Aromatase inhibitors in post-menopausal endometriosis

Postmenopausal endometriosis is a rare clinical condition. The diagnosis and treatment of an endometriotic lesion in postmenopausal women is complicated. First line treatment choice should be surgical, given that there is a potential risk of malignancy. Medical treatment may be considered as second line or as an alternate first line treatment whenever surgery is contradicted and aims to alter the hormonal pathway leading to endometriosis progress. Different hormonal regimens have been administered to these patients, with conflicting however results. Aromatase inhibitors (AIs) represent one of the most recently used drugs for postmenopausal endometriosis. Clinical data for the use of (AIs) in postmenopausal patients is scarce. Up to date only 5 case reports are available regarding the use of these agents in postmenopausal women. Although definite conclusions may be premature, AIs appear to considerably improve patients' symptoms and reduce endometriotic lesions size. Nonetheless the subsequent induced reduction in estrogen production, leads to certain short-term and long-term adverse effects. Despite the limited available data, AIs appear to represent a new promising method which may improve symptoms and treat these patients, either as first line treatment, when surgery is contraindicated or as a second line for recurrences following surgical treatment. However, careful monitoring of patients' risk profile and further research regarding long-term effects and side-effects of these agents is essential prior implementing them in everyday clinical practice

Presence of Hypertension Is Reduced by Mediterranean Diet Adherence in All Individuals with a More Pronounced Effect in the Obese: The Hellenic National Nutrition and Health Survey (HNNHS)

Hypertension is a major risk of cardiovascular diseases. This study's aim was to examine associations between hypertension and a priori known lifestyle risk factors, including weight status and Mediterranean diet adherence. The study included a representative sample of the adult population (N = 3775 (40.8% males)), from the Hellenic National Nutrition and Health Survey (HNNHS), which took place from September 2013 to May 2015. Demographic and anthropometric data were collected using validated questionnaires, and blood pressure (BP) measurements were performed for the two main metropolitan areas (N = 1040; 41.1%). Hypertension diagnosis was according to the International Classification of Diseases (ICD-10) guidelines. Weighted proportions, extended Mantel-Haenszel (M-H) analyses, and multiple logistic regressions (for the survey data) were performed. Mean systolic BP (SBP) and diastolic BP (DBP) were 118.6 mmHg and 72.2 mmHg respectively, with both values being higher in males compared to females in all age groups (p < 0.001). Study participants with hyperlipidemia or diabetes, and those overweight, were almost twice as likely to be hypertensives, with the odds increasing to 4 for those obese (p for all, < 0.05). Stricter Mediterranean diet adherence significantly decreased the likelihood of hypertension by 36% (OR: 0.64; 95% CI: 0.439, 0.943), and a significant interaction was found between Mediterranean diet adherence and weight status on hypertension. The presence of hypertension is clustered with comorbidities, but is significantly associated with modifiable risk factors, including Mediterranean diet and weight status, underlining the need for personalized medical nutritional treatment

Steroid receptor expression in human endometrium during the follicular phase of stimulated cycles

The biological role of endometrium is to provide an environment for the implantation and development of the embryo. In order to achieve this task, endometrium undergoes regular cyclic changes. It is well known, that these changes are regulated by ovarian steroids through their direct action on their endometrial receptors. The low implantation rate following ovarian stimulation has led to the hypothesis that decreased endometrial receptivity might be responsible for the high implantation failure in IVF. Most studies in stimulated cycles focus on luteal phase. Up to date there is limited information available in the literature about the status of endometrial steroid receptors in the follicular phase of patients undergoing stimulation. In 31 patients (age <39 years) stimulated with gonadotrophins and GnRH antagonists for intrauterine insemination (IUI) an endometrialbiopsy was performed on the first day after the end of menstruation and a second biopsy was performed two (Group 0 + 2, n = 10) or four (Group 0 + 4, n = 11) days after the first biopsy, or on the day of hCG administration (Group 0 + hCG, n = 10). Expression of progesterone (PR) and estrogen (ER) receptor was investigated by immunohistochemistry using monoclonal antibodies. The results of the current study shows that PR and ER levels were significantly increased in the second versus the first biopsy, in all groups analyzed (P = 0.01), in both stromal and glandular cells. Between the three groups compared, a significant increase in PR expression was observed for glandular cells (P = 0.03), with the highest value observed in Group 0 + 4. Moreover, the increase in PR expression in stromal cells differed between groups (P = 0.01), with the highest value observed in the Group 0 + hCG. In conclusion, in stimulated cycles for IUI, ER expression in both glandular and stromal endometrial cells, after an initial increase, does not appear to change significantly during the follicular phase. On the contrary, during the same period of time, following an initial rise, PR expression in glandular and stromal cells continues to increase.Ο βιολογικός ρόλος του ενδομητρίου είναι να παρέχει ένα φιλικό περιβάλλον για την εμφύτευση και ανάπτυξη του εμβρύου. Για να επιτευχθεί αυτό, το ενδομήτριο υποβάλλεται σε τακτικές κυκλικές αλλαγές. Είναι γνωστό, ότι οι μεταβολές αυτές ρυθμίζονται από τις στεροειδείς ορμόνες μέσω της άμεσης δράσης τους στους ενδομήτριους υποδοχείς τους. Το χαμηλό ποσοστό εμφύτευσης μετά τη διέγερση των ωοθηκών έχει οδηγήσει στην υπόθεση ότι η μείωση του ενδομήτριας δεκτικότητας μπορεί να ευθύνονται για την υψηλή αποτυχία εμφύτευσης στην εξωσωματική γονιμοποίηση. Οι περισσότερες μελέτες σε κύκλους διέγερσης αφορούν στην ωχρινική φάση. Μέχρι σήμερα υπάρχουν περιορισμένες διαθέσιμες πληροφορίες στη βιβλιογραφία σχετικά με τους ενδομήτριους ορμονικούς υποδοχείς στην ωοθυλακική φάση των ασθενών που υποβάλλονται σε διέγερση. Σε 31 ασθενείς (ηλικίας <39 ετών) οι οποίες δέχθηκαν διέγερση με rec FSH και GnRH ανταγωνιστές για ενδομήτρια σπερματέγχυση υποβλήθηκαν σε ενδομήτρια βιοψία την πρώτη ημέρα μετά το τέλος της εμμήνου ρύσεως και μια δεύτερη βιοψία σε δύο (Ομάδα 0 + 2, n = 10) ή τέσσερις (Ομάδα 0 + 4, n = 11) ημέρες μετά την πρώτη βιοψία, ή την ημέρα της χορήγησης της hCG (Ομάδα 0 + hCG, n = 10). Η Έκφραση των υποδοχέων της προγεστερόνης (PR) και των οιστρογόνων (ER) μελετήθηκε με ανοσοϊστοχημεία χρησιμοποιώντας μονοκλωνικά αντισώματα. Τα αποτελέσματα της τρέχουσας μελέτη δείχνουν ότι τα επίπεδα των ER αυξήθηκαν σημαντικά κατά τη δεύτερη σε σχέση με την πρώτη βιοψία, σε όλες τις ομάδες που αναλύθηκαν (P = 0,01), και στα στρωματικά και στα αδενικά κύτταρα. Μεταξύ των τριών ομάδων, μια σημαντική αύξηση στην έκφραση των PR παρατηρήθηκε για τα αδενικά κύτταρα (P = 0,03), με την υψηλότερη τιμή στην ομάδα 0 + 4. Επιπλέον, η αύξηση στην έκφραση των PR στα στρωματικά κύτταρα διέφερε μεταξύ των ομάδων (P = 0,01), με την υψηλότερη τιμή στην Ομάδα 0 + hCG. Συμπερασματικά, σε κύκλους διέγερσης για ενδομήτρια σπερματέγχυση, η έκφραση των ER στα αδενικά και στρωματικά κύτταρα του ενδομητρίου, μετά από μια αρχική αύξηση, δεν φαίνεται να μεταβάλλονται σημαντικά κατά τη διάρκεια της ωοθυλακικής φάσης. Αντιθέτως, κατά την ίδια χρονική περίοδο, μετά από μια αρχική αύξηση, η έκφραση των PR στα αδενικά και στρωματικά κύτταρα συνεχίζει να αυξάνεται

Bin Weather Data for HVAC Systems Energy Calculations

The increase in global air temperature is well documented, as during the last several years each decade has been consecutively warmer than the preceding. As climatic conditions affect the energy performance of buildings, the changes in outdoor air temperature and humidity will inevitably lead to significant alterations in energy consumption and costs for the heating, ventilating and air conditioning (HVAC) of buildings. The availability and quality of climatic data play an important role in the accuracy of energy analysis results. In this study, the hourly temperature and relative humidity of outdoor air measurements, for a period of three decades (1983–2012), recorded at the climatic station of the National Observatory of Athens were processed, and an up-to-date set of specific data for the application of bin methods was produced and presented. The data were then used to calculate changes in the energy demands in a typical office building throughout the specified period. Results showed a progressive reduction in the low and increase in the high temperature intervals, leading to an increase in the building’s annual energy requirements for air conditioning of up to 14.5% from the first to the third decade, with decrease in the energy demands for heating and increase in the energy demands for cooling

Vaginal progesterone supplementation has no effect on ongoing pregnancy rate in hCG-induced natural frozen-thawed embryo transfer cycles

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