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[PMID]:27779568
[Au] Autor:Santoro N; Allshouse A; Neal-Perry G; Pal L; Lobo RA; Naftolin F; Black DM; Brinton EA; Budoff MJ; Cedars MI; Dowling NM; Dunn M; Gleason CE; Hodis HN; Isaac B; Magnani M; Manson JE; Miller VM; Taylor HS; Wharton W; Wolff E; Zepeda V; Harman SM
[Ad] Endereço:1Department of Obstetrics & Gynecology 2Department of Biostatistics, University of Colorado School of Medicine, Aurora, CO 3Department of Obstetrics, Gynecology & Women's Health and Neurosciences, Albert Einstein College of Medicine, Bronx, NY 4Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, CT 5Department of Obstetrics & Gynecology, Columbia University College of Physicians and Surgeons, New York, NY 6Department of Obstetrics & Gynecology, New York University School of Medicine, New York, NY 7Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, CA 8Utah Foundation for Biomedical Research, Salt Lake City, UT 9Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA, Torrance, CA 10Department of Obstetrics & Gynecology, University of California at San Francisco, San Francisco, CA 11Departments of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI 12Kronos Longevity Research Institute, Phoenix, AZ 13Department of Medicine and Public Health, University of Wisconsin, Madison, WI 14Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA 15Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 16Departments of Surgery and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 17Department of Neurology, Emory University, Atlanta, GA 18Department of Reproductive Biology and Medicine, National Institutes of Health, Bethesda, MD 19Department of Medicine, Endocrine Division, Phoenix VA Health Care System, Phoenix, AZ.
[Ti] Título:Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal estradiol plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study.
[So] Source:Menopause;24(3):238-246, 2017 Mar.
[Is] ISSN:1530-0374
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective of the present study was to compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early postmenopausal women during 4 years. METHODS: A total of 727 women, aged 42 to 58, within 3 years of their final menstrual period, were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n = 230) or transdermal estradiol (t-E2) 50 µg (n = 225; both with micronized progesterone 200 mg for 12 d each mo), or placebos (PBOs; n = 275). Menopausal symptoms were recorded at screening and at 6, 12, 24, 36, and 48 months postrandomization. Differences in proportions of women with symptoms at baseline and at each follow-up time point were compared by treatment arm using exact χ tests in an intent-to-treat analysis. Differences in treatment effect by race/ethnicity and body mass index were tested using generalized linear mixed effects modeling. RESULTS: Moderate to severe hot flashes (from 44% at baseline to 28.3% for PBO, 7.4% for t-E2, and 4.2% for o-CEE) and night sweats (from 35% at baseline to 19% for PBO, 5.3% for t-E2, and 4.7% for o-CEE) were reduced significantly by 6 months in women randomized to either active hormone compared with PBO (P < 0.001 for both symptoms), with no significant differences between the active treatment arms. Insomnia and irritability decreased from baseline to 6 months postrandomization in all groups. There was an intermittent reduction in insomnia in both active treatment arms versus PBO, with o-CEE being more effective than PBO at 36 and 48 months (P = 0.002 and 0.05) and t-E2 being more effective than PBO at 48 months (P = 0.004). Neither hormone treatment significantly affected irritability compared with PBO. Symptom relief for active treatment versus PBO was not significantly modified by body mass index or race/ethnicity. CONCLUSIONS: Recently postmenopausal women had similar and substantial reductions in hot flashes and night sweats with lower-than-conventional doses of oral or transdermal estrogen. These reductions were sustained during 4 years. Insomnia was intermittently reduced compared with PBO for both hormone regimens.
[Mh] Termos MeSH primário: Estrogênios/administração & dosagem
Fogachos/tratamento farmacológico
Humor Irritável/efeitos dos fármacos
Progestinas/administração & dosagem
Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Cutânea
Administração Oral
Adulto
Doenças do Sistema Nervoso Autônomo/tratamento farmacológico
Doenças do Sistema Nervoso Autônomo/etiologia
Quimioterapia Combinada
Estradiol/administração & dosagem
Terapia de Reposição de Estrogênios/métodos
Estrogênios Conjugados (USP)/administração & dosagem
Feminino
Fogachos/etiologia
Seres Humanos
Estudos Longitudinais
Meia-Idade
Pós-Menopausa/efeitos dos fármacos
Progesterona/administração & dosagem
Distúrbios do Início e da Manutenção do Sono/etiologia
Resultado do Tratamento
Sistema Vasomotor/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Estrogens); 0 (Estrogens, Conjugated (USP)); 0 (Progestins); 4G7DS2Q64Y (Progesterone); 4TI98Z838E (Estradiol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1097/GME.0000000000000756


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[PMID]:29096805
[Au] Autor:Aziz A; Hansen HS; Sechtem U; Prescott E; Ong P
[Ad] Endereço:Department of Cardiology, Robert Bosch Krankenhaus, Stuttgart, Germany; Department of Cardiology, Odense University Hospital, Odense, Denmark. Electronic address: Ahmed.Aziz@rsyd.dk.
[Ti] Título:Sex-Related Differences in Vasomotor Function in Patients With Angina and Unobstructed Coronary Arteries.
[So] Source:J Am Coll Cardiol;70(19):2349-2358, 2017 Nov 07.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Coronary vasomotor dysfunction is an important mechanism for angina in patients with unobstructed coronary arteries. OBJECTIVES: The purpose of this study was to determine sex differences in the prevalence and clinical presentation of vasomotor dysfunction in a European population and to examine sex differences in the dose of acetylcholine leading to a positive acetylcholine provocation test (ACH test). METHODS: Between 2007 and 2014, we included 1,379 consecutive patients with stable angina, unobstructed coronaries and ACH test performed for epicardial vasospasm or coronary microvascular dysfunction (CMD) due to microvascular spasm. The predictive value of sex, risk factors, symptoms, and noninvasive test results was analyzed by means of logistic regression. RESULTS: The mean patient age was 62 years, and 42% were male. There were 813 patients (59%) with a pathological ACH test, 33% for CMD and 26% for epicardial vasospasm. A pathological test was more common in females (70% vs. 43%; p < 0.001). In a multivariable logistic regression model the sex difference was statistically significant with a female-male odds ratio for CMD and epicardial vasospasm of 4.2 (95% confidence interval: 3.1 to 5.5; p < 0.001) and 2.3 (95% confidence interval: 1.7 to 3.1; p < 0.001), respectively. Effort-related symptoms, but neither risk factors nor noninvasive stress tests, contributed to predicting a pathological test. Female patients were more sensitive to acetylcholine with vasomotor dysfunction occurring at lower ACH doses compared with male patients. CONCLUSIONS: Vasomotor dysfunction is frequent in patients with angina and unobstructed coronaries in a European population. Female patients have a higher prevalence of vasomotor dysfunction (especially CMD) compared with male patients. A pathological ACH test was observed at lower ACH doses in women compared with men.
[Mh] Termos MeSH primário: Angina Pectoris/fisiopatologia
Vasoespasmo Coronário/fisiopatologia
Vasos Coronários/fisiologia
Caracteres Sexuais
Vasodilatadores/farmacologia
Sistema Vasomotor/fisiologia
[Mh] Termos MeSH secundário: Acetilcolina/farmacologia
Idoso
Angina Pectoris/epidemiologia
Vasoespasmo Coronário/induzido quimicamente
Vasoespasmo Coronário/epidemiologia
Vasos Coronários/efeitos dos fármacos
Relação Dose-Resposta a Droga
Europa (Continente)/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Sistema Vasomotor/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasodilator Agents); N9YNS0M02X (Acetylcholine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171104
[St] Status:MEDLINE


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[PMID]:28949974
[Au] Autor:Goranitis I; Bellanca L; Daley AJ; Thomas A; Stokes-Lampard H; Roalfe AK; Jowett S
[Ad] Endereço:Health Economics Unit, University of Birmingham, Birmingham, United Kingdom.
[Ti] Título:Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial.
[So] Source:PLoS One;12(9):e0184328, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. DESIGN: Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. SETTING: Primary care. POPULATION: Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. METHODS: An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. MAIN OUTCOME MEASURE: Cost per quality-adjusted life-year (QALY). RESULTS: Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. CONCLUSIONS: Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms.
[Mh] Termos MeSH primário: Análise Custo-Benefício
Exercício
Menopausa
Sistema Vasomotor/fisiopatologia
[Mh] Termos MeSH secundário: Feminino
Alocação de Recursos para a Atenção à Saúde
Seres Humanos
Meia-Idade
Qualidade de Vida
Medicina Estatal
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170927
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184328


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[PMID]:28810262
[Au] Autor:Müller JJ; Schwab M; Rosenfeld CR; Antonow-Schlorke I; Nathanielsz PW; Rakers F; Schubert H; Witte OW; Rupprecht S
[Ad] Endereço:Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
[Ti] Título:Fetal Sheep Mesenteric Resistance Arteries: Functional and Structural Maturation.
[So] Source:J Vasc Res;54(5):259-271, 2017.
[Is] ISSN:1423-0135
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fetal blood pressure increases during late gestation; however, the underlying vascular mechanisms are unclear. Knowledge of the maturation of resistance arteries is important to identify the mechanisms and vulnerable periods for the development of vascular dysfunction in adulthood. METHODS: We determined the functional and structural development of fetal sheep mesenteric resistance arteries using wire myography and immunohistochemistry. RESULTS: Media mass and distribution of myosin heavy-chain isoforms showed no changes between 0.7 (100 ± 3 days) and 0.9 (130 ± 3 days) gestation. However, from 0.7 to 0.9 gestation, the resting wall tension increased accompanied by non-receptor-dependent (potassium) and receptor-dependent (noradrenaline; endothelin-1) increases in vasocontraction. Angiotensin II had no contractile effect at both ages. Endothelium-dependent relaxation to acetylcholine and prostaglandin E2 was absent at 0.7 but present at 0.9 gestation. Augmented vascular responsiveness was paralleled by the maturation of sympathetic and sensory vascular innervation. Non-endothelium-dependent relaxation to nitric oxide showed no maturational changes. The expression of vasoregulator receptors/enzymes did not increase between 0.7 and 0.9 gestation. CONCLUSION: Vascular maturation during late ovine gestation involves an increase in resting wall tension and the vasoconstrictor and vasodilator capacity of the mesenteric resistance arteries. Absence of structural changes in the tunica media and the lack of an increase in vasoregulator receptor/enzyme expression suggest that vasoactive responses are due to the maturation of intracellular pathways at this gestational age.
[Mh] Termos MeSH primário: Pressão Arterial
Feto/irrigação sanguínea
Artérias Mesentéricas/embriologia
Resistência Vascular
Sistema Vasomotor/embriologia
[Mh] Termos MeSH secundário: Animais
Pressão Arterial/efeitos dos fármacos
Relação Dose-Resposta a Droga
Idade Gestacional
Imuno-Histoquímica
Técnicas In Vitro
Artérias Mesentéricas/efeitos dos fármacos
Artérias Mesentéricas/inervação
Artérias Mesentéricas/metabolismo
Miografia
Cadeias Pesadas de Miosina/metabolismo
Carneiro Doméstico
Resistência Vascular/efeitos dos fármacos
Vasoconstrição
Vasoconstritores/farmacologia
Vasodilatação
Vasodilatadores/farmacologia
Sistema Vasomotor/efeitos dos fármacos
Sistema Vasomotor/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasoconstrictor Agents); 0 (Vasodilator Agents); EC 3.6.4.1 (Myosin Heavy Chains)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE
[do] DOI:10.1159/000477629


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[PMID]:28778914
[Au] Autor:Tsai CY; Poon YY; Chen CH; Chan SHH
[Ad] Endereço:Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China; and.
[Ti] Título:Anomalous baroreflex functionality inherent in floxed and Cre-Lox mice: an overlooked physiological phenotype.
[So] Source:Am J Physiol Heart Circ Physiol;313(4):H700-H707, 2017 Oct 01.
[Is] ISSN:1522-1539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The last two decades have seen the emergence of Cre-Lox recombination as one of the most powerful and versatile technologies for cell-specific genetic engineering of mammalian cells. Understandably, the primary concerns in the practice of Cre-Lox recombination are whether the predicted genome has been correctly modified and the targeted phenotypes expressed. Rarely are the physiological conditions of the animals routinely examined because the general assumption is that they are normal. Based on corroborative results from radiotelemetric recording, power spectral analysis, and magnetic resonance imaging/diffusion tensor imaging in brain-derived neurotrophic factor-floxed mice, the present study revealed that this assumption requires amendment. We found that despite comparable blood pressure and heart rate with C57BL/6 or Cre mice under the conscious state, floxed and Cre-Lox mice exhibited diminished baroreflex-mediated sympathetic vasomotor tone and cardiac vagal baroreflex. We further found that the capacity and plasticity of baroreflex of these two strains of mice under isoflurane anesthesia were retarded, as reflected by reduced connectivity between the nucleus tractus solitarii and rostral ventrolateral medulla or nucleus ambiguus. The identification of anomalous baroreflex functionality inherent in floxed and Cre-Lox mice points to the importance of incorporating physiological phenotypes into studies that engage gene manipulations such as Cre-Lox recombination. We established that anomalous baroreflex functionality is inherent in floxed and Cre-Lox mice. These two mouse strains exhibited diminished baroreflex-mediated sympathetic vasomotor tone and cardiac vagal baroreflex under the conscious state, retarded capacity and plasticity of baroreflex under isoflurane anesthesia, and reduced connectivity between key nuclei in the baroreflex neural circuits.
[Mh] Termos MeSH primário: Barorreflexo/genética
Pressão Sanguínea/genética
Frequência Cardíaca/genética
Reflexo Anormal/genética
[Mh] Termos MeSH secundário: Anestésicos Inalatórios/farmacologia
Animais
Animais Geneticamente Modificados
Barorreflexo/efeitos dos fármacos
Barorreflexo/fisiologia
Pressão Sanguínea/fisiologia
Fator Neurotrófico Derivado do Encéfalo/genética
Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética
Estado de Consciência
Imagem de Tensor de Difusão
Frequência Cardíaca/fisiologia
Integrases
Isoflurano/farmacologia
Imagem por Ressonância Magnética
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Vias Neurais
Fenótipo
Reflexo Anormal/efeitos dos fármacos
Reflexo Anormal/fisiologia
Núcleo Solitário/fisiopatologia
Nervo Vago/fisiopatologia
Sistema Vasomotor
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 0 (Brain-Derived Neurotrophic Factor); CYS9AKD70P (Isoflurane); EC 2.7.11.17 (Calcium-Calmodulin-Dependent Protein Kinase Type 2); EC 2.7.11.17 (Camk2a protein, mouse); EC 2.7.7.- (Cre recombinase); EC 2.7.7.- (Integrases)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE
[do] DOI:10.1152/ajpheart.00346.2017


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[PMID]:28703650
[Au] Autor:Cobin RH; Goodman NF; AACE Reproductive Endocrinology Scientific Committee
[Ti] Título:AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON MENOPAUSE-2017 UPDATE.
[So] Source:Endocr Pract;23(7):869-880, 2017 Jul.
[Is] ISSN:1530-891X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:EXECUTIVE SUMMARY This American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) Position Statement is designed to update the previous menopause clinical practice guidelines published in 2011 but does not replace them. The current document reviews new clinical trials published since then as well as new information regarding possible risks and benefits of therapies available for the treatment of menopausal symptoms. AACE reinforces the recommendations made in its previous guidelines and provides additional recommendations on the basis of new data. A summary regarding this position statement is listed below: New information available from randomized clinical trials and epidemiologic studies reported after 2011 was critically reviewed. No previous recommendations from the 2011 menopause clinical practice guidelines have been reversed or changed. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, selective estrogen-receptor modulators (SERMs), and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, SERMs, and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. New recommendations in this position statement include: 1. RECOMMENDATION: the use of menopausal hormone therapy in symptomatic postmenopausal women should be based on consideration of all risk factors for cardiovascular disease, age, and time from menopause. 2. RECOMMENDATION: the use of transdermal as compared with oral estrogen preparations may be considered less likely to produce thrombotic risk and perhaps the risk of stroke and coronary artery disease. 3. RECOMMENDATION: when the use of progesterone is necessary, micronized progesterone is considered the safer alternative. 4. RECOMMENDATION: in symptomatic menopausal women who are at significant risk from the use of hormone replacement therapy, the use of selective serotonin re-uptake inhibitors and possibly other nonhormonal agents may offer significant symptom relief. 5. RECOMMENDATION: AACE does not recommend use of bioidentical hormone therapy. 6. RECOMMENDATION: AACE fully supports the recommendations of the Comité de l'Évolution des Pratiques en Oncologie regarding the management of menopause in women with breast cancer. 7. RECOMMENDATION: HRT is not recommended for the prevention of diabetes. 8. RECOMMENDATION: In women with previously diagnosed diabetes, the use of HRT should be individualized, taking in to account age, metabolic, and cardiovascular risk factors. ABBREVIATIONS: AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CAC = coronary artery calcification; CEE = conjugated equine estrogen; CEPO = Comité de l'Évolution des Pratiques en Oncologie; CAD = coronary artery disease; CIMT = carotid intima media thickness; CVD = cardiovascular disease; FDA = Food and Drug Administration; HDL = high-density lipoprotein; HRT = hormone replacement therapy; HT = hypertension; KEEPS = Kronos Early Estrogen Prevention Study; LDL = low-density lipoprotein; MBS = metabolic syndrome; MPA = medroxyprogesterone acetate; RR = relative risk; SERM = selective estrogen-receptor modulator; SSRI = selective serotonin re-uptake inhibitor; VTE = venous thrombo-embolism; WHI = Women's Health Initiative.
[Mh] Termos MeSH primário: Terapia de Reposição de Estrogênios/métodos
Menopausa
Osteoporose/prevenção & controle
[Mh] Termos MeSH secundário: Administração Cutânea
Administração Oral
Idoso
Aminas/uso terapêutico
Neoplasias da Mama/epidemiologia
Doenças Cardiovasculares/epidemiologia
Cimicifuga
Cognição
Ácidos Cicloexanocarboxílicos/uso terapêutico
Diabetes Mellitus
Endocrinologia
Estradiol/uso terapêutico
Estrogênios/uso terapêutico
Antagonistas de Aminoácidos Excitatórios/uso terapêutico
Feminino
Fogachos
Seres Humanos
Meia-Idade
Fitoestrógenos/uso terapêutico
Fitoterapia
Progesterona/uso terapêutico
Progestinas/uso terapêutico
Medição de Risco
Inibidores da Captação de Serotonina/uso terapêutico
Sociedades Médicas
Trombose/epidemiologia
Sistema Vasomotor
Ácido gama-Aminobutírico/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Amines); 0 (Cyclohexanecarboxylic Acids); 0 (Estrogens); 0 (Excitatory Amino Acid Antagonists); 0 (Phytoestrogens); 0 (Progestins); 0 (Serotonin Uptake Inhibitors); 4G7DS2Q64Y (Progesterone); 4TI98Z838E (Estradiol); 56-12-2 (gamma-Aminobutyric Acid); 6CW7F3G59X (gabapentin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.4158/EP171828.PS


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[PMID]:28655717
[Au] Autor:Winn NC; Grunewald ZI; Gastecki ML; Woodford ML; Welly RJ; Clookey SL; Ball JR; Gaines TL; Karasseva NG; Kanaley JA; Sacks HS; Vieira-Potter VJ; Padilla J
[Ad] Endereço:Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.
[Ti] Título:Deletion of UCP1 enhances ex vivo aortic vasomotor function in female but not male mice despite similar susceptibility to metabolic dysfunction.
[So] Source:Am J Physiol Endocrinol Metab;313(4):E402-E412, 2017 Oct 01.
[Is] ISSN:1522-1555
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Females are typically more insulin sensitive than males, which may be partly attributed to greater brown adipose tissue (BAT) activity and uncoupling protein 1 (UCP1) content. Accordingly, we tested the hypothesis that UCP1 deletion would abolish sex differences in insulin sensitivity and that whitening of thoracic periaortic BAT caused by UCP1 loss would be accompanied with impaired thoracic aortic function. Furthermore, because UCP1 exerts antioxidant effects, we examined whether UCP1 deficiency-induced metabolic dysfunction was mediated by oxidative stress. Compared with males, female mice had lower HOMA- and AT-insulin resistance (IR) despite no significant differences in BAT UCP1 content. UCP1 ablation increased HOMA-IR, AT-IR, and whitening of BAT in both sexes. Expression of UCP1 in thoracic aorta was greater in wild-type females compared with males. Importantly, deletion of UCP1 enhanced aortic vasomotor function in females only. UCP1 ablation did not promote oxidative stress in interscapular BAT. Furthermore, daily administration of the free radical scavenger tempol for 8 wk did not abrogate UCP1 deficiency-induced increases in adiposity, hyperinsulinemia, or liver steatosis. Collectively, we report that ) in normal chow-fed mice housed at 25°C, aortic UCP1 content was greater in females than males and its deletion improved ex vivo aortic vasomotor function in females only; ) constitutive UCP1 content in BAT was similar between females and males and loss of UCP1 did not abolish sex differences in insulin sensitivity; and ) the metabolic disruptions caused by UCP1 ablation did not appear to be contingent upon increased oxidative stress in mice under normal dietary conditions.
[Mh] Termos MeSH primário: Tecido Adiposo Marrom/metabolismo
Tecido Adiposo Branco/metabolismo
Aorta/metabolismo
Resistência à Insulina/genética
Estresse Oxidativo/genética
Proteína Desacopladora 1/genética
Sistema Vasomotor/metabolismo
[Mh] Termos MeSH secundário: Adiposidade/genética
Animais
Aorta/fisiopatologia
Fígado Gorduroso/genética
Fígado Gorduroso/metabolismo
Feminino
Hiperinsulinismo/genética
Hiperinsulinismo/metabolismo
Técnicas In Vitro
Masculino
Camundongos
Camundongos Knockout
Fatores Sexuais
Sistema Vasomotor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Ucp1 protein, mouse); 0 (Uncoupling Protein 1)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1152/ajpendo.00096.2017


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[PMID]:28591133
[Au] Autor:Lambert MNT; Thorup AC; Hansen ESS; Jeppesen PB
[Ad] Endereço:Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
[Ti] Título:Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms.
[So] Source:PLoS One;12(6):e0176590, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Natural estrogen decline leads to vasomotor symptoms (VMS). Hormone therapy alleviates symptoms but increases cancer risk. Effective treatments against VMS with minimal cancer risks are needed. We investigate the effects of a highly bioavailable aglycone rich Red Clover isoflavone treatment to alleviate existing menopausal VMS, assessed for the first time by 24hour ambulatory skin conductance (SC). METHODS AND RESULTS: We conducted a parallel, double blind, randomised control trial of 62 peri-menopausal women aged 40-65, reporting ≥ 5 hot flushes/day and follicle stimulating hormone ≥35 IU/L. Participants received either twice daily treatment with bioavailable RC extract (RCE), providing 34 mg/d isoflavones and probiotics, or masked placebo formulation for 12 weeks. The primary outcome was change in daily hot flush frequency (HFF) from baseline to 12 weeks using 24hr SC. Secondary outcomes were change in SC determined hot flush intensity (HFI), self-reported HFF (rHFF) and hot flush severity (rHFS), blood pressure and plasma lipids. A significant decrease in 24hr HFF (P < 0.01) and HFI (P<0.05) was found when comparing change from baseline to 12 months of the RCE (-4.3 HF/24hr, CI -6.8 to -2.3; -12956 µS s-1, CI -20175 to -5737) with placebo (0.79 HF/24hr, CI -1.56 to 3.15; 515 µS s-1, CI -5465 to 6496). rHFF was also significantly reduced (P <0.05)in the RCE (-2.97 HFs/d, CI -4.77 to -1.17) group compared to placebo (0.036 HFs/d, CI -2.42 to 2.49). Other parameters were non-significant. RCE was well tolerated. CONCLUSION: Results suggest that moderate doses of RCE were more effective and superior to placebo in reducing physiological and self-reported VMS. Findings support that objective physiological symptom assessment methods should be used together with self-report measures in future studies on menopausal VMS. TRIAL REGISTRATION: ClinicalTrials.gov NCT02028702.
[Mh] Termos MeSH primário: Isoflavonas/administração & dosagem
Menopausa/efeitos dos fármacos
Probióticos/administração & dosagem
Sistema Vasomotor/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Feminino
Fogachos/tratamento farmacológico
Fogachos/fisiopatologia
Seres Humanos
Isoflavonas/química
Medicago/química
Menopausa/fisiologia
Meia-Idade
Resultado do Tratamento
Sistema Vasomotor/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Isoflavones)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176590


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[PMID]:28539355
[Au] Autor:Lastra G; Manrique C; Jia G; Aroor AR; Hayden MR; Barron BJ; Niles B; Padilla J; Sowers JR
[Ad] Endereço:Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri; lastrag@health.missouri.edu.
[Ti] Título:Xanthine oxidase inhibition protects against Western diet-induced aortic stiffness and impaired vasorelaxation in female mice.
[So] Source:Am J Physiol Regul Integr Comp Physiol;313(2):R67-R77, 2017 Aug 01.
[Is] ISSN:1522-1490
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Consumption of a high-fat, high-fructose diet [Western diet (WD)] promotes vascular stiffness, a critical factor in the development of cardiovascular disease (CVD). Obese and diabetic women exhibit greater arterial stiffness than men, which contributes to the increased incidence of CVD in these women. Furthermore, high-fructose diets result in elevated plasma concentrations of uric acid via xanthine oxidase (XO) activation, and uric acid elevation is also associated with increased vascular stiffness. However, the mechanisms by which increased xanthine oxidase activity and uric acid contribute to vascular stiffness in obese females remain to be fully uncovered. Accordingly, we examined the impact of XO inhibition on endothelial function and vascular stiffness in female C57BL/6J mice fed a WD or regular chow for 16 wk. WD feeding resulted in increased arterial stiffness, measured by atomic force microscopy in aortic explants (16.19 ± 1.72 vs. 5.21 ± 0.54 kPa, < 0.05), as well as abnormal aortic endothelium-dependent and -independent vasorelaxation. XO inhibition with allopurinol (widely utilized in the clinical setting) substantially improved vascular relaxation and attenuated stiffness (16.9 ± 0.50 vs. 3.44 ± 0.50 kPa, < 0.05) while simultaneously lowering serum uric acid levels (0.55 ± 0.98 vs. 0.21 ± 0.04 mg/dL, < 0.05). In addition, allopurinol improved WD-induced markers of fibrosis and oxidative stress in aortic tissue, as analyzed by immunohistochemistry and transmission electronic microscopy. Collectively, these results demonstrate that XO inhibition protects against WD-induced vascular oxidative stress, fibrosis, impaired vasorelaxation, and aortic stiffness in females. Furthermore, excessive oxidative stress resulting from XO activation appears to play a key role in mediating vascular dysfunction induced by chronic exposure to WD consumption in females.
[Mh] Termos MeSH primário: Alopurinol/administração & dosagem
Aorta/fisiologia
Dieta Ocidental
Ácido Úrico/sangue
Rigidez Vascular/fisiologia
Vasodilatação/fisiologia
Xantina Oxidase/metabolismo
[Mh] Termos MeSH secundário: Animais
Aorta/efeitos dos fármacos
Inibidores Enzimáticos/administração & dosagem
Feminino
Camundongos
Camundongos Endogâmicos C57BL
Estresse Oxidativo/efeitos dos fármacos
Estresse Oxidativo/fisiologia
Rigidez Vascular/efeitos dos fármacos
Vasodilatação/efeitos dos fármacos
Sistema Vasomotor/efeitos dos fármacos
Sistema Vasomotor/fisiologia
Xantina Oxidase/antagonistas & inibidores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Enzyme Inhibitors); 268B43MJ25 (Uric Acid); 63CZ7GJN5I (Allopurinol); EC 1.17.3.2 (Xanthine Oxidase)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1152/ajpregu.00483.2016


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[PMID]:28427595
[Au] Autor:Dudek D; Rzeszutko L; Onuma Y; Sotomi Y; Depukat R; Veldhof S; Ediebah D; Staehr P; Zasada W; Malinowski KP; Kaluza GL; Serruys PW
[Ad] Endereço:Jagiellonian University Institute of Cardiology, Krakow, Poland. Electronic address: mcdudek@cyfronet.pl.
[Ti] Título:Vasomotor Response to Nitroglycerine Over 5 Years Follow-Up After Everolimus-Eluting Bioresorbable Scaffold Implantation.
[So] Source:JACC Cardiovasc Interv;10(8):786-795, 2017 Apr 24.
[Is] ISSN:1876-7605
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study investigated the vasomotor response to nitroglycerine (NTG) up to 5 years after ABSORB implantation. BACKGROUND: There are no data regarding long-term vasomotor response after everolimus-eluting bioresorbable vascular scaffold ABSORB implantation. METHODS: We performed quantitative coronary angiography of the scaffolded and proximal and distal adjacent segments of patients from ABSORB Cohort B study before and after 200 µg of intracoronary NTG at 2, 3, and 5 years of follow-up. The mean changes of maximal and mean lumen diameters in the scaffolded and adjacent segments were calculated. RESULTS: The mean in-scaffold lumen diameter change in response to NTG showed a trend to increase over time with absolute values of 0.03 ± 0.09 mm, 0.05 ± 0.12 mm, and 0.07 ± 0.08 mm at 2, 3, and 5 years, respectively (p = 0.40). The maximal in-scaffold lumen diameter change significantly increased with values of 0.03 ± 0.14 mm, 0.06 ± 0.16 mm, and 0.11 ± 0.1 mm at 2, 3, and 5 years, respectively (p = 0.03). The normalized mean lumen diameter change after NTG in the scaffold relative to the adjacent segments was 51.9 ± 54.8% at 5 years of follow-up (p = 0.60). CONCLUSIONS: Although there was a numerical increase of the vasomotor response to NTG after ABSORB implantation measured by quantitative coronary angiography with mean lumen diameter, the change was not statistically significant. However, the maximal lumen diameter changes increased over time from 2 to 5 years and attained statistical significance. The vasomotor response to NTG after ABSORB implantation moderately trended to increase, which is consistent with the progressive degradation and bioresorption of the scaffold, but the degree of vasomotor response remained lower in comparison with adjacent segments.
[Mh] Termos MeSH primário: Implantes Absorvíveis
Fármacos Cardiovasculares/administração & dosagem
Materiais Revestidos Biocompatíveis
Doença da Artéria Coronariana/terapia
Vasos Coronários/efeitos dos fármacos
Everolimo/administração & dosagem
Nitroglicerina/administração & dosagem
Intervenção Coronária Percutânea/instrumentação
Vasodilatação/efeitos dos fármacos
Vasodilatadores/administração & dosagem
Sistema Vasomotor/efeitos dos fármacos
[Mh] Termos MeSH secundário: Fármacos Cardiovasculares/efeitos adversos
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/fisiopatologia
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/fisiopatologia
Everolimo/efeitos adversos
Seres Humanos
Intervenção Coronária Percutânea/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Ultrassonografia de Intervenção
Vasoconstrição/efeitos dos fármacos
Sistema Vasomotor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Cardiovascular Agents); 0 (Coated Materials, Biocompatible); 0 (Vasodilator Agents); 9HW64Q8G6G (Everolimus); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE



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