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)

This review of endometrial cancer summarizes the demographic characteristics of patients with the disease, their hormonal risk factors related to endogenous and exogenous estrogens and medical history, and other risk factors. Endometrial cancer increased in incidence in the US in the early 1970s, but then declined again in the last 2 decades. Possible reasons are classification including estrogen- induced hyperplasia, but also increased use of exogenous estrogens primarily in post-menopausal women, who are the predominant victims. Postmenopausal estrogen usage decreased at the same time. The highest incidence occurs in Polynesian women, although US Caucasians have more endometrial cancer then Blacks or European women. Endometrial cancer is common in women with estrogen-secreting ovarian cancer. Women with polycystic ovaries, where the steroid androstenedione is secreted and converted to estrone in peripheral tissues, but progesterone is lacking, are higher risk for endometrial hyperplasia and cancer. Obese women are also at risk (estimated 20-fold), as they have low sex binding globulin and higher estrogen levels. Any exogenous estrogen, by any route, even if stopped for a week per month confers higher risk for endometrial cancer, as shown by virtually all case control studies. Very little data exists on the actual effect of taking progestins with postmenopausal estrogens. These tumors are less invasive, more differentiated, and often detected earlier than non-estrogen dependent endometrial cancers. Other putative risk factors, e.g., diabetes, hypertension, gall bladder disease, radiation exposure, and family history of breast cancer have no solid evidence for association. Smoking, however, is associated with a lower risk of endometrial cancer.
 ...
PMID:Epidemiology of endometrial cancer. 257 97

Due to the increasingly elderly population of the United States, it was elected to review the experience at the Cleveland Clinic Foundation in treating women older than 75 years of age for gynecologic cancer. The charts of 114 patients were reviewed to study the presentation of primary cancers, the morbidity and mortality associated with therapies, and patient survival. Cardiovascular disease, including hypertension, and diabetes mellitus were the most common associated medical problems. 36% of patients had endometrial cancer, 25% cervical cancer, 19% vulvar cancer, 12% ovarian cancer and 7% vaginal cancers. Compared to data for patients of all ages in Annual Report on the Results of Treatment in Gynecologic Cancer (Vol. 18), patients with endometrial, cervical, and vulvar cancers were of a significantly more advanced stage than expected. Therapy was modified due to patient age or medical status in 42 patients. No postoperative mortality was encountered, although patients often required multiple prolonged hospitalizations. The projected overall survival rate (Kaplan-Meier Analysis) was 44% at 5 years. It is concluded that despite their advanced age and associated medical problems, very elderly patients can usually receive definitive cancer therapies, including surgery, after careful preoperative medical evaluation and therapy.
 ...
PMID:Gynecologic cancer in the very elderly. 290 49

The majority of epidemiological studies on the benefits and risks of oral contraceptive (OC) use have been conducted during the late 1960s and early 1970s when OCs had 50 mcg of estrogen. Based on these studies, the risk of death due to OC use for nonsmokers 35-39 years old was lower than using no contraceptive at all (14.1 deaths/100,000 women/year vs. 25.7 deaths/100,000 women/year). In addition to smoking, other contraindications include women with a history of angina, myocardial infarction, blood clots or stroke, estrogen dependent cancer, hypertension, a known lipid disorder, and women with hepatitis or cirrhosis of the liver. Suitable 35 year old candidates for OC use would be nonsmokers with blood group O, at low risk for cardiovascular disease, and who might receive additional benefits, including those with severe dysmenorrhea or hypermenorrhea and possibly those who have a strong family history of osteoporosis, early menopause, or ovarian cancer. Practitioners should take a thorough history of these women and give a physical examination with a blood pressure check. They should also administer screening tests, such as a PAP test, mammograms, a lipoprotein profile, and a glucose test. After the practitioners have deemed these women to be healthy based on the examination and the results of the screening test, they then should prescribe only a low dose OC containing 50 mcg of estrogen. Today most estrogen based OCs contain 35 mcg and research on their effects have not yet begun. Scientists expect to find that the dose response effects for risks for thromboembolism, myocardial infarction, stroke, and gallbladder disease to be lower in users of the low dose preparations.
 ...
PMID:Risks and benefits of oral contraceptive use in women over 35. 323 16

Adverse and beneficial effects, especially with regard to mortality rates, of oral contraceptives (OC) are reviewed. In 1980 approximately 80 million women used OCs worldwide. OCs were first marketed in the United States in the 1960's, but by the 1980's low-dose combination pills with less estrogen and progesterone content became widespread along with the minipill, injectable preparations depo- medroxyprogesterone DMPA, and norethindrone containing capsules. Relative disease risk estimates are based on cohort studies and case- control studies. The Royal College of General Practitioners RCGP Oral Contraceptive Study of 1974 involved 46,000 women aged over 15 (50% were OC users, 50% were nonusers) the Oxford Family Planning Association Contraceptive Study of 1976 recruited 17,032 women aged 25-39, 56% of whom used OCs, and the Walnut Creek Contraceptive Drug Study of 1981 studied 16,638 women aged 18-54 of whom 28% were OC users and 33% were former users. A somewhat elevated mortality among ever-users of OCs in the order of 20% seems to be indicated by these studies mostly attributable to diseases of the circulatory system. Current OC use is also a risk factor in thrombotic stroke of the order of 4 or 5, but former use of OCs lowers the risk to 2. The effect of OC dose and formulation, duration of use, and predisposing factors on hemorrhagic and thrombotic stroke appears to be inconclusive with varying data from different studies. There is evidence for some increase in ischemic heart disease among current OC users, and also a 2-fold increase of myocardial infarction (MI) when smoking, serum cholesterol, and hypertension is taken into account, moreover higher estrogen dosage also contributes to a higher incidence of MI. There is also a 5-fold increase of venous thromboembolism among OC users induced by duration of use and estrogen potency, as OCs seem to promote atherogenesis, although the roles of progesterone and estrogen are conflicting. combination pills reduce the rate of endometrial cancer, provided protection against ovarian cancer, and do not seem to increase breast cancer incidence, although the relative risk of cervical cancer is elevated. Mortality risks with older OCs outweigh the benefits.
 ...
PMID:On the epidemiology of oral contraceptives and disease. 331 96

Oral hormonal contraception is a low risk and safe form of contraception for women between the ages of 15-35 without risk factors such as smoking, obesity, diabetes mellitus, hypertension, or hypercholesteremia. Women over 35 years of age should take the pill only when risk factors can be excluded. In general, low dose pills with less than 50 mcg ethinyl estradiol should be used since they have the lowest impact on the metabolism. Use of the pill could in fact have positive effects on health. For example, benign mamma tumors occur less frequently, dysmenorrhea generally improves, anemia and inflammatory adnexal diseases are less common occurrences, and there appears to be a clearly protective effect against morbidity of the endometrium and ovarian cancer. (author's modified)
 ...
PMID:[Risk-benefit analysis of contraception with steroids]. 333 Mar 69

Until recently, most 40-year-old women considered their families complete and wanted no more children. At present, however, with more women working, easier contraception, and more frequent divorces, many 40-year-old women are ambivalent about their future childbearing plans. Their fertility is in decline, but some form of contraception is still necessary. At all ages from puberty to menopause, contraceptive choice is related to ambivalence in desire for a child, body image, and the contraceptive method itself. For a psychologically well-balanced and healthy woman of 40 wanting no more children, almost any method of contraception may be acceptable. Women this age fearing loss of fertility and aging may come to desire another child. Couples with 2 children of the same sex or working women wanting a family "eventually" may realize they can defer their decision no longer. Women who do not feel comfortable unless they are pregnant or caring for a small child by this age may have several children and are usually considered good candidates for sterilization. They in fact should probably not be sterilized because of the likelihood of psychological complications or psychosomatic problems. IUDs are probably the best choice for such women. Good tolerance of contraception depends on the sexual adjustment and mutual understanding of the couple. As to the choice of method, oral contraceptives (OCs) are controversial because of the increase of vascular risks with age. Smoking, metabolic disorders, and hypertension are absolute contraindications. OCs may however have protective effects against endometrial and ovarian cancer, and the increased surveillance provided to women on OCs is an argument in their favor. Progestin-only pills combine contraception and therapy for some mammary or uterine pathologies. IUDs may be a good choice although local problems such as fibromas may limit their use.
 ...
PMID:[Contraception at 40 years of age]. 340 11

This artical examines the risks and benefits associated with use of the oral contraceptive pill (OCP) by adolescents and the various alternatives and methods of prescribing OCPs. Any adolescent who is either sexually active or contemplating sexual activity should be offered a contraceptive method that is appropriate to her individual needs. The contraceptive needs to be highly effective, safe and within the means and desires of the adolescent. For the majority of teenagers, the contraceptive of choice will be the OCP. The IUD should almost never be prescribed to the adolescent. Most OCPs marketed today are combination pills containing both an estrogen and a progestin in each pill. A variety of contraceptive actions combines to create a contraceptive method that is 99.3-99.9% effective. OCPs provide some protection against the development of pelvic inflammatory disease (PID). Oral contraceptives also decrease the incidence of anemia by decreasing the amount and duration of menstrual flow. Ovarian cysts do not form in the ovaries of the OCP user. On the other hand, a serious risk of the use of OCPs is the increased danger of thromboembolic events including deep venous thrombosis, pulmonary embolus, and myocardial infarction. The increased risk of myocardial infarction in OCP users is additive with other risk factors including hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes mellitus, and age. OCP use seems to provide some protection against development of endometrial or ovarian cancer. Oral contraceptives are associated with the development of benign hepatocellular adenomas. A variety of metabolic and hormonal alterations also occur in pill users. Most appropriate for the adolescent is a formulation containing a low dose of estrogen because of the decreased risk of thromboembolic complications. Dysmenorrhea effects more than 1/2 of female adolescents, and can best be treated with ibuprofen.
 ...
PMID:Oral contraceptives and dysmenorrhea. 354 24

Oral contraceptive agents are expected to be legalized in Japan in the near future. Although pills are more convenient and effective than other methods used in Japan such as condom (73%), IUD (12.4%) and Ogino Method (11.0%), they are not safe for many women. Neither will legalization of pills necessarily reduce the number of abortions. The abortion rate per 1000 women aged 15-44 is 29.3 in America where pills are legal, and 22.5 in Japan where they are illegal. Steroid hormones affect the overall physical and mental functioning of the human body. Pill-users who are near 40 and/or smokers may have such side-effects as high blood pressure, cerebrovascular-related syndrome, and thrombosis. Among very young pill users, side-effects include temporary amenorrhea after stopping pills, 4 times more cases of thrombosis triggered by emergency operations on appendixes and fractured bones, and development of uterine myoma. Side effects are more prevalent among those who have a family history of diabetes, circulatory organ dysfunction, high blood pressure, breast or ovarian cancer. Minor side-effects include weight increase, nausea, blemishes, acne and pigmentation.
 ...
PMID:[Oral contraceptive agents]. 364 11

Adenocarcinoma of the endometrium in patients 40 years of age or younger is rare and accounts for 2.9% of all endometrial cancers diagnosed in the study community. However, the diagnosis of malignancy was confirmed in only 32 of 54 patients (59.2%) with pathologic material available for review. None of the 32 patients had Stein-Leventhal syndrome or was receiving sequential oral contraceptives. Obesity was found in only 37.5%, nulligravidity in 37.5%, and hypertension in 25%. In 81%, the presenting symptom was abnormal vaginal bleeding, and 6 patients (19%) had coexisting ovarian neoplasms (4 endometrioid carcinomas, 1 mucinous cystadenocarcinoma, and 1 adenocarcinoma arising in a cystic teratoma). Atypical endometrial hyperplasia, previously interpreted as well-differentiated adenocarcinoma, was diagnosed in 11 of 22 patients. The pathologic criteria for establishing a diagnosis of atypical endometrial hyperplasia and distinguishing it from well differentiated adenocarcinoma of the endometrium are emphasized. Thirteen of 32 patients received no radiation therapy and none developed pelvic recurrence or metastatic tumor. The 2 deaths from tumor were in patients with stage 3 ovarian cancer, and no patients died of endometrial carcinoma. The current policy is to treat patients with atypical endometrial hyperplasia and well-differentiated adenocarcinoma (clinical stage I, pathology confirmed) by hysterectomy without irradiation treatment. Because of 6 of the 32 patients (19%) had coexisting ovarian neoplasms, careful examination of the adnexa at the time of clinical staging is emphasized.
 ...
PMID:Endometrial carcinoma in women 40 years of age or younger. 701 3

An 81-year-old G2 P2 white female in good health with the exception of well-controlled hypertension presented to her family physician with a newly discovered lesion in the skin of the abdominal left lower quadrant. Initially, this nodule was viewed as innocuous and was followed with the expectation that it would soon resolve. Three months later, the lesion was biopsied, revealing a pattern consistent with papillary serous carcinoma from a presumed ovarian primary. CT scan revealed a pelvic mass. Subsequent laparotomy revealed a benign tubal cystadenofibroma, but otherwise normal pelvic viscera. Additional findings, however, included multiple small parietal peritoneal nodules histopathologically diagnosed as extraovarian peritoneal serous papillary carcinoma similar to the skin lesion. All gross disease was extirpated. The patient received chemotherapy as for advanced ovarian cancer.
 ...
PMID:Extraovarian stage IV peritoneal serous papillary carcinoma presenting as an asymptomatic skin lesion--a case report and literature review. 777 52


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