Clinical Efficacy of Qingxin Zishen Decoction on Hot Flashes After Endocrine Therapy for Prostate Cancer and Its Preliminary Mechanism / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of Qingxin Zishen decoction on hot flashes after endocrine therapy for prostate cancer and explore its therapeutic mechanism. MethodA total of 60 patients who met the criteria and were admitted to Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 were collected and randomly divided into a treatment group and a control group， with 30 cases in each group. The treatment group was treated with Qingxin Zishen decoction， while the control group was only given routine nursing. The observation period of this study was eight weeks. The improvement of hot flash frequency， hot flash degree， hot flash score， ISS score， and TCM syndrome score were observed in the two groups before and after treatment. The changes of serum endothelin-1 （ET-1）， nitric oxide （NO）， calcitonin gene-related peptide （CGRP）， prostate specific antigen （PSA）， and testosterone were detected. ResultIn terms of efficacy， after treatment， the frequency， degree， and score of hot flashes， ISS score， and TCM syndrome score decreased in the treatment group （P<0.05）. Compared with the control group， all indicators were better in the treatment group （P<0.05）. In terms of laboratory indicators， after treatment， the serum NO level in the treatment group was increased. ET-1 level was decreased. The ratio of ET-1/NO was decreased， and the CGRP level was decreased （P<0.05）. However， testosterone and PSA levels were not significantly changed . Compared with the control group， after treatment， the serum NO level in the treatment group was higher， and the level of ET-1 was lower. The ratio of ET-1/NO and the CGRP level were lower （P<0.05）. There were no significant differences in testosterone and PSA levels between the two groups. ConclusionQingxin Zishen decoction can significantly improve hot flashes in patients with prostate cancer after endocrine therapy. The mechanism of Qingxin Zishen decoction may be to improve the vasomotor function by regulating the expression level of vasomotor factors， so as to treat hot flashes.

Tachykinin/neurokinin 3 receptor antagonists: In silico ADME/T analysis of novel compounds for menopause hot flashes therapy

SUMMARY Introduction: Neurokinin-B receptor (NK3R) activation is tightly involved in the onset of vasomotor symptoms during menopause, yet there are still no NK3R antagonistic drugs approved for hot flashes therapy. Determining the pharmacokinetic properties of current drug candidates is crucial for scaffold identification and prediction of feasible outcomes in future clinical trials. Aim: To develop a pharmacokinetic profile of new NK3R blockers with hot flashes reducing activity and by comparing them with trial-suspended NK3R antagonists (Osanetant & Talnetant), it is expected to identify enhanced properties in novel compounds. Methodology: For in silico evaluation, Smiles were retrieved from PubChem and DrugBank, and further analysis was carried out through ADMETlab and SwissADME to calculate compounds drug-likeness and pharmacokinetics. Results: Pavinetant & Fezoline-tant and SB-222.200 & SB-218.795 exhibited higher compliance with drug-likeness rules and more suitable physicochemical properties when compared to Osanetant & Talnetant. ADME/T evaluation showed considerable disparities between groups, yet no significant difference was reported. Pharmacokinetic properties varied irregularly among studied compounds. Conclusion: Novel NK3R antagonists exhibit enhanced properties when compared to formerly suspended ones. Fezolinetant is predicted to have more favorable outcomes based on in silico evaluation.

Introducción: la activación del receptor de neuroquinina-B (NK3R) está estrechamente relacionada con la aparición de síntomas vasomotores durante la menopausia, no obstante, a la fecha no se reportan fármacos antagonistas de NK3R aprobados para el manejo de sofocos. La evaluación de las propiedades farmacocinéticas de los compuestos inhibidores de NK3R resulta indispensable para la identificación de potenciales farmacóforos y para la estimación de posibles resultados en ensayos clínicos. Objetivo: determinar las características farmacocinéticas de los nuevos compuestos inhibidores de NK3R con propiedades reductoras de los fogajes asociados a la menopausia, y por medio de un análisis comparativo con los antagonistas de NK3R cuyo ensayo clínico fue suspendido (Osanetant & Talnetant), se espera identificar propiedades superiores en los nuevos compuestos desarrollados. Metodología: se obtuvieron los códigos Smiles a partir de PubChem y DrugBank, posteriormente, el análisis se basó en el cálculo de las propiedades farmacocinéticas y drug-like mediante las plataformas ADMETlab y SwissADME. Resultados: Pavi-netant & Fezolinetant y SB-222.200 & SB-218.795 exhiben mejores propiedades fisicoquímicas y cumplen a mayor cabalidad las reglas drug-likeness al compararse con Osanetant & Talnetant. La evaluación ADMET reveló variaciones entre los grupos, pero ninguna fue significativa. Las propiedades farmacocinéticas varían de forma irregular entre los distintos compuestos. Conclusiones: los antagonistas de NK3R recientemente desarrollados exhibieron propiedades superiores frente a los compuestos de ensayos suspendidos. Los resultados del estudio in silico permiten deducir que el Fezolinetant podría tener mejores resultados en futuros ensayos clínicos.

Introdução: a ativação do receptor de neuroquinina-B (NK3R) está intimamente relacionada ao aparecimento de sintomas vasomotores durante a menopausa, entretanto, até o momento não há relatos de drogas antagonistas de NK3R aprovadas para o manejo das ondas de calor. A avaliação das propriedades farmacocinéticas de compostos inibidores de NK3R é essencial para a identificação de potenciais farmaco-foros e para a estimativa de possíveis resultados em ensaios clínicos. Objetivo: determinar as características farmacocinéticas dos novos compostos inibidores de NK3R com propriedades redutoras de ondas de calor associadas à menopausa, e através de uma análise comparativa com os antagonistas de NK3R cujo ensaio clínico foi suspenso (Osanetant & Talnetant), espera-se identificar propriedades superiores nos compostos recém-desenvolvidos. Metodologia: os códigos Smiles foram obtidos do PubChem e DrugBank, posteriormente, a análise foi baseada no cálculo das propriedades farmacocinéticas e farmacocinéticas utilizando as plataformas ADMETlab e SwissADME. Resultados: Pavinetant & Fezolinetant e SB-222.200 & SB-218.795 apresentam melhores propriedades físico-químicas e atendem mais plenamente às regras de ""drug-likeness" quando comparados ao Osanetant & Talnetant. A avaliação ADMET revelou variações entre os grupos, mas nenhuma foi significativa. As propriedades farmacocinéticas variam irregularmente entre os diferentes compostos. Conclusões: os antagonistas de NK3R recém-desenvolvidos exibiram propriedades superiores em relação aos compostos de teste suspensos. Os resultados do estudo in silico permitem-nos deduzir que o Fezolinetant poderá ter melhores resultados em futuros ensaios clínicos.

Sintomas e compreensões de mulheres na menopausa em área metropolitana do Nordeste brasileiro: estudo quantiqualitativo / Symptoms and understandings of women in menopause in a metropolitan area of brazilian northeast: a quanti-qualitative study

Avaliar como as mulheres em área metropolitana do Nordeste brasileiro sentem e compreendem a menopausa. Estudo misto, com 417 mulheres de 40 a 60 anos no qual se utilizou um roteiro de questões socioeconômicas, ginecológicas/obstétricas, morbidades, medicações e sexualidade, além do Female Sexual Function Index e Menopause Rating Scale. A menopausa, constatada em 56,6% das mulheres com média de idade de 50,4±5,7 anos, teve sintomatologia associada severa (falta de ar, suor, calor e ansiedade); 52,5% apresentaram dúvidas ou falta de conhecimento sobre a menopausa, e 44,6%, redução na função sexual, que se correlacionou negativamente com a idade (r= -0,208; p<0,001). A disfunção sexual é quase duas vezes maior nas mulheres em menopausa do que naquelas em pré menopausa (OR=1,81; p=0,036). A sexualidade das mulheres com dificuldades ou disfunções sexuais por causa da menopausa pode estar permeada por inibições emocionais e psicológicas.

To evaluate what women feel and how they understand the menopause period in a metropolitan area of the Brazilian Northeast. A mixed study with 417 women aged 40 to 60 years that used a script of socioeconomic, gynecological/obstetrical, morbidity, medication, and sexuality questions, as well as the Female Sexual Function Index and Menopause Rating Scales. Menopause, observed in 56.6% of women with a mean age of 50.4±5.7 years, had severe associated symptoms (shortness of breath, sweat, heat and anxiety); 52.5% had doubts or lack of knowledge about menopause, and 44.6%, reduction in sexual function, which correlated negatively with age (r= -0.208; p<0.001). Sexual dysfunction is almost twice as high in menopausal women as in premenopausal women (OR=1.81; p=0.036). The sexuality of women with sexual issues or dysfunctions due to menopause may be permeated by emotional and psychological inhibitions.

Prevalence of hot flashes in women of 40 to 65 years of age with metabolic syndrome

SUMMARY OBJECTIVE: Hot flashes have a negative impact on the quality of life of women during the menopausal transition and thereafter. The progressive reduction in gonadal estrogen levels associated with aging promotes an accumulation of abdominal fat, dyslipidemia, and arterial hypertension, all of which are components of metabolic syndrome (MetS). The objective of the present study was to estimate the prevalence of hot flashes and evaluate their relationship with MetS in women ≥ 40 years of age. METHODS: This was a cross-sectional study involving women aged between 40 and 65 years. We used the Kupperman index to quantify the climacteric symptoms and the National Cholesterol Education Program Adult Treatment Panel III criteria for the diagnosis of MetS. RESULTS: 1,435 women were initially selected, and we obtained information from 647. The mean age at menopause was 45.99 years (SD 6.61 years) and the prevalence of hot flashes and MetS were 55.83% (95% CI: 52.35-59.25%) and 46.29% (95% CI: 44.75-52.53%), respectively. We identified a positive association between MetS and hot flashes (OR 1.16; 95% CI: 1.01-1.33). CONCLUSIONS: In women ≥ 40 years of age, hot flashes are highly prevalent and appear to be associated with MetS.

RESUMO OBJETIVO: As ondas de calor têm um impacto negativo na qualidade de vida das mulheres no climatério. A redução progressiva dos níveis de estrogênio gonadal associada ao envelhecimento promovem o acúmulo de gordura abdominal, dislipidemia e hipertensão arterial, componentes da síndrome metabólica (SM). O objetivo do presente estudo foi estimar a prevalência de ondas de calor e avaliar sua relação com SM em mulheres com idade ≥40 anos. MÉTODOS: Estudo transversal envolvendo mulheres entre 40 e 65 anos de idade. Utilizamos o índice de Kupperman para quantificar os sintomas climatéricos e os critérios do National Cholesterol Education Program Adult Treatment Panel III para o diagnóstico de SM. RESULTADOS: Mil, quatrocentas e trinta e cinco mulheres foram selecionadas inicialmente e obtivemos informações de 647. A idade média da menopausa foi de 45,99 anos (DP 6,61 anos) e a prevalência de ondas de calor e SM foi de 55,83% (95% CI: 52,35-59,25%) e 46,29% (95% CI: 44,75-52,53%), respectivamente. Identificamos uma associação positiva entre SM e ondas de calor (OR 1,16; IC95%: 1,01-1,33). CONCLUSÕES: Em mulheres com idade ≥40 anos, as ondas de calor são altamente prevalentes e parecem estar associadas a SM.

Ação da acupuntura no sintoma de fogachos em mulheres após câncer de mama: revisão integrativa / Acción de la acupuntura sobre los síntomas de sofocos en mujeres después de cáncer de mama: revisión integrativa / Acupuncture action on hot flashes in women after breast cancer: an integrative review

Objetivo: Investigar evidências, na literatura, acerca da ação da acupuntura no sintoma de fogachos em mulheres, após câncer de mama e estabelecer um protocolo para o tratamento dessa condição. Método: Revisão integrativa, conduzida em agosto de 2019. Utilizaram-se bases de dados nacionais e internacionais. Resultados: Foram encontradas 288 pesquisas e 11 foram incluídas no estudo. A acupuntura demonstrou resultados positivos sobre os sintomas de fogachos. Não há padronização no tratamento, porém um possível protocolo foi proposto: realização da acupuntura sistêmica ou eletroacupuntura nos acupontos Baço 6, Fígado 3, Rim 3, Circulação sexo 6, Vaso concepção 4, Bexiga 23 e Vaso Governador 20, agulhas sistêmicas que devem ser manipuladas até obter a sensação De qi, 10 sessões, uma ou duas vezes por semana, com retenção das agulhas nos acupontos em aproximadamente 25 minutos. Conclusão: a acupuntura parece ser uma intervenção efetiva para o tratamento e controle dos fogachos em mulheres, após câncer de mama e consiste em uma opção terapêutica a qual o enfermeiro pode executar de maneira autônoma e independente em todos os níveis de atenção. Torna-se necessária a realização de ensaios clínicos randomizados com a utilização do protocolo proposto a fim de validá-lo(AU)

Aim: to investigate evidence in the literature about the action of acupuncture on hot flashes in women after breast cancer and to establish a protocol for the treatment of this condition. Method: an integrative review of national and international databases conducted in August 2019. Results: 288 studies were found and 11 were included in this study. Acupuncture has shown positive results on the symptoms of hot flashes. Even though there is no standardization in treatment, the following protocol was proposed: a) performing systemic acupuncture or electroacupuncture in acupoints Spleen 6, Liver 3, Kidney 3, Circulation sex 6, Conception vessel 4, Bladder 23 and Governor vessel 20, b) systemic needles should be manipulated until the patient gets the De qi sensation, c) 10 sessions, once or twice a week, with needles retained in the acupoints for approximately 25 minutes. Conclusion: acupuncture appears to be an effective intervention for the treatment and control of hot flashes in women after breast cancer. In addition, it is a qualified therapeutic option which nurses can perform autonomously and independently at all levels of care. Further randomized clinical trials are necessary to validate the proposed protocol.(AU)

Objetivo: investigar la evidencia en la literatura sobre la acción de la acupuntura en los síntomas de sofocos en mujeres después del cáncer de mama y establecer un protocolo para el tratamiento de esta afección. Método: una revisión integradora realizada en agosto de 2019. Se utilizaron bases de datos nacionales e internacionales. Resultados: se encontraron 288 búsquedas y se incluyeron 11 en el estudio. La acupuntura ha mostrado resultados positivos en los síntomas de los sofocos. No hay estandarización, no hay tratamiento, un posible protocolo: realizar acupuntura sistémica o electroacupuntura en puntos de acupuntura Bazo 6, Hígado 3, Riñón 3, Circulación sexual 6, Vaso de concepción 4, Vejiga 23 y Vaso gobernador 20, agujas sistémicas que deberían ser manipuladas hasta obtener la sensación De qi, 10 sesiones, una o dos veces por semana, con agujas retenidas en los puntos de acupuntura durante aproximadamente 25 minutos. Conclusión: la acupuntura parece ser una intervención efectiva para el tratamiento y el control de los sofocos en mujeres después del cáncer de mama y es una opción terapéutica en la cual el enfermero puede actuar de forma autónoma e independiente en todos los niveles de atención. Fue necesario realizar ensayos clínicos aleatorios utilizando el protocolo propuesto con el fin de validarlo.(AU)

Descripción demográfica, bioquímica y sintomática según los estadios reproductivos STRAW+10 en mujeres mexicanas en la peri y posmenopausia / Demographic, biochemical and symptomatic description according to STRAW + 10 reproductive stages in Mexican women in peri and postmenopause

Resumen OBJETIVO: Categorizar el perfil demográfico, bioquímico y sintomático de la población mexicana atendida en el Instituto Nacional de Perinatología para describir su comportamiento en los estadios del envejecimiento reproductivo. MATERIALES Y MÉTODOS: Estudio transversal y descriptivo efectuado entre junio y diciembre de 2018 en pacientes de la Clínica de peri y posmenopausia del Instituto Nacional de Perinatología. Criterios de inclusión: mujeres mayores de 41 años con diagnóstico de peri y posmenopausia, clasificadas según STRAW+10 en tres categorías: Categoría 1 (-2 a -1), Categoría 2 (+1A a +1C) y Categoría 3 (+2). Para el análisis estadístico se obtuvieron medidas de tendencia central, χ2 y ANOVA para el análisis inferencial. RESULTADOS: Se estudiaron 741 pacientes peri y posmenopáusicas, con edad promedio a la menopausia de 50.08 años. El promedio de edad poblacional fue de 57.11 años, con un índice de masa corporal promedio de 27.92, con 56.2% de la población en límites de obesidad. La comorbilidad más frecuente fue la hipertensión arterial y el síntoma más reportado, los bochornos, más prevalentes durante la transición a la menopausia. CONCLUSIONES: El sistema STRAW+10 es una manera clínica y objetiva de estadificar a las pacientes en transición a la menopausia. Es importante emprender más estudios poblacionales en mujeres para describir el comportamiento del envejecimiento reproductivo en México.

Abstract OBJECTIVE: Categorize the demographic, biochemical and symptomatic profile of the Mexican population served at the Instituto Nacional de Perinatología to describe their behavior in the stages of reproductive aging. MATERIALS AND METHODS: The following is an observational, descriptive, cross sectional study women from the Peri- and Postmenopause clinic at the National Institute of Perinatology in Mexico that enrolled 741 women over 41 years of age with a diagnosis of menopause according to the STRAW+10 criteria and classified in three categories: Category 1 (-2 to -1), Category 2 (+1A to +1C), and Category 3 (+2). The statistical analysis was performed by measure of central tendency, χ2 and ANOVA for the inferential analysis. RESULTS: In our population of 741 women, the average age at menopause was 50.08 years, while the population's age average was 57.11 years. Average body mass index was 27.92 kg/m2, with 56.2% of the population within obesity range. The most prevalent comorbidity was arterial hypertension and the most frequent symptom was hot flushes. Hot flushes were most prevalent during the transition to menopause. CONCLUSIONS: The STRAW+10 is an objective way to clinically classify patients in transition to menopause. There is an important need for more population-based studies in women to describe the reproductive ageing behavior in Mexico.

Enfoque diagnóstico del paciente con rubor facial transitorio en atención primaria / A Diagnostic Approach of Patient with Flushing in Primary Care

El rubor facial transitorio se define como una sensación de calor, acompañada de enrojecimiento de la piel, causada por una respuesta vasomotora con el resultante incremento en el flujo sanguíneo regional, debido a la acción directa de diferentes mediadores liberados por los nervios. Los cuadros pueden ser episódicos o constantes y se relacionan con respuestas fisiológicas y con patologías de origen benigno y maligno. El objetivo de la revisión es realizar un abordaje racional de esta condición en el escenario de atención primaria, con el fin de llegar a un diagnóstico precoz y completo, abordando los principales diagnósticos diferenciales asociados con esta condición.

The definición of flushing involves a sensation of heat along with redness of the skin, caused by vasomotor influx resulting in an increased of the regional vascular blood flow due to the direct action of different mediators through the vasomotor nerves. These symptoms can be episodio or repetitive and they' can be related to benign or malignant conditions. The objective of this review is to develope a racional approach of the condition at primary care, with the purpose of an early and complete diagnosis, covering the main differential diagnosis related to this condition.

Systematic review and Meta-analysis of acupuncture intervention on hot flushes in breast cancer patients / 中国实用护理杂志

Objective@#To assess the effectiveness of acupuncture for hot flushes (HFs) in women with breast cancer (BC).@*Methods@#Ten databases (PubMed, Springer, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, CINAHL, CNKI, VIP, CBM, and Wan Fang Database) were searched from their inceptions to autumn 2017 without language restrictions. The searching terms in English and Chinese literatures were"breast tumors/breast neoplasms/breast tumor/breast neoplasm/breast cancer/breast cancers/breast carcinoma/mammary cancer/mammary neoplasm/mammary neoplasms/mammary carcinoma" "hot flushes / hot flashes""acupuncture/ electro-acupuncture / needle/ acupoint". Finally, randomized controlled trials (RCTs) were aggregated to evaluate the therapeutic effect of acupuncture for HFs in women with BC.@*Results@#Eleven articles were systematically reviewed, and five trials (692 patients) were included in the Meta-analysis. Significant combined effects of acupuncture were observed in Hot Flash Related quality of life (d=-3.14; 95% CI, -4.93 to -1.34; P=0.000 6; I2 = 54%), however, no effect was evident for hot flash frequency. The articles included had low risk of bias. No serious adverse effects were reported in the included studies.@*Conclusions@#Acupuncture are associated with significant effects on HFs in women with BC. Large randomized controlled trials (RCTs) were recommended to carry out in China to verify the conclusion.

Effect of estradiol valerate on expression of adrenergic rceptors in the preoptic area of hypothalamus of ovariectomized rats / 医学研究生学报

Objective The occurrence of perimenopausal hot flashes involves many theories, among which the study of neurotransmitter mechanism has attracted much attention. This study aims to investigate the changes of α1 and α2 adrenoreceptors in the preoptic area of the hypothalamus(POAH) in ovariectomized rats after 4 weeks treatment with estradiol valerate, and explore the potential neurotransmitter mechanism of perimenopausal hot flashes. Methods 30 female Sprague-Dawley rats, weighing 230±10 g and aged 6-8WK, were divided into three groups: ovariectomy (OVX)group , sham group, and ovariectomy plus estradiol valerate (OVX+E2) group, each 10. Rats in sham-operated group opened pelvic cavity to find ovaries, but did not remove them. The other rats underwent bilateral ovariectomy under sterile conditions. Rats in OVX group and (OVX+E2) group received bilateral ovariectomy, rats in OVX group received isotonic saline gavage (10 mg/kg), and rats in (OVX+E2) group received estradiol valerate gavage (0.8 mg /kg). Anesthesia, cardiac perfusion and paraffin section were made after taking the brain. The expression of α1 and α2 adrenoreceptors in POAH of the rats was detected by immunohistochemistry. Results After 4 weeks’ treatment, the number of α1[(54.0±3.9)/100μm2] and α2[(89.0±2.4)/100μm2] adrenoreceptor positive cells in POAH of OVX group significantly decreased compared with that in sham group[(66.3±4.0)、(71.0±2.2)/100μm2](P<0.01),while the number of α1 and α2 [(63.7±4.5)、(73.1±3.5)/100μm2)] adrenoreceptor positive cells in POAH of（OVX+E2 ）group significantly increased compared with that in OVX group(P<0.01). The difference was statistically significant. Conclusion The expression of two adrenergic receptors in the POAH of ovariectomized rats changed. The central noradrenergic system may be involved in the mechanism of perimenopausal hot flashes,which need further studying.

Systematic review and Meta-analysis of acupuncture intervention on hot flushes in breast cancer patients / 中国实用护理杂志

Objective To assess the effectiveness of acupuncture for hot flushes (HFs) in women with breast cancer (BC). Methods Ten databases (PubMed, Springer, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, CINAHL, CNKI, VIP, CBM, and Wan Fang Database) were searched from their inceptions to autumn 2017 without language restrictions. The searching terms in English and Chinese literatures were"breast tumors/breast neoplasms/breast tumor/breast neoplasm/breast cancer/breast cancers/breast carcinoma/mammary cancer/mammary neoplasm/mammary neoplasms/mammary carcinoma" "hot flushes/ hot flashes""acupuncture/ electro-acupuncture/ needle/ acupoint". Finally, randomized controlled trials (RCTs) were aggregated to evaluate the therapeutic effect of acupuncture for HFs in women with BC. Results Eleven articles were systematically reviewed, and five trials (692 patients) were included in the Meta-analysis. Significant combined effects of acupuncture were observed in Hot Flash Related quality of life ( d=-3.14; 95% CI ,-4.93 to-1.34; P=0.000 6; I2=54% ), however, no effect was evident for hot flash frequency. The articles included had low risk of bias. No serious adverse effects were reported in the included studies. Conclusions Acupuncture are associated with significant effects on HFs in women with BC. Large randomized controlled trials (RCTs) were recommended to carry out in China to verify the conclusion.

Effect of Lavender on Sleep, Sexual Desire, Vasomotor, Psychological and Physical Symptom among Menopausal and Elderly Women: A Systematic Review

OBJECTIVES: The present systematic review was conducted to compare the effect of lavender on the quality of sleep, sexual desire, and vasomotor, psychological and physical symptoms among menopausal and elderly women. METHODS: There were five electronic databases which selected to search respective articles which included were Scopus, PubMed, Web of Science, Google Scholar, and the Cochrane Library without any language restriction since the study inception to March 10, 2018. The quality of studies was assessed in accordance with a jaded scale. RESULTS: According to three trials, the lavender as utilized in a capsule form or aromatherapy could significantly improve the measured Pittsburgh Sleep Quality Index score (P < 0.05) in the menopausal and elderly women. The aromatherapy with lavender improved sexual function (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), and physical (P < 0.001) symptoms. Based on a trial, 66.7%, 70.0%, and 53.3% of subjects reported feelings of relaxation, happiness, and cleanness effects of having used lavender respectively. CONCLUSIONS: The results suggested the effectiveness of the use of lavender either in capsule form or aromatherapy on the improved quality of sleep, depression, anxiety, sexual desire, and psychological and physical symptoms. These results, however, should be interpreted with caution considering the limitations of the study.

Comparison between manual acupuncture and electroacupuncture for hot flashes and sex hormone of perimenopausal syndrome / 中国针灸

<p><b>OBJECTIVE</b>To compare the effect and differences sex the influence of hormone levels of perimenopau-sal syndrome patients between manual acupuncture and electroacupuncture (EA).</p><p><b>METHODS</b>A total of 50 cases with perimenopausal syndrome were randomly assigned into an manual acupuncture group (27 cases) and an EA group (23 cases), and 1 case dropped in the EA group. The acupoints in the two groups were Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25), and Sanyinjiao (SP 6). Acupuncture with 3-time small and even manipulation of lifting, thrusting and twirling was used in the acupuncture group, once 10 min. EA with sparse-dense wave and 10 Hz/50 Hz was applied in the EA group for 30 min. The treatments in the two groups were for continuous 8 weeks (24 times in total), once the other day, 3 times a week. The scores of 24-hour hot flashes even, menopausal rating scale (MRS) and menopause-specific quality of life questionnaire (MENQOL) were recorded before treatment and after 4-week and 8-week treatment, as well as 12 and 24 weeks after treatment. Serum sex hormone levels were tested before and after 8-week treatment as well as 12 weeks after treatment, including serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estracliol (E).</p><p><b>RESULTS</b>Compared with those before treatment, the 24-hour hot flashes even score, MRS and MENQOL scores were significantly lower after 4-week and 8-week treatments, 12 and 24 weeks after treatment (all<0.05). All the above scores after 8-week treatment were lower than those after 4-week treatment (all<0.05); and the scores 12 and 24 weeks after treatment were lower than those after 4-week and 8-week treatments (all<0.05); all the scores after treatment were not significantly different at any time between the two groups (all>0.05). Compared with those before treatment, serum FSH and Eapparently improved in the two groups after 8-week treatment and 12 weeks after treatment (all<0.05). LH levels did not significantly change in the two groups (all>0.05). All the serum sex hormone levels showed no significant difference between the two groups (all>0.05).</p><p><b>CONCLUSIONS</b>Both acupuncture and EA can improve perimenopausal symptoms and serum sex hormone. The effects are similar.</p>

Polimorfismos genéticos asociados a complicaciones crónicas de la menopausia

La menopausia es una transición hormonal asociada a la senescencia ovárica, usualmente con presentación entre los 45 y 59 años de edad después de una disminución progresiva de la capacidad reproductiva, hasta el cese definitivo, marcado por la ausencia de períodos menstruales después de 12 meses consecutivos. Se caracteriza por un amplio y variado cuadro clínico, que incluye oleadas de calor (sofocos), dispareunia, trastornos del sueño, entre otros. A pesar de las numerosas investigaciones no se tiene evidencia clara sobre un tratamiento que supere la efectividad de la terapia de reemplazo hormonal (TRH). Un campo que se ha convertido en blanco de actuales investigaciones, es el de los polimorfismos genéticos y su relación con las variaciones en la forma de presentación de las diferentes condiciones asociadas a la menopausia tales como: riesgo cardiovascular, osteoporosis y cáncer de mama.

Menopause is a hormonal transition associated to ovarian senescence, usually presenting between 45 and 59 years after a progressive decrease in the reproductive capacity until termination, the menopause is marked by the absence of menstrual periods after 12 consecutive months. It is characterized by a broad clinical profile, including hot flashes (flushing), dyspareunia, sleep disorders, among others. Despite much research there is no clear evidence about a treatment which overcome the effectiveness of hormone replacement therapy (HRT). A field that has become the target of current research is the genetic polymorphisms and their relation to changes in the presentation of the different conditions associated with menopause such as cardiovascular risk, osteoporosis and breast cancer.

Effectiveness of Traditional Chinese Acupuncture versus Sham Acupuncture: a Systematic Review / Efetividade da Acupuntura Tradicional Chinesa versus Sham Acupuntura: revisão sistemática / Eficacia de la Acupuntura Tradicional China frente a la Acupuntura Sham: una revisión sistemática

ABSTRACT Objective: to identify and synthesize the evidence from randomized clinical trials that tested the effectiveness of traditional Chinese acupuncture in relation to sham acupuncture for the treatment of hot flashes in menopausal women with breast cancer. Method: systematic review guided by the recommendations of the Cochrane Collaboration. Citations were searched in the following databases: MEDLINE via PubMed, Web of Science, CENTRAL, CINAHL, and LILACS. A combination of the following keywords was used: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, and vasomotor symptoms. Results: a total of 272 studies were identified, five of which were selected and analyzed. Slight superiority of traditional acupuncture compared with sham acupuncture was observed; however, there were no strong statistical associations. Conclusions: the evidence gathered was not sufficient to affirm the effectiveness of traditional acupuncture compared with sham acupuncture.

RESUMO Objetivo: identificar e sintetizar as evidências oriundas de ensaios clínicos randomizados que testaram a efetividade da acupuntura tradicional chinesa em relação à sham acupuntura para o tratamento dos fogachos em mulheres com câncer de mama no climatério. Método: revisão sistemática guiada pelas recomendações da Colaboração Cochrane. A busca foi realizada nas bases de dados: MEDLINE via PubMed, Web of Science, CENTRAL Cochrane, CINAHL e LILACS. Adotou-se a combinação dos descritores: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms. Resultados: foram identificados 272 estudos, sendo 5 selecionados e analisados. Foi observada discreta superioridade da acupuntura tradicional em relação à sham, entretanto, sem fortes associações estatísticas. Conclusões: as evidências obtidas não foram suficientes para afirmar quanto à efetividade da acupuntura tradicional em relação à sham.

RESUMEN Objetivo: Identificar y sintetizar la evidencia de un ensayo clínico aleatorizado que examinó la eficacia de la acupuntura tradicional en relación a la acupuntura sham para el tratamiento de sofocos en las mujeres menopáusicas con cáncer de mama. Método: Revisión sistemática guiada por las recomendaciones de la Colaboración Cochrane. Las referencias bibliográficas se buscaron en las siguientes bases de datos: MEDLINE vía PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL y LILACS. Se utilizó una combinación de las siguientes palabras clave: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms. Resultados: Se identificó un total de 272 estudios, cinco de los cuales fueron seleccionados y analizados. Se encontró una ligera superioridad de la acupuntura tradicional comparada con la acupuntura sham; sin embargo, no se encontraron asociaciones estadísticas fuertes. Conclusiones: La evidencia obtenida no fue suficiente para confirmar la eficacia de la acupuntura tradicional comparada con la acupuntura sham.

Stellate ganglion block in the treatment of breast cancer with tidal fever:24 cases of clinical report / 中国基层医药

Objective To provide application stellate ganglion block treatment of hot flashes′latest data by clinical.Methods 24 patients who were put in the research were taken record of each patient after stellate ganglion block when two months later,especially of the clinical symptoms and hot -flashes -onset,and they were asked to fill a symptom questionnaire for each one.The main concern of hot flashes in patients with seizure frequency of hot flashes and score changes were observed.The data were analyzed.Results After the implementation of stellate ganglion block,the number of episodes of hot flashes in breast cancer patients,and ratings declined,and after 6 weeks decreased by 46% and 49%.21 patients observed in Horner's syndrome.Conclusion Stellate ganglion block for the control of hot flashes in breast cancer is effective.

The Association between Body Mass Index and Hot Flash in Midlife Women: A Meta-analysis

OBJECTIVES: The association between body mass index (BMI) and hot flash risk has not been specifically clarifies yet. This meta-analysis was, therefore, conducted to estimate the association between overweight and obesity and hot flash risk. METHODS: We searched PubMed, Web of Science, and Scopus for observational studies addressing the association between BMI and hot flash until August 2015. Data were independently extracted and analyzed using 95% odds ratio (OR), and confidence intervals (CI) based on the random-effects models. RESULTS: We identified 2,244 references and conducted seven studies with 4,219 participants. The association between hot flash and overweight was estimated 1.13 (95% CI: 0.97-1.32) and that of obesity was estimated 1.79 (95% CI: 1.52-2.11). No evidence of heterogeneity and publication bias was observed. CONCLUSION: This meta-analysis demonstrated that, though not to a great extent, obesity does increase the risk of hot flash. The findings from this meta-analysis indicated that obesity is associated with an increased risk of hot flash. Further large prospective cohort studies are required to provide convincing evidence as to whether or not BMI is associated with an increased risk of hot flashes.

Hops for Menopausal Vasomotor Symptoms: Mechanisms of Action

Menopause is a critical stage of women's life associated with various complaints and distresses. Vasomotor symptoms (VMS), such as hot flushes, night sweats, sleep disturbances, and fatigue, are the most common menopause symptoms affecting about 50% to 80% of middle-aged women. Obviously, these symptoms, resulting from estrogen deficiency during menopause, can exert negative effects on women's health and quality of life and thus require to be managed through approaches such as hormone replacement therapy (HRT). Many herbal treatments for menopause symptoms contain and its components such as 8-prenylnaringenin, 6-PN, isoxanthohumol and xanthohumol. Recent in-vivo studies have highlighted the ability of 8-prenylnaringenin to reduce serum-luteinizing hormone (LH) and follicle-stimulating hormone (FSH), to increase serum prolactin levels and uterine weight, and to induce vaginal hyperplastic epithelium. Previous research has shown that hops extract can strongly bind to both estrogen receptors, stimulate alkaline phosphatase activity in Ishikawa cells, and upregulate presenelin-2 and progesterone receptor mRNA in Ishikawa cells. Numerous clinical trials have documented significant reductions in the frequency of hot flushes following the administration of hop-containing preparations. Nevertheless, further clinical trials with larger sample size and longer follow-up are warranted to confirm such benefits.

<b>Three Cases of Trigger Finger which were Successfully Treated with U</b><b>nkeito</b> / 日本東洋医学雑誌

Trigger finger develops because of stenosis around the A1 annular ligament, which causes inhibition of smooth expansion and contraction of the finger. It is effectively treated by an anti-inflammatory analgesic and/or steroid infusion, and by Western style medical surgery. Here, we report 3 cases of trigger finger effectively treated with unkeito. The first case was a 71-year-old female who had been treated with Kampo medicine for an enlarged feeling in the abdomen. She complained of trigger finger, in the knuckle of her right third finger, dry lips, and hot flashes in her hands and feet. The second case was a 56-year-old female who had been treated with Kampo medicine for polyarticular pain in her fingers. She complained of trigger finger of the left fourth finger and hot flashes in her hands. The third case was a 71-year-old female who had been treated for chronic renal failure. She complained of trigger finger in the left first finger and dry skin but had neither hot flashes in the hands nor dry lips. One of the target symptoms of unkeito is hot flashes in the hands and dry lips. Unkeito is composed of herbs which improve <i>ketsu </i>deficiency, <i>oketsu</i>, inflammation, and dry skin. It is possible that these actions of unkeito are effective in trigger finger as well.

Lúpus eritematoso sistêmico e terapia de reposição hormonal: atualização / Lupus erythematosus systemic and hormonal replacement therapy: update

O Lúpus Eritematoso Sistêmico (LES) é uma doença inflamatória crônica, de maior prevalência no sexo feminino, multissistêmica e de natureza autoimune, caracterizada pela presença de diversos autoanticorpos que evolui com manifestações clínicas polimórficas, com períodos de exacerbações e remissões Este artigo consistiu de revisão da literatura realizada pela consulta de seis bases de dados em busca de artigos nacionais e internacionais que relataram o evento tromboembólico e cardíaco nas pacientes lúpicas usuárias de terapia hormonal (TH), buscou relatos sobre o efeito da TH na prevenção da osteoporose nestas pacientes, e saber se o estrogênio pode ser fator etiológico no aparecimento da doença ou causando exacerbação de mulheres lúpicas expostas à TH. Como resultado, conclui-se que terapia hormonal pode ser usada na ausência de atividade da doença e sem agudizações por alguns anos, em mulheres com anticorpo anticardiolipina e/ou anticoagulante lúpico negativo e com doses terapêuticas de glicorticóide baixa e que se deve preferir baixa dose de estrogênio transdérmico combinado com progesterona natural, micronizada ou derivados pregnanos, por apresentar menor potencial trombogênico. E, naquelas pacientes com atividade da doença em controle e ainda com sintomas vasomotores, um agente não-estrogênico (antidepressivo ou progesterona) deve ser a primeira linha de tratamento.(AU)

Systemic Lupus Erythematosus (SLE) is a chronic multisystemic inflammatory disease, more prevalent in women. It is considered an autoimmune disease, characterized by the presence of several autoantibodies. Its clinical presentation is polymorphic, characterized by exacerbation and remissions periods. It was performed an extensive literature research in six databases searching for articles related to the thromboembolic and cardiac events in female SLE patients exposed to replacement hormone therapy (HT). Furthermore, it was searched articles on the effects of HT in the prevention of osteoporosis, as well as if estrogen therapy could be an etiologic factor in the emergence or exacerbation of LES in female patients. HT can be safely used in the absence of disease activity, in patients without exacerbation for some years, in women with no evidence of anticardiolipin or lupus anticoagulant antibodies, and using low corticoid doses. When the use of HT is necessary it is preferable to use low dose of transdermical estrogen combined with natural progesterone, micronised or pregnane derivatives that have less thrombogenic potential. In addition, in patients with LES activity controlled that maintain hot flashes a non-estrogenic therapy (antidepressant or progesterone) should be the first treatment line.(AU)

Terapias alternativas no climatério / Alternative therapies in climacteric

O climatério representa um fenômeno de transição entre a fase reprodutiva e a não reprodutiva, caracterizando um estado fisiológico de hipoestrogenismo progressivo. Existe, atualmente, muito interesse e procura por terapias alternativas à terapia hormonal (TH), uma vez que alguns estudos sugerem que a TH pode aumentar o risco de desenvolvimento de doenças cardiovasculares e câncer de mama. Objetiva-se identificar na literatura evidências recentes acerca dos benefícios das terapias alternativas à TH na redução dos sintomas climatéricos. Dessa forma, foi realizada uma revisão na literatura por meio de consulta nas principais bases de dados e no site Up to date utilizando como estratégia de busca combinação entre as palavras climatério, atividade física, ioga, técnicas de relaxamento, acupuntura, fitoestrogênios, e antidepressivos priorizando artigos mais recentes e com maior nível de evidência. Os resultados demonstraram que, paulatinamente, a terapia não hormonal tem ganhado espaço no tratamento dos sintomas climatéricos, por diversas razões. Entretanto, são necessários mais estudos controlados/randomizados para mostrar eficácia das diversas modalidades de terapia alternativa e também para delinear o perfil das pacientes que teriam maior benefício com esse tipo de tratamento, pois existe um grupo de mulheres que ainda se beneficiam da TH devido a não adaptação às terapias alternativas.(AU)

The climacteric is a phase of transition between the reproductive and the non-reproductive stage, featuring a progressive physiological state of hypoestrogenism. There is a current and increasing demand for alternative therapies to hormone therapy (HT), since same studies suggest that HT may significantly increase the risk of developing cardiovascular disease and breast cancer. This study aims to identify recent evidence in the literature about the benefits of alternative therapies to HT in reducing climacteric symptoms. Thereby, we conducted a literature review in the main database and the website Up To Date, researching the combination between the words climacteric, physical activity, yoga, relaxation techniques, acupuncture, phytoestrogens and antidepressants. The most recent articles with highest level of evidence were prioritized. The results showed that, gradually, alternative therapies to hormones have gained reliability in the treatment of climacteric symptoms for several reasons. However, additional controlled studies / trials are needed to show efficacy of various forms of alternative therapy and also to outline the profile of patients who would most benefit from this type of treatment. Besides, there is a group of women who would still benefit from HT since they are maladapted to alternative therapies.(AU)