The review deals with the role of endocrine and metabolic deteriorations in the development of overlapping clinically manifested benign hyperplastic lesion of endo- and myometrium. Hyperleptinemia is a powerful potentiating factor of endocrine diseases of the uterus. Modern correction of both endocrine and metabolic disorders is a key component of the comprehensive treatment and prevention of hyperplastic diseases of the uterus.
Purpose. To reflect the current understanding of the frequency, molecular mechanisms, and means of overcoming alopecia in cancer patients, taking into account the fundamental data of recent years on the physiology of the hair follicle and the pharmacological profile of the toxicity of anticancer drugs.Material and Methods. A literature search using Medline, Pubmed, etc. databases was carried out. More than 200 publications devoted to the study of alopecia were found, of which 42 were included in this review.Results. Chemotherapy-induced hair loss is a common adverse effect in cancer patients undergoing treatment. The frequency and molecular mechanism of the development of alopecia are related to the pharmacological features of the drug-based treatments, initial nutritional premorbid status, and predisposing polymorphisms of genes involved in drug conversion and excretion. Focal or diffuse alopecia may be the first sign of malignant growth within the paraneoplastic syndrome, primary or metastatic malignancies of the scalp, or be a manifestation of nutritional insufficiency. Baldness negatively affects the psycho-emotional state of patients, exacerbating depressive disorders, anxiety, reducing self-esteem and adherence to treatment. Thus, prevention or rapid overcoming of alopecia can significantly improve the quality of life of cancer patients. The use of scalp cooling or ‘cold caps’ is proven to be an effective way of combating chemotherapy-induced hair loss.Conclusion. Further studies are needed to prevent and treat alopecia in cancer patients.
Background: The frequency of menstrual disorders in patients with acromegaly is 4084% and are caused by three main reasons the development of normal or hypogonadotropic hypogonadism due to hyperprolactinemia or a mass effect of the tumor and direct effects of GH and IGF-1 on the reproductive system. Nevertheless the exact mechanisms of reproductive dysfunction are not clear now. Hypothalamic structures play significant role in the regulation of hypothalamic-pituitary-ovary axis, so its important to study key neuropeptides and evaluate their effects to the pathogenesis of ovarian dysfunction during excessive secretion of growth hormone. Aim: The aim of the work is to study the hormonal regulation of menstrual function in patients of reproductive age with acromegaly in the active stage of the disease. Material and methods: The study included patients with a confirmed diagnosis of acromegaly and healthy women, comparable in age and BMI. Blood serum samples were taken in the morning (89 hours) on an empty stomach for 35 days of the menstrual cycle or on any day with amenorrhea and frozen at -70C. The hormonal study was carried out by an enzyme immunoassay, in the case of a kisspeptin, with the preliminary extraction of serum samples. Results: The study included 31 patients with acromegaly and 15 healthy women. Between groups there was a statistically significant decrease in levels of LH (p = 0.001), FSH (p = 0.09), inhibin B (p = 0.003), and kisspeptin (p = 0.00005). The frequency of hyperprolactinemia in the cohort of patients was 51.6%. During the correlation analysis, a negative dependence of kisspeptin on the levels of GH and IGF-1 was detected (r = -0.54, p = 0.002 and r = -0.63, p = 0.0002). Conclusions: The severity of the central depression of regulation of menstrual function in patients with acromegaly may be due to the degree of disease activity.
Цель работы. Изучение динамического изменения интра- и ранних послеоперационных гормональных показателей (адренокортикотропного гормона (АКТГ) и кортизола) в качестве предикторов ремиссии гиперкортицизма. Материал и методы. Проведен сравнительный анализ результатов эндоскопической аденомэктомии у 50 пациентов с болезнью Иценко–Кушинга. Пациенты были разделены на три группы в зависимости от исхода операции. Первая группа – пациенты с вторичной надпочечниковой недостаточностью, подтвержденной клинической картиной и уровнем кортизола меньше 50 нмоль/л; вторая группа – с нормализацией уровней АКТГ и кортизола; третья – с персистенцией болезни Иценко–Кушинга. Оценена динамика снижения уровней АКТГ и кортизола во время операции и в раннем послеоперационном периоде. Группу составили 38 женщин и 12 мужчин в возрасте от 15 до 66 лет. Заборы крови для оценки уровней АКТГ и кортизола производились из периферической вены: первый – на этапе разреза твердой мозговой оболочки, второй – сразу после удаления опухоли и заключительный – через 20 мин после удаления аденомы. Затем исследование вышеуказанных гормонов проводилось всем пациентам через сутки после операции. Уровни АКТГ и кортизола определялись путем иммунохемилюминесцентного анализа на автоматизированной системе Сobas 6000 (Roche, Франция). Референсные интервалы АКТГ – 0–30 нг/мл, кортизола – 123–626 нмоль/л. Результаты. Не получено четкой зависимости между изменениями уровня исследуемых гормонов в интра- и раннем послеоперационном периоде (20 мин после удаления опухоли) и вероятностью наступления ремиссии заболевания (p > 0,0125). Результаты гормонального исследования через сутки коррелировали с частотой послеоперационной ремиссии (p < 0,0125). В послеоперационном периоде из 50 пациентов у 41 (82%) развилась надпочечниковая недостаточность, у 5 (10%) пациентов показатели нормализовались и у 4 (8%) пациентов наблюдалась персистенция гиперкортицизма. Заключение. Интраоперационное определение уровней АКТГ и кортизола не является целесообразным для оценки радикальности удаления опухоли.
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