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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and pathologic findings were compared in 43 postmenopausal endometrial carcinoma patients who had received exogenous estrogens prior to diagnosis and 79 similar patients unexposed to estrogens. Estrogen non-users were more likely to manifest lower parity, later menopause, obesity, hypertension, and diabetes, all of which have been considered to be constitutional risk factors for the development of endometrial carcinoma. Although estrogen users and non-users had similar extent of disease as judged by clinical stage, there was a tendency to more myometrial invasion in hysterectomy specimens from non-users, as well as greater frequency of unfavorable histologic types and grades of tumor. At short-term follow-up, more recurrences occurred in non-users, and this tendency appeared to be independent of clinical stage, histologic type, histologic grade, or modality of treatment. The significance of these and other observation to the determination of the risk-benefit ratio for estrogen administration is discussed.
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PMID:Endometrial carcinoma: clinical-pathologic comparison of cases in postmenopausal women receiving and not receiving exogenous estrogens. 738 46

This paper reviews both minor and major adverse reactions caused by estrogenic substances (natural and synthetic, steroidal and nonsteroidal) of which diethylstilbestrol is the prototype of nonsteroidal synthetic estrogen. Minor side effects include nausea, breast tenderness, and excessive cervical secretions (most common), headache, and water and salt retention (less common and often eradicated by lowering estrogen dosage). Vertigo, yeast infections, depression, and photosensitivity are other minor effects. Major side effects are discussed in some detail. Major effects include those on the endocrine system (e.g., feminization in boys and men and precocious puberty in girls); breast tumors; endometrial carcinoma; ovarian tumors; hypertension; thromboembolism; blood clotting excesses; various metabolic effects (including lipid metabolism and carbohydrate metabolism alterations); liver changes (bile alterations and neoplasms); porphyria; melanoma; and effects on a fetus in situ during maternal estrogen administration. In general, lowering doses of estrogen should help eradicate or alleviate most of these effects.
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PMID:Clinical toxicology of estrogens. 741 28

In a retrospective case control study, 501 cases of endometrial cancer were observed from 1955-1975 and an equal number of matched control cases were compared regarding the following parameters: obesity, hypertension, diabetes, age a menopause, parity, age at first and last delivery, age at menarche, menstrual abnormalities, history of prior endometrial biopsies, concomitant ovarian tumours, family history of cancer and history of exposure to radiation. The statistical analysis revealed significant differences regarding the incidence of obesity, hypertension, late menopause, low parity, prior endometrial biopsies and prior exposure to ionizing radiation. However, no significant difference was found between endometrial cancer patients and control patients as to the incidence of diabetes, age at menarche, age at first delivery and family history of cancer. The results of the investigation are discussed and compared with similar reports from the literature.
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PMID:[An epidemiological study of endometrial cancer. Controlled trial of 501 cases (author's transl)]. 742 39

Using a population-based tumor registry serving western Washington state, all female residents of King County aged 50-74 years with a new diagnosis of endometrial cancer were identified. Then a comparable group of controls was found, and a case-control study of endometrial cancer was done to determine whether, in a woman's menstrual cycle and medical history, factors that modify the increased risk of endometrial cancer from estrogen use for menopausal symtoms could be identified. Endometrial cancer was found to be associated with overweight, hypertension, low parity, nonsmoking, late onset of menopause, and history of cholecystectomy. Use of estrogen produced large increases in risk both in the presence and absence of these characteristics, however. Because of this lack of association, it was concluded that information on other known risk factors for endometrial cancer gives little or no help as to selection for estrogen treatment in perimenopause.
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PMID:Oestrogens and endometrial cancer: effect of other risk factors on the association. 744 52

Various aspects of climacteric treatment with natural human estrogens are discussed. Estradiol, estradiol valerate, estron sulfate, or estriol are used separately or together in various preparations to treat the symptoms of approaching menopause. Estrogen treatment causes proliferation of the endometrium and causes a decrease in LHRH, FSH, and LH secretion. Treatment can take the form of continuous or cyclic treatment with estrogens alone, or sequential estrogne/gestagen preparations can be used. Ovarian function decreases as menopause approaches and results in the cessation of ovulation. Then the hypolutein phase begins, during which the secretion of progesterone is reduced and menstrual bleeding irregularities begin to occur. Eventually, estrogen production decreases so much that menstruation ceases completely, and symptoms such as heat flashes are experienced. Women who want treatment for climacteric symptoms but who want no regular menstrual bleeding can be administered low doses of pure estrogen. Regular abrasio control of endometrial development should be performed, however. Pure estrogen treatment can also be used in the case of hysterectomized women. Otherwise, a sequential treatment is generally indicated. Possible side effects of estrogen substitution therapy are changes in the genitalia, breasts, menstrual bleeding, blood pressure, and weight. There is also an indication that estrogen use can induce endometrial cancer. Besides the definite contraindication of endometrial cancer, relative contraindications of estrogen therapy include breast cancer, reduced liver function, thromboembolic disease, and serious hypertension. Estrogen therapy is to be used to solve acute climacteric symptoms; women should be well informed about possible side effects and that the therapy is no panacea for all menopausal problems.
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PMID:[Peroral treatment with natural human estrogens in the climacteric]. 744 54

Data gathered during an epidemiologic study of endometrial cancer in Israel are presented. In the nine-year period of this survey, 877 new cases of primary cancer of the endometrium were diagnosed, representing an incidence of 17.8/100,00 females over the age of 25. Two thirds of the patients were in the sixth and seventh decades of life at diagnosis of the tumor. Endometrial carcinoma was two to three times more prevalent in women of European-American origin than in those of Asian-African Background. In 85% of the patients, diagnosis was made while the disease was in Stage I. A strong correlation was found between endometrial cancer, diabetes (14%), hypertension (18%), and infertility (25%). The five-year survival rate in the present survey was 69.2%. Factors affecting prognosis are clinical stage of the disease at diagnosis, degree of myometrial invasion, tumor differentiation, age of the patient, and type of treatment.
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PMID:Adenocarcinoma of the endometrium in Israel, 1960-1968. 744 15

30 patients with advanced breast carcinoma, and 20 patients with advanced endometrial carcinoma were treated with high doses, 500 mg./day, of MPA (medroxyprogesterone acetate) administered orally for 3 months. Evaluation of results showed responses in only 30% of women treated, independently of the type of carcinoma. In the breast carcinoma group median duration of response was 10 months, and median survival time 15 months; in the second group of patients median duration of response was 15 months, and median survival time was not yet reached after 28 months of follow-up. Negative side effects were gain of body weight and hypertension; oral MPA administration seems to have a lower response rate than parenteral administration; it is, however, easier to handle, and could present a useful alternative in maintenance therapy.
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PMID:[Oral high doses of medroxyprogesterone acetate (MPA) in the treatment of advanced phases of breast and endometrial cancer]. 745 90

In a case-control-study an epidemiological investigation of cancer of the endometrium was carried out. The study included 159 cases and 159 controls. It was shown, that woman in the sixth life decade with overweight, a smaller number of deliveries and a later menopause had a higher risk for endometrial cancer. Other risk factors are diabetes mellitus and hypertension. But it is necessary to see the relationship between the typical age for these two characteristics and the typical age for endometrial cancer. The intake of estrogens without enough gestagens during an estrogen replacement therapy was associated with an increased risk. Furthermore the patients with carcinoma of the uterine corpus had a higher incidence of malignant tumors in their families and more breast cancer in their own case history. A history of oral contraceptive use appeared to reduce the risk of endometrial cancer. In addition there is an negative association between smoking and endometrial cancer. Thus factors of high risk related to cancer of the endometrium could be defined. Preventive examinations of high risk groups could help to decrease the incidence of endometrial cancer.
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PMID:[Evaluation of epidemiologic risk factors for endometrial carcinoma based on a case-control study]. 766 68

Insulin is a major regulator of circulating insulin-like growth factor (IGF)-binding protein-1 (IGFBP-1), suppressing the hepatic production of IGFBP-1. Postmenopausal age, obesity, hypertension, and impaired glucose tolerance, which are known risk factors for endometrial cancer, are all associated with hyperinsulinemia and insulin resistance. In this study, we investigated the relationship among serum insulin, glucose, insulin-like growth factors (IGF-I and IGF-II), and IGFBP-, -2, and -3 in 32 nondiabetic postmenopausal women with endometrial cancer and in 18 healthy controls. The mean fasting levels of glucose and insulin were higher, whereas the mean basal IGF-I, IGF-II, and IGFBP-3 levels were lower in the endometrial cancer patients than in the healthy control subjects. The mean fasting IGFBP-1 and IGFBP-2 levels did not differ between the groups, and no correlation was found between fasting insulin and IGFBP-1 concentrations or between insulin and IGFBP-2 concentrations in either of the study groups. During an oral glucose tolerance test, the mean glucose levels at 1 and 3 h as well as the mean insulin level at 3 h were significantly higher in the endometrial cancer patients than in the controls, and the area under the glucose curve was larger in the first group. An oral glucose load resulted in a similar fall in serum IGFBP-1 levels in endometrial cancer patients and controls (51% and 55% at 3 h). When the cancer patients were divided into two subgroups according to the body mass index (kilograms per m2), the obese group had higher glucose and insulin indices than the nonobese group. No difference was found by the same measures in healthy controls. The fasting serum IGFBP-1 levels tended to be lower in the obese than in the normal weight subjects, but the difference did not reach statistical significance. In summary, these results provide preliminary evidence that the inverse relation between fasting insulin and IGFBP-1, well established in children and young adults, disappears in elderly women, although short term suppression by insulin still occurs. Further, our data indicate that in addition to carbohydrate metabolism, postmenopausal women with endometrial cancer have alterations in their circulating IGF system compared to controls.
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PMID:Relationship between carbohydrate metabolism and serum insulin-like growth factor system in postmenopausal women: comparison of endometrial cancer patients with healthy controls. 768 14

Carcinoma of the endometrium is the most common gynecologic malignancy. The majority of women present with stage I disease, and the most common presenting symptom is postmenopausal bleeding. Early detection of endometrial cancer is important, because up to 90 percent of patients with stage I disease can be successfully treated. Certain risk factors, such as obesity, hypertension and diabetes mellitus, are associated with the development of this malignancy. Office endometrial sampling has a sensitivity of up to 97 percent for diagnosing carcinoma of the endometrium and can often eliminate the need for dilatation and curettage. Endometrial cancer is treated by total abdominal hysterectomy, bilateral salpingo-oophorectomy and, in many cases, postoperative radiation therapy.
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PMID:Carcinoma of the endometrium. 773 53


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