Postmenopausal craniofacial hyperhidrosis treated with botulinum toxin type B

Hyperhidrosis can seriously impair patients’ quality of life. Medical history, including heredity and hyperhidrosis during youth, as well as current age and time elapsed since menopause, is important to consider when distinguishing between postmenopausal hyperhidrosis and vasomotor symptoms to enable adequate treatment. This report concerns a subgroup of eight postmenopausal patients participating in a randomized controlled trial regarding botulinum toxin (Btx) type B treatment in craniofacial hyperhidrosis. Even though the sample size is small and the enrolment is not yet completed, the promising data collected hitherto are interesting to present in advance because this subtype of craniofacial hyperhidrosis is often underrecognized and challenging to treat. Patients were randomized to receive Btx type B or placebo. Measurements were performed before treatment and 3 ± 1 weeks after. The Dermatology Life Quality Index (DLQI) score was improved for all patients after Btx type B treatment (n = 3) with a median decrease of 9 points (90% median improvement). The placebo group (n = 5) had a median increase of 2 points (–18% median decline). When the same group (n = 5) received Btx type B (open) the DLQI score decreased with a median of 7 points compared with baseline (91% median improvement). Treatment‐related adverse events were temporary and did not prevent improvement of life quality. Furthermore, background data evaluation uncovered interesting findings regarding vasomotor symptoms in relation to postmenopausal hyperhidrosis. In conclusion, the results indicated that Btx type B seems to be a safe and effective treatment in postmenopausal craniofacial hyperhidrosis. Further research is encouraged.     

绝经后阴道出血852例临床分析

探讨经经后阴道出血的原因，相关因素来指导临床实践。方法；对我院收治的８５２例绝经后阴道出血的临床资料进行回顾性分析。结果；以阴道炎最多２６９例、慢性宫颈炎１８８例，功能失调性子宫出血１０２例，宫内节育器９８例，恶性肿瘤５９例，以内膜癌 ３３例，卵巢恶性肿瘤次之１６例。     

Associations of resting and peak fat oxidation with sex hormone profile and blood glucose control in middle-aged women

Background and aimsMenopause may reduce fat oxidation. We investigated whether sex hormone profile explains resting fat oxidation (RFO) or peak fat oxidation (PFO) during incremental cycling in middle-aged women. Secondarily, we studied associations of RFO and PFO with glucose regulation.Method and resultsWe measured RFO and PFO of 42 women (age 52–58 years) with indirect calorimetry. Seven participants were pre- or perimenopausal, 26 were postmenopausal, and nine were postmenopausal hormone therapy users. Serum estradiol (E2), follicle-stimulating hormone, progesterone, and testosterone levels were quantified with immunoassays. Insulin sensitivity (Matsuda index) and glucose tolerance (area under the curve) were determined by glucose tolerance testing. Body composition was assessed with dual-energy X-ray absorptiometry; physical activity with self-report and accelerometry; and diet, with food diaries. Menopausal status or sex hormone levels were not associated with the fat oxidation outcomes. RFO determinants were fat mass (β = 0.44, P = 0.006) and preceding energy intake (β = ?0.40, P = 0.019). Cardiorespiratory fitness (β = 0.59, P = 0.002), lean mass (β = 0.49, P = 0.002) and physical activity (self-reported β = 0.37, P = 0.020; accelerometer-measured β = 0.35, P = 0.024) explained PFO. RFO and PFO were not related to insulin sensitivity. Higher RFO was associated with poorer glucose tolerance (β = 0.52, P = 0.002).ConclusionAmong studied middle-aged women, sex hormone profile did not explain RFO or PFO, and higher fat oxidation capacity did not indicate better glucose control.     

Lipid profile,inflammation, and oxidative status in peri- and postmenopausal women

Objective: To evaluate the effect of perimenopause and postmenopause on lipid profile, inflammation, and oxidative stress in women.

Methods: This cross-sectional study included 117 women (47?±?6 years) classified as perimenopausal (n?=?47), postmenopausal (n?=?40), or non-menopausal (n?=?30). In serum, we analyzed lipid profile, tumor necrosis factor-alpha (TNF-α), interleukin-1α (IL-1α), and C-reactive protein (CRP). Pro-oxidant status was assessed by thiobarbituric acid reactive substances (TBARS) and protein carbonyls. Antioxidant defense was performed by analysis of superoxide dismutase (SOD) and catalase activities.

Results: Compared to non-menopausal women, triacylglycerols (TG) were similar, total cholesterol and LDL-C were higher in perimenopausal and postmenopausal women, while HDL-C concentrations were decreased. TNF-α and IL-1α were higher in postmenopausal women, while CRP concentrations were elevated in both peri-and postmenopausal women (p?p?p?Conclusion: Menopausal transition and postmenopause were associated with dyslipidemia, inflammation, and unbalanced oxidative status exposing women to cardiovascular risk.     

选择性雌激素受体调节剂对绝经后乳腺癌患者子宫内膜的影响

目的探讨应用选择性雌激素受体调节剂(SERM)的绝经后乳腺癌患者子宫内膜病变相关因素及筛查方法。方法分析上海市长宁区妇幼保健院2013年1月至2020年6月间84例口服SERM的绝经后乳腺癌患者因经阴道超声(TVS)发现子宫内膜增厚行宫腔镜下子宫内膜活检术患者的临床资料。结果宫腔镜术前有13例(15.5%)患者有阴道出血症状,71例(84.5%)无临床症状;宫腔镜术后病理提示子宫内膜不典型增生/恶性病变共11例,术前经阴道超声检查(TVS)提示子宫内膜厚度为(17.0±11.5)mm,高于其他病理结果组(P<0.05)。术前TVS提示子宫内膜≥13mm,对子宫内膜不典型增生/恶性病变诊断的特异度为93.2%,敏感度为81.8%。Logistic回归分析示术前TVS提示子宫内膜厚度以及绝经后阴道出血是子宫内膜发生不典型增生/恶性病变高风险因素。结论子宫内膜厚度增加和绝经后阴道出血是子宫内膜不典型增生/恶性病变的高危因素。TVS仍然是绝经后乳腺癌使用SERM患者的首选筛查方法。     

激素治疗对围绝经期及绝经期妇女乳腺的病理影响——附乳腺穿刺病理91例分析

目的:探讨应用激素治疗(HT)对围绝经及绝经期妇女乳腺的病理影响。方法:选择91例围绝经及绝经期妇女为研究对象,52例用HT治疗(HT组),予倍美力0.3 mg/d,安宫黄体酮6 mg/d×10天周期用药或2 mg/d连续联合用药,39例无性激素治疗史(对照组),彩超扫描乳腺并测量腺体的厚度、检测血流信号,多普勒超声取样,之后在其引导下对乳腺结节或增生部位进行粗针针芯活检穿刺,对取得的组织进行病理分析。结果:超声检测乳腺腺体厚度及血流阻力指数(P=0.918、P=0.146)、乳腺穿刺组织病理呈增生改变的(P=0.882),两组比较无显著性差异。再将以上妇女分成HT≥5年组、HT<5年组、对照围绝经组、对照绝经组进行分组分析。超声检查腺体厚度依次为:对照围绝经组>HT<5年组>HT≥5年组>对照绝经组,但乳腺腺体的厚度及检出血流比、血流阻力指数、乳腺穿刺组织病理呈增生改变的,四组间比较仍无显著性差异(P>0.05)。91例中无乳腺异常血流及乳腺上皮细胞非典型增生的病例。结论:应用低剂量的激素治疗对乳腺的血流无影响,对乳腺无促其增生作用。     

Skin contamination by oestradiol gel--a remarkable source of error in plasma oestradiol measurements during percutaneous hormone replacement therapy

Objectives: To study the consequence of skin contamination by oestradiol gel on circulating plasma oestradiol levels. Methods: We studied ten healthy, hysterectomized postmenopausal women who had used percutaneous oestradiol gel for at least 2 years. After wash-out period percutaneous dose of 1.5 mg 17β-oestradiol was administered once a day in the evening. The gel was applied with a bare or gloved hand to an arm or thigh according to the schedule. Blood samples for assay of plasma oestradiol concentrations were collected from both cubital veins 12 h after gel administration, at baseline and every time after using the gel, for 2 weeks. Results: Plasma oestradiol concentrations were significantly higher in the gel-contaminated samples: in the cubital vein of the gel-applying arm and in the cubital vein of the forearm on which the gel had been spread. Conclusions: Skin contamination by topical 17β-oestradiol can distort plasma oestradiol measurements by giving much higher oestradiol concentrations than in reality there are in the systemic circulation. This has an important meaning when tailoring individual oestrogen therapy.