Genitourinary syndrome of menopause: a modern approach to treatment

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 16-20
Author(s):  
Madina I. Mazitova ◽  
Rezeda R. Mardieva
Keyword(s):  
Life Expectancy ◽  
Menopausal Syndrome ◽  
Modern Approach ◽  
Age Related ◽  
Appropriate Treatment ◽  
Past Half Century ◽  
Quality Life ◽  
Common Marker ◽  
Active Interest ◽  
Genitourinary Syndrome

Life expectancy over the past half century has increased significantly and by 2025 approximately one in six people on Earth will be over 60 years old, thus, age-related diseases become even more relevant, this also applies to menopausal syndrome in postmenopausal women. The average age of menopause is 5052 years. In the world 25 million women annually experience menopause and only 10% of them have no pathological manifestations. Genitourinar menopausal syndrome is the second most common marker of menopause. Urogenital disorders are a fairly common nosology, which is confirmed by numerous studies, but not every woman considers it necessary to report a problem to a doctor, considering this a natural course of aging. The increase in life expectancy and rejuvenation of the population is undoubtedly associated with socio-social development and the achievement of medicine, the purpose of which is also to increase the extension of the term of a healthy and quality life. Studies conducted in recent decades to study atrophic hypoestrogenic changes in the urogenital tract will allow us to reconsider our attitude to genitourinar menopausal syndrome and to select appropriate treatment for various groups of patients. But the inability of women, at times, to declare their symptoms associated with vulvovaginal atrophy, and the lack of active interest in this issue by doctors, especially gynecologists, leaves this problem unresolved.

Endokrinológiai tényezők és metabolikus folyamatok szerepe az élettartam szabályozásában

2021 ◽  
Vol 162 (33) ◽  
pp. 1318-1327
Author(s):  
Tamás Halmos ◽  
Ilona Suba
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Life Expectancy ◽  
Significant Risk ◽  
Low Grade ◽  
Aging Effects ◽  
Protective Function ◽  
Beneficial Effects ◽  
Age Related

Összefoglaló. Az emberek a lehető leghosszabb ideig akarnak élni, jó egészségben. Ha kiküszöbölnénk a kedvezőtlen külső körülményeket, a várható élettartam meghaladhatná a 100 évet. A 20. és 21. században a jóléti társadalmakban a várható élettartam jelentősen megnőtt, így Magyarországon is. Az áttekintett irodalom alapján megvizsgáltuk, hogy a genetika és az öröklődés mellett milyen endokrinológiai és metabolikus tényezők játszanak szerepet az élet meghosszabbításában. Megvizsgáltunk minden endogén tényezőt, amely pozitívan vagy negatívan befolyásolhatja az életkorral összefüggő betegségeket (Alzheimer-kór, szív- és érrendszeri betegségek, rák) és az élettartamot. Kiemeltük a hyperinsulinaemia, az inzulinrezisztencia, a metabolikus szindróma öregedést gyorsító hatását, az inzulinszerű növekedési hormon-1 ellentmondásos szerepét, valamint az élet meghosszabbításában részt vevő, újabban felfedezett peptideket, mint a klotho és a humanin. Ismertettük a mitochondriumok szerepét az élettartam meghatározásában, bemutattuk a mitohormesis folyamatát és annak stresszvédő funkcióját. Bemutattuk a rapamicin célszervét, az mTOR-t, amelynek gátlása meghosszabbítja az élettartamot, valamint a szirtuinokat. Kitértünk az autophagia folyamatára, és ismertettük a szenolitikumok szerepét az öregedésben. Az időskori autoimmunitás csökkenése hozzájárul az élettartam rövidüléséhez, utaltunk a thymus koordináló szerepére. Kiemeltük a bélmikrobiom fontos szerepét az élettartam szabályozásában. Hivatkoztunk a „centenáriusok” megfigyeléséből nyert humánadatokra. Megvizsgáltuk, milyen beavatkozási lehetőségek állnak rendelkezésre az egészségben tölthető élettartam meghosszabbításához. Az életmódbeli lehetőségek közül kiemeltük a kalóriabevitel-csökkentés és a testmozgás jótékony szerepét. Megvizsgáltuk egyes gyógyszerek feltételezett hatásait. Ezek közé tartozik a metformin, az akarbóz, a rezveratrol. E gyógyszerek mindegyikének hatása hasonló a kalóriamegszorításéhoz. Nincs olyan „csodaszer”, amely igazoltan meghosszabbítja az élettartamot emberben. Egyes géneknek és génmutációknak jótékony hatásuk van, de ezt környezeti tényezők, betegségek, balesetek és más külső ártalmak módosíthatják. Kiemeljük az elhízás, az alacsony fokozatú gyulladás és az inzulinrezisztencia öregedésre gyakorolt gyorsító hatását. A metabolikus szindróma elterjedtsége miatt ez jelentős népegészségügyi kockázatot jelent. Az inzulin, a növekedési hormon és az inzulinszerű növekedési faktorok hatásainak értékelése továbbra is ellentmondásos. Az egészséges, szellemileg és fizikailag aktív életmód, a kalóriacsökkentés mindenképpen előnyös. Az életet meghosszabbító szerek értékelése még vitatott. Orv Hetil. 2021; 162(33): 1318–1327. Summary. People want to live as long as possible in good health. If we eliminate the unfavorable external conditions, the life expectancy could exceed 100 years. In the 20th and 21th centuries, life expectancy in welfare societies increased significantly, including in Hungary. Based on the reviewed literature, we examined what endocrinological and metabolic factors play a role in prolonging life in addition to genetics and inheritance. We examined all endogenous factors that can positively or negatively affect age-related diseases (Alzheimer’s disease, cardiovascular disease, cancer) and longevity. We highlighted the aging effects of hyperinsulinemia, insulin resistance, metabolic syndrome, the controversial role of insulin-like growth factor-1, and more recently discovered peptides involved in prolonging lifespan, such as klotho and humanin. We described the role of mitochondria in determining longevity, we demonstrated the process of mitohormesis and its stress-protective function. We presented the target organ of rapamycin, mTOR, the inhibition of which prolongs lifespan, as well as sirtuins. We covered the process of autophagy and described the role of senolytics in aging. The decrease in autoimmunity in old age contributes to the shortening of life expectancy, we referred to the coordinating role of the thymus. We highlighted the important role of intestinal microbiome in the regulation of longevity. We referred to human data obtained from observations on “centenarians”. We examined what intervention options are available to prolong healthy life expectancy. Among the lifestyle options, we highlighted the beneficial role of calorie reduction and exercise. We examined the putative beneficial effects of some drugs. These include metformin, acarbose, resveratrol. The effect of each of these drugs is similar to calorie restriction. There is no “miracle cure” that has been shown to prolong life-span in humans. Some genes and gene mutations have beneficial effects, but this can be modified by environmental factors, diseases, accidents, and other external harms. We highlight the accelerating effects of obesity, low-grade inflammation, and insulin resistance on aging. Due to the prevalence of metabolic syndrome, this poses a significant risk to public health. The assessment of the effects of insulin, growth hormone, and insulin-like growth factors remains controversial. A healthy, mentally and physically active lifestyle, calorie reduction is definitely beneficial. The evaluation of life-prolonging agents is still controversial. Orv Hetil. 2021; 162(33): 1318–1327.

Modern approach to the treatment of arterial hypertension

2021 ◽  
pp. 28-34
Author(s):  
Dmitriy Sergeevich Kovalev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Pathological Condition ◽  
Cardiovascular Complications ◽  
European Population ◽  
Modern Approach ◽  
Appropriate Treatment ◽  
Literary Sources ◽  
The Impact

Arterial hypertension (AH) refers to an increase in blood pressure above the level of 140/90 mm Hg; the risk of cardiovascular complications increases significantly with this pathological condition. Thus, arterial hypertension is an independent risk factor for the development of prediabetes / type 2 diabetes mellitus, heart failure, coronary heart disease, chronic kidney damage, and multifocal atherosclerosis. The frequency of arterial hypertension occurrence varies in different countries: in particular, it is from 23 to 36% for the European population, according to various literary sources. The main goal of treatment is to minimize the overall risk of developing cardiovascular complications. This involves the impact on all identified reversible risk factors, such as smoking and high cholesterol levels, and most importantly, appropriate treatment of concomitant diseases (diabetes mellitus, thyroid gland pathology, kidney disease, etc.), as well as the correction of high blood pressure.

scholarly journals Mortality in Russia: the second epidemiological revolution that never was

2015 ◽  
pp. 4-33 ◽  
Author(s):  
Anatoly Vishnevsky
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
Age Distribution ◽  
Circulatory System ◽  
Developed Countries ◽  
Significant Rise ◽  
Past Half Century ◽  
External Causes Of Death ◽  
External Causes ◽  
Age Of Death

The article looks at different approaches to the conceptualization of the modern stage of mortality reduction (the "new stages” of the epidemiological transition, "the second epidemiological revolution”, the “health transition”). During this stage, which has lasted for at least half a century, revolutionary changes have taken place in most developed countries. These changes manifest themselves in the drastic expansion of the degree of control over non-infectious causes of death—particularly over diseases of the circulatory system, neoplasms, and other non-communicable diseases, as well as over external causes of death. As a consequence of these changes, there has been a rapid shift of deaths from the abovementioned causes to older ages, an increase in the mean age of death from these causes, and, ultimately, a significant rise in life expectancy. Russia, unfortunately, is watching this revolution from the outside, without taking any part in it. The age distribution of deaths from major classes of causes of death in Russia has not changed over the past half-century, life expectancy has stagnated, and Russia has increasingly lagged behind the majority of developed countries with respect to this indicator. Thus, the “second epidemiological revolution” has not yet to occur in Russia.

Common age-related eye diseases and visual impairment

2017 ◽  
pp. 1165-1170
Author(s):  
Jacqueline Chua ◽  
Ching-Yu Cheng ◽  
Tien Yin Wong
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Macular Degeneration ◽  
Refractive Error ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Eye Disorders ◽  
Appropriate Treatment ◽  
Uncorrected Refractive Error

General physicians have an essential role in preventing vision loss in older people. However, most vision-threatening eye disorders are initially asymptomatic and often go underdiagnosed. Therefore screening, early detection, and timely intervention are important in their management. The most common cause of visual impairment is uncorrected or undercorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. Spectacles and cataract surgery can successfully restore sight for uncorrected refractive error and cataract, respectively. Visual impairment as a result of age-related macular degeneration, glaucoma, and diabetic retinopathy can be prevented with appropriate treatment if they are identified early enough. This chapter provides an overview of common age-related eye disease and visual impairment.

scholarly journals Kidney Disease in HIV Infection

2019 ◽  
Vol 8 (8) ◽  
pp. 1254 ◽  
Author(s):  
Gaetano Alfano ◽  
Gianni Cappelli ◽  
Francesco Fontana ◽  
Luca Di Lullo ◽  
Biagio Di Iorio ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Life Expectancy ◽  
Early Recognition ◽  
Renal Involvement ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Age Related ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living With Hiv

Antiretroviral therapy (ART) has significantly improved life expectancy of infected subjects, generating a new epidemiological setting of people aging withHuman Immunodeficiency Virus (HIV). People living with HIV (PLWH), having longer life expectancy, now face several age-related conditions as well as side effects of long-term exposure of ART. Chronic kidney disease (CKD) is a common comorbidity in this population. CKD is a relentlessly progressive disease that may evolve toward end-stage renal disease (ESRD) and significantly affect quality of life and risk of death. Herein, we review current understanding of renal involvement in PLWH, mechanisms and risk factors for CKD as well as strategies for early recognition of renal dysfunction and best care of CKD.

scholarly journals NIA HEALTH DISPARITIES RESEARCH NETWORK: APPROACHES AND FINDINGS FROM GERIATRICS AND CLINICAL GERONTOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S13-S13
Author(s):  
Lyndon Joseph ◽  
CarlV Hill
Keyword(s):  
Health Disparities ◽  
Life Expectancy ◽  
Research Network ◽  
Imaging Biomarkers ◽  
Sociocultural Factors ◽  
Multiple Chronic Conditions ◽  
Structural Level ◽  
Biological Mechanisms ◽  
Age Related ◽  
Reduce Life Expectancy

Abstract Health disparities are differences in the incidence, prevalence and burden of diseases, mortality rates and causes of death that exist among population groups. Health disparities are associated with a broad, complex, and interrelated array of factors that influence health, accelerate aging and reduce life expectancy. NIA’s health disparities research goals are to understand environmental and sociocultural factors and related behavioral and biological mechanisms that diminish health and reduce life expectancy for vulnerable populations, explore the biological mechanisms through which disparities influence age-related change, and identify where disparities emerge in diagnosis, prognosis or treatment in geriatric conditions. Presentations will focus on whether structural-level discrimination may be a key factor in potentiating well known race-related health disparities especially those with an accelerated onset and may be associated with MRI-indicators of subclinical brain pathology; identifying biomarkers for early detection of cognitive and functional decline in high risk subpopulations and how ethnicity influences cerebral spinal fluid and imaging biomarkers link to early identification of cognitive and functional impairment ; effects of medication management and deprescribing among African American and Hispanic older adults with Alzheimer’s disease and related dementias and multiple chronic conditions; examine the use of multi-level factors and technology to overcome the barriers to urban-rural health disparities in managing many chronic diseases such as hepatitis C virus infection and delivery of appropriate medical services; and understanding the racial and ethnic differences in the link between environmental exposures and auto-immune comorbid asthma.

scholarly journals Deficient testosterone levels in men above 45 years with major depressive disorder - an age-matched case control study

2007 ◽  
Vol 13 (3) ◽  
pp. 5
Author(s):  
A M Dikobe ◽  
C W Van Staden ◽  
S Reif ◽  
M Bornman
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Options ◽  
Serum Testosterone ◽  
Control Group ◽  
Major Depressive ◽  
Age Related ◽  
Appropriate Treatment ◽  
Matched Case

<p><strong>Background.</strong> Symptoms of partial androgen deficiency in ageing men (PADAM) overlap considerably with those of major depressive disorder. The relationship between these conditions is complicated by the usual age-related decline in serum testosterone concentrations.</p><p><strong>Objectives.</strong> To test the hypothesis that depressed men above 45 years of age have lower serum testosterone concentrations than age-matched controls.</p><p><strong>Method.</strong> Serum testosterone fractions of 20 men above the age of 45 years suffering from a major depressive disorder were compared with those of 20 healthy men. An age-matched controlled design was used to account for the usual age-related decline in serum testosterone concentrations.</p><p><strong>Results.</strong> Testosterone concentrations of men suffering from a major depressive disorder were statistically significantly lower than those of an age-matched control group without depression. Conclusion. The role of testosterone deficiency in depressed men needs to be examined further in order for appropriate treatment options to be developed.</p>

Poisoning among older people with dementia: a wake up call

2015 ◽  
Vol 27 (11) ◽  
pp. 1755-1756
Author(s):  
Christopher D. Etherton-Beer
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Diseases ◽  
Life Expectancy ◽  
Older People ◽  
Medical Care ◽  
Human Lifespan ◽  
People With Dementia ◽  
Age Related

Medical care can be both “a blessing and a curse”. The contributions of medicines to increased human lifespan and falling mortality from the major cardiovascular diseases are undisputed. However, in lockstep with remarkable extension of human lifespan has been increase in the numbers of people living with chronic age related neurodegenerative conditions and frailty. In frail, multi-morbid populations, with limited homeostatic reserve and life expectancy, the balance between the risk and harms of medicines can be in equipoise. In this context the number of older people living with dementia is increasing, and understanding threats to the quality of life of people with dementia is of growing significance. Among the myriad potential causes of harm to older people with dementia, in this issue of the journal Mitchell and colleagues present new Australian data reminding us of the importance of admissions due to both intentional and unintentional poisoning.

scholarly journals Ageing and learning disability

2000 ◽  
Vol 176 (1) ◽  
pp. 26-31 ◽  
Author(s):  
A. J. Holland
Keyword(s):  
Learning Disabilities ◽  
Life Expectancy ◽  
Learning Disability ◽  
Social Care ◽  
Developmental Process ◽  
Social Issues ◽  
Later Life ◽  
Severe Disabilities ◽  
Age Related ◽  
Health And Social Care

BackgroundAgeing is a continuation of the developmental process and is influenced by genetic and other biological factors as well as personal and social circumstances.AimsTo identify some key biological, psychological and social issues relevant to how ageing might particularly effect people with learning disabilities.MethodThis selected review considers the extent to which there are similarities and differences relative to people without learning disabilities.ResultsThere is a convergence, in later life, between people with a learning disability and those without, owing to the reduced life expectancy of people with more severe disabilities. People with Down's syndrome have particular risks of age-related problems relatively early in life.ConclusionsThe improved life expectancy of people with learning disabilities is well established. There is a lack of a concerted response to ensure that the best possible health and social care is provided for people with learning disabilities in later life.

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