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Oliveira TS, Campos HM, Costa RM, Georg RC, Leite JA, Tostes RC, Costa EA, Santos FCA, Lobato NS, Filgueira FP, Ghedini PC. Estrone-mediated lowering of ROS and NOX4 improves endothelial function in ovariectomized wistar rats. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-03106-7. [PMID: 38643455 DOI: 10.1007/s00210-024-03106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/13/2024] [Indexed: 04/22/2024]
Abstract
Estrone (E1) constitutes the primary component in oral conjugated equine estrogens (CEEs) and serves as the principal estrogen precursor in the female circulation in the post-menopause. E1 induces endothelium-dependent vasodilation and activate PI3K/NO/cGMP signaling. To assess whether E1 mitigates vascular dysfunction associated with postmenopause and explore the underlying mechanisms, we examined the vascular effects of E1 in ovariectomized (OVX) rats, a postmenopausal experimental model. Blood pressure was measured using tail-cuff plethysmography, and aortic rings were isolated to assess responses to phenylephrine, acetylcholine (ACh), and sodium nitroprusside. Responses to ACh in rings pre-incubated with superoxide dismutase (SOD), catalase (CAT), or apocynin were also evaluated. Protein expression of SOD, CAT, NOX1, NOX2, and NOX4 was determined by Western blotting. E1 treatment resulted in decreased body weight and retroperitoneal fat, increased uterine weight, and prevented elevated blood pressure in the OVX group. Furthermore, E1 improved endothelium-dependent ACh vasodilation, activated compensatory antioxidant mechanisms - i.e. increased SOD and CAT antioxidant enzymes activity, and decreased NOX4 expression. This, in turn, helped prevent oxidative stress and endothelial dysfunction in OVX rats. Additionally, E1 treatment reversed the increased total LDL cholesterol observed in the OVX group. The findings underscore protective effects of E1 on the cardiovascular system, counteracting OVX-related oxidative stress and endothelial dysfunction in Wistar rats. E1 exhibits promising therapeutic benefits for managing cardiovascular health, particularly in postmenopausal conditions.
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Affiliation(s)
- Thiago S Oliveira
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
- Department of Pharmacy, Laboratory of Experimental Pharmacology, FCBS, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, MG, Brazil
| | - Hericles M Campos
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Rafael M Costa
- Department of Pharmacology, Laboratory of Vascular Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
- School of Medicine, Federal University of Jataí, Jataí, Brazil
| | - Raphaela C Georg
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Jacqueline A Leite
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Rita C Tostes
- Department of Pharmacology, Laboratory of Vascular Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Elson A Costa
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Fernanda Cristina A Santos
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Núbia S Lobato
- School of Medicine, Federal University of Jataí, Jataí, Brazil
| | | | - Paulo César Ghedini
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil.
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Douxfils J, Morimont L, Gaspard U, Utian WH, Foidart JM. Estetrol is not a SERM but a NEST and has a specific safety profile on coagulation. Thromb Res 2023; 232:148-150. [PMID: 36130859 DOI: 10.1016/j.thromres.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Jonathan Douxfils
- University of Namur, Faculty of Medicine, Department of Pharmacy, Namur Research Institute for Life Sciences (NARILIS), Clinical Pharmacology Research Group, Namur, Belgium; Qualiblood sa, Namur, Belgium.
| | - Laure Morimont
- University of Namur, Faculty of Medicine, Department of Pharmacy, Namur Research Institute for Life Sciences (NARILIS), Clinical Pharmacology Research Group, Namur, Belgium; Qualiblood sa, Namur, Belgium
| | - Ulysse Gaspard
- Department of Obstetrics and Gynecology, University of Liège, Belgium
| | - Wulf H Utian
- Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Jean-Michel Foidart
- Estetra SRL, An affiliate's Company of Mithra Pharmaceuticals, Liège, Belgium; University of Liège, Liège, Belgium
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Eliyahu E, Katz MG, Vincek A, Freage-Kahn L, Ravvin S, Tal S, Grage H, Shtraizent N, Barak T, Arkush B. Effects of Hormone Replacement Therapy on Women's Lung Health and Disease. Pulm Ther 2023; 9:461-477. [PMID: 37815696 PMCID: PMC10721592 DOI: 10.1007/s41030-023-00240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023] Open
Abstract
This review provides an overview of menopausal hormone therapy and pulmonary disease risk, with a focus on the effect of hormone replacement therapy (HRT) on pulmonary function and its relation to lung diseases. This summary is based on authors' knowledge in the field of HRT and supplemented by a PubMed search using the terms "menopause hormone therapy," "asthma", "lung cancer", "chronic obstructive pulmonary disease", "lung function", and "pulmonary hypertension". Available evidence indicates that there is limited research on the role of sex hormones in the susceptibility, severity, and progression of chronic respiratory diseases. However, some studies suggest that the hormonal changes that occur during the menopausal transition may have an impact on pulmonary function and respiratory diseases. Women are in need of convenient access to a safe and effective modality for personalized HRT based on an artificial intelligence (AI)-driven platform that will enable them to receive personalized hormonal treatment through frequent, convenient, and accurate measurements of hormone levels in peripheral blood.
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Affiliation(s)
- Efrat Eliyahu
- Aveta.Life, Hoboken, NJ, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, Box 1030, New York, NY, 10029-6574, USA.
- Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Michael G Katz
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, Box 1030, New York, NY, 10029-6574, USA
- Department of Pediatric Cardiac Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam Vincek
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, Box 1030, New York, NY, 10029-6574, USA
| | | | - Shana Ravvin
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, Box 1030, New York, NY, 10029-6574, USA
| | - Smadar Tal
- Department of Animal Sciences, Tel-Hai College, Qiryat Shemona, Israel
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Katuwal S, Tapanainen J, Pukkala E. Multivariate analysis of independent roles of socioeconomic status, occupational physical activity, reproductive factors, and postmenopausal hormonal therapy in risk of breast cancer. Breast Cancer Res Treat 2022; 193:495-505. [PMID: 35366162 PMCID: PMC9090885 DOI: 10.1007/s10549-022-06571-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/12/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This case-control study assesses the independent roles of reproductive history, postmenopausal hormonal therapy (HT), socioeconomic status (SES), and occupational physical activity on the risk of breast cancer (BC). METHODS Odds ratios (OR) were estimated from conditional logistic multivariate regression model in a data set of 19,253 Finnish women diagnosed with BC between 1994 and 2013 and 96,265 age-matched population controls. RESULTS Both pre- and postmenopausal white-collar workers had significantly increased risk of ductal and lobular BC as compared to manual workers. Moderate occupational physical activity reduced risk of lobular BC by 14%. There was a transient increase in the risk of BC observed after each birth followed by a protective effect starting some years after the delivery. As the number of children increased, the short-term excess risk was lower and protective effect was observed earlier. Continuous estrogen-progestin therapy (EPT) significantly increased the risk of both ductal and lobular BC and the magnitude of risk was directly proportional to duration of use (OR for 5+ years of use 2.26, 95% confidence interval 2.12-2.42). Monthly EPT for 5+ years increased the risk (OR 1.32, 95% CI 1.20-1.45). Users of estradiol plus levonorgestrel intrauterine system devices showed ORs of 1.56 (95% CI 1.45-1.69) and 2.18 (95% CI 1.81-2.64) for ductal and lobular BC, respectively. CONCLUSION This study concludes that pregnancy has a dual effect on BC risk, with a transient increase in risk followed by a long-term protective effect. The SES and HT have a large effect on BC risk while occupational physical activity has only a small independent effect.
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Affiliation(s)
- Sushmita Katuwal
- Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - Juha Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Eero Pukkala
- Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.,Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Maignien C, Bourdon M, Marcellin L, Laguillier-Morizot C, Borderie D, Chargui A, Patrat C, Plu-Bureau G, Chapron C, Santulli P. Low serum progesterone affects live birth rate in cryopreserved blastocyst transfer cycles using hormone replacement therapy. Reprod Biomed Online 2021; 44:469-477. [PMID: 34980570 DOI: 10.1016/j.rbmo.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 01/25/2023]
Abstract
RESEARCH QUESTION Does serum progesterone concentration on the day of vitrified-warmed embryo transfer affect live birth rate (LBR) with hormonal replacement therapy (HRT) cycles? DESIGN Observational cohort study of patients (n = 915) undergoing single autologous vitrified-warmed blastocyst transfer under HRT using vaginal micronized progesterone. Women were included once, between January 2019 and March 2020. Serum progesterone concentration was measured by a single laboratory on the morning of embryo transfer. The primary end point was LBR. Univariate and multivariate logistic regression models were used for statistical analyses. RESULTS Median (25th-75th percentile) serum progesterone concentration on the day of embryo transfer was 12.5 ng/ml (9.8-15.3). The LBR was 31.5% (288/915) in the overall population. No significant differences were found in implantation rates (40.7% versus 44.9%); LBR was significantly lower in women with a progesterone concentration ≤25th percentile (≤9.8 ng/ml) (26.1% versus 33.2%, P = 0.045) versus women with a progesterone concentration >25th percentile. This correlated with a significantly higher early miscarriage rate (35.9% versus 21.6%, P = 0.005). After adjusting for potential confounding factors in multivariate analysis, low serum progesterone levels (≤9.8 ng/ml) remained significantly associated with lower LBR (OR 0.68 95% CI 0.48 to 0.97). CONCLUSION A minimum serum progesterone concentration is needed to optimize reproductive outcomes in HRT cycles with single autologous vitrified-warmed blastocyst transfer. Whether modifications of progesterone administration routes, dosage, or both, can improve pregnancy rates needs further study so that treatment of patients undergoing HRT cycles can be further individualized.
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Affiliation(s)
- Chloé Maignien
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Mathilde Bourdon
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Louis Marcellin
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Christelle Laguillier-Morizot
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Biological Endocrinology (Professor Guibourdenche), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Didier Borderie
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Automated Biological Diagnosis (Professor Borderie), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Ahmed Chargui
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Histology and Reproductive Biology (Professor Patrat), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Catherine Patrat
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Histology and Reproductive Biology (Professor Patrat), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Geneviève Plu-Bureau
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Equipe EPOPE, INSERM U1153
| | - Charles Chapron
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Pietro Santulli
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France.
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Szeliga A, Stefanowski B, Meczekalski B, Snopek M, Kostrzak A, Smolarczyk R, Bala G, Duszewska A, Smolarczyk K, Maciejewska-Jeske M. Menopause in women with schizophrenia, schizoaffective disorder and bipolar disorder. Maturitas 2021; 152:57-62. [PMID: 34674808 DOI: 10.1016/j.maturitas.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 01/07/2023]
Abstract
The transition to menopause, usually occurring between the ages of 40 and 55, is a time when women are particularly vulnerable. When preexisting mental illness is present, symptoms are often amplified during this period. Moreover, women with mental illnesses experience menopausal symptoms similarly to healthy women. In this narrative review we summarize the current data regarding menopause in women with schizophrenia, schizoaffective disorder, and bipolar disorder, as well as current standards of management and care. The management of chronic disease in women suffering from severe mental illness is also considered.
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Affiliation(s)
- Anna Szeliga
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Bogdan Stefanowski
- First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
| | - Milena Snopek
- First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Anna Kostrzak
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Roman Smolarczyk
- Department of Gynecological Endocrinology, Warsaw Medical University, 00-315 Warsaw, Poland
| | - Gregory Bala
- Appletree Medical Group, 2150 Robertson Rd., Ottawa, Ontario, Canada
| | - Anna Duszewska
- Division of Histology and Embryology, Department of Morphological Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Katarzyna Smolarczyk
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland.
| | - Marzena Maciejewska-Jeske
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
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Yariv O, Mutai R, Rotem O, Tsoref D, Korzets Y, Moore A, Shochat T, Yerushalmi R, Goldvaser H. The Impact of Exogenous Estrogen Exposure on the Characteristics and Outcome of Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early-Stage Breast Cancer. Oncology 2021; 99:713-721. [PMID: 34515186 DOI: 10.1159/000518183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The impact of exogenous estrogen exposure on breast cancer characteristics and outcomes is not well described. We aimed to investigate the effect of prior treatment with oral contraceptives (OCT), hormone replacement therapy (HRT), and fertility treatments on early-stage, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. METHODS This is a single-center retrospective cohort study comprising all women with ER-positive, HER2-negative, early breast cancer whose tumors were sent to Oncotype DX analysis between 2005 and 2012. Data on prior exposures to OCT, HRT, and fertility treatments were collected. The impact of these exposures on prespecified histopathological features was assessed including tumor size, nodal status, intensity of the hormonal receptors, grade, Oncotype recurrence score, Ki67, and lymphovascular and perineural invasion. The impact of these exposures on disease-free survival (DFS) and overall survival (OS) was also evaluated. RESULTS A total of 620 women were included, of which 19% had prior exposure to OCT, 30% to HRT, and 11% to fertility treatments. OCT use was associated with smaller (≤1 cm) tumors (p = 0.023) and were less likely to have grade 3 disease (p = 0.049). No other associations were found between exogenous estrogen exposure and tumor characteristics. Median follow-up was 10.4 years. Ten-year DFS was 85.7%, and it was not influenced by exogenous exposure. Ten-year OS was 90.2%, and OCT was associated with improved OS in univariate analysis (HR = 0.31, 95% CI: 0.11-0.85), but this difference did not remain significant in multivariate analysis (p = 0.275). CONCLUSION The impact of exogenous estrogen exposure on ER-positive, HER2-negative early breast cancer characteristics is limited. In the long term, none of the evaluated exposures had negative effect on DFS and OS.
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Affiliation(s)
- Orly Yariv
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel, .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
| | - Raz Mutai
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Rotem
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daliah Tsoref
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yasmin Korzets
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Assaf Moore
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.,Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tzippy Shochat
- Statistical Consulting Unit, Rabin Medical Center, Petah Tikva, Israel
| | - Rinat Yerushalmi
- Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Goldvaser
- Shaare Zedek Medical Center, Oncology Institute, Jerusalem, Israel.,The Faculty of Medicine, The Hebrew University, Jerusalem, Israel
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Christin-Maitre S, Givony M, Albarel F, Bachelot A, Bidet M, Blanc JV, Bouvattier C, Brac de la Perrière A, Catteau-Jonard S, Chevalier N, Carel JC, Coutant R, Donadille B, Duranteau L, El-Khattabi L, Hugon-Rodin J, Houang M, Grynberg M, Kerlan V, Leger J, Misrahi M, Pienkowski C, Plu-Bureau G, Polak M, Reynaud R, Siffroi JP, Sonigo C, Touraine P, Zenaty D. Position statement on the diagnosis and management of premature/primary ovarian insufficiency (except Turner Syndrome). Ann Endocrinol (Paris) 2021; 82:555-571. [PMID: 34508691 DOI: 10.1016/j.ando.2021.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Premature ovarian insufficiency (POI) is a rare pathology affecting 1-2% of under-40 year-old women, 1 in 1000 under-30 year-olds and 1 in 10,000 under-20 year-olds. There are multiple etiologies, which can be classified as primary (chromosomal, genetic, auto-immune) and secondary or iatrogenic (surgical, or secondary to chemotherapy and/or radiotherapy). Despite important progress in genetics, more than 60% of cases of primary POI still have no identifiable etiology; these cases are known as idiopathic POI. POI is defined by the association of 1 clinical and 1 biological criterion: primary or secondary amenorrhea or spaniomenorrhea of>4 months with onset before 40 year of age, and elevated follicle-stimulating hormone (FSH)>25IU/L on 2 assays at>4 weeks' interval. Estradiol level is low, and anti-Müllerian hormone (AMH) levels have usually collapsed. Initial etiological work-up comprises auto-immune assessment, karyotype, FMR1 premutation screening and gene-panel study. If all of these are normal, the patient and parents may be offered genome-wide analysis under the "France Génomique" project. The term ovarian insufficiency suggests that the dysfunction is not necessarily definitive. In some cases, ovarian function may fluctuate, and spontaneous pregnancy is possible in around 6% of cases. In confirmed POI, hormone replacement therapy is to be recommended at least up to the physiological menopause age of 51 years. Management in a rare diseases center may be proposed.
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Affiliation(s)
- Sophie Christin-Maitre
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France.
| | - Maria Givony
- French National Healthcare Network for Rare Endocrine Diseases (FIRENDO), AP-HP, Paris, France
| | - Frédérique Albarel
- Conception University Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Anne Bachelot
- Sorbonne University, Hôpital de la Pitié-Salpétrière, AP-HP, Paris, France
| | - Maud Bidet
- Clinique mutualiste La Sagesse, Rennes, France
| | - Jean Victor Blanc
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
| | | | | | | | | | | | | | - Bruno Donadille
- Sorbonne University, Hôpital St Antoine, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
| | - Lise Duranteau
- Saclay University, Hôpital du Kremlin-Bicêtre, AP-HP, Paris, France
| | - Laïla El-Khattabi
- Paris-Centre University, Hôpital Cochin Port-Royal, AP-HP, Paris, France
| | | | - Muriel Houang
- Sorbonne University, Hôpital Trousseau, AP-HP, Paris, France
| | - Michaël Grynberg
- Saclay University, Hôpital Antoine Béclère, AP-HP, Clamart, France
| | - Véronique Kerlan
- University of Brest, Centre Hospitalier Régional Universitaire, Brest, France
| | - Juliane Leger
- Paris-Centre University, Hôpital Robert Debré, AP-HP, Paris, France
| | | | | | | | - Michel Polak
- Paris Centre University, Hôpital Necker, AP-HP, Paris, France
| | | | | | - Charlotte Sonigo
- Saclay University, Hôpital Antoine Béclère, AP-HP, Clamart, France
| | - Phillipe Touraine
- Sorbonne University, Hôpital de la Pitié-Salpétrière, AP-HP, Paris, France
| | - Delphine Zenaty
- Paris-Centre University, Hôpital Robert Debré, AP-HP, Paris, France
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Hamdaoui N, Boubli L. [Management of side effects under hormonal replacement therapy in menopausal women: Abnormal uterine bleeding. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. Gynecol Obstet Fertil Senol 2021; 49:474-484. [PMID: 33757921 DOI: 10.1016/j.gofs.2021.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To publish, under the aegis of the French National College of Gynecologists and Obstetricians (CNGOF) and the Study Group on Menopause and Hormonal Aging (GEMVi), recommendations based on the evidence available in the literature for the management of abnormal uterine bleeding (AUB) in women taking hormonal replacement therapy (HRT). A review of the literature was performed by consulting Medline, Cochrane Library data as well as international recommendations in French and English up to September 1, 2020. RESULTS AUB occurring in a woman taking HRT (FIGO 2011) is one of the main factors of poor adherence to the HRT. AUB must seek an organic cause including endometrial cancer. The main functional causes of AUB in a woman taking HRT are resumption of ovarian activity, poor compliance, and trophic disorders of the endometrium. AUB are dependent on the type of HRT. In the event of AUB under HRT, it is suggested to perform a pelvic ultrasound at the end of the progestational sequence in the event of sequential HRT. In a single episode of AUB and when the ultrasound estimates the endometrial thickness less than or equal to 4mm, it is possible to postpone further uterine exploration. In case of recurrent AUB or when the endometrium thickness is greater than 4mm in a postmenopausal woman, additional uterine investigations (hysteroscopy and histology) are recommended. CONCLUSION AUB under HRT must seek an organic cause. The measurement of endometrial thickness by pelvic ultrasound is relevant for screening for endometrial cancer.
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Affiliation(s)
- N Hamdaoui
- Centre hospitalier universitaire Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrely, 13015 Marseille, France.
| | - L Boubli
- Centre hospitalier universitaire Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrely, 13015 Marseille, France
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Gamsjaeger S, Eriksen EF, Paschalis EP. Effect of hormone replacement therapy on bone formation quality and mineralization regulation mechanisms in early postmenopausal women. Bone Rep 2021; 14:101055. [PMID: 33850974 PMCID: PMC8022851 DOI: 10.1016/j.bonr.2021.101055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 10/26/2022] Open
Abstract
Post-menopausal osteoporosis is characterized by a negative imbalance between bone formation and bone resorption resulting in a net bone loss, increasing the risk of fracture. One of the earliest interventions to protect against this was hormonal replacement therapy (HRT). Bone strength depends on both the amount and quality of bone, the latter including compositional / material and structural properties. Bone compositional / material properties are greatly dependent on both patient-, and tissue-age. Raman spectroscopy is an analytical tool ideally suited for the determination of bone compositional / material properties as a function of tissue age as it is capable of analyzing areas ~1 × 1 μm2 in tetracycline labeled bone forming areas. Using such analysis of humeri from an ovariectomized primate animal model, we reported that loss of estrogen results in alteration in the mineralization regulation mechanisms by osteoid organic matrix attributes at actively forming bone surfaces. In the present work, we used Raman microspectroscopic techniques to compare osteoid and youngest mineralized tissue composition, as well as relationships between osteoid organic matrix quality and quality attributes of the earliest mineralized tissue in paired iliac crest biopsies obtained from early postmenopausal women before and after two years of HRT therapy. Significant correlations between osteoid proteoglycans, sulfated proteoglycans, pyridinoline, and earliest mineralized tissue mineral content were observed, suggesting that in addition to changes in bone turnover rates, HRT affects the osteoid composition, mineralization regulation mechanisms, and potentially fibrillogenesis.
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Affiliation(s)
- S Gamsjaeger
- Ludwig Boltzmann Institute for Osteology, at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - E F Eriksen
- Department of Clinical Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Institute of Clinical Medicine, Oslo University, Oslo, Norway
| | - E P Paschalis
- Ludwig Boltzmann Institute for Osteology, at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
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11
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Desai K, Almeida B, Miteva M. Understanding Hormonal Therapies: Overview for the Dermatologist Focused on Hair. Dermatology 2021; 237:786-791. [PMID: 33465769 DOI: 10.1159/000512888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/08/2020] [Indexed: 11/19/2022] Open
Abstract
Hormones have an intimate relationship with hair growth. Hormonal replacement therapy is used to treat menopausal symptoms and to provide protection from chronic diseases for which postmenopausal women may be at risk. Additionally, hormonal therapies are prescribed for contraception and treatment of acne. Considering the widespread use of such therapies, there is a demand for further understanding of their implications in hair disorders. This article reviews the specific properties of current estrogen- and progesterone-containing hormonal treatments and their implications for the patient with hair loss. The complexity of the task comes from the paucity of data and discrepancy in the literature on the effect of the specific hormonal-receptor activities.
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Affiliation(s)
- Karishma Desai
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA,
| | | | - Mariya Miteva
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Allen A, Mallahan S, Ortega A, Miller H, Saleh A, Bonny AE. Administration of Exogenous Hormones and the Implications for Cigarette Smoking-Related Behaviors. Curr Psychiatry Rep 2020; 22:70. [PMID: 33089443 DOI: 10.1007/s11920-020-01197-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Preclinical evidence indicates progesterone and estrogen influence drug-taking behaviors, including nicotine/tobacco. However, clinical research on this relationship is less clear. This lack of clarity may be due to measuring naturally occurring endogenous hormones to examine this relationship, which introduces substantial error. Therefore, the goal of this review is to examine the link between the delivery of exogenous hormones and cigarette smoking-related behavior. RECENT FINDINGS Exogenous progesterone may have favorable effects on cognition, symptomatology, consumption, and smoking cessation. Hormonal replacement therapy does not have a clear relationship with smoking-related behaviors. Oral contraceptive use may have adverse effects on stress response, nicotine metabolism, and symptomatology. Additional research is needed to explore how the administration of exogenous hormones may (a) strengthen research methodology on this topic, (b) enhance our understanding of the role of progesterone/estrogen on smoking-related behaviors, and (c) improve smoking cessation outcomes.
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Affiliation(s)
- Alicia Allen
- Department of Family and Community Medicine, College of Medicine, Tucson, University of Arizona, Tucson, AZ, 85721, USA.
| | - Stephanie Mallahan
- Department of Family and Community Medicine, College of Medicine, Tucson, University of Arizona, Tucson, AZ, 85721, USA
| | - Alexis Ortega
- Office of Equity, Diversity, and Inclusion, Health Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Heather Miller
- Department of Obstetrics and Gynecology, College of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Ahlam Saleh
- Health Sciences Library, University Libraries, University of Arizona, Tucson, AZ, 85721, USA
| | - Andrea E Bonny
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, OH, 43215, USA
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Archibugi L, Graglia B, Valente R, Stigliano S, Roberto M, Capalbo C, Marchetti P, Nigri G, Capurso G. Gynecological and reproductive factors and the risk of pancreatic cancer: A case-control study. Pancreatology 2020; 20:1149-54. [PMID: 32800645 DOI: 10.1016/j.pan.2020.07.398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/28/2020] [Accepted: 07/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND /Objectives: Pancreatic ductal adenocarcinoma (PDAC) has a higher incidence in men compared to women, although the difference in known risk factors cannot explain this disparity completely. Reproductive and hormonal factors have been demonstrated in pre-clinical studies to influence pancreatic carcinogenesis, but the few published data on the topic are inconsistent. The aim was to investigate the role of reproductive and hormonal factors on PDAC occurrence in women. METHODS We conducted a unicenter case-control study; PDAC cases were matched to controls by age with a 1:2 ratio. Risk factors were screened through questionnaires about gynecologic and medical history. Comparisons were made using Chi-square and Fisher's exact tests where appropriate for categorical variables and Student's t-test for continuous variables. Logistic regression was used to calculate Odds Ratios (ORs) and their 95% confidence intervals (CI). Multivariable logistic regression models were adjusted for potential confounders. RESULTS 253 PDAC and 506 matched controls were enrolled. At logistic regression multivariable analysis adjusted for confounding factors, older age at menopause (OR:0.95 per year; 95% CI:0.91-0.98; p = 0.007), use of Oral Contraceptives (OR:0.52; 95% CI:0.30-0.89; p = 0.018), use of Hormonal Replacement Therapy (OR:0.31; 95% CI:0.15-0.64; p = 0.001), and having had two children (OR:0.57; 95% CI:0.38-0.84; p = 0.005) were significant, independent protective factors for the onset of PDAC. CONCLUSIONS These data confirm some previous findings on menopause age and number of births while, to our knowledge, this is the first study to show a protective effect of HRT and OC use. The results collectively support the hypothesis that exposure to estrogens plays a protective role towards PDAC.
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Dias D, Esteves S, Andrade S, Maciel J, Cavaco D, Simões-Pereira J, Pereira MC. Is Gonadal Therapy a Promoter of Breast Cancer? Incidence of Breast Cancer in a Cohort of Survivors of Oncological Diseases Treated with Gonadal Steroids. Case Rep Oncol 2020; 13:347-357. [PMID: 32308603 PMCID: PMC7154255 DOI: 10.1159/000506395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 01/17/2023] Open
Abstract
There is a great controversy about hormonal replacement therapy in women among the members of the scientific community. Cancer survivors have sometimes had their ovary function totally or partially destroyed, thus affecting their development and quality of life. In this study, we were looking for adverse effects caused, eventually, by estroprogestative therapy in a cohort of supplemented survivors. The occurrence of breast cancer was our main concern. Ours is a retrospective study based on the clinical records of 174 survivors of several cancer diseases. Their median ages within each of the following time frames were: diagnosis − 22 years old; start of endocrine treatment − 26 years old, and duration of treatment − 12 years old. Evaluation was composed of breast cancer assessment, osteopenia and osteoporosis incidence, and vascular events. We have found a very low incidence of breast cancer as well as of vascular events. After treatment, a high percentage of our sample displayed bone mass improvement.
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Affiliation(s)
- Daniela Dias
- Endocrinology Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
| | - Susana Esteves
- Clinical Research Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
| | - Sónia Andrade
- Endocrinology Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
| | - Joana Maciel
- Endocrinology Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
| | - Daniela Cavaco
- Endocrinology Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
| | - Joana Simões-Pereira
- Endocrinology Department, Portuguese Cancer Institute of Lisbon, Lisbon, Portugal
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Commissaire M, Cédrin-Durnerin I, Peigné M. [Progesterone and frozen-thawed embryo transfer after hormonal replacement therapy for endometrial preparation: An update on medical practices]. ACTA ACUST UNITED AC 2019; 48:196-203. [PMID: 31778812 DOI: 10.1016/j.gofs.2019.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Indexed: 11/16/2022]
Abstract
Frozen-thawed embryo transfer (FET) has recently become the most frequently performed ART procedure. Many protocols for endometrial preparation are used, without any evidence-based superiority of one protocol above the others. Most French fertility centers mainly use hormonal replacement treatment (HRT) for endometrial preparation for organizational reasons. According to some studies, early pregnancy losses rate is higher with HRT endometrial preparation for FET than with other protocols, leading to new insights in improving outcomes into ART centers. There is a lack of consensual guidelines regarding the use of HRT for FET: there are various protocols, with different dosages, duration and routes for progesterone (PG) prescription. To date, the vaginal route is the most popular around the world as it gives higher intra-uterine concentration of PG because of the first uterine pass. However, recent scientific publications have pointed the importance of PG measurement in order to detect a lack of PG supplementation. Whatever the route of administration, it seems that a significant proportion of patients do not reach adequate PG concentrations for successful implantation and ongoing pregnancy. Timing of the measurement and ideal serum PG rate to reach are yet to be defined. What treatment strategy to adopt according to the results is still under investigation. Individualization of PG doses and routes of administration could lead to a decrease in miscarriages and better outcome.
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Affiliation(s)
- M Commissaire
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris Descartes, Paris, France.
| | - I Cédrin-Durnerin
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France
| | - M Peigné
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris 13, Bobigny, France
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Abstract
BACKGROUND Osteoporosis represents a common and severe complication in patients with anorexia nervosa (AN) that normally persists despite weight restoration and the resumption of regular menses. The condition may result in significant pain, injury, and disability. CASE PRESENTATION We report the only published case of a complete return to normal bone density following many years of severe osteoporosis in a severely malnourished patient with AN. We describe a patient with severe and enduring AN whose osteoporosis, with resultant fractures, was completely reversed. Available patient records, imaging, and laboratory data were evaluated. CONCLUSIONS This case represents a common yet often improperly treated complication of AN. It demonstrates the potential important clinical role that targeted medicines coupled with a multifaceted supplementation and lifestyle interventions, may have for some very malnourished patients with AN. Medications, in the treatment of osteoporosis in patients with severe AN, may decrease fracture risk, enhance overall bone density, and contribute to an improved quality of life.
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Affiliation(s)
- Pratibha Anand
- 1University of Colorado School of Medicine, Aurora, Colorado USA
| | - Philip S Mehler
- 1University of Colorado School of Medicine, Aurora, Colorado USA.,Eating Recovery Center of Denver, Denver, Colorado USA.,3ACUTE, Denver Health, Denver, Colorado USA
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17
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Gao Y, Yu B, Mao J, Wang X, Nie M, Wu X. Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis. BMC Endocr Disord 2018; 18:85. [PMID: 30453944 PMCID: PMC6245556 DOI: 10.1186/s12902-018-0313-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/05/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND After hormonal replacement therapy (HRT) including androgen replacement or sequential therapy of estrogen and progesterone, The combination of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) and pulsatile GnRH, is not sufficient to produce sufficient gametes in some patients with Congenital hypogonadotropic hypogonadism (CHH). A Systematic review and meta-analysis was performed to determine that assisted reproductive techniques (ART) can effectively treat different causes of infertility. METHODS To determine the effect of ART on fertility of CHH patients and investigate whether outcomes are similar to infertility due to other causes, we conducted a systematic review and meta-analysis of retrospective trials. Clinical trials were systematically searched in Medline, Embase, and the Cochrane central register of controlled trials databases. The keywords and major terms covered "hypogonadotropic hypogonadism", "kallmann syndrome", "assisted reproductive techniques", "intrauterine insemination", "intracytoplasmic sperm injection", "testicular sperm extraction", "in vitro fertilization", "embryo transplantation" and "intra-Fallopian transfer". RESULTS A total of 388 pregnancies occurred among 709 CHH patients who received ART (effectiveness 46, 95% confidence interval 0.39 to 0.53) in the 20 studies we included. The I2 in trials assessing overall pregnancy rate (PR) per embryo transfer (ET) cycle was 73.06%. Similar results were observed in subgroup analysis by different gender. Regression indicates pregnancy rate decreases with increasing age. Fertilization, implantation and live birth rates (72, 36 and 40%) showed no significant differences as compared to infertility due to other causes. CONCLUSIONS Despite CHH patients usually being difficult to generate gametes, their actual chances of fertility are similar to subjects with other non-obstructive infertility. ART is a suitable option for CHH patients who do not conceive after long-term gonadotropin treatment.
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Affiliation(s)
- Yinjie Gao
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
| | - Bingqing Yu
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
| | - Jiangfeng Mao
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
| | - Xi Wang
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
| | - Min Nie
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
| | - Xueyan Wu
- Key laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Wang Fu Jing St, Dongcheng district, Beijing, 100730 China
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Barahona-Garrido J, Camacho-Escobedo J, Cerda-Contreras E, Hernández-Calleros J, Yamamoto-Furusho JK, Torre A, Uribe M. Factors that influence outcome in non-invasive and invasive treatment in polycystic liver disease patients. World J Gastroenterol 2008; 14:3195-200. [PMID: 18506925 PMCID: PMC2712852 DOI: 10.3748/wjg.14.3195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease.
METHODS: Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006.
RESULTS: Forty-one patients (male, 7; female, 34), 47.8 ± 11.9 years age, and 5.7 ± 6.7 years follow-up, were studied. Alkaline phosphatase (AP) elevation (15% of patients) was associated with the requirement of invasive treatment (IT, P = 0.005). IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%, P = 0.002), and in women taking hormonal replacement therapy (HRT) (P = 0.001). Cysts complications (CC) were more frequent (22%) in the symptomatic patients group (P = 0.023). Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075). Abdominal pain was the most common symptom (56%) and indication for IT (78%). Nineteen patients (46%) required a first IT: 12 open fenestration (OF), 4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR). Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% (OF 16.7%, LF 25%, FHR 66.7%), and in the second IT in 66.7% (OF 100%). Follow-up mortality rate was 0.
CONCLUSION: Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI > 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.
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