RESUMO
The need to improve access to health services for the transgender community has become evident, especially concerning cardiovascular risk, which is higher compared to the general population. Surgical procedures and hormone therapies are common in this population to affirm gender identity, but they pose challenges as they are associated with disruptions in lipid metabolism, body fat concentration, and insulin resistance. Additionally, there is an increased risk of adverse cardiovascular events such as venous thromboembolism, stroke, and myocardial infarction. The influence of sex hormones on the electrophysiological properties of the heart has been studied, highlighting gender differences that may predispose the transgender population to cardiac arrhythmias. Exogenous hormone therapy, for both transgender women and men, can affect the QT interval and increase the risk of arrhythmias, including atrial fibrillation. Although the incidence of arrhythmias in the transgender population is not entirely clear, evidence suggests the need for careful cardiovascular monitoring and consideration of risk factors before initiating hormone therapies.
La necesidad de mejorar el acceso a servicios de salud para la comunidad transgénero se ha vuelto evidente, especialmente en relación con el riesgo cardiovascular, que es más alto en comparación con la población general. Los procedimientos quirúrgicos y las terapias hormonales son comunes en esta población para reafirmar la identidad de género, pero plantean desafíos, ya que se asocian con alteraciones en el metabolismo de lípidos, la concentración de grasa corporal y la resistencia a la insulina. Además, existe un aumento en el riesgo de eventos cardiovasculares adversos, como tromboembolia venosa, accidente cerebrovascular e infarto de miocardio. La influencia de las hormonas sexuales en las propiedades electrofisiológicas del corazón ha sido estudiada, destacando diferencias entre géneros que pueden predisponer a la población transgénero a arritmias cardiacas. La terapia hormonal exógena, tanto para mujeres como para hombres trans, puede afectar el intervalo QT y aumentar el riesgo de arritmias, incluida la fibrilación auricular. Aunque la incidencia de arritmias en la población transgénero aún no está completamente clara, la evidencia sugiere la necesidad de un monitoreo cardiovascular cuidadoso y la consideración de factores de riesgo antes de iniciar terapias hormonales.
Assuntos
Fibrilação Atrial , Sistema Cardiovascular , Pessoas Transgênero , Humanos , Feminino , Masculino , Identidade de Gênero , Hormônios Esteroides Gonadais/efeitos adversos , Fibrilação Atrial/epidemiologiaRESUMO
Estrogens and progestogens are hormones produced by maternal organs and it is required for recognition and maintenance of pregnancy. In addition, the embryo may also be a source. For this, the aim was to identify steroidogenic expression on Galea spixii embryos early in the embryonic period. Embryos were collected on Days 10 and 15 of gestation; some were fixed in 4% paraformaldehyde for morphological and immunohistochemical analysis (P450arom), whereas others had RNA extracted to determine presence of CYP19a1 gene. In addition, for immunochemistry, maternal ovaries were collected as positive control tissues. Maternal tissues had positive staining for aromatase, whereas none of the embryos stained for P450 aromatase. Based on qPCR reactions, CYP19a1 gene were expressed in all embryos. Galea spixii embryos expressed steroidogenic genes during the post-implantation period, indicating they have the potential to produce steroid hormones.(AU)
Assuntos
Animais , Feminino , Roedores/embriologia , Hormônios Esteroides Gonadais/efeitos adversos , Aromatase/químicaRESUMO
Anabolic androgenic steroids (AAS) are recommended for therapeutic clinic, but their use has increased in recent decades for aesthetic reasons. No study has evaluated the impact of AAS in the fallopian tube, after treatment and recovery periods. Herein, the aim of study was to investigate the effects of Nandrolone Decanoate (ND), administered in different doses (1.87; 3.75; 7.5 and 15â¯mg/kg) on the ampulla of the fallopian tube in rats, following post-treatment (PT; 15 consecutive days) and post-recovery (PR; 30 consecutive days) periods. The control group received mineral oil. Estrous cycle was monitored daily during both periods and in sequence the rats (nâ¯=â¯8/group/period) were killed. All ND-treated animals showed estral acyclicity during the PT and PR periods, but the histomorphometric changes in the fallopian tube varied according to the ND dose level. The expression of AR, ERα and ERß varied in the nucleus and cytoplasm of epithelial cells. No AR expression was observed in the stroma. The muscle cells exhibited variation in immunostaining. In conclusion, ND promoted histomorphometric and immunohistochemical changes in the ampullary portion of the fallopian tube after treatment and recovery periods in a dose-independent manner.
Assuntos
Anabolizantes/administração & dosagem , Tubas Uterinas/efeitos dos fármacos , Hormônios Esteroides Gonadais/administração & dosagem , Nandrolona/análogos & derivados , Anabolizantes/efeitos adversos , Animais , Relação Dose-Resposta a Droga , Receptor alfa de Estrogênio/genética , Receptor beta de Estrogênio/genética , Ciclo Estral/efeitos dos fármacos , Tubas Uterinas/patologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Hormônios Esteroides Gonadais/efeitos adversos , Nandrolona/administração & dosagem , Nandrolona/efeitos adversos , Decanoato de Nandrolona , Tamanho do Órgão/efeitos dos fármacos , Ratos , Receptores Androgênicos/genéticaRESUMO
CONTEXT AND OBJECTIVE:: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING:: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS:: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS:: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS:: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.
Assuntos
Asma/etiologia , Hormônios Esteroides Gonadais/efeitos adversos , Asma/fisiopatologia , Brasil , Anticoncepcionais Orais/efeitos adversos , Feminino , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Menopausa , Gravidez , Complicações na Gravidez , Progesterona/efeitos adversos , Fatores de RiscoRESUMO
ABSTRACT CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.
RESUMO CONTEXTO E OBJETIVO: A relação entre os hormônios sexuais e a asma tem sido investigada em diversos estudos. Esta revisão tem como objetivo descrever a relação entre hormônios sexuais (endógenos e exógenos) e a inflamação nas vias aéreas, especialmente na asma, em eventos diferentes (na asma pré-menstrual, durante o uso de anticoncepcionais, na menopausa, no uso de terapia hormonal e na gestação). TIPO DE ESTUDO E LOCAL: Revisão narrativa da literatura médica, Universidade Federal do Tocantins (UFT) e Universidade Federal de São Paulo (Unifesp). MÉTODO: Pesquisamos o Portal de Periódicos Capes, uma plataforma brasileira que fornece acesso a artigos nas bases de dados MEDLINE, PubMed, SciELO e LILACS. Os descritores utilizados foram asma, hormônios sexuais, mulheres e uso de anticoncepcionais, com base no "Medical Subject Headings". RESULTADOS: As associações entre hormônios sexuais e asma ainda permanecem obscuras. Em adultos, a asma é mais frequente em mulheres do que em homens. Além disso, a mortalidade por asma é significativamente maior no sexo feminino, destacando-se que o sistema imunológico sofre influência de hormônios sexuais, seja porque a progesterona estimula o fator bloqueador induzido pela progesterona e citocinas Th2 ou porque contraceptivos derivados de progesterona e estrógeno estimulam o fator de transcrição GATA-3. CONCLUSÕES: A associação entre asma e hormônios sexuais femininos permanece obscura. Nós especulamos que as flutuações do estrogênio são responsáveis pelas exacerbações da asma que ocorrem nas mulheres. Devido à ação anti-inflamatória do estrogênio há redução da produção de TNF-α, da expressão do interferon-γ e da atividade das células NK. Sugerimos que sejam realizados novos estudos para esclarecer os mecanismos fisiopatológicos dessas interações.
Assuntos
Humanos , Feminino , Gravidez , Asma/etiologia , Hormônios Esteroides Gonadais/efeitos adversos , Complicações na Gravidez , Progesterona/efeitos adversos , Asma/fisiopatologia , Brasil , Menopausa , Fatores de Risco , Anticoncepcionais Orais/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversosRESUMO
OBJECTIVE: This article seeks to understand the experiences of transgender women in relation to the hormone therapy and sex reassignment surgery that make up the Gender Reassignment Process. METHOD: It is a qualitative study inserted into the field of cultural and gender studies. Data collection used narrative interviews, conducted in 2010 and 2011, with seven transsexual women who had been undergoing the Gender Reassignment Process for at least two years. The data was submitted to a thematic analysis. RESULTS: The results show that the transformation processes for construction of the female body include behavior adaptation, posture modification, voice modulation, hormone use, vaginal canal dilation and surgical complications. Such processes subject the body to be built as idealized to fit the gender identity, infringing on pleasures and afflictions. CONCLUSION: We concluded that the discussion involving the Gender Reassignment Process brings allowances for nursing regarding body changes experienced by transgender women.
Assuntos
Prazer , Procedimentos de Readequação Sexual/psicologia , Estresse Psicológico , Pessoas Transgênero/psicologia , Adulto , Comportamento , Imagem Corporal , Feminino , Identidade de Gênero , Hormônios Esteroides Gonadais/efeitos adversos , Hormônios Esteroides Gonadais/uso terapêutico , Humanos , Entrevistas como Assunto , Masculino , Satisfação do Paciente , Narrativas Pessoais como Assunto , Complicações Pós-Operatórias/psicologia , Pesquisa Qualitativa , Autoimagem , Procedimentos de Readequação Sexual/enfermagemRESUMO
OBJECTIVE: This article seeks to understand the experiences of transgender women in relation to the hormone therapy and sex reassignment surgery that make up the Gender Reassignment Process. METHOD: It is a qualitative study inserted into the field of cultural and gender studies. Data collection used narrative interviews, conducted in 2010 and 2011, with seven transsexual women who had been undergoing the Gender Reassignment Process for at least two years. The data was submitted to a thematic analysis. RESULTS: The results show that the transformation processes for construction of the female body include behavior adaptation, posture modification, voice modulation, hormone use, vaginal canal dilation and surgical complications. Such processes subject the body to be built as idealized to fit the gender identity, infringing on pleasures and afflictions. CONCLUSION: We concluded that the discussion involving the Gender Reassignment Process brings allowances for nursing regarding body changes experienced by transgender women. .
OBJETIVO: Esta investigación busca entender experiencias de mujeres transexuales con relación a la terapia hormonal y cirugía de reasignación de sexo, que constituyen el Proceso Transexualizador. MÉTODO: Se trata de una investigación cualitativa ubicada en el campo de los Estudios Culturales y de Género. Para la recolección de datos se utilizó la entrevista narrativa, llevada a cabo entre enero de 2010 y diciembre de 2011 con siete mujeres transexuales que se sometieron a la totalidad del Proceso Transexualizador por, un mínimo de dos años. Los datos fueron sometidos a análisis temático. RESULTADOS: Los resultados muestran que la construcción de un cuerpo femenino implica procedimientos para cambiar el comportamiento, postura, el tono de voz, el uso de la terapia hormonal, dilatación del canal vaginal y complicaciones quirúrgicas. Estos procesos someten al cuerpo a construirse como fue diseñado para adaptarse a su identidad de género, causando placeres y sufrimientos. CONCLUSIÓN: Este estudio muestra que la discusión del Proceso Transexualizador trae subsidios para enfermería acerca de los cambios corporales que experimentan las mujeres transexuales. .
OBJETIVO: Neste artigo, busca-se compreender as experiências de mulheres transexuais em relação à hormonioterapia e à cirurgia de redesignação sexual que constituem o Processo Transexualizador. MÉTODO: Trata-se de uma pesquisa qualitativa inserida no campo dos estudos culturais e de gênero. A coleta de dados utilizou entrevistas narrativas, realizadas em 2010 e 2011 com sete mulheres transexuais que se submeteram ao Processo Transexualizador há, pelo menos, dois anos. Os dados foram submetidos à análise temática. RESULTADOS: Os resultados mostram que os processos de transformação para a construção do corpo feminino envolvem adequar o comportamento, postura, empostação da voz, uso de hormônios, dilatação do canal vaginal e complicações cirúrgicas. Tais processos sujeitam o corpo a se construir conforme idealizado para adequar-se a sua identidade de gênero, infringindo-lhe prazeres e padecimentos. CONCLUSÃO: Conclui-se que a discussão que envolve o Processo Transexualizador traz subsídios para a enfermagem acerca das modificações corporais vivenciadas pelas mulheres transexuais. .
Assuntos
Humanos , Masculino , Feminino , Adulto , Prazer , Estresse Psicológico , Procedimentos de Readequação Sexual/psicologia , Pessoas Transgênero/psicologia , Comportamento , Imagem Corporal , Identidade de Gênero , Hormônios Esteroides Gonadais/efeitos adversos , Hormônios Esteroides Gonadais/uso terapêutico , Entrevistas como Assunto , Satisfação do Paciente , Narrativas Pessoais como Assunto , Complicações Pós-Operatórias/psicologia , Pesquisa Qualitativa , Autoimagem , Procedimentos de Readequação Sexual/enfermagemRESUMO
BACKGROUND: Although young maternal age has been identified as a risk factor for gastroschisis, its role remains undisclosed. To our knowledge, the differences between young mothers of infants with gastroschisis and young mothers of infants with other pregnancy outcomes have not been established. The aim of this work was to compare characteristics of young mothers whose newborn had gastroschisis with same aged mothers of malformed and nonmalformed control infants, diagnosed within the ECLAMC maternity hospital network. METHODS: Data base records of live and stillborn infants of one of three groups (with isolated gastroschisis, with 1 of 5 other isolated birth defects, and nonmalformed), and whose mothers were younger than 20 years, were selected. Secular trends were obtained for all birth defects; frequencies and odds ratios (OR) of demographic and reproductive variables were compared among the 3 groups. Significantly associated variables were adjusted with a multivariate regression. RESULTS: The association was higher with gastroschisis 1) than with other birth defects for African ancestry, smoking, adequate prenatal control and diagnosis 2) than with nonmalformed controls for maternal illnesses and alcohol 3) and than both for previous pregnancy loss and medication, mainly sex hormones. After adjustment, only previous pregnancy loss maintained its significance when compared with malformed (OR = 2.34; 1.37-3.97; P = 0.002), as well as with nonmalformed (OR = 3.43; 2.07-5.66; P < 0.001) controls. CONCLUSION: A previous pregnancy loss was identified as the main risk factor for gastroschisis, while an increased use of sex hormones, perhaps related to the previous loss, could trigger a disruptive mechanism, due to their thrombophilic effect.
Assuntos
Aborto Espontâneo/epidemiologia , Gastrosquise/epidemiologia , Gastrosquise/etiologia , Hormônios Esteroides Gonadais/efeitos adversos , Idade Materna , Adolescente , Argentina/epidemiologia , Anormalidades Congênitas/epidemiologia , Feminino , Humanos , Recém-Nascido , Razão de Chances , Gravidez , Análise de Regressão , Fatores de RiscoRESUMO
Ovary cancer is a disease charged of paradigms and a serious health problem. It's important to know its natural history, because has a multifactor origins, and understanding its behavior since risk factors until patient's death because metastatic disease is a challenger for oncology group. In this work we made a bibliographic, analytic review that brings up concepts related to its origin, evolution, risk factors, preclinical horizon, and clinical symptoms until the death of patient.
Assuntos
Carcinoma/patologia , Neoplasias Ovarianas/patologia , Neoplasias da Mama/epidemiologia , Carcinoma/classificação , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/etiologia , Carcinoma/secundário , Comorbidade , Progressão da Doença , Detecção Precoce de Câncer , Diagnóstico Precoce , Feminino , Predisposição Genética para Doença , Hormônios Esteroides Gonadais/efeitos adversos , Hormônios Esteroides Gonadais/fisiologia , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Mutação , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/etiologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Primárias Múltiplas/epidemiologia , Obesidade/epidemiologia , Oncogenes , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/etiologia , Síndrome do Ovário Policístico/epidemiologia , Síndrome do Ovário Policístico/fisiopatologia , História Reprodutiva , Taxa de SobrevidaRESUMO
Risk preferences drive much of human decision making including investment, career and health choices and many more. Thus, understanding the determinants of risk preferences refines our understanding of choice in a broad array of environments. We assess the relationship between risk preferences, prenatal exposure to sex hormones and gender for a sample of Ladinos, which is an ethnic group comprising 62.86% of the population of Guatemala. Prenatal exposure to sex hormones has organizational effects on brain development, and has been shown to partially explain risk preferences for Caucasians. We measure prenatal exposure to sex hormones using the ratio of the length of the index finger to the length of the ring finger (2D:4D), which is negatively (positively) correlated with prenatal exposure to testosterone (estrogen). We find that Ladino males are less risk averse than Ladino females, and that Ladino males have lower 2D:4D ratios than Ladino females on both hands. We find that the 2D:4D ratio does not explain risk preferences for Ladinos. This is true for both genders, and both hands. Our results highlight the importance of exploring the behavioral significance of 2D:4D in non-Caucasian racial groups.