Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A matched pairs analysis of 130 cases of endometrial cancer was undertaken to determine the relationship between post-menopausal estrogen treatment and endometrial cancer. 90% of the cases were in FIGO stage I, 6.9% stage II, and 2.3% stage III. The matching took place according to a wide range of criteria, e.g. age at menopause, age at diagnosis, no. of births, weight, etc., within certain tolerances. After the matching was finished, the information on estrogen use was collated, and the relative risk (RR) for various estrogen preparations was calculated according to the length of estrogen treatment. The number of estrogen users was smaller among the women with endometrial cancer than among the control group (p .01); the RR of endometrial cancer does not increase with estrogen use (RR=.44). The same held true when conjugated estrogens, estriol, estradiol, estrogen-androgen preparations, and ovulation inhibitors were considered separately (.05 p . 05). The RR of endometrial cancer does not increase with the length of estrogen treatment. It was also observed that the RR of endometrial cancer was significantly lower (p .01-.001) among women with predisposing factors such as hypertension, obesity, and nulligravidity. This suggests that the risk of endometrial cancer is not increased by estrogen treatment.
 ...
PMID:[Estrogen therapy and carcinoma of the endometrium (author's transl)]. 21 85

A review of the literature concerning the relationship between menopausal estrogen treatment and endometrial carcinoma is presented. Results from animal studies indicate that estrogens may work in conjunction with carcinogenic substances to stimulate proliferation of cancerous growths. Since estrone is produced by fatty tissue, obesity and certain correlated diseases, such as hypertension or diabetes, may be predisposing factors to developing endometrial cancer. Other risk factors are a hereditary predisposition and age. Several American epidemiologica studies showed an increased risk of developing endometrial cancer among women who undergo hormone treatments during menopause. It must be remembered, however, that such studies cannot establish causal relationships. Also, in the American studies, several biases complicate evaluation of the data, e.g. a disregard for social factors, the uncertainty of the state of the endometrium before the beginning of the study, and the inclusion of the problematic "stage 0" into the study. Furthermore, in America there is a tendency to proscribe estrogens alone in high dosages for menopausal treatment over long periods of time. It is concluded that individually determined low-dosage cyclical estrogen therapy during menopause does not increase the risk of endometrial cancer.
 ...
PMID:[Oestrogens during the menopause and the risk of endometrial carcinoma (author's transl)]. 21 69

An increasing incidence of endometrial cancer caused by a higher life expectancy and a number of other facters (i.e. obesity, diabetes, hypertension, lower pregnancy rate) as well as the unfavorable location for early detection when compared with cervical cancer has initiated this review in order to single out women with increased risk. Clinical characteristics of patients with endometrial cancer represented by age, menstrual disorders, reduced fertility, obesity, diabetes, hypertension, hirsutism, hyperplasia of the ovarian stroma or hilus cells in connection with an increased oestrogen effect in the vaginal smear and proliferative changes of the endometrium can be explained by extraglandular respectively peripheral aromatization of androgens to oestrogens, particular by the conversion of androstenedione to oestrone. This is supported by an increased plasma oestrone/oestradiol-ratio and increased conversion rate with age and overweight. In vivo- and in vitro-investigations have demonstrated the participation of adipose tissue in peripheral oestrogene production. The compiled data point towards the importance of the extraglandular oestrone production for the etiology of endometrial cancer by effecting the endometrium over a long period of time. The counter action of the normally cyclic changes of oestradiol and progesterone is lacking. Therefore, a dysoestrogenic effect of oestrone upon the endometrium can be fully effective, depending on the hormone receptor content of the respective endometrium. Based upon these data including recent publications, pre- and postmenopausal oestrogen therapy has to be critically reevaluated.
 ...
PMID:[Endometrial cancer and extraglandular oestrogen biosynthesis (author's transl)]. 32 98

For a population-based, case-control study of cancer of the endometrium in Greater Boston from 1965 through mid-1969, 440 cases were drawn from nearly all hospitals in the area; controls were drawn at random from the general population. The age-adjusted incidence rate was 18.1/100,000 woman-years, with a peak at ages 55-59 and a gradual decline thereafter. Information was provided from 212 cases and 1,198 controls by mall questionnaire. A trend of reduced risk of endometrial cancer with increased parity was noted, the relative incidence (RI) for multiparous women being 0.3 compared to a RI of unity for married nulliparous women. The association of risk with age at first birth was irregular. Early menarche (RI=1.6) and late menopause (RI=1.7) were associated with increased risk of disease. Endometrial cancer risk was also found to be directly related to socioeconomic status, relative weight, diabetes, hypertension, and arthritis. The findings supported the idea that hormone activity during, and perhaps after, reproductive life is an important cause of this disease.
 ...
PMID:Epidemiology of endometrial cancer. 33 20

Although oral contraception (OC) offers reliable and esthetic contraception for 40-50 million women in the world today, serious complications do occur with its use and must be considered in a basic risk-benefit equation. Thorough knowledge of these complications and their predisposing factors may guide the selection of patients for OC use and management of its use. The following complications are reviewed: Vascular thrombosis (cerebrovascular disease, coronary artery disease), hypertension, carbohydrate metabolism, lipid metabolism, neoplasms (cervical tumors, breast tumors, endometrial carcinoma, benign tumors of the uterus and ovary, liver tumors), subsequent reproductive function (outcome of pregnancy), subjective effects (emotional state), gallbladder disease, liver function, and other effects. The incidence of complications may be decreased by proper prescribing and selection of patients. OC use in hypertensive or diabetic patients is not recommended. They should be used with caution in the younger obese patient and not used in the obese patient over age 35. OC may be prescribed for women over age 35 who do not smoke or have any other risk factor and who are apprised of the possible but uncertain degree of increased risk of coronary occlusion from pill use alone. Women with headaches developing or increasing with OC use should discontinue this method of contraception. It is recommended that women with any of these risk factors who have completed their desired families should be offered surgical sterilization.
 ...
PMID:Oral contraception. 38 49

Metabolic effects of long-term (at least 5 years) estrogen replacement therapy were studied. 301 patients were treated with replacement estrogen and 309 patients were untreated. Incidence figures for various metabolic diseases present at entry, and both during and after estrogen therapy were compared by statistical adjustments for certain group differences (Mantel-Haenszel statistics) and by statistical analysis. Long-term administration of estrogen to these women with hypoestrogenism was associated with significantly lower rates of development of cardiovascular disease (p .001), hypertension (p .001), osteoporosis (p .001), and fractures (p .01). The detrimental effects included a higher rate of abnormal uterine bleeding (47% of 207 women with uteri in situ) and an increase in the likelihood of developing adenocarcinoma of the endometrium. Cyclic adminsitration of estrogen did not seem to protect from the risk of endometrial carcinoma, however the addition of progesterone to sequential estrogen treatment did. It is believed that long-term estrogen therapy is of benefit for the woman deprived of estrogen function, particularly if this loss occurs at a relatively young age.
 ...
PMID:Effects of long-term estrogen replacement therapy. I. Metabolic effects. 44 93

During a 25 year period in a university hospital gynecology service, 300 obese women, weighing 200 pounds or more, underwent abdominal total hysterectomy. In comparison with nonobese controls, the overweight patients were more likely to have carcinoma of the endometrium, hypertension and diabetes mellitus. Postoperatively, the most striking difference between the obese and nonobese groups was in the incidence of wound complications, with no significant difference in the occurrence of other disorders. The incidence of wound complications was 29 per cent with obesity, seven times that in patients of normal weight, and all types of wound disorders, except evisceration, occurred more frequently in obese patients. Among identifiable factors potentially responsible for wound infection were an increased incidence of diabetes, longer operating time and greater blood loss in overweight patients. The increased incidence of wound infection was responsible for greater febrile morbidity and the more frequent need for prolonged hospitalization. The mortality rate was 1 per cent in the obese group and zero per cent in the control group, a statistically insignificant difference. Since abdominal hysterectomy in obese women is associated with increased risk of morbidity, although not necessarily of mortality, obesity per se should rarely, if ever, contraindicate necessary surgical therapy. In situations in which surgical treatment is more elective, its complications should be borne in mind.
 ...
PMID:Abdominal hysterectomy in obese women. 76 2

The use of estrogen during the climacterium is discussed. Estrogen should be used only when objective symptoms of a lack of estrogen can be established. Thrombosis, hypertension, breast cancer, uterine cancer and ruptured blood vessels are contraindications to climacteric estrogen use. Progestagens administered in conjunction with sedatives and diuretics can often relieve climacteric afflictions. Continued administration of estrogen should be avoided; estrogen can be administered with or without gestagens 7-10 days before menstruation or in 21-day periods. General practitioners are qualified to administer estrogen and should give patients regular examinations. There is a risk of developing endometrial cancer under climacteric estrogen treatment. Only women who want and need climacteric estrogen treatment should receive it.
 ...
PMID:[Estrogen treatment only when symptoms are present but complaints should not be neglected]. 86 7

Guidelines for the climacteric administration of estrogen are presented. Estrogens should be given in as low dosages and for as short a time as possible. Estrogens should not be given prophylactically, but only to alleviate actual symptoms. Estrogens should be administered cyclically and dosages should be adjusted to the individual case. A gynecologic examination and cytologic tests should be given before administering estrogens, 6 months after the beginning of treatment, and once a year thereafter. Liver dysfunction, breast or endometrial cancer, hypertension, and any thromboembolic or vascular illness are contraindications to climacteric estrogen use.
 ...
PMID:[Norwegian guidelines on estrogen treatment]. 86 6

The evidence concerning the most important factors related to prognosis in endometrial carcinoma stage I has been reviewed in 500 cases. Histologic differentiation of the tumor and depth of myometrial invasion have been found to be definitely correlated with survival, whereas uterine site in stage I lesions treated by hysterectomy shows no correlation between depth of uterine sounding and survival. Obesity and hypertension influence outcome in cases treated by radiation alone.
 ...
PMID:[Prognostic factors in early endometrial carcinoma (FIGO stage I)]. 95 64


1 2 3 4 5 6 7 8 9 10 Next >>