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Journal Article 2011; 32(1): 77-81 PubMed PMID: 21407165 Citation  Keywords:  Cholecalciferol:blood, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Dehydroepiandrosterone Sulfate:blood, Estrogens:blood, Female, Hormone Replacement Therapy:methods, Hormones:blood, Humans, Hydrocortisone:blood, Hypercholesterolemia:blood, Hypogonadi.   

OBJECTIVE: In 2002 we proposed a new hypothesis of the etiology and pathogenesis of hypercholesterolemia. There is paucity of information in the literature regarding the association of steroidopenia and hypercholesterolemia. Our goal is to determine if the treatment of steroidopenia with hormonorestorative therapy (HT) to youthful levels will normalize total cholesterol (TC) levels.

MATERIAL AND METHODS: We retrospectively analyzed 43 hypercholesterolemic patients treated with HT. Laboratory workup included lipid profile, serum pregnenolone, dehydroepiandrosterone sulfate (DHEA-S), progesterone, total estrogen, cortisol, total testosterone, and vitamin D-3 levels at presentation with follow up ranging from 3 to 9 months. HT therapy included a combination of several agents such as pregnenolone, dehydroepiandrosterone (DHEA), triestrogen, progesterone, testosterone, hydrocortisone, and vitamin D-3.

RESULTS: HT lowered mean TC from 228.8 mg/dL to 183.7 mg/dL (19.7%) (p<0.05) in all patients. In 12 men of mean age 58, HT statistically significantly lowered TC from 227.9 mg/dL to 177.1 mg/dL (22.3%) (p<0.05). Apparently it did so mostly by lowering LDL and triglycerides (TRG) while HDL did not appreciably change. In 31women, mean age 57, TC declined from 229.2 mg/dL to 186.3 mg/dL (19%) (p<0.05). HDL, LDL, and TRG are also decreased to a statistically significant degree. These results were associated with statistically significant elevations in pregnenolone, DHEA Sulfate, testosterone, progesterone but not total estrogen, cortisol or vitamin D-3 changes in both men and women.

CONCLUSIONS: We conclude that correction of steroidopenia with the use of hormonorestorative therapy is an effective strategy for normalizing and maintaining cholesterol homeostasis....

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Case Reports 2007; 28(6): 745-748 PubMed PMID: 18063931 Citation  Keywords:  Adrenal Insufficiency:blood, Adrenocorticotropic Hormone:blood, Empty Sella Syndrome:blood, Female, Hormone Replacement Therapy, Humans, Hydrocortisone:blood, Hypoglycemia:blood, Hyponatremia:blood, Methylprednisolone:therapeutic use, Middle Aged, Pituita.   

: Isolated ACTH deficiency is an uncommon cause of secondary adrenocortical insufficiency and accompaniment with primary empty sella has been reported in several cases. We present a case of isolated ACTH deficiency associated with empty sella. A sixty-two year old woman was admitted to our endocrine clinic with complaints of weakness, fatigue, weight loss, nausea, vomiting, and lack of appetite for about one month. Physical examination indicated orthostatic hypotension and epigastric tenderness. Laboratory investigations revealed hypoglycemia, hyponatremia and anemia, in addition low plasma cortisole and ACTH levels. Serum cortisole responses to short and prolonged ACTH stimulation were tested and partial and accurate responses were obtained, respectively. Plasma ACTH and serum cortisole levels failed to respond after intravenous injection of human corticotropin releasing hormone. Other hypophysial hormone levels were within the normal reference ranges. Although cranial and abdominal computerized tomography images were evaluated as normal, cranial magnetic resonance imaging of the pituitary gland revealed 'primary empty sella turcica'. Replacement therapy with methylprednisolon resulted in the improvement of hypoglycemia, hyponatremia and clinical symptoms. Based on these results, the patient was diagnosed as isolated ACTH deficiency and was scheduled for follow up by our outpatient clinic. Our report is consistent with other reports pointing out that primary empty sella may be responsible for pathogenesis of isolated ACTH deficiency....

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Comparative Study 2007; 28(5): 717-720 PubMed PMID: 17984942 Citation  Keywords:  Animals, Estradiol:administration & dosage, Female, Homocysteine:blood, Hormone Replacement Therapy, Ovariectomy, Ovary:physiology, Pineal Gland:physiology, Progesterone:administration & dosage, Rats, Rats, Sprague-Dawley,.   

OBJECTIVE: Hyperhomocysteinemia plays a role in obstetric and gynecological diseases and such diseases are seen as a consequence of an impaired methionine cycle. In the present study, it was aimed to determine the effect of estradiol and progesterone on homocysteine levels in pinealectomized and ovariectomized rats.

MATERIALS AND METHODS: The study was carried out on 24 adult Spraque-Dawley female rats. Rats were divided into 4 groups as follows: Group 1: Sham ovariectomy group (Sham-Ovx), Group 2: Ovariectomized and sham pinealectomized group (Ovx-Sham-Px), Group 3: Ovariectomized and pinealectomized group (Ovx-Px), Group 4: Group which were supplemented with estradiol and progesterone after ovariectomy and pinealectomy (Ovx-Px-E+P). Serum homocysteine levels were determined after experimental period.

RESULTS: Homocysteine levels in Group 3 were higher than those in Groups 1, 2 and 4 (p<0.05). Homocysteine levels in Groups 2 and 4 were higher than those in Group 1 (p<0.05). Homocysteine levels in Groups 2 and 4 were not different.

CONCLUSION: The findings of the present study demonstrate that ovariectomy lead to increases homocysteine levels. Pinealectomy in addition to ovariectomy increases homocysteine levels. However, administration of estradiol and progesterone following pinealectomy prevents the increase in homocysteine levels in ovariectomized rats....

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Comparative Study 2007; 28(4): 484-488 PubMed PMID: 17693962 Citation  Keywords:  Aging:physiology, Albinism:genetics, Animals, Antithyroid Agents:adverse effects, Bone Density:drug effects, Bone Development:drug effects, Carbimazole:adverse effects, Hormone Replacement Therapy:methods, Hypothyroidism:chemically induced, Rats, Rats, Mu.   

: To evaluate the effect of carbimazole induced hypothyroidism and thyroxine replacement, on the growth of long bones of albino rats of different age groups. Experimental albino rats were developed with carbimazole and carbimazole plus thyroxine for a period of six weeks. At the end of the experiment the animals were sacrificed, fixed and processed to demonstrate the bony and cartilaginous parts. The ulna and tibia of both sides were measured for intact bone length & diameter and the data compared. The reduction in length and circumference observed, at the end of experiment, in ulna was 10.89%, & 11.94% and in tibia it was 12.52%, 14.81% in carbimazole treated group respectively, while in carbimazole plus thyroxin treated group the reduction in length & circumference of ulna was 1.37% & 1.88% and in tibia it was 1.86% & 3.08% respectively. They were compared to their age matched controls. The reduction in length and circumference in ulna was 5.58% & 6.25% and 6.42% and 5.88% in tibia respectively among the carbimazole treated animals while in the carbimazole plus thyroxine treated animals the reduction was only 0.63% and 3.12% in ulna and 0.91% and 1.06% in tibia respectively. The results show that hypothyroidism and its replacement therapy affects the endochondral as well as periosteal bone growth and results in reduction in length as well as circumference of long bones....

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Clinical Trial 2006; 27(3): 387-391 PubMed PMID: 16816826 Citation  Keywords:  Administration, Cutaneous, Administration, Oral, Adult, Drug Combinations, Drug Therapy, Combination, Estradiol:administration & dosage, Female, Follow-Up Studies, Hormone Replacement Therapy:methods, Hormones:administration & dosage, Humans, Kidney Trans.   

OBJECTIVES: The assessment of efficacy and safety of two regimens of hormonal replacement therapy (HRT) in women after kidney transplantation with climacteric symptoms.

MATERIAL AND METHODS: Combined transdermal or transdermal-oral hormonal replacement therapy was administered to 86 kidney-transplanted women, aged 31-52 years, with moderate to severe climacteric symptoms in years 1995-2005. The patients underwent follow-up examinations one, three and six months after onset of the therapy and every four months subsequently. Blood pressure, body weight, sex hormone profile, serum parameters of both kidney and liver function, endometrial image in transvaginal sonography and reduction of climacteric symptoms were assessed.

RESULTS: The mean time of the therapy was 5.6 years for transdermal-oral regimen (54 patients) and 4.7 years for transdermal regimen (32 patients). Most patients reported reduction of climacteric symptoms and improved life quality after 6 months of HRT. 28% of women discontinued therapy for medical indications, most often due to significant deterioration of liver function. One case of profound vein thrombosis was noted. 21% of women decided to discontinue therapy after the results of the WHI trial had been published.

CONCLUSIONS: Hormonal replacement therapy is effective in climacteric symptoms relief and improvement of life quality in kidney transplanted women. Higher rate of side effects observed in that group of patients contributes to the need for frequent, attentive surveillance. Further studies should be conducted to establish the optimal doses and routes of administration of HRT as well as to assess the range of necessary follow-up examinations....

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Case Reports 2006; 27(1-2): 203-208 PubMed PMID: 16648804 Citation  Keywords:  Child Development:physiology, Congenital Hypothyroidism:drug therapy, Female, Growth:physiology, Hormone Replacement Therapy, Humans, Infant, Newborn, Schools, Twins, Monozygotic,.   

: Authors present the long-term development of two monozygotic twin sisters. One of them was detected by newborn screening as athyreotic (gemelus A) and healthy gemelus B sister. Therapy in athyreotic girl started at 4 weeks after birth and was monitored in order to maintain serum thyroxine and TSH in normal range. Both sisters spent their chilhood and adolescence together in the same family, school and work together as tailors in the same factory. Their development was very similar. In order to detect subclinical difference of their development, the school achievements were tested using their school certificates. Studies were divided to testing mechanical memory, logical thinking and skills. The evaluation of all classes of school attendance (13 years) reveals subtle differences - deficit of patient at approximately 6-15% level, mainly in studies demanding skills. However, dynamic evaluation after years reveals that the worse results of the patient (gemelus A) occurred during the first years of basic school whereas during adolescence having attended the special school tailor, she attained better results than her healthy sister. It seems that mental deficit in early treated hypothyroid patient is not severe and varies even during the life. Problem of the fetal hypothyroidism is probably more related to the iodine deficiency, which assures necessity of thyroid hormones for athyreotic child from mother's or twin's normally supplemented thyroid glands....

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Clinical Trial 2005; 26(2): 131-135 PubMed PMID: 15855884 Citation  Keywords:  Adolescent, Adult, Autoantibodies:analysis, Drug Combinations, Estradiol:therapeutic use, Estriol:therapeutic use, Female, Germ Cells:immunology, Hormone Replacement Therapy, Humans, Medroxyprogesterone Acetate:therapeutic use, Menstruation Disturbances:c.   

INTRODUCTION: To investigate levels of antiovarian autoantibodies in girls and young women with disturbances of menstrual cycle before and during treatment with hormonal therapy. To explain morphological changes in ovarian structure in these patients.

MATERIAL AND METHODS: Studied group included 39 patients. 18 patients were treated for primary amenorrhoea, 21 for menstrual cycle disorders. Patients included in the study were repeatedly examined at the beginning of the study and after six months during which they were treated by estrogen and gestagen. In all patients we have tested FSH, LH and FSH/LH ratio, presence of antiovarian antibodies. Results were compared with those obtained in control women. 21 antiovarian antibodies positive patients were indicated for laparoscopic biopsy. Bioptic sample was examined using light and electron microscopy.

RESULTS: Our treatment with hormonal therapy lead to the reduction of ovarian antigens. In 85% of the cases marked decrease of antiovarian autoantibodies levels was observed, while in 28% of the cases the levels were undetectable. From morphological changes of the bioptic sample enhanced atresia of follicules at different developmental stages was frequently observed. It evoked marked reduction of follicular apparatus up to its complete disappearing.

CONCLUSION: The results of our study and mapping of the antiovarian antibodies positivity support our hypothesis that the antiovarian antibodies positivity corresponds with the clinical symptoms. Appropriate treatment with hormonal replacement therapy minimizes ovarian destruction, preserves ovarian hormonal functions and saves healthy ovarian tissue necessary for future fertility....

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Clinical Trial 2002; 23(5-6): 455-458 PubMed PMID: 12500172 Citation  Keywords:  Adult, Auditory Threshold, Delayed-Action Preparations:administration & dosage, Estradiol:administration & dosage, Female, Follicle Stimulating Hormone:blood, Follow-Up Studies, Hearing Loss:diagnosis, Hearing Tests, Hormone Replacement Therapy, Humans, M.   

BACKGROUND: Estrogens have not only direct and beneficial effect on relaxation of the arteries increasing the blood flow in the blood vessels, but also their level of secretion has considerable effect on synthesis of acetylcholine a neurotransmitter indispensable for appropriate functioning of the hearing organ. The aim of this study is analysis of the effect of hormones on the hearing organ in women who underwent surgical castration.

MATERIAL: The study included 40 females, aged between 32 55 years who had undergone an operative treatment mainly because of uterine myoma. A group of 50 women aged between 32 50 years with appropriate hormone level comprised the control group.

METHOD: Each woman investigated underwent the following examinations: gynaecological, otolaryngological and laboratory tests, such as: evaluation of levels of estradiol (E) and folliculin stimulating hormone (FSH). The assessment of hearing was carried out using tone and speech audiometry, tympanometry, test registration of auditory brain stem responses (ABR) and otoacoustic emissions (EOAE). The examinations mentioned above are performed in women as initial examinations before surgical treatment and as follow-up examinations 1, 3 and 12 months after the surgery.

RESULTS: The results presented in this paper include initial examinations and follow-ups 3 months after the surgical treatment taking into consideration the correlation with the results of laboratory tests and the results obtained in the control group....

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