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[PMID]:27771155
[Au] Autor:Sükür YE; Özmen B; Özdemir ED; Seval MM; Kalafat E; Sönmezer M; Berker B; Aytaç R; Atabekoglu CS
[Ad] Endereço:Department of Obstetrics and Gynecology, Ankara University School of Medicine, Kadin Hastaliklari ve Dogum AD, 06100 Cebeci, Ankara, Turkey.
[Ti] Título:Final oocyte maturation with two different GnRH agonists in antagonist co-treated cycles at risk of ovarian hyperstimulation syndrome.
[So] Source:Reprod Biomed Online;34(1):5-10, 2017 Jan.
[Is] ISSN:1472-6491
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Triptorelin 0.2 mg and leuprolide 1 mg subcutaneous injections for triggering final follicular maturation were compared in patients with a high risk for ovarian hyperstimulation syndrome (OHSS). Infertile patients treated with GnRH antagonist protocol between January 2014 and March 2016 were recruited. Patients with high serum oestradiol levels on HCG day (>3000 pg/ml) indicating a risk of OHSS consisted of the study groups (A and B). Patients with serum oestradiol levels less than 3000 pg/ml consisted of the control group (C). A single injection of 0.2 mg triptorelin, 1 mg leuprolide and 10000 IU HCG were administered for final oocyte triggering in groups A (n = 63), B (n = 74) and C (n = 131), respectively. Demographic parameters were comparable between the groups. No cases of severe or moderate OHSS occurred in any group. The clinical pregnancy rates were 31.7%, 37.8% and 32.8% in groups A, B and C, respectively. Both injections had comparable efficacy in clinical outcome and OHSS risk. Regardless of preferred drug, GnRH agonist trigger for final oocyte maturation seems to be safe for patients with high OHSS risk, and can be safely used in fresh embryo transfer cycles.
[Mh] Termos MeSH primário: Hormônio Liberador de Gonadotropina/agonistas
Hormônio Liberador de Gonadotropina/antagonistas & inibidores
Oócitos/citologia
Síndrome de Hiperestimulação Ovariana/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estradiol/sangue
Feminino
Antagonistas de Hormônios/uso terapêutico
Seres Humanos
Infertilidade Feminina/terapia
Infertilidade Masculina/terapia
Leuprolida/administração & dosagem
Masculino
Oócitos/efeitos dos fármacos
Oogênese
Indução da Ovulação
Gravidez
Taxa de Gravidez
Estudos Retrospectivos
Risco
Injeções de Esperma Intracitoplásmicas
Pamoato de Triptorrelina/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hormone Antagonists); 33515-09-2 (Gonadotropin-Releasing Hormone); 4TI98Z838E (Estradiol); 57773-63-4 (Triptorelin Pamoate); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29017178
[Au] Autor:Haque R; UlcickasYood M; Xu X; Cassidy-Bushrow AE; Tsai HT; Keating NL; Van Den Eeden SK; Potosky AL
[Ad] Endereço:Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
[Ti] Título:Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study.
[So] Source:Br J Cancer;117(8):1233-1240, 2017 Oct 10.
[Is] ISSN:1532-1827
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As androgen deprivation therapy (ADT) is increasingly being used in men with localised prostate cancer, our goal was to examine the association between ADT and the risk of cardiovascular disease (CVD). METHODS: We conducted a prospective cohort study using records of a large health-care system in California. The study included men with newly diagnosed localised prostate cancer (1998-2008) who initially underwent active surveillance (N=7637) and were followed through 2010. We examined 10 individual CVD outcomes. Cox proportional hazard models incorporated time-varying treatment variables and controlled for race/ethnicity, age, and tumour characteristics, recurrence risk, CVD medication use, and CVD risk factors. RESULTS: Of the 7637 subjects, nearly 30% were exposed to ADT. In the multivariable analyses, ADT was associated with an increased risk of heart failure (adjusted HR=1.81, 95% CI 1.40-2.32) in men without preexisting CVD. Elevated risks of arrhythmia (adjusted HR=1.44, 95% CI 1.02-2.01), and conduction disorder (adjusted HR=3.11, 95% CI 1.22, 7.91) were only observed among patients with preexisting CVD. CONCLUSIONS: In men with clinically localised prostate cancer who were initially under active surveillance, ADT was associated with a greater risk of heart failure in men without any preexisting CVD. We also found an increased risk of arrhythmia and conduction disorder in men with preexisting CVD. This study provides the basis for identifying high-risk men treated with ADT who might benefit from regular cardiac monitoring and lifestyle modification recommendations.
[Mh] Termos MeSH primário: Antagonistas de Androgênios/uso terapêutico
Antineoplásicos Hormonais/uso terapêutico
Arritmias Cardíacas/epidemiologia
Insuficiência Cardíaca/epidemiologia
Neoplasias da Próstata/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Anilidas/uso terapêutico
California/epidemiologia
Doenças Cardiovasculares/epidemiologia
Estudos de Coortes
Flutamida/uso terapêutico
Hormônio Liberador de Gonadotropina/agonistas
Gosserrelina/uso terapêutico
Seres Humanos
Imidazolidinas/uso terapêutico
Leuprolida/uso terapêutico
Masculino
Meia-Idade
Análise Multivariada
Gradação de Tumores
Nitrilos/uso terapêutico
Modelos de Riscos Proporcionais
Estudos Prospectivos
Neoplasias da Próstata/epidemiologia
Neoplasias da Próstata/patologia
Fatores de Risco
Compostos de Tosil/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androgen Antagonists); 0 (Anilides); 0 (Antineoplastic Agents, Hormonal); 0 (Imidazolidines); 0 (Nitriles); 0 (Tosyl Compounds); 0F65R8P09N (Goserelin); 33515-09-2 (Gonadotropin-Releasing Hormone); 51G6I8B902 (nilutamide); 76W6J0943E (Flutamide); A0Z3NAU9DP (bicalutamide); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1038/bjc.2017.280


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[PMID]:28973010
[Au] Autor:Lin YC; Lin CY; Chee SY; Yen HR; Tsai FJ; Chen CY; Wang CH
[Ad] Endereço:Department of Chinese Medicine, China Medical University Hospital, Taichung City, Taiwan.
[Ti] Título:Improved final predicted height with the injection of leuprolide in children with earlier puberty: A retrospective cohort study.
[So] Source:PLoS One;12(10):e0185080, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The adult height of children with early onset puberty is limited by the premature maturation of hypothalamic-pituitary-gonadal axis. To evaluate the effects of gonadotropin-releasing hormone analog (GnRHa) treatment on the final height (FH) and bone maturation rate (BMR) in girls with early puberty (EP) or idiopathic central precocious puberty (ICPP), we examined data from girls who were diagnosed with EP or ICPP and underwent GnRHa (Leuplin Depot: 3.75 mg/month) at China Medical University Hospital, in Taiwan, between 2006 and 2015. Patients were observed until the achievement of FH and divided into an "EP group" (T-ep) and "ICPP group" (T-icpp) according to the age of onset of puberty. Eighty-seven patients were enrolled (T-ep, N = 44, puberty onset at 8-10 years; T-icpp, N = 43, puberty onset before 8 years). The demographic data of girls with EP or IPP was characterized. BMR, change in predicted final height (PFH) after GnRHa treatment, target height (TH) and FH were measured. After GnRHa treatment, the study groups (T-ep: 160.24±6.18 cm, T-icpp: 158.99±5.92 cm) both had higher PFH than at initiation (T-ep: 159.83±7.19 cm, T-icpp: 158.58±5.93 cm). There was deceleration of BMR in both groups (T-ep: 0.57±0.39; T-icpp: 0.97±0.97) and a significant difference between the groups (p = 0.027). The gap in FH standard deviation scores (SDS) and TH SDS had a significant difference in T-ep (p = 0.045) but not in T-icpp. Moreover, there was no difference in the gap of PFH SDS between the 1st and final treatment in both groups. We concluded that GnRHa decelerated BMR in girls with earlier puberty. Further prospective clinical studies are warranted.
[Mh] Termos MeSH primário: Estatura/efeitos dos fármacos
Leuprolida/uso terapêutico
Puberdade Precoce/tratamento farmacológico
[Mh] Termos MeSH secundário: Criança
Feminino
Seres Humanos
Leuprolida/administração & dosagem
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EFY6W0M8TG (Leuprolide)
[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:171004
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185080


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[PMID]:28641384
[Au] Autor:Santosa S; Bush NC; Jensen MD
[Ad] Endereço:Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota 55905.
[Ti] Título:Acute Testosterone Deficiency Alters Adipose Tissue Fatty Acid Storage.
[So] Source:J Clin Endocrinol Metab;102(8):3056-3064, 2017 Aug 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Although the long-term effects of testosterone on adipose tissue lipid metabolism in men have been defined, the short-term regulation of these effects is not well understood. Objective: We examined the effects of acute testosterone withdrawal on subcutaneous abdominal and femoral adipose tissue fatty acid (FA) storage and cellular mechanisms. Design: This was a prospective, randomized trial. Setting: Mayo Clinic Clinical Research Unit. Patients or Participants: Thirty-two male volunteers ages 18 to 50 participated in these studies. Interventions: Volunteers were randomized to receive (1) no treatment (control), (2) injections (7.5 mg) of Lupron®, or (3) Lupron and testosterone (L+T) replacement for 49 days, resulting in 4 weeks of sex steroid suppression in the Lupron group. Main Outcome Measures: We measured body composition, fat cell size, adipose tissue meal FA and direct free FA storage, lipoprotein lipase (LPL), acyl coenzyme A synthetase (ACS), diacylglycerol acyltransferase activities, and CD36 content. Results: Compared with control and L+T groups, acute testosterone deficiency resulted in greater femoral adipose tissue meal FA storage rates, fasting and fed LPL activity, and ACS activity. Conclusions: These results suggest that in men, testosterone plays a tonic role in restraining FA storage in femoral adipose tissue via suppression of LPL and ACS activities. FA storage mechanisms in men appear sensitive to short-term changes in testosterone concentrations.
[Mh] Termos MeSH primário: Adipócitos/efeitos dos fármacos
Antagonistas de Androgênios/farmacologia
Androgênios/farmacologia
Composição Corporal/efeitos dos fármacos
Leuprolida/farmacologia
Metabolismo dos Lipídeos/efeitos dos fármacos
Gordura Subcutânea/efeitos dos fármacos
Testosterona/farmacologia
[Mh] Termos MeSH secundário: Abdome
Absorciometria de Fóton
Acil Coenzima A/efeitos dos fármacos
Acil Coenzima A/metabolismo
Adipócitos/citologia
Adolescente
Adulto
Western Blotting
Antígenos CD36/efeitos dos fármacos
Antígenos CD36/metabolismo
Tamanho Celular/efeitos dos fármacos
Diacilglicerol O-Aciltransferase/efeitos dos fármacos
Diacilglicerol O-Aciltransferase/metabolismo
Ácidos Graxos/metabolismo
Ácidos Graxos não Esterificados/metabolismo
Seres Humanos
Lipase Lipoproteica/efeitos dos fármacos
Lipase Lipoproteica/metabolismo
Masculino
Meia-Idade
Estudos Prospectivos
Gordura Subcutânea/metabolismo
Coxa da Perna
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Acyl Coenzyme A); 0 (Androgen Antagonists); 0 (Androgens); 0 (CD36 Antigens); 0 (Fatty Acids); 0 (Fatty Acids, Nonesterified); 3XMK78S47O (Testosterone); EC 2.3.1.20 (Diacylglycerol O-Acyltransferase); EC 3.1.1.34 (Lipoprotein Lipase); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170624
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00757


  5 / 2751 MEDLINE  
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[PMID]:28444736
[Au] Autor:Murji A; Whitaker L; Chow TL; Sobel ML
[Ad] Endereço:Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, 700 University Ave - 3rd Floor, Toronto, ON, Canada, M5G 1Z5.
[Ti] Título:Selective progesterone receptor modulators (SPRMs) for uterine fibroids.
[So] Source:Cochrane Database Syst Rev;4:CD010770, 2017 Apr 26.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Uterine fibroids are smooth muscle tumours arising from the uterus. These tumours, although benign, are commonly associated with abnormal uterine bleeding, bulk symptoms and reproductive dysfunction. The importance of progesterone in fibroid pathogenesis supports selective progesterone receptor modulators (SPRMs) as effective treatment. Both biochemical and clinical evidence suggests that SPRMs may reduce fibroid growth and ameliorate symptoms. SPRMs can cause unique histological changes to the endometrium that are not related to cancer, are not precancerous and have been found to be benign and reversible. This review summarises randomised trials conducted to evaluate the effectiveness of SPRMs as a class of medication for treatment of individuals with fibroids. OBJECTIVES: To evaluate the effectiveness and safety of SPRMs for treatment of premenopausal women with uterine fibroids. SEARCH METHODS: We searched the Specialised Register of the Cochrane Gynaecology and Fertility Group, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and clinical trials registries from database inception to May 2016. We handsearched the reference lists of relevant articles and contacted experts in the field to request additional data. SELECTION CRITERIA: Included studies were randomised controlled trials (RCTs) of premenopausal women with fibroids who were treated for at least three months with a SPRM. DATA COLLECTION AND ANALYSIS: Two review authors independently reviewed all eligible studies identified by the search. We extracted data and assessed risk of bias independently using standard forms. We analysed data using mean differences (MDs) or standardised mean differences (SMDs) for continuous data and odds ratios (ORs) for dichotomous data. We performed meta-analyses using the random-effects model. Our primary outcome was change in fibroid-related symptoms. MAIN RESULTS: We included in the review 14 RCTs with a total of 1215 study participants. We could not extract complete data from three studies. We included in the meta-analysis 11 studies involving 1021 study participants: 685 received SPRMs and 336 were given a control intervention (placebo or leuprolide). Investigators evaluated three SPRMs: mifepristone (five studies), ulipristal acetate (four studies) and asoprisnil (two studies). The primary outcome was change in fibroid-related symptoms (symptom severity, health-related quality of life, abnormal uterine bleeding, pelvic pain). Adverse event reporting in the included studies was limited to SPRM-associated endometrial changes. More than half (8/14) of these studies were at low risk of bias in all domains. The most common limitation of the other studies was poor reporting of methods. The main limitation for the overall quality of evidence was potential publication bias. SPRM versus placebo SPRM treatment resulted in improvements in fibroid symptom severity (MD -20.04 points, 95% confidence interval (CI) -26.63 to -13.46; four RCTs, 171 women, I = 0%; moderate-quality evidence) and health-related quality of life (MD 22.52 points, 95% CI 12.87 to 32.17; four RCTs, 200 women, I = 63%; moderate-quality evidence) on the Uterine Fibroid Symptom Quality of Life Scale (UFS-QoL, scale 0 to 100). Women treated with an SPRM showed reduced menstrual blood loss on patient-reported bleeding scales, although this effect was small (SMD -1.11, 95% CI -1.38 to -0.83; three RCTs, 310 women, I = 0%; moderate-quality evidence), along with higher rates of amenorrhoea (29 per 1000 in the placebo group vs 237 to 961 per 1000 in the SPRM group; OR 82.50, 95% CI 37.01 to 183.90; seven RCTs, 590 women, I = 0%; moderate-quality evidence), compared with those given placebo. We could draw no conclusions regarding changes in pelvic pain owing to variability in the estimates. With respect to adverse effects, SPRM-associated endometrial changes were more common after SPRM therapy than after placebo (OR 15.12, 95% CI 6.45 to 35.47; five RCTs, 405 women, I = 0%; low-quality evidence). SPRM versus leuprolide acetate In comparing SPRM versus other treatments, two RCTs evaluated SPRM versus leuprolide acetate. One RCT reported primary outcomes. No evidence suggested a difference between SPRM and leuprolide groups for improvement in quality of life, as measured by UFS-QoL fibroid symptom severity scores (MD -3.70 points, 95% CI -9.85 to 2.45; one RCT, 281 women; moderate-quality evidence) and health-related quality of life scores (MD 1.06 points, 95% CI -5.73 to 7.85; one RCT, 281 women; moderate-quality evidence). It was unclear whether results showed a difference between SPRM and leuprolide groups for reduction in menstrual blood loss based on the pictorial blood loss assessment chart (PBAC), as confidence intervals were wide (MD 6 points, 95% CI -40.95 to 50.95; one RCT, 281 women; low-quality evidence), or for rates of amenorrhoea (804 per 1000 in the placebo group vs 732 to 933 per 1000 in the SPRM group; OR 1.14, 95% CI 0.60 to 2.16; one RCT, 280 women; moderate-quality evidence). No evidence revealed differences between groups in pelvic pain scores based on the McGill Pain Questionnaire (scale 0 to 45) (MD -0.01 points, 95% CI -2.14 to 2.12; 281 women; moderate-quality evidence). With respect to adverse effects, SPRM-associated endometrial changes were more common after SPRM therapy than after leuprolide treatment (OR 10.45, 95% CI 5.38 to 20.33; 301 women; moderate-quality evidence). AUTHORS' CONCLUSIONS: Short-term use of SPRMs resulted in improved quality of life, reduced menstrual bleeding and higher rates of amenorrhoea than were seen with placebo. Thus, SPRMs may provide effective treatment for women with symptomatic fibroids. Evidence derived from one RCT showed no difference between leuprolide acetate and SPRM with respect to improved quality of life and bleeding symptoms. Evidence was insufficient to show whether effectiveness was different between SPRMs and leuprolide. Investigators more frequently observed SPRM-associated endometrial changes in women treated with SPRMs than in those treated with placebo or leuprolide acetate. As noted above, SPRM-associated endometrial changes are benign, are not related to cancer and are not precancerous. Reporting bias may impact the conclusion of this meta-analysis. Well-designed RCTs comparing SPRMs versus other treatments are needed.
[Mh] Termos MeSH primário: Antineoplásicos Hormonais/uso terapêutico
Estrenos/uso terapêutico
Leiomioma/tratamento farmacológico
Mifepristona/uso terapêutico
Norpregnadienos/uso terapêutico
Oximas/uso terapêutico
Receptores de Progesterona/antagonistas & inibidores
Neoplasias Uterinas/tratamento farmacológico
[Mh] Termos MeSH secundário: Amenorreia/tratamento farmacológico
Feminino
Seres Humanos
Leuprolida/uso terapêutico
Menstruação/efeitos dos fármacos
Dor Pélvica/tratamento farmacológico
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 0 (Estrenes); 0 (Norpregnadienes); 0 (Oximes); 0 (Receptors, Progesterone); 320T6RNW1F (Mifepristone); 72W09924WP (asoprisnil); EFY6W0M8TG (Leuprolide); YF7V70N02B (ulipristal acetate)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010770.pub2


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[PMID]:28427285
[Au] Autor:Schmidt PJ; Martinez PE; Nieman LK; Koziol DE; Thompson KD; Schenkel L; Wakim PG; Rubinow DR
[Ad] Endereço:From the Behavioral Endocrinology Branch, NIMH, Bethesda, Md.; the Intramural Research Program on Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md.; the Biostatistics and Clinical Epidemiology Service, Clinical Center
[Ti] Título:Premenstrual Dysphoric Disorder Symptoms Following Ovarian Suppression: Triggered by Change in Ovarian Steroid Levels But Not Continuous Stable Levels.
[So] Source:Am J Psychiatry;174(10):980-989, 2017 Oct 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Premenstrual dysphoric disorder (PMDD) symptoms are eliminated by ovarian suppression and stimulated by administration of ovarian steroids, yet they appear with ovarian steroid levels indistinguishable from those in women without PMDD. Thus, symptoms could be precipitated either by an acute change in ovarian steroid levels or by stable levels above a critical threshold playing a permissive role in expression of an underlying infradian affective "pacemaker." The authors attempted to determine which condition triggers PMDD symptoms. METHOD: The study included 22 women with PMDD, ages 30 to 50 years. Twelve women who experienced symptom remission after 2-3 months of GnRH agonist-induced ovarian suppression (leuprolide) then received 1 month of single-blind (participant only) placebo and then 3 months of continuous combined estradiol/progesterone. Primary outcome measures were the Rating for Premenstrual Tension observer and self-ratings completed every 2 weeks during clinic visits. Multivariate repeated-measure ANOVA for mixed models was employed. RESULTS: Both self- and observer-rated scores on the Rating for Premenstrual Tension were significantly increased (more symptomatic) during the first month of combined estradiol/progesterone compared with the last month of leuprolide alone, the placebo month, and the second and third months of estradiol/progesterone. There were no significant differences in symptom severity between the last month of leuprolide alone, placebo month, or second and third months of estradiol/progesterone. Finally, the Rating for Premenstrual Tension scores in the second and third estradiol/progesterone months did not significantly differ. CONCLUSIONS: The findings demonstrate that the change in estradiol/progesterone levels from low to high, and not the steady-state level, was associated with onset of PMDD symptoms. Therapeutic efforts to modulate the change in steroid levels proximate to ovulation merit further study.
[Mh] Termos MeSH primário: Afeto/efeitos dos fármacos
Estradiol/farmacologia
Estrogênios/farmacologia
Inibição da Ovulação/metabolismo
Transtorno Disfórico Pré-Menstrual/metabolismo
Progesterona/farmacologia
Progestinas/farmacologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Fármacos para a Fertilidade Feminina/uso terapêutico
Hormônio Liberador de Gonadotropina/agonistas
Seres Humanos
Leuprolida/uso terapêutico
Meia-Idade
Análise Multivariada
Inibição da Ovulação/psicologia
Transtorno Disfórico Pré-Menstrual/tratamento farmacológico
Transtorno Disfórico Pré-Menstrual/psicologia
Método Simples-Cego
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Estrogens); 0 (Fertility Agents, Female); 0 (Progestins); 33515-09-2 (Gonadotropin-Releasing Hormone); 4G7DS2Q64Y (Progesterone); 4TI98Z838E (Estradiol); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.16101113


  7 / 2751 MEDLINE  
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[PMID]:28368521
[Au] Autor:Roelfsema F; Aoun P; Takahashi PY; Erickson D; Yang R; Veldhuis JD
[Ad] Endereço:Department of Endocrinology and Metabolism, Leiden University Medical Center, 2333ZA Leiden, The Netherlands.
[Ti] Título:Regulation of Pulsatile and Entropic ACTH Secretion Under Fixed Exogenous Secretagogue Clamps.
[So] Source:J Clin Endocrinol Metab;102(7):2611-2619, 2017 Jul 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Adrenocorticotropic hormone (ACTH) secretion is controlled by unobservable hypothalamic corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) pulses. Clamping exogenous CRH or AVP input could allow indirect quantification of the impact of the endogenous heterotypic hormone. Methods: We conducted a randomized, double-blind, placebo-controlled, crossover study in 28 healthy adults (16 men). Volunteers underwent a sex-steroid clamp and a cortisol clamp. ACTH was measured over 10 hours by 10-minute sampling during each of four randomized intravenous (IV) secretagogue clamps (i.e., continuous IV CRH, AVP, both peptides, or saline). Desensitization was tested by bolus injection of the noninfused peptide. Results: Mean ± standard error of the mean 10-hour ACTH concentrations (ng/L) in the sex-combined analysis were: saline, 32 ± 4.6; AVP, 29 ± 4.6; CRH, 67 ± 6.2; and CRH-AVP, 67 ± 8.8 (any CRH vs AVP or saline, P < 0.0001). CRH and AVP increased approximate entropy (relative randomness) of ACTH release (P < 0.0001). Bolus AVP injection after CRH infusion yielded a 2.5-hour ACTH concentration of 46 ± 4.3, exceeding that seen after bolus CRH or saline injection (26 ± 3.3 and 24 ± 3.6, respectively; P = 0.002 and 0.001). Sex hormone clamps did not influence ACTH levels. Conclusions: A CRH, but not AVP, clamp yields sustained pulsatile ACTH secretion with high ACTH secretory-burst mass and randomness. After 10-hour CRH infusion, bolus AVP but not CRH, evoked marked ACTH release, likely caused by heterotypic sensitization of corticotropes by CRH. Similar interactions might underlie chronic stress states.
[Mh] Termos MeSH primário: Hormônio Adrenocorticotrópico/secreção
Arginina Vasopressina/administração & dosagem
Hormônio Liberador da Corticotropina/administração & dosagem
Leuprolida/administração & dosagem
[Mh] Termos MeSH secundário: Hormônio Adrenocorticotrópico/sangue
Idoso
Constrição
Estudos Cross-Over
Método Duplo-Cego
Feminino
Seguimentos
Hormônios Esteroides Gonadais/metabolismo
Seres Humanos
Hidrocortisona/sangue
Infusões Intravenosas
Masculino
Meia-Idade
Valores de Referência
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Gonadal Steroid Hormones); 113-79-1 (Arginine Vasopressin); 9002-60-2 (Adrenocorticotropic Hormone); 9015-71-8 (Corticotropin-Releasing Hormone); EFY6W0M8TG (Leuprolide); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00115


  8 / 2751 MEDLINE  
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[PMID]:28347848
[Au] Autor:Hetényi G; Griesser J; Moser M; Demarne F; Jannin V; Bernkop-Schnürch A
[Ad] Endereço:Thiomatrix Forschungs-und Beratungs GmbH, Trientlgasse 65, Innsbruck, Austria.
[Ti] Título:Comparison of the protective effect of self-emulsifying peptide drug delivery systems towards intestinal proteases and glutathione.
[So] Source:Int J Pharm;523(1):357-365, 2017 May 15.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIM: The aim of this study was to evaluate the protective effect of self-emulsifying drug delivery systems (SEDDS) for therapeutic peptides towards intestinal proteases and reduced glutathione (GSH). METHODS: Sodium docusate was applied as anionic surfactant for hydrophobic ion pairing with leuprorelin (LEU), insulin (INS) and desmopressin (DES). The complexes were loaded into SEDDS that were characterized regarding droplet size distribution and zeta potential. The release profile of the peptides was examined by dialysis membrane method. Enzymatic digestion studies were performed by applying α-chymotrypsin, trypsin and elastase. Furthermore, the protective effect of SEDDS towards degradation through thiol-disulfide exchange reactions was examined by addition of GSH. RESULTS: SEDDS showed a mean droplet size of 0.27-3.9µm and a zeta potential of -25 to -33mV. All formulations provided a sustained release of the peptides over 6h. Degradation of the model peptides by intestinal proteases and GSH could only be observed in the release medium. In the oily phase of SEDDS neither any of the proteases nor GSH was soluble (≤0.1%). Furthermore, no degradation of the model peptides by proteases and GSH took place in the oily phase of SEDDS. CONCLUSION: SEDDS can provide a 100% protective effect towards protease degradation and deactivation by GSH. According to this, SEDDS might be promising tools for oral delivery of peptide drugs.
[Mh] Termos MeSH primário: Desamino Arginina Vasopressina/química
Sistemas de Liberação de Medicamentos
Glutationa/química
Insulina/química
Leuprolida/química
Peptídeo Hidrolases/química
[Mh] Termos MeSH secundário: Ácido Dioctil Sulfossuccínico/química
Liberação Controlada de Fármacos
Emulsificantes/química
Intestinos/enzimologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Emulsifying Agents); 0 (Insulin); 10041-19-7 (Dioctyl Sulfosuccinic Acid); EC 3.4.- (Peptide Hydrolases); EFY6W0M8TG (Leuprolide); ENR1LLB0FP (Deamino Arginine Vasopressin); GAN16C9B8O (Glutathione)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE


  9 / 2751 MEDLINE  
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[PMID]:28256923
[Au] Autor:Yang S; Kong F; Hou R; Rong F; Ma N; Li S; Yang J
[Ad] Endereço:Department of Gynecology and Obstetrics, First Affiliated Hospital of Xinxiang Medical University, Weihui, China.
[Ti] Título:Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T weighted MR imaging.
[So] Source:Br J Radiol;90(1073):20160760, 2017 May.
[Is] ISSN:1748-880X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The study aimed to evaluate the safety and efficiency of ultrasound-guided high-intensity focused ultrasound (USgHIFU) combined with gonadotropin-releasing hormone analogue (GnRHa)-ablating symptomatic uterine leiomyoma with homogeneous hyperintensity on T weighted MRI prospectively. METHODS: A total of 34 patients with 42 symptomatic uterine leiomyomas with homogeneous hyperintensity on T weighted MRI were enrolled in our study. In the patient who had multiple uterine leiomyomas, only one dominant leiomyoma was treated. According to the principles of voluntariness, 18 patients underwent a 3-month therapy of GnRHa (once a month) before the high-intensity focused ultrasound (HIFU) treatment, while 16 patients received only HIFU treatment. Enhanced MRI was performed before and after GnRHa and HIFU treatment. Evaluation of the main indicators included treatment time, sonication time, treatment efficiency, non-perfused volume (NPV) (indicative of successful ablation) ratio and energy effect ratio; adverse events were also recorded. RESULTS: The treatment time and sonication time of the combination group were 102.0 min (55.8-152.2 min) and 25.4 min (12.2-34.1 min); however, they were 149.0 min (87.0-210.0 min) and 38.9 min (14.0-46.7 min) in the simple USgHIFU group. The treatment and sonication time for the combination group was significantly shorter than that for the simple USgHIFU group. Treatment efficiency, NPV ratio and energy effect ratio were 46.7 mm s (28.5-95.8 mm s ), 69.2 ± 29.8% (35.5-97.4%) and 9.9 KJ mm (4.5-15.7 KJ mm ) in the combination group, respectively; but, the lowest treatment efficiency, lowest NPV ratio and more energy effect ratio were observed in the simple HIFU group, which were 16.8 mm s (8.9-32.9 mm s ), 50.2 ± 27.3% (0-78.6%) and 23.8 KJ mm (12.4-46.2 KJ mm ), respectively. Pain scores in the combination group were 3.0 ± 0.5 points (2-4 points)-significantly less than the simple USgHIFU group. There were no significant adverse reactions in either group. CONCLUSION: Our data suggest that USgHIFU combined with GnRHa may be performed to ablate symptomatic uterine leiomyoma with homogeneous hyperintensity on T weighted MRI. Advances in knowledge: The conclusions indicate that GnRHa can improve the effectiveness of the USgHIFU treatment of a homogeneous hyperintense leiomyoma on T weighted MRI, and combination treatment could be a promising alternative treatment for the uterine leiomyoma.
[Mh] Termos MeSH primário: Antineoplásicos Hormonais/uso terapêutico
Hormônio Liberador de Gonadotropina/análogos & derivados
Ablação por Ultrassom Focalizado de Alta Intensidade/métodos
Leiomioma/terapia
Leuprolida/uso terapêutico
Neoplasias Uterinas/terapia
[Mh] Termos MeSH secundário: Adulto
Terapia Combinada/métodos
Feminino
Hormônio Liberador de Gonadotropina/uso terapêutico
Seres Humanos
Leiomioma/diagnóstico por imagem
Imagem por Ressonância Magnética
Meia-Idade
Ultrassonografia de Intervenção/métodos
Neoplasias Uterinas/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 33515-09-2 (Gonadotropin-Releasing Hormone); 79561-22-1 (LHRH, Ala(6)-Gly(10)-ethylamide-); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20160760


  10 / 2751 MEDLINE  
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[PMID]:28221866
[Au] Autor:Gershenson DM; Bodurka DC; Coleman RL; Lu KH; Malpica A; Sun CC
[Ad] Endereço:All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
[Ti] Título:Hormonal Maintenance Therapy for Women With Low-Grade Serous Cancer of the Ovary or Peritoneum.
[So] Source:J Clin Oncol;35(10):1103-1111, 2017 Apr 01.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose The purpose of this study was to examine outcomes associated with hormonal maintenance therapy (HMT) compared with routine observation (OBS) after primary cytoreductive surgery and platinum-based chemotherapy in women with stage II to IV low-grade serous carcinoma of the ovary or peritoneum. Patients and Methods Eligibility criteria for patients from our database were: treatment with primary surgery followed by platinum-based chemotherapy, stage II to IV disease, at least 2 years of follow-up for patients who had not experienced recurrence, and adequate clinical information. The two groups were compared for progression-free survival (PFS) and overall survival, and a multivariable Cox regression analysis was performed. Subset analyses for patients who were disease free or had persistent disease were also performed. Results Between 1981 and 2013, 203 eligible patients-133 who underwent OBS and 70 who received HMT-were seen at our institution. Median PFS for patients who underwent OBS was 26.4 months, compared with 64.9 months for those who received HMT ( P < .001). No statistically significant difference in overall survival was observed between the two groups (102.7 v 115.7 months, respectively). For subgroups of women who were disease free or had persistent disease, median PFS was superior for those who received HMT (81.1 v 30.0 months; P < .001 and 38.1 v 15.2 months; P < .001, respectively). Women who received HMT had a significantly lower risk of disease progression compared with those who underwent OBS (hazard ratio, 0.44; 95% CI, 0.31 to 0.64; P < .001). Conclusion Women with stage II to IV low-grade serous carcinoma who received HMT after primary treatment had significantly longer PFS compared with women who underwent OBS. These findings warrant further investigation using a prospective trial design.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimioterapia de Manutenção
Neoplasias Císticas, Mucinosas e Serosas/terapia
Neoplasias Ovarianas/terapia
Neoplasias Peritoneais/terapia
Conduta Expectante
[Mh] Termos MeSH secundário: Adulto
Idoso
Procedimentos Cirúrgicos de Citorredução
Progressão da Doença
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Leuprolida/administração & dosagem
Acetato de Medroxiprogesterona/administração & dosagem
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Neoplasias Císticas, Mucinosas e Serosas/patologia
Nitrilos/administração & dosagem
Neoplasias Ovarianas/patologia
Neoplasias Peritoneais/patologia
Compostos de Platina/administração & dosagem
Taxa de Sobrevida
Tamoxifeno/administração & dosagem
Triazóis/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nitriles); 0 (Platinum Compounds); 0 (Triazoles); 094ZI81Y45 (Tamoxifen); 2Z07MYW1AZ (anastrozole); 7LKK855W8I (letrozole); C2QI4IOI2G (Medroxyprogesterone Acetate); EFY6W0M8TG (Leuprolide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2016.71.0632



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