Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Androgen suppressive maneuvers still represent the gold standard for prostate cancer patients. However, they are associated with side effects (fatigue, sexual impotence, hot flushes, anemia, anxiety, depression and osteoporosis) all of which have a negative impact on quality of life. Nonsteroidal antiandrogens compete with dihydrotestosterone for the linkage of its own receptors. These compounds are commonly used in combination with suppressive maneuvers. However, there is a growing experience with them as monotherapy, based on the possibility to spare gonadal function and therefore prevent the effects related to its suppression. Many studies have demonstrated the feasibility and safety of this approach, which can represent a valuable alternative to suppressive maneuvers for patients wishing to retain sexual function, especially for those without distant metastases. Unfortunately, none of the comparative studies performed so far had the power to detect the equivalence between monotherapy and castration.
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PMID:Hormone therapy of prostate cancer: is there a role for antiandrogen monotherapy? 1093 69

Exemestane is an orally active steroidal aromatase inhibitor that has demonstrated efficacy in the treatment of postmenopausal patients with advanced breast cancer. This compound exhibits a good tolerability and safety profile, which may result from its highly selective mechanism of action. Exemestane binds irreversibly to the aromatase enzyme causing inactivation of the enzyme. This irreversible loss of enzyme may contribute to the sustained inhibition of estrogen synthesis noted following exemestane administration. Exemestane is a potent inhibitor of aromatization reducing estrogen synthesis in vivo by greater than 97%. The recommended dose of exemestane is 25 mg once daily. Although dosages up to 600 mg/day have been tested, the maximum tolerated dose of exemestane has not been reached in clinical study. The most frequently reported drug-related adverse events are hot flushes, nausea and fatigue, which are consistent with the estrogen-suppressive effects of the drug. Discontinuation due to adverse events is rare. Exemestane is a safe and well-tolerated alternative for the treatment of postmenopausal patients with advanced breast cancer.
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PMID:Exemestane in advanced breast cancer. 1108 51

The purpose of this study was to ascertain whether acute menopause symptoms experienced by women with breast cancer differed from those of women experiencing a natural menopause. For the study, 200 women younger than 65 years of age receiving adjuvant systemic treatment for breast cancer were invited to complete a self-report questionnaire incorporating a previously validated tool: the Greene Climacteric Scale. The control group consisted of 200 women 50 to 64 years of age who did not have a breast cancer diagnosis. An overall response rate of 59.5% was obtained. The majority of the respondents were peri- or postmenopause at the time of the study, reporting either "irregular periods" or "no periods." Findings demonstrated that women receiving adjuvant systemic breast cancer treatment were more likely than the control group to report a current experience of menopause symptoms. Women with breast cancer also reported a higher incidence and severity of specific menopause symptoms (tiredness, hot flushes, night sweats) than control subjects. These differences remained statistically significant when controls were used for potential confounding variables such as age, menopause status, and time since last period. Hot flushes ranked second only to tiredness as side effects attributed to cancer treatments. Because of the intimate and supportive nature of their role, nurses are in a key position to conduct future research relating to women's experiences of menopause symptoms and potential therapeutic interventions. Within the specific context of breast cancer care, oncology nurses are recognized as having a central role in informing and supporting women throughout the breast cancer trajectory. Thus they are ideally placed to address menopause as a particular survivorship issue.
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PMID:Acute menopause symptoms during adjuvant systemic treatment for breast cancer: a case-control study. 1112 22

This paper investigates if the highly selective norepinephrine reuptake inhibitor reboxetine leads to a dose-dependent cortisol release and if this response depends on personality dimensions related to clinical depression in healthy volunteers. Twenty-four male subjects received placebo, 2 mg, or 4 mg reboxetine in a balanced, randomized cross-over study. Cortisol was measured in saliva at six different time-points according to the kinetics of the drug. Furthermore, several measurements of cardiovascular parameters, emotional states, and possible side-effects were obtained. Subjects were divided into two groups scoring above or below the median of a depressiveness questionnaire scale [n = 11, low (D-); n = 13, high (D+)]. Results clearly demonstrated, that reboxetine stimulates cortisol release. Whereas blood pressure was not affected, heart rate increased after 2 and 4 mg but not dose dependently. Subjects reported more non-specific arousal while the dimensions of tiredness-wakefulness and positive-negative emotional states were not affected by the drug. Somatic complaints were low and only non-specific complaints were statistically elevated but of negligible amount. Subjects classified as D+ can be characterized as high responders to the drug. This is especially true not only for cortisol increases but also for changes in heart rate and some ratings on physical complaints. Hot flushes, sweating and a throbbing sensation in blood vessels in the head were observed in D+ but only with the 4 mg dose. The results clearly demonstrate that reboxetine stimulates cortisol release and heart rate and that this is particularly pronounced in subjects scoring high on depression-related personality dimensions. Reboxetine, therefore, is a promising tool for investigating neuroendocrine response to noradrenergic challenge tests. The question whether increased responses in D+ are due to an up-regulation of receptor sensitivity as a consequence of low norepinephrine supply is discussed.
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PMID:Reboxetine in a neuroendocrine challenge paradigm: evidence for high cortisol responses in healthy volunteers scoring high on subclinical depression. 1134 96

Comparative analysis among 357 inhabitants, who live in two areas: noisy (above 70 dB /A/) and moderate (below 57 dB /A/) showed significant differences between the groups in many variables under consideration. This differences, after eliminating socio-economic influences and behavior factors such as: gender, age, economical conditions, education or smoking confirmed existence of relation between living condition caused by motorization and life quality, well-being and self assessed health of inhabitants. Details showed, that urban intensive traffic noise disturbs realization of many important daily activities, evoke emotional tension, irritation, nervousness. In group of people from noisy areas more often are observed characteristic mental pressure caused by noise, throat and eyes irritation, disturbances in rest, speech, listen to music, sleep, and when going to sleep. Feeling of discomfort and annoyance dominates. More often there is a need to close or seal up the windows, use earplugs or take a sleeping pills. Relative risk of appearance of disturbances mentioned above or mental and emotional reactions in group of people who are exposed to high noise from 3 do 6 times bigger in comparison with people from quiet area. Apart from a decrease in the mental comfort and live quality, intensive traffic noise has a big influence on well-being and self assessed health status. The intensification of complaints and symptoms of neurotic character are observed in noisy areas. Most of these problems are connected with cardiovascular system (palpitation, constriction in chest, hot flush, tiredness after effort) and excessive nervous stimulation. Long lasting influence of noise is probably also a cause for a frequent nervousness, feeling of tiredness after night sleep and overstress, troubles with concentration or distinct reduction of well-being (feel unhappy and miserable, inability to cope with troubles, reduce ability to take of decisions). Additionally, the escalation of troubles probably connected with bigger air pollution (frequent dry cough, sneezing, nasal stuffing) is observed in areas of intensive traffic noise. Relative risk of appearance mentioned above unfavourably health symptoms in group of people from noisy areas is about 1.5 times higher than in areas below 57 dB /A/. Analyzed data did not confirm hypothesis on influence of traffic noise on increasing appearance of diseases confirmed by physician. In both areas noisy and quiet morbidity are similar. Also consumption of medicines was similar.
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PMID:[The estimate of well-being and self-assessed health status in urban population in various acoustic areas]. 1155 1

Abrupt onset of hot flashes poses a significant problem for women treated with chemotherapy for breast cancer. Alternatives to hormone replacement, such as the use of the selective serotonin re-uptake inhibitor (SSRI) paroxetine hydrochloride, are being explored as therapies for hot flashes in this patient population. The present study investigated the efficacy of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer. This study included 13 patients who were seen in the Psychosocial Clinic at Moffitt Cancer Center. They were referred by their medical oncologist after reporting complaints of significant difficulty with hot flashes. Baseline questionnaires were completed and a structured diagnostic interview for clinical depression was conducted, all of which were repeated 5 weeks after the paroxetine 20 mg daily was started. Significant improvements were seen in the ratings of hot flash severity (P = 0.002). In addition, significant improvements were observed in general, emotional, and mental fatigue. Rates of clinically significant depressive symptomatology also decreased and sleep quality improved significantly as well. Finally, the incidence of clinical depression improved from 39% at baseline to 8% after treatment. These preliminary data suggest that the antidepressant paroxetine can be helpful in the treatment of hot flashes and associated fatigue, sleep disturbance, and depression in women with breast cancer treated with chemotherapy. Further controlled studies are needed to more fully evaluate the efficacy of the SSRIs for hot flashes in women with breast cancer.
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PMID:A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer. 1199 3

The aims of this study were to describe a population of patients with cancer referred for complementary therapies to an NHS homeopathic hospital, and to explore the homeopathic approach to symptom control and its impact on mood disturbance and quality of life. One hundred consecutive patients attending a designated research cancer clinic were seen for a consultation, lasting up to 60 min, and prescription of a homeopathic remedy. A maximum of three symptoms were identified and rated by the patient as a problem, using a numerical self-rating scale. The effect these symptoms have on daily life and overall sense of well being were recorded using similar scales. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment in Cancer--Quality of Life Questionnaire--Core 30 (EORTC QLQ-30) at the initial consultation and at four to six consultations later. After this time, the patients completed a final assessment questionnaire asking about satisfaction with the homeopathic approach, how helpful they had found the approach for the targeted symptoms and what factors they felt may have contributed to the changes perceived. One hundred patients were entered into the study. Thirty-nine patients had metastatic disease. Nine patients were refusing conventional cancer treatments. The most common symptoms were pain, fatigue and hot flushes. Symptom scores for fatigue and hot flushes improved significantly over the study period but not for pain scores. Side effects included a transient worsening of symptoms in a few cases, which settled on stopping the remedy. Fifty-two patients completed the study, and in those patients satisfaction was high, and 75% (n=38) rated the approach as helpful or very helpful for their symptoms. Results suggest that further research is warranted to explore the management of hot flushes in women with breast cancer and fatigue in the cancer diagnosis.
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PMID:The homeopathic approach to symptom control in the cancer patient: a prospective observational study. 1204 99

This article analyzes physical symptoms experienced by mid-age Australian women in different stages of the menopause transition. A total of 8,623 women, aged 45 to 50 years in 1996, who participated the mid-age cohort of the Australian Longitudinal Study on Women's Health, completed Survey 1 in 1996 and Survey 2 in 1998. Women were assigned to 1 of 6 menopause groups according to their menopausal status at Surveys 1 and 2, and compared on symptoms experienced at Surveys 1 and 2, adjusted for lifestyle, behavioral and demographic factors. At Survey 1, the most commonly reported symptoms were headaches, back pain, stiff joints, tiredness, and difficulty sleeping. Perimenopausal women were more likely than premenopausal or postmenopausal women to report these symptoms. Hot flushes and night sweats were more common among postmenopausal women. Compared with those who remained premenopausal, women who were in the early stages of menopause or perimenopausal were more likely to report tiredness, stiff joints, difficulty sleeping, and hot flushes at Survey 2. Women who remained perimenopausal were also more likely to report back pain and leaking urine. Compared with premenopausal women, odds ratios for night sweats increased for women in consecutive stages of the menopause transition and remained high in the postmenopausal women.
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PMID:Changes in physical symptoms during the menopause transition. 1211 96

The female life period in which hormonal share begins to drop and the first menopausal clinical symptoms occur, is called perimenopausal period. During this female life phase, frequently, time of regular function and time of ovarian dysfunctions occur, with a limited luteal phase and an estrogen production fall. So, perimenopausal clinical symptoms begin: hot flushes, tiredness and libido decrease; to these problems, others can be connected to inadequate luteal phase, as breast pain, nervousness and body increase. Therefore, it's possible to affirm that the perimenopause is a particularly delicate period, either because it represents a transient moment to climateric phase, or because it's possible to detect a great hormonal instability, fundamental step for clinical problems. In our investigation we discuss this problem, explain the causes and the possible remedies to delay the onset of symptoms or to treat hormonal perimenopausal modifications.
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PMID:[The perimenopause. Problems and therapeutic changes]. 1211 67

A multi-center trial of exemestane 25 mg, an oral aromatase irreversible inactivator, was conducted to evaluate its efficacy and safety in 33 postmenopausal patients, and to investigate the pharmacokinetics/serum hormone levels in 16 postmenopausal patients, respectively, with breast cancer and anti-estrogen resistance. Exemestane 25 mg was given once daily for up to 48 weeks (maximum). The objective of this study was to confirm the reproducibility of the results shown in two studies in other countries with similar patients, to investigate the possibility of extrapolating the overseas data to Japanese. The response rate (CR + PR) was 24.2% (8.33%), which exceeded the minimum number (6 cases) required to evaluate efficacy. The response rate in this study was very similar to that observed in the two international open studies. Adverse events (subjective/objective symptoms), in which a causal relationship with exemestane administration could not be excluded, were observed in 26 cases (78.8%). Of these, hot flushes, increased sweating, fatigue, and insomnia occurred in more than 10% of patients, which was similar to that observed in the two international open studies. Abnormal laboratory results occurring in more than 10% of patients, in which a causal relationship with exemestane administration could not be excluded, were as follows: lymphocyte count decrease, alkaline phosphate increase, GOT increase, GPT increase, gamma-GTP increase, triglyceride increase, and inorganic phosphate increase, most of which were either grade 1 or 2. A remarkable decrease in serum hormone concentration was observed only for estrogen. The values of AUC0-infinity at day 1 and AUC0-24 h at day 29 (steady state) were similar, suggesting no accumulative effect of exemestane. These results demonstrate the anti-tumor effect and safety of exemestane in postmenopausal anti-estrogen resistant breast cancer patients. The reproducibility of the results of the two foreign studies was verified in Japanese patients, and it is concluded that the foreign trial data on exemestane can be extrapolated to Japanese.
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PMID:[Late phase II study of exemestane in postmenopausal patients with breast cancer resistant to anti-estrogenic agents]. 1214 2


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