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[PMID]:29180385
[Au] Autor:Shafran DM; Wu C
[Ad] Endereço:Department of Medicine (Shafran, Wu); Division of Hematology (Wu), University of Alberta, Edmonton, Alta.
[Ti] Título:Treatment of venous thromboembolism in a 22-year-old woman taking an oral contraceptive pill.
[So] Source:CMAJ;189(47):E1459-E1460, 2017 11 27.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/efeitos adversos
Inibidores do Fator Xa/uso terapêutico
Embolia Pulmonar/tratamento farmacológico
Rivaroxabana/uso terapêutico
Tromboembolia Venosa/tratamento farmacológico
[Mh] Termos MeSH secundário: Angiografia por Tomografia Computadorizada
Feminino
Seres Humanos
Embolia Pulmonar/diagnóstico por imagem
Fatores de Risco
Tromboembolia Venosa/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined); 0 (Factor Xa Inhibitors); 9NDF7JZ4M3 (Rivaroxaban)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.170398


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[PMID]:28912358
[Au] Autor:Alpañés M; Álvarez-Blasco F; Fernández-Durán E; Luque-Ramírez M; Escobar-Morreale HF
[Ad] Endereço:DiabetesObesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades
[Ti] Título:Combined oral contraceptives plus spironolactone compared with metformin in women with polycystic ovary syndrome: a one-year randomized clinical trial.
[So] Source:Eur J Endocrinol;177(5):399-408, 2017 Nov.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We aimed to compare a combined oral contraceptive (COC) plus the antiandrogen spironolactone with the insulin sensitizer metformin in women with polycystic ovary syndrome (PCOS). DESIGN: We conducted a randomized, parallel, open-label, clinical trial comparing COC (30 µg of ethinylestradiol and 150 µg of desogestrel) plus spironolactone (100 mg/day) with metformin (850 mg b.i.d.) for one year in women with PCOS (EudraCT2008-004531-38). METHODS: The composite primary outcome included efficacy (amelioration of hirsutism, androgen excess and menstrual dysfunction) and cardiometabolic safety (changes in the frequencies of disorders of glucose tolerance, dyslipidemia and hypertension). A complete anthropometric, biochemical, hormonal and metabolic evaluation was conducted every three months and data were submitted to intention-to-treat analyses. RESULTS: Twenty-four patients were assigned to COC plus spironolactone and 22 patients to metformin. Compared with metformin, COC plus spironolactone caused larger decreases in hirsutism score (mean difference 4.6 points, 95% CI: 2.6-6.7), total testosterone (1.1 nmol/L, 0.4-1.7), free testosterone (25 pmol/L, 12-39), androstenedione (5.5 nmol/L, 1.8-9.2) and dehydroepiandrosterone sulfate (2.7 µmol/L, 1.4-4.0). Menstrual dysfunction was less frequent with COC plus spironolactone (OR: 0.06, 95% CI: 0.02-0.23). No differences were found in frequencies of abnormal glucose tolerance (OR: 1.7, 95% CI: 0.7-4.4), dyslipidemia (OR: 0.6, 95% CI: 0.2-1.8) or hypertension (OR: 0.3, 95% CI: 0.5-2.0). No major adverse events occurred and biochemical markers were similarly safe with both treatments. CONCLUSIONS: COC plus spironolactone was more effective than metformin for symptoms of PCOS showing similar safety and overall neutral effects on cardiometabolic risk factors.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/uso terapêutico
Metformina/uso terapêutico
Síndrome do Ovário Policístico/tratamento farmacológico
Espironolactona/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Anticoncepcionais Orais Combinados/administração & dosagem
Anticoncepcionais Orais Combinados/efeitos adversos
Esquema de Medicação
Feminino
Hirsutismo/sangue
Hirsutismo/tratamento farmacológico
Seres Humanos
Hipoglicemiantes/administração & dosagem
Hipoglicemiantes/efeitos adversos
Hipoglicemiantes/uso terapêutico
Metformina/administração & dosagem
Metformina/efeitos adversos
Síndrome do Ovário Policístico/sangue
Espironolactona/administração & dosagem
Espironolactona/efeitos adversos
Testosterona/sangue
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined); 0 (Hypoglycemic Agents); 27O7W4T232 (Spironolactone); 3XMK78S47O (Testosterone); 9100L32L2N (Metformin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170916
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0516


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[PMID]:28911925
[Au] Autor:Harada T; Kosaka S; Elliesen J; Yasuda M; Ito M; Momoeda M
[Ad] Endereço:Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan. Electronic address: tasuku@med.tottori-u.ac.jp.
[Ti] Título:Ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial.
[So] Source:Fertil Steril;108(5):798-805, 2017 Nov.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the efficacy and safety of ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen (Flexible ) compared with placebo to treat endometriosis-associated pelvic pain (EAPP). DESIGN: A phase 3, randomized, double-blind, placebo-controlled, parallel-group study, consisting of a 24-week double-blind treatment phase followed by a 28-week open-label extension phase with an unblinded reference arm. SETTING: Thirty-two centers. PATIENT(S): A total of 312 patients with endometriosis. INTERVENTION(S): Patients were randomized to Flexible , placebo, or dienogest. The Flexible and placebo arms received 1 tablet per day continuously for 120 days, with a 4-day tablet-free interval either after 120 days or after ≥3 consecutive days of spotting and/or bleeding on days 25-120. After 24 weeks, placebo recipients were changed to Flexible . Patients randomized to dienogest received 2 mg/d for 52 weeks in an unblinded reference arm. MAIN OUTCOME MEASURE(S): Absolute change in the most severe EAPP based on visual analog scale scores from the baseline observation phase to the end of the double-blind treatment phase. RESULT(S): Compared with placebo, Flexible significantly reduced the most severe EAPP (mean difference in visual analog scale score: -26.3 mm). Flexible also improved other endometriosis-associated pain and gynecologic findings and reduced the size of endometriomas. CONCLUSION(S): Flexible improved EAPP and was well tolerated, suggesting it may be a new alternative for managing endometriosis. CLINICAL TRIALS REGISTRATION NUMBER: NCT01697111.
[Mh] Termos MeSH primário: Androstenos/administração & dosagem
Anticoncepcionais Orais Combinados/administração & dosagem
Endometriose/tratamento farmacológico
Etinilestradiol/administração & dosagem
Dor Pélvica/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Androstenos/efeitos adversos
Anticoncepcionais Orais Combinados/efeitos adversos
Método Duplo-Cego
Esquema de Medicação
Endometriose/complicações
Endometriose/diagnóstico
Etinilestradiol/efeitos adversos
Feminino
Seres Humanos
Japão
Medição da Dor
Dor Pélvica/diagnóstico
Dor Pélvica/etiologia
Índice de Gravidade de Doença
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstenes); 0 (Contraceptives, Oral, Combined); 0 (drospirenone and ethinyl estradiol combination); 423D2T571U (Ethinyl Estradiol)
[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:170916
[St] Status:MEDLINE


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[PMID]:28834877
[Au] Autor:Hugon-Rodin J; Horellou MH; Conard J; Flaujac C; Gompel A; Plu-Bureau G; and for the COntraception, REcurrent Venous Event (COREVE) investigators
[Ad] Endereço:aUniversity Paris-Saclay and Paris-Sud, UVSQ, CESP, U1018, INSERM, Villejuif bGynecology Endocrinology Unit, Port-Royal Hospital, Paris cUniversity Paris Descartes dHematology Biology Unit, Hôpital Universitaire Paris centre, Paris, France.
[Ti] Título:First venous thromboembolism and hormonal contraceptives in young French women.
[So] Source:Medicine (Baltimore);96(34):e7734, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Information on the clinical and biological characteristics of combined hormonal contraceptives (CHC) users experiencing a venous thromboembolism (VTE) event is scarce. Better knowledge of factors determining the VTE risk in CHC users could help identify women at high risk.Data were obtained from a large cohort of consecutive women with the first documented VTE event. Cross-sectional analysis of clinical and biological characteristics of the women was performed.Of the 3009 women with the first VTE included, 31% were nonusers and 69% CHC users at time of VTE. CHC users were significantly younger (29.0 ±â€Š7.2) than nonusers (31.6 ±â€Š7.1) (P < .001). No difference in VTE familial history was observed between the 2 groups. Compared with nonusers, the CHC users experienced more frequently pulmonary embolism: odds ratio (OR) = 1.28 (1.06-1.55; 95% confidence interval [CI]), factor V Leiden mutations were more frequent in this group (OR = 1.41 [1.11-1.80; 95% CI]). Venous sclerotherapy and travel were associated with VTE in CHC users, whereas surgery and bed rest were significantly associated with VTE in nonusers. Finally, 2/3 of CHC users with VTE had additional VTE risk factors.CHC users experiencing the first VTE differ from nonusers with respect to clinical and genetic background. Better understanding of the characteristics of VTE and associated risk factors could allow more appropriate management of these women and contribute to more accurate benefit-risk assessment before prescribing a CHC.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/administração & dosagem
Tromboembolia Venosa/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idade de Início
Estudos Transversais
Feminino
Seres Humanos
Meia-Idade
Razão de Chances
Medição de Risco
Fatores de Risco
Escleroterapia/estatística & dados numéricos
Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos
Viagem/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007734


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[PMID]:28750087
[Au] Autor:McDaid A; Logette E; Buchillier V; Muriset M; Suchon P; Pache TD; Tanackovic G; Kutalik Z; Michaud J
[Ad] Endereço:Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
[Ti] Título:Risk prediction of developing venous thrombosis in combined oral contraceptive users.
[So] Source:PLoS One;12(7):e0182041, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Venous thromboembolism (VTE) is a complex multifactorial disease influenced by genetic and environmental risk factors. An example for the latter is the regular use of combined oral contraceptives (CC), which increases the risk to develop VTE by 3 to 7 fold, depending on estrogen dosage and the type of progestin present in the pill. One out of 1'000 women using CC develops thrombosis, often with life-long consequences; a risk assessment is therefore necessary prior to such treatment. Currently known clinical risk factors associated with VTE development in general are routinely checked by medical doctors, however they are far from being sufficient for risk prediction, even when combined with genetic tests for Factor V Leiden and Factor II G20210A variants. Thus, clinical and notably genetic risk factors specific to the development of thrombosis associated with the use of CC in particular should be identified. METHODS AND FINDINGS: Step-wise (logistic) model selection was applied to a population of 1622 women using CC, half of whom (794) had developed a thromboembolic event while using contraceptives. 46 polymorphisms and clinical parameters were tested in the model selection and a specific combination of 4 clinical risk factors and 9 polymorphisms were identified. Among the 9 polymorphisms, there are two novel genetic polymorphisms (rs1799853 and rs4379368) that had not been previously associated with the development of thromboembolic event. This new prediction model outperforms (AUC 0.71, 95% CI 0.69-0.74) previously published models for general thromboembolic events in a cross-validation setting. Further validation in independent populations should be envisaged. CONCLUSION: We identified two new genetic variants associated to VTE development, as well as a robust prediction model to assess the risk of thrombosis for women using combined oral contraceptives. This model outperforms current medical practice as well as previously published models and is the first model specific to CC use.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/efeitos adversos
Trombose Venosa/induzido quimicamente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Área Sob a Curva
Feminino
Seres Humanos
Meia-Idade
Curva ROC
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182041


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[PMID]:28732067
[Au] Autor:Hasegawa S; Matsui T; Hane Y; Abe J; Hatahira H; Motooka Y; Sasaoka S; Fukuda A; Naganuma M; Hirade K; Takahashi Y; Kinosada Y; Nakamura M
[Ad] Endereço:Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan.
[Ti] Título:Thromboembolic adverse event study of combined estrogen-progestin preparations using Japanese Adverse Drug Event Report database.
[So] Source:PLoS One;12(7):e0182045, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Combined estrogen-progestin preparations (CEPs) are associated with thromboembolic (TE) side effects. The aim of this study was to evaluate the incidence of TE using the Japanese Adverse Drug Event Report (JADER) database. Adverse events recorded from April 2004 to November 2014 in the JADER database were obtained from the Pharmaceuticals and Medical Devices Agency (PMDA) website (www.pmda.go.jp). We calculated the reporting odds ratios (RORs) of suspected CEPs, analyzed the time-to-onset profile, and assessed the hazard type using Weibull shape parameter (WSP). Furthermore, we used the applied association rule mining technique to discover undetected relationships such as the possible risk factors. The total number of reported cases in the JADER contained was 338,224. The RORs (95% confidential interval, CI) of drospirenone combined with ethinyl estradiol (EE, Dro-EE), norethisterone with EE (Ne-EE), levonorgestrel with EE (Lev-EE), desogestrel with EE (Des-EE), and norgestrel with EE (Nor-EE) were 56.2 (44.3-71.4), 29.1 (23.5-35.9), 42.9 (32.3-57.0), 44.7 (32.7-61.1), and 38.6 (26.3-56.7), respectively. The medians (25%-75%) of the time-to-onset of Dro-EE, Ne-EE, Lev-EE, Des-EE, and Nor-EE were 150.0 (75.3-314.0), 128.0 (27.0-279.0), 204.0 (44.0-660.0), 142.0 (41.3-344.0), and 16.5 (8.8-32.0) days, respectively. The 95% CIs of the WSP-ß for Ne-EE, Lev-EE, and Nor-EE were lower and excluded 1. Association rule mining indicated that patients with anemia had a potential risk of developing a TE when using CEPs. Our results suggest that it is important to monitor patients administered CEP for TE. Careful observation is recommended, especially for those using Nor-EE, and this information may be useful for efficient therapeutic planning.
[Mh] Termos MeSH primário: Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/genética
Estrogênios/administração & dosagem
Estrogênios/efeitos adversos
Progestinas/administração & dosagem
Progestinas/efeitos adversos
Tromboembolia/induzido quimicamente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Sistemas de Notificação de Reações Adversas a Medicamentos
Androstenos/administração & dosagem
Androstenos/efeitos adversos
Criança
Anticoncepcionais Orais Combinados/administração & dosagem
Anticoncepcionais Orais Combinados/efeitos adversos
Bases de Dados Factuais
Desogestrel/administração & dosagem
Desogestrel/efeitos adversos
Etinilestradiol/administração & dosagem
Etinilestradiol/efeitos adversos
Feminino
Seres Humanos
Japão
Levanogestrel/administração & dosagem
Levanogestrel/efeitos adversos
Masculino
Meia-Idade
Noretindrona/administração & dosagem
Noretindrona/efeitos adversos
Norgestrel/administração & dosagem
Norgestrel/efeitos adversos
Razão de Chances
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androstenes); 0 (Contraceptives, Oral, Combined); 0 (Estrogens); 0 (Progestins); 3J8Q1747Z2 (Norgestrel); 423D2T571U (Ethinyl Estradiol); 5W7SIA7YZW (Levonorgestrel); 81K9V7M3A3 (Desogestrel); N295J34A25 (drospirenone); T18F433X4S (Norethindrone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182045


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[PMID]:28712325
[Au] Autor:Farris M; Bastianelli C; Rosato E; Brosens I; Benagiano G
[Ad] Endereço:a Department of Gynecology, Obstetrics and Urology , Sapienza, University of Rome , Rome , Italy.
[Ti] Título:Pharmacodynamics of combined estrogen-progestin oral contraceptives: 2. effects on hemostasis.
[So] Source:Expert Rev Clin Pharmacol;10(10):1129-1144, 2017 Oct.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The pharmacodynamic effects of various combined oral estrogen-progestin combinations (COC) are examined for their components alone or in the various combined formulations. Special emphasis is given to products containing natural estrogens. Areas covered: Recent information on the effect of androgens, estrogens, progestins, as well as various COC combinations on the coagulation cascade will be reviewed aiming at providing an updated picture. The present article reviews hemostatic changes occurring during use of classic and modern combinations of estrogens (ethinyl estradiol, estradiol, estradiol valerate and estetrol) and new progestins (desogestrel, gestodene, dienogest, drospirenone, nomegestrol acetate), compared to classic compounds, such as levonorgestrel. Both pro- and anti-coagulatory effects of COC in healthy women are detailed and possible links with incidence of thromboembolic events are discussed. Expert commentary: Overall, the picture is reassuring: the use of natural estrogens and of new generation progestins has reduced pro-coagulatory changes in healthy subjects, although the observed differences in the risk of venous thromboembolism between second and third generation progestins is still incompletely understood. At the same time, there still is a need for large comparative and surveillance studies before firm conclusions can be drawn. At any rate, available evidence indicates that hemostatic effects of the newer COC, especially those utilizing natural estrogens, are minimal and often remain with the normal range.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/efeitos adversos
Anticoncepcionais Orais Hormonais/efeitos adversos
Hemostasia/efeitos dos fármacos
[Mh] Termos MeSH secundário: Androgênios/administração & dosagem
Androgênios/efeitos adversos
Anticoncepcionais Orais Combinados/administração & dosagem
Anticoncepcionais Orais Hormonais/administração & dosagem
Estrogênios/administração & dosagem
Estrogênios/efeitos adversos
Feminino
Seres Humanos
Progestinas/administração & dosagem
Progestinas/efeitos adversos
Tromboembolia Venosa/induzido quimicamente
Tromboembolia Venosa/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Androgens); 0 (Contraceptives, Oral, Combined); 0 (Contraceptives, Oral, Hormonal); 0 (Estrogens); 0 (Progestins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2017.1356718


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[PMID]:28700760
[Au] Autor:Lam Y; Coe C; Mounsey A
[Ad] Endereço:Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
[Ti] Título:PURLs: Which combined OC to prescribe with CV safety in mind?
[So] Source:J Fam Pract;66(7):454-456, 2017 Jul.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:With various formulations available, which combined OC should you recommend to minimize not only the risk of PE, but also the risk of stroke and MI?
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/efeitos adversos
Prescrições de Medicamentos
Segurança do Paciente
Padrões de Prática Médica
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Infarto do Miocárdio/induzido quimicamente
Congêneres da Progesterona/efeitos adversos
Embolia Pulmonar/induzido quimicamente
Fatores de Risco
Acidente Vascular Cerebral/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined); 0 (Progesterone Congeners)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE


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[PMID]:28625324
[Au] Autor:Xu Z; Li Y; Huang X; Shen W; Bai J; Shen C; Zhao Y
[Ad] Endereço:Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China; Hohai University Hospital, Hohai University, Nanjing, China.
[Ti] Título:ESR2 Genetic Variants and Combined Oral Contraceptive Use Associated with the Risk of Stroke.
[So] Source:Arch Med Res;48(2):203-211, 2017 Feb.
[Is] ISSN:1873-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIM: There is accumulating evidence suggesting an important role of estrogen receptor-ß in the development of cardiovascular disease. The present study aims to investigate the relationship of estrogen receptor ß gene (ESR2) polymorphisms with stroke risk in Chinese women, and further evaluate the gene-environment interaction of ESR2 and combined oral contraceptive (COC) use on stroke risk. METHODS: A case-control study was conducted with 446 first-ever stroke patients and 864 control subjects recruited from our prospective female cohort. Four polymorphisms of ESR2 gene were genotyped, and the information of contraceptive use was obtained by a face-to-face interview. RESULTS: Women with rs1256065 CC genotype were at a 1.59 fold increased risk of stroke. Subtype analyses showed that the risk genotype of rs1256065 was associated with ischemic stroke, but not with hemorrhagic stroke. AA genotype of rs4986938 showed a significant correlation with an elevated risk of hemorrhagic stroke. COC users with rs1256065 CC genotype had a 2.36 fold increased risk of stroke, compared with the non-users with the wild-type genotype. Moreover, a significant multiplicative interaction on hemorrhagic stroke was detected between COC use and rs4986938 (p = 0.023). The risk of hemorrhagic stroke was significantly elevated among carriers of rs4986938 GA or AA genotype combined with COC use. No associations were observed for rs1256049 and rs1271572. CONCLUSIONS: ESR2 genetic polymorphisms were associated with the risk of first-ever stroke in Chinese women, and the AA genotype of rs4986938 combined with COC use could significantly increase the risk of hemorrhagic stroke.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados
Receptor beta de Estrogênio/genética
Acidente Vascular Cerebral/genética
[Mh] Termos MeSH secundário: Idoso
Grupo com Ancestrais do Continente Asiático
Isquemia Encefálica/etnologia
Isquemia Encefálica/genética
Estudos de Casos e Controles
Feminino
Interação Gene-Ambiente
Estudos de Associação Genética
Predisposição Genética para Doença
Genótipo
Seres Humanos
Hemorragias Intracranianas/etnologia
Hemorragias Intracranianas/genética
Masculino
Meia-Idade
Polimorfismo de Nucleotídeo Único
Estudos Prospectivos
Risco
Acidente Vascular Cerebral/etnologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined); 0 (Estrogen Receptor beta)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170802
[Lr] Data última revisão:
170802
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE


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[PMID]:28433366
[Au] Autor:Zethraeus N; Dreber A; Ranehill E; Blomberg L; Labrie F; von Schoultz B; Johannesson M; Hirschberg AL
[Ad] Endereço:Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:A first-choice combined oral contraceptive influences general well-being in healthy women: a double-blind, randomized, placebo-controlled trial.
[So] Source:Fertil Steril;107(5):1238-1245, 2017 May.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine whether there is a causal effect of oral contraceptive (OC) treatment on general well-being and depressed mood in healthy women. DESIGN: Double-blind, randomized, and placebo-controlled trial. SETTING: University hospital. PATIENT(S): Three hundred and forty healthy women aged 18-35 years randomized to treatment, of whom 332 completed the data collection at follow-up evaluation. INTERVENTION(S): A combined OC (150 µg levonorgestrel and 30 µg ethinylestradiol) or placebo for 3 months of treatment. MAIN OUTCOME MEASURE(S): Primary outcome measures: global score of Psychological General Well-Being Index (PGWBI) and the Beck Depression Inventory (BDI); secondary outcome measures: six separate dimensions of the PGWBI. RESULT(S): The OC treatment statistically significantly decreased general well-being compared with placebo -4.12 (95% CI, -7.18 to -1.06). Furthermore, OC decreased the following PGWBI dimensions compared with placebo: positive well-being -3.90 (95% CI, -7.78 to -0.01), self-control -6.63 (95% CI, -11.20 to -2.06), and vitality -6.84 (95% CI, -10.80 to -2.88). The effect of OC on depressive symptoms and on the PGWBI dimension depressed mood were not statistically significant. CONCLUSION(S): This study demonstrates a statistically significant reduction in general well-being by a first-choice OC in comparison with placebo in healthy women. We found no statistically significant effects on depressive symptoms. A reduction in general well-being should be of clinical importance.
[Mh] Termos MeSH primário: Anticoncepcionais Orais Combinados/uso terapêutico
Depressão/epidemiologia
Depressão/prevenção & controle
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Nível de Saúde
Gravidez/psicologia
Gravidez/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Método Duplo-Cego
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia
Feminino
Seres Humanos
Incidência
Preferência do Paciente
Efeito Placebo
Valores de Referência
Suécia/epidemiologia
Resultado do Tratamento
Saúde da Mulher/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170424
[St] Status:MEDLINE



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