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[PMID]:28411144
[Au] Autor:Whicker M; Black J; Altwerger G; Menderes G; Feinberg J; Ratner E
[Ad] Endereço:Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT.
[Ti] Título:Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer.
[So] Source:Am J Obstet Gynecol;217(4):395-403, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms.
[Mh] Termos MeSH primário: Neoplasias Ovarianas/fisiopatologia
Neoplasias Ovarianas/psicologia
Qualidade de Vida
Disfunções Sexuais Fisiológicas
Disfunções Sexuais Psicogênicas
Sexualidade
[Mh] Termos MeSH secundário: Administração Tópica
Anabolizantes/uso terapêutico
Imagem Corporal
Terapia Cognitiva
Depressão/fisiopatologia
Depressão/psicologia
Antagonistas de Estrogênios/uso terapêutico
Estrogênios/administração & dosagem
Fadiga/fisiopatologia
Fadiga/psicologia
Feminino
Terapia de Reposição Hormonal
Seres Humanos
Lubrificantes/uso terapêutico
Menopausa Precoce/fisiologia
Menopausa Precoce/psicologia
Norpregnenos/uso terapêutico
Neoplasias Ovarianas/terapia
Distúrbios do Assoalho Pélvico/reabilitação
Modalidades de Fisioterapia
Fitoterapia
Inibidores da Captação de Serotonina/uso terapêutico
Disfunções Sexuais Fisiológicas/terapia
Disfunções Sexuais Psicogênicas/terapia
Tamoxifeno/análogos & derivados
Tamoxifeno/uso terapêutico
Testosterona/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anabolic Agents); 0 (Estrogen Antagonists); 0 (Estrogens); 0 (Lubricants); 0 (Norpregnenes); 0 (Serotonin Uptake Inhibitors); 094ZI81Y45 (Tamoxifen); 3XMK78S47O (Testosterone); B0P231ILBK (Ospemifene); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170416
[St] Status:MEDLINE


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[PMID]:28364865
[Au] Autor:Anagnostis P; Galanis P; Chatzistergiou V; Stevenson JC; Godsland IF; Lambrinoudaki I; Theodorou M; Goulis DG
[Ad] Endereço:Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. Electronic address: anagnwstis.pan@yahoo.gr.
[Ti] Título:The effect of hormone replacement therapy and tibolone on lipoprotein (a) concentrations in postmenopausal women: A systematic review and meta-analysis.
[So] Source:Maturitas;99:27-36, 2017 May.
[Is] ISSN:1873-4111
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Data on the effect of hormone replacement therapy (HRT) and tibolone on lipoprotein (a) [Lp(a)], an independent risk factor for cardiovascular disease, are heterogeneous and conflicting. Studies of the effect of HRT and tibolone on Lp(a) concentrations in post-menopausal women are reviewed in this meta-analysis. DESIGN AND METHODS: MEDLINE, Scopus, EMBASE and Cochrane databases were searched (up to February 10, 2017). Two researchers identified randomized controlled studies and extracted data. Potential controversies were resolved by a third reviewer. RESULTS: In 24 eligible studies, HRT caused a significant reduction in Lp(a) concentrations compared with placebo or no treatment [mean relative difference: -20.35%, 95% Confidence Interval (CI): -25.33% to -15.37%, p<0.0001], with significant heterogeneity between studies (I =98.5%), but without evidence of publication bias. No significant effect was found for tibolone (n=7) (mean relative difference: -23.84%, 95% CI: -63.43% to 15.74%, p=0.238) (I =98.7%, but without publication bias). Oral estrogen caused a greater reduction in Lp(a) concentrations than transdermal estrogen (n=10) (mean relative difference: 37.66%, 95% CI: 16.84% to 58.48%, p<0.0001), with significant heterogeneity between studies (I =99%), but no evidence of publication bias. No difference was observed when continuous was compared with cyclical HRT, conventional with low-dose estrogen, and estrogen monotherapy with estrogen combined with progestogen. No difference was observed between HRT and tibolone regarding their effect on Lp(a). CONCLUSIONS: HRT significantly decreases Lp(a) concentrations, with oral being more effective than transdermal estradiol. The type of HRT, dose of estrogen and addition of progestogen do not seem to modify the Lp(a)-lowering effect of HRT.
[Mh] Termos MeSH primário: Estradiol/uso terapêutico
Moduladores de Receptor Estrogênico/uso terapêutico
Terapia de Reposição de Estrogênios/métodos
Estrogênios/uso terapêutico
Lipoproteína(a)/sangue
Norpregnenos/uso terapêutico
Pós-Menopausa/sangue
Progestinas/uso terapêutico
[Mh] Termos MeSH secundário: Administração Cutânea
Administração Oral
Doenças Cardiovasculares/sangue
Feminino
Seres Humanos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Estrogen Receptor Modulators); 0 (Estrogens); 0 (Lipoprotein(a)); 0 (Norpregnenes); 0 (Progestins); 4TI98Z838E (Estradiol); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170403
[St] Status:MEDLINE


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[PMID]:28331292
[Au] Autor:Zhang C; Li H; Xiong X; Zhai S; Wei Y; Zhang S; Zhang Y; Xu L; Liu L
[Ad] Endereço:Department of Pharmacy.
[Ti] Título:An open-label, two-period comparative study on pharmacokinetics and safety of a combined ethinylestradiol/gestodene transdermal contraceptive patch.
[So] Source:Drug Des Devel Ther;11:725-731, 2017.
[Is] ISSN:1177-8881
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:We investigated the pharmacokinetics and safety profiles of a newly developed combined ethinylestradiol (EE)/gestodene (GSD) transdermal contraceptive patch after a single-dose administration and compared with the market available tablet formulation in healthy adult subjects. An open-label, two-period comparative study was conducted in 12 healthy women volunteers. A single dose of the study combined EE/GE transdermal contraceptive patch and oral tablet (Milunet ) were administered. Blood samples at different time points after dose were collected, and concentrations were analyzed. A reliable, highly sensitive and accurate high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC/MS/MS) assay method was developed in this study to determine the plasma concentrations of EE and GSD. Compared to the tablet, the study patch had a significantly decreased maximum plasma concentration ( ), extended time to reach the and half-life, as well as increased clearance and apparent volume of distribution. The half-lives of EE and GSD of the patch were 3.3 and 2.2 times, respectively, than the half-life of the tablet. The areas under the plasma concentration-time curve (AUCs) of EE and GSD of the patch were 8.0 and 16.2 times, respectively, than the AUC of the tablet. No severe adverse event was observed during the whole study, and the general safety was acceptable. In conclusion, compared to the oral tablet Milunet, the study contraceptive patch was well tolerated and showed potent drug exposure, significant extended half-life and stable drug concentrations.
[Mh] Termos MeSH primário: Anticoncepcionais Femininos/administração & dosagem
Anticoncepcionais Femininos/efeitos adversos
Etinilestradiol/efeitos adversos
Etinilestradiol/farmacocinética
Norpregnenos/efeitos adversos
Norpregnenos/farmacocinética
Adesivo Transdérmico
[Mh] Termos MeSH secundário: Administração Oral
Adolescente
Adulto
Anticoncepcionais Femininos/sangue
Anticoncepcionais Femininos/farmacocinética
Composição de Medicamentos
Etinilestradiol/administração & dosagem
Etinilestradiol/sangue
Feminino
Voluntários Saudáveis
Seres Humanos
Norpregnenos/administração & dosagem
Norpregnenos/sangue
Comprimidos
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptive Agents, Female); 0 (Norpregnenes); 0 (Tablets); 1664P6E6MI (Gestodene); 423D2T571U (Ethinyl Estradiol)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.2147/DDDT.S131123


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[PMID]:28191467
[Au] Autor:Pinto-Almazán R; Segura-Uribe JJ; Farfán-García ED; Guerra-Araiza C
[Ad] Endereço:Unidad de Investigación del Hospital Regional de Alta Especialidad de Ixtapaluca, Carretera Federal México-Puebla km 34.5, Pueblo Zoquiapan, Municipio de Ixtapaluca, MEX, Mexico; Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Keck
[Ti] Título:Effects of Tibolone on the Central Nervous System: Clinical and Experimental Approaches.
[So] Source:Biomed Res Int;2017:8630764, 2017.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hormone replacement therapy (HRT) increases the risk of endometrial and breast cancer. A strategy to reduce this incidence is the use of tibolone (TIB). The aim of this paper was to address the effects of TIB on the central nervous system (CNS). For the present review, MEDLINE (via PubMed), LILACS (via BIREME), Ovid Global Health, SCOPUS, Scielo, and PsycINFO (ProQuest Research Library) electronic databases were searched for the results of controlled clinical trials on peri- and postmenopausal women published from 1990 to September 2016. Also, this paper reviews experimental studies performed to analyze neuroprotective effects, cognitive deficits, neuroplasticity, oxidative stress, and stroke using TIB. Although there are few studies on the effect of this hormone in the CNS, it has been reported that TIB decreases lipid peroxidation levels and improves memory and learning. TIB has important neuroprotective effects that could prevent the risk of neurodegenerative diseases in postmenopausal women as well as the benefits of HRT in counteracting hot flashes, improving mood, and libido. Some reports have found that TIB delays cognitive impairment in various models of neuronal damage. It also modifies brain plasticity since it acts as an endocrine modulator regulating neurotransmitters, Tau phosphorylation, and decreasing neuronal death. Finally, its antioxidant effects have also been reported in different animal models.
[Mh] Termos MeSH primário: Sistema Nervoso Central/efeitos dos fármacos
Norpregnenos/farmacologia
[Mh] Termos MeSH secundário: Climatério/efeitos dos fármacos
Transtornos Cognitivos/tratamento farmacológico
Seres Humanos
Plasticidade Neuronal/efeitos dos fármacos
Norpregnenos/química
Norpregnenos/uso terapêutico
Estresse Oxidativo/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Norpregnenes); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1155/2017/8630764


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[PMID]:27843051
[Au] Autor:Vitale C; Mammi C; Gambacciani M; Russo N; Spoletini I; Fini M; Volterrani M; Rosano GMC
[Ad] Endereço:Department of Medical Sciences, IRCCS San Raffaele, Roma, Italy. Electronic address: cristiana.vitale@sanraffaele.it.
[Ti] Título:Effect of hormone replacement therapy with the anti-mineralocorticoid progestin Drospirenone compared to tibolone on endothelial function and central haemodynamics in post-menopausal women.
[So] Source:Int J Cardiol;227:217-221, 2017 Jan 15.
[Is] ISSN:1874-1754
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Drospirenone (DRSP) is an antialdosterone agent with progestogenic and antiandrogenic effects. This compound, has been recently used in combination with 17ß-estradiol (E2) as hormonal therapy in postmenopausal women and has been shown to exert a significant antihypertensive effect in hypertensive post-menopausal women. Aim of the present study was to compare the effect of DRSP/E2 with those of Tibolone (T) on endothelial function, arterial stiffness, and lipid profile of early postmenopausal women naïve on post-menopausal hormonal therapy. Twenty-four women met the inclusion criteria and entered the study. Women were randomized to receive either DRSP/E2 or T for 6months. Blood pressure and heart rate were similar in both groups at baseline and at the end of the study. Compared to baseline, endothelial function assessed by Reactive Hyperemia (RH) significantly improved in women receiving E2/DRSP, whereas no significant differences between baseline and follow up were detected in women receiving Tibolone. Women receiving E2/DRSP showed a significant decrease in pulse wave velocity and Augmentation Index compared to baseline while no changes were observed in women receiving Tibolone. The capacity of sera to trigger endothelial cells apoptosis in vitro measured by cell death assay was significantly reduced by E/DRSP but not by T (HFA-E 70±5,6% vs HFD-E 41±4,5%, p<0,001). In conclusion, the present study shows that the association of Estradiol and Drospirenone as hormonal replacement therapy significantly improves vascular parameters and the composition of sera relevant for vascular protection in early post-menopausal normotensive women. These effects are not shared by Tibolone.
[Mh] Termos MeSH primário: Androstenos/uso terapêutico
Endotélio Vascular/efeitos dos fármacos
Hemodinâmica/efeitos dos fármacos
Antagonistas de Receptores de Mineralocorticoides/uso terapêutico
Norpregnenos/uso terapêutico
Pós-Menopausa/efeitos dos fármacos
[Mh] Termos MeSH secundário: Determinação da Pressão Arterial
Doenças Cardiovasculares/prevenção & controle
Células Cultivadas
Método Duplo-Cego
Combinação de Medicamentos
Células Endoteliais/efeitos dos fármacos
Células Endoteliais/fisiologia
Endotélio Vascular/fisiologia
Estradiol/uso terapêutico
Feminino
Terapia de Reposição Hormonal/métodos
Seres Humanos
Hipertensão/prevenção & controle
Meia-Idade
Pós-Menopausa/fisiologia
Progestinas/uso terapêutico
Análise de Onda de Pulso
Valores de Referência
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstenes); 0 (Drug Combinations); 0 (Mineralocorticoid Receptor Antagonists); 0 (Norpregnenes); 0 (Progestins); 4TI98Z838E (Estradiol); FF9X0205V2 (tibolone); N295J34A25 (drospirenone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161116
[St] Status:MEDLINE


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[PMID]:27959876
[Au] Autor:Nájera-Aguilar HA; Gutiérrez-Hernández RF; González de Los Santos R; García-Lara C; Méndez-Novelo R; Rojas-Valencia MN
[Ad] Endereço:Escuela de Ingeniería Ambiental, Facultad de Ingeniería de la Universidad de Ciencias y Artes de Chiapas, Lib. Norte Pte. No. 1150, Colonia Lajas Maciel, Tuxtla Gutiérrez, Chiapas C.P. 29039, México.
[Ti] Título:Degradation of gestodene (GES)-17α-ethinylestradiol (EE2) mixture by electrochemical oxidation.
[So] Source:J Water Health;14(6):980-988, 2016 Dec.
[Is] ISSN:1477-8920
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Evidence of the negative effects of several pharmaceutical molecules, such as hormones and steroids, on the environment can be observed throughout the world. This paper presents the results of the anodic oxidation of the mixture of gestodene steroid hormones and 17 α-ethinylestradiol present in aqueous medium. The tests were conducted in an undivided cell containing a working volume of 50 mL, using a Na SO solution as support electrolyte and boron-doped diamond electrodes. The experiments were adjusted to the structure of a 3 factorial design. The evaluated factors were: support electrolyte concentration (0.02, 0.05, and 0.10 M), pH of the reaction media (2, 3, and 4), and current density (16, 32, and 48 mA cm ). Under the optimum conditions (0.02 M Na SO , pH 4, and current density of 32 mA cm ), the degradation of at least 93% of the initial concentration of gestodene and 17α-ethinylestradiol was reached in a reaction time of 5 and 10 min, respectively. The complete degradation of both molecules required 15 min of reaction. Under these conditions, the degradation profile of the pharmaceutical mixture as each one of the active ingredients, followed a pseudo-first order kinetic behavior (k = 0.0321, k = 0.4206, and k = 0.3209 min ).
[Mh] Termos MeSH primário: Etinilestradiol/química
Norpregnenos/química
Eliminação de Resíduos Líquidos
Poluentes Químicos da Água/química
[Mh] Termos MeSH secundário: Boro/química
Anticoncepcionais Orais Sintéticos/química
Diamante/química
Técnicas Eletroquímicas
Eletrodos
Estrogênios/química
Oxirredução
Progestinas/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Synthetic); 0 (Estrogens); 0 (Norpregnenes); 0 (Progestins); 0 (Water Pollutants, Chemical); 1664P6E6MI (Gestodene); 423D2T571U (Ethinyl Estradiol); 7782-40-3 (Diamond); N9E3X5056Q (Boron)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170323
[Lr] Data última revisão:
170323
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161214
[St] Status:MEDLINE


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[PMID]:27733017
[Au] Autor:Formoso G; Perrone E; Maltoni S; Balduzzi S; Wilkinson J; Basevi V; Marata AM; Magrini N; D'Amico R; Bassi C; Maestri E
[Ad] Endereço:Emilia-Romagna Health and Welfare Directorate, Community Care Department, Pharmaceuticals and Medical Devices Area, Viale Aldo Moro 21, Bologna, Italy, 40127.
[Ti] Título:Short-term and long-term effects of tibolone in postmenopausal women.
[So] Source:Cochrane Database Syst Rev;10:CD008536, 2016 Oct 12.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tibolone is a synthetic steroid used for the treatment of menopausal symptoms, on the basis of short-term data suggesting its efficacy. We considered the balance between the benefits and risks of tibolone. OBJECTIVES: To evaluate the effectiveness and safety of tibolone for treatment of postmenopausal and perimenopausal women. SEARCH METHODS: In October 2015, we searched the Gynaecology and Fertility Group (CGF) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO (from inception), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and clinicaltrials.gov. We checked the reference lists in articles retrieved. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing tibolone versus placebo, oestrogens and/or combined hormone therapy (HT) in postmenopausal and perimenopausal women. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures of The Cochrane Collaboration. Primary outcomes were vasomotor symptoms, unscheduled vaginal bleeding and long-term adverse events. We evaluated safety outcomes and bleeding in studies including women either with or without menopausal symptoms. MAIN RESULTS: We included 46 RCTs (19,976 women). Most RCTs evaluated tibolone for treating menopausal vasomotor symptoms. Some had other objectives, such as assessment of bleeding patterns, endometrial safety, bone health, sexuality and safety in women with a history of breast cancer. Two included women with uterine leiomyoma or lupus erythematosus. Tibolone versus placebo Vasomotor symptomsTibolone was more effective than placebo (standard mean difference (SMD) -0.99, 95% confidence interval (CI) -1.10 to -0.89; seven RCTs; 1657 women; moderate-quality evidence), but removing trials at high risk of attrition bias attenuated this effect (SMD -0.61, 95% CI -0.73 to -0.49; odds ratio (OR) 0.33, 85% CI 0.27 to 0.41). This suggests that if 67% of women taking placebo experience vasomotor symptoms, between 35% and 45% of women taking tibolone will do so. Unscheduled bleedingTibolone was associated with greater likelihood of bleeding (OR 2.79, 95% CI 2.10 to 3.70; nine RCTs; 7814 women; I = 43%; moderate-quality evidence). This suggests that if 18% of women taking placebo experience unscheduled bleeding, between 31% and 44% of women taking tibolone will do so. Long-term adverse eventsMost of the studies reporting these outcomes provided follow-up of two to three years (range three months to three years). Breast cancerWe found no evidence of differences between groups among women with no history of breast cancer (OR 0.52, 95% CI 0.21 to 1.25; four RCTs; 5500 women; I = 17%; very low-quality evidence). Among women with a history of breast cancer, tibolone was associated with increased risk (OR 1.5, 95% CI 1.21 to 1.85; two RCTs; 3165 women; moderate-quality evidence). Cerebrovascular eventsWe found no conclusive evidence of differences between groups in cerebrovascular events (OR 1.74, 95% CI 0.99 to 3.04; four RCTs; 7930 women; I = 0%; very low-quality evidence). We obtained most data from a single RCT (n = 4506) of osteoporotic women aged 60 to 85 years, which was stopped prematurely for increased risk of stroke. Other outcomesEvidence on other outcomes was of low or very low quality, with no clear evidence of any differences between the groups. Effect estimates were as follows:• Endometrial cancer: OR 2.04, 95% CI 0.79 to 5.24; nine RCTs; 8504 women; I = 0%.• Cardiovascular events: OR 1.38, 95% CI 0.84 to 2.27; four RCTs; 8401 women; I = 0%.• Venous thromboembolic events: OR 0.85, 95% CI 0.37 to 1.97; 9176 women; I = 0%.• Mortality from any cause: OR 1.06, 95% CI 0.79 to 1.41; four RCTs; 8242 women; I = 0%. Tibolone versus combined HT Vasomotor symptomsCombined HT was more effective than tibolone (SMD 0.17, 95% CI 0.06 to 0.28; OR 1.36, 95% CI 1.11 to 1.66; nine studies; 1336 women; moderate-quality evidence). This result was robust to a sensitivity analysis that excluded trials with high risk of attrition bias, suggesting a slightly greater disadvantage of tibolone (SMD 0.25, 95% CI 0.09 to 0.41; OR 1.57, 95% CI 1.18 to 2.10). This suggests that if 7% of women taking combined HT experience vasomotor symptoms, between 8% and 14% of women taking tibolone will do so. Unscheduled bleedingTibolone was associated with a lower rate of bleeding (OR 0.32, 95% CI 0.24 to 0.41; 16 RCTs; 6438 women; I = 72%; moderate-quality evidence). This suggests that if 47% of women taking combined HT experience unscheduled bleeding, between 18% and 27% of women taking tibolone will do so. Long-term adverse eventsMost studies reporting these outcomes provided follow-up of two to three years (range three months to three years). Evidence was of very low quality, with no clear evidence of any differences between the groups. Effect estimates were as follows:• Endometrial cancer: OR 1.47, 95% CI 0.23 to 9.33; five RCTs; 3689 women; I = 0%.• Breast cancer: OR 1.69, 95% CI 0.78 to 3.67; five RCTs; 4835 women; I = 0%.• Venous thromboembolic events: OR 0.44, 95% CI 0.09 to 2.14; four RCTs; 4529 women; I = 0%.• Cardiovascular events: OR 0.63, 95% CI 0.24 to 1.66; two RCTs; 3794 women; I = 0%.• Cerebrovascular events: OR 0.76, 95% CI 0.16 to 3.66; four RCTs; 4562 women; I = 0%.• Mortality from any cause: only one event reported (two RCTs; 970 women). AUTHORS' CONCLUSIONS: Moderate-quality evidence suggests that tibolone is more effective than placebo but less effective than HT in reducing menopausal vasomotor symptoms, and that tibolone is associated with a higher rate of unscheduled bleeding than placebo but with a lower rate than HT.Compared with placebo, tibolone increases recurrent breast cancer rates in women with a history of breast cancer, and may increase stroke rates in women over 60 years of age. No evidence indicates that tibolone increases the risk of other long-term adverse events, or that it differs from HT with respect to long-term safety.Much of the evidence was of low or very low quality. Limitations included high risk of bias and imprecision. Most studies were financed by drug manufacturers or failed to disclose their funding source.
[Mh] Termos MeSH primário: Moduladores de Receptor Estrogênico/uso terapêutico
Terapia de Reposição de Estrogênios/métodos
Fogachos/tratamento farmacológico
Norpregnenos/uso terapêutico
Pós-Menopausa/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Neoplasias da Mama/induzido quimicamente
Neoplasias da Mama/prevenção & controle
Dispareunia/tratamento farmacológico
Moduladores de Receptor Estrogênico/efeitos adversos
Terapia de Reposição de Estrogênios/efeitos adversos
Feminino
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia/induzido quimicamente
Norpregnenos/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/induzido quimicamente
Sudorese/efeitos dos fármacos
Hemorragia Uterina/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Estrogen Receptor Modulators); 0 (Norpregnenes); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1611
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161013
[St] Status:MEDLINE


  8 / 1633 MEDLINE  
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[PMID]:27731811
[Au] Autor:Li C; Ning M; Yao X; Wang Y; Liu Y
[Ad] Endereço:Research Center of Biomaterial and Novel Drug Delivery Systems, National Research Institute for Family Planning, Da Hui Si Haidian District, Beijing, PR China / Graduate School of Peking Union Medical College; No. 9, Dongdan No. 3 Avenue, Beijing, PR China.
[Ti] Título:Preparation and in vitro/in vivo evaluation of gestodene (GEST) intravaginal ring.
[So] Source:Pak J Pharm Sci;29(5):1545-1553, 2016 Sep.
[Is] ISSN:1011-601X
[Cp] País de publicação:Pakistan
[La] Idioma:eng
[Ab] Resumo:Preparation and in vitro/in vivo evaluation of gestodene (GEST) intravaginal ring (IVR) formulations which can release a constant dose of GEST during 3 weeks were investigated. In present study a reservoir gestodene intravaginal ring, including a gestodene silicone elastomer core and the non-active silicone layer, was reported, which was manufactured by reaction injection moulding at 80°C for 20 min. The raw materials compatibility experiments showed that the silicone elastomer core carrier wouldn't interact with drugs. In vitro release samples were determined by HPLC and the experiment was performed under sink conditions. The equation of cumulative release verse time was Y=64.76χ+5.44 (r=0.9998), performing zero-order release at about the target dose of 60 µg/day over 21 days. Drug release increased with temperature elevating from 45 to 55°C, which could be attributed to optimizing the prescription. In addition, the pharmacokinetic and safety studies of gestodene intravaginal ring were evaluated in female New Zealand White rabbits. The GEST in plasma was analyzed by LC-MS/MS and the results proved that the correlation between in vitro and in vivo was relatively well.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Sintéticos/administração & dosagem
Portadores de Fármacos
Sistemas de Liberação de Medicamentos/instrumentação
Dispositivos Intrauterinos Medicados
Norpregnenos/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intravaginal
Animais
Cromatografia Líquida de Alta Pressão
Anticoncepcionais Orais Sintéticos/sangue
Anticoncepcionais Orais Sintéticos/química
Anticoncepcionais Orais Sintéticos/farmacocinética
Preparações de Ação Retardada
Composição de Medicamentos
Desenho de Equipamento
Feminino
Técnicas In Vitro
Modelos Biológicos
Norpregnenos/sangue
Norpregnenos/química
Norpregnenos/farmacocinética
Coelhos
Elastômeros de Silicone
Solubilidade
Espectrometria de Massas em Tandem
Vagina/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Synthetic); 0 (Delayed-Action Preparations); 0 (Drug Carriers); 0 (Norpregnenes); 0 (Silicone Elastomers); 1664P6E6MI (Gestodene)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170127
[Lr] Data última revisão:
170127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161013
[St] Status:MEDLINE


  9 / 1633 MEDLINE  
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[PMID]:27698111
[Au] Autor:Worsley A; Smythe J; Kulkarni J
[Ad] Endereço:Monash Alfred Psychiatry Research Centre, Alfred Hospital, Melbourne, VIC, Australia.
[Ti] Título:A case of perimenopausal depression.
[So] Source:Aust N Z J Psychiatry;50(11):1109, 2016 Nov.
[Is] ISSN:1440-1614
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Transtorno Depressivo/tratamento farmacológico
Terapia de Reposição Hormonal
Perimenopausa
[Mh] Termos MeSH secundário: Antidepressivos/uso terapêutico
Quimioterapia Combinada
Moduladores de Receptor Estrogênico/uso terapêutico
Feminino
Seres Humanos
Meia-Idade
Norpregnenos/uso terapêutico
Perimenopausa/efeitos dos fármacos
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Estrogen Receptor Modulators); 0 (Norpregnenes); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161005
[St] Status:MEDLINE


  10 / 1633 MEDLINE  
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Fotocópia
[PMID]:27357711
[Au] Autor:Khan N; Gavrilidis E; Kulkarni J
[Ad] Endereço:The Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC, Australia.
[Ti] Título:Tibolone treatment for perimenopausal depression: Three cases.
[So] Source:Aust N Z J Psychiatry;50(12):1213-1214, 2016 Dec.
[Is] ISSN:1440-1614
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Depressão/tratamento farmacológico
Moduladores de Receptor Estrogênico/uso terapêutico
Norpregnenos/uso terapêutico
Perimenopausa
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Nm] Nome de substância:
0 (Estrogen Receptor Modulators); 0 (Norpregnenes); FF9X0205V2 (tibolone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160701
[St] Status:MEDLINE



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