The North-East Moroccan physicians' management of menopause: Prescription vs. nonprescription of hormonal treatment

This study examined the management of North-East Moroccan physicians of menopause. The poll was carried out on a representative sample of physicians in the Nador region. The sample included gynecologists and general practitioner physicians in both public and private medical sectors. The survey contained focused and open-ended questions on the good knowledge or not of physicians about menopause, their patient population, their prescribing practices, their perceptions, and the different medical approaches to managing the symptoms of menopause. Among the general practitioners interviewed, only 16% of physicians are very knowledgeable about the management of menopause and only 3 physicians have followed continuous training. The others have mainly acquired their information from the internet, medical journals, and scientific magazines. Only one-third of physicians interviewed prescribe menopausal hormonal treatment in this region. The treatment is mainly prescribed to cope with hot flashes (97.1%) and menstrual cycle disruption (85.7%). Others are in favor of non-hormonal treatments and advise women to change their bad daily habits to relieve symptoms. In this region of Morocco, hormonal treatment for menopause is not very common and the majority of general practitioners are not familiar with menopause. (Afr J Reprod Health 2022; 26[6]:116-124).

Tratamiento hormonal y sus complicaciones en el paciente con disforia de género / Hormonal treatment and complications in patients with gender dysphoria

RESUMEN Introducción: Las personas con disforia de género sienten incongruencia entre el sexo con el que nacen y aquel al que sienten pertenecer, por lo que necesitan adaptar su cuerpo a este último, y uno de los pilares en el logro de ese propósito es el empleo del tratamiento hormonal cruzado. Objetivo: Identificar los esquemas terapéuticos más empleados en la automedicación y en el manejo especializado, y sus complicaciones en pacientes con disforia de género. Métodos: Se revisaron 78 historias, de las cuales 76 correspondían a transexuales hombre-mujer, atendidos en el periodo 2012-2017 en la Consulta Nacional de Atención Integral a Personas Transgénero. Se recuperó información relacionada con los esquemas terapéuticos utilizados, tanto durante la automedicación como durante el manejo por el endocrinólogo, y las complicaciones. Para el análisis de los datos se obtuvieron distribuciones de frecuencia de las variables cualitativas, media y desviación estándar de las cuantitativas. Resultados: La frecuencia de pacientes que se autoadministraron hormonas antes de comenzar la atención especializada fue de 82,9 por ciento. El medicamento más utilizado en la automedicación fue la cipresta (acetato de ciproterona 2 mg/etinilestradiol 50 µg) en el 90,5 por ciento de los casos. De los tratamientos indicados por el endocrinólogo al inicio de la atención; al 50,0 por ciento se les administró cipresta más androcur (acetato de ciproterona 50 mg) de 1 a 2 tabletas de cada uno, mientras que al 39,5 por ciento estrógenos conjugados asociado a androcur, igualmente de 1 a 2 tabletas de cada uno de estos medicamentos. En cuanto a la frecuencia de complicaciones como consecuencia del tratamiento hormonal, el 40,7 por ciento de los casos tuvo en algún momento niveles elevados de prolactina, al 26,3 por ciento los niveles de triglicéridos se le elevaron luego de iniciada la terapia. Conclusiones: La mayoría de los pacientes acuden por primera vez automedicados. Los medicamentos más utilizados son la cipresta y el androcur. La complicación más frecuente como consecuencia del tratamiento es la hiperprolactinemia(AU)

ABSTRACT Introduction: Persons with gender dysphoria feel incongruity between the sex they are born with and the one they feel they belong to, therefore they need to adapt their body to the latter, and one of the pillars in achieving that purpose is the use of cross hormonal treatment. Objective: To identify the therapeutic schemes most used in self-medication and specialized management, and their complications in patients with gender dysphoria. Methods: Seventy eight medical records were reviewed. Seventy six of them corresponded to male-female transsexuals, assisted in the 2012-2017 period at the National Consultation of Comprehensive Care to Transgender Persons. The study team recovered information related to the therapeutic schemes used, both during self-medication and during the endocrinological management, as well as complications. Frequency distributions of the qualitative variables, mean and standard deviation of the quantitative variables were obtained for data analysis. Results: The frequency of patients who self-administered hormones before beginning specialized care was 82.9 percent. The most commonly medication used in self-medication was cypress (cyproterone acetate 2 mg / ethinylestradiol 50 µg) in 90.5 percent of cases. Out of the treatments indicated by the endocrinologist at the beginning of the care; 50.0 percent were given cypress plus androcur (50 mg cyproterone acetate) of 1 to 2 tablets each, while 39.5 percent conjugated estrogens associated with androcur, also 1 to 2 tablets of each of these medications. Regarding the frequency of complications as a result of hormonal treatment, 40.7 percent of the cases had elevated prolactin levels at some time, and triglyceride levels increased to 26.3 percent after the start of therapy. Conclusions: Most patients who come for the first time, are self-medicated. The most used medications are cipresta and androcur. The most frequent complication is hyperprolactinemia as a consequence of treatment(AU)

Screening mamario en pacientes transgénero bajo tratamiento hormonal cruzado (thc). Situación actual y controversias / Mammary screening in trans patients undergoing hormonal cross-over treatment. Current situation and controversies

Introducción Las personas transgénero (varones y mujeres trans, género neutro, etc.) realizan tratamientos médicos y/o quirúrgicos a fin de adecuarse a su identidad de género. Dentro de los procedimientos disponibles, se encuentran incluidos aquellos que pueden modificar la glándula mamaria (tratamiento hormonal cruzado, mastectomía/masculinización del tórax/colocación de prótesis mamarias). Se desconoce actualmente el riesgo de desarrollar cáncer de mama en la población trans. Sin embargo, están establecidas pautas de screening mamario que permitirían un adecuado seguimiento de la salud mamaria, tanto en varones trans como en mujeres trans. Objetivo El objetivo principal es estudiar la situación actual respecto del screening mamario realizado a pacientes trans por parte de sus médicos de cabecera en un hospital de la Ciudad de Buenos Aires. Material y método Se evaluaron las historias clínicas de un total de 489 personas trans atendidas en el Hospital Durand entre los años 2006 y 2017. 1. Se relevó la realización de estudios mamarios de screening previos a la instauración del tratamiento hormonal cruzado (thc) en pacientes trans. 2. Se analizó la valoración de riesgo de cáncer de mama previo al inicio del thc. 3. Finalmente, se propone un algoritmo de evaluación previo y posterior al comienzo del tratamiento hormonal en estos pacientes, según hormonoterapia recibida, y la realización de cirugía mamaria, acorde a normas internacionales y la revisión de la bibliografía. Resultados Se observó que un 37,7% de varones trans y un 18,1% de mujeres trans tenían estudios mamarios realizados. Respecto de la valoración de riesgo, en un 11,5 y un 11,1% (varones y mujeres trans) no estaban recolectados los antecedentes familiares, y, en los casos en que figuraban, estaban incompletos. Conclusiones Se postula mantener las pautas de screening mamario aplicadas para mujeres cis tanto en varones trans hasta la realización de la mastectomía/masculinización del tórax (luego mantener el examen físico) como en mujeres trans que reciben thc

Introduction Transgender patients perform both medical and surgical treatments in order to adapt to their gender identity. Within the procedures, those that can modify the mammary gland are included (cross-hormonal treatment, mastectomy / placement of breast prostheses). The risk of developing breast cancer in the trans population is currently unknown. However, screening guidelines are established and would allow adequate monitoring of mammary health, both in trans men and trans women. Objective The main objective is to study the current situation regarding breast screening performed on trans patients by their family doctors in a hospital in the City of Buenos Aires. Materials and method The clinical histories of a total of 489 transgender people attended at the Durand Hospital between 2006 and 2017 were evaluated. We studied: 1. breast screening studies prior to the initiation of cross-hormone treatment (thc) in trans patients; 2. the risk assessment of breast cancer prior to the start of thc; 3. finally, an algorithm of evaluation before and after the start of hormonal treatment is proposed in these patients, according to hormone therapy received and the performance of breast surgery, according to international standards and bibliographic review. Results It was observed that 37.7% of trans men and 18.1% of trans women had breast studies performed. Regarding the risk assessment, 11.5 and 11.1% (men and trans women) there was no family history collected, and most cases they were incomplete. Conclusions It is postulated to maintain the mammary screening guidelines for cis women both in trans men until the completion of the mastectomy (then maintain the physical examination) and in trans women who receive thc

Therapeutic potential of omega fatty acids in breast cancer. Review / Potencial terapéutico de ácidos grasos omega en cáncer de mama. Revisión

Background: Breast cancer is the second cause of death in women in developed and undeveloped countries, including Colombia. A high percentage of these tumors is estrogen dependent, for which the hormonal treatment is the most used therapy in breast cancer. Currently, the first line treatment for breast tumor in postmenopausal women is the letrozole, an aromatase enzyme inhibitor that avoids the transformation of androgens to estrogens. Since letrozole produced adverse effects on patients, there is a requirement for new alternative treatments. Furthermore, omega fatty acids (ω-FA), essential as they are obtained from the normal diet or from dietary supplements, have demonstrated nutraceutical potential because of their anti-inflammatory or pro-inflammatory activity. Nonetheless, there is controversy in in vitro, in vivo and epidemiologic reports regarding their preventive or inducing activities of carcinogenesis in animals and humans, depending on the structure of the ω-FA. Objectives: This review aims to show the main in vitro, in vivo and epidemiologic evidences of the chemotherapeutic potential of ω-3 and ω-6 FA in different types of neoplasm, particularly in breast cancer, in individual or combined treatments with diverse antineoplastics. Methods: PubMed and Science Direct databases revealed the most representative studies, published during the last two decades, about ω-3 and ω-6 FA, breast cancer and the principal therapeutic strategies for this neoplasm. Findings were presented in separated topics to provide an overview of ω-FA and their potential in treatments for breast cancer. Results: Patients treated with estrogens and progesterone derivate have shown predisposition to develop breast cancer after two years of continued therapy. Furthermore, ω-FA with known nutraceutical potential have demonstrated their potential as adjuvants in the treatment against different neoplasms, like hepatic and colon cancer. Conclusions: Current therapies for breast cancer and their low efficacy in the long term led to explore new alternative treatments with ω-FA. These essential fatty acids in daily consumption could enhance the antineoplastic agent effect. Nevertheless, metabolism of the ω-FA must be considered for this use.

Antecedentes: el cáncer de mama es la segunda causa de muerte de mujeres en países desarrollados y no desarrollados, incluido Colombia. La mayoría de estos tumores son dependientes de estrógeno por esa razón, la terapia más utilizada es la hormonal. Actualmente, el tratamiento de primera línea en mujeres posmenopáusicas es el letrozol, inhibidor de la enzima aromatasa, que evita la conversión de andrógenos en estrógenos. El letrozol causa efectos adversos en las pacientes, lo cual motiva la búsqueda de nuevas alternativas que disminuyan estos efectos. Los ácidos grasos omega, esenciales en la dieta regular o suplementaria, han mostrado su potencial nutracéutico ambivalente, como antiinflamatorios o proinflamatorios. Debido a esto, existe controversia en distintos reportes a nivel in vitro, in vivo y epidemiológicos sobre la actividad preventiva o quimioterapéutica de los ω-3 y ω-6 AGOs. Objetivos: el aporte de este artículo, es mostrar las principales evidencias in vitro, in vivo y epidemiológicas del potencial quimioterapéutico de los AGOs en tratamientos individuales y combinados con antineoplásicos, en distintos tipos de cánceres, particularmente en el cáncer de mama. Métodos: se revisaron las bases de datos PubMed y Science Direct y se seleccionaron los estudios más representativos de las dos últimas décadas sobre ω-3 y ω-6 AGOs y las principales estrategias usadas en el cáncer de mama. Los hallazgos se presentan en temas separados, primero una visión general de los AGOs y luego su potencial bioactivo en tratamientos contra el cáncer de mama. Resultados: la mayoría de los estudios en pacientes con cáncer de mama, tratadas con estrógenos y derivados de progesterona, han mostrado predisposición a desarrollar cáncer de mama después de dos años de terapia continua. De otro lado, los AGOs han demostrado su potencial como adyuvantes en el tratamiento en diferentes cánceres como el de colon y hepático. Conclusiones: las terapias actuales para el cáncer de mama y su baja eficacia a largo plazo exigen explorar nuevas alternativas de terapias, que incluyen los AGOs podrían potenciar fármacos, no obstante, es necesario tener en cuenta, el metabolismo de los AGOs, para uso

The current status of hormone treatment for prostate cancer patients in Korean real-world practice: A multi-institutional observational study / 亚洲男科学杂志(英文版)

We aimed to evaluate the current nationwide trend, efficacy, safety, and quality of life (QoL) profiles of hormone treatment in real-world practice settings for prostate cancer (PCa) patients in Korea. A total of 292 men with any biopsy-proven PCa (TanyNanyMany) from 12 institutions in Korea were included in this multi-institutional, observational study of prospectively collected data. All luteinizing hormone-releasing hormone (LHRH) agonists were allowed to be investigational drugs. Efficacy was defined as (1) the rate of castration (serum testosterone ≤50 ng dl-1) at 4-week visit and (2) breakthrough (serum testosterone >50 ng dl-1 after castration). Safety assessments included routine examinations for potential adverse events, laboratory tests, blood pressure, body weight, and bone mineral density (BMD, at baseline and at the last follow-up visit). QoL was assessed using the Expanded Prostate Cancer Index Composite-26 (EPIC-26). The most common initial therapeutic regimen was LHRH agonist with anti-androgen (78.0%), and the most commonly used LHRH agonist for combination and monotherapy was leuprolide (64.0% for combination and 58.0% for monotherapy). The castration and breakthrough rates were 78.4% and 6.6%, respectively. The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment. In addition, the mean BMD T-score was significantly lower at the last follow-up (mean: -1.950) compared to baseline (mean: -0.195). The mean total EPIC-26 score decreased from 84.8 (standard deviation [s.d.]: 12.2) to 78.3 (s.d.: 8.1), with significant deterioration only in the urinary domain (mean: 23.5 at baseline and 21.9 at the 4-week visit). These findings demonstrate the nationwide trend of current practice settings in hormone treatment for PCa in Korea.

Estrategias no farmacológicas para el manejo de los síntomas vasomotores en la menopausia

Los síntomas vasomotores afectan a gran número de mujeres en la peri y posmenopausia, impactando notablemente en la calidad de vida; por otro lado, su duración en el tiempo es incierta y muchas veces prolongada. Si bien la terapia hormonal de la menopausia (THM) constituye el tratamiento más efectivo para los síntomas climatéricos en su conjunto, en algunos casos existen contraindicaciones para su uso. Por lo tanto, ofrecer estrategias de tratamiento en las mujeres con contraindicación al tratamiento hormonal resulta mandatorio. Contamos con una amplia gama de opciones no hormonales, tanto farmacológicas como no farmacológicas. Dentro de estas últimas se incluyen las terapias alternativas o naturales (isoflavonas y cimicifuga racemosa), las modificaciones sobre el estilo de vida y las terapias complementarias. Las terapias alternativas presentaron resultados controvertidos en cuanto a la efectividad sobre los síntomas climatéricos y, por otro lado, debido a que su mecanismo de acción involucra a los receptores estrogénicos, están contraindicadas en las pacientes con antecedentes personales de cánceres hormonodependientes. Las modificaciones del estilo de vida impactan positivamente la salud general de la mujer, más allá de los síntomas climatéricos. En cuanto a las terapias complementarias, las únicas recomendadas son la terapia cognitiva conductual y la hipnosis. Se debe individualizar en cada caso la mejor opción terapéutica, teniendo en cuenta los antecedentes, interacciones medicamentosas, estado cognitivo, entre otros, ya que el objetivo final es mejorar la calidad de vida de nuestras pacientes.

Vasomotor symptoms affect a large number of women in the peri and post menopause with significant impact on quality of life; the duration of these symptoms is uncertain and often prolonged. Although menopausal hormone therapy is the most effective treatment for climacteric symptoms, there are some contraindications for its use. Therefore, it is mandatory to offer other treatment strategies for women with contraindication to hormonal treatment. We have a wide range of non-hormonal options available, both pharmacological and non-pharmacological. Among the latter, we include alternative or natural therapies (isoflavones and cimicifuga racemosa), lifestyle changes, and complementary therapies. Alternative therapies show controversial results regarding effectiveness on climacteric symptoms, and their mechanism of action involves estrogen receptors; they are contraindicated in patients with a personal history of hormone-dependent cancers. Lifestyle modifications have a positive impact on women's general health, beyond the climacteric symptoms. The only complementary therapies recommended are cognitive behavioral therapy and hypnosis. In each case, the best therapeutic option should be individualized, taking into account the patient's clinical history, drug interactions and cognitive status, since the ultimate goal is to improve quality of life.

Parâmetros reprodutivos após indução de estro com diferentes intervalos de permanência do dispositivo vaginal em cabras Toggenburg acíclicas / Reproductive parameters after induction of estrus with different ranges of the vaginal device in acyclic Toggenburg goats

Este estudo objetivou avaliar o comportamento sexual e a dinâmica ovulatória de cabras da raça Toggenburg após a indução do estro com dispositivo intravaginal de progesterona durante seis, nove e 12 dias de permanência. No momento da inserção do dispositivo e 24 horas antes da retirada do dispositivo, foi administrado 5mg de dinoprost e 200UI de eCG, respectivamente. A dinâmica ovulatória foi acompanhada por ultrassonografia a cada oito horas, enquanto o estro foi observado a cada 12 horas. Todas as cabras apresentaram estro. O intervalo da retirada do dispositivo ao início do estro foi de 29,5 ± 9,6 para G6dias; 34,0 ± 6,0 e 32,4 ± 7,7h, G9dias e G12dias, respectivamente. Igualmente, foi encontrada diferença (P<0,05) entre o G6dias e os outros grupos. A duração do estro diferiu (P<0,05) entre o G6dias (36,0 ± 12,6) e os outros dois grupos (G9dias: 31,2 ± 14,3; G12dias: 33,4 ± 8,6). A taxa de ovulação (81%; 89,5% e; 71,4%), intervalo da retirada do dispositivo à ovulação (50,5 ± 11,4; 46,3 ± 5,9 e; 46,7 ± 8,3), diâmetro do maior folículo (6,6 ± 0,3; 6,6 ± 0,9 e; 6,9 ± 0,8) diâmetro do segundo maior folículo (6,4 ± 0,7; 6,6 ± 0,8 e; 6,8 ± 0,6) e o número de folículos ovulados (1,5 ± 0,6; 1,7 ± 0,6 e 2,0 ± 0,9) para G6dias, G9dias e G12dias, respectivamente, foram semelhantes (P>0,05). Todos os protocolos foram eficientes em induzir o estro sincronizado em cabras da raça Toggenburg, trabalhando em conjunto com a eficiência reprodutiva e produtiva desses animais.(AU)

This study aimed to evaluate the sexual behavior and the ovulatory dynamics of Toggenburg goats after induction of synchronized estrus by an intravaginal progesterone device for six, nine and twelve days. At the device insertion and 24 h before the device removal, 5mg of dinoprost and 200 UI of eCG was administered, respectively. The ovulatory dynamics was assessed by ultrasound every 8 h, while the sexual behavior was observed every 12 h. All goats showed estrus. The intervals from device removal to estrus were 29.5 ± 9.7, 34.0 ± 6.0 and 32.4 ± 7.7h to G6days, G9days and G12days, respectively. Iqually, it was found difference (P<0.05) among G6days and the other groups. The duration of estrus differed (P<0.05) among the G6days (36.0 ± 12.6) and the other two groups (G9days: 31.2 ± 14.3; G12days: 33.4 ± 8.6). The ovulation rate (81.0%; 89.5% and; 71.4%); the interval from device removal to ovulation (50.5 ± 11.4; 46.3 ± 5.9 and; 46.7 ± 8.3), the diameter of the largest follicle (6.6 ± 0.3; 6.6 ± 0.9 and; 6.9 ± 0.8), diameter of the second largest follicle (6.4 ± 0.7; 6.6 ± 0.8 and; 6.8 ± 0.6) and the number of ovulations (1.5 ± 0.6; 1.7 ± 0.6 and; 2.0 ± 0.9) for G6days, G9days and G12days, respectively, were similar (P>0.05). All treatments were effective for the induction of synchronized estrus in Toggenburg goats, working jointly with the reproductive and productive efficiency of these animals.(AU)

Influence of category-heifers, primiparous and multiparous lactating cows-in a large-scale resynchronization fixed-time artificial insemination program

This study was conducted to evaluate the influence of category (heifers, primiparous or multiparous cows) on pregnancy rates in a large scale resynchronization ovulation program. Nelore heifers (n = 903), primiparous lactating cows (n = 338) and multiparous lactating cows (n = 1,223) were synchronized using a conventional protocol of estradiol/P4-based fixed-time artificial insemination (FTAI). Thirty days after ultrasonography, females who failed the first FTAI were resynchronized with the same hormonal protocol prior to a second FTAI. The pregnancy status of each cohort was evaluated by ultrasonography 30 days after each FTAI. The average conception rate after the first FTAI and resynchronization was 80.5%. Heifers had a higher conception rate (85%) than primiparous (76%) or multiparous cows (78%; p = 0.0001). The conception rate after the first FTAI was similar among heifers (57%), primiparous cows (51%) and multiparous cows (56%; p = 0.193). After the second FTAI, heifers exhibited a higher conception rate (66%) than primiparous or multiparous cows (51%; p = 0.0001). These results demonstrate the feasibility of resynchronization in large beef herds for providing consistent pregnancy rates in a short period of time. We also demonstrated that ovulation resynchronization 30 days after FTAI is particularly effective for heifers, providing a conception rate of up to 66%.

Fitoestrogênios no tratamento da mulher no climatério / Phytoestrogens in the treatment of women in climacteric

Algumas divergências da literatura quanto a terapia hormonal motivaram a procura de tratamentos alternativos que fossem efetivos e seguros para aliviar os sintomas da mulher no climatério. Neste artigo serão abordados trabalhos de relevância sobre fitoestrogênios, indicações, efeitos colaterais e contraindicações destas substâncias que têm atividades biológicas semelhantes aos estrogênios. Os resultados observados mostram que os efeitos e segurança dos fitoestrogênios ainda são inconclusivos...

Tratamento hormonal no climatério / Climacteric hormonal treatment

Objetivo: Analisar os aspectos relevantes do tratamento hormonal no climatério, orientado por monitorização adequada, para aumentar benefícios e reduzir riscos.Material e métodos: Análise de trabalhos e livros relevantes pertinentes ao tema, que em conjunto favoreçam a monitorização clínica, laboratorial e a individualização das mulheres climatéricas, conduzindo assim para a melhor opção de tratamento hormonal.Resultados e conclusões: As evidências da literatura e os dados observados em publicação do Setor de Ginecologia Endócrina e Climatério da Clínica Ginecológica da FMUSP mostram que a individualização das mulheres climatéricas, de acordo com suas condições clínicas, possibilita tratamento hormonal individualizado para cada mulher, oferecendo maiores benefícios e segurança.

Perfil neuropsicológico en transexuales: efecto del tratamiento de reasignación de sexo / Neuropsychological profile in transsexuals: effect of sex reassignment treatment

Las funciones cognitivas, como el aprendizaje, la memoria y las funciones ejecutivas, son afectadas por las hormonas esteroides sexuales. El objetivo fue evaluar el perfil cognoscitivo en personas transexuales hombre a mujer (TH-M) en presencia y ausencia de tratamiento hormonal con estrógenos. Participaron un total de 54 sujetos. El grupo experimental fue de 22 pacientes TH-M, dividido en dos grupos: con tratamiento hormonal (n=9) y sin tratamiento hormonal (n=13). El grupo control fue conformado por hombres (n=16) y mujeres (n=16), pareados en edad y escolaridad. Evaluados con la batería NEUROPSI: Atención y Memoria (Ostrosky-Solís, Gómez, Matute, Roselli, Ardila & Pineda, 2003). Los grupos transexuales tuvieron mejores puntajes que los controles en atención inmediata y en formación de categorías, pero mostraron menores puntajes que los controles en codificación de material visoespacial y de caras, en memoria verbal inmediata y evocada. Se encontraron correlaciones negativas entre meses de tratamiento y la codificación visoespacial, memoria para caras y memoria verbal. Los resultados sugieren que las hormonas sexuales tienen efectos organizadores y activadores sobre la cognición.

Mental functions, including learning, executive functions and memory, are susceptible to be affected by sexual steroids hormones. The objective was to evaluate the cognitive profile of transsexual’s male to female (TM-F) in presence and absence of hormonal treatment with estrogens. A total of 54 subjects participated. The experimental group was conformed by 22 patients in condition transsexual male to female, divided in two groups: with hormonal treatment (n=9) and without hormonal treatment (n=13). The control group was conformed by heterosexual men (n=16) and women (n=16) paired in age and schooling to the experimental group. Subjects were evaluated by a comprehensive neuropsychological battery, NEUROPSI: Attention and Memory (Ostrosky-Solís, Gómez, Matute, Roselli, Ardila & Pineda, 2003). Transsexual’s groups performed better than controls in immediate attention, category formation, but worse than controls in visuospatial codification, faces, recall and immediate verbal memory. Negative correlations were founded between treatment months in visuospatial codification, faces, and verbal memory.

Tratamento hormonal da acne baseado em evidências / Hormonal treatment of acne based on evidence

Este trabalho de revisão apresenta o tratamento hormonal da acne baseado em evidências. O trabalho resume a clínica, a classificação, a fisiopatologia e a etiologia da acne. A avaliação de estudos selecionados mostrou que o tratamento hormonal da acne deve ser complementado por tratamento cosmiátrico, e não está indicado para gestantes ou mulheres com planos de engravidar. A primeira escolha para esse tratamento são os contraceptivos hormonais orais, pois são efetivos e seguros para tratamento da acne e também para anticoncepção. Após tempo estabelecido, se o resultado for insatisfatório, outro medicamento, como acetato de ciproterona ou espironolactona, deve ser adicionado. A finasterida é o medicamento indicado para acne de origem idiopática, e a flutamida apresenta efeitos colaterais significativos, não constituindo indicação segura até o momento.

This review shows the hormonal treatment of acne. The review summarizes the clinical aspects, classification, physiopathology and etiology of the acne. The evaluation of selected papers showed that hormonal treatment of acne with hormones has to be complemented by esthetics treatment and is not prescribed for pregnant women or those who want to get pregnant. The first choice of treatment is the hormonal oral contraceptive one, because it is effective and safe for treatment of acne and also for contraception. After an established period with unsatisfactory results, other medicines, such as ciproterone acetate or spironolactone, can be added. The finasteride is prescribed for idiopathic acne and flutamide has many relevant side effects and is also not safe.

Effects of Drospirenone 2 mg with 17-beta-Estradiol 1 mg on blood pressure and body weight in postmenopausal Korean women / 대한산부인과학회지

OBJECTIVE: To evaluate effects of Drospirenone 2 mg (DRSP) with 17-beta-Estradiol 1 mg (E2) on blood pressure (BP) and body weight in postmenopausal Korean women. METHODS: BP and body weight were measured at baseline and 3 months of the treatment. We compared the change in BP and body weight between normotensive (group 1, control) and high-normotensive (group 2) group during treatment. And we compared the change in BP and body weight between hypertensive group receiving anti-hypertensive with (group 3) and without (group 4, control) DRSP/E2 during treatment. RESULTS: The mean systolic BP/diastolic BP of group 1 was not significantly decreased from baseline (116.9/75.0 mmHg) after treatment with DRSP/E2 for 3 months (116.1/73.2 mmHg) (P<0.152/P=0.088), however that of group 2 was significantly decreased from baseline (128.8/81.8 mmHg) after treatment with DRSP/E2 for 3 months (126.2/79.3 mmHg) (P<0.001/P=0.002). The mean systolic BP/diastolic BP of group 3 was significantly decreased from baseline (133.5/82.5 mmHg) after treatment with DRSP/E2 for 3 months (129.3/77.9 mmHg) (P<0.001/P<0.001), and that of group 4 was also significantly decreased from baseline (133.2/80.7 mmHg) after treatment with DRSP/E2 for 3 months (131.0/78.3 mmHg) (P=0.002/P<0.001). However change in the mean systolic BP/diastolic BP of group 3 was greater than that of group 4 (P=0.041/P=0.024). There was no weight change in all four groups. CONCLUSION: The use of DRSP/E2 showed a tendency to decrease the BP of high-normotensive or above in postmenopausal Korean women, and hypertensive patients receiving anti-hypertensive showed greater decline in BP. However there was no statistical significance in body weight change.

Hormonal therapy for metastatic prostate cancer / 中国癌症杂志

The development and progress of prostate cancer is hormone dependent. Currently, hormonal treatment remains the most important treatment modality for alleviating the symptoms caused by metastatic prostate cancer. Hormonal therapy for prostate cancer includes orchidectomy(with or without adrenectomy) or drug therapy. The most commonly prescribed hormonal therapy medication for prostate cancer is LHRH agonists. Whether total androgen block using LHRH agonist and androgen blocking agents (combined androgen blockade) is more effective than single agent LHRH agonist in the treatment of late stage prostate cancer is unknown. Second line hormonal treatment is effective for selected patients with hormone refractory prostate cancer (HRPC). Although certain chemotherapeutic agents such as taxol has shown its efficacy for prostate cancer, second line chemotherapy should be utilized prior to chemotherapy for HRPC.

Clinical Experience with Hormonal Treatment of Testicular Azoospermia / 대한비뇨기과학회지

No abstract available.