جستجوی مقالات مرتبط با کلیدواژه « hormone therapy » در نشریات گروه « پزشکی »
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Background
This retrospective cohort study explores the long-term effects of different endocrine therapy regimens on mortality, local recurrence, and metastasisin breast cancer patients.
MethodsData from the Referral Cancer Research Center of Shahid Beheshti University of Medical Sciences were analyzed. Records of 2262 histologically confirmed reast cancerb patients with 25 years of follow-up were included. Wecollected patient data, including treatment modalities and details of the endocrine therapy, and conducted statistical analysis to assess treatment outcome associations.
ResultsPatients had an average age of 49.45 years, and 99.1% were female. The average tumor size was 2.8 cm, with a 12.3% mortality rate. Positive expression of human epidermal growth factor receptor 2, progesterone receptor, and estrogen receptor was found in 17.3%, 71.8%, and 70.6% of patients, respectively. Tamoxifen was administeredto 1,700 patients, letrozole to 715, and exemestane to 540, with an average endocrine therapy duration of 5.2 years. Letrozole treatment duration (P = 0.001) and lymph node involvement (P=0.028) were independent predictive variables for local recurrence, with longer letrozole therapy associated with lower recurrence.
ConclusionEstrogen receptor expression and endocrine therapy duration are independent predictive markers for recurrence and mortality. Longer letrozole therapy predicts lower local recurrence. Endocrine therapy duration inversely relates to mortality, recurrence, and local recurrence.
Keywords: Endocrine therapy, hormone therapy, breast cancer, local recurrence} -
مقدمه
کم کاری تیرویید، از جمله اختلالاتی است که با افزایش خطر ابتلا به بیماری های قلبی- عروقی همراه است. یکی از اولین پاسخ های به تجویز هورمون تیرویید، کاهش مقاومت عروقی سیستمیک و افزایش خروجی قلب و انقباض قلب است.
شیوه ی مطالعه:
در این مطالعه که بصورت نیمه تجربی (بصورت قبل و بعد) انجام شد، 50 بیمار مراجعه کننده به کلینیک فوق تخصصی غدد و داخلی بیمارستان توحید سنندج (دو گروه 25 نفره دریافت کننده ی دارو و گروهی که دارو دریافت نکردند) بر اساس معیارهای ورود و خروج وارد مطالعه شدند. فشارخون، ضربان قلب و نوار قلب توسط فوق تخصص قلب و عروق انجام شد.
یافته هامیانگین سنی بیماران شرکت کننده در مطالعه 7/74 ± 48/0 سال بود. از نظر مقایسه ی بیماران دریافت کننده ی دارو و گروه دیگر، از نظر توزیع جنسی و سن، نتایج نشان داد؛ دو گروه تفاوت معنی دار آماری باهم نداشتند (0/05 < p value) اما از نظر مقایسه ی شاخص های فشارخون و ضربان قلب در مراحل قبل و بعد، در دو گروه نشان داد تفاوت معنی دار آماری بین دریافت کنندگان دارو و بیمارانی که دارو دریافت نکردند از نظر فشارخون سیستولیک و دیاستولیک در مرحله ی قبل مداخله، مشاهده شد (0/01 > p value).
نتیجه گیریتوجه ویژه به بیماران هایپوتیروییدی با توجه به نتایج بدست آمده و کنترل، پیگیری و برنامه ریزی برای این بیماران، توسط دست اندکاران امر و مسوولین حوزه ی بهداشت و سلامت، مهم و ضروری به نظر می رسد و می بایست مورد توجه قرار گیرد.
کلید واژگان: هیپوتیروئید, فشارخون, نوار قلب, هورمون درمانی}BackgroundHypothyroidism is one of the disorders that is associated with an increased risk of cardiovascular disease. One of the first responses to thyroid hormone administration is to reduce systemic vascular resistance and increase cardiac output and heart contraction.
MethodsIn this study, which was performed as a quasi-experimental study (before and after), 50 patients were referred to the endocrinology and internal medicine clinic of Towhid Hospital in Sanandaj (in two groups of 25 patients receiving medication and the group that did not receive medication) They were included in the study based on inclusion and exclusion criteria. Blood pressure, heart rate, and ECG were performed by a cardiologist after recording them.
ResultsThe mean age of patients participating in the study was 48.0 ± 7.74 years. Compared the patients receiving the drug and the other group, in terms of sex distribution and age, showed results; There was no statistically significant difference between the two groups (p value > 0.05) However, in terms of comparing blood pressure and heart rate indices in the before and after stages, the two groups showed a statistically significant difference between patients receiving medication and patients who did not receive medication in terms of systolic and diastolic blood pressure in the previous phase of hormone therapy (p value < 0.01).
ConclusionSpecial attention to hypothyroid patients according to the obtained results, Control, follow-up, and planning for these patients, by those involved in the matter and those responsible for the health sector, seems important and necessary and should be taken into consideration.
Keywords: Hypothyroidism, Blood pressure, ECG, Hormone therapy} -
Background
Asherman syndrome is a controversial issue in obstetrics and gynecology without any consensus on its management and treatment. It is characterized by variable lesions inside the uterine cavity and also causes menstrual irregularities, infertility, and placental abnormalities. The study aimed to assess the platelet‑rich plasma (PRP) effect in women with intrauterine adhesions by evaluating the improvement of the menstrual cycle and intrauterine adhesion (IUA) stage.
Materials and MethodsThis clinical trial study was performed on 60 women with Asherman syndrome in two groups of 30. For the first group, only hormone therapy was performed and for the second group, hormone therapy with platelet‑rich plasma after hysteroscopy. Recovery of Asherman syndrome and IUA stage was assessed at 6 to 8 weeks after hysteroscopy and compared between the two groups.
ResultsOur results demonstrated that there was no significant difference between demographic data in the two groups as well as the menstrual pattern of both groups before or after treatment (P > 0.05). Frequency distribution of IUA after the intervention in the PRP + hormone therapy group in grade I, II, and III were equal to 73.3%, 20%, and 6.7% and in the hormone therapy group were 53.3%, 26.7%, and 20%, respectively (P = 0.22). In addition, hypo menorrhea was observed in 33.3% of PRP+ hormone therapy group and 40% of the hormone therapy group with no significant difference between the two groups (P = 0.71).
ConclusionHormone therapy with PRP compared to hormone therapy alone after routine surgical treatment had not a significant effect on the IUA stage, duration, and severity of menstruation.
Keywords: Adhesions, Asherman syndrome, hormone therapy, intrauterine, platelet rich plasma} -
ContextHormone replacement therapy (HRT) is widely used to control postmenopausal symptoms. This therapy is also used to prevent diseases such as osteoporosis and dementia. However, clinical trials suggest some negative effects regarding postmenopausal HRT. This study evaluates the effects of HRT on postmenopausal cardiovascular events.Evidence AcquisitionWe collected data from 32 articles by using valid keywords and searching databases of PubMed, Medlib, ScienceDirect, EmBase, Scopus, Index Copernicus, SID, and Iranmedex. Analysis was performed by comparing three groups of postmenopausal women: combined hormone therapy (estrogen + progesterone), estrogen alone treated group, and placebo-receiving group (control group). Data were analyzed using the random effect model meta-analysis by using R software and Stata software Version 11.2.ResultsOf the collected 32 studies between 1998 and 2016, there were 1277686 subjects with an average age of 60.6 years. The prevalence of myocardial infarction were (2.64%), coronary heart disease (1.7%), stroke (254%), cardiovascular death (1.54%), revascularization (3.26 %), and cerebrovascular disease (CVD) (2.78%) in the combined hormone therapy group. Also, in the estrogen-treated group were 2.95%, 3.41%, 2.49%, 2.8%, - , 3.14%, respectively. In the placebo-receiving group these events were 2.09%, 2.73%, 2.9%, 2.25%, 4.96%, and 11.92, respectively. The results showed that estrogen therapy could increase the incidence of stroke. Moreover, HRT could have positive effects on the serum lipid profile in postmenopausal women.ConclusionPostmenopausal HRT appears to be non-effective on coronary artery disease, revascularization, myocardial infarction, and cardiac-related deaths; however, it could play a role in increasing the stroke rate.Keywords: Cardiovascular, Hormone Therapy, Meta-Analysis, Postmenopausal}
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BackgroundFunctional hypothalamic menstrual disorder (FHMD) has a destructive effect on the athletes bone mineral density and cardiovascular system. Utilizing hormone replacement therapy to treat FHMD in athletes is controversial.
This study was conducted to examine the effect of hormone therapy on bone density and the cardiovascular system of professional female athletes with FHMD.MethodsIn this study, 18 female athletes with at least a 2- year history of FHMD were recruited in a 9-month single blind randomized clinical intervention (RCT) and randomly classified into 2 groups: the oral contraceptive pills (OCP) group, who received a low-dose combined oral contraceptive (OC) containing 30 µg ethinyl estradiol and 150 µg levonorgestrel (n= 10), and the control group (n = 8). Bone mineral densitometry (BMD) and certain cardiovascular risk factors were measured before and after the 9-month trial. The Chi square test was used to compare the quantitative and qualitative results.ResultsBone mineral density did not change significantly in either group. Very low density lipoprotein (VLDL) (p= 0.035) and Apolipoprotein B (Apo B) (p= 0.04) reduced significantly in the OCP group. An increase was observed in the serum levels of Apolipoprotein A (Apo A) (p= 0.01) in the control group. Changes in the Apo B to Apo A ratio was significant in both groups (OCP group: p= 0.018, control group: p= 0.040). No significant changes were observed in the other measured factors.ConclusionAlthough the administration of estrogen did not significantly increase bone mineral density, it had positive effects on the cardiovascular system and lipid profile.Keywords: Functional hypothalamic menstrual disorder (FHMD), Hypoestrogenism, Bone density, Cardiovascular risk factor, Hormone therapy, OCP (oral contraceptive pills)} -
BackgroundThis study was designed to suggest the possibility of hormone-related derangement in salvage radiotherapy (SRT) after radical prostatectomy in terms of prostate-specific antigen (PSA) control.Materials And MethodsAmong 160 consecutive prostate cancer patients who received radical prostatectomy, 34 with SRT between 2004 and 2012 were retrospectively reviewed. The numbers of patients with pathologic T3-T4 stage, Gleason score 8-10, and positive resection margin were 11 (32.4%), 10 (29.4%), and 17 (50.0%), respectively. Median SRT dose was 64.8 Gy (range, 52.9-70.0 Gy) with 1.8-2.3 Gy fractionations. Biochemical failure-free survival after SRT was counted and the median follow-up period was 32.5 months (range, 10-118 months).ResultsAfter SRT, the median time for PSA to decrease to less than 0.2 ng/mL was four months (range, 0-25 months). The three-year survival rate was 60.3%. On univariate analysis, preferential hormone therapy (PHT) (p=0.022), higher PSA at SRT (p=0.005), and higher PSA after surgery (p=0.003) were related to a shorter biochemical survival period. On multivariate analysis, lower PSA at SRT (p=0.016), higher radiation dose (p=0.007), and non-PHT (p=0.046) suggested a consistent PSA control.ConclusionAccording to these results, low PSA values by hormonal intervention need to be reconsidered with a different way to look at the relationship between the PSA and hormone therapy. SRT should be considered for postoperative salvage treatment regardless of the hormone-related PSA values.Keywords: Hormone therapy, Prostate cancer, Salvage radiotherapy}
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Breast cancer is the most common cancer in women around the world. So far, many attempts have been made to treat this disease, but few e?ective treatments have been discovered. In this work, we reviewed the related articles in the limited period of time, 20002016, through search in PubMed, Scopus database, Google Scholar, and psychology and psychiatry literature (PsycINFO). We selected the articles about the correlation of microRNAs (miRNAs) and breast cancer in the insight into therapeutic applicability from mentioned genetics research databases. Te miRNAs as an e?ective therapy for breast cancer was at the center of our attention. Hormone therapy and chemotherapy are two major methods that are being used frequently in breast cancer treatment. In the search for an e?ective therapy for breast cancer, miRNAs suggest a promising method of treatment. miRNAs are small, noncoding RNAs that can turn genes on or o? and can have critical roles in cancer treatment; therefore, in the near future, usage of these biological molecules in breast cancer treatment can be considered a weapon against most common cancer?related concerns in women. Here, we discuss miRNAs and their roles in various aspects of breast cancer treatment to help fnd an alternative and e?ective way to treat or even cure this preventable disease.Keywords: Breast cancer, chemotherapy, hormone therapy, microRNA, treatment}
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مجله دانشگاه علوم پزشکی سبزوار، سال بیست و چهارم شماره 1 (پیاپی 90، فروردین و اردیبهشت 1396)، صص 9 -15اهداف سرطان پستان یکی از شایع ترین سرطان ها در جهان است که فاکتورهای مختلف ژنتیکی و اپی ژنتیکی بر آن موثر است. هورمون استروژن یکی از فاکتورهای موثر در بروز این سرطان به حساب می آید. این فاکتور منجر به ایجاد یک سری تغییرات و آغاز و پیشرفت سرطان پستان می شود.
مواد و روش ها در این تحقیق اساس مولکولی سرطان پستان، اثر فاکتورهای رشد، هورمون استروژن و گیرنده های استروژنی در وقوع سرطان، استفاده از داروهای آنتی استروژنی نظیر تاموکسیفن در درمان سرطان پستان و سازوکار های مقاومت در برابر این داروها بررسی شده است. از پایگاه های اطلاعاتی NCBI، PUBMED، Google Scholar و OVID MEDLINE در جمع آوری اطلاعات مورد نیاز استفاده شد.
یافته ها افزایش هورمون استروژن و گیرنده استروژنی به شدت در وقوع سرطان پستان موثر است. تاموکسیفن درمان کمکی استانداردی برای زنان با سرطان پستان از نوع گیرنده مثبت استروژن ( ER-positive) است، اما گاهی مقاومت ذاتی یا اکتسابی به اندوکراین درمانی وجود دارد.
نتیجه گیری داروهای آنتی استروژنی نظیر تاموکسیفن نقش مهاری در سرطان های پستان وابسته به استروژن دارد و مانع از اتصال استروژن به گیرنده خود در سرطان های ER+ می شود. دانستن اساس مولکولی سرطان پستان برای رسیدن به شیوه درمانی موثر و غلبه به مقاومت مهم است.کلید واژگان: استروژن, تاموکسیفن, سرطان پستان, هورمون درمانی}Background and ObjectivesBreast cancer is one of the most common cancers in the world that is affected by various genetics, epigenetic and many other environmental factors. Estrogen is one of the risk factors for this cancer. This factor lead to genetic alterations and the beginning and promotion of breast cancer.Materials and MethodsIn this review, we provide information using databases of NCBI, PubMed, Google Scholar, and Ovid MEDLINE, about the molecular basis of breast cancer, the effect of estrogen hormone, and estrogen receptors on cancer incidence, the use of anti-estrogens such as Tamoxifen in treatment of breast cancer and mechanisms of resistant to these drugs.ResultAnti-estrogens such as tamoxifen play an important role in treatment of estrogen-receptor positive breast cancers by preventing estrogen binding to its receptors in these tumors. Finding the molecular basis of breast cancer will help us to achieve effective treatment for breast cancer.ConclusionIncreased estrogen and estrogen receptor highly influence the incidence of breast cancer. Tamoxifen is standard adjuvant therapy for women with ER-positive [], but there is some intrinsic or acquired resistance to endocrine treatment that require further investigations.Keywords: breast cancer, estrogen, hormone therapy, tamoxifen} -
Context: Breast cancer is the most common cancer in women worldwide. Estrogen receptor (ER) positive breast cancer constitutes the majority of these cancers. Hormone therapy has significantly improved clinical outcomes for early- and late-stage hormone receptor positive breast cancer. Although most patients with early stage breast cancer are treated with curative intent, approximately 20% - 30% of patients eventually experience a recurrence. During the last two decades, there have been tremendous efforts to understand the biological mechanisms of hormone therapy resistance, with the ultimate goal of implementing new therapeutic strategies to improve the current treatments for ER positive breast cancer. Several mechanisms of hormone therapy resistance have been proposed, including genetic alterations that lead to altered ER expression or ERs with changed protein sequence.
Evidence Acquisition: A Pubmed search was performed utilizing various related terms. Articles over the past 20 years were analyzed and selected for review.ResultsOn the basis of published studies, the frequencies of ESR1 (the gene encoding ER) mutations in ER positive metastatic breast cancer range from 11% to 55%. Future larger prospective studies with standardized mutation detection methods may be necessary to determine the true incidence of ESR1 mutations. ESR1 amplification in breast cancer remains a controversial issue, with numerous studies either confirmed or challenged the reports of ESR1 amplification. The combination of intra-tumor heterogeneity regarding ESR1 copy number alterations and low level ESR1 copy number increase may account for these discrepancies.ConclusionsWhile numerous unknown issues on the role of ESR1 mutations in advanced breast cancer remain, these new findings will certainly deepen current knowledge on molecular evolution of breast cancer and acquired resistance to hormone therapy.Keywords: Estrogen Receptor, ESR1 Amplification, ESR1 Mutation, Breast Cancer, Hormone Therapy} -
BackgroundMenopause is a critical phenomenon in womens life. After cardiac diseases, menopause is the second major cause of living with a disability in 4560 year old women. The majority of women will experience bothersome vasomotor symptoms (VMS). Menopausal hormone therapy (MHT) is the most effective treatment for these symptoms. The objective of this review is to focus on hormone therapy for relieving postmenopausal vasomotor symptoms.MethodsFor this systematic review, we primarily explored 125 papers published about hormone therapy for VMS from 2001 to 2015 by searching with combinations of the keywords in various databases. Among those, 59 papers met the initial search criteria and among them, 9 papers were potentially retrievable and reviewed. All included studies used estrogen formulations in the management of VMS.ResultsNine studies met all inclusion criteria. All studies assessed the effects of hormone replacement therapy on VSM. The results showed that low-dose oral and transdermal estrogen in all dose ranges were more likely than placebo to decrease the frequency of VMS. Indeed, the nanostructured formulation was safe and effective in relieving the symptoms of menopause. The mean daily decrease in the number of hot flashes from baseline was found in the studies.ConclusionMHT has a complex pattern. Understanding the natural history of VMS, and the risks and benefits of both hormonal therapies, helps to individualize management plans. Low-dose estrogen-based therapies can be the most effective regimens to relieve VMS. These medications can be used by different administration routes and formulations.Keywords: hormone therapy, menopause, vasomotor symptoms}
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IntroductionObesity and visceral fat accumulation after menopause are associated with insulin resistance and cardiovascular diseases. We investigated the interactive effect of aerobic-resistance training and estrogen replacement therapy on visceral fat, omentin-1 and HOMA-IR in ovariectomized rats.Materials And MethodsFifty female Wistar rats were ovariectomized (OVX) and divided into 5 groups (n=10 rats per group): Ovx+sedentary (Sedentary), aerobic-resistance training (Ovx+Exe), aerobic-resistance training+estrogen replacement therapy (Ovx+Exe+Est), estrogen replacement therapy (Ovx+Est) and sesame oil (Ovx+Oil). The exercise consisted of 8-week aerobic-resistance training (20 m/min, 3 days/week, 60 min/day, 10% slope, Load; 3% body weight).17b-estradiol valerate (30 μg/kg bw; in 0.2 ml sesame oil) were injected subcutaneously, three days a week during 8 weeks; and the Ovx+Est+Est received both exercise protocol and estradiol as previous groups. Obtained data were analyzed by ANOVA and post hoc Tukey test.ResultsOmentin-1showed significant increase in Ovx+Exe compared to Ovx+Exe+Est and Ovx+Est (P<0.05). HOMA-IR and visceral fat was decreased in Ovx+Exe, Ovx+Exe+Est compared to Sedentary (P<0.05).ConclusionEight-week aerobic-resistance training, 17-b estradiol replacement and co-treatment of exercise+estrogen successfully decreased visceral fat and insulin resistance probably via elevation in omentin-1 in ovaryectomized rats. Regarding the risk of hormone replacement therapy this study suggests that 2- month aerobic-resistance training is more effective in treating metabolic syndrome, rather than estrogen replacement therapy.Keywords: Combined Exercise, Hormone Therapy, HOMA, IR, Omentin, 1, Visceral Adipose}
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مقدمههورمون درمانی به طور گسترده ای جهت کنترل علائم یائسگی، پیشگیری و درمان بیماری قلبی عروقی، استئوپروز و زوال عقل در زنان مسن استفاده می شود. مطالعه حاضر با هدف شناسایی اثرات طولانی مدت هورمون درمانی بر مشکلات یائسگی انجام شد.روش کاراین مطالعه به صورت مروری با جستجوی 25 مقاله مرتبط در مورد هورمون درمانی بعد از یائسگی طی سال های 1999 تا 2010 صورت گرفت. جستجو در پایگاه های اطلاعاتی ISI Web of Science، Up to date و Scopus با استفاده از کلیدواژه هایی نظیر یائسگی، هورمون درمانی، عوارض هورمون درمانی، استروژن و پروژسترون انجام گرفت. معیارهای ورود مقالات به مطالعه شامل درج واژه های مورد جستجو در بخش عنوان یا کلیدواژه های مقالات بود. مقالات با داده های ناقص و مقالاتی که تنها چکیده آن ها در دسترس بود از مطالعه خارج شدند.یافته هادر زنان نسبتا سالم، هورمون درمانی ترکیبی مداوم به میزان قابل توجهی خطر ترومبوآمبولیسم وریدی یا حوادث کرونری، سکته، سرطان پستان و بیماری کیسه صفرا را افزایش می دهد. هورمون درمانی طولانی مدت با استروژن تنها به میزان قابل توجهی خطر سکته و بیماری کیسه صفرا را افزایش می دهد. به طور کلی، تنها فواید مهم هورمون درمانی، کاهش بروز شکستگی ها و سرطان کولون با مصرف طولانی مدت می باشد.نتیجه گیریهورمون درمانی برای درمان معمول بیماری مزمن اندیکاسیون ندارد. نیاز به شواهد بیشتر در زمینه بی خطر بودن هورمون درمانی جهت کنترل علائم یائسگی وجود دارد. تصور بر این است که مصرف کوتاه مدت هورمون برای زنان سالم جوان تر، نسبتا بی خطر باشد.
کلید واژگان: استروژن, استروژن و پروژسترون, هورمون درمانی, یائسگی}IntroductionHormone therapy is widely used to control the menopause symptoms، prevention and treatment of cardiovascular disease، osteoporosis and dementia in old women. This study was performed with aim to identify the long-term effects of hormone therapy on menopausal problems.MethodsThis study was performed as a review of 25 articles related to hormone therapy after menopause between 1999 and 2010. Searching was performed in databases including ISI web of Science، Up to date، and Scopus using keywords of menopause، hormone therapy، complications of hormone therapy، estrogen and progesterone. Inclusion criteria included the insertion of search terms in the title or keywords of the article. Articles with incomplete data and articles which only their abstracts are available were excluded.ResultsIn relatively healthy women، continuous combined hormone therapy significantly increases the risk of venous thromboembolism or coronary events، stroke، breast cancer and gallbladder disease. Long-term hormone therapy with estrogen alone significantly increases the risk of stroke and gallbladder disease. In general، the only benefits of hormone therapy are reducing the incidence of fractures and colon cancer with long-term use.ConclusionsHormone therapy is not an indication for routine management of chronic disease. There is a need for more evidence on the safety of hormone therapy to control the menopausal symptoms. It is believed that short-term use of hormones is relatively safe for healthy younger women.Keywords: Estrogen, Estrogen, Progesterone, Hormone Therapy, Menopause} -
پیش زمینه و هدفیائسگی حادثه ای است که در طول زندگی همه ی زنان اتفاق می افتد. زنان در این دوران به دنبال راهی برای تخفیف علائم و مشکلات ناشی از قطع استروژن می باشند. هدف از این مطالعه بررسی فراوانی برخی مکمل های مصرفی و هورمونی در زنان یائسه می باشد.
مواد و روش هااین مطالعه توصیفی- مقطعی بر روی 384 زن یائسه مراجعه کننده به مراکز بهداشتی درمانی شهر همدان انجام شد. روش نمونه گیری به صورت خوشه ایچند مرحله ای بود. اطلاعات مورد نیاز با تکمیل پرسشنامه توسط پرسشگران به روش مصاحبه جمع آوری گردید. اطلاعات بدست آمده با نرم افزار SPSS16 مورد آنالیز قرار گرفت.
یافته هامیانگین سن یائسگی 38/3 ±45/48 سال بود. 5/81درصد از زنان مکمل مصرف می کردند که 1/9درصد از مکمل های هورمونی و 4/72درصد از مکمل های غیرهورمونی که شامل 3/38درصد کلسیم، 3/27درصد انواع ویتامین و 8/6درصد از گیاهان داروئی استفاده می کردند. بین سن منارک، مصرف سیگار، تحصیلات مادر، شاخص توده بدنی، نوع یائسگی و مصرف انواع مکمل های هورمونی و غیر هورمونی در بین گروه های سنی یائسگی از لحاظ آماری ارتباط معنی دار وجود نداشت (05/0 p>).بحث و نتیجه گیرینتایج این پژوهش نشان داد 5/81درصد از زنان یائسه مکمل مصرف می کردند که 4/72درصد آن از مکمل های غیر هورمونی بوده است. لذا برنامه های آموزشی و مداخله های موثر در دوران یائسگی سبب بهبود کیفیت زندگی زنان یائسه خواهد شد.
کلید واژگان: یائسگی, مکمل, هورمون درمانی, شهر همدان}Background and AimsMenopause happens in the life of all women. During this process women inter to the new era of life that have many side effects and difficulties. The purpose of study was to evaluate the frequency of hormone therapy and other supplements.Materials and MethodsThis cross-sectional study carried out on 384 menopausal women who attended in medical and health centers of Hamadan city in 2012. The way of sampling was multi- stage cluster. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed by using SPSS 16. 0.ResultsThe results revealed that mean age of menopause was 38/3 ± 45/48 year. 81. 5% of the women were taking supplements that used hormone therapy (9. 1%)، and 72. 4% used non hormonal supplement that included calcium (38. 3%)، vitamin (27. 3%) and herbal drugs (6. 8%). Regarding to this results x2 test showed that age at menarche، smoking، mother education، BMI، type of menopause، and use of supplements in different menopause groups was not statistically significant (p >0/05).ConclusionThe results showed that 81. 5% of menopausal women were taking supplements from which 72. 4% was non-hormonal supplements. Therefore، effective educational programs with supplement interventions can improve the quality of life in postmenopausal women.Keywords: Menopause, Supplement, Hormone Therapy, Hamadan City} -
مقدمهشواهد نشان دهنده تاثیر یائسگی بر سلامت زنان می باشند ولی میزان آگاهی زنان از مراقبت در این دوره نامشخص است ولی آگاهی زنان از دوره یائسگی و مراقبت در این دوره مشخص نمی باشد.هدفهدف از این مطالعه، تعیین آگاهی از هورمون درمانی و فیزیولوژی تولیدمثل و یایسگی در زنان 60-40 سال بود.مواد و روش هااین مطالعه به صورت توصیفی و با استفاده از روش نمونه گیری خوشه ای، بر روی 330 زن در شهر یزد و در کشور جمهوری اسلامی ایران در سال 1389 صورت گرفت. داده ها با استفاده از پرسشنامه ای شامل سوالاتی درباره فیزیولوژی تولیدمثل در رابطه با یائسگی و هورمون درمانی، از طریق مصاحبه جمع آوری گردید. تجزیه و تحلیل داده ها با استفاده از آمار توصیفی و استنباطی و با کمک نرم افزار Spss.16 انجام شد.نتایجدر کل %2/1 از زنان شرکت کننده در حال استفاده از هورمون درمانی، %13/4 درگذشته استفاده کرده بودند ولی در حال حاضر آن را قطع کرده بودند و %84/5 نیز هرگز از هورمون درمانی استفاده نکرده بودند. زنان ایرانی دانش پایینی در مورد هورمون درمانی، فیزیولوژی تولیدمثل و یائسگی داشتند. بیشتر زنان (85/5%) می دانستند که گرگرفتگی در نزدیکی یائسگی شایع می باشد و تنها %77/2 می دانستند که یائسگی تولید استروژن را کاهش می دهد. زنان آگاهی کمی درباره اثرات پروژسترون و هورمون درمانی بر روی باروری داشتند. رگرسیون لجستیک نشان داد که سن، سطح تحصیلات و شاخص چاقی مهمترین فاکتورهای پیش بینی کننده استفاده از هورمون درمانی بعد از کنترل دیگر متغیرها هستند.نتیجه گیریمیزان استفاده از هورمون درمانی در زنان ایرانی پایین می باشد و بیشتر آن ها آگاهی کمی در مورد هورمون درمانی و یائسگی دارند. زنان نیازمند بهبود دانش خود در مورد مزایا و معایب هورمون درمانی و آموزش در مورد دستگاه تولید مثل هستند.
کلید واژگان: یائسگی, آگاهی, هورمون درمانی, فیزیولوژی تولیدمثل, زنان ایرانی}BackgroundEvidences shows that menopause affects women's health, but women's knowledge of proper care and maintenance is insufficient.ObjectiveTo determine knowledge of hormone therapy (HT), reproductive physiology, and menopause in a population of 40-60 year old women.Materials And MethodsThis cross-sectional study was conducted through a cluster sampling among 330 women in Yazd, Islamic Republic of Iran, in 2010. Data was collected using a questionnaire containing questions about reproductive physiology related to menopause and HT by interviewing. Inferential and descriptive statistics via SPSS.15 software were used for data analysis.ResultsOverall, 2.1% of women were current takers of HT, 13.4% had taken it in the past but had stopped and 84.5% had never taken hormone replacement therapy. Iranian women had low knowledge of HT, reproductive physiology, and menopause. Most of the women (85.5%) knew that hot flashes are common around menopause and only 77.2% knew decreasing estrogen production causes the menopause. They knew little about the effects of progestagens and the effects of HT on fertility. Logistic regression determined that age, educational level and BMI were the most important factors predicting use of HT after adjusting for other variables.ConclusionIranian women have a low HT usage rate and the majority of them are lacking of the knowledge about HT and menopause. Women need improved knowledge of the risks and benefits of HT as well as education about the reproductive system around menopause.Keywords: Menopause, Knowledge, Hormone therapy, Reproduction physiology, Women, Iranian} -
زمینه و هدفوجود گیرنده های هورمونی در سلول های سرطانی از جنبه های مختلف حائز اهمیت است. بررسی وضعیت گیرنده های استروژنی در ارزیابی پاسخ سلول های سرطانی پستان به هورمون درمانی مهم است. در سال های اخیر مطالعات بسیاری روی گیرنده های پرولاکتین به خصوص در سرطان پستان انجام شده است. هدف مطالعه حاضر بررسی وضعیت گیرنده های استروژن و پرولاکتین در نمونه های سرطان پستان است.مواد و روش هادر این مطالعه مقطعی چهل نمونه سرطان پستان مورد بررسی قرار گرفت. گیرنده استروژن با استفاده از روش اتصال توسط لیگاند رادیواکتیو سنجش شد. گیرنده آزاد و تام پرولاکتین با استفاده از پرولاکتین نشاندار شده با ید 125(125I - PRL) سنجش گردید. برای سنجش گیرنده تام پرولاکتین از محلول کلرید منیزیم (3.5 مولار) استفاده شد.یافته ها%85 نمونه ها از نوع سرطان مهاجم مجرایی بودند و مشخص شد که به ترتیب %62.5، %45 و %62.5 موارد دارای گیرنده استروژن، گیرنده پرولاکتین آزاد و گیرنده پرولاکتین تام هستند. 45% سلول های توموری مورد مطالعه دارای هر دو گیرنده استروژن و پرولاکتین تام بودند. ارتباط معنی داری (p<0.05) بین گیرنده استروژن و گیرنده پرولاکتین آزاد مشاهده شد. هم چنین ارتباط بین گیرنده استروژن و گیرنده پرولاکتین تام نیز معنی دار (p<0.05) بود. در این مطالعه هم چنین مشخص گردید که 20% نمونه ها دارای هیچ یک از گیرنده های استروژنی یا پرولاکتینی نیستند.نتیجه گیریبا در نظر گرفتن وجود گیرنده های استروژنی و پرولاکتینی در سلول های توموری و نقش این هورمون ها در رشد سلول های سرطانی پستان اهمیت استفاده از داروهای ضد استروژنی و ضد پرولاکتینی در مهار رشد این تومورها مشخص می گردد.
کلید واژگان: سرطان پستان, گیرنده استروژن, گیرنده پرولاکتین, هورمون درمانی}Survey of the Status of Estrogen and Prolactin Receptors in Breast Cancer M. Sirati Sabet PhD, F. Karami Tehrani PhD Received: 23/01/06 Sending for Revision: 19/04/06 Receiving Revised Manuscript: 16/08/06 Accepted: 27/09/06Background And ObjectiveThe existence of hormonal receptors in cancer cells is very important in various aspects. Survey of the status of estrogen receptors (ERs) in the evaluation of breast cancer cells is important due to their response to hormonal therapy. Many studies have been recently carried out on prolactin receptors (PRLRs) especially in breast cancer. The aim of the present study was survey of the status of ERs and PRLRs in breast cancer.Materials And MethodsIn this cross-sectional study 40 samples from breast cancer tumors were studied. Estrogen receptor was assessed by radio-ligand binding assay method. Free and total prolactin receptors were also measured using iodinated prolactin (125I-PRL). Magnesium chloride solution (3.5 M) was used to assay the total prolactin receptor.ResultsEighty five percent of tumor samples were ductal tubular carcinoma. In 62.5%, 45% and 62.5% of tumor samples ER, free PRLR and total PRLR were observed respectively. Forty Five percent of the tumor cells expressed both ER and total PRLR. A positive significant relation between ER and free PRLR was observed (p<0.05). There was also a significant relation (p<0.05) between ER and total PRLR. Twenty Percent of tumor cells expressed neither ER nor total PRLR.ConclusionSince the existence of estrogen and prolactin receptors in breast tumor cells have been shown, application of antiestrogenic and antiprolactin drugs in the inhibition of these tumors growth are possibly of value.Keywords: Breast Cancer, Estrogen Receptor, Prolactin Receptor, Hormone Therapy} -
مقدمهدر مسیر خارجی انعقاد یا مسیر وابسته به فاکتور بافتی، کمپلکسی بین فاکتور VII، کلسیم و فاکتور بافتی که یک لیپوپروتئین در غشاء سلولی است و پس از آسیب سلولی در معرض تماس قرار می گیرد، تشکیل می شود. فاکتور VII برای فعالیت بیولوژیک خود نیاز به کلسیم و ویتامین K دارد. افزایش سطح سرمی و فعالیت فاکتورهای انعقادی VII، VIII وIX، باعث پیدایش بیماری های عروق کرونر می شود. استروژن بعد از یائسگی با اصلاح چربی های خون، خطر ابتلا به بیماری های عروق کرونر را کاهش می دهد. اما اثر استروژن بر سایر عوامل زمینه ساز استعداد به بیماری عروق کرونر از جمله سیستم انعقادی به خوبی شناخته نشده است. هدف این مطالعه بررسی اثر رژیم های هورمون درمانی خوراکی بر فیبرینوژن و فاکتورهای انعقادی می باشد.روش ها60 زن منوپوز هسیتوکتومی شده بطور تصادفی در دو گروه قرار گرفتند. در یک گروه استروژن کونژوگه mg/d625/0 و در گروه دیگر استروژن کونژوگه 0.625 mg/d و 2.5 mg/d مدروکسی پروژسترون دریافت نمودند. قبل و سه ماه پس از هورمون درمانی، سطح سرمی فیبرینوژن، فعالیت فاکتورهای انعقادی VII، VIII و IX و سطح سرمی چربی های خون اندازه گیری شد.یافته هادر گروهی که استروژن دریافت نمودند، میانگین فعالیت فاکتور VII، سه ماه پس از هورمون درمانی، افزایش معنی داری نسبت به قبل از هورمون درمانی پیدا نمود (P<0.05). میانگین فعالیت فاکتورهای انعقادی VIII و IX و میانگین سطح سرمی فیبرینوژن قبل و سه ماه پس از هورمون درمانی، با استروژن ± مدروکسی پروژسترون تفاوت معنی داری نداشت (p>0.000)، اما میزان تری گلیسرید در گروه استروژن بدون پروژسترون افزایش پیدا کرد.نتیجه گیریافزایش معنی دار فعالیت فاکتور VII با افزایش معنی دار تری گلیسرید سرم در دریافت کنندگان استروژن در این مطالعه قابل توجیه است. این مطالعه نشان می دهد که هورمون درمانی با روش به کار برده شده تغییر معنی داری در میانگین فیبرینوژن سرم و فعالیت فاکتور VIII و IX ایجاد نمی کند. این یافته ممکن است، به طور واقعی یا ناشی از محدود بودن تعداد نمونه ها با توجه به وسیع بودن محدوده طبیعی فعالیت فاکتورهای انعقادی و فیبرینوژن سرم باشد که با انجام مطالعات طولانی تر و با تعداد نمونه بیشتر قابل بررسی می باشد.
کلید واژگان: فاکتورهای انعقادی خون, هورمون درمانی, فاکتور VII, فاکتور VIII, فاکتور IX فیبرینوژن سرم}BackgroundDuring extrinsic coagulation pathway, a complex is developed between factor VII, calcium and tissue factor (a cell membrane lipoprotein that is exposed after cell injury). Factor VII needs calcium and vitamin K for its biologic activation. Coronary artery disease can be induced by increased level and activity of the coagulation factors VII, VIII and IX. In postmenopausal period, estrogen can decrease blood lipids and thereby decreases risk of coronary artery disease. However, the exact effects of the estrogen on the other predisposing factors of the coronary artery diseases are unknown. Our objective in this study was to evaluate the effects of oral hormone therapy regimen on fibrinogen and other coagulation factors.Methods60 menopause women with history of hysterectomy were randomly allocated in 2 groups. One group was treated with conjugated estrogen 0.625mg/day and the other group was treated with conjugated estrogen 0.625mg/day and medroxy progesterone 2.5mg/day. Serum fibrinogen level and activity of coagulation factors VII, VIII and IX and blood lipids level were checked before and 3 months after treatment.ResultsIn the estrogen alone treated group, mean of factor VII activity showed significant elevation 3 months after treatment as compared with prior to hormone therapy(p<0.05). There were no significant changes in means of coagulation factors VIII, IX activities and serum fibrinogen level in estrogen medroxy progesterone treated patients before and after treatment (p>0.05). In both groups, honi1one therapy significantly decreased serum cholesterol level and LDL-C and increased HDL-C (p>0.00) but the serum triglyceride level was increased in the estrogen alone treated group.ConclusionSignificant elevation of coagulation factors VII with significant elevation of serum triglyceride in estrogen treated patients is explainable. This study confirms that hormone therapy with this protocol does not change serum fibrinogen mean and activity of coagulation factor VIII and IX. This finding may be real or may be related to inadequacy of samples regarding the wide normal range of coagulation factors and serum fibrinogen. Studies with more prolonged follow-up or more samples are suggested.Keywords: Blood coagulation factors, Hormone Therapy, Factor VII, Factor VIII, Factor IX, Serum fibrinogen} -
COMPARING EFFICACY OF TWO DIFFERENT HORMONAL THERAPY REGIMEN ON ACTIVITY OF COAGULATION FACTORS VII, VIII, IX AND SERUM LIPIDS IN MENOPAUSED WOMENBackgroundDuring extrinsic coagulation pathway, a complex is developed between factor VII, calcium and tissue factor (a cell membrane lipoprotein that is exposed after cell injury). Factor VII needs calcium and vitamin K for its biologic activation. Coronary artery disease can be induced by increased level and activity of the coagulation factors VII, VIII and IX. In postmenopausal period, estrogen can decrease blood lipids and thereby decreases risk of coronary artery disease. However, the exact effects of the estrogen on the other predisposing factors of the coronary artery diseases are unknown. Our objective in this study was to evaluate the effects of oral hormone therapy regimen on fibrinogen and other coagulation factors.Methods60 menopause women with history of hysterectomy were randomly allocated in 2 groups. One group was treated with conjugated estrogen 0.625mg/day and the other group was treated with conjugated estrogen 0.625mg/day and medroxy progesterone 2.5mg/day. Serum fibrinogen level and activity of coagulation factors VII, VIII and IX and blood lipids level were checked before and 3 months after treatment.ResultsIn the estrogen alone treated group, mean of factor VII activity showed significant elevation 3 months after treatment as compared with prior to hormone therapy(p0.05). In both groups, honi1one therapy significantly decreased serum cholesterol level and LDL-C and increased HDL-C (p>0.00) but the serum triglyceride level was increased in the estrogen alone treated group.ConclusionSignificant elevation of coagulation factors VII with significant elevation of serum triglyceride in estrogen treated patients is explainable. This study confirms that hormone therapy with this protocol does not change serum fibrinogen mean and activity of coagulation factor VIII and IX. This finding may be real or may be related to inadequacy of samples regarding the wide normal range of coagulation factors and serum fibrinogen. Studies with more prolonged follow-up or more samples are suggested.Keywords: Blood coagulation factors, Hormone Therapy, Factor VII, Factor VIII, Factor IX, Serum fibrinogen}
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