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Journal Article 2015; 36(5): 401-406 PubMed PMID: 26707036 Citation  Keywords:  Bone Density Conservation Agents:therapeutic use, Estrogen Replacement Therapy:methods, Female, Humans, Jaw:metabolism, Male, Osteoporosis:drug therapy, Osteoporosis, Postmenopausal:drug therapy, Periodontitis:epidemiology,.   

: Today's knowledge and studies show a firm correlation between osteoporosis and periodontitis, particularly in postmenopausal women. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and an osteoporosis. A special emphasis is put on explanation of possible relations between a premature tooth loss and decrease of length and density of jaw bones, particularly their alveolar prolongations. The second part of the paper deals with principles of treatment in patients suffering of osteoporosis. Osteoporosis reduces density of jaw bones and decreases a number of teeth in jaws, but it does not affect other clinical signs and markers of periodontitis such as inflammation, bleeding and the depth of periodontal pockets and microbial plaque....

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Journal Article 2013; 34(7): 635-642 PubMed PMID: 24464001 Citation  Keywords:  Aged, Apolipoprotein E2:genetics, Apolipoprotein E4:genetics, Cognition:drug effects, Cognition Disorders:epidemiology, Dementia:epidemiology, Estrogen Replacement Therapy:methods, Female, Humans, Middle Aged, Polymorphism, Genetic, Postmenopause:drug eff.   

OBJECTIVE: The results of many studies revealed that estrogen plus progestogen therapy (EPT) may modify dementia development risk in relation to the apolipoprotein E gene (APOE) polymorphisms. However, the mechanism and subsequently clinical importance of such an effect are still unexplained. The objective of this study was to explore the influence of EPT on cognitive functioning of women in their postmenopausal life in relation to APOE polymorphism.

METHODS: The group of 214 women was recruited (106 out of this group with EPT) to the study. The inclusion criteria were: minimum two years after the last menstruation, FSH concentration over 30 U/ml and no dementia signs on Montreal Cognitive Assessment (MoCA). Computerized battery of Central Nervous System Vital Signs (CNS VS) test was used to diagnostic cognitive functions. APOE genotype was performed by multiplex PCR. Statistical analysis was performed using two-way analysis of variance in STATISTICA software.

RESULTS & CONCLUSION: The women after menopause have reduced neurocognitive index (NCI) and cognitive functions. NCI and all studied cognitive functions of the patients depended significantly on APOE polymorphisms. The presence of APOE4 corresponded with decreased cognitive functions as opposed to APOE2 which was present in women with better level of cognitive functions. Constantly using EPT correlated with three cognitive functions: memory, verbal memory and processing speed, which were significantly worse for women taking EPT than not taking ones. The interaction between APOE polymorphisms and EPT application was significant only for processing speed. EPT applying women with ε2/ε3 and ε4 obtained better scores in processing speed than women not taking EPT with these APOE polymorphisms. The opposite situation concerned women with ε3/ε3, women taking EPT achieved worse processing scores in comparison with those not taking EPT. It should be noted that APOE polymorphism assessment may be a factor in predicting the effect of EPT on cognitive functioning in postmenopausal period....

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Journal Article 2012; 33(Suppl 2): 17-21 PubMed PMID: 23183504 Citation  Keywords:  Aged, Climacteric, Coronary Disease:epidemiology, Estrogen Replacement Therapy:statistics & numerical data, Estrogens:administration & dosage, Female, Humans, Middle Aged, Progestins:administration & dosage, Risk Factors, Time Factors,.   

: The aim of this work is to give summary of changes in recommendation for hormone replacement therapy (HT) and cardiovascular prevention during last decade. Conclusions from observational studies demonstrated a positive effect of HT in both the primary and secondary prevention of coronary heart disease (CHD). But large randomized trials failed to prove this positive effect; on the contrary, the cardiovascular risk was increased in the beginning of therapy. But estrogen arm of Women's Health Initiative (WHI) show neutral influence and the Estrogen in the Prevention of Atherosclerosis Trial (EPAT) indicate possible positive effects of some HT regimens. Also reanalysis of WHI in age-related groups show the window of opportunity. The prevention of CHD was excluded from possible indications of HT. Many questions regarding optimal choice in the individual treatment strategies have been raised. HT in its individualized form remains the first choice therapy for the acute climacteric syndrome, for the prevention and the therapy of urogenital atrophy and prevention of osteoporosis. Early start of HT has neutral or slightly positive effect on cardiovascular prevention....

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Clinical Trial 2010; 31(1): 161-167 PubMed PMID: 20150864 Citation  Keywords:  Adult, Brain Mapping:methods, Cerebral Cortex:metabolism, Cystine:analogs & derivatives, Estrogen Replacement Therapy, Female, Humans, Hypothyroidism:diagnosis, Male, Neuropsychological Tests, Prognosis, Severity of Illness Index, Technetium:chemistry, Th.   

OBJECTIVE: The purpose of this study was to correlate hypothyroid-related symptomatology with regional cerebral blood flow (rCBF) during hypothyroidism.

MATERIALS AND METHODS: Nine thyroidectomized patients underwent neuropsychological testing and single photon emission computed tomography (SPECT) of their brains with technetium-99m (Tc-99m) ethyl cysteinate dimer (ECD), a lipophilic cerebral blood flow radiotracer, while hypothyroid, and again following thyroid hormone replacement. Neuropsychological test scores and TSH levels while hypothyroid were correlated with rCBF in hypothyroid-affected areas of the brain.

RESULTS: Correlations were found during hypothyroidism between the noted parameters and ECD radiotracer accumulation in the following respective regions, all of which demonstrated hypothyroid-related cerebral blood flow (CBF) aberrations: TSH and left middle occipital gyrus; psychomotor performance speed and left precentral gyrus; and depression and right middle frontal gyrus, left middle frontal gyrus, right insula, and left thalamus.

CONCLUSIONS: Severity of psychomotor impairment and depression, and TSH level during hypothyroidism appeared to correlate with CBF to brain regions associated with motor activity, mood and vision, respectively; and previously shown to manifest significantly altered rCBF during hypothyroidism....

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Comparative Study 2007; 28(4): 496-501 PubMed PMID: 17693976 Citation  Keywords:  Administration, Oral, Administration, Topical, Adult, Capillaries:drug effects, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Cross-Over Studies, Estradiol:administration & dosage, Estrogen Replacement Therapy:methods, Estrogens:administration & dosage,.   

OBJECTIVES: The aim of the study was to evaluate skin microvascular reactivity (MVR) measured by laser Doppler flowmetry in women early after bilateral ovarectomy treated with oral and transdermal estrogen replacement therapy (ERT).

DESIGN: Interventional, randomized study with a cross-over design.

PATIENTS AND METHODS: 41 patients (49+/-6 years, 6-12 weeks after surgical castration) were treated with 17-beta-estradiol transdermally (0.05 mg/day) or orally (2 mg/day) for three months and 20 healthy female subjects (47+/-5 years) served as controls.

RESULTS: Records of laser Doppler flowmetry were blinded prior to the evaluation. Maximal perfusion and velocity of perfusion increase during post-occlusive reactive hyperemia (PORH) were lower before ERT comparing to controls at baseline (36+/-16 vs. 48+/-18 PU, p<0.05, and 2.8+/-1.9 vs. 4.2+/-2.3 PU, p<0.05, respectively). Velocity of perfusion increase in PORH decreased after oral ERT compared to baseline and also to transdermal ERT (2.1+/-1.2 vs. 2.8+/-1.9 PU.s-1, p<0.05, and vs. 3.5+/-3.2 PU.s-1, p<0.01, respectively), nonsignificant increase of this parameter after transdermal ERT led to normalization when comparing to control group (3.6+/-3.2 vs. 4.2+/-2.3 PU.s-1, NS). Increase of HDL-cholesterol and decrease of LDL-cholesterol (2.1+/-0.4 vs. 1.8+/-0.4 mmol.l-1, p<0.01, and 2.5+/-0.7 vs. 3.1+/-1.0 mmol.l-1, p<0.01) was observed after oral ERT while HDL-cholesterol increase after transdermal ERT was less pronounced (1.96+/-0.42 mmol.l-1, p<0.05). LDL-cholesterol levels did not change. A correlation between HDL-cholesterol and maximal post-occlusive flow expressed in % of basal perfusion was observed in patients before treatment (r=0.47, p=0.002).

CONCLUSIONS: Microvascular reactivity is impaired in women early after bilateral ovarectomy. No statistically significant improvement of MVR was observed after oral estrogen replacement therapy, normalization of MVR after transdermal ERT was only partial. Changes of MVR and lipid profile differed between oral and transdermal routes of estrogen replacement therapy....

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Journal Article 2006; 27(5): 665-668 PubMed PMID: 17159824 Citation  Keywords:  Administration, Cutaneous, Administration, Oral, Adult, Antithrombin III:analysis, Cross-Over Studies, Estradiol:administration & dosage, Estrogen Replacement Therapy:methods, Female, Fibrinogen:analysis, Humans, Lipoproteins:blood, Middle Aged, Postmenop.   

OBJECTIVES: The purpose of the present study was to determine changes of biochemical risk factors of thromboembolism especially of TFPI during the use of oral versus transdermal administration of early estrogen replacement therapy.

METHODS: In a 12-week prospective, randomized, cross-over trial, oestradiol was administered orally in a dose of 2 mg daily or transdermally in an equivalent dose of 0.05 mg daily. Forty-five healthy early postmenopausal women were included into the study within 12 weeks after the hysterectomy and ovariectomy (surgical castration). Forty-one women completed the study and their data were analyzed. The average age was of 49+/- 6 years.

RESULTS: After an oral therapy, the average value of TFPI decreased significantly (p < 0.0001) from 87.5 +/- 38.5 ng/ml to 68 +/- 37 ng/ml but remained stable in transdermal group (81.9 +/- 36.8 ng/ml). No significant changes occurred in D-dimers. In both groups AT-III and fibrinogen decreased without exceeding their physiological ranges.

CONCLUSIONS: The oral therapy reduced significantly TFPI levels compared to transdermal route of administration. The results confirm more pronounced impact of oral estrogen on hemostasis variables....

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Journal Article 2002; 23(Suppl 2): 37-42 PubMed PMID: 12163846 Citation  Keywords:  Aging:metabolism, Animals, Estrogen Replacement Therapy, Estrogens, Non-Steroidal:therapeutic use, Female, Homeostasis:physiology, Humans, Isoflavones, Menopause:physiology, Neurosecretory Systems:metabolism, Phytoestrogens, Plant Preparations, Receptors,.   

: Endocrine modulation by natural and synthetic chemicals and the eventually resulting beneficial or adverse effects for human and animal health are controversially debated not only among scientists but particularly in the public. Most information is available on so-called environmental estrogens, however the amount of information on substances interfering with other hormonal axes steadily increases, particularly on those exhibiting (anti)androgenic activities. The aim of this paper is to summarize existing data and to give an overview on the potential pathways leading to interferences of environmental hormones with homeostasis and eventually resulting health effects. Experimental evidence suggests the hypothesis that fetal and neonatal organisms may be at risk if exposed to environmental estrogens. In contrary, it appears as if phytoestrogens, particularly those with selective estrogen receptor modulator- (SERM-)like activities have the potential to be useful in medical application, both as dietary means and as pharmaceuticals. Lacking valid information about the detailed analysis of the molecular mode of action for environmental estrogens, the possibility for an ultimate classification of environmental estrogens in "dangerous endocrine disruptors" and phytoestrogens in "useful pharmaceuticals" cannot be supported conclusively. Nevertheless both activities are likely....

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Journal Article 2002; 23(3): 243-248 PubMed PMID: 12080286 Citation  Keywords:  Aged, Asthma:drug therapy, Circadian Rhythm, Estrogen Replacement Therapy, Female, Glucocorticoids:therapeutic use, Humans, Melatonin:metabolism, Middle Aged, Postmenopause:physiology,.   

OBJECTIVE: The aim of the study was to check if in postmenopausal women such a disease as asthma and use of hormone replacement therapy (HRT) influence daily melatonin (MEL) secretion.

MATERIAL AND METHODS: Studies were performed in 55 asthmatics (treated and not treated with glucocorticosteroids) and 20 healthy postmenopausal women (aged 48-60) before HRT and after 6 months of transdermal 17beta-estradiol and medroxyprogesterone acetate treatment (cyclical method). During the circadian study blood samples for the measurement of MEL were collected every 3 hours during the day. MEL concentrations were assessed with the use of RIA methods. Statistical analysis of the circadian rhythm was performed with the use of cosinor test according to Halberg et al.

RESULTS: Existence of daily rhythm of MEL secretion was shown in all studied groups, before as well as after HRT. A significant decrease of mesor and amplitude's rhythm was observed in the group of women with asthma treated with glucocorticosteroids (GC) before and after HRT use in relation to women not treated with GC and the control group. Secretion of MEL in these patients was lower at nocturnal hours. A significant decrease of mean daily MEL secretion in relation to values before HRT use was shown in all groups.

CONCLUSIONS: Asthmatic postmenopausal women treated with GC show lowered circadian secretion of melatonin as a consequence of lowering its secretion at nocturnal hours. Hormonal replacement therapy causes a decrease of daily melatonin secretion in healthy as well as asthmatic women, not disturbing circadian rhythm of this hormone's secretion....

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