Modification of blood pressure in postmenopausal women: role of hormone replacement therapy

The rate of hypertension increases after menopause. Whether estrogen and progesterone deficiency associated with menopause play a role in determining a worst blood pressure (BP) control is still controversial. Also, studies dealing with the administration of estrogens or hormone therapy (HT) have reported conflicting evidence. In general it seems that, despite some negative data on subgroups of later postmenopausal women obtained with oral estrogens, in particular conjugated equine estrogens (CEE), most of the data indicate neutral or beneficial effects of estrogen or HT administration on BP control of both normotensive and hypertensive women. Data obtained with ambulatory BP monitoring and with transdermal estrogens are more convincing and concordant in defining positive effect on BP control of both normotensive and hypertensive postmenopausal women. Overall progestin adjunct does not hamper the effect of estrogens. Among progestins, drospirenone, a spironolactone-derived molecule, appears to be the molecule with the best antihypertensive properties

Efficacy, safety, and patient acceptability of thecombined chlormadinone acetate-ethinylestradioloral contraceptive

Since their introduction in 1959, development of hormonal contraceptives has beenongoing, with the ultimate aim of creating not only an effective and safe contraceptive method,but also a drug able to meet the need for treatment of other conditions, such as acne, seborrhea,and hirsutism, with few or no side effects. With this objective, a new progestin, chlormadinoneacetate (CMA), has been developed as a derivative of progesterone for contraception.Thisnew molecule has been introduced in combination with ethinylestradiol (EE) 30 μg as a safecontraceptivewith antiandrogenic properties. Many clinical studies have investigated this neworal combination and found it to be safe, with a Pearl Index similar to that of other combinedhormonal contraceptives. CMA, because of its antiandrogenic properties, has been also consideredeffective for resolution of acne, seborrhea, and hirsutism. The data show it to be asafe molecule in terms of glucose and lipid metabolism. No major weight changes have beenlinked with its use, and it seems to be the only progestin able to reduce fat mass during use.The CMA-EE combination is well tolerated and acceptable to women. Adverse events relatedto its use are similar to those reported with other third-generation contraceptives.We canconclude that CMA-EE is an effective, safe, and well tolerated antiandrogenichormonalcontraceptive

Efficacy, safety, and patient acceptability of thecombined chlormadinone acetate-ethinylestradioloral contraceptive

Since their introduction in 1959, development of hormonal contraceptives has beenongoing, with the ultimate aim of creating not only an effective and safe contraceptive method,but also a drug able to meet the need for treatment of other conditions, such as acne, seborrhea,and hirsutism, with few or no side effects. With this objective, a new progestin, chlormadinoneacetate (CMA), has been developed as a derivative of progesterone for contraception.Thisnew molecule has been introduced in combination with ethinylestradiol (EE) 30 \u3bcg as a safecontraceptivewith antiandrogenic properties. Many clinical studies have investigated this neworal combination and found it to be safe, with a Pearl Index similar to that of other combinedhormonal contraceptives. CMA, because of its antiandrogenic properties, has been also consideredeffective for resolution of acne, seborrhea, and hirsutism. The data show it to be asafe molecule in terms of glucose and lipid metabolism. No major weight changes have beenlinked with its use, and it seems to be the only progestin able to reduce fat mass during use.The CMA-EE combination is well tolerated and acceptable to women. Adverse events relatedto its use are similar to those reported with other third-generation contraceptives.We canconclude that CMA-EE is an effective, safe, and well tolerated antiandrogenichormonalcontraceptive

Folati ed osteoporosi

Esistono varie evidenze che sembrano legare folati ed osteoporosi. I folati sono una serie di composti vitaminici del gruppo della vitamina B che sono necessari quali donatori di metile per la trasformazione dell’omocisteina in metionina. Studi osservazionali hanno evidenziato che individui con deficit genetici nel metabolismo dell’omocisteina hanno un maggior rischio di sviluppare osteoporosi e frattura. Ugualmente studi osservazionali hanno evidenziato che elevati livelli di omocisteina si associano ad un maggior rischio di frattura. La presenza di folati è necessaria per la riduzione dei livelli di omocisteina. Gli studi che hanno considerato oltre che i livelli di omocisteina anche i livelli di folati hanno evidenziato come i bassi livelli di folati rappresentino un fattore di rischio maggiore rispetto ai livelli di omocisteina per bassi valori di massa ossea, per la velocità di perdita di massa ossea e per fratture osteoporotiche. I folati sembrano pertanto agire nella prevenzione dell’osteoporosi attraverso meccanismi che sono solo in parte mediati dalla loro capacità di ridurre i livelli di omocisteina. La supplemetazione con folati in individui con precedente ictus ha ridotto il numero successivo di fratture. Ulteriori studi sono necessari per meglio definire quale sia l’effettivo ruolo dei folati nella fisiologia dell’osso e come la supplementazione con folati si collochi tra le stategie preventive della perdita di massa ossea

Folati. Implicazioni nella patogenesi e nella prevenzione dei disturbi dell'invecchiamento della donna

.

Seasonal trend of acute pelvic inflammatory disease

Purpose Many infections follow a seasonal trend. Aim of our study was to check whether acute pelvic inflammatory disease (PID) follows a seasonal progress. Methods In a retrospective study on 12,152 hospital records, 158 cases of acute pelvic inflammatory disease were identified. Periodogram analysis was applied to the date of pelvic inflammatory disease admission and to related envi- ronmental factors, such as temperature and photoperiod. Results Pelvic inflammatory disease follows a seasonal rhythm with mean to peak variation of 23 % and maximal values in September (\ub137.2 days). The rhythm, more evident in married women, is related to the rhythm of temperature advanced by 2 months and of photoperiod advanced by 3 months. Cases of pelvic inflammatory disease are more frequent than expected in unmarried (36 vs. 17.3/34,626, p = 0.015), particularly divorced women 30\u201340 years of age. Conclusions Our study evidences a seasonal trend and confirms unmarried, particularly divorced status, as important risk factor for acute pelvic inflammatory disease