 1960s, the number of users has grown steadily, to reach proportions of long-term users among women...

  14. Aortic cusp extension valvuloplasty with or without tricuspidization in children and adolescents: long-term results and freedom from aortic valve replacement.

    Science.gov (United States)

    Polimenakos, Anastasios C; Sathanandam, Shyam; Elzein, Chawki; Barth, Mary J; Higgins, Robert S D; Ilbawi, Michel N

    2010-04-01

    Aortic cusp extension valvuloplasty is increasingly used in the management of children and adolescents with aortic stenosis or regurgitation. The durability of this approach and the freedom from valve replacement are not well defined. A study was undertaken to investigate outcomes. From July 1987 to November 2008, 142 patients aged less than 19 years underwent aortic cusp extension valvuloplasty in the form of pericardial cusp extension and tricuspidization (when needed). Three patients with truncus arteriosus and severe truncal valve insufficiency were excluded. From the available follow-up data of 139 patients, 50 had bicuspid aortic valves, 40 had congenital aortic valve stenosis, 41 had combined congenital aortic valve stenosis/insufficiency, and 8 had other diagnoses. Median follow-up was 14.4 years (0.1-21.4). Long-term mortality and freedom from aortic valve replacement were studied. There were no early, intermediate, or late deaths. Z-values of left ventricular end-diastolic dimension, aortic annulus, aortic sinus diameter, and sinotubular junction diameter before aortic valve replacement were 4.2 +/- 3.11, 2.3 +/- 1.25, 4.4 +/- 1.23, and 1.84 +/- 1.28, respectively. During the follow-up period, 64 patients underwent aortic valve reinterventions. The Ross procedure was performed in 32 of 139 patients (23%) undergoing aortic cusp extension valvuloplasty. Other aortic valve replacements were undertaken after 16 aortic cusp extension valvuloplasties (11.5%). Freedom from a second aortic cusp extension valvuloplasty or aortic valve replacement at 18 years was 82.1% +/- 4.2% and 60.0% +/- 7.2%, respectively. Aortic cusp extension valvuloplasty is a safe and effective surgical option with excellent survival and good long-term outcomes in children and adolescents. The procedure provides acceptable durability and satisfactory freedom from aortic valve replacement. Copyright 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights

  15. Long-term exposure to triphenylphosphate alters hormone balance and HPG, HPI, and HPT gene expression in zebrafish (Danio rerio).

    Science.gov (United States)

    Liu, Xiaoshan; Jung, Dawoon; Jo, Areum; Ji, Kyunghee; Moon, Hyo-Bang; Choi, Kyungho

    2016-09-01

    With the global decline in the use of polybrominated diphenyl ethers, the demand for alternative flame retardants, such as triphenylphosphate (TPP), has increased substantially. Triphenylphosphate is now detected in various environments including aquatic ecosystems worldwide. However, studies on the toxicological consequences of chronic TPP exposure on aquatic organisms are scarce. The zebrafish model was used to investigate the effects of long-term TPP exposure on the endocrine system. Zebrafish embryos were exposed to 5 µg/L, 50 µg/L, or 500 µg/L TPP for 120 d, and hormonal and transcriptional responses were measured along the hypothalamic-pituitary-gonad (HPG) axis, the hypothalamic-pituitary-interrenal (HPI) axis, and the hypothalamic-pituitary-thyroid (HPT) axis. Exposure to TPP significantly increased plasma 17β-estradiol, but decreased 11-ketotestosterone in both sexes. Gene expression data support these changes. In the HPI axis, plasma cortisol and proopiomelanocortin (pomc) and mineralocorticoid receptor transcripts increased in females, but in males cortisol decreased whereas pomc increased (p HPG axis, but modulated the HPI, and HPT axes differently by sex, suggesting that both genomic and nongenomic responses might be involved. Environ Toxicol Chem 2016;35:2288-2296. © 2016 SETAC. © 2016 SETAC.

  16. PET Study in a Patient with Spinocerebellar Degeneration before and after Long-Term Administration of Thyrotropin Releasing Hormone

    Directory of Open Access Journals (Sweden)

    H. Tanji

    1996-01-01

    Full Text Available We studied the chronic effect of thyrotropin releasing hormone (TRH in a patient with spinocerebellar degeneration by measuring cerebral metabolic rate for glucose (CMRG1c using 2-[18F]fluoro-2-deoxy-D-glucose (18FDG and positron emission tomography (PET. A 56-year-old female, who had suffered from progressive ataxia for 2 years, was treated by intravenous administration of 2 mg TRH for 3 weeks, and CMRG1c of the brain was measured before and after treatment. CMRG1c was markedly decreased in the cerebellum and there was no significant difference before and after the treatment, i.e. mean CMRG1c values were 4.92 and 4.90 mg/100 g/min, and the ratios of the cerebellum versus the frontal cortex were 0.50 and 0.51, respectively. The degree of disequilibrium of her body examined with stabilography became better by the 19th day and further improved by the 26th day after the start of TRH treatment. Based on the present study we conclude that long-term administration of TRH did not improve CMRG1c in the cerebellum, but evidently improved the sway of gravity center by stabilography. We speculate that the chronic effect of TRH was not necessarily due to an improvement of cerebellar function, because TRH receptors are widely distributed throughout the central nervous system.

  17. Thyroid hormone is required for pruning, functioning and long-term maintenance of afferent inner hair cell synapses

    Science.gov (United States)

    Sundaresan, Srividya; Kong, Jee-Hyun; Fang, Qing; Salles, Felipe T.; Wangsawihardja, Felix; Ricci, Anthony J.; Mustapha, Mirna

    2016-01-01

    Functional maturation of afferent synaptic connections to inner hair cells (IHCs) involves pruning of excess synapses formed during development, as well as the strengthening and survival of the retained synapses. These events take place during the thyroid hormone (TH)-critical period of cochlear development, which is in the perinatal period for mice and in the third trimester for humans. Here, we used the hypothyroid Snell dwarf mouse (Pit1dw) as a model to study the role of TH in afferent type I synaptic refinement and functional maturation. We observed defects in afferent synaptic pruning and delays in calcium channel clustering in the IHCs of Pit1dw mice. Nevertheless, calcium currents and capacitance reached near normal levels in Pit1dw IHCs by the age of onset of hearing, despite the excess number of retained synapses. We restored normal synaptic pruning in Pit1dw IHCs by supplementing with TH from postnatal day (P)3 to P8, establishing this window as being critical for TH action on this process. Afferent terminals of older Pit1dw IHCs showed evidence of excitotoxic damage accompanied by a concomitant reduction in the levels of the glial glutamate transporter, GLAST. Our results indicate that a lack of TH during a critical period of inner ear development causes defects in pruning and long-term homeostatic maintenance of afferent synapses. PMID:26386265

  18. Yolk hormones have sex-specific long-term effects on behavior in the pied flycatcher (Ficedula hypoleuca).

    Science.gov (United States)

    Ruuskanen, Suvi; Laaksonen, Toni

    2010-02-01

    The hormonal environment during early development, such as maternally derived androgens in bird eggs, shapes the development and phenotype of the offspring in ways that may have important long-term consequences for behaviour. We studied the effects of yolk androgens on multiple behavioural traits in female and male pied flycatchers (Ficedula hypoleuca) by experimentally elevating androgen levels (testosterone and androstenedione) in the eggs. The birds were housed in a common-garden environment in captivity until full independence, after which their behaviour was tested. We found that androgen-treated males were more likely than control males to explore a novel environment and showed higher activity in the presence of a novel object. In response to a simulated predator attack, androgen-treated males mainly showed freezing behaviour, while control males showed escape behaviour. Females from the androgen treatment and control group showed no differences in these behaviours. Androgen treatment did not affect neophobia (latency to approach the novel object) or dominance behaviour in either sex. Behaviour in the novel environment and towards a novel object was repeatable, but behaviours in the different experiments were mostly not inter-correlated. These results indicate that yolk androgens have various long-lasting effects on behaviour, especially in males, but that they do not induce a distinct behavioural syndrome. As behaviour is strongly linked with fitness, our results suggest that yolk androgens may play a role in determining fitness, and thus play a potentially adaptive role. Copyright 2009 Elsevier Inc. All rights reserved.

  19. Rationale and design of PATRO Adults, a multicentre, noninterventional study of the long-term efficacy and safety of Omnitrope(®) for the treatment of adult patients with growth hormone deficiency.

    Science.gov (United States)

    Beck-Peccoz, Paolo; Minuto, Francesco; Leal-Cerro, Alfonso; Zabransky, Markus; Stalla, Günter

    2012-06-01

    To describe the rationale and design of PATRO Adults, a postmarketing surveillance study of the long-term efficacy and safety of somatropin (Omnitrope(®)) for the treatment of adult patients with growth hormone deficiency (GHD). PATRO Adults is an observational, multicentre, open, longitudinal, noninterventional study being conducted in hospitals and specialized endocrinology clinics across several European countries. The primary objective is to assess the safety and efficacy of Omnitrope(®) in adults treated in routine clinical practice. Eligible patients are male or female adults who are receiving treatment with Omnitrope(®) and who have provided informed consent. Patients who have been treated with another human growth hormone (hGH) product before starting Omnitrope(®) therapy will also be eligible for inclusion. Efficacy assessments will be based on the analysis of the following: insulin-like growth factor-1 levels within age- and gender-adjusted normal ranges; anthropometric measures (weight, waist circumference, total fat mass, lean body mass, total body water); bone mineral density; lipids; effects on cardiovascular risk factors such as glucose metabolism, blood pressure and inflammatory markers (e.g. C-reactive protein); and quality of life. All adverse events will be monitored and recorded. Particular emphasis will be placed on long-term safety, the recording of malignancies, the occurrence and clinical impact of antirecombinant hGH antibodies, the incidence, severity and duration of hyperglycaemia, and the development of diabetes during treatment with Omnitrope(®). PATRO Adults is a large, long-term, postmarketing surveillance study that will extend the safety database for Omnitrope(®), as well as contributing to the available data for all recombinant hGH products. Of particular interest, the study will provide important data on the impact of long-term GH replacement therapy on the development of diabetes mellitus, the recurrence/regrowth of

  20. Short-term efficacy of nicotine replacement therapy for smoking cessation in adolescents : A randomized controlled trial

    NARCIS (Netherlands)

    Scherphof, Charlotte S.|info:eu-repo/dai/nl/341769797; van den Eijnden, Regina J. J. M.|info:eu-repo/dai/nl/17399394X; Engels, Rutger C. M. E.; Vollebergh, Wilma A. M.|info:eu-repo/dai/nl/090632893

    The aim of this randomized, double-blind placebo-controlled clinical trial is to test the efficacy and safety of nicotine replacement therapy (NRT) in promoting end-of-treatment abstinence among adolescents and whether this relation is moderated by medication compliance. Participants (N = 257, age:

  1. Long-term Clinical Outcome of Antibody Replacement Therapy in Humoral Immunodeficient Adults With Respiratory Tract Infections

    NARCIS (Netherlands)

    van Kessel, Diana A; Hoffman, Thijs W; van Velzen-Blad, Heleen; Zanen, Pieter|info:eu-repo/dai/nl/173876412; Grutters, Jan|info:eu-repo/dai/nl/258116129; Rijkers, Ger T

    In severe humoral immunodeficiency the indication for antibody replacement therapy (ART) is clear, and supported by several large studies. However, for milder forms of humoral immunodeficiency, the indication for ART is less clear. This is a retrospective cohort study of 87 adults with recurrent

  2. Short-term efficacy of nicotine replacement therapy for smoking cessation in adolescents: A randomized controlled trial

    NARCIS (Netherlands)

    Scherphof, C.S.; Eijnden, R.J.J.M. van den; Engels, R.C.M.E.; Vollebergh, W.A.M.

    2014-01-01

    The aim of this randomized, double-blind placebo-controlled clinical trial is to test the efficacy and safety of nicotine replacement therapy (NRT) in promoting end-of-treatment abstinence among adolescents and whether this relation is moderated by medication compliance. Participants (N = 257, age:

  3. Enzyme-replacement Therapy in Classic Infantile Pompe Disease: Long-term outcome, dosing and the role of antibodies

    NARCIS (Netherlands)

    C.M. Van Gelder (Carin)

    2013-01-01

    textabstract__Abstract__ The introduction of enzyme-replacement therapy (ERT) in 2006 has dramatically increased the interest in Pompe disease. In the three decades following the discovery of acid a-glucosidase deficiency as cause of the disease by H.G. Hers in 1963 only very few research

  4. Cardioprotective effects of lipoic acid, quercetin and resveratrol on oxidative stress related to thyroid hormone alterations in long-term obesity.

    Science.gov (United States)

    Cheserek, Maureen Jepkorir; Wu, Guirong; Li, Longnan; Li, Lirong; Karangwa, Eric; Shi, Yonghui; Le, Guowei

    2016-07-01

    This study investigated possible mechanisms for cardioprotective effects of lipoic acid (LA), quercetin (Q) and resveratrol (R) on oxidative stress related to thyroid hormone alterations in long-term obesity. Female C57BL/6 mice were fed on high-fat diet (HFD), HFD+LA, HFD+R, HFD+Q and normal diet for 26weeks. Body weight, blood pressure, thyroid hormones, oxidative stress markers, angiotensin converting enzyme (ACE), nitric oxide synthase (NOS) and ion pump activities were measured, and expression of cardiac genes was analyzed by real-time polymerase chain reaction. HFD induced marked increase (Pstress, while plasma triidothyronine levels reduced. ACE activity increased (Pobesity thereby restoring plasma thyroid hormone levels and attenuating oxidative stress in the heart and thus may have therapeutic potential in heart diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effect of 12 months of recombinant human growth hormone replacement therapy on insulin sensitivity in GH-deficient adults as determined by different methods.

    Directory of Open Access Journals (Sweden)

    Micic D

    2002-10-01

    Full Text Available BACKGROUND: Controversial results have been obtained in measuring insulin sensitivity (S(I during recombinant human growth hormone (rhGH treatment in adult growth hormone deficient (GH-deficient patients. AIMS: The aim of our study was to estimate S(I before and during treatment using three different methods for quantifying insulin sensitivity in GH-deficient adults treated with rhGH. SETTINGS AND DESIGN: Twenty-one GH-deficient adults were treated with rhGH during 12 months. S(I was estimated using Minimal model analysis, Homeostatic Model of Assessment (HOMA and Quantitative Insulin Sensitivity Check Index (QUICKI before and after 3, 6, 9 and 12 months of rhGH therapy. MATERIAL AND METHODS: Oral Glucose Tolerance Test (OGTT and Frequently Sampled Intravenous Glucose Tolerance Test (FSIGT were performed in each patient at respective time intervals. QUICKI and HOMA were calculated using basal values of glucose and insulin from FSIGT. Minimal model computer analysis was calculated from glucose and insulin data obtained during FSIGT. STATISTICAL ANALYSIS: Area under the curve for glucose, insulin and C-peptide were calculated using trapezoidal rule from OGTT data. Differences and correlations were tested using ANOVA for repeated measures, Wilcoxon′s matched-paired test, paired t-test, Pearson′s correlation and Bland Altman plot. RESULTS: There were no significant changes in S(I using Minimal model analysis and QUICKI during rhGH treatment. On the contrary, HOMA analysis indicated significant deterioration in S(I after 12 months of therapy. CONCLUSION: Our study did not demonstrate any changes in S(I using Minimal model and QUICKI analysis, while there was significant increase in insulin resistance using HOMA model. We suggest that the choice of method for the determination of S(I may influence the interpretation of results concerning the effect of rhGH therapy on S(I in GH-deficient adults.

  6. SHORT- AND MIDDLE-TERM RESULTS OF KNEE JOINT REPLACEMENT WITH ZIMMER NexGen CR AND LPS IMPLANTS

    Directory of Open Access Journals (Sweden)

    A. B. Slobodskoy

    2011-01-01

    Full Text Available The article presents the experience gained by orthopedic unit of Saratov Regional Clinical Hospital at knee joint replacement with modern implants. We analyzed use of Zimmer NexGen CR and LPC implants for initial total knee joint replacement in 285 patients. The monitoring continued for 5 years. Good and excellent results were observed in 92% of cases. Pyogenic complications were observed in 2.3% of cases. The article describes the methods of surgical intervention and post-surgical rehabilitation. We consider our experience with Zimmer NexGen LPS and CR knee-joint implants as positive and prospective for further use.

  7. Short- and Long-Term Lead Release after Partial Lead Service Line Replacements in a Metropolitan Water Distribution System.

    Science.gov (United States)

    Deshommes, Elise; Laroche, Laurent; Deveau, Dominique; Nour, Shokoufeh; Prévost, Michèle

    2017-09-05

    Thirty-three households were monitored in a full-scale water distribution system, to investigate the impact of recent (lead service line replacements (PLSLRs). Total and particulate lead concentrations were measured using repeat sampling over a period of 1-20 months. Point-of-entry filters were installed to capture sporadic release of particulate lead from the lead service lines (LSLs). Mean concentrations increased immediately after PLSLRs and erratic particulate lead spikes were observed over the 18 month post-PLSLR monitoring period. The mass of lead released during this time frame indicates the occurrence of galvanic corrosion and scale destabilization. System-wide, lead concentrations were however lower in households with PLSLRs as compared to those with no replacement, especially for old PLSLRs. Nonetheless, 61% of PLSLR samples still exceeded 10 μg/L, reflecting the importance of implementing full LSL replacement and efficient risk communication. Acute concentrations measured immediately after PLSLRs demonstrate the need for appropriate flushing procedures to prevent lead poisoning.

  8. Differences in preterm and term milk fatty acid compositions may be caused by the different hormonal milieu of early parturition

    NARCIS (Netherlands)

    Kuipers, Remko S.; Luxwolda, Martine F.; Dijck-Brouwer, D. A. Janneke; Muskiet, Frits A. J.

    2011-01-01

    Introduction: The hormonal milieus of pregnancy and lactation are driving forces of nutrient fluxes supporting infant growth and development. The decrease of insulin sensitivity with compensatory hyperinsulinemia with advancing gestation, causes adipose tissue lipolysis and hepatic de novo

  9. Relationship of long-term macronutrients intake on anabolic-catabolic hormones in female elite volleyball players.

    Science.gov (United States)

    Mielgo Ayuso, Juan; Zourdos, Michael C; Urdampilleta, Aritz; Calleja González, Julio; Seco, Jesús; Córdova, Alfredo

    2017-10-24

    Specific macronutrient distribution and training can alter acute and chronic hormone behavior and, subsequently, sport performance. The main aim was to examine relationships between dietary intake and anabolic/catabolic hormone response in elite female volleyball players during a 29-week season. Twenty-two elite female volleyballers (26.4 ± 5.6 years; 178 ± 9 cm; 67.1 ± 7.5 kg) had dietary intake (seven-day dietary recall and food frequency questionnaire), blood concentration of anabolic/catabolic hormones concentration, physical performance, and body composition assessed at four time points: a) T1: baseline/pre-testing; b) T2: eleven weeks after T1; c) T3: ten weeks after T2; and d) T4: eight weeks after T3. Hormones evaluated were: total testosterone (TT), free testosterone (FT) adrenocorticotropic hormone (ACTH), and cortisol (C), along with hormone ratios. Positive correlations were observed between carbohydrate/protein ratio with ΔFT (r = 0.955; p 0.05) in body mass or body mass index at any time point, and the sum of six skinfolds improved (p speed improved (p < 0.05) from T1 to T4. A high carbohydrate/protein ratio was associated with positive changes in anabolism, while high protein and low carbohydrates (CHO) were associated with an attenuated anabolic response.

  10. Long-term monitoring of fecal steroid hormones in female snow leopards (Panthera uncia) during pregnancy or pseudopregnancy.

    Science.gov (United States)

    Kinoshita, Kodzue; Inada, Sayaka; Seki, Kazuya; Sasaki, Aiko; Hama, Natsuki; Kusunoki, Hiroshi

    2011-05-02

    Knowledge of the basic reproductive physiology of snow leopards is required urgently in order to develop a suitable management conditions under captivity. In this study, the long-term monitoring of concentrations of three steroid hormones in fecal matter of three female snow leopards was performed using enzyme immunoassays: (1) estradiol-17β, (2) progesterone and (3) cortisol metabolite. Two of the female animals were housed with a male during the winter breeding season, and copulated around the day the estradiol-17β metabolite peaked subsequently becoming pregnant. The other female was treated in two different ways: (1) first housed with a male in all year round and then (2) in the winter season only. She did not mate with him on the first occasion, but did so latter around when estradiol-17β metabolite peaked, and became pseudopregnant. During pregnancy, progesterone metabolite concentrations increased for 92 or 94 days, with this period being approximately twice as long as in the pseudopregnant case (31, 42, 49 and 53 days). The levels of cortisol metabolite in the pseudopregnant female (1.35 µg/g) were significantly higher than in the pregnant females (0.33 and 0.24 µg/g) (Pleopards. The female housed with a male during the non-breeding season had high levels of cortisol metabolites and low levels of estradiol-17β in the breeding season, and failed to become pregnant. This indicates that housing conditions in snow leopards may be an important factor for normal endocrine secretion and resulting breeding success.

  11. Root ABA Accumulation in Long-Term Water-Stressed Plants is Sustained by Hormone Transport from Aerial Organs.

    Science.gov (United States)

    Manzi, Matías; Lado, Joanna; Rodrigo, María Jesús; Zacarías, Lorenzo; Arbona, Vicent; Gómez-Cadenas, Aurelio

    2015-12-01

    The reduced pool of the ABA precursors, β,β-carotenoids, in roots does not account for the substantial increase in ABA content in response to water stress (WS) conditions, suggesting that ABA could be transported from other organs. Basipetal transport was interrupted by stem-girdling, and ABA levels were determined in roots after two cycles of WS induced by transplanting plants to dry perlite. Leaf applications of isotope-labeled ABA and reciprocal grafting of ABA-deficient tomato mutants were used to confirm the involvement of aerial organs on root ABA accumulation. Disruption of basipetal transport reduced ABA accumulation in roots, and this decrease was more severe after two consecutive WS periods. This effect was linked to a sharp decrease in the β,β-carotenoid pool in roots in response to water deficit. Significant levels of isotope-labeled ABA were transported from leaves to roots, mainly in plants subjected to water dehydration. Furthermore, the use of different ABA-deficient tomato mutants in reciprocal grafting combinations with wild-type genotypes confirmed the involvement of aerial organs in the ABA accumulation in roots. In conclusion, accumulation of ABA in roots after long-term WS periods largely relies on the aerial organs, suggesting a reduced ability of the roots to synthesize ABA from carotenoids. Furthermore, plants are able to transport ABA basipetally to sustain high hormone levels in roots. © The Author 2015. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Effects of recombinant growth hormone (GH) replacement and psychomotor and cognitive stimulation in the neurodevelopment of GH-deficient (GHD) children with cerebral palsy: a pilot study.

    Science.gov (United States)

    Devesa, Jesús; Alonso, Begoña; Casteleiro, Nerea; Couto, Paula; Castañón, Beatriz; Zas, Eva; Reimunde, Pedro

    2011-01-01

    Cerebral palsy (CP) is the main cause of physical disability in childhood and is an important health issue that has a strong socioeconomic impact. There is no effective treatment for CP and therapeutic approaches report only partial benefits for affected people. In this study we assessed the effects of growth hormone (GH) treatment combined with psychomotor and cognitive stimulation in the neurodevelopment of children with CP and GH deficiency (GHD). The study was carried out in 11 patients (7 boys and 4 girls; 4.12 ± 1.31 years) with GHD and CP who were treated with recombinant GH (rGH) and psychomotor and cognitive stimulation during 2 months. Battelle Developmental Inventory Screening Test (BDIST) was performed 2 months before commencing GH treatment, just before commencing GH administration, and after 2 months of combined treatment involving GH and cognitive stimulation. Psychomotor and cognitive status did not change during the period in which only cognitive stimulation was performed; however, significant improvements in personal and social skills, adaptive behavior, gross motor skills and total psychomotor abilities, receptive and total communication, cognitive skills and in the total score of the test (P motor skills and expressive communication (P stimulation seem to be useful for the appropriate neurodevelopment of children with GHD and CP.

  13. Gonadectomy and Hormone Replacement Exert Region- and Enzyme Isoform-Specific Effects on Monoamine Oxidase and Catechol-O-Methyltransferase Activity in Prefrontal Cortex and Neostriatum of Adult Male Rats

    Science.gov (United States)

    Meyers, B.; D'Agostino, A.; Walker, J.; Kritzer, M. F.

    2010-01-01

    Sex differences and gonadal hormone influences are well known for diverse aspects of forebrain amine and indolamine neurotransmitter systems, the cognitive and affective functions they govern and their malfunction in mental illness. This study explored whether hormone regulation/dysregulation of these systems could be related to gonadal steroid effects on catechol-O-methyltransferase and monoamine oxidase which are principal enzymatic controllers of forebrain dopamine, serotonin and norepinephrine levels. Driven by male over female differences in cortical enzyme activities, by male-specific associations between monoamine oxidase and catechol-O-methyltransferase gene polymorphisms and cognitive and dysfunction in disease and by male-specific consequences of gene knockouts in mice, the question of hormone sensitivity was addressed here using a male rat model where prefrontal dopamine levels and related behaviors are also known to be affected. Specifically, quantitative O-methylation and oxidative deamination assays were used to compare the activities of catechol-O-methyltransferase's soluble and membrane-bound isoforms and of monoamine oxidase's A and B isoforms in the pregenual medial prefrontal cortex and dorsal striatum of male rats that were sham operated, gonadectomized or gonadectomized and supplemented with testosterone propionate or with estradiol for 28 days. These studies revealed significant effects of hormone replacement but not gonadectomy on the soluble but not the membrane-bound isorfom of catechol-O-methyltransferase in both striatum and cortex. A significant, cortex-specific testosterone—but not estradiol—attenuated effect (increase) of gonadectomy on monoamine oxidase's A but not B isoform was also observed. Although none of these actions suggest potential roles in the reguation/dysregulation of prefrontal dopamine, the suppressive effects of testosterone on cortical monoamine oxidase-A that were observed could have bearing on the increased

  14. TSH (Thyroid-Stimulating Hormone) Test

    Science.gov (United States)

    ... feedback system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood ... their thyroid gland removed is receiving too little thyroid hormone replacement medication and the dose may need to ...

  15. Long-term changes in attitudes toward premarital sex in the United States: reexamining the role of cohort replacement.

    Science.gov (United States)

    Elias, Vicky L; Fullerton, Andrew S; Simpson, Joseph M

    2015-01-01

    Attitudes toward premarital sex in the United States have changed considerably since the 1970s. However, it is unclear whether these changes are due to cohort replacement, broader changes within cohorts, or a combination of the two processes. We examined within- and between-cohort changes in attitudes toward premarital sex in the United States from 1975 to 2008 using hierarchical age-period-cohort models based on data from the General Social Survey. We used a religious plausibility structure framework to examine several possible mechanisms for within- and between-cohort variation in premarital sex attitudes over time, including changes in religious participation, marital patterns, and family structure. The results provided mixed support for our hypotheses. Attitudes toward premarital sex became more permissive over time in the United States in part because of the process of cohort replacement, but the level of permissiveness peaked with the baby boomer cohorts. This cohort effect is due in part to differences in rates of religious service attendance and educational attainment. However, the overall increase in permissive attitudes toward premarital sex is also due to period effects that are not captured by the measures included in our analyses.

  16. Different long-term response to growth hormone therapy in small- versus appropriate-for-gestational-age children with growth hormone deficiency.

    Science.gov (United States)

    Meazza, Cristina; Pagani, Sara; Pietra, Benedetta; Tinelli, Carmine; Calcaterra, Valeria; Bozzola, Elena; Bozzola, Mauro

    2013-01-01

    The role of birth weight on growth hormone (GH) therapy response in GH-deficient (GHD) children has not been fully elucidated. Therefore, we examined the growth of 23 small-for-gestational-age GHD children (SGA-GHD, 11 females and 12 males), 26 appropriate-for-gestational-age GHD children (AGA-GHD, 11 females and 15 males) during the first 5 years of GH therapy and that of 22 non-GH-treated SGA children (12 females and 10 males). We collected height and height velocity measurements yearly. In AGA-GHD children, height was always greater than in the SGA groups and significantly increased from the fourth year of treatment. Height velocity was higher (SGA-GHD: 1.72 ± 0.30 standard deviation score, SDS, AGA-GHD: 2.67 ± 0.21 SDS; p = 0.039) in AGA-GHD children during the first year of treatment. The AGA-GHD group showed the highest percentage (52.4%) of subjects surpassing mid-parental height and the greatest height gain after 5 years of follow-up. Our results show that birth size is an important factor affecting the response to GH therapy in GHD children during the first 5 years of treatment. The paediatric endocrinologist should be aware of this factor when planning the management of GHD children born SGA. Copyright © 2013 S. Karger AG, Basel.

  17. Long-Term Antitumor Activity and Safety of Enzalutamide Monotherapy in Hormone Naïve Prostate Cancer

    DEFF Research Database (Denmark)

    Tombal, Bertrand; Borre, Michael; Rathenborg, Per

    2018-01-01

    evaluated enzalutamide antitumor activity and safety at 3 years. MATERIALS AND METHODS: In a single arm analysis 67 patients with hormone naïve prostate cancer and noncastrate testosterone (230 ng/dl or greater) received enzalutamide 160 mg per day orally until disease progression or unacceptable toxicity....... CONCLUSIONS: Enzalutamide antitumor activity was maintained in patients with hormone naïve prostate cancer at 3 years. Overall bone mineral density, global health status and safety results were similar to those at 2 years.......PURPOSE: A phase 2 study of enzalutamide monotherapy in patients with hormone naïve prostate cancer demonstrated high prostate specific antigen response rates at 25 weeks, 1 year and 2 years with minimal effects on total body bone mineral density and favorable safety. In this followup analysis we...

  18. Mitral valve repair versus replacement in patients with ischaemic mitral regurgitation and depressed ejection fraction: risk factors for early and mid-term mortality†.

    Science.gov (United States)

    Lio, Antonio; Miceli, Antonio; Varone, Egidio; Canarutto, Daniele; Di Stefano, Gioia; Della Pina, Francesca; Gilmanov, Daniyar; Murzi, Michele; Solinas, Marco; Glauber, Mattia

    2014-07-01

    Mitral valve (MV) surgery for ischaemic mitral regurgitation (IMR) in patients with depressed left ventricular ejection fraction (LVEF) is associated with poor outcomes. The optimal surgical strategy for IMR in these patients remains controversial. The objective of this study was to compare the early mortality and mid-term survival of MV repair versus MV replacement in patients with IMR and depressed LVEF undergoing coronary artery bypass grafting (CABG). A retrospective, observational, cohort study was undertaken of prospectively collected data on 126 consecutive CABG patients with IMR and LVEF <40% undergoing either MV repair (n = 98, 78%) or MV replacement (n = 28, 22%) between July 2002 and February 2011. The overall mortality rate was 7.9% (n = 10). MV replacement was associated with a 4-fold increase in the risk of death compared with MV repair [17.9%, n = 5 vs 5.1%, n = 5; odds ratio (OR) 4.04, 95% confidence interval (CI) 1.08-15.1, P = 0.04]. However, after adjusting for preoperative risk factors, the type of surgical procedure was not an independent risk factor for early mortality (OR 0.1, 95% CI 0.01-31, P = 0.7). Multivariable analysis showed that preoperative LVEF (OR 0.8, 95% CI 0.6-0.9, P = 0.018), preoperative B-type natriuretic peptide (BNP) levels (OR 1.01, 95% CI 1-1.02, P = 0.025), preoperative left ventricle end-systolic diameter (OR 0.8, 95% CI 0.7-1.0, P = 0.05) and preoperative left atrial diameter (OR 1.3, 95% CI 1.0-1.6, P = 0.015) were independent risk factors of early mortality. At the median follow-up of 45 months (interquartile range 20-68 months), the mid-term survival rate was 74% in the MV repair group and 70% in the MV replacement group (P = 0.08). At follow-up, predictors of worse survival were BNP levels [hazard ratio (HR) 1.0, 95% CI 1.0-1.01, P = 0.047], preoperative renal failure (HR 4.6, 95% CI 1.1-20.3, P = 0.039) and preoperative atrial fibrillation (HR 3.3, 95% CI 1.1-10, P = 0.032). MV repair in CABG patients with IMR and

  19. Long-term consumption of isoflavone-enriched foods does not affect bone mineral density, bone metabolism, or hormonal status in early postmenopausal women: A randomized, double-blind, placebo controlled study

    NARCIS (Netherlands)

    Brink, E.; Coxam, V.; Robins, S.; Wahala, K.; Cassidy, A.; Branca, F.

    2008-01-01

    Background: Osteoporosis is a major health problem. It was hypothesized that isoflavone-containing products may be a potential alternative to hormone replacement therapy for preventing bone loss during the menopausal transition. Objective: The objective was to investigate whether the consumption of

  20. Does short-term fasting lead to stressed-out parents? A study of incubation commitment and the hormonal stress responses and recoveries in snow petrels.

    Science.gov (United States)

    Angelier, Frédéric; Wingfield, John C; Parenteau, Charline; Pellé, Marie; Chastel, Olivier

    2015-01-01

    The hormonal stress response is flexible and can be modulated by individuals according to its costs and benefits. Therefore, it is predicted that parents in poor body condition should modify their hormonal stress response, and thus, redirect energy allocation processes from parental care to self-maintenance when stressors occur. To test this prediction, most studies on free-living vertebrates have only focused on the stress response while the stress recovery - how quickly hormonal levels return to baseline values - has been neglected. Moreover, most studies have only focused on corticosterone - the primary mediator of allostasis - without paying attention to prolactin despite its major role in mediating parental behaviors. Here, we examined the effect of a short-term fasting event on the corticosterone and prolactin stress responses and recoveries, and we subsequently explored their relationships with parental decision in the snow petrel (Pagodroma nivea). By comparing the hormonal profiles of fasting and non-fasting snow petrels, we showed that parents modulate their corticosterone (but not prolactin) stress response according to their energetic status. We also described for the first time the hormonal stress recoveries in wild birds and found that they did not differ between fasting and non-fasting birds. Importantly, egg neglect was negatively correlated with circulating prolactin but not corticosterone levels in this species, demonstrating therefore a complex link between body condition, parental behavior and circulating corticosterone and prolactin levels. We suggest that both corticosterone and prolactin play a major role in the way parents adjust to stressors. This multiple signaling may allow parents to fine-tune their response to stressors, and especially, to activate specific allostasis-related mechanisms in a timely manner. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Long-term exposure to xenoestrogens alters some brain monoamines and both serum thyroid hormones and cortisol levels in adult male rats

    Directory of Open Access Journals (Sweden)

    Nashwa M. Saied

    2014-10-01

    Full Text Available The present study was designed to examine the effect of long-term treatment with the phytoestrogen soy isoflavone [(SIF; 43 mg/kg body weight/day] and/or the plastics component bisphenol-A [(BPA; 3 mg/kg body weight/day] on some monoamines in the forebrain and both serum thyroid hormones and cortisol levels of adult rats. Significant increases in serotonin (5-HT and norepinephrine (NE level, and significant decreases in 5-hydroxyindoleacetic acid (5-HIAA level and 5-HIAA/5-HT ratio, were observed after treatment with SIF or BPA. Level of dopamine (DA was increased in SIF-treated group and decreased in BPA-treated group. Activity of monoamine oxidase (MAO was decreased in all treated groups. The level of serum thyroid hormones (fT3 and fT4 was increased after treatment with SIF and decreased after exposure to BPA, while cortisol level was increased in all treated groups. It may be concluded that long-term exposure to SIF or BPA disrupts monoamine levels in the forebrain of adult rats through alteration in the metabolic pathways of amines and disorders of thyroid hormones and cortisol levels.

  2. Clinical response to long term enzyme replacement treatment in children, adolescent and adult patients with Hunter syndrome.

    Science.gov (United States)

    Dalmau Serra, Jaime; Vitoria Miñana, Isidro; Calderón Fernández, Rafael; Cortell Aznar, Isidoro

    2015-11-06

    Since enzyme replacement treatment (ERT) with idursulfase is available for Hunter syndrome (HS; mucopolysaccharidosis type II), for the first time, disease progression can be limited and organ damage reduced or prevented. We described retrospectively the clinical evolution of eight HS males, treated with ERT and followed in routine clinical practice in Hospital Infantil La Fe (Valencia, Spain). We studied three children, three adolescents and two adults. Time from diagnosis to ERT ranged from 13.7 to 0.2 years, and duration of ERT ranged from 24 to 77.1 months. From the start of ERT, weight and height increased in children and adolescents and remained stable in adults. Glycosaminoglycans (GAG) decreased in all patients; in patient 5 (aged 23 years), we observed the highest reduction (86%) with recovery of carpal tunnel syndrome, splenomegaly and a decrease in nocturnal oxygen dependence. Our results show that ERT improve respiratory impairment and organomegalies and decrease GAGs levels in all patients including children, adolescent and adults. While cardiac manifestations and facial features stabilized, responses in other parameters were heterogeneous. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  3. Long-term efficacy of nicotine replacement therapy for smoking cessation in adolescents : A randomized controlled trial

    NARCIS (Netherlands)

    Scherphof, Charlotte S.|info:eu-repo/dai/nl/341769797; van den Eijnden, Regina J. J. M.|info:eu-repo/dai/nl/17399394X; Engels, Rutger C. M. E.; Vollebergh, Wilma A. M.|info:eu-repo/dai/nl/090632893

    2014-01-01

    Background: A double-blind RCT on the short-term efficacy of nicotine patches compared to placebo patches among Dutch adolescents was conducted. The findings demonstrated that nicotine patches are efficacious for smoking cessation at end-of-treatment; however, only in highly compliant participants.

  4. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  5. Medium-term outcomes and complications after total replacement of the temporomandibular joint. Prospective outcome analysis after 3 and 5 years.

    Science.gov (United States)

    Gruber, E A; McCullough, J; Sidebottom, A J

    2015-05-01

    In this prospective analysis, we assess the medium-term benefits, efficacy, and safety of the TMJ Concepts joint replacement system in the United Kingdom. Outcome measures of pain, maximum mouth opening, and diet were recorded preoperatively and at intervals up to 3 and 5 years. All patients who had replacement temporomandibular joints (TMJ) within a 6-year period were included. A total of 58 patients (84 joints) were followed up for 3 years (mean age 47, range 19-72) and 26 (42 joints) for 5 years (mean age 46, range 27-70). The female to male ratio was 52:6 at 3 years and 23:3 at 5 years. The most common diagnosis was degenerative disease, and the mean number of previous TMJ procedures was 2.4 (range 0-14). There were significant improvements in pain scores (7.4 reduced to 0.6 at 3 years and 0.8 at 5 years), maximum mouth opening (21.0-35.5mm at 3 years and 23.8-33.7mm at 5 years), and dietary scores (4.1-9.7 at 3 years and 3.7-9.6 at 5 years). Revision operations were required in 2 patients (not included in the outcome data) for biofilm infection of the prosthesis secondary to local infection in the head and neck. One patient had weakness of the temporal branch of the facial nerve that needed correction. TMJ replacement is an effective form of management for an irreparably damaged joint, particularly in cases of ankylosis. It lessens pain and improves function with minimal long-term morbidity. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. [Early and long term results of mechanical aortic valve replacement at the Instituto Nacional del Torax in Chile].

    Science.gov (United States)

    Villavicencio, Mauricio; Turner, Eduardo; Naranjo, Lorenzo

    2005-10-01

    Mechanical aortic valve replacement (AVR) results have been published extensively in industrialized countries. To assess our immediate and late results in patients subjected to AVR. We retrospectively studied 194 patients subjected to isolated AVR between 1995 and 2003. Mean age was 57 +/- 13 years and 119 (61%) were male. One hundred thirty nine (73%) were in functional class III-IV, 20 (10%) had a previous cardiac operation and 25 (13%) were operated as an emergency. Surgical indication was stenosis in 110 (58%), regurgitation in 49 (26%) and stenosis/regurgitation in 31 (16%). Etiology was bicuspid valve 56 (29%), degenerative lesions 55 (28%), rheumatic valve disease 38 (20%) and endocarditis 27 (14%). Medtronic Hall was the most common prosthesis used in 157 patients (81%). Mean cardiopulmonary bypass time 97 +/- 29 min and mean cross clamp time was 69 +/- 21 min. Operative mortality was 4.6% (3% in elective surgery, 16% in emergency surgery and 0% in reoperations). Follow-up was complete in 100% of cases, totalizing 636 patients-year. Survival was 91 +/- 2%, 80 +/- 4% and 73 +/- 6%, at 1, 5 and 7 years, respectively. Multivariate risk analysis identified renal failure and endocarditis as predictors of early and late mortality. During follow up, the linear incidence rate for hemorrhage was 3.29% /patients-year, thromboembolism 2.04% patients-year and endocarditis 1.1% patients-year. AVR has low overall and elective mortality. Midterm survival is good but linear event rates related to anticoagulant treatment are higher than those previously published in industrialized countries. Renal failure and endocarditis were risk factors for early and late death.

  7. Magnetic resonance imaging of bone marrow changes in Gaucher disease during enzyme replacement therapy: first German long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Poll, L.W.; Koch, J.A.; Scherer, A.; Boerner, D.; Moedder, U. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische Radiologie; Dahl, S. vom; Niederau, C.; Haeussinger, D. [Duesseldorf Univ. (Germany). Medizinische Fakultaet; Willers, R. [Duesseldorf Univ. (Germany). Rechenzentrum

    2001-09-01

    Objective:. Since 1991, enzyme replacement therapy (ERT) has been available for patients with Gaucher disease in Germany. The aim of this study was to analyse the MR pattern of bone marrow involvement and response to ERT in Gaucher disease type I. Patients and design:. Thirty patients with Gaucher disease type I had MRI examinations prior to initiation of ERT with alglucerase/imiglucerase and during follow-up. Median MR follow-up and duration of ERT were 36 months. Coronal T1- and T2-weighted spin-echo images of the lower extremities were obtained to evaluate changes in the appearance of yellow marrow. MR images were categorized as having either a homogeneous (type A) or non-homogeneous patchy (type B) appearance of bone involvement and response to ERT was assessed by two radiologists. Results:. Overall, 19 of 30 patients (63%) showed an increased signal intensity on T1- and T2-weighted images after 36 months of ERT, consistent with partial reconversion of fatty marrow during treatment. Focal bone lesions surrounded by a low signal intensity (SI) rim did not respond to ERT, suggesting bone infarcts. Of the 11 patients with bone infarcts (low SI rim lesion), 82% had the non-homogeneous type B pattern (P=0.0021). In 86% of patients with splenectomy, bone infarcts were seen (P<0.05). Conclusions:. MRI using T1- and T2-weighted spin-echo sequences is a valuable, non-invasive method for monitoring bone marrow response in patients receiving ERT. A non- homogeneous patchy signal intensity of bone marrow involvement correlates with the presence of bone infarcts (P=0.0021). (orig.)

  8. Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up.

    Science.gov (United States)

    Unwin, Olivia; Hassaballa, Mohammed; Murray, James; Harries, William; Porteous, Andrew

    2017-03-01

    MIS TKA has been shown to offer a reduced in-patient stay, but no clinical difference at two years. Whilst there may be a benefit from earlier discharge, we need to ensure that there are no detrimental effects in the medium and long-term following MIS-TKA. To report the mid-term result from a prospective randomised controlled trial (RCT) comparing MIS-TKA with standard approach for TKA. Using knee score questionnaires, we collected patient reported outcome measures (PROMs) regarding pain and function. Sixty-six patients (from an eligible cohort of 83 patients) completed the mid-term postal follow-up. There was no significant difference between groups for change in score from pre-operative to final follow-up in all three PROMs. Mean MIS and standard group improvement was: AKSS 53 and 51 (p=0.7644), OKS 15 and 16 (p=0.2341) or WOMAC 15 and 15 (p=0.9900) respectively. Both groups showed improvement in pain and function with no significant difference between groups. There was no difference between groups for revision due to malalignment at a mean six year follow-up. In addition to the early benefits regarding hospital stay and complications, we have found that at a mean of six years there was no increase in malalignment, pain or function with MIS techniques. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Periodontal disease-associated micro-organisms in peri-menopausal and post-menopausal women using or not using hormone replacement therapy. A two-year follow-up study

    Directory of Open Access Journals (Sweden)

    Furuholm Jussi

    2010-04-01

    Full Text Available Abstract Background Despite conflicting results on the use of hormone replacement therapy (HRT there is no doubt that many women benefit from it. Women using HRT are known to be more health conscious in general with putative positive implications in the mouth. However, we observed recently in our cohort hardly any difference in oral health status between HRT-users and non-users. There are only a few studies about HRT and oral microbiota. We hypothesized that counts of periodontal micro-organisms are lower in health-conscious HRT-users than non-users. Methods Two-year open follow-up study was conducted on originally 200 HRT-users and 200 non-users from age cohorts of 50-58 years. After clinical examination pooled subgingival plaque samples were taken for polymerase chain reaction analyses. The results of finally 135 women meeting the inclusion criteria were analyzed with cross-tabulation and chi-square test. Explanatory factors were studied by step-wise logistic regression analysis. Results In HRT group, the numbers of positive samples for Porphyromonas gingivalis (P. gingivalis, p Prevotella intermedia (P. intermedia, p Tannerella forsythia (T. forsythia, p P. gingivalis (p T. forsythia (p Conclusion Although use of HRT did not correlate with periodontal health status, HRT led to decreasing numbers of positive samples of the periodontal pathogens P. gingivalis and T. forsythia. Further studies with longer observation time are needed to observe the clinical relevance of the results.

  10. RESULTS OF LONG-TERM THERAPY WITH GROWTH-HORMONE IN 2 DOSE REGIMENS IN TURNER SYNDROME

    NARCIS (Netherlands)

    NIENHUIS, HE; RONGENWESTERLAKEN, C; WIT, JM; OTTEN, BJ; KEIZERSCHRAMA, SMPFD; DRAYER, NM; DELEMARREVANDEWAAL, HA; VULSMA, T; OOSTDIJK, W; WAELKENS, JJJ

    1993-01-01

    Girls with Turner syndrome were divided according to age (group A 6-12 years, and group B 12-19 years) and human growth hormone (GH) dose regimen (A1 and B1, three injections/week; A2 and B2, six injections/week). All groups responded to GH, 24 IU/M2/week, with an increase in height velocity, though

  11. Assessing environmental factors to the replacement of Neanderthals by modern humans in terms of eco-cultural niche modelling

    Science.gov (United States)

    Kondo, Yasuhisa; Sano, Katsuhiro; Kadowaki, Seiji; Naganuma, Masaki; Omori, Takayuki; Yoneda, Minoru; Nishiaki, Yoshihiro

    2014-05-01

    Eco-cultural niche modelling (ECNM) is an application of ecological niche modelling (ENM) to estimate the human niche in response to environmental settings. The niche probability is calculated for each spatial pixel, based on (1) the location of known archaeological sites as occurrence data and (2) environmental factors such palaeoclimate (temperature and precipitation), palaeovegetation (biome) and palaeotopography (elevation, slope and aspect). Some ENM software packages, including MaxEnt (maximum entropy model), output the percentage of contribution for each environmental factor, and therefore it is possible to identify and evaluate environmental constraints to the geographic expansion of human populations. Based on this thought, the authors applied ECNM to Palaeolithic stone tool industries in Europe and Siberia at 50-46 kya, the time period during which the first anatomically modern humans (AMHs) are presumed to have appeared in those regions, under the assumption that stone tool groups may reflect different human groups in terms of subsistence strategy. The preliminary results suggested that the population using Emiran and related industries (Bohunician and Bachokirian) were likely to construct their niches in the geographic zones where the long-term variability of the coldest month temperature was larger than in those occupied by the populations using the Late Mousterian, Szeletian and Châtelperronean stone tool industries.

  12. Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments.

    Science.gov (United States)

    Berreklouw, Eric; Koene, Bart; De Somer, Filip; Bouchez, Stefaan; Chiers, Koen; Taeymans, Yves; Van Nooten, Guido J

    2011-05-01

    Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments. The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation. No coumarin derivates were given. No or minimal aortic regurgitation was confirmed in all surviving pigs at the end of the operation. Total follow-up was 846 days. In 4 pigs, follow-up was shorter than 90 days (28-75 days); the other 6 pigs did reach 90 days' survival or more. Repeat angiography in 4 pigs at the end of follow-up confirmed the unchanged position of the device at the aortic annulus, without aortic regurgitation. At autopsy, in all pigs the devices proved to be well grown in at the annulus, covered with endothelium, and sometimes tissue overgrowth related to not using coumarin derivates. There was no case of para-device leakage, migration, or embolization. No damage to surrounding anatomic structures or prosthetic valves was found. Nitinol attachment rings can be used to replace the aortic valve suturelessly with St Jude Medical mechanical aortic valve prostheses, without para-device leakage, migration, or damage to the surrounding tissues, in long-term pig experiments during a follow-up of 90 days or more. Refraining from anticoagulation in pigs with mechanical valve prostheses can lead to tissue overgrowth of the valve prosthesis. Further studies are needed to determine long-term feasibility of this method in human beings. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  13. Replacement of chordae tendineae with polytetrafluoroethylene (PTFE) sutures in mitral valve repair: early and long-term results.

    Science.gov (United States)

    Chiappini, Bruno; Sanchez, Alvaro; Noirhomme, Philippe; Verhelst, Robert; Rubay, Jean; Poncelet, Alain; Funken, Jean Christophe; El Khoury, Gebrine

    2006-09-01

    A variety of reliable techniques are now available for chordal disease management and repair of the anterior mitral valve leaflet prolapse. The study aim was to review the authors' experience with polytetrafluoroethylene (PTFE), using a standardized technique for length adjustment, and to analyze the long-term results in patients who underwent mitral valve repair. A total of 111 patients (mean age 56.2 +/- 16.1 years) underwent mitral valve repair with PTFE neochordae, in addition to a variety of other surgical procedures. Etiologies were degenerative in 82 patients (73.9%), Barlow disease in 13 (11.7%), rheumatic in 10 (9%), and infection in six (5.4%). Prolapse of the anterior leaflet was present in 78 patients (70.3%), of the posterior leaflet in 15 (13.5%), a bileaflet prolapse was present in 12 (10.8%), and a commissural prolapse in six (5.4%). In all cases the anterior annulus was used as the reference level in order to assess the appropriate length of the PTFE neochordae. The mean number of PTFE neochordae used was 6 +/- 4 per patient. In-hospital mortality was 1.8% (n = 2); mean follow up was 36.8 +/- 25.6 months (range: 12-94 months). There were no late deaths. At five years postoperatively the patient overall survival was 98.2 +/- 1.8%, freedom from reoperation rate 100%, and freedom from grade 1+ mitral regurgitation rate 97.2 +/- 2.8%. There were no documented thromboembolism or hemorrhagic events. In degenerative and myxomatous mitral valve disease, leaflet prolapse can be successfully repaired by implantation of PTFE neochordae. Both immediate and long-term results proved the versatility, efficiency and durability of this technique.

  14. Sex hormones and urticaria.

    Science.gov (United States)

    Kasperska-Zajac, A; Brzoza, Z; Rogala, B

    2008-11-01

    Chronic urticaria is characterized by mast cells/basophils activation which initiate the inflammatory response. Pathogenetically, the disease may in many cases represent an autoimmune phenomenon. Altered function of the neuro-endocrine-immune system due to stress and other factors has also been implicated its pathogenesis. Sex hormones modulate immune and inflammatory cell functions, including mast cell secretion, and are regarded as responsible for gender and menstrual cycle phase-associated differential susceptibility and severity of some autoimmune and inflammatory diseases. Chronic urticaria is approximately twice more frequent in women than in men. In addition, urticaria may be associated with some diseases and conditions characterized by hormonal changes, including endocrinopathy, menstrual cycle, pregnancy, menopause and hormonal contraceptives or hormone replacement therapy. Hypersensitivity reactions to endogenous or exogenous female sex hormones have been implicated in the pathogenesis of urticarial lesions associated with estrogen and autoimmune progesterone dermatitis. We observed lower serum dehydroepiandrosterone sulfate (DHEA-S) concentration in patients with chronic urticaria with positive and negative response to autologous serum skin test. Thus, the influence of fluctuations in the hormonal milieu and altered sex hormone expression on the triggering-off, maintenance or aggravation of urticaria should be taken into account. In addition, the possible impact of estrogen mimetics, in the environment and in food, on the development of disease associated with mast cell activation must be considered. This review endeavours to outline what is known about the possible influence of sex hormones in the expression of urticaria.

  15. Plasma Growth Hormone and Prolactin Levels in Healthy Sedentary Young Men after Short-Term Endurance Training under Hot Environment

    Directory of Open Access Journals (Sweden)

    İbrahim Cicioglu

    2013-09-01

    Full Text Available Pituitary hormones play an important role energy expenditure and body temperature regulation during exercise. The aim of the stu¬dy was to investigate the effect of two different endurance training in ambient temperature (30.76 ± 1.71oC and 57.92 ± 5.80% r.h. on plasma growth hormone (GH and prolactin (PRL levels in non-trained healthy subjects. Twenty-four untrained healthy men participated in an 8-wk progressive two different endurance-training program. Subjects were divided into two groups: an in¬ter¬val running group (IR, and continuous running group (CR. Both groups were performed 3 days/wk. Growth hormone, PRL and VO2max levels were assessed at the beginning and the end of the training period. Body temperature (TB was also measured at the be¬ginning and immediately after each training. The exercise type affected plasma PRL (8.52 vs. 6.50 ng/ml IR and CT groups, P 0.38. Plasma GH level at the end of training pro¬gram increased from 0.42 to 1.48 ng/ml and 0.58 to 0.67 ng/ml for IR and CR groups. Expectedly, both training types increased TB, at a greater rate for IR group than CR group. In conclusion, an 8-wk regular exercise result in an increase in plasma PRL level, with¬out altering plasma GH level, which accompanied by elevated body temperature, regardless of the individual’s sporting rou¬ti¬ne. These suggest that untrained individuals could benefit from a regular exercise program as much as those doing the routine sport.

  16. Successful C1 inhibitor short-term prophylaxis during redo mitral valve replacement in a patient with hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Coleman Suzanne

    2010-10-01

    Full Text Available Abstract Hereditary angioedema is characterized by sudden episodes of nonpitting edema that cause discomfort and pain. Typically the extremities, genitalia, trunk, gastrointestinal tract, face, and larynx are affected by attacks of swelling. Laryngeal swelling carries significant risk for asphyxiation. The disease results from mutations in the C1 esterase inhibitor gene that cause C1 esterase inhibitor deficiency. Attacks of hereditary angioedema result from contact, complement, and fibrinolytic plasma cascade activation, where C1 esterase inhibitor irreversibly binds substrates. Patients with hereditary angioedema cannot replenish C1 esterase inhibitor levels on pace with its binding. When C1 esterase inhibitor is depleted in these patients, vasoactive plasma cascade products cause swelling attacks. Trauma is a known trigger for hereditary angioedema attacks, and patients have been denied surgical procedures because of this risk. However, uncomplicated surgeries have been reported. Appropriate prophylaxis can reduce peri-operative morbidity in these patients, despite proteolytic cascade and complement activation during surgical trauma. We report a case of successful short-term prophylaxis with C1 esterase inhibitor in a 51-year-old man with hereditary angioedema who underwent redo mitral valve reconstructive surgery.

  17. Migraine in women: the role of hormones and their impact on vascular diseases

    National Research Council Canada - National Science Library

    Sacco, Simona; Ricci, Silvia; Degan, Diana; Carolei, Antonio

    2012-01-01

    Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence...

  18. [The long term (15 years) evolution after valvular replacement with mechanical prosthesis or bioprosthesis between the age of 60 and 70 years].

    Science.gov (United States)

    Hanania, G; Michel, P L; Montély, J M; Warembourg, H; Nardi, O; Leguerrier, A; Agnino, A; Despins, P; Legault, B; Petit, H; Bouraindeloup, M

    2004-01-01

    the aim of this study was to document the choice between prosthesis and bioprosthesis in cases of valvular replacement during the seventh decade of life. a retrospective and cooperative study linking eleven cardiac surgical teams and five medical cardiology teams combined 497 subjects born between 1915 and 1925 (average age 64.4 years) who underwent aortic (313 cases) or mitral (184 cases) valvular replacement with mechanical prosthesis (259 cases) or bioprosthesis (238 cases). Information was collected at each centre during the year 2000 on the long term evolution (going back 15 years), in particular on the mortality, non-fatal complications linked to the valve, cardiac complications and extra-cardiac events. These results were subjected to statistical analysis. the operative mortality of this group was 4.8%. The 15 year survival was 46% for the aortic mechanical prostheses, 32% for the aortic bioprostheses (p=0.04). 34% for the mitral bioprostheses and 33% for the mitral mechanical prostheses. Events linked to the valve were more frequent for the mitral valvulopathies than for the aortic valves (49% vs 26%, pautocontrol.

  19. MENOPAUSE AND HORMONAL REPLACEMENT THERAPY – HISTORICALREVIEW

    Directory of Open Access Journals (Sweden)

    Helena Meden Vrtovec

    2008-12-01

    Last decade in the field of menopausal medicine is characterized by discussions aboutbenefits and risks of HRT. The experts reached consensual position statement that benefitsovercome risks of HRT when introduced in early postmenopause

  20. Empirical D3 Dispersion as a Replacement for ab Initio Dispersion Terms in Density Functional Theory-Based Symmetry-Adapted Perturbation Theory.

    Science.gov (United States)

    Sedlak, Robert; Řezáč, Jan

    2017-04-11

    In density functional theory-based symmetry-adapted perturbation theory (DFT-SAPT) interaction energy calculations, the most demanding step is the calculation of the London dispersion term. For this bottleneck to be avoided and DFT-SAPT to be made applicable to larger systems, the ab initio dispersion terms can be replaced by one calculated empirically at an almost negligible cost ( J. Phys. Chem. A 2011 ; 115 , 11321 - 11330 ). We present an update of this approach that improves accuracy and makes the method applicable to a wider range of systems. It is based on Grimme's D3 dispersion correction for DFT, where the damping function is changed to one suitable for the calculation of the complete dispersion energy. The best results have been achieved with the Tang-Toennies damping function. It has been parametrized on the S66×8 data set for which we report density fitting DFT-SAPT/aug-cc-pVTZ interaction energy decomposition. The method has been validated on a diverse set of noncovalent systems including difficult cases such as very compact noncovalent complexes of charge-transfer type. The root-mean-square errors in the complete test set are 0.73 and 0.42 kcal mol -1 when charge-transfer complexes are excluded. The proposed empirical dispersion terms can also be used outside the DFT-SAPT framework, e.g., for the estimation of the amount of dispersion in a calculation where only the total interaction energy is known.

  1. Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study.

    Science.gov (United States)

    Shahab, Lion; Goniewicz, Maciej L; Blount, Benjamin C; Brown, Jamie; McNeill, Ann; Alwis, K Udeni; Feng, June; Wang, Lanqing; West, Robert

    2017-03-21

    Given the rapid increase in the popularity of e-cigarettes and the paucity of associated longitudinal health-related data, the need to assess the potential risks of long-term use is essential. To compare exposure to nicotine, tobacco-related carcinogens, and toxins among smokers of combustible cigarettes only, former smokers with long-term e-cigarette use only, former smokers with long-term nicotine replacement therapy (NRT) use only, long-term dual users of both combustible cigarettes and e-cigarettes, and long-term users of both combustible cigarettes and NRT. Cross-sectional study. United Kingdom. The following 5 groups were purposively recruited: combustible cigarette-only users, former smokers with long-term (≥6 months) e-cigarette-only or NRT-only use, and long-term dual combustible cigarette-e-cigarette or combustible cigarette-NRT users (n = 36 to 37 per group; total n = 181). Sociodemographic and smoking characteristics were assessed. Participants provided urine and saliva samples and were analyzed for biomarkers of nicotine, tobacco-specific N-nitrosamines (TSNAs), and volatile organic compounds (VOCs). After confounders were controlled for, no clear between-group differences in salivary or urinary biomarkers of nicotine intake were found. The e-cigarette-only and NRT-only users had significantly lower metabolite levels for TSNAs (including the carcinogenic metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL]) and VOCs (including metabolites of the toxins acrolein; acrylamide; acrylonitrile; 1,3-butadiene; and ethylene oxide) than combustible cigarette-only, dual combustible cigarette-e-cigarette, or dual combustible cigarette-NRT users. The e-cigarette-only users had significantly lower NNAL levels than all other groups. Combustible cigarette-only, dual combustible cigarette-NRT, and dual combustible cigarette-e-cigarette users had largely similar levels of TSNA and VOC metabolites. Cross-sectional design with self-selected sample. Former

  2. Análise de correspondência para avaliação do perfil de mulheres na pós-menopausa e o uso da terapia de reposição hormonal Correspondence analysis for the evaluation of women's profile during post-menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Renata Nunes Aranha

    2004-02-01

    Full Text Available Neste estudo ilustra-se a utilização da técnica de análise de correspondência na caracterização do perfil das usuárias e das não-usuárias da Terapia de Reposição Hormonal (TRH. Analisou-se dados seccionais de 195 mulheres com relato de menopausa natural, entre 2.240 participantes do Estudo Pró-Saúde (Rio de Janeiro. As mulheres não-usuárias da TRH apresentaram perfil mais desfavorável em relação às usuárias dessa terapia, por exemplo, ganho ponderal mais acentuado na vida adulta, idade mais avançada, menopausa mais tardia e menor nível de escolaridade. O uso desta ferramenta analítica deveria ser estimulada na área da saúde, em análises exploratórias das inter-relações entre um grande número de variáveis em populações de interesse.This study illustrates the use of correspondence analysis to identify distinct profiles characterizing hormone replacement therapy (HRT users and non-users, allowing the visualization of concurrent characteristics associated with this self-selection process. We analyzed cross-sectional information provided by 195 women reporting natural menopause, among 2,240 participants in the Pro-Saude Study (Rio de Janeiro, Brazil. Non-users had an unfavorable profile, including greater weight gain during adult life, older age, later menopause, and less schooling. This analytic tool should be used more extensively in public health research, in exploratory analyses of the relations among a large number of variables in key populations.

  3. Medium and long term outcome of growth hormone therapy in growth hormone deficient adults Resultados en el mediano y largo plazo del tratamiento con hormona de crecimiento en adultos deficitarios de dicha hormona

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    Hugo L. Fideleff

    2006-08-01

    Full Text Available We evaluated long-term replacement therapy outcomes in various subsets of patients with adult growth hormone (GH deficiency (AGHD as well as the patients' susceptibility to adverse events. Fifty-nine patients with AGHD were evaluated, 27 with childhood onset (CO (18-44 years old, 12 females and 32 with adult onset (AO (27-70 years, 18 females. A significant improvement in HDL-cholesterol was observed in AGHD-AO males (basal: 41.3 ± 12.9 mg/dl, intratreatment: 47.5 ± 13.2 mg/dl, p= 0.009. However, individual analyses showed that total cholesterol decreased below 240 mg/dl in 33% of AGHD-CO patients and in 50% of AGHD-AO patients, and below 200 mg/dl in 67% of AGHD-CO patients and in 29% of AGHD-AO patients; in the AGHD-AO group, normalization of LDL-cholesterol (£ 160 mg/dl and triglycerides (£ 200 mg/dl was found in 100% and 50% of patients, respectively; the total cholesterol/HDL ratio decreased below 4.5 in 20% of AGHD-CO patients and in 25% of AGHD-AO patients. The cardiological evaluation showed a significant intra- and interindividual heterogeneity, but cardiac mass improved in patients with a baseline cardiac mass index below 60 g/m². Markers of bone apposition increased significantly, while bone resorption markers were found to remain unchanged during treatment. A correlation was found between increased bone mineral content and lean body mass (p= 0.0009. Susceptibility to adverse events was not found to be dependent on gender or on the time of onset of the deficiency. Our findings would appear to confirm that a more severe metabolic impairment is correlated with a better therapeutic outcome.Evaluamos resultados terapéuticos a largo plazo en subgrupos de pacientes con deficiencia de hormona de crecimiento (GH del adulto (AGHD y la susceptibilidad para desarrollar eventos adversos. Estudiamos 59 pacientes con AGHD, 27 de inicio en la infancia (CO (18-44 años, 12 mujeres y 32 de inicio en la adultez (AO (27-70 años, 18 mujeres. El

  4. The effects of long-term endurance training on the immune and endocrine systems of elderly men: the role of cytokines and anabolic hormones

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    Natale Valéria

    2006-08-01

    Full Text Available Abstract Background a decline in immune and endocrine function occurs with aging. The main purpose of this study was to investigate the impact of long-term endurance training on the immune and endocrine system of elderly men. The possible interaction between these systems was also analysed. Results elderly runners showed a significantly higher T cell proliferative response and IL-2 production than sedentary elderly controls. IL-2 production was similar to that in young adults. Their serum IL-6 levels were significantly lower than their sedentary peers. They also showed significantly lower IL-3 production in comparison to sedentary elderly subjects but similar to the youngs. Anabolic hormone levels did not differ between elderly groups and no clear correlation was found between hormones and cytokine levels. Conclusion highly conditioned elderly men seem to have relatively better preserved immune system than the sedentary elderly men. Long-term endurance training has the potential to decelerate the age-related decline in immune function but not the deterioration in endocrine function.

  5. Caracterização das usuárias de terapia de reposição hormonal do Município de Campinas, São Paulo Characterization of hormone replacement therapy users in Campinas, São Paulo

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    Aarão Mendes Pinto Neto

    2002-02-01

    Full Text Available Realizou-se um estudo descritivo de corte transversal, de base populacional, com o objetivo de caracterizar as mulheres climatéricas do Município de Campinas, Estado de São Paulo, de acordo com o uso da terapia de reposição hormonal (TRH. Selecionaram-se, por processo de amostragem, 456 mulheres na faixa etária de 45-60 anos de idade, segundo informações obtidas da agência local da Fundação Instituto Brasileiro de Geografia e Estatística (IBGE. As mulheres foram selecionadas por conglomerados e a unidade de referência foi um setor censitário, conforme definido pelo IBGE. Os dados foram coletados por intermédio de entrevistas domiciliares, com questionários estruturados e pré-testados, fornecidos pela Fundação Internacional de Saúde, Sociedade Internacional de Menopausa e pela Sociedade Norte-Americana de Menopausa e adaptados pelos autores. Para caracterizar as mulheres segundo o uso atual ou passado de TRH, utilizou-se o modelo de regressão logística politômica, com processo de seleção backward de variáveis. Concluiu-se que no Município de Campinas as principais características das usuárias da terapia de reposição hormonal foram estar na perimenopausa, ter maior escolaridade e melhor classe social.This study employed a descriptive, cross-sectional, population-based design to characterize climacteric women from Campinas, São Paulo State, based on use of hormone replacement therapy (HRT. An area cluster sample was selected with 456 women 45 to 60 years of age, residing in Campinas, based on data from the Brazilian Institute of Statistics and Geography (IBGE. Women were selected by area cluster, and the reference unit was the census tract as defined by the IBGE. Data were collected through home interviews using a structured and pre-tested questionnaire provided by the International Health Foundation/International Menopause Society and by the North American Menopause Society and adapted by the authors. In order to

  6. Avaliação tomográfica e tensiométrica de fêmures de ratas ooforectomizadas submetidas à terapia de reposição hormonal Tomografic and tensiometric assessment of femurs of oophorectomized rats submitted to hormone replacement therapy

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    Fábio Alexandre Martynetz

    2010-01-01

    Full Text Available OBJETIVO: Analisar os efeitos da TRH na avaliação biomecânica e tomográfica dos fêmures de ratas submetidas à menopausa induzida. MÉTODOS: Foram divididas igualmente em três grupos 45 ratas Wistar adultas. O primeiro e o segundo constituíram-se de ratas ooforectomizadas e o terceiro, o grupo controle, de ratas não ooforectomizadas. Após a constatação da falência hormonal (citologia esfoliativa. somente o primeiro grupo recebeu TRH, durante dois meses. Após esse período, os fêmures foram desarticulados e submetidos a testes biomecânicos através de máquina universal de ensaios para avaliação da resistência e submetidos a tomografia para determinação da densidade óssea. RESULTADOS: A citologia esfoliativa demonstrou indução de falência hormonal em todos os animais ooforectomizados. Notou-se diferença significante (p = 0,030 entre os grupos ao se mensurar a força máxima de resistência, maior no grupo que recebeu TRH. Observou-se maior fragilidade óssea nos animais ooforectomizados sem TRH quando comparados com os com TRH (p = 0,010 em relação ao grupo controle (p = 0,0107. Houve aumento da resistência óssea nas ratas ooforectomizadas com TRH em relação às sem TRH e valores semelhantes aos do grupo controle (p = 0,179. Na avaliação tomográfica, não se encontraram diferenças significantes entre os grupos (p = 0,625. CONCLUSÃO: Observou-se aumento significativo da resistência óssea com a utilização de TRH. No entanto, o tratamento com TRH não apresentou alteração significante da densidade mineral óssea.OBJECTIVE: To analyze the effects of Hormone Replacement Therapy on the biomechanical and tomographic evaluation of femurs of rats submitted to induced menopause. METHODS: Forty-five adult Wistar rats were divided equally into three groups. The first and second groups consisted of rats submitted to oophorectomy, and the third was the control group, consisting of non-oophorectomized rates. After

  7. A Population-Based Randomized Trial to Assess the Effects of Short-Term Cessation of Hormone Replacement Therapy on Mammography Assessments and Breast Density

    Science.gov (United States)

    2008-06-01

    mammograms, where recall was defined as any assessment requiring additional imaging or evaluation on either breast (BI-RADS assessment of 0). 7/10/2008 7... images are being randomly selected, rescanned and re-read for density outcomes on an ongoing basis. All mammographic breast density measures were...timing of the exam (index or study mammogram). To evaluate quality assurance, we included four inter-batch repeats and four intra-batch repeats within

  8. Concomitant coronary artery bypass graft and aortic and mitral valve replacement for rheumatic heart disease: short- and mid-term outcomes.

    Science.gov (United States)

    Davarpasand, Tahereh; Hosseinsabet, Ali; Jalali, Arash

    2015-09-01

    It has been reported that the short-term mortality of concomitant aortic and mitral valve replacement (AVR and MVR) is considerable and concomitant coronary artery bypass graft (CABG) has adverse effects on the survival of patients with valve replacement surgery. We summarize the short- and mid-term outcome after concomitant CABG, AVR and MVR in our centre. Between 2003 and 2013, 103 patients (68 males, 35 females, age: 60.1 ± 10.1 years) underwent CABG, AVR and MVR for rheumatic heart disease (RHD) and coronary artery disease (CAD). The median follow-up was 47.6 months. Most of the patients were asymptomatic at rest. We analysed demographic, clinical and operative data of patients to define independent predictors of overall survival, cardiac event-free survival as well as cardiac death. The rate of 30-day survival was 93% (n = 96). The corresponding rates of overall survival and cardiac event-free survival and the cumulative incidence rate of cardiac death at 1 year were 80.2, 77.3 and 10.9%; the same at 4 years were 73.7, 64.6 and 15.8%. The corresponding freedom rates from anticoagulation-associated major haemorrhage; a composite of major bleeding events, thromboemboli and valvular thrombosis; cardiac rehospitalization; major adverse valve-associated events; and significant malfunction of the prosthetic valve were 96.2, 95.3, 94.7, 81.6 and 97.7% at 1 year. The corresponding freedom rates from anticoagulation-associated major haemorrhage; a composite of major bleeding events, thromboemboli and valvular thrombosis; cardiac rehospitalization; major adverse valve-associated events; and significant malfunction of the prosthetic valve were 93.5, 91.0, 91.4, 73.5 and 95.5% at 4 years. The independent predictors of overall survival were age, cigarette smoking, chronic kidney diseases and balloon pump insertion. The independent predictors of cardiac event-free survival were age and previous myocardial infarction, while age, cigarette smoking, history of cerebrovascular

  9. Targeted gene transfer into ependymal cells through intraventricular injection of AAV1 vector and long-term enzyme replacement via the CSF.

    Science.gov (United States)

    Yamazaki, Yoshiyuki; Hirai, Yukihiko; Miyake, Koichi; Shimada, Takashi

    2014-07-01

    Enzyme replacement via the cerebrospinal fluid (CSF) has been shown to ameliorate neurological symptoms in model animals with neuropathic metabolic disorders. Gene therapy via the CSF offers a means to achieve a long-term sustainable supply of therapeutic proteins within the central nervous system (CNS) by setting up a continuous source of transgenic products. In the present study, a serotype 1 adeno-associated virus (AAV1) vector was injected into a lateral cerebral ventricle in adult mice to transduce the gene encoding human lysosomal enzyme arylsulfatase A (hASA) into the cells of the CNS. Widespread transduction and stable expression of hASA in the choroid plexus and ependymal cells was observed throughout the ventricles for more than 1 year after vector injection. Although humoral immunity to hASA developed after 6 weeks, which diminished the hASA levels detected in CSF from AAV1-injected mice, hASA levels in CSF were maintained for at least 12 weeks when the mice were tolerized to hASA prior of vector injection. Our results suggest that the cells lining the ventricles could potentially serve as a biological reservoir for long-term continuous secretion of lysosomal enzymes into the CSF following intracerebroventricular injection of an AAV1 vector.

  10. Long-term effects of recombinant human growth hormone therapy in children with Prader-Willi syndrome.

    Science.gov (United States)

    Wolfgram, Peter M; Carrel, Aaron L; Allen, David B

    2013-08-01

    Recombinant human growth hormone (hGH) therapy in children with Prader-Willi syndrome (PWS) improves linear growth, body composition, physical strength and agility, and other metabolic parameters. These benefits must be weighed against potential adverse effects, including rare occurrences of sudden death. This review summarizes recent evidence important to a benefit-risk analysis of hGH use in children with PWS. Studies consistently show that hGH improves stature, body composition, fat percentage and distribution, and other metabolic markers in children with PWS. Preliminary reports of improved cognitive development during hGH have also emerged. Scoliosis progression is influenced by growth rate, but frequency of occurrence and severity are not increased by hGH exposure. PWS genotype does not appear to affect response to hGH. Concerns about hGH-associated sudden death persist, but recent studies show either absence of change in sleep-disordered breathing or improved sleep cardiovascular function during hGH therapy. Recent studies confirm and expand reported benefits of hGH therapy in children with PWS, including a possible salutary role in cognitive development. These findings support previous assertions that hGH can reduce morbidity and improve function in children with PWS, and suggest that potential risks of such treatment are favorably balanced by its benefits.

  11. Shoulder replacement

    Science.gov (United States)

    ... problems Bleeding , blood clot , or infection Risks of shoulder replacement surgery are: Allergic reaction to the artificial joint Blood vessel damage during surgery Bone break during surgery Nerve damage during surgery Dislocation of the artificial joint Loosening of the implant ...

  12. Ankle replacement

    Science.gov (United States)

    ... ankle replacement surgery are: Ankle weakness, stiffness, or instability Loosening of the artificial joint over time Skin ... Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  13. Replacing penalties

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    Vitaly Stepashin

    2017-01-01

    Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the

  14. Effect of estrogen-progestin hormonal replacement therapy on blood coagulation and fibrinolysis in postmenopausal women Efeitos da terapia de reposição hormonal estroprogestativa sobre o sistema de coagulação e de fibrinólise em mulheres na pós-menopausa

    Directory of Open Access Journals (Sweden)

    Claudio E Bonduki

    2007-01-01

    Full Text Available OBJECTIVE: To evaluate antithrombin III (AT, thrombin (Fragment 1+2 [F1+2] and thrombin-antithrombin [TAT] generation markers, as well as other coagulation parameters, such as prothrombin time, partial activated thromboplastin time, thrombin time, fibrinogen, euglobulin lysis time, and platelet count, in postmenopausal women after hormonal therapy. STUDY DESIGN: Forty-five patients who received either 0.625 mg/day unopposed oral conjugated equine estrogen (CEE, 0.625 mg/day oral CEE plus medroxyprogesterone acetate (MP, or 50 µg/day transdermal 17beta-estradiol plus MP, were included. Tests were performed before (T0 and after 3 (T3, 6 (T6 and 12 (T12 months of treatment. AT was determined by an amidolytic method, whereas F1+2 and TAT complex were measured by ELISA. RESULTS: There was a significant reduction in the AT level of patients who received oral CEE plus MP at T3. There was no AT reduction in patients taking either oral CEE alone or transdermal 17beta-estradiol plus MP. F1+2 increased in all patients, but it reached statistical significance only in patients receiving transdermal 17beta-estradiol MP at T3. CONCLUSIONS: The CEE associated with MP treatment may reduce AT levels, whereas unopposed CEE or transdermal 17beta-estradiol plus MP does not change AT. These changes might not be clinically relevant in the general population; however, hormonal replacement therapy may increase the risk of thrombosis in women with congenital or acquired thrombophilia.OBJETIVO: Avaliar os marcadores antitrombina III (AT, fragmento 1 + 2 da trombina (F1+2 e complexo trombina-antitrombina (TAT, bem como outros parâmetros da coagulação, como tempo de pró-trombina, tempo parcial de tromboplastina ativado, tempo de trombina, fibrinogênio e tempo de lise da euglobulina em mulheres na pós-menopausa após terapia hormonal. DESENHO DO ESTUDO: Foram incluídas 45 voluntárias que receberam estrogênios conjugados eqüinos (ECE 0,625 mg/dia, isoladamente ou

  15. The effects of aglepristone alone and in combination with cloprostenol on hormonal values during termination of mid-term pregnancy in bitches.

    Science.gov (United States)

    Kaya, D; Küçükaslan, I; Ağaoğlu, A R; Ay, S S; Schäfer-Somi, S; Emre, B; Bal, Y; Einspanier, A; Gürcan, I S; Gültiken, N; Aslan, S

    2014-05-01

    This study was designed to assess endocrine changes associated with termination of mid-term pregnancy after use of two different protocols. For this purpose we compared the effects of aglepristone (AGL) alone and in combination with cloprostenol (CLO) on serum concentrations of progesterone (P4), estradiol (E2) and relaxin (RLN) measured at short-term intervals during the abortion period in bitches. Fourteen pregnant bitches between day 25 and 32 of gestation were used in the study. In the AGL group (n=7), aglepristone was administered solely (10mg/kg body weight (BW), subcutaneously, once daily on two consecutive days) whereas in the AGL-CLO group (n=7), aglepristone (dosage as in AGL group) and cloprostenol (1μg/kg BW, subcutaneously, same with aglepristone) were combined. All pregnancies were successfully terminated 5.2±1.6 days after initiation of treatments, which was significant in both groups (P>0.05). At the time of the start of abortion (SA) and the end of abortion (EA), the mean P4 concentrations were 26.6±7.3 and 12.0±6.4ng/ml in AGL group, and 2.7±0.7 and 0.9±0.1ng/ml, in AGL-CLO group, respectively (Pchange from the initiation of treatment to EA (P>0.05). However, markedly higher RLN concentrations (Pchanges in the hormonal concentrations affect the mechanism of abortion in different ways. Further in depth studies investigating changes in the expression of hormone receptors inside the ovary, endometrium and placenta might be helpful to our understanding of the endocrinological differences observed in this study. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Health-related quality of life of young adults with Turner syndrome following a long-term randomized controlled trial of recombinant human growth hormone

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    Van Vliet Guy

    2011-05-01

    Full Text Available Abstract Background There are limited long-term randomized controlled trials of growth hormone (GH supplementation to adult height and few published reports of the health-related quality of life (HRQOL following treatment. The present follow-up study of young adults from a long-term controlled trial of GH treatment in patients with Turner syndrome (TS yielded data to examine whether GH supplementation resulted in a higher HRQOL (either due to taller stature or from the knowledge that active treatment and not placebo had been received or alternatively a lower HRQOL (due to medicalization from years of injections. Methods The original trial randomized 154 Canadian girls with TS aged 7-13 years from 13 centres to receive either long-term GH injections at the pharmacologic dose of 0.3 mg/kg/week or to receive no injections; estrogen prescription for induction of puberty was standardized. Patients were eligible for the follow-up study if they were at least 16 years old at the time of follow-up. The instrument used to study HRQOL was the SF-36, summarized into physical and mental component scales (PCS and MCS; higher scores indicate better HRQOL. Results Thirty-four of the 48 eligible participants (71% consented to participate; data were missing for one patient. Both groups (GH and no treatment had normal HRQOL at this post-treatment assessment. The GH group had a (mean ± SD PCS score of 56 ± 5; the untreated group 58 ± 4; mean score for 16-24 year old females in the general population 53.5 ± 6.9. The GH group had a mean MCS score of 52 ± 6; the untreated group 49 ± 13; mean score for 16-24 year old females in the general population 49.6 ± 9.8. Secondary analyses showed no relationship between HRQOL and height. Conclusions We found no benefit or adverse effect on HRQOL either from receiving or not receiving growth hormone injections in a long-term randomized controlled trial, confirming larger observational studies. We suggest that it remains

  17. A experiência da perimenopausa e pós-menopausa com mulheres que fazem uso ou não da terapia de reposição hormonal Peri-menopausal and post-menopausal experience among women with and without hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Sônia Maria Garcia Vigeta

    2004-12-01

    Full Text Available Este estudo, uma pesquisa qualitativa, tem por objetivo conhecer o significado da perimenopausa/pós-menopausa e o vivenciar de seus sinais e sintomas para mulheres que usam ou não a terapia de reposição hormonal (TRH. Os dados empíricos foram obtidos por meio de entrevista realizada com 11 mulheres, de 45 a 59 anos de idade, usuárias ou não de TRH e freqüentadoras de diferentes serviços de saúde no Município de São Paulo, Brasil. A análise foi realizada por meio da hermenêutica. Os resultados mais significativos revelam que as mulheres que não fazem uso da TRH apresentam os sintomas da perimenopausa, mas convivem com eles; as mulheres que fazem uso da isoflavona procuram por terapias alternativas para os sintomas que as incomodam; ao passo que as mulheres sob o uso da TRH declaram uma sensação de bem estar. O artigo sugere a importância de capacitar os profissionais da área de saúde para compreenderem que a perimenopausa e a pós-menopausa fazem parte do processo de envelhecimento e, portanto, devem ser consideradas como processo vital e não patológico.This qualitative study focuses on peri-menopausal and post-menopausal experience and its signs and symptoms for women with and without use of hormone replacement therapy (HRT. Empirical data were obtained through interviews with 11 women (range: 45 to 59 years with or without HRT at different health clinics in the Municipality of São Paulo, Brazil. The analysis used the hermeneutic method. Most significantly, women who are not on HRT present peri-menopausal symptoms, but they "live with" such symptoms; meanwhile, women in use of isoflavone rely on alternative therapies for the bothersome symptoms; women using HRT report a feeling of wellbeing. The article suggests the importance of training health professionals to understand the peri-menopausal and post-menopausal periods as part of the aging process, and thus as a vital rather than pathological process.

  18. One-piece zirconia oral implants for single tooth replacement: Three-year results from a long-term prospective cohort study.

    Science.gov (United States)

    Kohal, Ralf-Joachim; Spies, Benedikt Christopher; Bauer, Annalena; Butz, Frank

    2017-09-13

    This 3-year report of a prospective long-term cohort investigation aimed to evaluate the clinical and radiographic outcomes of a one-piece zirconia oral implant for single tooth replacement. 65 patients received a 1-stage implant surgery with immediate temporization. Standardized radiographs were taken at implant insertion, after 1 year, and after 3 years to monitor peri-implant bone levels. A univariate analysis of the association of different baseline parameters on marginal bone loss from implant insertion to 36 months was performed. Soft tissue parameters were evaluated at prosthesis insertion, after 6 months, after one year, and at the three-year follow-up. After 3 years, 6 posterior site implants were lost, giving a cumulative survival rate of 90.8%. The mean marginal bone loss was 1.45 mm. 35% of the implants lost at least 2 mm bone, and 22% more than 3 mm. The univariate analysis did not identify any parameter associated with marginal bone loss. Probing depth, clinical attachment level, and bleeding index increased over 3 years, plaque index decreased. The low survival rate of the presented ceramic implant, and especially the high frequency of advanced bone loss are noticeable but remain unexplained. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Implementing a practice change: early initiation of continuous renal replacement therapy during neonatal extracorporeal life support standardizes care and improves short-term outcomes.

    Science.gov (United States)

    Murphy, Heidi J; Cahill, John B; Twombley, Katherine E; Annibale, David J; Kiger, James R

    2017-10-30

    We hypothesized that a standardized approach to early continuous renal replacement therapy (CRRT) during neonatal extracorporeal life support (ECLS) results in greater homogeneity of CRRT initiation times with improvements in fluid balance and outcomes. Retrospective analysis of data (2007-2015) obtained from neonates treated prior to (E1; n = 32) and after (E2; n = 31) a 2011 practice change: CRRT initiation within 48 h of ECLS. Birthweight, gestational age, ECLS mode, and age at ECLS initiation were similar to each epoch. Survival [E1: median 75%, E2: 71%] and length of ECLS [E1: median 221 h, E2: 180 h] were comparable. During E2, 100% of infants received CRRT (vs. E1: 37%; p CRRT within 48 h of ECLS (vs. E1: 13%; p CRRT differed between Epochs [E1: median 105 h, E2: 9 h; p CRRT initiation [E1: 4.13 kg (29% above baseline), E2: 3.19 kg (0%); p CRRT within 48 h of ECLS cannulation, leading to decreased practice variation and improved short-term outcomes including decreased weight gain at CRRT initiation and faster return to baseline weight during the first 7 days of ECLS. We did not demonstrate changes in duration of ECLS, invasive ventilation, or survival.

  20. Early weight loss predicts the reduction of obesity in men with erectile dysfunction and hypogonadism undergoing long-term testosterone replacement therapy.

    Science.gov (United States)

    Salman, Mahmoud; Yassin, Dany-Jan; Shoukfeh, Huda; Nettleship, Joanne Elisabeth; Yassin, Aksam

    2017-03-01

    We and others have previously shown that testosterone replacement therapy (TRT) results in sustained weight loss in the majority of middle-aged hypogonadal men. Previously, however, a small proportion failed to lose at least 5% of their baseline weight. The reason for this is not yet understood. In the present study, we sought to identify early indicators that may predict successful long-term weight loss, defined as a reduction of at least 5% of total body weight relative to baseline weight (T0), in men with hypogonadism undergoing TRT. Eight parameters measured were assessed as potential predictors of sustained weight loss: loss of 3% or more of baseline weight after 1 year of TU treatment, severe hypogonadism, BMI, waist circumference, International Prostate Symptom Score (IPSS), glycated hemoglobin (HbA1C), age and use of vardenafil. Among the eight measured parameters, three factors were significantly associated with sustained weight loss over the entire period of TU treatment: (1) a loss of 3% of the baseline body weight after 1 year of TRT; (2) baseline BMI over 30; and (3) a waist circumference >102 cm. Age was not a predictor of weight loss.

  1. Long-term effectiveness of mailed nicotine replacement therapy: study protocol of a randomized controlled trial 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Vladyslav Kushnir

    2017-07-01

    Full Text Available Abstract Background Our group recently completed a randomized controlled trial, evaluating the efficacy of providing 5 weeks of free nicotine replacement therapy (NRT; in the form of the nicotine patch by expedited postal mail without behavioral assistance to regular adult smokers interested in receiving it. The findings revealed that mailed provision of nicotine patches resulted in more than a doubling of quit rates at a six-month follow-up compared to a no intervention control group. While this trial provided evidence for the effectiveness of mailed nicotine patches in promoting cessation, the findings speak only to the short term effectiveness of this approach. As relapse to smoking is known to occur beyond the 6 month period, it is important to evaluate whether the net benefit of NRT in naturalistic settings can be maintained long-term. The present study aims to perform a 5-year follow-up survey of participants in the original trial to evaluate the long-term effectiveness of mailed NRT. Methods/Design Trained interviewers will contact participants in the randomized controlled trial 5 years post-enrollment. A total of 924 participants will be eligible to be contacted. Interviewers will first assess participants’ smoking status and their level of nicotine dependence. Participants reporting not currently smoking will be asked whether they have smoked tobacco, even a puff, in the last 30 days (primary outcome measure: 30-day point prevalence abstinence, past 6 months (secondary outcome measure: prolonged 6-month abstinence, and since the 8-week follow-up survey (secondary outcome measure: > 4 year continuous abstinence. Interviewers will be blind to experimental condition at the time the primary outcome measure will be assessed. It is hypothesized that participants who received nicotine patches at baseline will display significantly higher quit rates at the 5-year follow-up as compared to participants who did not receive nicotine patches

  2. Association of Patient-Reported Health Status with Long-Term Mortality after Transcatheter Aortic Valve Replacement: A Report from the STS/ACC TVT Registry™

    Science.gov (United States)

    Arnold, Suzanne V.; Spertus, John A.; Vemulapalli, Sreekanth; Dai, Dadi; O’Brien, Sean M.; Baron, Suzanne J.; Kirtane, Ajay J.; Mack, Michael J.; Green, Philip; Reynolds, Matthew R.; Rumsfeld, John S.; Cohen, David J.

    2015-01-01

    Background Although transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic stenosis, long-term mortality after TAVR remains high and challenging to predict. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a health status measure, assessed directly from patients, that integrates two clinically relevant factors (symptoms and functional status) that may predict TAVR outcomes. Methods and Results Among 7769 patients from 286 sites in the STS-ACC TVT Registry, we examined the association between pre-procedure (baseline) patient health status, as assessed by the KCCQ, and 1-year mortality after TAVR. The KCCQ Overall Summary Score was categorized as very poor: <25, poor: 25–49, fair: 50–74, or good: ≥75. Prior to TAVR, health status was rated as very poor in 28%, poor in 38%, fair in 24%, and good in 10%. Patients with worse health status were more likely to be female and had more comorbidities and higher STS mortality risk scores. Compared with those with good health status prior to TAVR, and after adjusting for a broad range of baseline covariates, patients with very poor health status had a 2-fold increased hazard of death over the first year after TAVR (adjusted HR 2.00, 95% CI 1.58–2.54), while those with poor and fair health status had intermediate outcomes (adjusted HRs 1.54, 95% CI 1.22–1.95 and 1.20, 95% CI 0.94–1.55, respectively). Conclusions In a national, contemporary practice cohort, worse pre-procedure patient health status, as assessed by the KCCQ, was associated with greater long-term mortality after TAVR. These results support the measurement and integration of the KCCQ into mortality risk assessments for patients considering TAVR. PMID:26643740

  3. Influence of fluor salts, hormone replacement therapy and calcitonin on the concentration of insulin-like growth factor (IGF)-I, IGF-II and transforming growth factor-beta 1 in human iliac crest bone matrix from patients with primary osteoporosis.

    Science.gov (United States)

    Pepene, C E; Seck, T; Diel, I; Minne, H W; Ziegler, R; Pfeilschifter, J

    2004-01-01

    Data from cell culture experiments suggest that local growth factors (GFs) may mediate the effects of estrogens, calcitonin or fluor ions on the skeleton. To assess the in vivo relevance of the in vitro reports, the effect of fluor salts, hormone replacement therapy (HRT) and calcitonin on the concentrations of IGF-I, IGF-II and transforming growth factor (TGF)-beta 1 in bone matrix extracts from osteoporotic patients was evaluated. Iliac crest bone biopsies were obtained from 170 patients (76 men and 94 women) with primary osteoporosis aged 55.5+/-0.8 Years. Bone matrix extraction was performed based on a guanidine-HCl/ethylendiamine-tetra-acetic acid method. In comparison with age- and body mass index (BMI)-matched controls, no influence of long-term therapy with fluor ions (n=41) or calcitonin (n=16) on the bone matrix concentration of GFs was noticed. Postmenopausal women with osteoporosis on HRT (n=39) had lower skeletal IGF-I but not IGF-II levels as compared with age- and BMI-matched non-users. However, the lower rate of bone turnover in women with HRT may account for this difference, since the significance was lost after adjustment for alkaline phosphatase. Likewise, a tendency for lower TGF-beta 1 levels was observed in HRT users as compared with non-users but was lost after adjustment for bone turnover. None of the therapies influenced the serum levels of GFs when patients receiving continuous therapy for at least 1 Year before bone biopsy were considered. Our data suggest no direct effect of fluor therapy on skeletal GFs levels. At the concentrations used, neither HRT nor calcitonin appeared to exert any significant influence on serum or bone matrix GF levels.

  4. Long-term, hormone-responsive organoid cultures of human endometrium in a chemically-defined medium

    OpenAIRE

    Turco, Margherita Y.; Gardner, Lucy; Hughes, Jasmine; Cindrova-Davies, Tereza; Gomez, Maria J.; Farrell, Lydia; Hollinshead, Michael; Marsh, Steven G E; Brosens, Jan J.; Critchley, Hilary O.; Simons, Benjamin D.; Hemberger, Myriam; Koo, Bon-Kyoung; Moffett, Ashley; Burton, Graham J.

    2017-01-01

    In humans, the endometrium, the uterine mucosal lining, undergoes dynamic changes throughout the menstrual cycle and pregnancy. Despite the importance of the endometrium as the site of implantation and nutritional support for the conceptus, there are no long-term culture systems that recapitulate endometrial function in vitro. We adapted conditions used to establish human adult stem cell-derived organoid cultures to generate 3D cultures of normal and decidualised human endometrium. These orga...

  5. [Hormonal contraception in men].

    Science.gov (United States)

    de Ronde, W; Meuleman, E J H

    2007-11-17

    Over the past few decades, female hormonal contraception has been seen to be very successful. However, this has still not resulted in a hormonal contraceptive for men. Certain injectable combinations ofandrogens and progestagens have been found to suppress spermatogenesis. All combinations that have been tested so far suffer from a relative lack of efficacy, a long lag time to achieve azoospermia, requiring the user to undergo one or more semen analyses, a moderate user friendliness, and concerns about the long-term safety and reversibility. It is not to be expected that male hormonal contraception will become a serious alternative to the already existing female equivalent during the coming 5 years.

  6. Variação da densidade mamográfica em usuárias e não-usuárias de terapia de reposição hormonal Mammographic density variation in users and nonusers of hormonal replacement therapy

    Directory of Open Access Journals (Sweden)

    Cesar Cabello dos Santos

    1998-07-01

    forma significativa (p=0,003.Objective: to compare mammographic density changes, case by case, according to image digitization in three consecutive evaluations of users or nonusers of hormonal replacement therapy (HRT. Methods: 59 postmenopausal women were evaluated, 43 being users of cyclic or continuous estro-progestin hormonal replacement therapy, and 16 nonusers. The criteria of inclusion were: amenorrhea for at least 12 months, a normal mammographic examination at the beginning of the HRT (users or the clinical follow-up without HRT (nonusers, at two incidences (mediolateral and craniocaudal. The following variables were used for the evaluation of mammary density: initial change - the difference between the first mammography after HRT performed in 12 ± 3 months and the mammography performed before HRT-and final change - the difference between the second mammography after HRT performed in 24 ± 3 months and the mammography performed before HRT. Wilcoxon and c² tests were used in order to evaluate the differences in mammographic density changes. Results: more than half (56.3% of the women, HRT users with initial increase in mammographic density remained with the increase after the final evaluation. This finding was not significant (p=0.617. In the same group, the initial nonincrease was significantly associated with the final nonincrease (p=0.017. Among the nonusers, all breasts that were not totally fat at the initial evaluation presented a mammographic density decrease at the final evaluation. Conclusions: the majority of HRT users presenting mammographic density increase at the first evaluation, after approximately one year of use, remained with the increase at a second evaluation. After some time, the nonusers tended to present a significant mammographic density decrease (p=0.003.

  7. [Does the medial-lateral stability of total knee replacements have an effect on short-term clinical outcomes? One-year results of a multicentre study with computer assisted surgery].

    Science.gov (United States)

    Martín-Hernández, C; Revenga-Giertych, C; Hernández-Vaquero, D; Albareda-Albareda, J; Queiruga-Dios, J A; García-Aguilera, D; Ranera-García, M

    2014-01-01

    To evaluate the influence of the medial-lateral stability of the joint on the short-term clinical outcomes after performing navigation in total knee replacement. A multicentre prospective study was conducted on 111 consecutive total knee replacements performed with computer assisted surgery. The study included the evaluation of KSS, WOMAC, and SF-12 preoperatively, and at 3 and 12 months of follow-up, and correlation with stability data obtained during surgery, in extension and at 20° and 90° of flexion. No differences were found in WOMAC, KSS and SF-12 relative to coronal stability during surgery. Variations in coronal stability were shown to have no influence on the short-term clinical results of navigated total knee replacement. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  8. Bone mass, bone geometry, and body composition in female-to-male transsexual persons after long-term cross-sex hormonal therapy.

    Science.gov (United States)

    Van Caenegem, E; Wierckx, K; Taes, Y; Dedecker, D; Van de Peer, F; Toye, K; Kaufman, J-M; T'Sjoen, G

    2012-07-01

    Female-to-male transsexual persons (transsexual men) undergo extreme hormonal changes due to ovariectomy and testosterone substitution, allowing studies on sex steroid effects on bone geometry and physiology in the adult. The objective of the study was to examine the effects of cross-gender sex steroid exposure on volumetric bone parameters in transsexual men. This was a cross-sectional study. Participants were recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital (Ghent, Belgium). Fifty transsexual men after sex reassignment surgery with 50 age-matched control women and an additional 16 transsexual men before testosterone substitution and sex reassignment surgery with 16 control women participated in the study. The main outcome measures were areal and volumetric bone parameters using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, body composition (dual-energy X-ray absorptiometry), sex steroids, markers of bone turnover and grip strength. Before hormonal treatment, transsexual men had similar body composition and bone geometry as female controls. The transsexual men on long-term testosterone therapy, however, demonstrated a higher lean body mass and muscle mass and a greater grip strength as well as a lower body and subcutaneous fat mass and a larger waist and smaller hip circumference compared with female controls (all P transsexual men on testosterone therapy. Transsexual men on testosterone substitution therapy present with a different body composition with more muscle mass and strength and less fat mass as well as an altered bone geometry with larger bones compared with female controls.

  9. Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy.

    Science.gov (United States)

    Storey, D J; McLaren, D B; Atkinson, M A; Butcher, I; Frew, L C; Smyth, J F; Sharpe, M

    2012-06-01

    The purpose of the study was to determine the prevalence and associations of clinically relevant fatigue (CRF) in men with biochemically controlled prostate cancer on long-term androgen deprivation therapy (ADT). One hundred and ninety-eight men were surveyed and the prevalence of CRF (Brief Fatigue Inventory score >3) determined. Associations with other measures (Hospital Anxiety and Depression Scale; International Prostate Symptom Score; European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire; Brief Pain Inventory worst pain; clinical and demographic information) were explored in univariate and multivariate analyses. Eight-one per cent (160 of 198) of questionnaires were analysable. CRF prevalence was 43% (68 of 160). CRF associations included moderate/severe urinary symptoms, anxiety and medical co-morbidities; the strongest associations were depression [odds ratio (OR) 9.8, 95% confidence interval (CI) 4.3-22.8] and pain (OR 9.2, 95% CI 4.0-21.5). After controlling for other factors, the independent associations were depression (OR 4.7, 95% CI 1.6-14.0) and pain (OR 3.1, 95% CI 1.0-8.9). There was no association with age, disease burden or treatment duration. Two-fifths of men with biochemically controlled prostate cancer on long-term ADT report CRF that interferes with function. Management aimed at improving CRF should address depression and pain.

  10. [The value and comparison of plasma adrenocorticotropic hormone and urinary free cortisol in predicting long-term outcome after operation of Cushing's disease].

    Science.gov (United States)

    Feng, M; Liu, X H; Bao, X J; Yong, C X; Lu, L; Deng, K; Lian, W; Xing, B; Zhu, H J; Ma, W B; Yan, Y; Wang, R Z

    2016-12-06

    Objective: To study and the value of morning plasma adrenocorticotropic hormone (ACTH) and urinary free cortisol (24 h UFC) within 3 days after operation in patients with Cushing's disease in predicting the long-term outcome. Methods: The clinical data of 140 patients with Cushing's disease who were treated in Department of Neurosurgery of PUMCH from 2012 to 2014 were analyzed retrospectively.The univariate analysis, multivariate Logistic analysis, ROC curve analysis and other statistical methods were used to study the predicting value of morning plasma ACTH and 24 h UFC in 3 days post operation. Results: Univariate analysis showed that in the two groups of the early remission and no remission, there was significant statistical difference between the preoperative ACTH, preoperative 24 h UFC, postoperative ACTH and postoperative 24 h UFC ( P significant difference ( P significantly better than that of 24 h UFC ( P =0.005). Conclusion: Early morning 24 h UFC and ACTH within 3 days after operation both showed considerable accuracy in predicting the long-term outcome of Cushing's disease, and the significance of ACTH was even greater than that of 24 h UFC.

  11. The use of laser capture microdissection (LCM) and quantitative polymerase chain reaction to define thyroid hormone receptor expression in human 'term' placenta.

    Science.gov (United States)

    Chan, S; Murray, P G; Franklyn, J A; McCabe, C J; Kilby, M D

    2004-01-01

    Term 'villous' placenta consists of a heterogeneous mix of different cell types comprising the trophoblast layers, villous stroma and fetal blood vessels. The importance of using techniques which allow investigation of pure populations of cells has been increasingly recognised. We demonstrate the use of laser capture microdissection (LCM) in combination with quantitative RT-PCR (QPCR) to assess the relative expression of mRNAs encoding the major thyroid hormone receptor (TR) isoforms (alpha1, alpha2 and beta1) in trophoblasts (syncytiotrophoblast and cytotrophoblast layers) compared with stromal cells in human term placenta. Highly reproducible results for each gene were obtained for each placental sample studied (n = 6). There was significantly less mRNA encoding TRalpha1 (68%; p = 0.05) and TRbeta1 (40%; p = 0.03) in the trophoblast layer compared to the heterogeneous stromal cells. However, there was no significant difference in TRalpha2 mRNA expression between the two groups of cells. LCM with QPCR can precisely locate and accurately quantify mRNA expression in specific cell populations from placental tissue.

  12. Postoperative Fluid Overload is a Useful Predictor of the Short-Term Outcome of Renal Replacement Therapy for Acute Kidney Injury After Cardiac Surgery.

    Science.gov (United States)

    Xu, Jiarui; Shen, Bo; Fang, Yi; Liu, Zhonghua; Zou, Jianzhou; Liu, Lan; Wang, Chunsheng; Ding, Xiaoqiang; Teng, Jie

    2015-08-01

    To analyze the predictive value of postoperative percent fluid overload (PFO) of renal replacement therapy (RRT) for acute kidney injury (AKI) patients after cardiac surgery.Data from 280 cardiac surgery patients between 2005 January and 2012 April were collected for retrospective analyses. A receiver operating characteristic (ROC) curve was used to compare the predictive values of cumulative PFO at different times after surgery for 90-day mortality.The cumulative PFO before RRT initiation was 7.9% ± 7.1% and the median PFO 6.1%. The cumulative PFO before and after RRT initiation in intensive care unit (ICU) was higher in the death group than in the survival group (8.8% ± 7.6% vs 6.1% ± 5.6%, P = 0.001; -0.5[-5.6, 5.1]% vs 6.9[2.2, 14.6]%, P 731, and 0.752. PFO during the whole ICU stay ≥7.2% was determined as the cut-off point for 90-day mortality prediction with a sensitivity of 77% and a specificity of 64%. Kaplan-Meier survival estimates showed a significant difference in survival among patients with cumulative PFO ≥ 7.2% and PFO < 7.2% after cardiac surgery (log-rank P < 0.001).Postoperative cumulative PFO during the whole ICU stay ≥7.2% would have an adverse effect on 90-day short-term outcome, which may provide a strategy for the volume control of AKI-RRT patients after cardiac surgery.

  13. What are the effects of varenicline compared with nicotine replacement therapy on long-term smoking cessation and clinically important outcomes? Protocol for a prospective cohort study.

    Science.gov (United States)

    Davies, Neil M; Taylor, Gemma; Taylor, Amy E; Thomas, Kyla H; Windmeijer, Frank; Martin, Richard M; Munafò, Marcus R

    2015-11-05

    Smoking is a major avoidable cause of ill-health and premature death. Treatments that help patients successfully quit smoking have an important effect on health and life expectancy. Varenicline is a medication that can help smokers successfully quit smoking. However, there are concerns that it may cause adverse effects, such as increase in the occurrence of depression, self-harm and suicide and cardiovascular disease. In this study we aim to examine the effects of varenicline versus other smoking cessation pharmacotherapies on smoking cessation, health service use, all-cause and cause-specific mortality and physical and mental health conditions. In this project we will investigate the effects of varenicline compared to nicotine replacement therapies on: (1) long-term smoking cessation and whether these effects differ by area level deprivation; and (2) the following clinically-important outcomes: rate of general practice and hospital attendance; all-cause mortality and death due to diseases of the respiratory system and cardiovascular disease; and a primary care diagnosis of respiratory illness, myocardial infarction or depression and anxiety. The study is based on a cohort of patients prescribed these smoking cessation medications from the Clinical Practice Research Datalink (CPRD). We will use three methods to overcome confounding: multivariable adjusted Cox regression, propensity score matched Cox regression, and instrumental variable regression. The total expected sample size for analysis will be at least 180,000. Follow-up will end with the earliest of either an 'event' or censoring due to the end of registration or death. Ethics approval was not required for this study. This project has been approved by the CPRD's Independent Scientific Advisory Committee (ISAC). We will disseminate our findings via publications in international peer-reviewed journals and presentations at international conferences. Published by the BMJ Publishing Group Limited. For permission

  14. GH-replacement therapy in adults

    DEFF Research Database (Denmark)

    Christiansen, J S; Jørgensen, J O; Pedersen, S A

    1991-01-01

    Growth hormone (GH) deficiency in adults, whether GH deficient since childhood or patients rendered GH deficient in adult life, is associated with psychosocial maladjustment, reduced muscle strength and reduced exercise capacity. Body composition is significantly altered with increased fat...... and decreased muscle volume as compared to healthy subjects. Kidney function is subnormal, and so is sweat secretion. Epidemiological data suggest premature mortality due to cardiovascular disease in hypopituitary patients. Short-term GH treatment trials have shown improved psychosocial performance......, normalization of body composition, increased muscle strength, improved exercise capacity, increased cardiac performance and increase in bone mineral mass as well as in serum markers of bone turnover, and normalization of kidney function. Thus GH replacement therapy in GH-deficient adults exhibits potential long...

  15. Mechanical valves versus the Ross procedure for aortic valve replacement in children: propensity-adjusted comparison of long-term outcomes.

    Science.gov (United States)

    Alsoufi, Bahaaldin; Al-Halees, Zohair; Manlhiot, Cedric; McCrindle, Brian W; Al-Ahmadi, Mamdouh; Sallehuddin, Ahmed; Canver, Charles C; Bulbul, Ziad; Joufan, Mansoor; Fadel, Bahaa

    2009-02-01

    We aimed to identify characteristics differentiating children undergoing aortic valve replacement by using mechanical prostheses versus the Ross procedure and to compare survival and the need for aortic valve reoperation after each procedure. From 1983 to 2004, 346 children underwent aortic valve replacement (215 underwent the Ross procedure and 131 underwent placement of a mechanical prosthesis). Factors associated with procedure choice were used to construct a propensity score for use as a covariate in regression models to adjust for potential confounding by indication. Patients undergoing the Ross procedure were younger, more likely to have a congenital cause, and less likely to have a rheumatic or connective tissue cause. They had a lower frequency of regurgitation, required more annular enlargement, and had less concomitant cardiac surgery. Competing-risk analysis showed that 16 years after aortic valve replacement, 20% of patients had died without subsequent aortic valve replacement, 25% underwent second aortic valve replacement, and 55% remained alive without further replacement. After propensity adjustment, factors associated with early-phase death included mechanical valves and a nonrheumatic cause. Mechanical valves were also associated with constant-phase mortality. Repeated aortic valve replacement was associated with the Ross procedure and a rheumatic cause. Both factors were also associated with all-cause cardiac reoperation. In children receiving mechanical prostheses, younger age and smaller valve size were significant risk factors for death. Freedom from homograft replacement after the Ross procedure was 82% at 16 years of follow-up. Results from this study showed good outcomes and an acceptable complication rate with both valve choices. Given the significantly increased risk of early and late death in younger children receiving smaller mechanical valves, the Ross procedure confers survival advantage in this age group at the expense of increased

  16. Headache And Hormones

    Directory of Open Access Journals (Sweden)

    Shukla Rakesh

    2002-01-01

    Full Text Available There are many reasons to suggest a link between headache and hormones. Migraine is three times common in women as compared to men after puberty, cyclic as well as non-cyclic fluctuations in sex hormone levels during the entire reproductive life span of a women are associated with changes in frequency or severity of migraine attack, abnormalities in the hypothalamus and pineal gland have been observed in cluster headache, oestrogens are useful in the treatment of menstrual migraine and the use of melatonin has been reported in various types of primary headaches. Headache associated with various endocrinological disorders may help us in a better understanding of the nociceptive mechanisms involved in headache disorders. Prospective studies using headache diaries to record the attacks of headache and menstrual cycle have clarified some of the myths associated with menstrual migraine. Although no change in the absolute levels of sex hormones have been reported, oestrogen withdrawal is the most likely trigger of the attacks. Prostaglandins, melatonin, opioid and serotonergic mechanisms may also have a role in the pathogenesis of menstrual migraine. Guidelines have been published by the IHS recently regarding the use of oral contraceptives by women with migraine and the risk of ischaemic strokes in migraineurs on hormone replacement therapy. The present review includes menstrual migraine, pregnancy and migraine, oral contraceptives and migraine, menopause and migraine as well as the hormonal changes in chronic migraine.

  17. Effects of Chronic Vitamin D3 Hormone Administration on Anxiety-Like Behavior in Adult Female Rats after Long-Term Ovariectomy

    Directory of Open Access Journals (Sweden)

    Julia Fedotova

    2017-01-01

    Full Text Available The present preclinical study was created to determine the therapeutic effects of vitamin D hormone treatment as an adjunctive therapy alone or in a combination with low dose of 17β-estradiol (17β-E2 on anxiety-like behavior in female rats with long-term absence of estrogen. Accordingly, the aim of the current study was to examine the effects of chronic cholecalciferol administration (1.0, 2.5 or 5.0 mg/kg subcutaneously, SC, once daily, for 14 days on the anxiety-like state after long-term ovariectomy in female rats. Twelve weeks postovariectomy, cholecalciferol was administered to ovariectomized (OVX rats and OVX rats treated with 17β-E2 (0.5 µg/rat SC, once daily, for 14 days. Anxiety-like behavior was assessed in the elevated plus maze (EPM and the light/dark test (LDT, and locomotor and grooming activities were tested in the open field test (OFT. Cholecalciferol at two doses of 1.0 and 2.5 mg/kg alone or in combination with 17β-E2 produced anxiolytic-like effects in OVX rats as evidenced in the EPM and the LDT, as well as increased grooming activity in the OFT. Our results indicate that cholecalciferol, at two doses of 1.0 and 2.5 mg/kg, has a profound anxiolytic-like effects in the experimental rat model of long-term estrogen deficiency.

  18. Short-Term Thyroid Hormone Excess Affects the Heart but Does not Affect Adrenal Activity in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Szkudlarek, Ariani Cavazzani, E-mail: arianiinaira@yahoo.com.br; Aldenucci, Bruno; Miyagui, Nelson Itiro; Silva, Ilana Kassouf [Universidade Federal do Paraná, Curitiba, PR (Brazil); Moraes, Rosana Nogueira [Pontifícia Universidade Federal do Paraná, Curitiba, PR (Brazil); Ramos, Helton Estrela [Universidade Federal da Bahia, Salvador, BA (Brazil); Fogaça, Rosalva Tadeu Hochmuller [Universidade Federal do Paraná, Curitiba, PR (Brazil)

    2014-03-15

    Hyperthyroidism (Hy) exerts a broad range of influences on a variety of physiological parameters. Its disruptive effect on cardiovascular system is one of its most remarkable impacts. Moreover, Hy has been clinically associated with stress - induced hyperactivation of the hypothalamic-pituitary-adrenal axis. Evaluate the impact of short-term Hy on cardiac performance and adrenal activity of rats. Induction of Hy in Wistar rats through injections of T3 (150 µg/kg) for 10 days (hyperthyroid group - HG) or vehicle (control group). The cardiovascular performance was evaluated by: echocardiography (ECHO); heart weight/body weight (mg/gr) ratio; contractility of isolated papillary muscles (IPM) and direct measurement of blood pressures. Adrenal activity was evaluated by adrenal weight/body weight (mg/gr) ratio and 24-hour fecal corticosterone (FC) levels on the, 5{sup th} and 10{sup th} days of T3 treatment. In HG, the ECHO showed reduction of the End Systolic and End Diastolic Volumes, Ejection, Total Diastolic and Isovolumic Relaxation Times, Diastolic and Systolic Areas and E/A ratio. Heart Rate, Ejection Fraction and Cardiac Output increased. The heart weight/body weight ratio was higher. Similarly, in IPM, the maximum rate of force decay during relaxation was higher in all extracellular calcium concentrations. Systolic blood pressure (SBP) levels were higher. (p ≤ 0.05). On the other hand, there was no difference in the adrenal weight/body weight ratio or in the 24-hour FC levels. Hy induces positive inotropic, chronotropic and lusitropic effects on the heart by direct effects of T3 and increases SBP. Those alterations are not correlated with changes in the adrenal activity.

  19. Short-term thyroid hormone excess affects the heart but does not affect adrenal activity in rats.

    Science.gov (United States)

    Szkudlarek, Ariani Cavazzani; Aldenucci, Bruno; Miyagui, Nelson Itiro; Silva, Ilana Kassouf; Moraes, Rosana Nogueira; Ramos, Helton Estrela; Fogaça, Rosalva Tadeu Hochmuller

    2014-03-01

    Hyperthyroidism (Hy) exerts a broad range of influences on a variety of physiological parameters. Its disruptive effect on cardiovascular system is one of its most remarkable impacts. Moreover, Hy has been clinically associated with stress - induced hyperactivation of the hypothalamic-pituitary-adrenal axis. Evaluate the impact of short-term Hy on cardiac performance and adrenal activity of rats. Induction of Hy in Wistar rats through injections of T3 (150 µg/kg) for 10 days (hyperthyroid group - HG) or vehicle (control group). The cardiovascular performance was evaluated by: echocardiography (ECHO); heart weight/body weight (mg/gr) ratio; contractility of isolated papillary muscles (IPM) and direct measurement of blood pressures. Adrenal activity was evaluated by adrenal weight/body weight (mg/gr) ratio and 24-hour fecal corticosterone (FC) levels on the, 5th and 10th days of T3 treatment. In HG, the ECHO showed reduction of the End Systolic and End Diastolic Volumes, Ejection, Total Diastolic and Isovolumic Relaxation Times, Diastolic and Systolic Areas and E/A ratio. Heart Rate, Ejection Fraction and Cardiac Output increased. The heart weight/body weight ratio was higher. Similarly, in IPM, the maximum rate of force decay during relaxation was higher in all extracellular calcium concentrations. Systolic blood pressure (SBP) levels were higher. (p ≤ 0.05). On the other hand, there was no difference in the adrenal weight/body weight ratio or in the 24-hour FC levels. Hy induces positive inotropic, chronotropic and lusitropic effects on the heart by direct effects of T3 and increases SBP. Those alterations are not correlated with changes in the adrenal activity.

  20. Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age.

    Science.gov (United States)

    van Pareren, Yvonne K; Duivenvoorden, Hugo J; Slijper, Froukje S M; Koot, Hans M; Hokken-Koelega, Anita C S

    2004-11-01

    Short stature is not the only problem faced by small for gestational age (SGA) children. Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence, and behavioral problems. Although GH treatment in short children born SGA can result in a normalization of height during childhood, the effect of GH treatment on intelligence and psychosocial functioning remains to be investigated. We show the longitudinal results of a randomized, double-blind, GH-dose response study initiated in 1991 to follow growth, intelligence quotient (IQ), and psychosocial functioning in SGA children during long-term GH treatment. Patients were assigned to one of two treatment groups (1 or 2 mg GH/m(2) body surface.d, or approximately 0.035 or 0.07 mg/kg.d). Intelligence and psychosocial functioning were evaluated at start of GH treatment (n = 74), after 2 yr of GH treatment (n = 76), and in 2001 (n = 53). IQ was assessed by a short-form Wechsler Intelligence Scale for Children-Revised or Wechsler Adult Intelligence Scale (Block-design and Vocabulary subtests). Behavioral problems were measured by the Achenbach Child Behavior Checklist or Young Adult Behavior Checklist, and self-perception was measured by the Harter Self-Perception Profile. Mean (sem) birth length sd score was -3.6 (0.2), mean age and height at start was 7.4 (0.2) yr and -3.0 (0.1) sd score, respectively, mean duration of GH treatment was 8.0 (0.2) yr, and mean age in 2001 was 16.5 (0.3) yr. After 2 yr of GH treatment, 96% of both GH groups showed a height gain sd score of 1 sd from the start of treatment or more, resulting in a normal height (i.e. height >/= -2.0 sd for age and sex) in 70% of the children. In 2001, 48 (91%) of the 53 children participating in this study had reached a normal height. Block-design s-score and the estimated total IQ significantly increased (P children whose height over time became closer to that of their peers showed less problem behavior.

  1. Justified and unjustified use of growth hormone.

    NARCIS (Netherlands)

    A-J. van der Lely (Aart-Jan)

    2004-01-01

    textabstractGrowth hormone (GH) replacement therapy for children and adults with proven GH deficiency due to a pituitary disorder has become an accepted therapy with proven efficacy. GH is increasingly suggested, however, as a potential treatment for frailty, osteoporosis,

  2. Different short-term effect of protein and carbohydrate intake on TSH, growth hormone (GH), insulin, C-peptide, and glucagon in humans

    DEFF Research Database (Denmark)

    Matzen, L E; Andersen, B B; Jensen, B G

    1990-01-01

    hormone (GH) and thyroid stimulating hormone (TSH) to protein and carbohydrate was identical, with a reduction in both GH and TSH, and nadir occurring after 45-60 min and 120 min, respectively. During the next 120 min TSH returned to starting level after carbohydrate intake but was still reduced after...

  3. Cervical intervertebral disc replacement.

    Science.gov (United States)

    Cason, Garrick W; Herkowitz, Harry N

    2013-02-06

    Symptomatic adjacent-level disease after cervical fusion has led to the development and testing of several disc-replacement prostheses. Randomized controlled trials of cervical disc replacement (CDR) compared with anterior cervical discectomy and fusion (ACDF) have demonstrated at least equivalent clinical results for CDR with similar or lower complication rates. Biomechanical, kinematic, and radiographic studies of CDR reveal that the surgical level and adjacent vertebral level motion and center of rotation more closely mimic the native state. Lower intradiscal pressures adjacent to CDR may help decrease the incidence of adjacent spinal-level disease, but long-term follow-up is necessary to evaluate this theory.

  4. Presenting features and long-term effects of growth hormone treatment of children with optic nerve hypoplasia/septo-optic dysplasia

    Directory of Open Access Journals (Sweden)

    Vedin Amy M

    2011-11-01

    Full Text Available Abstract Background Optic nerve hypoplasia (ONH with/or without septo-optic dysplasia (SOD is a known concomitant of congenital growth hormone deficiency (CGHD. Methods Demographic and longitudinal data from KIGS, the Pfizer International Growth Database, were compared between 395 subjects with ONH/SOD and CGHD and 158 controls with CGHD without midline pathology. Results ONH/SOD subjects had higher birth length/weight, and mid-parental height SDS. At GH start, height, weight, and BMI SDS were higher in the ONH/SOD group. After 1 year of GH, both groups showed similar changes in height SDS, while weight and BMI SDS remained higher in the ONH/SOD group. The initial height responses of the two groups were similar to those predicted using the KIGS-derived prediction model for children with idiopathic GHD. At near-adult height, ONH/SOD and controls had similar height, weight, and BMI SDS. Conclusions Compared to children with CGHD without midline defects, those with ONH/SOD presented with greater height, weight, and BMI SDS. These differences persisted at 1 year of GH therapy, but appeared to be overcome by long-term GH treatment.

  5. Joint replacement in Zambia: A review of Hip & Knee Replacement ...

    African Journals Online (AJOL)

    Background: Incidence of major joint replacement surgery is on the rise in Africa but this trend has not been matched by proper audits in the form of National Joint Registries. Objective: This paper presents the short-term findings from a joint replacement register started at the Zambian-Italian Orthopaedic Hospital (ZIOH) in ...

  6. Short-term changes in bone formation markers following growth hormone (GH) treatment in short prepubertal children with a broad range of GH secretion.

    Science.gov (United States)

    Andersson, Björn; Swolin-Eide, Diana; Magnusson, Per; Albertsson-Wikland, Kerstin

    2015-01-01

    Growth hormone (GH) promotes longitudinal growth and bone modelling/remodelling. This study investigated the relationship between levels of bone formation markers and growth during GH treatment in prepubertal children with widely ranging GH secretion levels. The study group comprised 113 short prepubertal children (mean age ± SD, 9·37 ± 2·13 years; 99 boys) on GH treatment (33·0 ± 0·06 μg/kg/day) for 1 year. Blood samples were taken at baseline and 1 and 2 weeks, 1 and 3 months, and 1 year after treatment start. Intact amino-terminal propeptide of type I procollagen (PINP), bone-specific alkaline phosphatase (BALP) and osteocalcin were measured using an automated IDS-iSYS immunoassay system. Intact amino-terminal propeptide of type I procollagen (PINP), BALP and osteocalcin, increased in the short-term during GH treatment. PINP after 1 week (P = 0·00077), and BALP and osteocalcin after 1 month (P growth response. No significant correlations were found between BALP and first year growth. Multiple regression analysis showed that bone marker levels together with auxological data and insulin-like growth factor binding protein-3 explained the variation in first year growth response to 36% at start, 32% after 2 weeks and 48% at 3 months. Short-term increases in levels of the bone formation markers PINP, BALP and osteocalcin showed different temporal patterns, but all correlated with first year growth response during GH treatment. These markers may be a useful addition to existing prediction models for growth response. © 2014 John Wiley & Sons Ltd.

  7. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

    Directory of Open Access Journals (Sweden)

    Zoya Gridneva

    2016-12-01

    Full Text Available Human milk (HM components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE, a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo. Stomach volumes (SV were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001 GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001, and longer GE times (0.24 [0.03, 0.46], p = 0.033. Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023. Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002 and dose (0.02 [0.01, 0.03], p = 0.005, and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003. FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  8. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants.

    Science.gov (United States)

    Gridneva, Zoya; Kugananthan, Sambavi; Hepworth, Anna R; Tie, Wan J; Lai, Ching T; Ward, Leigh C; Hartmann, Peter E; Geddes, Donna T

    2016-12-28

    Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (-0.07 [-0.10, -0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher