Estrogen and Progesterone Therapy and Meningiomas

Abstract Meningiomas are common intracranial tumors with female predominance. Their etiology is still poorly documented. The role of sexual hormones has long been evoked, and data have been conflicting across studies. However, a dose-dependent relationship between the incidence and growth of meningiomas and hormonal treatment with the progestin cyproterone acetate (CPA) has recently been established. CPA- associated meningiomas seem to be mainly located in the anterior and middle skull base, are more likely to be multiple; may harbor P1K3CA mutations in up to 1/3 of cases and are favored by a longer duration of treatment. A similar but lower risk of meningiomas has been recently reported with the use of chlormadinone acetate and nomegestrol acetate as progestin treatments. Concerning hormonal replacement therapy (HRT) in menopausal patients, evidence from epidemiological studies seem to favor an increased risk of meningiomas in treated patients although a recent study failed to show an increased growth of meningiomas in HRT treated vs. non treated patients. Until larger studies are available, it seems wise to recommend avoiding HRT in patients with meningiomas. Evidence from published data does not seem to support an increased risk of meningiomas with oral contraceptive (OC) use. Data are too scarce to conclude on fertility treatments. Based on studies demonstrating the expression of hormonal receptors in meningiomas, therapies targeting these receptors have been tried but have failed to show an overall favorable clinical outcome in meningioma treatment.

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Introduction to odontoid fractures: controversies in the management of odontoid fractures

Neurosurgical FOCUS ◽

10.3171/foc.2000.8.6.1 ◽

2000 ◽

Vol 8 (6) ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Gregory J. Przybylski

Keyword(s):

Treatment Options ◽

Surgical Techniques ◽

Patient Characteristics ◽

Epidemiological Studies ◽

Scientific Data ◽

Published Data ◽

Odontoid Fractures ◽

Technological Advances ◽

Increased Risk ◽

Cord Injury

Although odontoid fractures were first classified more than 25 years ago,5 the management of these fractures remains controversial. Whereas the nonoperative management with external immobilization devices often leads to successful healing, certain fracture features and patient characteristics have been associated with an increased risk of bone nonunion.6,17 Recent technological advances in cervical spine instrumentation techniques have provided additional options for the management of these common fractures.1,12,13,24,27,28 However, an absence of rigorous studies in which the investigators compare management methods may contribute to the varying methods used by spine surgeons when approaching similar injuries. In this issue of Neurosurgical Focus, various aspects of the management of odontoid fractures are examined. In an evidence-based analysis of methods for treating odontoid fractures the authors examine the best available published data to determine the level of scientific data supporting the use of various treatment options.3 In epidemiological studies the investigators examine factors contributing to the unusual incidence of spinal cord injury with odontoid fractures as well as the unique considerations that may be attendant on the management of posteriorly displaced fractures. In two other studies the authors discuss the application of specific surgical techniques in treating odontoid fractures, whereas in an additional two reports the authors evaluate the difficulties in managing elderly patients with these injuries. Finally, the use of newer osteoinductive agents is examined as a potential adjunct in the surgical management of bony defects in the dens.

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Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽

10.1027/0227-5910.30.3.115 ◽

2009 ◽

Vol 30 (3) ◽

pp. 115-119 ◽

Cited By ~ 10

Author(s):

Stephanie De Munck ◽

Gwendolyn Portzky ◽

Kees Van Heeringen

Keyword(s):

Young Adults ◽

Attempted Suicide ◽

Suicide Attempts ◽

Epidemiological Studies ◽

Adolescents And Young Adults ◽

University Hospital ◽

International Studies ◽

Suicide Attempters ◽

Increased Risk ◽

Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

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Transiently increased risk of breast cancer after childbirth: implications for fertility treatments and surrogacy

Human Reproduction ◽

10.1093/humrep/deaa102 ◽

2020 ◽

Vol 35 (6) ◽

pp. 1253-1255

Author(s):

Zeev Blumenfeld ◽

Norbert Gleicher ◽

Eli Y Adashi

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Meta Analysis ◽

Small Degree ◽

Short Term ◽

Benefit Ratio ◽

Professional Societies ◽

Fertility Treatments ◽

Increased Risk

Abstract Whereas longstanding dogma has purported that pregnancies protect women from breast cancer, a recent meta-analysis now mandates reconsideration since it reported an actual higher breast cancer risk for more than two decades after childbirth before the relative risk turns negative. Moreover, the risk of breast cancer appears higher for women having their first birth at an older age and with a family history and it is not reduced by breastfeeding. The process of obtaining informed consent for all fertility treatments, therefore, must make patients aware of the facts that every pregnancy, to a small degree, will increase the short-term breast cancer risk. This observation may be even more relevant in cases of surrogacy where women agree to conceive without deriving benefits of offspring from assuming the risk, thus creating a substantially different risk-benefit ratio. Consequently, it appears prudent for professional societies in the field to update recommendations regarding consent information for all fertility treatments but especially for treatments involving surrogacy.

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Upgrade rates and outcomes of screen-detected atypical intraductal epithelial proliferation (AIDEP) diagnosed on core needle biopsy

Breast Disease ◽

10.3233/bd-201031 ◽

2021 ◽

pp. 1-6

Author(s):

Emma C. Dunne ◽

Edel M. Quinn ◽

Maurice Stokes ◽

John M. Barry ◽

Malcolm Kell ◽

...

Keyword(s):

Breast Cancer ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Demographic Data ◽

Screening Mammography ◽

Published Data ◽

Epithelial Proliferation ◽

Core Needle ◽

In Situ Carcinoma ◽

Increased Risk

INTRODUCTION: Atypical intraductal epithelial proliferation (AIDEP) is a breast lesion categorised as “indeterminate” if identified on core needle biopsy (CNB). The rate at which these lesions are upgraded following diagnostic excision varies in the literature. Women diagnosed with AIDEP are thought to be at increased risk of breast cancer. Our aim was to identify the rate of upgrade to invasive or in situ carcinoma in a group of patients diagnosed with AIDEP on screening mammography and to quantify their risk of subsequent breast cancer. METHODS: We conducted a retrospective review of a prospectively maintained database containing all patients diagnosed with AIDEP on CNB between 2005 and 2012 in an Irish breast screening centre. Basic demographic data was collected along with details of the original CNB result, rate of upgrade to carcinoma and details of any subsequent cancer diagnoses. RESULTS: In total 113 patients were diagnosed with AIDEP on CNB during the study period. The upgrade rate on diagnostic excision was 28.3% (n = 32). 6.2% (n = 7) were upgraded to invasive cancer and 22.1% (n = 25) to DCIS. 81 patients were not upgraded on diagnostic excision and were offered 5 years of annual mammographic surveillance. 9.88% (8/81) of these patients went on to receive a subsequent diagnosis of malignancy. The mean time to diagnosis of these subsequent cancers was 65.41 months (range 20.18–145.21). CONCLUSION: Our data showing an upgrade rate of 28% to carcinoma reflects recently published data and we believe it supports the continued practice of excising AIDEP to exclude co-existing carcinoma.

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Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

Brain Plasticity ◽

10.3233/bpl-200111 ◽

2020 ◽

pp. 1-15

Author(s):

Daniel Joseph Lamport ◽

Claire Michelle Williams

Keyword(s):

Systematic Reviews ◽

Evidence Base ◽

Epidemiological Studies ◽

Cognitive Outcome ◽

Current Evidence ◽

Duration Of Treatment ◽

Current Evidence Base ◽

Cognitive Benefits ◽

Meta Analyses ◽

The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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Comparative Proteomic Analysis of Carbonylated Proteins from the Striatum and Cortex of Pesticide-Treated Mice

Parkinson s Disease ◽

10.1155/2015/812532 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Christina Coughlan ◽

Douglas I. Walker ◽

Kelly M. Lohr ◽

Jason R. Richardson ◽

Laura M. Saba ◽

...

Keyword(s):

Oxidative Stress ◽

Pesticide Exposure ◽

Epidemiological Studies ◽

Cytoskeletal Proteins ◽

Synaptic Function ◽

Behavioral Alterations ◽

Mechanisms Of Toxicity ◽

Kegg Pathways ◽

Increased Risk ◽

Proteomic Analyses

Epidemiological studies indicate exposures to the herbicide paraquat (PQ) and fungicide maneb (MB) are associated with increased risk of Parkinson’s disease (PD). Oxidative stress appears to be a premier mechanism that underlies damage to the nigrostriatal dopamine system in PD and pesticide exposure. Enhanced oxidative stress leads to lipid peroxidation and production of reactive aldehydes; therefore, we conducted proteomic analyses to identify carbonylated proteins in the striatum and cortex of pesticide-treated mice in order to elucidate possible mechanisms of toxicity. Male C57BL/6J mice were treated biweekly for 6 weeks with saline, PQ (10 mg/kg), MB (30 mg/kg), or the combination of PQ and MB (PQMB). Treatments resulted in significant behavioral alterations in all treated mice and depleted striatal dopamine in PQMB mice. Distinct differences in 4-hydroxynonenal-modified proteins were observed in the striatum and cortex. Proteomic analyses identified carbonylated proteins and peptides from the cortex and striatum, and pathway analyses revealed significant enrichment in a variety of KEGG pathways. Further analysis showed enrichment in proteins of the actin cytoskeleton in treated samples, but not in saline controls. These data indicate that treatment-related effects on cytoskeletal proteins could alter proper synaptic function, thereby resulting in impaired neuronal function and even neurodegeneration.

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A narrative review of chronic alcohol-induced atrial fibrillation

Future Cardiology ◽

10.2217/fca-2021-0007 ◽

2021 ◽

Author(s):

Rea Mittal ◽

Lilly Su ◽

Devyani Ramgobin ◽

Ashwani Garg ◽

Rahul Jain ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Use ◽

Alcohol Intake ◽

Cardiovascular Complications ◽

Chronic Alcohol ◽

Higher Alcohol ◽

Dependent Relationship ◽

Increased Risk ◽

Low Levels ◽

Dose Dependent

Alcohol use disorder (AUD) is highly prevalent and can lead to many cardiovascular complications, including arrhythmias. Chronic alcohol use has a dose-dependent relationship with incidence of atrial fibrillation (AF), where higher alcohol intake (>3 drinks a day) is associated with higher risk of AF. Meanwhile, low levels of chronic alcohol intake (<1 drink a day) is not associated with increased risk of AF. Mechanistically, chronic alcohol intake alters the structural, functional and electrical integrity of the atria, predisposing to AF. Increased screening can help identify AUD patients early on and provide the opportunity to educate on chronic alcohol use related risks, such as AF. The ideal treatment to reduce risk of incident or recurrent AF in AUD populations is abstinence.

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Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

Psychological Medicine ◽

10.1017/s003329171800332x ◽

2018 ◽

Vol 49 (14) ◽

pp. 2397-2404 ◽

Cited By ~ 7

Author(s):

Mu-Hong Chen ◽

Ju-Wei Hsu ◽

Kei-Lin Huang ◽

Tung-Ping Su ◽

Cheng-Ta Li ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Population Based ◽

Autism Spectrum ◽

The Public ◽

First Degree Relatives ◽

Relative Risks ◽

Dependent Relationship ◽

Increased Risk ◽

Bipolar Patients

AbstractBackgroundBipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.MethodsAmong the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.ResultsFDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.ConclusionsOur study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

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Depressive symptoms in a treated multiple sclerosis cohort

Multiple Sclerosis Journal ◽

10.1191/1352458503ms960oa ◽

2003 ◽

Vol 9 (6) ◽

pp. 616-620 ◽

Cited By ~ 46

Author(s):

Scott B Patten ◽

Shanika Fridhandler ◽

Cynthia A Beck ◽

Luanne M Metz

Keyword(s):

Multiple Sclerosis ◽

Depressive Symptoms ◽

Interferon Beta ◽

Rating Scale ◽

Epidemiological Studies ◽

Treatment Groups ◽

Increased Risk ◽

The University ◽

Depression Ratings

Background: Recent side effect data from clinical trials of interferon beta in multiple sclerosis (MS) have failed to confirm that these medications are associated with an increased risk of depression. However, these studies have used highly selected samples and the results may not be generalizable to real world settings. Methods: C linical data on subjects from southern A lberta who have applied for, or are receiving, public reimbursement for MS treatment are maintained in a database at the University of C algary Multiple Sclerosis C linic. Depression ratings obtained using the C enter for Epidemiological Studies Depression Rating Scale (C ES-D) are included in this database. In the current analysis, these longitudinal data were used to determine whether depressive symptoms were associated with disease-modifying treatments. Results: A t baseline, ratings were available for 163 subjects. Those choosing interferon beta resembled those choosing glatiramer acetate in most respects. During follow-up, no differences were observed in the prevalence or incidence of depression and C ES-D scores were not found to differ between the treatment groups. Conclusions: The failure to identify higher rates of depression both in previous intervention studies and in the current observational study provides confirmation that these drugs are not substantially associated with the occurrence of depression.

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The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-020062 ◽

2018 ◽

Vol 8 (11) ◽

pp. e020062 ◽

Cited By ~ 10

Author(s):

Xiaosu Bai ◽

Zhiming Liu ◽

Zhisen Li ◽

Dewen Yan

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Therapy ◽

Depressive Disorders ◽

Meta Analysis ◽

Epidemiological Studies ◽

Cochrane Library ◽

Increased Risk

ObjectivesSeveral patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.DesignA meta-analysis.MethodsWe conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.ResultsTwenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.ConclusionsOur meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

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