- Estrogen in vascular smooth muscle cells: A friend or a foe? [Review]
- VPVascul Pharmacol 2018 Sep 15
- Cardiovascular disease (CVD) continues to be the leading cause of death worldwide. The effect of estrogen on these diseases has been assessed in in vitro and in vivo models, as well as in observation...
Cardiovascular disease (CVD) continues to be the leading cause of death worldwide. The effect of estrogen on these diseases has been assessed in in vitro and in vivo models, as well as in observational studies. Collectively, these studies alluded to a cardiovasculo-protective effect of estrogen. However, comprehensive clinical investigation failed to produce concrete proof of a cardiovascular protective effect for hormone replacement therapy (HRT), let alone rule out potential harm. These seemingly paradoxical effects of estrogen were explained by the 'theory of timing and opportunity'. This theory states that the effect of estrogen, whether cardiovasculo-protective or pathological, significantly depends on the age of the individual when estrogen administration takes place. Here, we review the conflicting effects of estrogen on vascular smooth muscle cells, mainly proliferation and migration as two cellular capacities intimately related to physiology and pathophysiology of the cardiovascular system. Furthermore, we critically discuss the major parameters and signaling pathways that may account for the aforementioned paradoxical observations, as well as the key molecular players involved.
- Ovarian survival after pelvic radiation: transposition until the age of 35 years. [Journal Article]
- AGArch Gynecol Obstet 2018 Sep 14
- CONCLUSIONS: Our data shows that ovarian transposition prior to pelvic radiation is effective in women until the age of 35 years and needs to be discussed in patients aged 36-40 years.
- Development of metabolic syndrome after bilateral total thyroidectomy despite the l-t4 replacement therapy: A prospective study. [Journal Article]
- TJTurk J Surg 2018 Aug 28; :1-6
- CONCLUSIONS: The frequency and severity of MetS is high in adult patients with non-toxic multinodular goitre after total thyroidectomy. The frequency of metabolic syndrome increased in patients with a high body mass index after total thyroidectomy.
- A Heartfelt Message, Estrogen Replacement Therapy: Use It or Lose It. [Journal Article]
- AJAm J Physiol Heart Circ Physiol 2018 Sep 14
- The issue of cardiovascular and cognitive health in women is complex. During the premenopausal phase of life women have healthy blood pressure (BP) levels that are lower than age-matched men and they...
The issue of cardiovascular and cognitive health in women is complex. During the premenopausal phase of life women have healthy blood pressure (BP) levels that are lower than age-matched men and they have less cardiovascular disease. However, in the post-menopausal stage of life women's BP increases and they are increasingly susceptible to cardiovascular disease, cognitive impairments and dementia, exceeding the incidence in men. The major difference between pre- and post-menopausal women is the loss of estrogen. Thus, it seemed logical that post-menopausal estrogen replacement therapy, with or without a progestin, generally referred to as menopausal hormone treatment (MHT), would prevent these adverse sequelae. However, despite initially promising results, a major randomized clinical trial refuted the benefits of MHT leading to it falling from favor. However, reappraisal of this study in the framework of a "Critical Window", or "Timing Hypothesis" has changed our perspective on the benefit to risk ratio of MHT and this review discusses the historical, current and future approaches to MHT.
- Treatment outcomes of intracranial germinoma: a retrospective analysis of 170 patients from a single institution. [Journal Article]
- JCJ Cancer Res Clin Oncol 2018 Sep 12
- CONCLUSIONS: WVI or WBRT+ primary boost (PB) is a sufficient irradiation field for localized intracranial germinoma, while patients with bifocal disease should undergo craniospinal irradiation (CSI), especially when treated with RT alone. CSF β-HCG is not a prognostic marker for intracranial germinomas. The treatment results of chemotherapy followed by reduced-dose RT are comparable to those of RT alone. IMRT is recommended for intracranial germinoma to improve the target volume accuracy and decrease the complications of RT.
- Thyroid Function 'in Egyptian Children with Sickle Cell Anemia in correlation with iron' load. [Journal Article]
- EMEndocr Metab Immune Disord Drug Targets 2018 Sep 12
- CONCLUSIONS: Thyroid hormones deficiency may occur in some patients with SCD.'Regular assessment of thyroid function in children with SCD may be recommended as they are more vulnerable to develop hypothyroidism and may require replacement therapy'.
- Insulin-like peptide 3 (INSL3) is a major regulator of female reproductive physiology. [Journal Article]
- HRHum Reprod Update 2018 Sep 11
- Insulin-like peptide 3 (INSL3) is a member of the relaxin family of neohormones which has evolved to address specifically mammalian aspects of reproduction related to viviparity and internal fertiliz...
Insulin-like peptide 3 (INSL3) is a member of the relaxin family of neohormones which has evolved to address specifically mammalian aspects of reproduction related to viviparity and internal fertilization. It was originally identified as a major product of testicular Leydig cells and has proved to be an important biomarker of Leydig cell functional capacity. However, INSL3 is also produced by theca interna cells of growing antral follicles and is secreted into the bloodstream in phases corresponding to the number and health of the follicles. Moreover, gene silencing experiments have shown that INSL3 is essentially required for androstenedione synthesis, which is the major steroid precursor for the granulosa cells of antral follicles to produce oestrogens. Knockout studies in mice confirm that loss of INSL3 or its receptor in females leads to partial infertility, with reduced follicle numbers, ovulations and litter size. Circulating INSL3 concentration corresponds to the reproductive lifespan, beginning with puberty and declining at the menopause, and thus may contribute to the physiology of other organ systems, particularly those relevant for hormone replacement strategies.
- Klotho and Postmenopausal Hormone Replacement Therapy in Women with Chronic Kidney Disease. [Review]
- JMJ Menopausal Med 2018; 24(2):75-80
- Kidney function is highly susceptible to age-related changes, with chronic kidney disease (CKD) serving as an important cause of morbidity and mortality in older patients. The prevalence of CKD in Ko...
Kidney function is highly susceptible to age-related changes, with chronic kidney disease (CKD) serving as an important cause of morbidity and mortality in older patients. The prevalence of CKD in Korea is higher among the elderly, relative to the general population, with the most significant increases seen following the onset of menopause. Under normal conditions, estrogen attenuates renal superoxide production and protects the kidney from oxidative damage. As estrogen levels are known to decrease by as much as 80% during menopause, this represents a significant risk for older women. Postmenopausal hormone replacement therapy (HRT) modulates the renin-angiotensin system, thereby reducing the progressive deterioration of renal function. Use of estrogen-based HRT has been shown to ameliorate renal function in postmenopausal women, and delay CKD progression. Renal expression of klotho, an important suppressor of aging, is markedly decreased in CKD patients, making it a promising candidate for use as a prognostic biomarker in CKD. Here, we review the key links between renal function, sex, age, and estrogen levels during menopause, and discuss the use of postmenopausal HRT in CKD attenuation.
- [Case of thyroid ectopia in the hyoid region in a young Malagasy girl]. [Journal Article]
- PAPan Afr Med J 2018; 30:54
- Thyroid ectopia is rare. It results from a failure of migration of the thyroid gland during its embryonic development. It is most often asymptomatic. We here report a case of thyroid ectopia in the h...
Thyroid ectopia is rare. It results from a failure of migration of the thyroid gland during its embryonic development. It is most often asymptomatic. We here report a case of thyroid ectopia in the hyoid region in a young Malagasy girl, presenting as aesthetic discomfort associated with subclinical hypothyroidism. Diagnosis was confirmed using cervical ultrasound and scintigraphy with technetium-99m. Hormone replacement therapy is the gold standard even in patients with subclinical hypothyroidism because it results in physiologic euthyroidism and good clinical evolution.
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- High-risk HPV detection and associated cervical lesions in a population of French menopausal women. [Journal Article]
- JCJ Clin Virol 2018 Aug 31; 108:12-18
- CONCLUSIONS: HR-HPV was detected in 9.9% of menopausal women. HR-HPV detection was a better predictor of CIN2+ lesions than cytology in this population. Women with previous CIN history should benefit from HR-HPV testing and need long term follow-up.