scholarly journals Advantages of the Ultralow-dose Hormonal Menopausal Therapy: An Ample Opportunity with Minimal Risks

Doctor Ru ◽  
2021 ◽  
Vol 20 (8) ◽  
pp. 41-47
Author(s):  
S.S. Apetov ◽  
◽  
V.V. Apetova ◽  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Hormone Therapy ◽  
Hormonal Therapy ◽  
Elderly Women ◽  
Sex Hormone ◽  
Efficacy And Safety ◽  
Ultralow Dose ◽  
Post Menopause

Objective of the Review: To analyse the efficacy and safety of the ultralow-dose menopausal hormonal therapy (MHT). Key Points. In developed countries, the life expectancy is growing and the issue of improved quality of life of elderly women is becoming quite acute. On the average, a third (or a half for early menopause) of a modern woman’s life falls on the post-menopause period. Termination of oestrogen synthesis in ovaries during menopause is associated with marked reduction in the quality of life, development of vasomotor symptoms, sleep disturbances, accelerated skin ageing, an increased risk of cardiovascular pathologies and a number of somatic disorders, urinogenital atrophy, osteoporosis, and cognitive disorders. MHT is a proven and efficient means of quality of life improvement; however, the safety of sex hormone therapy in elderly women is still a topical issue. In this article, we are discussing the efficacy and safety of oral MHT drug containing 0.5 mg of 17β-estradiol and 2.5 mg of didrogesteron. Conclusion. The advent of ultralow-dose MHT drugs allowed significantly reducing the number of side effects from sex hormone therapy during post-menopause vs. side effects from higher doses of estradiol with comparable clinical effects. Keywords: menopausal hormonal therapy, ultralow-dose drugs, estradiol, didrogesteron.

A Systematic Review On The Use Of Pharmacological Agents In Patients With Hereditary Hemorrhagic Telangiectasia (HHT)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4745-4745 ◽  
Author(s):  
Mansoor Radwi ◽  
Arjuna Ponnampalam ◽  
Marie E Faughnan ◽  
Nadine Shehata
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Hormonal Therapy ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Post Intervention ◽  
Pharmacological Agents ◽  
Plasma Coagulation ◽  
Grade 3

Introduction Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant vascular disorder that affects approximately 1 in 5,000 people. Recurrent epistaxis occurs in 90% of adults & chronic GI bleeding in 20%, and when severe may require transfusion support, repeat emergency department visits & admissions for endoscopic/surgical intervention. Use of various systemic & topical agents to reduce bleeding & its associated co-morbidities are highly needed. We conducted a systematic review to determine if the use of pharmacological agents in patients with HHT reduces bleeding, mortality due to bleeding, frequency of transfusion, frequency of hospital admissions/visits, or improved quality of life. Methods We searched MEDLINE & EMBASE from 1946 to February 2013 for medical treatments used to control bleeding (e.g. antifibrinolytics agent, angiogenic inhibitors, estrogen) in patients with HHT. We excluded articles if they were animal studies, case reports, letters, reviews, series with < 5 patients, or not published in English language. We also included conference proceedings published in the last 5 years (2008-2013). Results 2 independent reviewers assessed 414 citations. Of these, 21 nonrandomized trials (15 prospective & 6 retrospective) & 4 randomized controlled trials (RCT) met our criteria for inclusion. From 25 trials reviewed, 21 had sample sizes fewer than 50 participants. The spectrum of medical therapy studied included estrogens, antiestrogens, antifibrinolytics & angiogenesis inhibitors: Bevacizumab was the most evaluated agent (10 trials) followed by hormonal therapy (9 trials). Measured outcomes included the Epistaxis Severity Score (ESS), change in hemoglobin concentration (Hb), the Sadick scale score (a scale evaluating amount & frequency of epistaxis), intensity & frequency of bleeding, hemorrhage free time, & quality of life (QoL). The metrics used to evaluate outcomes were heterogeneous across the studies & therefore a meta-analysis was not performed on available data. When using Bevacizumab, ESS scores (reported in 5 of 10 trials) significantly improved in 4 trials (mean ranges pre intervention: 6-8.12 vs. post intervention: 2.82-3.6) while Hb levels (reported in 4 of 10 trials) showed significant improvement in 3 trials (mean ranges pre-intervention: 85-106 g/L vs. post intervention: 97-130 g/L). QoL (reported in 4 of 10 trials), was reported to be improved in 3 trials. Hormonal therapy was also effective. Topical hormonal therapy combined with Argon plasma coagulation (APC) showed significant efficacy in 2 trials. Decreased intensity of bleeding (67-71% of patients converted from grade 3 to grade 1) & frequency of bleeding (68-69% of patients converted from grade 3 to grade 1) were reported. Oral estrogen & tranexamic acid trials yielded mixed results. On the other hand, a prospective trial using raloxifine showed improvement in Sadick scale score (Mean Frequency: pre 2.36, post 1.13, Mean Quantity: pre 2.26, post 1.42), & a rise in hemoglobin of 9.25 % (before treatment 11.18 ± 0.10, after treatment 12.08 ± 0.15). Tamoxifen therapy showed a significant improvement in severity & frequency of epistaxis in a RCT & an additional observational trial showed improvement in epistaxis bleeding score, hemoglobin & quality of life. Side effects (SE) were reported in 13 trials. Topical Bevacizumab alone had no side effects (3 out 4 trials reported SE), however when combined with laser treatment in high doses, 40% of patients developed septal perforation in one trial. Side effects were seen in 84% of patients receiving IV Bevacizumab, most common SE were headache (58% of events), nausea & vomiting (13% of events). 3 trials that used oral estrogen reported vaginal bleeding (10-50%) & gynecomastia/breast engorgement (33-47%). No thromboembolic events were reported. Topical hormonal treatment did not result in side effects although only one trial reported events. Conclusion Bevacizumab, tamoxifen & combined topical hormonal with Argon plasma coagulation therapy appear to be effective in reducing bleeding for patients with HHT. Other agents such raloxifine & thalidomide also showed improvement in outcomes but further studies are needed to evaluate their efficacy. Limitations include a lack of a well-structured RCT, the predominance of small non-randomized trials, & a lack of coherent data reporting on outcomes. Disclosures: No relevant conflicts of interest to declare.

The effect of hormone therapy on the health-related quality of life in elderly women

Maturitas ◽  
2007 ◽  
Vol 56 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Sirpa Eviö ◽  
Tuula Pekkarinen ◽  
Harri Sintonen ◽  
Aila Tiitinen ◽  
Matti J. Välimäki
Keyword(s):  
Quality Of Life ◽  
Hormone Therapy ◽  
Elderly Women ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Adverse effects of adjuvant endocrine therapy

2018 ◽  
pp. 64-69
Author(s):  
E. I. Kovalenko ◽  
I. B. Kononenko ◽  
A. V. Snegovoi ◽  
O. P. Grebennikova ◽  
L. V. Manzyuk
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Adverse Effects ◽  
Adverse Events ◽  
Endocrine Therapy ◽  
Aromatase Inhibitors ◽  
Hormonal Therapy ◽  
Adjuvant Endocrine Therapy

Hormonal therapy is a highly effective and well tolerable treatment of hormone-responsive breast cancer. However, it has some side effects that can affect quality of life and lead to treatment discontinuation. Common side effects of tamoxifen and aromatase inhibitors are discussed in this article: menopausal, gynecological symptoms, cardiovascular and musculoskeletal adverse events. Some of them are preventable and manageable. In order to maintain good quality of life during treatment the oncologists should pay more attention to the side effects that lead to it’s deterioration and not be too anxious about insignificant ones.

scholarly journals A cilostazol hatékony és biztonságos lehetőség a claudicatio intermittens kezelésére. A NOCLAUD vizsgálat eredményei

2017 ◽  
Vol 158 (4) ◽  
pp. 123-128 ◽  
Author(s):  
Katalin Farkas ◽  
Zoltán Járai ◽  
Endre Kolossváry
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Intermittent Claudication ◽  
Walking Distance ◽  
Claudicatio Intermittens ◽  
Efficacy And Safety ◽  
Walking Test ◽  
Efficacy Analysis

Abstract: Intermittent claudication can seriously impair the patients’ quality of life. Cilostazol was registered in Hungary in 2014. This study aimed to evaluate the efficacy and safety of cilostazol in patients with intermittent claudication. 1405 patients were enrolled to the 6 months, multicenter, non-interventional trial. From the 1331 patients, who completed the study, the data of 674 patients were subjected to efficacy analysis. Pain free and maximal walking distance and the 6 minute walking test improved significantly at 3 months (78.65%, 65.23%, 56.09%; respectively, p<0.001), and a further increase was observed after 6 months treatment (129.74%, 107.2, 80.38% respectively, p<0.001). Adverse events occured in 7.26% of the patients. The most frequent adverse events were headache, diarrhea, dizziness, tachycardia or palpitation. 24 patients (1.7%) stopped cilostazol treatment because of side effects. 6 month cilostazol treatment significantly increased the walking distance in patients with intermittent claudication, without important safety problems. Orv. Hetil., 2017, 158(4), 123–128.

scholarly journals Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Lu Li ◽  
Rongyun Wang ◽  
Aolin Zhang ◽  
Ling Wang ◽  
Qianwen Ge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Bone Mineral Density ◽  
Side Effects ◽  
Endocrine Therapy ◽  
Adjuvant Treatment ◽  
Efficacy And Safety ◽  
Mineral Density ◽  
Chinese Medicines

BackgroundBreast cancer, a malignant disorder, occurs in epithelial tissue of the breast glands and ducts. Endocrine therapy is commonly applied as an important adjuvant treatment for breast cancer, but it usually induces a variety of side effects. Chinese Medicines (CM) has therapeutic effect on reducing adverse effects of the endocrine therapy in many clinical studies. But strong evidence is still limited on the efficacy and safety of CM combined western medicines (CM-WM) for breast cancer.ObjectiveTo study the efficacy and safety of CM-WM as an adjuvant treatment for reducing side effects induced by endocrine therapy in breast cancer patients.MethodWe searched relevant clinical studies in PubMed and the Chinese National Knowledge Infrastructure (CNKI) databases up to February 28, 2021 and only Randomized Controlled Trials (RCTs) were included. There were no limitations on the languages. We extracted data from the included RCTs, assessed study quality, conducted meta-analyses by RevMan 5.4 and compared the pooled Risk Ratios (RR) or Mean Difference (MD) with 95% CIs.ResultsIn total 28 trials involving 1,926 participants were included. Six RCTs compared CM-WM with CM placebo-WM, while 22 RCTs compared CM-WM with WM alone. No study compared CM-WM with no treatment. Meta-analysis showed that CM-WM treatment significantly improved quality of life (MD = 0.73, 95% CI = 0.11–1.35, P = 0.02) when compared with CM placebo-WM treatment. When compared with WM treatment alone, CM-WM treatment significantly improved bone mineral density (MD = 0.24, 95% CI = 0.13–0.35, P &lt;0.0001), TCM syndrome score (MD = −5.39, 95% CI = −8.81 to −1.97, P = 0.0002), Kupperman Scale (MD = 0.24, 95% CI = −2.76 to −1.94, P &lt;0.0001), Karnofsky Performance Scale (MD = 3.76, 95% CI = 1.64–5.88, P = 0.0005), quality of life (MD = 3.01, 95% CI = 1.00–5.02, P = 0.003), and pain relief (MD = 2.10, 95% CI = 0.72–3.48, P &lt;0.0001). Compared with WM, CM-WM significantly decreased incidence of TCM symptoms (nausea, vomiting, fatigue, etc.) (RR = 1.60, 95% CI = 1.40–1.84, P &lt;0.0001). For safety, serum calcium, estradiol, ALP, and blood CD3, CD4 and CD8 counts were not significantly difference between two treatments (P &gt;0.05). Serious side effects or reactions were not reported in all included studies.ConclusionThe adjunctive use of CM reduced the endocrine therapy associated adverse events, including bone mineral density loss, perimenopausal symptoms, poor quality of life, pain and impaired immune function. But large-scale and high quality RCTs are needed to support the application of CM-WM therapy.

scholarly journals Menorrhagia Management in Iranian Traditional Medicine

2015 ◽  
Vol 21 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Mojgan Tansaz ◽  
Hajar Memarzadehzavareh ◽  
Marzieh Qaraaty ◽  
Tahereh Eftekhar ◽  
Malihe Tabarrai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Traditional Medicine ◽  
Hormonal Therapy ◽  
Medical Management ◽  
Medicinal Herbs ◽  
Traditional Medicines ◽  
Iranian Traditional Medicine

Menorrhagia is a common problem. Medical management for menorrhagia includes hormonal and nonhormonal treatments. These treatments have different side effects, which reduce quality of life. Complementary and traditional medicines have been used to handle menorrhagia for centuries in many cultures. There is a lot of information and data in Iranian traditional documents or books about medicinal herbs that are used by Iranian traditional medicine scientists for the treatment of menorrhagia. The aim of this study was to review the approaches to menorrhagia in Iranian traditional medicine texts. In this study, some main Iranian traditional medicine manuscripts including Canon of Medicine and Al-Havi of Rhazes were studied to extract important information about menorrhagia management. Iranian traditional medicine physicians have relied on an organized system of etiological theories and treatments for menorrhagia. Their methods for menorrhagia management may be able to convince the desire of many women to preserve their uterus and avoid hormonal therapy.

scholarly journals EFFICACY AND SAFETY OF LOW-DOSE HORMONAL THERAPY FOR EPILEPSY IN CHILDREN

ASJ. ◽  
2021 ◽  
Vol 1 (54) ◽  
pp. 4-10
Author(s):  
M. Korotkikh ◽  
G. Korotkikh
Keyword(s):  
Side Effects ◽  
Positive Result ◽  
Hormone Therapy ◽  
Hormonal Therapy ◽  
Low Dose ◽  
Dna Analysis ◽  
Focal Epilepsy ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Efficacy And Safety

Objective: to evaluate the efficacy and safety of low-dose hormonal therapy of epilepsy in children. Material and methods: a study was conducted of 32 children aged 3 months to 11 years (21 boys, 11 girls) who received hormone therapy in the lowest clinically effective doses due to the resistance of epileptic seizures to the ongoing therapy with antiepileptic drugs, cognitive, behavioral disorders and regression development. Hormonal preparations were used: tetracosactide (synacthen depot) at a maximum single dose of 0.25-0.5 mg intramuscularly and dexamethasone at a dose of 0.15 mg/kg/day per os. All patients underwent: electroencephalography (EEG) and EEG-video monitoring with the inclusion of sleep, magnetic resonance imaging of the brain, according to indications - tandem mass spectrometry, DNA analysis by clinical sequencing (panel "Inherited epilepsy"), studies aimed at identifying possible side effects of corticosteroid therapy. The duration of follow-up after completion of hormone therapy was 1-4 years. Research results: a positive result of the therapy was: 1) reduction of epileptiform activity on the EEG, 2) relief of epileptic seizures, 3) restoration (improvement) of impaired higher cortical functions. Long-term positive results were obtained in 62,5% (20/32). The best results were observed in patients with epileptic encephalopathy with continuous spike and wave during sleep, atypical childhood epilepsy with centrotemporal spikes, LandauKleffner syndrome in 100% (8/8). In patients with structural focal epilepsy and continuous spike and wave during sleep, a positive result was achieved in 60% (3/5); in patients with West syndrome, in 57,1% (8/14). A short-term positive result (or lack thereof) was noted mainly in patients with a structure of brain pathology and late initiation of hormone therapy. Side effects were absent or were transient.

Glittre ADL test in eutrophic, overweight and obese elderly

2020 ◽  
Vol 21 (1) ◽  
pp. 49
Author(s):  
Augusto Baumhardt Guidoti ◽  
Ângelo Pereira Cattani ◽  
Cintia Laura De Araujo ◽  
Fernanda Beatriz Costa Delacoste ◽  
Guilherme Scotta Hentschke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Elderly Women ◽  
Handgrip Strength ◽  
Exercise Intolerance ◽  
World Health ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
World Health Organization Quality

The Glittre ADL-test (TGlittre) has been designed and validated to measure functional capacity during daily living activities in patients with chronic obstructive pulmonary disease (COPD) but is now used in several other situations. The aim of this study was to evaluate the applicability of TGlittre in a sample of overweight and obese eutrophic elderly. This was an experimental and cross-sectional study, which included 21 elderly women, allocated by BMI, in eutrophic (n = 8), overweight (n = 6) and obese (n = 7) groups. They were assessed for functional capacity (TGlittre and 6MWT), quality of life (QOL) with the questionnaire World Health Organization Quality of Life for Older People (WHOQOL-OLD) and handgrip strength (HGS). TGlittre correlated with age (p = 0.0040) and with 6MWT (p = 0.0086), but no statistical difference was found in TGlittre's performance time and the distance covered in 6MWT between groups. TGlittre did not correlate with HGS (p = 0.1493) and WHOQOL-Old (p = 0.0905). The data obtained in the present study corroborate that TGlittre is used as a functional measurement variable in the elderly population.Keywords: aged, obesity, exercise intolerance.­­­

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