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Hormone Replacement Therapy (hormone + replacement_therapy)
Selected AbstractsEffect of Teriparatide {rhPTH(1-34)} on BMD When Given to Postmenopausal Women Receiving Hormone Replacement TherapyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2006Louis G Ste-Marie Abstract The effects of teriparatide when given in combination with HRT were studied in postmenopausal women with low bone mass or osteoporosis. The data provide evidence that the adverse event profile for combination therapy with teriparatide + HRT together is consistent with that expected for each treatment alone and that the BMD response is greater than for HRT alone. Introduction: Teriparatide {rhPTH(1-34)}, given as a once-daily injection, activates new bone formation in patients with osteoporosis. Hormone replacement therapy (HRT) prevents osteoporosis by reducing bone resorption and formation. Combination therapy with these two compounds, in small clinical trials, increased BMD and reduced vertebral fracture burden. The purpose of this study was to determine whether teriparatide provided additional effect on BMD when given in combination with HRT. Materials and Methods: A randomized, double-blind, placebo-controlled study was conducted in postmenopausal women with either low bone mass or osteoporosis. Patients were randomized to placebo subcutaneous plus HRT (n = 125) or teriparatide 40 ,g/day (SC) plus HRT (TPTD40 + HRT; n = 122) for a median treatment exposure of 13.8 months. Approximately one-half of the patients in each group were pretreated with HRT for at least 12 months before randomization. Patients received 1000 mg calcium and 400,1200 IU of vitamin D daily as oral supplementation. BMD was measured by DXA. Results: Compared with HRT alone, TPTD40 + HRT produced significant (p < 0.001) increases in spine BMD (14% versus 3%), total hip (5.2% versus 1.6%), and femoral neck (5.2% versus 2%) at study endpoint. BMD, in whole body and ultradistal radius, was higher, and in the one-third distal radius was lower, in the combination therapy but not in the HRT group. Serum bone-specific alkaline phosphatase and urinary N-telopeptide/Cr were increased significantly (p < 0.01) in the women receiving TPTD40 + HRT compared with HRT. A similar profile of BMD and bone markers was evident in both randomized patients as well as in subgroups of patients not pretreated or pretreated with HRT. Patients tolerated both the treatments well. Nausea and leg cramps were more frequently reported in the TPTD40 + HRT group. Conclusions: Adding teriparatide, a bone formation agent, to HRT, an antiresorptive agent, provides additional increases in BMD beyond that provided by HRT alone. The adverse effects of teriparatide when added to HRT were similar to the adverse effects described for teriparatide administered alone. Whether teriparatide was initiated at the same time as HRT or after at least 1 year on HRT, the incremental increases over HRT alone were similar. [source] Effect of Hormone Replacement Therapy on Bone Quality in Early Postmenopausal WomenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2003Ep Paschalis PhD Abstract HRT is an effective prophylaxis against postmenopausal bone loss. Infrared imaging of paired iliac crest biopsies obtained at baseline and after 2 years of HRT therapy demonstrate an effect on the mineral crystallinity and collagen cross-links that may affect bone quality. Several studies have demonstrated that hormonal replacement therapy (HRT) is an effective prophylaxis against postmenopausal bone loss, although the underlying mechanisms are still debated. Infrared spectroscopy has been used previously for analyzing bone mineral crystallinity and three-dimensional structures of collagen and other proteins. In the present study, the technique of Fourier transform infrared microscopic imaging (FTIRI) was used to investigate the effect of estrogen on bone quality (arbitrarily defined as mineral/matrix ratio, mineral crystallinity/maturity, and relative ratio of collagen cross-links [pyridinoline/deH-DHLNL]) at the ultrastructural level, in mineralized, thin tissue sections from double (before and after administration of HRT regimen; cyclic estrogen and progestogen [norethisterone acetate]) iliac crest biopsy specimens from 10 healthy, early postmenopausal women who were not on any medication with known influence on calcium metabolism. FTIRI allows the analysis of undemineralized thin tissue sections (each image analyzes a 400 × 400 ,m2 area with a spatial resolution of ,6.3 mm). For each bone quality variable considered, the after-treatment data exhibited an increase in the mean value, signifying definite changes in bone properties at the molecular level after HRT treatment. Furthermore, these findings are consistent with suppressed osteoclastic activity. [source] 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,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2003LB Jensen MD Abstract 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 of the weight gain was a decline in physical fitness. Women opting for HRT had a significantly lower body weight at inclusion than the other participants, but the results in the self-selected part of the study followed the pattern found in the randomized part. The change in fat mass was the strongest predictor of bone changes in untreated women, whereas the change in lean body mass was the strongest predictor when HRT was given. Body weight increases after the menopause. The gain in weight is related to a decrease in working capacity. HRT is associated with a smaller increase in fat mass after menopause. Fat gain protects against bone loss in untreated women but not in HRT-treated women. The data suggest that women's attitudes to HRT are more positive if they have low body weight, but there is no evidence that the conclusions in this study are skewed by selection bias. [source] Influence of Hormone Replacement Therapy on the Accuracy of Screening MammographyTHE BREAST JOURNAL, Issue 2 2006María del Mar Vernet MD Abstract: The use of hormone replacement therapy (HRT) is currently a subject of debate because of the possibility of an increase in the incidence of breast cancer and difficulties associated with breast cancer detection. The objective of this study was to determine the influence of HRT on specificity and sensitivity in a breast cancer screening program. We found that although specificity was significantly lower in menopausal women who had ever used or were currently using HRT (93.3%) compared to HRT nonusers (94.8%) at the expense of a greater number of recalls (6.9% versus 5.6%), this difference seems to be clinically irrelevant. There were no significant differences with regard to the number of invasive procedures (2.5% in the HRT versus 2.1% in the control group). We conclude that the slight decrease in sensitivity of screening mammography in HRT users is not clinically significant in our setting, and in any case, false positives (recalled women) are diagnosed correctly with additional imaging studies without the need for invasive procedures. Most women given HRT are candidates to participate in population breast cancer screening campaigns., [source] Effects of Hormone Replacement Therapy on Heart Rate Variability in Postmenopausal WomenANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2001Aylin Yildirir M.D. Background: Hormone replacement therapy (HRT) is associated with reduced cardiovascular risk, but the underlying mechanism(s) are not fully understood. This study investigated the effects of a 6-month course of HRT on cardiac autonomic function parameters assessed by heart rate variability (HRV) in postmenopausal women. Methods: Forty-six healthy postmenopausal women (age 48 ± 5, range 40,60) with normal baseline electrocardiogram and negative exercise testing were enrolled. HRT, which was either 0.625 mg/day conjugated equine estrogen (CEE) plus 2.5 mg/day medroxyprogesterone acetate or 0.625 mg/day CEE alone were administered depending on hysterectomy status. Power spectral analysis of HRV was performed to calculate the low frequency component in absolute (LF) and normalized units (LF nu), high frequency component in absolute (HF), and normalized units (HF nu), and the LF/HF ratio. The standard deviation of RR intervals (SDNN) was calculated from the time series of RR intervals. Results: A 6-month course of HRT did not significantly alter resting heart rate (P > 0.05). The LF/HF ratio and LF nu significantly decreased after HRT (P = 0.022 and P = 0.032), whereas a significant increase was noted in the HF component of HRV (P = 0.043), indicating an improvement in cardiac autonomic function. The SDNN value, which was 28.8 ± 11.8 ms before HRT significantly increased to 35.4 ± 16.7 ms after 6 months (P = 0.011). Conclusion: Our results indicate that a 6-month course of HRT may significantly improve cardiac autonomic function parameters, a finding that could at least partly explain the potential cardiopro-tective effect(s) of HRT. A.N.E. 2001;6(4):280,284 [source] Hormone replacement therapy and headache prevalence in postmenopausal women.EUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2007The Head-HUNT study Conflicting evidence exists whether hormone replacement therapy (HRT) is a risk factor for headache. The aim of the study was to examine the prevalence of headache and migraine amongst postmenopausal women using HRT. In the Nord-Trøndelag Health Study 1995,97 (HUNT 2), 18 323 (62%) out of 29 679 women aged 40 years or more responded to headache questions (Head-HUNT). Amongst the 6007 postmenopausal women, 5507 (92%) responded to questions regarding use of HRT (2375 used or had used it) and questions related to headache (2407 had complaints). There was a significant association between headache and present use of HRT, both with local [odds ratio (OR) = 1.4, 95% confidence intervals (CI) 1.1,1.7] and systemic (OR = 1.6, 95% CI 1.4,1.9) application. This was found for non-migrainous headache (OR = 1.3, 95% CI 1.1,1.5) and migraine (OR = 1.6, 95% CI 1.4,1.9). Both migraine and non-migrainous headache were more probably amongst users of postmenopausal HRT than amongst those who had never used HRT. Whether HRT caused headache or was used partly because of headache cannot be determined in this cross-sectional study. [source] Estradiol enhances long term potentiation in hippocampal slices from aged apoE4-TR miceHIPPOCAMPUS, Issue 12 2007Sung Hwan Yun Abstract Hormone replacement therapy to treat or prevent Alzheimer Disease (AD) in postmenopausal women is controversial because it may pose other health risks such as cancer and thromboembolism. ApoE status is thought to influence the nootropic efficacy of hormone therapy, but findings are neither consistent nor well understood. We used a known in vitro memory model (long-term potentiation, LTP) in aged (24,27 month) female targeted replacement mice expressing human apoE3 or E4 to compare the effects of exogenous estradiol. Recording medial perforant path evoked field potentials in dentate gyrus of hippocampal slices, we found that both strains exhibited comparable basal synaptic transmission as assessed by input/output functions and paired pulse depression, and that these measures were not affected by estradiol. Vehicle-treated groups from both strains showed comparable LTP. Estradiol had no effect on LTP in apoE3-TR, but selectively increased LTP magnitude in apoE4-TR. The estradiol induced enhancement of LTP in aged female apoE4-TR is consistent with recent clinical observations that estrogen replacement decreases AD risk in some women with apoE4. Elucidating the mechanism of this selective enhancement may lead to more informed treatment decisions as well as to the development of safer alternatives to hormone therapy. © 2007 Wiley-Liss, Inc. [source] Effect of Teriparatide {rhPTH(1-34)} on BMD When Given to Postmenopausal Women Receiving Hormone Replacement TherapyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2006Louis G Ste-Marie Abstract The effects of teriparatide when given in combination with HRT were studied in postmenopausal women with low bone mass or osteoporosis. The data provide evidence that the adverse event profile for combination therapy with teriparatide + HRT together is consistent with that expected for each treatment alone and that the BMD response is greater than for HRT alone. Introduction: Teriparatide {rhPTH(1-34)}, given as a once-daily injection, activates new bone formation in patients with osteoporosis. Hormone replacement therapy (HRT) prevents osteoporosis by reducing bone resorption and formation. Combination therapy with these two compounds, in small clinical trials, increased BMD and reduced vertebral fracture burden. The purpose of this study was to determine whether teriparatide provided additional effect on BMD when given in combination with HRT. Materials and Methods: A randomized, double-blind, placebo-controlled study was conducted in postmenopausal women with either low bone mass or osteoporosis. Patients were randomized to placebo subcutaneous plus HRT (n = 125) or teriparatide 40 ,g/day (SC) plus HRT (TPTD40 + HRT; n = 122) for a median treatment exposure of 13.8 months. Approximately one-half of the patients in each group were pretreated with HRT for at least 12 months before randomization. Patients received 1000 mg calcium and 400,1200 IU of vitamin D daily as oral supplementation. BMD was measured by DXA. Results: Compared with HRT alone, TPTD40 + HRT produced significant (p < 0.001) increases in spine BMD (14% versus 3%), total hip (5.2% versus 1.6%), and femoral neck (5.2% versus 2%) at study endpoint. BMD, in whole body and ultradistal radius, was higher, and in the one-third distal radius was lower, in the combination therapy but not in the HRT group. Serum bone-specific alkaline phosphatase and urinary N-telopeptide/Cr were increased significantly (p < 0.01) in the women receiving TPTD40 + HRT compared with HRT. A similar profile of BMD and bone markers was evident in both randomized patients as well as in subgroups of patients not pretreated or pretreated with HRT. Patients tolerated both the treatments well. Nausea and leg cramps were more frequently reported in the TPTD40 + HRT group. Conclusions: Adding teriparatide, a bone formation agent, to HRT, an antiresorptive agent, provides additional increases in BMD beyond that provided by HRT alone. The adverse effects of teriparatide when added to HRT were similar to the adverse effects described for teriparatide administered alone. Whether teriparatide was initiated at the same time as HRT or after at least 1 year on HRT, the incremental increases over HRT alone were similar. [source] Risk of hormone replacement therapy in stroke patientsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2000Damczyk BSc Hormone replacement therapy (HRT) (oestrogen with or without progestin) is often initiated with the onset of menopause to decrease symptoms of oestrogen deficiency, such as vasomotor instability (hot flashes) and urogenital effects ( 1,3). HRT can also prevent long-term consequences of oestrogen deficiency, such as osteoporosis and cardiovascular disease ( 1,3). The decision to start HRT in peri- and postmenopausal women is complicated by concerns of increased risk for thromboembolic events, uterine cancer and breast cancer ( 2,4). Thromboembolic stroke is a particular concern due to its association with the use of oral contraceptives with high oestrogen content ( 3, 4). However, for older women it has been suggested that HRT use decreases or has no effect on stroke risk ( 5,9). Should these findings apply to a women with a history of thromboembolism, in this case ischemic stroke? [source] Hormone replacement therapy and cardiovascular disease: increased risks of venous thromboembolism and stroke, and no protection from coronary heart diseaseJOURNAL OF INTERNAL MEDICINE, Issue 5 2004G. D. O. Lowe Abstract. Hormone replacement therapy (HRT) was increasingly promoted over the last 40 years to improve quality of life, and to reduce the risks of osteoporotic fractures and coronary heart disease (CHD). In recent years, observational studies, randomized trials and systematic reviews of such trials have shown that HRT does not reduce, but actually increases cardiovascular risk. HRT increases the relative risks of venous thromboembolism (twofold), and of fatal or disabling stroke (by 50%); whilst increasing the early risk of myocardial infarction and having no protective effect against CHD on longer term use. Possible mechanisms for these increased cardiovascular risks include down-regulation of several inhibitory pathways of blood coagulation, resulting in increased coagulation activation, which promotes venous and arterial thrombosis. The implications for prescription are discussed, as are lessons for future evaluation of health care interventions. [source] A Clinician's Guide to Under standing the DilemmaNURSING FOR WOMENS HEALTH, Issue 2 2000JANICE DEMASTERS PHD As women approach menopause, they face a dilemma that can affect their health for the rest of their lives: choosing whether hormone replacement therapy (HRT) is right for them (Miller & Franklin, 1999). Hormone replacement therapy is typically prescribed in the short-term for the treatment of menopausal symptoms and for longer periods of time to reduce the risk of osteoporosis, heart disease, and Alzheimer's disease,all of which increase both in incidence and in prevalence in postmenopause (Brinton, 1999; Burki, 1999; Merrill & Verbrugge, 1999; Waring et al., 1999; Writing Group for the PEPI Trial, 1995). [source] Herba Epimedii water extract elevates estrogen level and improves lipid metabolism in postmenopausal womenPHYTOTHERAPY RESEARCH, Issue 9 2008Fang-Fang Yan Abstract Hormone replacement therapy (HRT) can ameliorate lipid metabolism after menopause, but it is not suitable for long-term use because of serious side effects. Herba Epimedii is a widely used herbal medicine in many Asian countries, it potentially treats menopausal syndrome and its complications with few side effects and good curative effects. The study aimed to evaluate the effects of Herba Epimedii water extract on blood lipid and sex hormone levels. Ninety subjects were randomly divided into two groups: a trial group which received Herba Epimedii water extract and a control group which was administered an equal amount of water placebo. At the baseline and after 6 months of medication, serum estradiol (E2), progesterone (P), testosterone (T), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) concentrations were measured. The results indicated that Herba Epimedii water extract decreased the TC and TG levels (p < 0.01). Furthermore, Herba Epimedii water extract significantly increased the serum level of E2 (p < 0.01) compared with the pre-treatment level. In conclusion, Herba Epimedii water extract produces its beneficial actions in postmenopausal women. Copyright © 2008 John Wiley & Sons, Ltd. [source] Cytokine Changes in Postmenopausal Women Treated with Estrogens: a Placebo-controlled StudyAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2002GÖRAN BERG PROBLEM:,Hormone replacement therapy (HRT) is being increasingly used in postmenopausal women. Sex steroids are known to affect the immune system in several ways, although this is mainly based on clinical observations and experimental studies. METHOD OF STUDY:,We studied the in vivo effects of transdermal estrogens (50 ,g 17 ,-Estradiol/24 hr) on cytokine production in postmenopausal women. A total of 17 women were randomized to either placebo (n=7) or active estrogen therapy (n=10) for 14 weeks, with addition of oral medoxyprogesterone acetate 10 mg daily during the last 2 weeks in both groups. Secretion of the cytokines IFN-,, IL-4, IL-10 and IL-6 in blood mononuclear cells was determined, spontaneously and after stimulation with common vaccination antigens and mitogen, using the cell ELISA technique. RESULTS:,IL-6 production after stimulation with purified protein derivate (PPD) decreased in the estrogen treated group (P < 0.01). Mitogen-induced IL-6 production was reduced in the estrogen treated group in contrast to an increase in the placebo group, leading to a significant difference (P < 0.01) between the groups after 12 weeks of treatment. This difference was eliminated after an addition of progestagens for 2 weeks. No significant changes were noted for IFN-,, IL-4 or IL-10 in relation to estrogen or placebo treatment. CONCLUSIONS:,In the present controlled study, the main in vivo effect of estrogens was a decrease in IL-6 production, indicating a possible beneficial effect of estrogen therapy. [source] Effects of Hormone Replacement Therapy on Heart Rate Variability in Postmenopausal WomenANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2001Aylin Yildirir M.D. Background: Hormone replacement therapy (HRT) is associated with reduced cardiovascular risk, but the underlying mechanism(s) are not fully understood. This study investigated the effects of a 6-month course of HRT on cardiac autonomic function parameters assessed by heart rate variability (HRV) in postmenopausal women. Methods: Forty-six healthy postmenopausal women (age 48 ± 5, range 40,60) with normal baseline electrocardiogram and negative exercise testing were enrolled. HRT, which was either 0.625 mg/day conjugated equine estrogen (CEE) plus 2.5 mg/day medroxyprogesterone acetate or 0.625 mg/day CEE alone were administered depending on hysterectomy status. Power spectral analysis of HRV was performed to calculate the low frequency component in absolute (LF) and normalized units (LF nu), high frequency component in absolute (HF), and normalized units (HF nu), and the LF/HF ratio. The standard deviation of RR intervals (SDNN) was calculated from the time series of RR intervals. Results: A 6-month course of HRT did not significantly alter resting heart rate (P > 0.05). The LF/HF ratio and LF nu significantly decreased after HRT (P = 0.022 and P = 0.032), whereas a significant increase was noted in the HF component of HRV (P = 0.043), indicating an improvement in cardiac autonomic function. The SDNN value, which was 28.8 ± 11.8 ms before HRT significantly increased to 35.4 ± 16.7 ms after 6 months (P = 0.011). Conclusion: Our results indicate that a 6-month course of HRT may significantly improve cardiac autonomic function parameters, a finding that could at least partly explain the potential cardiopro-tective effect(s) of HRT. A.N.E. 2001;6(4):280,284 [source] Sex steroids, ANGELS and osteoporosisBIOESSAYS, Issue 3 2003Jonathan G. Moggs Osteoporosis is characterized by reduced bone density and strength. Bone mass peaks between age 30 and 40 and then declines. This can be accelerated by factors including menopause and insufficient dietary calcium. Hormone replacement therapy (HRT) is currently the standard treatment for osteoporosis. However, growing concern over potential side effects of HRT has driven a search for alternative therapies. A recent report1 reveals a potential alternative to HRT: a gender-neutral synthetic steroid that increases bone mass and strength without affecting reproductive organs. This compound acts via a novel extranuclear sex steroid receptor signaling mechanism that has important implications for nuclear receptor biology and human health. BioEssays 25:195,199, 2003. © 2003 Wiley Periodicals, Inc. [source] Hormone replacement therapy and lung cancer risk in ChineseCANCER, Issue 8 2007Kuan-Yu Chen MD Abstract BACKGROUND. The association between hormone replacement therapy (HRT) and a reduced lung cancer risk has been reported in previous studies. There is a high female to male ratio in Chinese lung cancer patients, and female patients have different clinicopathological characteristics compared with Western patient populations. The authors investigated whether HRT may reduce lung cancer risk in Taiwan. METHODS. The authors used a case-control study design to investigate 826 women with lung cancer and 531 healthy controls. Personal interviews based on a structured questionnaire were performed to collect information on HRT use of at least 3 months, age, ethnicity, active and passive smoking, exposure to air pollution, cooking or incense fumes, body mass index (BMI), menopause, and family history of cancers. RESULTS. HRT use was associated with reduced lung cancer risk with a multivariate, adjusted odds ratio of 0.70 (95% CI, 0.53,0.94; P = .019). HRT use was associated with reduced odds ratio of lung cancer in all subset analyses stratified by histology, active and passive cigarette smoking, BMI, history of incense burning, cooking, and motorcycle riding, as well as family history of certain cancers. CONCLUSIONS. This study confirmed that HRT is associated with a reduced lung cancer risk. The results appeared to be applicable to Chinese female population groups. Cancer 2007. © 2007 American Cancer Society. [source] Hormone replacement therapy: current controversiesCLINICAL ENDOCRINOLOGY, Issue 5 2003I. B. Orija No abstract is available for this article. [source] Oestradiol and SERM treatments influence oestrogen receptor coregulator gene expression in human skeletal muscle cellsACTA PHYSIOLOGICA, Issue 3 2009C. M. Dieli-Conwright Abstract Aim:, Oestrogen receptors (ER) are present in human skeletal muscle (hSkM) cells; however, the function of the receptor is currently unknown. We investigated the influence of oestradiol and selective ER modulators [tamoxifen (TAM), raloxifene (RAL)] on ER coregulator mRNA expression in hSkM. Methods:, Human skeletal muscle cells were treated with 10 nm oestradiol, 5 ,m TAM and 10 ,m RAL over a 24-h period. Following the treatment period, mRNA expression was quantified using real-time PCR to detect changes in ER-,, ER-,, steroid receptor coactivator (SRC), silencing mediator for retinoid and thyroid hormone receptors (SMRT), MyoD, GLUT4 and c-fos. Results:, ER-, mRNA expression increased with all three drug treatments (P < 0.05) while there was no change in mRNA expression of ER-, in hSkM cells. mRNA expression of SRC increased and SMRT decreased with oestradiol, TAM and RAL in hSkM cells (P < 0.05). Importantly, mRNA expression of MyoD increased with oestradiol and decreased with TAM and RAL in hSkM cells (P < 0.05). mRNA expression of GLUT4 increased with oestradiol and RAL and decreased with TAM in hSkM cells (P < 0.05). Conclusions:, These findings are novel in that they provide the first evidence that oestradiol and selective ER modulators influence ER-, function in hSkM cells. This demonstrates the importance of the ER and alterations in its coregulators, to potentially prevent sarcopenia and promote muscle growth in postmenopausal women using these forms of hormone replacement therapy. [source] O-10 Endometrial cells in cervical smears: cytological features associated with clinically significant endometrial pathologyCYTOPATHOLOGY, Issue 2007R. N. Tiam Introduction:, To establish the significance of cytological features which could predict clinically significant endometrial pathology, and therefore guide reporting practice in cervical samples. Methods:, A retrospective review of SurePath liquid-based cytology (LBC) cervical samples between 2002 and 2006, obtained at screening and colposcopy. These smears contained normal endometrial cells present at inappropriate times of the menstrual cycle, endometrial cells with atypia (borderline change) and with features suspicious / diagnostic of endometrial carcinoma (glandular neoplasia). False negative and false positive cases detected on subsequent histology were also included. The control group comprised negative samples and a few abnormal smears. All smears were randomly assigned and blinded to menopausal status, age, use of oral contraceptive pill and hormone replacement therapy and presence of intrauterine device. Each smear was reviewed for 16 cytologic criteria and a cytological diagnosis was given for each. Results:, A total of 219 smears were available for review; 137 were negative, out of which 85 contained normal endometrial cells, 41 contained endometrial cells with atypia, 10 contained endometrial cells with features suggestive of adenocarcinoma and 31 contained endometrial cells with features diagnostic of adenocarcinoma. The feature most associated with benign endometrial cells is top hat with central cell condensation. In contrast, the features associated with malignant endometrial cells are smooth nuclear membrane, pale chromatin, small nucleoli and scalloped borders. Discussion:, The criteria identified in this study do not definitively define a neoplastic process, but appear to be helpful in individual cases. This study emphasises that endometrial changes should be always interpreted with the relevant clinical information, which would otherwise lead to overdiagnosis in premenopausal women. [source] Metabolic, endocrine and haemodynamic risk factors in the patient with peripheral arterial diseaseDIABETES OBESITY & METABOLISM, Issue 2002Jill J. F. Belch The morbidity and mortality associated with peripheral arterial disease (PAD) creates a huge burden in terms of costs both to the patient and to the health service. PAD is a deleterious and progressive condition that causes a marked increase in the risk of cardiovascular and cerebrovascular events. Further, PAD has a major negative impact on quality of life and mortality, and is associated with an increased risk of limb amputation. The clinical profile of patients at risk of PAD overlaps considerably with the known cardiovascular risk factors. These include, increasing age, smoking habit, diabetes, hypertension, dyslipidaemia, male sex and hyperhomocysteinaemia. For women, hormone replacement therapy appears to be associated with a reduced risk of PAD. Published PAD guidelines recommend aggressive management of risk factors, stressing the importance of lifestyle modification, antiplatelet agents, treating dyslipidaemia and diabetes. However, a large number of patients with PAD go undetected, either because they do not report their symptoms or because they are asymptomatic. It is therefore important to improve detection rates so that these patients can receive appropriate risk factor management. [source] The benefits of oestrogens on postprandial lipid metabolism are lost in post-menopausal women with Type 2 diabetesDIABETIC MEDICINE, Issue 7 2006M. G. Masding Abstract Aims, Women with Type 2 diabetes appear to lose the protection against cardiovascular disease (CVD) afforded by oestrogens. We examined the effects of oestrogen hormone replacement therapy (HRT) on postprandial clearance of dietary fat in non-diabetic and diabetic post-menopausal women. Methods, In a cross-sectional study, fasting subjects [HRT+ and HRT, control and diabetic women; Type 2 diabetes (DM) HRT+n = 8, DM HRT,n = 14, control HRT+n = 7, control HRT,n = 11] consumed a meal containing the stable isotope 1,1,1,[13]C-tripalmitin, with blood and breath sampled for 6 and 24 h, respectively, in the postprandial period. Results, In diabetic women, there were no differences between the HRT+ and HRT, groups for any of these parameters. In contrast, in HRT+ compared with HRT, control women, the triglyceride (TG) area under the curve was lower [AUC; HRT+ median (range) 7.7 (4.1, 12.8) mmol/l per 6 h, HRT, 9.7 (3.9, 18.5) mmol/l per 6 h, P < 0.05] and [13]C-palmitic acid in the TG fraction was also lower [HRT+ 23.2 (10.3, 41.3) ng/ml per 6 h, HRT, 47.7 (12.6, 77.2) ng/ml per 6 h, P < 0.05], suggesting the lower postprandial triglyceridaemia associated with HRT in non-diabetic women is because of better chylomicron clearance. Conclusions, The oestrogen-associated advantage in clearance of dietary lipid we observed in non-diabetic post-menopausal women is not seen in post-menopausal diabetic women. This is likely to promote an atherogenic lipoprotein profile and may contribute to the loss of CVD protection seen in diabetic women. [source] Cytohormonal and morphological alterations in cervicovaginal smears of postmenopausal women on hormone replacement therapyDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2006Sanjay Gupta M.D. Abstract The objective of the study was to study the cytohormonal and morphological alterations in cervicovaginal smears associated with the use of hormone replacement therapy (HRT) and to assess the utility of vaginal cytology in determining the response to HRT. Ninety postmenopausal women (30 on estrogen,progesterone combination (HRT) for 1 to 24 mo (user 1), 30 on estrogen therapy (ERT) for 1 to 44 mo (user 2), and 30 not on any hormones (nonusers)) were included in the cross-sectional study. Their lateral vaginal wall smears and cervical smears were examined for hormonal and morphological assessments, respectively. The smear pattern showed predominance of parabasal cells in 46.6% of nonusers, while none of the users had >70% parabasal cells. A high percentage (>70%) of intermediate cells was found in 46.6% of users and only in 16.6% of nonusers. A high maturation value (MV) was found in more than 75% of users but in only 16.6% of nonusers. The women with high MV (>50) were significantly less symptomatic than did nonusers. Atrophic changes were present in cervical smears of 14/20 (46.6%) nonusers when compared with 1/60 (1.66%) users. Atypical squamous cells of undetermined significance (ASC-US) were diagnosed in seven users and three nonusers. It persisted on follow-up in four users and one nonuser. Histology revealed one mild dysplasia among users. Lactobacilli were more frequently observed in users. The cytohormonal pattern on vaginal smears correlates well with the response to hormonal therapy and clinical symptoms. Awareness of the morphological alterations associated with the use of replacement hormones would enable the cytologists to reduce the false-positive diagnoses while evaluating postmenopausal smears. Diagn. Cytopathol. 2006;34:676,681. © 2006 Wiley-Liss, Inc. [source] Endogenous estrogen status, but not genistein supplementation, modulates 7,12-dimethylbenz[a]anthracene-induced mutation in the liver cII gene of transgenic big blue rats,ENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 5 2005Tao Chen Abstract A growing number of studies suggest that isoflavones found in soybeans have estrogenic activity and may safely alleviate the symptoms of menopause. One of these isoflavones, genistein, is commonly used by postmenopausal women as an alternative to hormone replacement therapy. Although sex hormones have been implicated as an important risk factor for the development of hepatocellular carcinoma, there are limited data on the potential effects of the estrogens, including phytoestrogens, on chemical mutagenesis in liver. Because of the association between mutation induction and the carcinogenesis process, we investigated whether endogenous estrogen and supplemental genistein affect 7,12-dimethylbenz[a]anthracene (DMBA)-induced mutagenesis in rat liver. Intact and ovariectomized female Big Blue rats were treated with 80 mg DMBA/kg body weight. Some of the rats also received a supplement of 1,000 ppm genistein. Sixteen weeks after the carcinogen treatment, the rats were sacrificed, their livers were removed, and mutant frequencies (MFs) and types of mutations were determined in the liver cII gene. DMBA significantly increased the MFs in liver for both the intact and ovariectomized rats. While there was no significant difference in MF between the ovariectomized and intact control animals, the mutation induction by DMBA in the ovariectomized groups was significantly higher than that in the intact groups. Dietary genistein did not alter these responses. Molecular analysis of the mutants showed that DMBA induced chemical-specific types of mutations in the liver cII gene. These results suggest that endogenous ovarian hormones have an inhibitory effect on liver mutagenesis by DMBA, whereas dietary genistein does not modulate spontaneous or DMBA-induced mutagenesis in either intact or ovariectomized rats. Environ. Mol. Mutagen., 2005. Published 2005 Wiley-Liss, Inc. [source] Hormone replacement therapy and headache prevalence in postmenopausal women.EUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2007The Head-HUNT study Conflicting evidence exists whether hormone replacement therapy (HRT) is a risk factor for headache. The aim of the study was to examine the prevalence of headache and migraine amongst postmenopausal women using HRT. In the Nord-Trøndelag Health Study 1995,97 (HUNT 2), 18 323 (62%) out of 29 679 women aged 40 years or more responded to headache questions (Head-HUNT). Amongst the 6007 postmenopausal women, 5507 (92%) responded to questions regarding use of HRT (2375 used or had used it) and questions related to headache (2407 had complaints). There was a significant association between headache and present use of HRT, both with local [odds ratio (OR) = 1.4, 95% confidence intervals (CI) 1.1,1.7] and systemic (OR = 1.6, 95% CI 1.4,1.9) application. This was found for non-migrainous headache (OR = 1.3, 95% CI 1.1,1.5) and migraine (OR = 1.6, 95% CI 1.4,1.9). Both migraine and non-migrainous headache were more probably amongst users of postmenopausal HRT than amongst those who had never used HRT. Whether HRT caused headache or was used partly because of headache cannot be determined in this cross-sectional study. [source] Effects of oestrogen replacement therapy on pattern reversal visual evoked potentialsEUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2000H. Yilmaz As a result of a regression in the ovarian functions, oestrogen level in circulation during the menopause drops to 1/50 of its value in the normal reproductive cycle. Excitatory oestrogen increases the sensitivity of the central nervous system to catecholamines by changing the opening frequency of voltage-related L-type calcium channels and augmenting the effect of glutamate; in addition it inhibits the formation of gamma-amino butyric acid (GABA) by the inhibition of glutamate decarboxylase enzyme. It is argued that oestrogen increases transmission in the optic pathways and that oestrogen is responsible for the shorter latency values and higher amplitudes of visual evoked potentials in women. We recorded the monocular pattern reversal visual evoked potentials (PRVEP) of both eyes of 54 post-menopausal women before treatment and of 30 of them after replacement therapy with Tibolon, and of 24 women receiving placebo treatment. The explicit values of P100 latency of right and left eyes before treatment were 98.8 ± 3.5 and 99.0 ± 3.3 ms, respectively. The explicit values of P100 latency of right and left eyes after placebo treatment were 98.6 ± 3.7 and 98.8 ± 4.0, respectively. The explicit values of P100 latency of right and left eyes after replacement treatment were 94.6 ± 3.7 and 94.8 ± 4.0, respectively. We found a statistically significant decrease in the mean PRVEP latencies and a statistically significant increase in mean amplitudes after replacement treatment (P < 0.001) compared with those before treatment and those after placebo treatment. We attributed the changes in PRVEP values after replacement treatment to the action of Tibolon, which acted as a natural sex steroid and speeded the visual transmission time via the widespread receptors in the central nervous system. It is concluded that PRVEP is an objective electrophysiological assessment method in evaluating the efficiency of hormone replacement therapy in post-menopausal women. [source] Heart Rate and its Variability Change After the MenopauseEXPERIMENTAL PHYSIOLOGY, Issue 3 2000C. L. Brockbank Resting heart rate and heart rate variability of 33 postmenopausal women were compared with those of 50 premenopausal women of comparable activity level, none of whom had used hormone replacement therapy. Heart rate was measured as the mean of at least 600 consecutive R-R intervals obtained from electrocardiograph (ECG) records, and its variability as the standard deviation of these intervals. Activity levels were assessed by a scale modified from the Allied Dunbar National Fitness Survey (1992). There was a significant reduction in both mean R-R interval and the standard deviation in the postmenopausal women who had experienced their last menstrual period (LMP) 1 year or more prior to the observations being made, but no observable changes during the first year post menopause. [source] Evidences of the gender-related differences in cardiac repolarization and the underlying mechanisms in different animal species and humanFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2006Jianhua Cheng Abstract Clinical and experimental studies have shown that gender differences exist in cardiac repolarization in various animal species and human, as is evidenced by significantly longer QT, JT intervals and action potential duration in females than in males due to a reduced repolarization reserve in females. The latter is shown by the relatively greater increase in ventricular repolarization and higher incidence of torsades de pointes (TdP) in preparations from females by drugs blocking repolarizing K+ currents. These results can be modulated by gonadectomy, suggesting that gonadal steroids are important determinants of gender difference in repolarization. In human subjects, QT and JT intervals are longer in women, whereas QT dispersion and Tp-e interval (the interval from the peak to the end of T wave) are longer in men. At slow heart rates greater prolongation in QT and increase in transmural repolarization heterogeneity (i.e. increase in Tp-e) may predispose to TdP tachycardias in women. In healthy postmenopausal women, hormone replacement therapy with estrogen alone usually produced a prolongation of QT interval, while estrogen plus progesterone had no significant effects on QT interval but reduced QT dispersion. Along with these, there are still conflicting data reported. Further work is needed before the elucidation of the basis of gender differences in ventricular repolarization. [source] Patient and clinician collaboration in the design of a national randomized breast cancer trialHEALTH EXPECTATIONS, Issue 1 2004Jo Marsden MD FRCS (Gen Surgery) Abstract Objective, To show breast cancer patient involvement in the design of a national randomized trial of hormone replacement therapy (HRT) in symptomatic patients will increase accrual. Setting and participants, Three stakeholder groups [(1) researchers from the Lynda Jackson Macmillan Centre, (2) the Consumers' Advisory Group for Clinical Trials (CAG-CT), (3) clinicians responsible for a pilot randomized HRT study in breast cancer patients] developed this collaborative study. Methods, (1) Nine focus group discussions were conducted to identify issues relevant to breast cancer patients about HRT and a national trial: six involved women from breast cancer support groups nationwide and three patients who had previously participated in the pilot randomized HRT study. (2) Recommendations from the focus groups (analysed by Grounded Theory) were debated by the research stakeholders and focus group representatives at a 1-day meeting and consensus reached (using a voting system) on mutual priorities for incorporation into the design of a national HRT trial. (3) Representatives from the CAG-CT and focus groups participated in subsequent national HRT steering committee meetings to ensure that these priorities were accounted for and the resulting trial design summary was circulated to the CAG-CT and all focus group representatives for comment. Results, Focus groups demonstrated that the complexity of factors relating to trial participation was not just restricted to the research topic in question. Patient,clinician interaction provided a platform for negotiating potential conflicts over trial design and outcomes. Patient feedback suggested that mutually agreed priorities were accounted for in the trial design. Interpretation, Clinical research planning should involve all research stakeholders at the outset. Quantifying the impact of patient involvement in terms of trial accrual may be too simple given the complexity of their motivations for participating in trials. [source] Comment on interaction of hormone replacement therapy with calcium and vitamin D supplementation on colorectal cancer riskINTERNATIONAL JOURNAL OF CANCER, Issue 7 2009Ivanka Stajner No abstract is available for this article. [source] HMG-CoA reductase expression in breast cancer is associated with a less aggressive phenotype and influenced by anthropometric factorsINTERNATIONAL JOURNAL OF CANCER, Issue 5 2008Signe Borgquist Abstract Although several studies have reported on the anti-tumoural properties exerted by 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoAR) inhibitors (statins), the in vivo expression of HMG-CoAR in human cancer has been considerably less investigated. In our study, we examined the immunohistochemical expression of HMG-CoAR in 511 incident breast cancers within the Malmö Diet and Cancer Study in order to explore its relationship to established clinicopathological and tumour biological parameters. Furthermore, the potential influence of estrogen exposure on HMG-CoAR expression was assessed by performing Cox's proportional hazards analyses of the relationship between the use of hormone replacement therapy (HRT), obesity (waist circumference) and tumour-cell specific HMG-CoAR expression. We found that HMG-CoAR was present in various fractions and intensities in the cytoplasm, sometimes with a membranous pattern, but not in the tumour cell nuclei. The expression of HMG-CoAR was associated with a smaller tumour size (p = 0.02), low histological grade (p = 0.001), low Ki67 index (p = 0.004), ER,+ (p = 0.02), ER,+ (p = 0.005), and high p27 expression (p = <0.001). The incidence of tumours with a high HMG-CoAR-expression was increased among HRT-users, although this was not statistically significant in a heterogeneity analysis. Obesity was significantly associated with a high HMG-CoAR expression assessed both as a high (>50%) fraction of positive cells (relative risk: 2.06; 95% confidence interval: 1.20,3.51), and a strong staining intensity (2.33: 1.08,5.02). In summary, we demonstrate that HMG-CoAR is differentially expressed in breast cancer and that a high expression is associated with prognostically favourable tumour parameters. Moreover, estrogen related life-style and anthropometric factors might indeed regulate HMG-CoAR expression. © 2008 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||||||||