Does Hypothyroidism Affect Gastrointestinal Motility?

Background. Gastrointestinal motility and serum thyroid hormone levels are closely related. Our aim was to analyze whether there is a disorder in esophagogastric motor functions as a result of hypothyroidism. Materials and Methods. The study group included 30 females (mean age ± SE 45.17 ± 2.07 years) with primary hypothyroidism and 10 healthy females (mean age ± SE 39.40 ± 3.95 years). All cases underwent esophagogastric endoscopy and scintigraphy. For esophageal scintigraphy, dynamic imaging of esophagus motility protocol, and for gastric emptying scintigraphy, anterior static gastric images were acquired. Results. The mean esophageal transit time (52.56 ± 4.07 sec for patients; 24.30 ± 5.88 sec for controls; P = .02) and gastric emptying time (49.06 ± 4.29 min for the hypothyroid group; 30.4 ± 4.74 min for the control group; P = .01) were markedly increased in cases of hypothyroidism. Conclusion. Hypothyroidism prominently reduces esophageal and gastric motor activity and can cause gastrointestinal dysfunction

Triglyceride-glucose index levels in patients with congenital hypogonadotropic hypogonadism and the relationship with endothelial dysfunction and insulin resistance

Introduction: The risk of cardiometabolic diseases is increased in patients with hypogonadism. The triglyceride-glucose (TyG) index is a novel surrogate marker of insulin resistance and is associated with cardiovascular diseases. We investigated the TyG index levels and the relationship with endothelial dysfunction and insulin resistance in patients with congenital hypogonadotropic hypogonadism (CHH). Material and methods: A total of 98 patients with CHH (mean age 21.66 ± 1.99 years) and 98 healthy control subjects (mean age 21.69 ± 1.21 years) were enrolled. The demographic parameters, TyG index, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. Results: The patients had higher waist circumference (p < 0.001), triglycerides (p = 0.001), insulin (p = 0.003), HOMA-IR (p = 0.002), ADMA (p < 0.001), and TyG index (p < 0.001) levels and lower HDL-C (p = 0.044) and total testosterone (p < 0.001) levels compared to healthy control subjects. TyG index levels significantly correlated with the ADMA (r = 0.31, p = 0.003) and HOMA-IR (r = 0.32, p < 0.001) levels. TyG index was also determinant of HOMA-IR levels (ß = 0.20, p = 0.018). Conclusion: The results of the present study show that patients with CHH had increased TyG index levels. Also, the TyG index is independently associated with insulin resistance in patients with CHH. Long-term follow-up studies are warranted to find out the role of the TyG index in determining cardiometabolic risk in patients with hypogonadism.

Care after premenopausal risk-reducing salpingo-oophorectomy in high-risk women: Scoping review and international consensus recommendations

Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease

Use of Oral Bisphosphonates by Older Adults with Fractures and Impaired Renal Function

ABSTRACTBackground: The manufacturers of oral bisphosphonates (alendronate, risedronate) recommend avoiding use of these drugs in patients with renal impairment. However, many patients who have osteoporosis or who are at risk of fracture are elderly and may have renal impairment. This situation poses a quandary for clinicians in deciding how best to manage osteoporosis in this high-risk population.Objective: To synthesize published evidence regarding the use and safety of oral bisphosphonates for patients with impaired renal function.Methods: The following databases were searched up to October 2010: PubMed, MEDLINE, Embase, the Cochrane Library, and International Pharmaceutical Abstracts. The following key words and terms were used for the searches: bisphosphonates, alendronate, risedronate, Fosamax, Actonel, "renal failure", "renal insufficiency", "chronic kidney disease", and "end-stage renal disease". The manufacturers of Fosamax and Actonel were asked to provide information about use of their products in patients with renal impairment, including unpublished pharmaco - kinetic studies or reports of adverse drug events.Results: The search yielded 2 post hoc analyses of safety data, 1 case-control study, 1 case series, 4 retrospective chart analyses, and 2 prospective studies. According to these publications, numerous patients with decreased renal function have received bisphosphonates and have experienced improvement in bone mineral density and/or reduction in risk of fractures, with no increase in adverse effects. Increased renal damage occurred in some individuals with underlying renal disorders, as described in case reports.Conclusions: Although the literature is limited, there is evidence that alendronate and risedronate are well tolerated and effective when used by individuals with renal impairment. Further research is required to confirm the benefits and risks of using these medications in patients with renal impairment.RÉSUMÉContexte : Les fabricants de bisphosphonates oraux (alendronate, risédronate) recommandent d'éviter l'emploi de ces médicaments chez les patients souffrant d'insuffisance rénale. Cependant, de nombreux patients souffrant d'ostéoporose ou qui sont à risque de fracture sont des personnes âgées qui pourraient souffrir d'insuffisance rénale. Cette situation est un véritable dilemme pour les cliniciens qui doivent décider de la meilleure conduite à tenir pour traiter l'ostéoporose chez cette population à risque élevé.Objectif : Mettre en lumière les données probantes publiées sur l'emploi et l'innocuité des bisphosphonates oraux chez les patients souffrant d'insuffisance rénale.Méthodes : Les bases de données suivantes ont été examinées : PubMed, MEDLINE, Embase, Bibliothèque Cochrane et International Pharmaceutical Abstracts. Les mots clés et termes suivants ont été utilisés pour les recherches : bisphosphonates, alendronate, risédronate, Actonel, Fosamax, « insuffisance rénale », « maladie rénale chronique » et « insuffisance rénale terminale ». Les recherches dans les bases de données ont été faites jusqu'en octobre 2010. On a demandé aux fabricants d'Actonel et de Fosamax de fournir de l'information sur l'utilisation de leurs produits chez les patients atteints d'insuffisance rénale, y compris les résultats d'études pharmacocinétiques inédites ou les rapports d'événements indésirables liés aux médicaments.Résultats : La recherche a révélé deux analyses a posteriori de données sur l'innocuité, une étude cas-témoin, une série de cas, quatre analyses rétrospectives de dossiers médicaux et deux études prospectives. D'après ces documents, de nombreux patients atteints d'insuffisance rénale ont reçu des bisphosphonates et présenté un accroissement de leur densité minérale osseuse ou une réduction du risque de fractures, sans augmentation des effets indésirables. On a observé une augmentation des lésions rénales chez certains patients présentant des troubles rénaux sous-jacents, comme décrit dans plusieurs observations cliniques.Conclusions : Bien que la documentation soit limitée, des données probantes montrent que l'alendronate et le risédronate sont bien tolérés et efficaces dans les cas d'insuffisance rénale. Des recherches plus approfondies sont nécessaires pour confirmer les bienfaits et les risques de ces médicaments chez les personnes souffrant d'insuffisance rénale

Cannabis use for menopause in women aged 35 and over: a cross-sectional survey on usage patterns and perceptions in Alberta, Canada

Objective Use of cannabis for medical reasons has increased in Canada since legalisation of recreational cannabis in 2018. The objective of this study was to examine the pattern of use and perceptions about cannabis for menopause in women aged 35 and over in Alberta, Canada.Design Cross-sectional, web-based survey.Setting Online (location of participant residence in Alberta, Canada).Participants Self-selected sample of women recruited through social media (Facebook, Instagram, Twitter) between October and December 2020. Inclusion criteria included: identified as woman, ages 35 and over, living in Alberta, Canada.Primary and secondary outcomes measures Self-reported data were collected on demographics, menopause status and symptoms, cannabis usage and how participants perceived cannabis. Descriptive statistics, comparative analysis and logistic regression explored relations in cannabis use and participant characteristics.Results Of 1761 responses collected, 1485 were included for analysis. Median age was 49 years; 35% were postmenopausal and 33% perimenopausal. Among analysed responses, 499 (34%) women reported currently using cannabis and 978 (66%) indicated ever using cannabis. Of the 499 current cannabis users, over 75% were using cannabis for medical purposes. Most common reasons for current use were sleep (65%), anxiety (45%) and muscle/joint achiness (33%). In current users, 74% indicated that cannabis was helpful for symptoms. Current cannabis users were more likely to report experiencing menopause symptoms compared with non-users. History of smoking and general health status were associated with current cannabis use.Conclusions Some women are using cannabis for symptoms related to menopause. Further research is required to assess safety and efficacy of cannabis for managing menopause and develop clinical resources for women on cannabis and menopause