Distribución de esteroides estrogénicos en plantas de tratamiento de aguas residuales municipales / Distribution of estrogenic steroids in municipal wastewater treatment plants

En la actualidad, existe una preocupación creciente por la presencia de estrógenos en el medio acuático, donde pueden ser introducidos a partir de aguas residuales después de su eliminación incompleta en las plantas de tratamiento. Las aguas residuales sistemáticamente reciben estrógenos naturales y sintéticos, y por lo tanto una comprensión más profunda de la suerte de ellos en el medio ambiente es necesaria. Se evaluaron los niveles de estrógenos en los efluentes de las Plantas de Tratamiento de Aguas Residuales (PTARs) Penha e Ilha do Governador, ambos de tipo convencional de flujo continuo de lodo activado con aireación prolongada. Fue utilizado como el parámetro de determinación de algunos compuestos de interés como estrógenos naturales [estrona (E1), 17β-estradiol (E2), estriol (E3)) y sintéticos (17α-etinilestradiol (EE2)]. Las muestras individuales se recogieron posteriormente al tratamiento de cada PTAR y después de los procedimientos de laboratorio se realizó la determinación de estrógenos basado en la extracción en fase sólida (SPE) y la cromatografía líquida de alta resolución con detector de arreglo de diodos (HPLC-DAD). Las concentraciones fueron de: 0,7 a 5,2 μg/l y de 0,5 a 5,6 de E1; 0,9 a 7,7 y 1,2 a 9,2 μg/l para E2; 2,01 a 6,09 y 1,07 a 4,08 μg/l para EE2 en PTAR Penha y PTAR Ilha do Governador, respectivamente. La capacidad de eliminación de estrógenos fue eficaz, pero denota que la eliminación sistemática de la población es en la actualidad alta. Se recomienda instalar mecanismos para mitigar el consumo exagerado de estas sustancias o implementar una eliminación completa más eficaz.

Currently, there is a growing concern over the presence of estrogens in the aquatic environment, where they can be introduced from wastewater after their incomplete elimination in the treatment plants. Wastewater systematically receives natural and synthetic estrogens, and thus a deeper understanding of the fate of them in the environment is extremely necessary. It was evaluated estrogen levels in the effluent from the Sludge Wastewater Treatment Plants (SWTPs) Penha and Ilha do Governador, both of type conventional continuous-flow activated sludge with extended aeration. The determination of some target compounds as natural estrogens was used as the evaluation parameter [estrone (E1), 17β-estradiol (E2), estriol (E3) and synthetic (17α-ethinylestradiol (EE2)]. Individual samples were collected posterior treatment of each SWTP, and after laboratory procedures, the determination of estrogens was performed by a method based on solid phase extraction (SPE) and high performance liquid chromatography-diode array detector (HPLC-DAD). Concentrations ranged from 0.7 to 5.2 μg/l and from 0.5 to 5.6 for E1; 0.9 to 7.7 and 1.2 to 9.2 μg/l for E2; 2.1 to 6.9 and 1.7 to 4.8 μg/l for EE2 at SWTPs Penha and Ilha do Governador, respectively. The removal capacity of estrogens despite its effectiveness denotes that the systematic elimination by the population is high nowadays and urging mechanisms to mitigate the exaggerated consumption or to implement most effective complete removal.

Measurement of serum estrogen and estrogen metabolites in pre- and postmenopausal women with osteoarthritis using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry

Although 17β-estradiol (E2) deficiency has been linked to the development of osteoarthritis (OA) in middle-aged women, there are few studies relating other estrogens and estrogen metabolites (EMs) to this condition. We developed a high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS) method to measure the levels of six EMs (i.e., estrone, E2, estriol, 2-hydroxyestrone, 2-hydroxyestradiol, and 16a-hydroxyestrone) in healthy pre- and postmenopausal women and women with OA. This method had a precision ranging from 1.1 to 3.1% and a detection limit ranging from 10 to 15 pg. Compared to healthy women, serum-free E2 was lower in the luteal and postmenopausal phases in women with OA, and total serum E2 was lower in postmenopausal women with OA. Moreover, compared to healthy women, total serum 2-hydroxyestradiol was higher in postmenopausal women with OA and total serum 2-hydroxyestrone was lower in both the luteal and follicular phases in women with OA. In conclusion, our HPLC-ESI-MS/MS method allowed the measurement of multiple biochemical targets in a single assay, and, given its increased cost-effectiveness, simplicity, and speed relative to previous methods, this method is suitable for clinical studies.

Serum marker screening during the second trimester for prenatal diagnosis and predicting pregnancy outcome / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical value of screening the serum markers during the second trimester of pregnancy in preventing congenital birth defect and predicting the pregnancy outcome.</p><p><b>METHODS</b>Between November, 2011 and October, 2013, a total of 25 520 pregnant women (15-20+6 gestational weeks) underwent a screening test of triple serum markers including free beta-human chorionic gonadotrophin (free βhCG), alpha-fetoprotein (AFP), and unconjugated estriol (µE3) during the second semester of pregnancy. The women identified by the screening test as having high risks were referred to invasive prenatal diagnosis by amniocentesis, or to color Doppler ultrasound examination for suspected patent neural tube defect (NTD), and their pregnancy outcomes were followed up.</p><p><b>RESULTS</b>High-risk pregnancies were identified by the screening test in 4.91% (1254/25520) of the total cohort. Of the 818 patients receiving invasive prenatal diagnosis, the abnormal rate was 5.75% (47/818). The high-risk pregnancies identified by the screening test was associated with a significantly higher rate of abnormal outcomes compared with the low-risk pregnancies (1.91% vs 0.1%, P<0.01). Of the 210 high-risk cases of NTD, a definite diagnosis was established in 34 cases. We also found that pregnancies at an advanced age (>35 years) was associated with increased risks for trisomy 21 compared with those at younger ages (15% vs 1.65%P<0.01). The detection rate of abnormal karyotypes in pregnancies with an abnormal MoM value of a single marker was 3.17% (6/189).</p><p><b>CONCLUSION</b>Screening tests of serum markers during the second trimester of pregnancy can be helpful to identify fetal chromosomal and anatomical anomalies, predict unfavorable pregnancy outcomes, and prevent birth defects in pregnancies at an advanced age. The MoM value of a single marker in the second trimester can be indicative of potential chromosomal abnormalities.</p>

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

OBJECTIVE: To determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms. METHODS: A total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. RESULTS: An improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04±4.9 to 57.12±4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. CONCLUSION: The nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women. .

Maternal serum progesterone, estradiol and estriol levels in successful dinoprostone-induced labor

Hormone-mediated quiescence involves the maintenance of a decreased inflammatory responsiveness. However, no study has investigated whether labor induction with prostanoids is associated with changes in the levels of maternal serum hormones. The objective of this study was to determine whether labor induction with dinoprostone is associated with changes in maternal serum progesterone, estradiol, and estriol levels. Blood samples were obtained from 81 pregnant women at term. Sixteen patients had vaginal birth after spontaneous labor, 12 required cesarean section after spontaneous labor and 16 underwent elective cesarean. Thirty-seven patients had labor induction with dinoprostone. Eligible patients received a vaginal insert of dinoprostone (10 mg) and were followed until delivery. Serum progesterone (P4), estradiol (E2) and estriol (E3) levels and changes in P4/E2, P4/E3 and E3/E2 ratios were monitored from admission to immediately before birth, and the association of these measures with the resulting clinical classification outcome (route of delivery and induction responsiveness) was assessed. Progesterone levels decreased from admission to birth in patients who underwent successful labor induction with dinoprostone [vaginal and cesarean birth after induced labor: 23% (P < 0.001) and 18% (P < 0.025) decrease, respectively], but not in those whose induction failed (6.4% decrease, P > 0.05). Estriol and estradiol levels, P4/E2, P4/E3 and E3/E2 ratios did not differ between groups. Successful dinoprostone-induced labor was associated with reduced maternal progesterone levels from induction to birth. While a causal relationship between progesterone decrease and effective dinoprostone-induced labor cannot be established, it is tempting to propose that dinoprostone may contribute to progesterone withdrawal and favor labor induction in humans.

Tratamento da atrofia urogenital com a administração local de estrogênios: um estudo randomizado, controlado em mulheres no climatério e na pós-menopausa / Treatment of urogenital atrophy with the local administration of oestrogens: a randomized, controlled study in climateric and postmenopausal women

Objetivo: Avaliar a eficácia, segurança e aceitabilidade de cremes vaginais contendo promestriene (Colpotrofine®, Laboratórios Teva do Brasil) ou estriol (Ovestrion®, MSD, Brasil), em mulheres no climatério e na menopausa. Método: Estudo prospectivo, randomizado, aberto, de grupos paralelos e controlado. Locais: Instituto de Ginecologia da Universidade Federal do Rio de Janeiro e Faculdade de Medicina da Valença. Material: 80 mulheres na menopausa ou climatério, para quem o tratamento com creme vaginal de estrogênio foi indicado. Intervenção(s): As pacientes aplicaram 1g do creme vaginal, respectivo, a cada noite por 20 dias e depois uma aplicação semanal durante seis meses consecutivos. As pacientes foram distribuídas aleatoriamente sucessivamente numa proporção de 1:1, de acordo com a sua ordem de chegada: as pacientes ímpares foram designadas para receber promestriene e as com números pares foram designadas para receber estriol. Principal medida de desfecho(s): A variável de resposta primária foi a maturação do epitélio vaginal, avaliada pela citologia vaginal e medida pelo índice de Frost. Ambos os tratamentos melhoraram significativamente o trofismo do epitélio vaginal. Resultado(s): Uma melhoria acentuada (94,1%) foi indicado para pacientes do grupo promestriene por três meses, culminando na melhoria de 100% em 6 meses (p <0,0001). Houve clara melhoria dos sintomas da menopausa para ambos os grupos, sendo os tratamentos seguros e bem tolerados. Pacientes do grupo promestriene foram significativamente (p <0,038) mais satisfeitas (100%) com seu tratamento em comparação ao grupo estriol (73,33%). Conclusão(s): Ambos os tratamentos reverteram a atrofia vaginal, levando a um epitélio vaginal saudável, com destaque estatisticamente significativo para o promestriene, o que condicionou a uma melhoria da qualidade de vida.

Establishment and application of median serum markers for second trimester screening in Qingdao region / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To establish the median of serum markers for second trimester screening in Qingdao region and to assess the influence of median correction on the performance of screening.</p><p><b>METHODS</b>Maternal serum alpha-fetoproteins (AFP), human chorionic gonadotrophin, free beta subunit (β -HCG) and unconjugated oestriol (uE3) were assayed for prenatal screening of 18 188 singleton pregnancies at 15-20(+ 6) weeks gestation from January 2009 to July 2010. The median of serum markers was calculated based on above results and applied for risk estimation in screening for fetal aneuploidy from August 2010 to March 2011. The screening performance, specified in terms of detection rates (DRs), false positive rates (FPRs) and odds of being affected given a positive result (OAPR) were compared between the two groups. The risks of 45 affected pregnancies detected during the study were estimated with both Caucasian and corrected medians.</p><p><b>RESULTS</b>The average level of AFP in local pregnancies was similar to that of the Caucasian population, whilst β -HCG and uE3 were respectively 11% and 33% higher than those of Caucasians. The multiple of median (MoM) value was between 0.94 and 1.02 for the dataset based on the corrected median. At a cut-off of l in 270, FPR has decreased from 5.2% to 4.9%, and DR of Down syndrome has increased from 60% to 69.2%, and OAPR has increased from 1:79 to 1:59 when evaluating risk based on the corrected median. For the 45 affected pregnancies, three Down syndrome pregnancies could be missed because their risk estimates were lower than the cut-off level based on Caucasian median.</p><p><b>CONCLUSION</b>It is useful to establish and apply population and laboratory-specific medians in order to improve the performance of prenatal screening and diagnosis.</p>

Efecto antinociceptivo de estriol y Glicina max l. (soya) en ratas ovariectomizadas / Antinociceptive effect of estriol and Glicina max l. (soya) in ovariectomized rats

Objetivo: Demostrar el efecto protector del estriol y Glicina max L. (soya) frente al dolor nociceptivo, en ratas ovariectomizadas. Diseño: Estudio experimental. Lugar: Bioterio de la Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Material biológico: Ratas hembras albinas Holtzman de 2,5 a 3 meses de edad. Métodos: Las 29 ratas fueron agrupadas aleatoriamente: grupo 1 (n=8), no ovariectomizadas, tratadas con solución salina (0,1 mL/kg); grupo 2 (n=7), ovariectomizadas y tratadas con solución salina (0,1 mL/kg); grupo 3 (n=7), ovariectomizadas y tratadas con estriol (0,2 mg/kg); grupo 4 (n=7), ovariectomizadas y tratadas con Glycine max L. (60 mg/kg). Se realizó una prueba basal de dolor térmico en el hornillo a todos los animales, así como tres días después del tratamiento farmacológico. Principales medidas de resultados: Se usó el porcentaje de eficiencia antinociceptiva máxima (porcentaje EAM). Resultados: Se encontró que el porcentaje EAM fue mayor en el grupo de ratas no ovariectomizadas (1,6 por ciento) que en el grupo de las ovariectomizadas (0,8 por ciento). Por otro lado, el porcentaje EAM en ratas ovariectomizadas con solución salina (0,8 por ciento) fue menor al compararlo con el grupo de las tratadas con estriol (5,8 por ciento); así también, el porcentaje EAM del grupo de ovariectomizadas tratadas con Glicina max L. (4,2 por ciento) fue superior al grupo de ovariectomizadas tratadas con solución salina (0,8 por ciento), pero esta no fue superior a las del grupo tratadas con estriol. Conclusiones: El estriol y la Glicina max L. ejercieron un papel protector frente al dolor nociceptivo térmico en ratas ovariectomizadas.

Objective: To determine the protective effect of estriol and Glycine max L. (soybean) compared to nociceptive pain in ovariectomized rats. Design: Experimental study. Setting: Faculty of Medicine bioterium, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological material: Holtzman albino female rats 2,5 to 3 months of age. Methods: The 29 rats were grouped randomly: group 1 (n = 8) non ovariectomized rats treated with saline (0.1 mL/kg); group 2 (n = 7) ovariectomized rats treated with saline (0.1 mL / kg); group 3 (n = 7) ovariectomized rats treated with estriol (0.2 mg/kg); group 4 (n = 7) ovariectomized rats treated with Glycine max L. (60 mg/kg). We determined baseline hotplate thermal pain as well as three days after treatment. Main outcome measures: Antinociceptive maximum efficacy (percentage AME). Results: We found that percentage EAM was higher in the non ovariectomized rats group (1.6 per cent) than in the ovariectomized group (0.8 per cent). Furthermore, the percentage of EAM in ovariectomized rats treated with saline (0.8 per cent) compared with the group treated with estriol (5.8 per cent) and also the percentage of EAM in the Glycine max L. group (4.2 per cent) was higher than in the ovariectomized group treated with saline (0.8 per cent) but not higher than the group treated with estriol. Conclusions: Estriol and Glycine max L. have protective role against thermal nociceptive pain in ovariectomized rats.

Study the levels of AFP, HCG and UE3 in pregnant women and their relation with gestational age and the age of the pregnant woman

AFP considers as important factor in the prenatal diagnosis of malformations and genetic abnormalities in fetus, since its level, in pregnant women, changes in the case of fetus malformation. So our study aimed to evaluate the change of the levels of serum AFP during pregnancy, and the relation between the levels of AFP and the levels of HCG and unconjugated Estriol 3 with the prenatal diagnosis of fetus malformations, to evaluate this procedure as non invasive prenatal diagnosis method. When HCG and unconjugated Estriol 3 determination is combined with AFP determination, it increases the sensitivity and the specifity of the method more than only AFP determination, considering both of the pregnant woman age and the gestational age. The study included 84 woman distributed into the following groups: 20 unpregnant women aged between 20-35 years, 12 pregnant women aged between 16-20 years, 33 pregnant women aged between 21-30 years, 19 pregnant women older than 31 years old, also we divided the pregnant women according to the gestational age, which determined by Ultrasound into: 34 pregnant women in fourth month, 28 pregnant women in fifth month, 2 pregnant women in sixth month. The AFP and HCG were assayed by Enzyme-linked immunosorbent assay [ELISA]. We found a strong correlation between gestational age and AFP levels [r = 0.86, p < 0.0001], between gestational age and HCG levels [r = 0.67, p < 0.0001], and between gestational age and uE3 [r = 0.85, p = 0.0001], but the correlation between the age of preganant woman and AFP levels was weak [r = 0.21, p = 0.088], also for the correlation between the age of pregnant woman and HCG levels [r = 0.30, p = 0.019], and no correlation between the age of pregnant woman and uE3 levels [r = 0.045, P = 0.8]

The Evaluation of Integrated Test as an Antenatal Screening Test for Down's Syndrome in Korea

BACKGROUND: Antenatal screening for Down's syndrome has been developed and improved over the past 20 yr. Recently, integrated test, which combines the first and second trimester markers has shown the highest detection rate (DR) and lowest false positive rate (FPR) among Down's syndrome screening tests currently in use. The purposes of this study were to evaluate the screening performance of integrated test and to compare the results with triple test studies in Korea. METHODS: The study population consisted of Korean pregnant women who underwent triple or integrated test between April 2005 and December 2008. Triple test was performed using measurements of alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG) in the second trimester. Integrated test was performed using nuchal translucency (NT) by ultrasonography and pregnancy-associated plasma protein A (PAPP-A) from maternal serum in the first trimester, and AFP, uE3, hCG, and inhibin-A in the second trimester. The screening performance of each test was evaluated by DR and FPR. RESULTS: Twenty-seven Down's syndrome pregnancies were confirmed in women screened by triple (N=6,736) or integrated test (N=7,688). At 1:100, 1:270, and 1:300 of risk cutoff, triple test showed 45%, 73%, and 73% of DR and 4.7%, 11.2%, and 12.4% of FPR, respectively. At 1:100, 1:150, and 1:300 of risk cutoff, integrated test showed 63%, 69%, and 75% of DR and 1.5%, 1.9%, and 3.0% of FPR, respectively. CONCLUSIONS: Integrated test showed higher DR and lower FPR, demonstrating better screening performance than triple test.

Evaluation of Down's syndrome screening methods using maternal serum biochemistry in the second trimester pregnancy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To provide basis for selecting the suitable method of Down's syndrome biochemical screening in the second trimester pregnancy.</p><p><b>METHODS</b>A total of 30 547 singleton pregnancies between 14 and 20(+ 6) weeks of pregnancy were collected and analyzed for maternal serum alpha-fetoproteins (AFP) and human chorionic gonadotrophin, free beta subunit (beta-HCG) with or without unconjugated estriol (uE3). The screening risks were calculated using the software Lifecycle. The detection rates and the cost of per Down's syndrome detected were calculated and compared. And four different methods were compared in a series of 64 serum samples from Down's syndrome pregnancies.</p><p><b>RESULTS</b>(1) Among the 64 affected cases, the detection rate of Down's syndrome was improved no matter in the double test (DT) or in the triple test (TT) if software Lifecycle (LC) was used to evaluate risks. And it was not suitable to evaluate risks with software 2T-Risks in the triple tests. (2) In the cohort of 30 547 singleton pregnancies, the detection rate of Down's syndrome with project DT-LC, which was double test using AFP and free beta-HCG together with software Lifecycle, and project TT-LC, which was triple test using AFP, free beta-HCG and uE3 together with software Lifecycle, was 56.25% and 57.14%, respectively. The former project was better because it decreased the false positive rate at a lower running cost.</p><p><b>CONCLUSION</b>The DT-LC is an effective screening strategy for second trimester detection of fetal Down's syndrome in mainland China.</p>

Urinary Tract Infection in Postmenopausal Women

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5+/-0.7 to 3.6+/-1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women.

Influence of estradiol analogue on cell growth, morphology and death in esophageal carcinoma cells

2-Methoxyestradiol-bis-sulphamate is a bis-sulphamoylated derivative of the naturally occurring 17-beta-estradiol metabolite namely 2-methoxyestradiol. 2-Methoxyestradiol-bis-sulphamate is regarded as a potential anticancer drug with increased antiproliferative activity when compared to 2-methoxyestradiol. The aim of this pilot in vitro study was to determine the influence of 2-methoxyestradiol-bis-sulphamate on cell growth, morphology and possible induction of certain types of cell death in the SNO esophageal carcinoma cell line. A dose-dependent study (0.2-1.0 microM) was conducted with an exposure time of 24 hours. Data revealed that 2-methoxyestradiol-bis-sulphamate reduced cell numbers statistically significantly to 74% after exposure to 0.4 microM of the drug. Morphological studies including light microscopy demonstrated hallmarks of apoptosis, while fluorescent microscopy revealed both the presence of apoptosis and autophagy as types of cell death being induced in SNO cells after 24 hours of exposure to 0.4 microM 2-methoxyestradiol-bis-sulphamate.

In vitro effects of 2-methoxyestradiol-bis-sulphamate on cell growth, morphology and cell cycle dynamics in the MCF-7 breast adenocarcinoma cell line

In the search for new and improved anticancer therapies, researchers have identified several potentially useful compounds. One of these agents is 2-methoxyestradiol-bis-sulphamate (2ME-BM), a sulphamoylated derivative of 2-methoxyestradiol. The objective of this study was to evaluate 2ME-BM's in vitro efficacy as antiproliferative agent in the MCF-7 breast adenocarcinoma cell line. Light- and fluorescent microscopy showed decreased cell density, increased apoptotic characteristics and significant ultrastructural aberrations indicative of autophagic cell death after 24 hours of exposure at a concentration of 0.4 microM. In addition, mitotic indices revealed that 2ME-BM induces a G2M block. The latter was confirmed by flow cytometric analyses where increased sub-G1 and G2/M fractions, as well as an increase in cycli n B1 levels were observed. Further in vitro research into the mechanism of this potentially useful anticancer compound is thus warranted.

Atrofia urogenital: seguridad del tratamiento con estrógenos vaginales / Safety of vaginal estrogens for urogenital atrophy

Urogenital atrophy is characterized by dryness, inflammation, and thinning of the epithelial lining of the vagina and lower urinary tract due to estrogen decline. Local estrogen therapy if effective to relieve signs and symptoms of vaginal atrophy without causing an elevation of serum estrogen levels. Although there are no big studies addressing the safety of this type of treatment, it can be maintained over long periods to avoid annoying symptoms. Special care must be taken with women with breast cancer in whom the effective dose must be titrated to avoid an increase in serum estrogens over the levels usually observed in postmenopausal women.

Performance Characteristics of the UniCel DxI 800 Immunoassay for the Maternal Serum Quadruple Test, Including Median Values for Each Week of Gestation, in Korean Women / 대한진단검사의학회지

BACKGROUND: Maternal serum prenatal quadruple screening includes testing for alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE3), and dimeric inhibin A (DIA). We evaluated quadruple screening using an automated platform and looked for any ethnic differences in the median values of each marker. METHODS: We measured the concentrations of each quadruple test analyte using the UniCel DxI 800 system (Beckman Coulter, USA) in 788 Korean mid-trimester maternal serum samples and calculated their median values using Benetech software (Benetech, Canada). We also compared the results with those obtained using the Immulite 2000 assay (Siemens Healthcare Diagnostics, USA) or ELISA (DSL, USA) in 442 samples. RESULTS: We obtained mid-trimester median values for each marker. The following are the comparative results for each test using the Immulite 2000 assay or ELISA (x) and the UniCel DxI 800 immunoassay (y): AFP, y=1.10x+0.01, r=0.925; uE3, y=0.28x+0.24, r=0.885; hCG, y=1.22x-3047.8, r=0.944; and DIA, y=0.86x+15.31, r=0.833. Assay results for each of the four markers showed good correlations. However, significant biases necessitated new median calculations of prenatal risk estimates in all four tests. CONCLUSIONS: We established gestational age-specific second-trimester median values for four markers in Korean samples using the UniCel DxI 800 immunoassay system. Despite significant bias, there were good correlations between the results obtained using the UniCel DxI 800 immunoassay and those obtained using the Immulite 2000 assay.

Changes in Atrophic Symptoms, the Vaginal Maturation Index, and Vaginal pH in Postmenopausal Women Treated with Vaginal Estrogen Tablets / 대한폐경학회지

OBJECTIVES: The aim of this study was to assess atrophic symptoms, the vaginal maturation index (VMI), and vaginal pH in postmenopausal women after use of estriol vaginal tablets for the treatment of vaginal atrophy. METHODS: In a randomized prospective study, 67 postmenopausal women were treated with 500microg estriol tablets 3 times a week for 1 week in the 1-week treatment group (n = 40) and for 2 weeks in the 2-week treatment group (n = 27). The primary endpoints were changes in the VMI, vaginal pH, and improvement in participant-reported most bothersome symptom (MBS; vaginal dryness, irritation/itching, or dyspareunia). We compared three endpoints before and after treatment in each group and between the two treatment groups. The correlation between the vaginal pH and maturation value (MV) was assessed. RESULTS: A statistically significant increase in the MV, decrease in pH, and improvement in the MBS occurred for women treated with estriol vaginal tablets in the 1- (P = 0.000, P = 0.002, and P = 0.000, respectively) and 2-week treatment groups (P = 0.000, P = 0.000, and P = 0.000, respectively). There were no significant differences between the 1- and 2-week treatment groups with respect to improvement in the VMI, vaginal pH, or MBS. The correlation between the vaginal pH and MV showed a negative linear correlation at 0, 1, and 2 weeks (P = 0.000, P = 0.000, and P = 0.011, respectively). CONCLUSION: Treatment with 500microg estriol vaginal tablets thrice-weekly for 1 week was effective in improving. It is thought that the three primary endpoints (VMI, vaginal pH, and MBS) improved at the same time during treatment.

Bioidentical Hormone Therapy in Postmenopausal Women / 대한폐경학회지

Bioidentical hormone therapy (BHT) refers to the use of hormones that are molecularly and chemically identical to endogenous hormones for purposes of hormone replacement therapy. The specific hormones used in BHT include estrone, estradiol, estriol, progesterone and testosterone. Since the result of the Women's Health Initiative (WHI) trial documented the increased risk of breast cancer, cardiovascular disease and stroke in users of conventional hormone therapy (CHT), use of CHT has declined and there has been increased interest in BHT. Bioidentical hormones have some distinctly different physiologic effects compared with synthetic hormones. Synthetic progestin is associated with an increased risk for breast cancer and cardiovascular disease, while natural progesterone is associated with a decreased risk of breast cancer and cardiovascular disease. Estriol has some unique physiologic effects, which differentiate it from estrone and estradiol. Estriol is associated with a lower risk of breast cancer and would be expected to prevent breast cancer, but few randomized controlled trials have been documented. Some clinical data demonstrate that BHT is associated with a lower risk of breast cancer and cardiovascular disease, and is more efficacious than synthetic hormones. However, there is little evidence in support of this claim. Moreover, estriol has not been approved by the U.S. Food and Drug Administration (FDA). Further studies are needed to confirm the safety and efficacy of BHT.

Bioidentical Hormone Therapy in Postmenopausal Women / 대한폐경학회지

Bioidentical hormone therapy (BHT) refers to the use of hormones that are molecularly and chemically identical to endogenous hormones for purposes of hormone replacement therapy. The specific hormones used in BHT include estrone, estradiol, estriol, progesterone and testosterone. Since the result of the Women's Health Initiative (WHI) trial documented the increased risk of breast cancer, cardiovascular disease and stroke in users of conventional hormone therapy (CHT), use of CHT has declined and there has been increased interest in BHT. Bioidentical hormones have some distinctly different physiologic effects compared with synthetic hormones. Synthetic progestin is associated with an increased risk for breast cancer and cardiovascular disease, while natural progesterone is associated with a decreased risk of breast cancer and cardiovascular disease. Estriol has some unique physiologic effects, which differentiate it from estrone and estradiol. Estriol is associated with a lower risk of breast cancer and would be expected to prevent breast cancer, but few randomized controlled trials have been documented. Some clinical data demonstrate that BHT is associated with a lower risk of breast cancer and cardiovascular disease, and is more efficacious than synthetic hormones. However, there is little evidence in support of this claim. Moreover, estriol has not been approved by the U.S. Food and Drug Administration (FDA). Further studies are needed to confirm the safety and efficacy of BHT.