Navegando por Palavras-chave "menopause"

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    Changes in the lower urinary tract in continent women and in women with stress urinary incontinence, according to menopausal status
    (Springer, 2001-06-01) Wakavaiachi, VMB; Girao, MJBC; Sartori, MGF; Baracat, E. C.; Lima, G. R. de; Novo, N. F.; Universidade Federal de São Paulo (UNIFESP)
    The aim of this study was to assess the impact of the postmenopausal period on clinical and urodynamic parameters and on the mobility of the bladder neck in continent women and in women with stress urinary incontinence. Fifty-seven postmenopausal women were studied: 30 were continent and 27 had stress urinary incontinence. They were subdivided according to postmenopausal stage into groups A (<5 years) and B (>5 years). Five years was a good marker to separate those women with mild and severe estrogen deficiency. Fifteen premenopausal incontinent women were selected for bladder neck ultrasound as controls. All underwent history, general physical and gynecologic examinations, LH and FSH determinations, type 1 urine and uroculture, circadian voiding diary, cotton-swab test, bladder neck ultrasound and urodynamic investigations. Analysis of the voiding diaries revealed a higher frequency of daytime micturition in both groups of incontinent patients than in the continent ones. Increased bladder neck mobility was also found, both in the cotton-swab test and an ultrasound, in group A and an ultrasound in the premenopausal incontinent women. Urodynamic investigation showed decreased bladder capacity at the first micturition urge, as well as decreased urinary volume in the group A patients compared to the continent ones. Decreased urethral closure maximum pressure was also found in group B patients in relation to the continent ones. We concluded that the effect of hypoestrogenism, manifested postmenopause, causes changes in the lower urinary tract of women, particularly those who are incontinent.
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    Collagen concentration on the facial skin of postmenopausal women after topical treatment with estradiol and genistein: a randomized double-blind controlled trial
    (Taylor & Francis Ltd, 2017) Silva, Lidia Aragao; Ferraz Carbonel, Adriana Aparecida [UNIFESP]; Barbosa de Moraes, Andrea Regina [UNIFESP]; Simoes, Ricardo S.; da Silva Sasso, Gisela Rodrigues [UNIFESP]; Goes, Livia [UNIFESP]; Nunes, Winnie [UNIFESP]; Simoes, Manuel Jesus{UNIFESP]; Patriarca, Marisa Teresinha [UNIFESP]
    Objective: The objective of this study is to compare the effects of topical estrogen and genistein (a soy isoflavone) on the facial skin collagen of postmenopausal women not undergoing systemic hormonal therapy.Methods: This is a prospective, double blind, randomized, controlled clinical trial. Volunteer women (N=30) 45-55year old from the Endocrine Gynecology sector of the Gynecology Department of the Federal University of SAo Paulo (UNIFESP). The Ethical Committee of the Federal University of SAo Paulo approved the study (report no. 386/2004
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    Concentração de colágeno na pele facial de mulheres na pós-menopausa após tratamento com estradiol e genisteína tópicos: um estudo randomizado duplo cego
    (Universidade Federal de São Paulo (UNIFESP), 2016-07-29) Sampaio, Lidia Lima Aragao [UNIFESP]; Patriarca, Marisa Teresinha [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To compare the known effects of estrogen with genistein on the facial skin collagen of postmenopausal women without hormone therapy. Methods: This is a clinical, cross over trial with randomized and blinded convenience sample with estrogen and isoflavones, which 30 volunteer postmenopausal women were recruited to quantify facial collagen concentration before and after topical use of estrogen and isoflavones for 24 weeks. Results: The amount of both types I and III collagen increased at the end of both treatments, but estrogen was superior to the phytoestrogen, with statistical significance. Conclusion: Treatment with topical estrogen is superior to phytoestrogen, but both showed an increase in facial skin collagen, with statistical significance. What is not yet clear is whether prolonged topical use of such substances can cause systemic effects, thus, more research is needed to clarify this question.
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    Effects of estrogen and estrogen-progestogen therapy on homocysteine levels and their correlation with carotid vascular resistance
    (Informa Healthcare-taylor & Francis, 2007-11-01) Machado, Rogerio Bonassi [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Fernandes, Cesar Eduardo [UNIFESP]; Lakryc, Eli Marcelo [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]; Fac Med Jundiai; Universidade Federal de São Paulo (UNIFESP); ABC Med Sch
    Objective. To evaluate the correlation between homocysteine levels and carotid vascular resistance in menopausal women submitted to estrogen and estrogen-progestogen therapy.Methods. Eighty-six women with a mean age of 52 years were enrolled in a prospective, randomized, double-blind, 6-month study. Patients were allocated to use one of three oral therapies: placebo (n = 26), micronized estradiol 2 mg/day (n = 30) or micronized estradiol 2 mg/day plus norethisterone acetate 1 mg/day (n = 30). Evaluation of homocysteine levels and Doppler sonography of the common carotid artery, used to calculate pulsatility index (PI), were carried out prior to initiating therapy and at the end of the study. the correlation between these two parameters was evaluated using Pearson's coefficient of correlation.Results. There was a significant reduction in homocysteine levels in the groups treated with estrogen alone or estrogen combined with norethisterone. PI was significantly lower only in users of estrogen alone; however, no significant correlation was found between homocysteine measurements and PI.Conclusion. No significant correlation was found between homocysteine levels and carotid vascular resistance following hormone therapy.
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    Effects of isoflavone on oxidative stress parameters and homocysteine in postmenopausal women complaining of insomnia
    (Soc Biolgia Chile, 2009-01-01) Brandao, Leticia de Campos [UNIFESP]; Hachul, Helena [UNIFESP]; Bittencourt, Lia Rita Azeredo [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Tufik, Sergio [UNIFESP]; D'Almeida, Vania [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Sleep disorders have an increased incidence after menopause. The objective of this work was to evaluate the effects of isoflavone on some oxidative stress markers in postmenopausal women complaining of insomnia. Women aged between 50-65 years (n=38) were recruited and assigned to a double-blind placebo controlled study for 4 months. The treated group received 100 mg/day of isoflavones. Blood collections were conducted on three different occasions to assess total gluthathione; superoxide dismutase and catalase in erythrocytes; lipid peroxidation; and homocysteine plasma concentrations. No differences between the groups were observed. However, all the patients seem to improve their oxidative stress Status and homocysteine concentration after treatment. Superoxide dismutase activity was correlated with age and time of menopause at the beginning of the treatment, but these correlations were no longer observed by the end of the study. Soy isoflavones were not able to overcome the placebo effect for either oxidative stress parameters or homocysteine concentrations.
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    EFFECTS OF PHYSICAL TRAINING ON THE MYOCARDIUM OF FEMALE LDL KNOCKOUT OVARIECTOMIZED MICE
    (Soc Brasileira Med Esporte, 2017) Brianezi, Ledimar; Marques, Mara Rubia; Cardoso, Clever Gomes; de Jesus Miranda, Maria Luiza; Affonso Fonseca, Fernando Luiz [UNIFESP]; Mesiano Maifrino, Laura Beatriz
    Introduction: The emergence of coronary heart disease increases with menopause, physical inactivity and with dyslipidemia. It is known that physical training promotes the improvement of cardiovascular functions. Objective: The purpose of this study was to investigate the effects of aerobic physical training on the left ventricle in female LDL knockout ovariectomized mice. Methods: Thirty animals were divided into 6 groups (n=5), namely, sedentary non-ovariectomized control; sedentary ovariectomized control; trained ovariectomized control; sedentary non-ovariectomized; sedentary ovariectomized; and trained ovariectomized. We analyzed the mean nuclear volume parameters, the cross sectional area of the myocytes, the apparent density of the capillaries, interstitium, myocytes and collagen fibers. Results: The results show that for the density of the number of nuclei, the physical activity decreased to values close to the ovariectomized control group. Regarding the mean nuclear volume and the average area of myocytes, training and ovariectomy promoted the elevation of these values but hypercholesterolemia was lower. the volume density of myocytes, hypercholesterolemia showed an increase of these values as well as the training. There was no change in the volumetric density of the capillaries and the density of collagen fibers. The training caused the decrease in the density of the interstitial volume, and the hypercholesterolemia changed to a smaller one than the control group. Conclusion: We concluded that the moderate aerobic activity or the training time used in our study were not sufficient to generate significant alterations in the hypercholesterolemic group.
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    Estrogen therapy reduces nocturnal periodic limb movements
    (Elsevier B.V., 2007-11-20) Hachul, Helena; Baracat, Edmund Chada [UNIFESP]; Soares, Jose Maria [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Tufik, Sergio [UNIFESP]; Bittencourt, Lia Rita Azeredo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    It is believed that periodic lirnb movement (PLM) and more specifically, restless leg syndrome (RLS), are a common cause of insomnia. and one study in the literature examined PLM when associated to the use of estrogens. Polo-Kantola et al. [Polo-Kantola P, Rauhala E, Erkkola R, Irjala K, Polo O. Estrogen replacement therapy and nocturnal periodic limb movements: a randomized controlled trial. Obstet Gynecol 2001;97(4):548-54] observed that estrogen therapy improved subjective sleep quality regardless of periodic limb movements or related arousals. Herein is a case of a symptomatic postmenopausal patient with high PLM index who complained of insomnia and leg pain. Given that the patient had hot flashes and a high Kupperman Menopausal Index (which evaluates climacteric symptoms), we decided to administer transdermal ESTRADOT 25 mu g (Novartis, Brazil) twice-a-week. Our patient experienced a significant decrease in PLM as well as a great increase in REM and a slight increase in slow wave sleep (stages 3 and 4), as shown in the polysomnography. the patient reported an overall improvement in her condition. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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    Evaluation of skin tolerability in patients on a 7-day regimen of a new matrix transdermal estradiol delivery system: An open-label study
    (Excerpta Medica Inc, 1997-07-01) Baracat, Edmund Chada [UNIFESP]; Yamada, Sérgio [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; De Lima, Geraldo Rodrigues [UNIFESP]; Peloso, Ulisses; Benedictis, Eliana; Casoy, Julio; Universidade Federal de São Paulo (UNIFESP); WYETH AYERST RES; WYETH AYERST INT
    The incidence and severity of local skin reactions, as well as the impact on the local bacteriologic profile, in a 7-day regimen of a matrix transdermal estradiol delivery system compared with placebo (a piece of adhesive tape for sensitive skin of approximately the same shape and area) were assessed in healthy postmenopausal Brazilian women in an open-label study. the matrix estradiol and placebo patches were applied to different sites of the abdominal area, worn for 7 consecutive days, and then replaced according to an established rotation schedule, until 5 weeks of treatment were completed. the rotation schedule was adopted to provide an assessment of skin reaction as related to (1) interval between two consecutive placements at the same application site; (2) number of repetitions; and (3) abdominal region (upper, middle, and lower). A skin reaction score was obtained at each site before the application of each patch, 80 minutes after patch removal, and 7 days after patch removal. Skin swabs were obtained for bacteriologic cultures immediately before patch application and immediately after patch removal. Twenty-seven women were enrolled and completed the study; 270 skin observations were made with the estradiol patch and 162 with placebo. Skin reactions 30 minutes after patch removal included erythema (23.7%), erythema with induration (4.1%), and erythema with induration and vesicles (1.1%). Seven days after patch removal, skin reactions had decreased to erythema (2.2%) and erythema with induration (0.4%); no erythema with induration and vesicles was seen. This reduction in incidence and severity was statistically significant. Thirty minutes after placebo removal, 2.5% of skin observations detected erythema; no erythema was observed 7 days later. No other severe reactions were observed, and no clinically significant alteration in skin flora was detected. the results of this study indicate an acceptable level of local skin responses to this 7-day estradiol patch application. in addition, 96.3% of patients rated the estradiol patch as good or very good in its acceptability.
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    Evaluation of the isoflavones and estrogen effects on the rat adrenal
    (Taylor & Francis Ltd, 2017) Marinho, Darci Souza [UNIFESP]; Calio, Michele Longoni [UNIFESP]; Santos, Miriam Aparecida [UNIFESP]; Ko, Gui Mi [UNIFESP]; Teixeira, Cristiane Paula [UNIFESP]; Carbonel, Adriana Ferraz [UNIFESP]; Lisboa-Nascimento, Telma [UNIFESP]; Castro, Rodrigo Aquino [UNIFESP]; Simoes, Ricardo Santos; Antonio Bertoncini, Clelia Rejane [UNIFESP]
    The aim of this study was to evaluate the morphometry and the gene expression of Ki-67, VEGF and caspase 3 and the stress oxidative in the adrenal gland of ovariectomized rats treated with estrogen or isoflavones. We used 15 Wistar rats ovariectomized treated with isoflavones or estrogen during 30days. At the end of the treatment, the left adrenal gland was removed for subsequent histological studies and the right was used to evaluate gene expression of angiogenesis (VEGF-A), cell proliferation (Ki-67), apoptose (caspase 3 clivated) and oxidative stress. Treatment with estrogen showed a largest increase in the layers of the adrenal cortex than with isoflavones. These hypertrofic effects agree with higher expression elevation of Ki67 and VEGF, which did not occur with the caspase 3, indicating that isoflavones have great proliferative effect on the adrenal gland. Similar results were also observed on superoxide quantification show that isoflavone has a protective effect against oxidative stress. Our results indicate positively the trophic therapeutic potential of isoflavones has a protective effect and can contribute to the development of effective therapies to decrease the symptoms of menopause.
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    The Follicle-Stimulating Hormone as Best Classifier for Diagnosis of Natural Menopause
    (Mary Ann Liebert, Inc, 2017) Polesel, Daniel Ninello [UNIFESP]; Nozoe, Karen T. [UNIFESP]; Sanchez, Zila M. [UNIFESP]; Prado, Mariangela C. O. [UNIFESP]; Bittencourt, Lia R. [UNIFESP]; Tufik, Sergio [UNIFESP]; Andersen, Monica L. [UNIFESP]; Hachul, Helena [UNIFESP]
    Objective: The aim of this study was to examine the cut-off value of parameters related to menopause in women recruited through the Sao Paulo Epidemiologic Sleep Study. Materials and Methods: A household survey sample of 397 women was submitted to biochemical analysis after overnight fasting for determination of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol levels. Volunteers were randomly selected to represent the population of SAo Paulo according to gender, age, and socioeconomic status. The cut-off values were determined from the receiver operating characteristic curve and by determining the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the parameters. Results: FSH, LH, and age provided >90% accuracy for defining the menopause group. Classification of menopause according to FSH level provided the highest level of accuracy (97.0%) based on a cut-off value of 21 mIU/mL as a classifier. Conclusions: The cut-off value for FSH alone was able to distinguish with higher efficiency premenopause and postmenopause groups. FSH levels provided greater accuracy in the diagnosis of natural menopause, compared to the other parameters.
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    Hysteroscopic evaluation of the endometrium of post-menopausal patients with breast cancer before and after tamoxifen use
    (Elsevier B.V., 1999-09-01) Goncalves, MAG; Goncalves, Wagner Jose [UNIFESP]; Matias, M. M.; Nazario, ACP; Lima, G. R. de; Baracat, E. C.; Pontificia Univ Catolica Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP); Porto Alegre Gen Hosp
    Objective: To evaluate by hysteroscopy and histopathology the influence of tamoxifen in the endometrium df post-menopausal women with previous breast cancer. Method: Out of 46 patients studied, 20 of them had been using tamoxifen for an average length of 12 months, and are still being followed-up. Hysteroscopy with endometrial biopsy was performed before and after the use of the drug. Results: the prevalence of endometrial activity before and after this hormoniotherapy was the same, i.e. 10.0%, showing a non-significant variation. Conclusion: the hormoniotherapy with tamoxifen has not increased the endometrial proliferactive activity of postmenopausal patients with breast cancer. the most common hysteroscopical finding was numerous vesicles disseminated throughout the uterine cavity probably due to atrophy of the endometrium, (C) 1999 International Federation of Gynecology and Obstetrics.
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    Intrauterine exposure to diesel exhaust diminishes adult ovarian reserve
    (Elsevier B.V., 2013-05-01) Ogliari, Karolyn Sassi; Lichtenfels, Ana Julia de Faria Coimbra; Marchi, Mary Rosa Rodrigues de; Ferreira, Alice Teixeira [UNIFESP]; Dolhnikoff, Marisa; Saldiva, Paulo Hilario Nascimento; Universidade de São Paulo (USP); Univ Estate São Paulo; Universidade Federal de São Paulo (UNIFESP)
    Objective: To analyze ovarian and uterine morphologic changes resulting from intrauterine and postnatal exposure to diesel exhaust.Design: Crossover study. Experimental groups: intrauterine and postnatal clean air exposure; intrauterine exposure to diesel only; postnatal exposure to diesel only; and intrauterine and postnatal exposure to diesel.Setting: Laboratory of Experimental Air Pollution.Animal(s): Swiss mice.Intervention(s): Mice exposed to diesel exhaust with doses that correspond to the daily average PM2.5 levels (fine particles in the ambient air 2.5 mu m or less in size) reported by the World Health Organization.Main Outcome Measure(s): Morphometric analyses of the ovaries and uterus were performed to define the relative area occupied by follicles, corpus luteum, and stroma and the proportionate area of glands, epithelial layer, and stroma within the uterine endometrium. Result(s): A significant reduction in the proportion of primordial follicles was observed in intrauterine-exposed animals, those exposed during the postnatal period, and in animals exposed during both phases. Primary follicle proportion was reduced in animals exposed during pregnancy. No significant changes were detected in uterine morphology.Conclusion(s): Intrauterine exposure to acceptable levels of diesel exhaust compromises the reproductive potential of female mice, diminishing ovarian reserve when sexual maturity is achieved. This effect could increase the risk of premature menopause. the findings raise concern about current environmental guidelines for diesel exposure, warranting more careful examination of this issue in humans by regulatory authorities. ((c) 2013 by American Society for Reproductive Medicine.)
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    Polimorfismos do receptor de estrogênios e sua eventual associação com os níveis do hormônio: folículo-estimulante (Fsh), hormonio luteinizante (Lh) e indice menopausal de Kupperman em mulheres na pós-menopausa
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-27) Lima, Erika Knabben de [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The post menopause has gained prominence since women survive this phase a third to half of their lives, typically show symptoms of decreased estrogen production and increased production of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). These symptoms can be interpreted using the Kupperman Menopausal Index (IMK). Some authors suggest that the presence of polymorphisms (SNPs) in the estrogen receptor gene may provide a different profile to that female. The account of the activity of these receptors and their SNPs do not lead to a common census, for this reason, we conducted a molecular polymorphisms XbaI, PvuII, HaeIII and MspI in postmenopausal women, in order to observe the behavior of the levels of FSH and LH and polymorphic variation in these individuals. We use 3 mL of peripheral blood from 100 postmenopausal women with early results and annual blood tests (FSH, LH) and questionnaire IMK. The extraction was done with GFX Kit ® from Amersham-Pharmacia Biotech and conducted four separate PCR-RFLP for identification of each polymorphism. In our study the PvuII T SNP seems to be related to the increase of serum FSH polymorphism and Hae classes with higher values in the index Kuppermam women in the postmenopausal period. The remaining associations between the SNPs studied and the explanatory variables showed no significant result.
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    A randomized, open-label study of conjugated equine estrogens plus medroxyprogesterone acetate versus tibolone: effects on symptom control, bleeding pattern, lipid profile and tolerability
    (Parthenon Publishing Group, 2002-03-01) Baracat, E. C.; Barbosa, I. C.; Giordano, M. G.; Haidar, Mauro Abi [UNIFESP]; Marinho, R. M.; Menegocci, J. C.; Morais, K. M.; Tomaz, G.; Wehba, S.; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia (UFBA); Universidade Federal do Rio de Janeiro (UFRJ); Fac Med Sci Minas Gerais; Pontifical Catholic Univ; Univ Fed Rio Grande Norte; Univ Fed Paraiba; Santa Casa Misericordia
    Objective To compare the effects of continuous combined conjugated equine estrogens plus medroxyprogesterone acetate (CEE/MPA) with those of tibolone on symptom control, bleeding pattern, lipid profile and tolerability in postmenopausal women.Methods This was a randomized, open-label, parallel-group, multicenter study. Generally healthy postmenopausal women with an intact uterus and no contraindications to hormone replacement therapy (HRT) or tibolone were enrolled. Each subject was randomly assigned to receive CEE/MPA 0.625 mg-5.0 mg or tibolone 2.5 mg daily for 13 treatment cycles, each of 28 days.Results A total of 85 subjects were enrolled and received at least one dose of study medication, of which 76 (89.4%) subjects completed the study (n = 40, CEE/MPA; n = 363 tibolone). the incidence of postmenopausal symptoms decreased significantly over time in both treatment groups, compared with baseline, including significant decreases in the incidence of urogenital and sexual health symptoms. Significant differences in symptom control (other than hot flushes) were observed between treatment groups in a few different cycles for different symptoms, but no consistent or clinically significant trends were observed. No statistically significant differences in the incidence of bleeding were observed between treatment groups after cycle 4. Significant decreases in total cholesterol (5.6%) and low-density lipoprotein (LDL) cholesterol (7.5%) were observed at cycle 13, compared with baseline, in the CEE/MPA group, and significant decreases in high-density lipoprotein (HDL) cholesterol (8.5%) and triglycerides (13.7%) were observed at cycle 13, compared with baseline, in the tibolone group. Significant weight gain was observed at cycle 13 in the. tibolone group (3.05 kg), compared with the CEE/MPA group (0.96 kg). the incidences of adverse events were similar in both treatment groups.Conclusions Women treated with CEE/MPA or tibolone showed significant improvement of postmenopausal symptoms, including urogenital and sexual health symptoms, and had similar bleeding patterns after four cycles of therapy. CEE/MPA and tibolone each induced a different mix of changes in the lipid profile.
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    Role of exercise training in cardiovascular autonomic dysfunction and mortality in diabetic ovariectomized rats
    (Lippincott Williams & Wilkins, 2007-10-01) Souza, Silvia Beatriz Paulino Cavasin de [UNIFESP]; Flues, Karin; Paulini, Janaina; Mostarda, Cristiano [UNIFESP]; Rodrigues, Bruno; Souza, Leandro E.; Irigoyen, Maria Claudia [UNIFESP]; De Angelis, Katia; Univ Sao Judas Tadeu; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Diabetes and menopause markedly increase the risk of cardiovascular disease in women. the objective of the present study was to investigate the effects of exercise training on cardiovascular autonomic dysfunction and on total mortality in diabetic female rats undergoing ovarian hormone deprivation. Female Wistar rats were divided into ovariectomized groups: sedentary and trained controls and sedentary and trained diabetic rats (streptozotocin, 50 mg/kg IV). Trained groups were submitted to an exercise training protocol on a treadmill (8 weeks). the baroreflex sensitivity was evaluated by heart rate responses to arterial pressure changes. Heart rate variability was determined using the SD of the basal heart rate. Vagal and sympathetic tonus were evaluated by pharmacological blockade. Diabetes impaired baroreflex sensitivity (approximate to 55%), vagal tonus (approximate to 68%), and heart rate variability (approximate to 38%). Exercise training improved baroreflex sensitivity and heart rate variability in control and diabetic groups in relation to their sedentary groups. Trained control rats presented increased vagal tonus compared with that of sedentary ones. the sympathetic tonus was reduced in the trained diabetic group as compared with that of other studied groups. Significant correlations were obtained between heart rate variability and vagal tonus with baroreflex sensitivity. Mortality, assessed during the training period, was reduced in trained diabetic (25%) rats compared with mortality in sedentary diabetic rats (60%). Together, these findings suggest that decreases in baroreflex sensitivity and heart rate variability may be related to increased mortality in female diabetic subjects and that improved autonomic regulation induced by exercise training may contribute to decreased mortality in this population.
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    Selective estrogen receptor modulators in chronic renal failure
    (Nature Publishing Group, 2003-06-01) Weisinger, Jose R; Heilberg, Ita Pfeferman [UNIFESP]; Hernandez, Eddy; Carlini, Raul; Bellorin-Font, Ezequiel; Univ Munich; Universidade Federal de São Paulo (UNIFESP); San Carlo Borromeo Hosp
    Background. In addition to renal osteodystrophy, postmenopausal women on dialysis could be at risk of osteoporosis. Hormone replacement therapy (HRT) could have beneficial effects as well as potentially serious risks, especially in uremic women, due to the pharmacokinetics of estradiol in renal failure. Therapeutic alternatives, such as the selective estrogen receptor modulators (SERMs), have shown the benefits of estrogen on bone and serum lipid levels, without its adverse effects on the breast and endometrium, in nonuremic women.Methods. Recent data on the effect of the SERM raloxifene in bone and lipid metabolism in osteoporotic postmenopausal women on dialysis is reviewed. Since the estrogen receptor (ER) gene has been suggested as a candidate marker for osteoporosis, we investigated whether ER polymorphism could have predicted the BMD response to raloxifene.Results. Hemodialyzed women on raloxifene demonstrated increased trabecular bone mineral density (BMD) and decreased bone resorption markers. Similarly, LDL-cholesterol values dropped significantly. ER gene polymorphism analysis of baseline BMD parameters did not differ between PP/xx or Pp/Xx groups. Nevertheless, patients on raloxifene with PP/xx genotypes, but not those with Pp/Xx, showed a higher trabecular BMD after one year on treatment, suggesting that homozygous women for P or x alleles of the ER have a better BMD response to raloxifene.Conclusion. Raloxifene and, most likely, other SERMs, could represent a good alternative to HRT in postmenopausal uremic women.
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    Sleep in Postmenopausal Women
    (Sage Publications Inc, 2012-04-01) Garcia Vigeta, Sonia Maria [UNIFESP]; Hachul, Helena [UNIFESP]; Tufik, Sergio [UNIFESP]; Oliveira, Eleonora Menicucci de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The aim of this study was to identify factors that most influence the perception of sleep quality in postmenopausal women. We used the methodological strategy of the Collective Subject Discourse (CSD), which is based on a theoretical framework of social representations theory. We obtained the data by interviewing 22 postmenopausal Brazilian women who were experiencing insomnia. the women gave accounts of their difficulties with sleep; a variety of dimensions were identified within the data. the onset of sleep disorders might have occurred during childhood or in situations considered to be stressful, and were not necessarily associated with menopause. We found that hormonal alterations occurring during menopause, psychosocial factors, and sleep-breathing disorders triggered occasional sleep disturbances during this time of life. Participants were aware of the consequences of sleep deprivation. in addition, inadequate sleep hygiene habits figured prominently as determinants in the persistence of sleep disturbances.
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    Transvaginal ultrasonography and the progestogen challenge test in postmenopausal endometrial evaluation
    (Elsevier B.V., 1997-09-01) Bortoletto, CCR; Baracat, E. C.; Goncalves, Wagner Jose [UNIFESP]; Lima, G. R.; Stavale, J. N.; Universidade Federal de São Paulo (UNIFESP)
    Objective: To analyze the morphologic and ultrasonographic aspects of the endometrium of postmenopausal women according to the progestogen challenge test. Methods: the study was conducted on 150 postmenopausal women. Each patient was submitted to transvaginal ultrasonography for measurement of endometrial echo thickness and to endometrial biopsies, followed by the progestogen challenge test. Results: Women with a negative test presented atrophic endometrium in 94% of cases. the other 6% have shown active endometrium, but none had hyperplasia. However, 56% of the patients with a positive test had atrophic endometrium. There was a correlation between endometrial thickness less than 5 mm and endometrial atrophy in patients with either positive or negative tests. Conclusion: Because the progestogen challenge test is cheap and easy to deal with, it can be done as a primary screening method in asymptomatic postmenopausal women. If the test is positive, ultrasonography is required in order to determine who needs a more accurate examination of the endometrium. If the test is negative, ultrasonography is not required due to the great number of women who have atrophic endometrium. (C) 1997 International Federation of Gynecology and Obstetrics.
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    Ultrasonographic and morphological studies of the postmenopausal endometrium using unopposed estrogen replacement therapy with regular pause: a prospective preliminary study
    (Elsevier B.V., 2001-09-01) Patriarca, M. T.; Lima, G. R. de; Stavale, J. N.; Goncalves, Wagner Jose [UNIFESP]; Freitas, V; Soares, J. M.; Simoes, M. J.; Baracat, E. C.; Universidade Federal de São Paulo (UNIFESP)
    Hormone replacement therapy with progestogen is known to have severe side effects or complications in certain patients. Objective: the goal of this study is to evaluate the safety and efficacy of an alternative treatment regimen with a mensal pause using both transvaginal sonography (TVS) and endometrial biopsy to follow patients. Methods: A total of 30 postmenopausal women were treated with unopposed estrogen for 21 days each month followed by a regular pause of 9-10 days, and were studied prospectively for 18 months. the TVS measurements of endometrial thickness and biopsy of the endometrium were done on the 21 st day of treatment and the 7th day of the pause at 6-month intervals throughout the study. Results: There was a significant decrease of proliferative activity at all three time points during the study (6, 12 and 18 months) when tested on the 7th pause day (PD7). the percentage of patients with hyperplasia without nuclear atypia and endometrial thickness greater than or equal to8 mm was 32% at 6 months, but decreased to 22 and 19% at 12 and IS months, respectively. All cases of hyperplasia regressed after the hormonal pause throughout the treatment period. Conclusions: This study presents an alternative treatment regimen for select patients having side effects or complications from progestogen administration; however, studies evaluating the safety and efficacy of this regimen over longer time periods are necessary. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.