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1.
Revagog ; 3(3): 78-79, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1343840

ABSTRACT

La pandemia de coronavirus-2 (SARS-CoV-2) relacionada con el SARS 2019-2020 ha traído desafíos sin precedentes a los sectores de la salud en todo el mundo. Hasta noviembre de 2020, ha habido más de 64 millones de casos confirmados y se acercan a 2 millones de muertes en todo el mundo. A pesar de la gran cantidad de casos positivos, existen muy pocos estándares establecidos de atención y opciones terapéuticas disponibles. Hasta la fecha, (Diciembre 2020) todavía no existe una vacuna aprobada por la Administración de Alimentos y Medicamentos (FDA) para COVID-19, aunque existen varias ensayos clínicos en diferentes. etapas de desarrollo. En este documento, hemos realizado una revisión global que evalúa los roles de la edad y el sexo en las hospitalizaciones por COVID-19, las admisiones a la UCI, las muertes en hospitales y las muertes en hogares de ancianos. Hemos identificado una tendencia en la que las personas mayores y los pacientes masculinos se ven afectados significativamente por los resultados adversos.


Subject(s)
Humans , Female , Middle Aged , Aged , Gonadal Steroid Hormones/pharmacology , Hormone Replacement Therapy , SARS-CoV-2 , COVID-19/mortality , Estrogens , Gender Role , COVID-19/drug therapy
2.
Revagog ; 3(3): 88-103, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344264

ABSTRACT

Describe los planteamientos sobre el beneficio de la terapia de reemplazo hormonal en las mujeres en la menopausia y el riesgo de contraer cáncer de mama con el uso prolongado del mismo.


Subject(s)
Humans , Female , Menopause/drug effects , Hormone Replacement Therapy/adverse effects , Estradiol/adverse effects , Breast Neoplasms/prevention & control , Cardiovascular Diseases/prevention & control , Osteoporosis, Postmenopausal/prevention & control , Hormone Replacement Therapy/classification
3.
Revagog ; 3(3): 104-110, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344331

ABSTRACT

El climaterio es una etapa fisiológica que permite al médico reconocer tempranamente los riesgos de patologías y la gran oportunidad de revertirlas. Este trabajo examinará la evidencia actual de la terapia hormonal en la prevención primaria de la enfermedad cardiovascular en mujeres, así como la importancia que igualmente tienen la indemnidad de los ovarios, el peso normal, el uso correcto de antibióticos, la preservación de la microbiota intestinal, las dietas antioxidantes, los estilos de vida saludables y el obligatorio abandono del hábito de fumar.


Subject(s)
Humans , Female , Climacteric/physiology , Menopause/physiology , Cardiovascular Diseases/prevention & control , Hormone Replacement Therapy , Heart Disease Risk Factors , Smoking/adverse effects , Andropause/physiology , Estradiol/therapeutic use , Atherosclerosis/prevention & control , Gastrointestinal Microbiome/drug effects , Healthy Lifestyle
4.
Cuad. Hosp. Clín ; 62(1): 63-71, jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284353

ABSTRACT

La enfermedad de Addison es una patología endocrinológica ocasionada por la disminución en la secreción de hormonas esteroideas por parte de la corteza adrenal; debida a múltiples etiologías (más comúnmente la tuberculosis en países en vías de desarrollo); con una evolución lenta, insidiosa y progresiva. Pudiendo llegar a una insuficiencia adrenal aguda, misma que puede llegar a ser de extrema gravedad; y en caso de no ser diagnosticada y tratada adecuadamente puede llevar a la muerte. El tratamiento primordial lo constituye la terapia hormonal sustitutiva con fármacos corticoesteroideos.


Addison's disease is an endocrinological pathology caused by the decrease in the secretion of steroid hormones by the adrenal cortex, due to multiple etiologies (most commonly tuberculosis in developing countries); with a slow, insidious and progressive evolution. Being able to reach an acute adrenal insufficiency, which can become extremely serious, and if it is not diagnosed and treated properly, it can lead to death. The primary treatment is hormone replacement therapy with corticosteroid drugs


Subject(s)
Humans , Female , Adult , Addison Disease , Adrenal Cortex Hormones , Adrenal Insufficiency , Tuberculosis , Hormone Replacement Therapy , Hormones , Hypothyroidism
6.
Rev. colomb. menopaus ; 27(1): 24-46, 2021.
Article in Spanish | LILACS, COLNAL | ID: biblio-1283533

ABSTRACT

En enero de 2021 la Asociación Colombiana de Menopausia realizó el simposio "Terapia hormonal de la menopausia" contando con la participación de respetados profesores de la especialidad y a cada uno se le asignó un tema para ser revisado y presentado de acuerdo a la evidencia actual. En noviembre del año 2020 el Instituto de Vigilancia de Medicamentos y Alimentos (INVIMA) había lanzado una alerta sobre "Riesgo de desarrollar cáncer de mama en mujeres postmenopáusicas en manejo con terapia de reemplazo hormonal", apoyándose en una decisión del Reino Unido. Dentro de las afirmaciones de INVIMA se encontró que el uso prolongado por más de un año incrementa el riesgo de cáncer de mama sin que sea claro su soporte científico para tal afirmación. El pronunciamiento del Reino Unido se soportó en el estudio "Tipo y momento de la terapia hormonal de la menopausia y el riesgo de cáncer de mama: Meta-análisis de participantes individuales de la evidencia epidemiológica mundial, del Grupo de colaboración sobre factores hormonales en el cáncer de mama, publicado en la revista médica The Lancet el 29 de agosto de 2019. Varias asociaciones científicas se manifestaron en contra de lo enunciado y por ende la Asociación Colombiana de Menopausia consideró apropiado hacer una revisión exhaustiva del papel de la terapia hormonal en la actualidad. El resultado de dicho trabajo es presentado en esta revisión.


On January 2021 de Colombian Menopause Association did a symposium "Menopause hormonal therapy" with participation of respectable professors of the specialty, to each one previously a topic had been assigned for its review and presentation according to actual evidence. On November 2020 the Colombian Institute for Drugs and Foods Vigilance (INVIMA) had issued an alert about the "Risk of developing breast cancer in postmenopausal women under treatment with hormone replacement therapy", having support in a decision taken in the United Kingdom. One of the things affirmed by INVIMA was that prolonged use, greater than one year, increases the risk of breast cancer, without clear scientifically supporting this issue. In the United Kingdom the pronunciation was supported on the study, "Type and moment of menopausal hormone therapy and risk of breast cancer: Metanalisis of individual participants of worldwide epidemiological evidence, from the Collaborative group on hormonal factors in breast cancer published in The Lancet on August 29, 2019. Various scientific associations manifested against what was expressed and the Colombian Menopause Association considered appropriate to do an exhaustive review of the role of hormonal therapy today. The result of such work is presented in this paper.


Subject(s)
Humans , Female , Middle Aged , Hormone Replacement Therapy , Breast Neoplasms , Menopause , Estrogens , Heart Disease Risk Factors
7.
Rev. méd. Minas Gerais ; 31: 31206, 2021.
Article in English, Portuguese | LILACS | ID: biblio-1291278

ABSTRACT

A menopausa é decorrente da queda gradativa de secreção hormonal ovariana e, nesse período, muitas mulheres apresentam sintomas que comprometem a qualidade de vida. A terapia hormonal (TH) surgiu como importante ferramenta para amenizar a sintomatologia climatérica. No entanto, foram levantadas suspeitas sobre a correlação entre o tratamento e o aumento do risco do câncer de mama (CM). O presente trabalho objetiva avaliar a relação entre CM e TH, abrangendo as implicações da terapia nos sintomas da menopausa, na incidência da neoplasia e na mortalidade. Trata-se de uma revisão narrativa de literatura, em que foram buscados artigos publicados entre julho de 2010 e julho de 2020, nas bases de dados LILACS, MEDLINE e SciELO. Os principais tipos de TH são o estrogênio isolado e o combinado com progesterona. Nos estudos analisados, a terapia combinada foi relacionada à maior incidência de CM quando comparada ao regime estrogênico. De acordo com a literatura, modificações na densidade mamográfica, induzidas pela TH, podem elevar o risco para carcinoma mamário. Os artigos relataram que fatores além da terapia hormonal, como o estilo de vida, podem interferir na incidência de CM e devem ser analisados individualmente. A mortalidade por CM influenciada pela TH não demonstrou aumento significativo. No geral, a TH foi considerada o tratamento mais eficaz para aliviar sintomas climatéricos. Entretanto, estudos a longo prazo que analisem os riscos e a confiabilidade da terapia devem ser estimulados, a fim de indicar a terapêutica mais segura e evitar intervenções indevidas.


Menopause is due to the gradual drop in ovarian hormonal secretion, and, during this period, many women have symptoms that compromise quality of life. Hormone therapy (HT) has emerged as an important tool to alleviate climacteric symptoms. However, suspicions were raised about the correlation between treatment and the increased risk of breast cancer (BC). The present study aims to evaluate the relationship between BC and HT, covering the implications of therapy for menopausal symptoms, the incidence of neoplasia and mortality. This is a narrative review of the literature, in which articles published between July 2010 and July 2020 were searched for in the LILACS, MEDLINE and SciELO databases. The main types of HT are estrogen alone and combined formula with progesterone. In the studies analyzed, combined therapy was related to a higher incidence of BC when compared to the estrogenic regimen. According to the literature, changes in mammographic density, induced by HT, can increase the risk for breast carcinoma. The articles reported that factors other than hormone therapy, such as lifestyle, can interfere with the incidence of BC and should be analyzed individually. Mortality from BC influenced by HT did not show a significant increase. Overall, HT was considered to be the most effective treatment for relieving climacteric symptoms. Although, long-term studies that analyze the risks and reliability of therapy should be encouraged in order to indicate the safest therapeutics and to avoid unnecessary interventions.


Subject(s)
Female , Middle Aged , Breast Neoplasms , Hormone Replacement Therapy , Climacteric , Menopause , Estrogen Replacement Therapy , Hormones
8.
Revista Digital de Postgrado ; 9(2): 227, ago. 2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1103383

ABSTRACT

Evaluar los efectos de la terapia hormonal (TH) con Drospírenona (DRSP)/17 ß -estradiol (E2), sobre los parámetros del Síndrome Metabólico (SM) en pacientes postmenopáusicas. Métodos: Investigación comparativa y aplicada, con diseño cuasi experimental, de casos y controles a simple ciego, prospectivo y de campo; realizada en la Consulta de Ginecología. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. Participaron 120 mujeres separadas al azar para recibir la combinación DRSP/E2 (Grupo A) o un placebo (Grupo B). Se evaluaron los componentes del SM antes y posterior a 6 meses de haber recibido la TH. Resultados: Se encontró una alta prevalencia de SM en ambos grupos antes de recibir el tratamiento (53,3% y 48%; grupo A y B respectivamente). Posterior al tratamiento, DRSP/E2 al compararse con un placebo, redujo significativamente tanto la prevalencia del SM como el riesgo de padecerlo (21,7% versus 48,3%, OR [IC95%]= 0,29 [0,13-0,65]; p < 0.001), con reducción significativa (p< 0.001) de la hipertensión arterial, glicemia basal alterada, hipertrigliceridemia y obesidad central; además de una reducción significativa de los síntomas vasomotores, síntomas psicológicos e incontinencia urinaria (p< 0.001). En el grupo B la prevalencia del SM se mantuvo sin cambios, salvo para la glicemia basal alterada y los síntomas vasomotores y psicológicos que mostraron una reducción significativa (p< 0.001). Conclusión: DRSP/E2 (2mg/1 mg) demostró ser eficaz luego de 6 meses de tratamiento tanto para el control de los parámetros que definen al SM; con pocos y leves efectos indeseados(AU)


To assess the effects of hormone therapy (HT) with drospirenone (DRSP)/17 ß -estradiol (E2) on the parameters of the metabolic syndrome (MS) in postmenopausal patients. Methods: We performed a comparative and applied research, with quasiexperimental, case-control, single-blind, prospective and field design. The study was realized in the Gynecology consultation. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. 120 women were included, they were separated to receive either the combination DRSP/E2 (Group A) or placebo (Group B). We assess MS components before and ather 6 months of receiving HT. Results: We found a high prevalence in both groups before receiving treatment (53.3% and 48%, group A and B respectively). A ther treatment, DRSP/E2 when compared to placebo, significantly reduced both the prevalence of MS as the risk of setting it (21.7% versus 48.3%, OR [95%] = 0.29 [0.13-0.65] p <0.001), with a significant reduction (p <0.001) of hypertension, impaired fasting glucose, hypertriglyceridemia, central obesity; and a significant reduction in vasomotor symptoms, psychological symptoms and urinary incontinence (p <0.001). In group B the prevalence of MS was unchanged, except for impaired fasting glycemia and vasomotor and psychological symptoms showed a significant reduction (p <0.001). Conclusion: DRSP/E2 (2mg /1mg), proved to be effective a ther 6 months of treatment both for the control of the parameters that define the SM, with few and mild side effects(AU)


Subject(s)
Humans , Female , Progestins/therapeutic use , Hormone Replacement Therapy , Metabolic Syndrome/physiopathology , Estradiol/therapeutic use , Postmenopause , Endocrinology , Gynecology
9.
Medicina (B.Aires) ; 80(3): 289-291, jun. 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1125082

ABSTRACT

El hipoparatiroidismo (hipoPTH) es una enfermedad infrecuente caracterizada por hipocalcemia y niveles inapropiadamente bajos o ausentes de parathormona. Presentamos el caso de un hombre de 25 años, deportista de alto rendimiento, con antecedente de hipoPTH secundario a tiroidectomía total dos años antes por cáncer papilar multifocal bilateral tiroideo, estadificado como T3 N1b M0, derivado por hipocalcemia sintomática. Presentaba calcemias promedio de 7mg%, síntomas de hipocalcemia en reposo y múltiples internaciones. Inicialmente, se optimizó tratamiento convencional con aporte de calcio vía oral hasta 12g/día, vitamina D y calcitriol, sin mejoría clínica ni bioquímica. Se descartaron malabsorción y complicaciones crónicas de hipoPTH. Se evidenció a través de cuestionario de salud SF-36 disminución de la calidad de vida. Se indicó sustitución con parathormona recombinante humana [rhPTH(1-84)] 50μg/día subcutánea con posterior ascenso a 75μg y reducción progresiva de la medicación por vía oral. Actualmente se encuentra asintomático, sin requerimiento de calcio ni vitamina D, mantiene calcemias de 9mg%, realiza actividad deportiva y demuestra marcada mejoría en la calidad de vida según cuestionario SF-36 (36-Item Short Form Health Survey).


Hypoparathyroidism (HypoPT) is a rare disease characterized by low calcium and inappropriately low circulating parathormone levels. We present the case of a 25-year-old high-performance athlete male, with history of HypoPT after total thyroidectomy for papillary thyroid carcinoma (T3 N1b M0) two years before, who was referred to our clinic for symptomatic hypocalcemia. The patient reported serum calcium average levels of 7mg%, presented symptoms of hypocalcemia at rest and had multiple hospital admissions. First, standard treatment was optimized by calcium supplementation up to 12g/d and active vitamin D, not showing clinical or biochemical improvement. Malabsorption and complications of chronic HypoPT were ruled out. The 36-Item Short Form Health Survey (SF-36) demonstrated an impaired quality of life (QoL). Full-length recombinant human parathyroid hormone [rhPTH(1-84)] therapy was started with 50μg/d subcutaneous, and later adjusted to 75μg/d and the oral treatment gradually decreased. Currently, he is asymptomatic, with serum calcium levels above 9mg%, without receiving oral medication. He performs sports activity and shows marked improvement in quality of life according to SF-36 questionnaire.


Subject(s)
Humans , Male , Adult , Parathyroid Hormone/therapeutic use , Hypoparathyroidism/drug therapy , Thyroidectomy/adverse effects , Vitamin D/therapeutic use , Calcitriol/therapeutic use , Thyroid Neoplasms/surgery , Thyroid Neoplasms/complications , Hormone Replacement Therapy/methods , Calcium-Regulating Hormones and Agents/therapeutic use , Thyroid Cancer, Papillary/surgery , Thyroid Cancer, Papillary/complications , Hypoparathyroidism/etiology
10.
Arch. med ; 20(1): 71-85, 2020-01-18.
Article in Spanish | LILACS | ID: biblio-1053232

ABSTRACT

Objetivo: evaluar la eficacia y seguridad de dos terapias hormonales sustitutivas, combinadas con testosterona, en el tratamiento del trastorno del deseo sexual hipoactivo en mujeres en climaterio. Materiales y métodos: ensayo clínico, aleatorizado, controlado, no enmascarado. Se incluyeron mujeres mayores o igual a 40 años y menores de 60 años, con útero, con actividad sexual en las últimas seis semanas, aquejadas por síntomas vasomotores, cuyo motivo de co sulta consistió en bajo deseo sexual. Se utilizó como instrumento el cuestionario Índice de Función Sexual Femenina (IFSF). Se asignaron dos grupos aleatorizados: grupo «A¼ (51 recibieron estrógenos conjugados de equinos y edroxiprogesterona más testosterona) y grupo «B¼ (54 tibolona más testosterona). El estudio fue realizado entre julio de 2015 y diciembre de 2016, en Armenia, Quindío, Colombia. Resultados: se analizó una población de 105 mujeres. La media de edad fue de 55,8 (DS±9,38) años. En la población total, al inicio del estudio, la mediana fue de 3 encuentros sexuales por mes. Al final la mediana fue de 5 encuentros sexuales por mes, (grupo «A¼ 4 encuentros y grupo «B¼ 7 encuentros, p=0,0036). Al finalizar la investigación se observó que las mujeres del grupo «B¼, mostraron puntuaciones promedias significativamente más altas en el IFSF (28,56 DS±4,63 puntos), al compararlas con las mujeres del grupo «A¼ (27,57 DS±4,32) (p<0,0001). Conclusiones: la terapia con tibolona asociada a testosterona es una opción de tratamiento efectiva en el trastorno del deseo sexual hipoactivo en mujeres en climaterio..(AU)


Objective: to evaluate the efficacy and safety of two hormone replacement therapies, combined with testosterone, in the treatment of hypoactive sexual desire disorder in women in climacteric. Materials and methods: clinical trial, randomized, controlled, not masked. Women over 40 years old and under 60 years old, with a uterus, with sexual activity in the last six weeks, suffering from vasomotor symptoms, whose reason for consultation consisted of low sexual desire were included. The Female Sexual Function Index questionnaire was used as an instrument. Two randomized groups were assigned: group "A" (51 received conjugated estrogens from equines and medroxyprogesterone plus testosterone) and group "B" (54 tibolone plus testosterone). The study was conducted between July 2015 and December 2016, in Armenia, Quindío, Colombia. Results: a population of 105 women was analyzed. The average age was 55,8 (SD ± 9,38) years. In the total population, at the beginning of the study, the median was 3 sexual encounters per month. In the end, the median was 5 sexual encounters per month, (group «A¼ 4 meetings and group «B¼ 7 meetings, p = 0,0036). At the end of the investigation, it was observed that the women of the «B¼ group showed significantly higher average scores in the IFSF (28,56 SD ± 4,63 points), compared with values in the women of the «A¼ group (27,57 DS ± 4,32) (p<0,0001). Conclusions: testosterone-associated tibolone therapy is an effective treatment option in hypoactive sexual desire disorder in women in climacteric..(AU)


Subject(s)
Female , Sexual Dysfunctions, Psychological , Hormone Replacement Therapy
11.
Article in English | WPRIM | ID: wpr-827432

ABSTRACT

OBJECTIVES@#The effects of hormone replacement therapy on the survival rate of female lung cancer patients are still controversial. The Meta-analysis aims to systematically evaluate the effect of hormone replacement therapy on the survival rate of female lung cancer patients.@*METHODS@#Retrospective studies regarding the effect of hormone replacement therapy on female lung cancer patients' survival rate were searched from the database of Embase, Cochrane, Pubmed, CNKI, Wanfang, and Weipu. The Meta-analysis was conducted with Stata 12.0 software. test was used to analyze the heterogeneity among included studies. The analysis was conducted by randomized model. Egger's test and Begg's test were used to assess the publication bias.@*RESULTS@#Five retrospective studies were included, involving 2 582 female patients with lung cancer. There were 1 054 cases of female lung cancer with hormone replacement therapy and 1 528 cases of female lung cancer without hormone replacement therapy. No publication bias was observed among these studies. The sensitivity analysis result showed that the overall results were stable. Meta-analysis showed that compared with patients without hormone replacement therapy, patients with hormone replacement therapy had an increased survival time for 5 years (ES=0.346; 95% CI 0.216 to 0.476; <0.001).@*CONCLUSIONS@#Hormone replacement therapy improves 5-year survival in female lung cancer patients. Female lung cancer patients with menopausal syndrome can use hormone replacement therapy properly under their doctors' suggestion.


Subject(s)
Female , Hormone Replacement Therapy , Humans , Lung Neoplasms , Drug Therapy , Retrospective Studies , Survival Rate
13.
Saúde Soc ; 29(1): e190918, 2020.
Article in Portuguese | LILACS | ID: biblio-1101915

ABSTRACT

Resumo Este artigo discute o papel das terapias hormonais na construção de uma narrativa da saúde para a longevidade da medicina anti-aging. O objetivo é identificar o significado dos hormônios na constituição de um processo de aprimoramento do corpo para manter suas funções naturais e possibilitar a personalização do envelhecimento. A análise é parte da pesquisa realizada no Brasil com médicos praticantes, pacientes e médicos críticos, membros do Conselho Federal de Medicina (CFM), por meio de entrevistas semiestruturadas e observação em campo. Discute-se o estabelecimento de uma rede internacional de profissionais e instituições que viabiliza a expansão das práticas anti-aging em um contexto institucional desfavorável. Na proposição de uma abordagem holística do envelhecimento, a medicina anti-aging se concentra não em doenças típicas da velhice, mas no aprimoramento das condições de saúde ao longo da vida. Considerados "combustíveis" da vida, os hormônios se destacam como elementos de integração entre a particularidade dos pacientes e a generalidade do processo natural de envelhecimento, fortalecendo uma perspectiva de aprimoramento natural, com recursos do próprio corpo. A modulação com hormônios bioidênticos é contraposta à hegemonia da indústria farmacêutica em uma narrativa que altera as fronteiras entre terapia e aprimoramento, natural e artificial, tratamento e estilo de vida.


Abstract This article discusses the role of hormonal therapies in the narrative concerning longevity present in anti-aging medicine. The objective is identifying the meaning that hormones have in the body enhancement process aimed to preserve natural functions and enable the personalization of aging. This analysis is part of a study conducted in Brazil with practitioners of anti-aging medicine, patients and objector members of the Brazilian Council of Medicine, by means of semi-structured interviews and fieldwork observation. The discussion addresses the formation of an international network of professionals and institutions supporting anti-aging practices in a disadvantageous institutional context in Brazil. Anti-aging medicine proposes a holistic approach to aging and focuses on enhancing health conditions throughout the patient's life instead of targeting aging-related diseases. Hormones are considered "fuel" for life processes and conceived as elements that can integrate the particularity of each patient and the general aspect of natural tendencies in the aging process. That perspective strengthens the conception of natural enhancement, using the body's own resources. Bioidentical hormone modulation contrasts with the pharmaceutical industry in a narrative that alters the boundaries between therapy and enhancement, natural and artificial, treatment and lifestyle.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aging , Hormone Replacement Therapy , Longevity , Holistic Health , Life Style
14.
Rev. colomb. menopaus ; 26(4): 54-59, 2020.
Article in Spanish | LILACS | ID: biblio-1253125

ABSTRACT

Es un artículo de opinión a raíz del artículo publicado en Lancet el 29 de agosto de 2019, (Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. DOI: https://doi.org/10.1016/S0140 6736(19)31709-X.). En noviembre de 2020 el ente regulatorio colombiano, INVIMA, se pronunció sobre el aumento de riesgo de cáncer de mama asociado a TRH. De antemano se sabe que la posibilidad de desarrollar cáncer de seno asociado a TRH es muy baja y que los beneficios superan con creces ese riesgo. Es importante que se distinga las diferencias entre "asociación" y "causalidad". Se presentan todos los argumentos basados en evidencia que soportan que el riesgo con esta asociación es débil y bajo. Se analizan los resultados presentados por los ingleses, considerando que no son consistentes con lo encontrado en estudios aleatorios controlados, enmascarados y multicéntricos. Finaliza demostrando las bondades de la TRH.


This is an opinion article following the article published in Lancet on August 29, 2019, (Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. DOI: https://doi.org/10.1016/S0140 6736(19)31709-X.). On November the regulatory entity in Colombia, INVIMA, pronounced about the increased risk of breast cancer associated to HRT. It is known that the possibility of developing breast cancer under HRT is very low and that benefits overcome that risk. It is important to distinguish the differences between "association" and "causality". Al arguments are presented based on evidence that supports that the risk with this association is weak and low. The results presented by the English are analyzed, considering they are inconsistent with those found in randomized, controlled, masked and multi center trials. Ends demonstrating benefits of HRT.


Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms , Association , Risk , Hormone Replacement Therapy
15.
Rev. Inst. Adolfo Lutz ; 78(único): 1-12, dez. 2019. tab
Article in Portuguese | LILACS, ColecionaSUS, SES-SP, CONASS, SESSP-ACVSES, SESSP-IALPROD, SES-SP, SESSP-IALACERVO | ID: biblio-1178334

ABSTRACT

Neste trabalho foram avaliados os fatores de risco para doenças cardiovasculares (DCV) e o consumo alimentar de mulheres climatéricas não usuárias de terapia de reposição hormonal (TRH), de acordo com os períodos climatéricos. Trata-se de um estudo transversal em 95 mulheres climatéricas residentes em três municípios do Sudoeste do Paraná. Foram coletados dados sociodemográficos e clínicos por meio de entrevista, além de dados antropométricos e de consumo alimentar. A média etária foi de 52,5 ± 5,85 anos, 77,9% estudaram 8 ou mais anos, 76,8% possuíam renda familiar de até três salários mínimos, 70,5% possuíam cônjuge e 60% não tiveram nenhum ou até dois partos. Foi observada frequência de excesso de peso e de risco para doenças cardiovasculares em mais de 65% das mulheres. A presença de comorbidades (p = <0,001) foi mais frequentes nas mulheres pós-menopáusicas. Quanto à ingestão de lipídios e ácidos graxos saturados, observou-se maior consumo excessivo nas pré- e peri-menopáusicas (p = 0,042 e p = 0,022, respectivamente). Os achados do estudo demonstram a importância da prevenção de DCV independentemente do período climatérico e da utilização de TRH. (AU)


The objective of this study was to evaluate the risk factors for cardiovascular diseases (CVD) and the dietary intake in climacteric women not using hormone replacement therapy (HRT), according to the climacteric periods. This is a cross-sectional study involving 95 climacteric women living in three municipalities located in the Southwest region of Parana. Socio-demographic and clinical data were collected by interviews, in addiction to the anthropometric data and on the food consumption. The mean age was 52.5 ± 5.85 years, 77.9% studied for eight years or more, 76.8% had a family income of up to three minimum wages, 70.5% had a spouse, and 60% did not have any or up to two deliveries. Frequencies of overweight and risk for cardiovascular disease were observed in more than 65% of women. The occurrence of comorbidities (p = 0.001) was more frequent in postmenopausal women. With regard to the lipids and saturated fatty acids intake, a higher consumption in the pre- and peri-menopausal periods (p = 0.042 and p = 0.022 respectively). These findings demonstrate the importance of preventing CVD, independently of the climacteric period and the use of HRT. (AU)


Subject(s)
Humans , Female , Women , Climacteric , Menopause , Cardiovascular Diseases , Risk Factors , Dietary Supplements , Hormone Replacement Therapy
16.
Rev. argent. mastología ; 38(140): 7-9, dic. 2019.
Article in Spanish | LILACS | ID: biblio-1116257

ABSTRACT

Si entendemos que el cáncer de mama es la principal causa de muerte por cáncer entre las mujeres, con una incidencia en la Argentina de 21.000 casos nuevos por año, y que una de cada 8 mujeres lo va a padecer si logra llegar a la expectativa de vida de 80 años, y que su mayor incidencia ocurre en la menopausia, entre los 55 y 70 años, vamos a comprender que el uso de Terapia Hormonal Menopáusica (thm) no incrementa como causa unifactorial el desarrollo de esta enfermedad


Subject(s)
Therapeutics , Breast Neoplasms , Hormone Replacement Therapy
17.
Arch. endocrinol. metab. (Online) ; 63(6): 592-600, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1055015

ABSTRACT

ABSTRACT Growth hormone (GH) deficiency (GHD) in adults is well-characterized and includes abnormal body composition, reduced bone mass, an adverse cardiovascular risk profile, and impaired quality of life. In the early 1990s, it was also shown that patients with hypopituitarism without GH replacement therapy (GHRT) had excess mortality. Today, GHRT has been shown to decrease or reverse the negative effects of GHD. In addition, recent papers have shown that mortality and morbidity are approaching normal in hypopituitary patients with GHD who receive modern endocrine therapy including GHRT. Since the first dose-finding studies, it has been clear that efficacy and side effects differ substantially between patients. Many factors have been suggested as affecting responsiveness, such as sex, age, age at GHD onset, adherence, and GH receptor polymorphisms, with sex and sex steroid replacement having the greatest impact. Therefore, the individual tailoring of GH dose is of great importance to achieve sufficient efficacy without side effects. One group that stands out is women receiving oral estrogen replacement, who needs the highest dose. Serum insulin-like growth factor-1 (IGF-1) is still the most used biochemical biomarker for GH dose titration, although the best serum IGF-1 target is still debated. Patients with GHD due to acromegaly, Cushing's disease, or craniopharyngioma experience similar effects from GHRT as others. Arch Endocrinol Metab. 2019;63(6):592-600


Subject(s)
Humans , Male , Female , Adult , Human Growth Hormone/administration & dosage , Human Growth Hormone/deficiency , Hormone Replacement Therapy/methods , Medication Adherence , Precision Medicine , Quality of Life , Age of Onset
18.
Int. braz. j. urol ; 45(5): 1008-1012, Sept.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1040079

ABSTRACT

ABSTRACT Purpose The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. Materials and Methods We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. Results Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. Conclusions Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and efficacious with no adverse events.


Subject(s)
Humans , Male , Adult , Aged , Reproductive Control Agents/therapeutic use , Testosterone/blood , Chorionic Gonadotropin/therapeutic use , Hypogonadism/drug therapy , Reference Values , Reproducibility of Results , Retrospective Studies , Treatment Outcome , Statistics, Nonparametric , Hormone Replacement Therapy/methods , Hypogonadism/blood , Middle Aged
19.
Rev. cuba. endocrinol ; 30(2): e182, mayo.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126425

ABSTRACT

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)


Subject(s)
Humans , Male , Female , Adult , Hyperprolactinemia/complications , Cyproterone Acetate/therapeutic use , Hormone Replacement Therapy/adverse effects , Gender Dysphoria/etiology , Self Medication/adverse effects , Data Analysis
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