Synthetic progestins are steroid hormones, which are not only part of the hormonal contraceptives, but they are also used to treat a number of health problems in human. Due to the widespread use of progestin-based drugs, their residues are being found in wastewaters, from where they also enter into the wastewater treatment plants and surface waters. The aim of this thesis was to assess whether the synthetic progestin etonogestrel affects the secondary sexual characteristics and gonad histology of Endler´s guppy (Poecilia wingei). During the experiment, males and females were separately exposed to 3.2 and 320 ng.l-1 etonogestrel for 34 days. A group of fish reared in pure water (K) and group of fish reared in pure water containing the solvent dimethylsulfoxide (KS) served as controls. At the end of the test, all the fish were photographed to capture any color changes. Then the fish were sacrificed and fixed in 10 % buffered formalin solution for morphometric and histological analysis. Fish samples taken for morphometric analysis were photographed using QuickPHOTO MICRO 2.3 software and individual morphometric parameters were measured on the images taken. Fish sample processing for histological analysis included decalcification, dehydration, and pouring of the samples into paraffin blocks. Then paraffin blocks were cut with the thickness of about 4.5 um, resulting slides were stained with hematoxylin and eosin. Histological changes of the gonads were determined on the histological samples prepared in this way. In females exposed to both concentrations of etonogestrel occurrence of color spots was observed. Color spots are characteristic for male and in females indicate masculinization. In addition, females exposed to 320 ng.l-1 etonogestrel showed a change in anal fin morphometry to a gonopodium-like structure (modified anal fin of males serving as helping copulatory organ), a sign also suggesting masculinization. Furthermore, exposure of etonogestrel in both lower and higher concentration of etonogestrel reduced number of mature oocytes in the ovaries, and their occurrence decreased with increasing concentration. In males exposed to both concentrations of etonogestrel a smaller ratio of the length of 4th ray to the length of 6th ray of gonopodium was found. In addition, at concentration of etonogestrel 320 ng.l-1 a greater ratio of the length of 6th ray to body length and extension of length of 6th ray was observed. Although there were no changes, which would indicate hypermasculinization, these changes could have a negative impact on reproduction, or sexual selection by the female. Etonogestrel exposure had no effect on the normal development of testes, because predominantly mature spermatophores were found in males of all treatment groups. Based on these findings, we can say that etonogestrel, like other progestins, represents a real risk to fish if it occures in aquatic environment at concentrations reaching units of ng.l-1.

The overall goal of this research was to verify the involvement of membrane progestin receptor alpha (mPRα) in mediating progestin-stimulated sperm hypermotility in the Atlantic croaker and southern flounder. Sperm motility in Atlantic croaker and southern flounder were tested with both the endogenous progestin, 17,20β,21-trihydroxy-4-pregnen-3-one (20β-S) or the selective mPRα agonist, 10-ethenyl-19-norprogesterone (Org OD 02-0). In croaker, the Pi3k/Akt/Pde and ErbB2/Mapk intracellular signaling pathways were examined. The role of mPRα in mediating sperm hypermotility and fertility in southern flounder was also studied. The effects of seasonal hypoxia on sperm motility in croaker were investigated in a field study in the northern Gulf of Mexico in the fall of 2010. Finally, the effects of acidified activator solution (simulating ocean acidification) were studied in the laboratory. In vitro, Org OD 02-0 mimicked the stimulatory actions of 20β-S in inducing sperm hypermotility and intracellular signaling cascades in croaker and flounder sperm, indicating that mPRα is the mediator of progestin signaling in the sperm of these species. In croaker sperm, both the Pi3k/Akt/Pde and ErbB2/Mapk intracellular signaling pathways were shown to be important mediators of progestin-induced sperm hypermotility, suggesting novel functions of G [subscript olf] βγ-subunits in teleost sperm. In flounder sperm, mPRα was shown to be important in mediating sperm hypermotility as only high motility sperm with high expression of mPRα were responsive to progestin stimulation, resulting in higher fertilization success compared to low motility sperm. A single LHRHa injection resulted in increased sperm motility and fertility, associated with an increase in mPRα expression in the sperm plasma membrane. The results also suggest that the mPRα/Acy/cAMP pathway first described in croaker sperm is present in flounder sperm. Field studies of male Atlantic croaker exposed to chronic seasonal hypoxia showed that hypoxia exposure resulted in smaller gonads, lower spermatogenesis, reduced testicular mPRα expression, and in some sites, reduced sperm motility. Studies with croaker sperm using acidified activator solution to simulate ocean acidification indicated that croaker sperm were sensitive to environmental insult. Furthermore, the results suggested that the progestin signaling mechanism is more sensitive to changes in ocean pH levels than the mechanism that controls sperm motility. / text

Background: During the past 5 decades, hormone replacement therapy (HRT) has been used, and appreciated for its beneficial effects, by millions of women in their menopause. As treatment for climacteric symptoms, estrogen is outstanding, and effects on hot flushes, vaginal dryness, and insomnia have been widely documented. The increased risks of venous thrombosis and breast cancer, however, restrict the use of estrogen. Estrogen treatment in women with a remaining uterus includes a progestin, added to protect the endometrium from hyperplasia and malignancies. The long-standing clinical impression, that progestin addition negatively influences mood, has been discussed in previous studies. Mood deterioration is, however, not mortal, although mood is important to the wellbeing and daily functioning of women treated with hormones. Studies of the mental side effects of HRT add to our understanding of steroid effects in the brain. Aims and methods: In our studies, we aimed to establish to what extent negative side effects cause women to discontinue HRT, and find out which drug compounds lead to mood deterioration. The questions asked were whether the type and dose of progestin and the estrogen dose during the progestin addition influence the mood and physical symptoms during sequential HRT. Compliance with HRT and reasons for discontinuing the therapy were evaluated in a retrospective longitudinal follow-up study. Treatment effects were studied in three randomized, double-blind, cross-over trials. During continuous estrogen treatment, effects of sequential addition of a progestin were studied by comparing two different progestins, medroxyprogesterone acetate (MPA) andnorethisterone acetate (NETA), comparing different doses of the same progestin, MPA, and comparing two doses of estrogen during addition of the same dose of MPA. The main outcome measure was the daily rating on mood and physical symptoms kept by the participants throughout the studies. The clinical trials were carried out at three gynecological centers in northern Sweden. Results and conclusions: Besides fear of cancer and a wish to determine whether climacteric symptoms had meanwhile disappeared, negative side effects was the most common reason or discontinuing HRT. Tension in the breasts, weight gain, a depressed mood, abdominal bloating, and irritability were the most important side effects seen both in women who continued HRT and in women who had discontinued the therapy. In our clinical trials, we showed that addition of a progestin to estrogen treatment induces cyclic mood swings characterized by tension, irritability, and depression, as well as increased breast tension, bloatedness, and hot flushes. Women with a history of premenstrual syndrome (PMS) appeared to be more sensitive to the progestin addition and responded with lower mood scores compared with women without previous PMS. In our studies, MPA provoked depressed mood to a lesser extent than did NETA. Surprisingly, the higher dose of MPA (20 mg) enhanced the mood, compared with 10 mg, when added to estrogen treatment. In women continuously treated with 3 mg estradiol, mood and physical symptoms worsened during the progestin addition, as compared with treatment with 2 mg estradiol. The negative side effects seen during sequential HRT have much in common with symptoms seen in the premenstrual dysphoric disorder (PMDD), which is a psychoneuroendocrine disorder with psychiatric expression. Explanations for treatment effects on mood are likely to be found in drug interactions with neurotransmitter systems of the brain. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 2003</p> / digitalisering@umu

O experimento 1 verificou o efeito de um protocolo de indução e sincronização de estros em novilhas sobre a cronologia das parições e a repetição de crias como primíparas. 194 novilhas Hereford e Braford foram divididas em 2 grupos: Tratamento, submetido a um protocolo misto de observação e sincronização de estros e inseminação artificial a tempo fixo (IATF); e Controle, submetido ao manejo convencional de inseminação artificial (IA). Ambos grupos foram submetidos a repasse por touros. O Experimento 2 avaliou o efeito de um pré-tratamento com norgestomet (NOR), prévio a um protocolo de sincronização para IATF em novilhas, sobre as taxas de prenhez, assim como os efeitos de características relacionadas com a reprodução. 74 novilhas Angus e cruzas, 18 e 24 meses de idade, com peso médio de 276 kg, condição corporal (CC) mínima de 3 (1-5) e avaliadas por ultra-som para o status ovariano, onde utilizaram-se somente novilhas 2 e 3 (1-3). Pesagens a cada 30 dias, desde os 60 dias anteriores aos serviços. Coletado sangue para dosagem de progesterona. Os animais foram divididos em 2 grupos: Tratamento, que recebeu um implante com 6 mg de NOR, na orelha direita, permanecendo por 14 dias; e Controle, que não recebeu implante. Dez dias após a retirada dos implantes, todas as novilhas foram a um protocolo para IATF, com uma injeção de GnRH, 7 dias depois uma aplicação de prostaglandina (PGF) e 48 horas mais tarde, as IATF e outra aplicação de GnRH. Quatorze dias após iniciou-se repasse com 2 touros, por mais 45 dias. O Experimento 3 avaliou o efeito da suplementação com progestágeno (acetato de medroxi-progesterona; MAP) ou progesterona, anteriormente a um protocolo para IATF, e verificou o efeito de características associadas à reprodução de novilhas, e de distintos manejos alimentares sobre as taxas de prenhez. Utilizaram-se 102 novilhas Angus, cruzas Angus e Braford, 22-24 meses, peso médio 241 kg e CC mínima de 2,5. Pesagens a cada 30 dias, a partir dos 60 dias anteriores aos serviços e ultra-som para o status ovariano (1-3). Quarenta e cinco dias antes da estação foram divididas em 2 grupos, Sem Suplementação, com 27 novilhas exclusivamente sobre pastagem natural, e Com Suplementação, com 75 novilhas consumindo 1% do peso em concentrado. Coletas de sangue para dosagem de progesterona. Grupos novamente divididos em 3, para receber dispositivo com progesterona, ou uma esponja intravaginal com MAP, ambos por 10 dias. O grupo Controle não recebeu nenhum tratamento. Na retirada dos implantes, todas as novilhas receberam PGF, e 4 dias depois, foram a um protocolo para IATF, com 2 mg de benzoato de estradiol na colocação de uma esponja com MAP. Sete dias depois, a esponja foi retirada, sendo aplicada PGF, seguindo-se nova aplicação de BE 24 horas depois, e IATF 52-56 horas após a PGF. Observação de estros 2 vezes por dia, desde a PGF até a IATF. Passados 14 dias, iniciou repasse por 4 touros, durante 45 dias. O Experimento 4 avaliou o efeito da suplementação de novilhas de corte com gammaorizanol, sobre o desempenho reprodutivo, assim como o efeito de outras características sobre a reprodução. Utilizaram-se 84 novilhas Angus, Hereford, Braford e Angus x Hereford, com 24 meses, peso médio de 283 kg e CC ≥ 3. Pesagens a cada 30 dias, desde 60 dias antes até o início dos serviços, coletas de sangue para dosagem de progesterona. Duas avaliações da espessura de gordura subcutânea, sobre a região P8 por ultra-som, com intervalo de 30 dias. Animais foram divididos em 2 grupos: Tratamento, que recebeu desde 45 dias antes até o início da estação reprodutiva, 150 ml/dia de gamma-orizanol junto à 1 kg de concentrado; e Controle, com 150 ml/dia de melaço, junto à 1 kg do mesmo concentrado. Observações de estros 2 vezes/dia e IA. Dez dias após aplicou-se PGF a todas ainda não observadas em estro, prosseguindo-se a observação e IA por mais 25 dias. Após, repasse por 2 touros por 45 dias. Diagnósticos de gestação por ultra-som, 30 dias após as IATF ou IA, e novamente, 30 dias depois de retirados os touros. No experimento 1, a porcentagem de prenhez na primeira estação reprodutiva foi semelhante para os 2 grupos. Entretanto, a repetição de crias nas primíparas do grupo Tratamento foi significativamente maior. No Experimento 2, não foram observadas diferenças entre as taxas de prenhez à IATF e final, e conforme a idade e o status ovariano. No Experimento 3, taxas de estro superiores para o grupo Progesterona em relação ao Progestágeno e Controle. Entretanto, taxas de prenhez semelhantes entre os grupos. Foi encontrada diferença entre o peso 24 dias antes dos serviços, para as novilhas que emprenharam em relação às que permaneceram vazias e para os pesos das novilhas ao final da temporada. As novilhas com status ovariano 2 e 3 foram mais pesadas em relação ao 1, mas as taxas de prenhez não diferiram com o status ovariano. O concentrado proporcionou superior GMD para o grupo Com Suplementação, mas sem diferenças para as taxas de prenhez. No Experimento 4, taxas de prenhez semelhantes para Tratamento e Controle. Novilhas prenhas foram as que acumularam maior quantidade de gordura na região P8. Concluindo, o manejo com sincronização de estros e IATF na primeira estação reprodutiva em novilhas, apesar de apresentar índices idênticos de prenhez ao final da temporada, proporcionou diferença significativa nos índices de prenhez na segunda estação. O pré-tratamento com norgestomet não proporcionou superiores taxas de prenhez em novilhas. Da mesma forma, o priming com progesterona ou MAP, não proporcionou taxas de prenhez superiores, assim como a utilização de suplementação alimentar. O peso corporal antes ou dos serviços, foi superior para as novilhas que emprenharam. Novilhas com status ovariano 2 e 3, foram mais pesadas. O fornecimento de gamma-orizanol não proporcionou superiores taxas de prenhez ou peso corporal, entretanto, novilhas que resultaram prenhas, acumularam maior quantidade de gordura antes da estação reprodutiva. / Experiment 1 verified the effect of an estrus synchronization protocol in heifers on parturition chronology and primiparous reproductive performance. 194 Hereford and Braford heifers were divided into 2 groups: Treatment group, submitted to an estrus observation and synchronization to fixed-time artificial insemination (FTAI) protocol; and Control group, submitted to a conventional artificial insemination (AI) management. All groups were submitted to a bull’s clean-up period. Experiment 2 evaluated the norgestomet (NOR) priming effect, before a fixed-time artificial insemination protocol (FTAI) in heifers, on pregnancy rates, as well as the effects of reproductive related characteristics. 74 Angus and cross-bred heifers, 18 and 24 months old, with 276 kg of body weight, body condition score (BCS) minimum of 3 (1- 5), and ovarian status evaluated by US. Only the 2 or 3 class heifers were used (1-3). Heifers were weighted at 30 days intervals, starting 60 days before the reproductive period. Blood was collected for progesterone assay. Heifers were divided in 2 groups: Treatment group, that received an ear implant with 6 mg of NOR, in the right ear, removing it 14 days after; and Control group, did not receive the implant. Ten days after the implants removal, all heifers were submitted to FTAI protocol, which including a GnRH i.m. injection, 7 days after the prostaglandin (PGF) aplication, and 48 hours later, FTAI and a second GnRH injection. Fourteen days later, started a clean-up period with 2 bulls, for 45 days more. Experiment 3 evaluated the progestin (medroxiprogesterone acetate; MAP) or progesterone suplementation effect, before a FTAI protocol, and evaluated the effects of reproductive associated characteristics in heifers, and feeding managements over pregnancy rates. 102 Angus, cross-bred Angus and Braford heifers, 22-24 months old were used, with an average body weight of 241 kg, and a minimum BCS of 2,5. Heifers were weighted at 30 days intervals, starting 60 days before the breeding period and an ecography was performed to evaluate ovarian status. Fourty five days before the season, heifers were divided into 2 groups. Without Suplementation group, with 27 heifers, only over natural pastures, and With Suplementation group, with 75 heifers receiving suplementation (72% TDN and 15% GP) about 1% body weight. Blood was collected for progesterone assay. Groups were again divided into 3, to receive a progesterone device or an intravaginal MAP sponge, for 10 days. The Control group, not received the treatment. At the implants removal, all heifers received PGF, and 4 days later were submitted to a FTAI protocol, with 2 mg estradiol benzoate with an intravaginal MAP sponge aplication. Seven days later, the sponge was removed, and PGF was injected, with a new EB injection, 24 hours later, and FTAI 52-56 hours after PGF. Estrus was observed from PGF injection to FTAI. A clean-up period started 14 days after with 4 bulls, for more 45 days. Experiment 4 evaluated the gamma-orizanol suplementation effects and other reproductive associated characteristics on fertility of beef heifers. 84 Angus, Angus x Hereford, Hereford and Braford heifers, 24 months old were used, with an average body weight of 283 kg and BCS ≥ 3. Heifers were weighted at 30 days intervals, to register ADG, and blood samples were collected for progesterone assay. Two subcutaneous fat thickness ecographic evaluations were performed at P8 region, with a 30 days interval. Animals were divided into 2 groups: Treatment group, that received 150 ml/day of gammaorizanol with 1 kg of concentrate since 45 days before the reproductive season start ; and Control group, with 150 ml/day of molasses with 1 kg of concentrate during the same period. Estrus control was done twice for day with AI of estrous heifers. Ten days later PGF was applied to all heifers that did not show estrus. The AI management continued for 25 days. In sequence, a clean-up period with 2 bulls was performed for 45 days. Gestational diagnostics by ecography at 30 days after FTAI, and again at 30 days after bulls removal. In experiment 1, pregnancy rates were similar between groups after first reproductive season. However, the repetition of Treatment group was significantly higher. In Experiment 2, were not observed differences between groups in FTAI and final pregnancy rates, without differences for age or ovarian status In Experiment 3, Progesterone group presented the higher estrus rates than Progestin and Control groups. However, were not observed differences in pregnancy rates among the groups. At the same experiment, difference on weights before mating was found between the heifers that became pregnant compared to heifers that stayed non pregnant. Heifers with ovarian status 2 and 3 had higher average weight than heifers with status 1. The suplementation enhanced ADG in the With Suplementation group, but it did not produce differences on pregnancy rates. In Experiment 4, pregnancy rates were similar between groups. Heifers which became pregnant acumulated more fat amount in P8 region, during the treatment period. In conclusion, the first breeding season management with synchronization to FTAI in heifers, since being presented identical final pregnancy rates, produced signifficative differences on pregnancy rates in the second breeding season. The priming with norgestomet did not enhance pregnancy rates in beef heifers, as well the progesterone or progestin primings and the different feeding managements. Heifers with ovarian status 2 and 3, had higher body weights. Gamma-orizanol supplementation did not enhanced pregnancy rates, ADG neither body weight. Heifers that became pregnant, acumulated more fat amount on P8 region before the reproductive season.

O experimento 1 verificou o efeito de um protocolo de indução e sincronização de estros em novilhas sobre a cronologia das parições e a repetição de crias como primíparas. 194 novilhas Hereford e Braford foram divididas em 2 grupos: Tratamento, submetido a um protocolo misto de observação e sincronização de estros e inseminação artificial a tempo fixo (IATF); e Controle, submetido ao manejo convencional de inseminação artificial (IA). Ambos grupos foram submetidos a repasse por touros. O Experimento 2 avaliou o efeito de um pré-tratamento com norgestomet (NOR), prévio a um protocolo de sincronização para IATF em novilhas, sobre as taxas de prenhez, assim como os efeitos de características relacionadas com a reprodução. 74 novilhas Angus e cruzas, 18 e 24 meses de idade, com peso médio de 276 kg, condição corporal (CC) mínima de 3 (1-5) e avaliadas por ultra-som para o status ovariano, onde utilizaram-se somente novilhas 2 e 3 (1-3). Pesagens a cada 30 dias, desde os 60 dias anteriores aos serviços. Coletado sangue para dosagem de progesterona. Os animais foram divididos em 2 grupos: Tratamento, que recebeu um implante com 6 mg de NOR, na orelha direita, permanecendo por 14 dias; e Controle, que não recebeu implante. Dez dias após a retirada dos implantes, todas as novilhas foram a um protocolo para IATF, com uma injeção de GnRH, 7 dias depois uma aplicação de prostaglandina (PGF) e 48 horas mais tarde, as IATF e outra aplicação de GnRH. Quatorze dias após iniciou-se repasse com 2 touros, por mais 45 dias. O Experimento 3 avaliou o efeito da suplementação com progestágeno (acetato de medroxi-progesterona; MAP) ou progesterona, anteriormente a um protocolo para IATF, e verificou o efeito de características associadas à reprodução de novilhas, e de distintos manejos alimentares sobre as taxas de prenhez. Utilizaram-se 102 novilhas Angus, cruzas Angus e Braford, 22-24 meses, peso médio 241 kg e CC mínima de 2,5. Pesagens a cada 30 dias, a partir dos 60 dias anteriores aos serviços e ultra-som para o status ovariano (1-3). Quarenta e cinco dias antes da estação foram divididas em 2 grupos, Sem Suplementação, com 27 novilhas exclusivamente sobre pastagem natural, e Com Suplementação, com 75 novilhas consumindo 1% do peso em concentrado. Coletas de sangue para dosagem de progesterona. Grupos novamente divididos em 3, para receber dispositivo com progesterona, ou uma esponja intravaginal com MAP, ambos por 10 dias. O grupo Controle não recebeu nenhum tratamento. Na retirada dos implantes, todas as novilhas receberam PGF, e 4 dias depois, foram a um protocolo para IATF, com 2 mg de benzoato de estradiol na colocação de uma esponja com MAP. Sete dias depois, a esponja foi retirada, sendo aplicada PGF, seguindo-se nova aplicação de BE 24 horas depois, e IATF 52-56 horas após a PGF. Observação de estros 2 vezes por dia, desde a PGF até a IATF. Passados 14 dias, iniciou repasse por 4 touros, durante 45 dias. O Experimento 4 avaliou o efeito da suplementação de novilhas de corte com gammaorizanol, sobre o desempenho reprodutivo, assim como o efeito de outras características sobre a reprodução. Utilizaram-se 84 novilhas Angus, Hereford, Braford e Angus x Hereford, com 24 meses, peso médio de 283 kg e CC ≥ 3. Pesagens a cada 30 dias, desde 60 dias antes até o início dos serviços, coletas de sangue para dosagem de progesterona. Duas avaliações da espessura de gordura subcutânea, sobre a região P8 por ultra-som, com intervalo de 30 dias. Animais foram divididos em 2 grupos: Tratamento, que recebeu desde 45 dias antes até o início da estação reprodutiva, 150 ml/dia de gamma-orizanol junto à 1 kg de concentrado; e Controle, com 150 ml/dia de melaço, junto à 1 kg do mesmo concentrado. Observações de estros 2 vezes/dia e IA. Dez dias após aplicou-se PGF a todas ainda não observadas em estro, prosseguindo-se a observação e IA por mais 25 dias. Após, repasse por 2 touros por 45 dias. Diagnósticos de gestação por ultra-som, 30 dias após as IATF ou IA, e novamente, 30 dias depois de retirados os touros. No experimento 1, a porcentagem de prenhez na primeira estação reprodutiva foi semelhante para os 2 grupos. Entretanto, a repetição de crias nas primíparas do grupo Tratamento foi significativamente maior. No Experimento 2, não foram observadas diferenças entre as taxas de prenhez à IATF e final, e conforme a idade e o status ovariano. No Experimento 3, taxas de estro superiores para o grupo Progesterona em relação ao Progestágeno e Controle. Entretanto, taxas de prenhez semelhantes entre os grupos. Foi encontrada diferença entre o peso 24 dias antes dos serviços, para as novilhas que emprenharam em relação às que permaneceram vazias e para os pesos das novilhas ao final da temporada. As novilhas com status ovariano 2 e 3 foram mais pesadas em relação ao 1, mas as taxas de prenhez não diferiram com o status ovariano. O concentrado proporcionou superior GMD para o grupo Com Suplementação, mas sem diferenças para as taxas de prenhez. No Experimento 4, taxas de prenhez semelhantes para Tratamento e Controle. Novilhas prenhas foram as que acumularam maior quantidade de gordura na região P8. Concluindo, o manejo com sincronização de estros e IATF na primeira estação reprodutiva em novilhas, apesar de apresentar índices idênticos de prenhez ao final da temporada, proporcionou diferença significativa nos índices de prenhez na segunda estação. O pré-tratamento com norgestomet não proporcionou superiores taxas de prenhez em novilhas. Da mesma forma, o priming com progesterona ou MAP, não proporcionou taxas de prenhez superiores, assim como a utilização de suplementação alimentar. O peso corporal antes ou dos serviços, foi superior para as novilhas que emprenharam. Novilhas com status ovariano 2 e 3, foram mais pesadas. O fornecimento de gamma-orizanol não proporcionou superiores taxas de prenhez ou peso corporal, entretanto, novilhas que resultaram prenhas, acumularam maior quantidade de gordura antes da estação reprodutiva. / Experiment 1 verified the effect of an estrus synchronization protocol in heifers on parturition chronology and primiparous reproductive performance. 194 Hereford and Braford heifers were divided into 2 groups: Treatment group, submitted to an estrus observation and synchronization to fixed-time artificial insemination (FTAI) protocol; and Control group, submitted to a conventional artificial insemination (AI) management. All groups were submitted to a bull’s clean-up period. Experiment 2 evaluated the norgestomet (NOR) priming effect, before a fixed-time artificial insemination protocol (FTAI) in heifers, on pregnancy rates, as well as the effects of reproductive related characteristics. 74 Angus and cross-bred heifers, 18 and 24 months old, with 276 kg of body weight, body condition score (BCS) minimum of 3 (1- 5), and ovarian status evaluated by US. Only the 2 or 3 class heifers were used (1-3). Heifers were weighted at 30 days intervals, starting 60 days before the reproductive period. Blood was collected for progesterone assay. Heifers were divided in 2 groups: Treatment group, that received an ear implant with 6 mg of NOR, in the right ear, removing it 14 days after; and Control group, did not receive the implant. Ten days after the implants removal, all heifers were submitted to FTAI protocol, which including a GnRH i.m. injection, 7 days after the prostaglandin (PGF) aplication, and 48 hours later, FTAI and a second GnRH injection. Fourteen days later, started a clean-up period with 2 bulls, for 45 days more. Experiment 3 evaluated the progestin (medroxiprogesterone acetate; MAP) or progesterone suplementation effect, before a FTAI protocol, and evaluated the effects of reproductive associated characteristics in heifers, and feeding managements over pregnancy rates. 102 Angus, cross-bred Angus and Braford heifers, 22-24 months old were used, with an average body weight of 241 kg, and a minimum BCS of 2,5. Heifers were weighted at 30 days intervals, starting 60 days before the breeding period and an ecography was performed to evaluate ovarian status. Fourty five days before the season, heifers were divided into 2 groups. Without Suplementation group, with 27 heifers, only over natural pastures, and With Suplementation group, with 75 heifers receiving suplementation (72% TDN and 15% GP) about 1% body weight. Blood was collected for progesterone assay. Groups were again divided into 3, to receive a progesterone device or an intravaginal MAP sponge, for 10 days. The Control group, not received the treatment. At the implants removal, all heifers received PGF, and 4 days later were submitted to a FTAI protocol, with 2 mg estradiol benzoate with an intravaginal MAP sponge aplication. Seven days later, the sponge was removed, and PGF was injected, with a new EB injection, 24 hours later, and FTAI 52-56 hours after PGF. Estrus was observed from PGF injection to FTAI. A clean-up period started 14 days after with 4 bulls, for more 45 days. Experiment 4 evaluated the gamma-orizanol suplementation effects and other reproductive associated characteristics on fertility of beef heifers. 84 Angus, Angus x Hereford, Hereford and Braford heifers, 24 months old were used, with an average body weight of 283 kg and BCS ≥ 3. Heifers were weighted at 30 days intervals, to register ADG, and blood samples were collected for progesterone assay. Two subcutaneous fat thickness ecographic evaluations were performed at P8 region, with a 30 days interval. Animals were divided into 2 groups: Treatment group, that received 150 ml/day of gammaorizanol with 1 kg of concentrate since 45 days before the reproductive season start ; and Control group, with 150 ml/day of molasses with 1 kg of concentrate during the same period. Estrus control was done twice for day with AI of estrous heifers. Ten days later PGF was applied to all heifers that did not show estrus. The AI management continued for 25 days. In sequence, a clean-up period with 2 bulls was performed for 45 days. Gestational diagnostics by ecography at 30 days after FTAI, and again at 30 days after bulls removal. In experiment 1, pregnancy rates were similar between groups after first reproductive season. However, the repetition of Treatment group was significantly higher. In Experiment 2, were not observed differences between groups in FTAI and final pregnancy rates, without differences for age or ovarian status In Experiment 3, Progesterone group presented the higher estrus rates than Progestin and Control groups. However, were not observed differences in pregnancy rates among the groups. At the same experiment, difference on weights before mating was found between the heifers that became pregnant compared to heifers that stayed non pregnant. Heifers with ovarian status 2 and 3 had higher average weight than heifers with status 1. The suplementation enhanced ADG in the With Suplementation group, but it did not produce differences on pregnancy rates. In Experiment 4, pregnancy rates were similar between groups. Heifers which became pregnant acumulated more fat amount in P8 region, during the treatment period. In conclusion, the first breeding season management with synchronization to FTAI in heifers, since being presented identical final pregnancy rates, produced signifficative differences on pregnancy rates in the second breeding season. The priming with norgestomet did not enhance pregnancy rates in beef heifers, as well the progesterone or progestin primings and the different feeding managements. Heifers with ovarian status 2 and 3, had higher body weights. Gamma-orizanol supplementation did not enhanced pregnancy rates, ADG neither body weight. Heifers that became pregnant, acumulated more fat amount on P8 region before the reproductive season.

O experimento 1 verificou o efeito de um protocolo de indução e sincronização de estros em novilhas sobre a cronologia das parições e a repetição de crias como primíparas. 194 novilhas Hereford e Braford foram divididas em 2 grupos: Tratamento, submetido a um protocolo misto de observação e sincronização de estros e inseminação artificial a tempo fixo (IATF); e Controle, submetido ao manejo convencional de inseminação artificial (IA). Ambos grupos foram submetidos a repasse por touros. O Experimento 2 avaliou o efeito de um pré-tratamento com norgestomet (NOR), prévio a um protocolo de sincronização para IATF em novilhas, sobre as taxas de prenhez, assim como os efeitos de características relacionadas com a reprodução. 74 novilhas Angus e cruzas, 18 e 24 meses de idade, com peso médio de 276 kg, condição corporal (CC) mínima de 3 (1-5) e avaliadas por ultra-som para o status ovariano, onde utilizaram-se somente novilhas 2 e 3 (1-3). Pesagens a cada 30 dias, desde os 60 dias anteriores aos serviços. Coletado sangue para dosagem de progesterona. Os animais foram divididos em 2 grupos: Tratamento, que recebeu um implante com 6 mg de NOR, na orelha direita, permanecendo por 14 dias; e Controle, que não recebeu implante. Dez dias após a retirada dos implantes, todas as novilhas foram a um protocolo para IATF, com uma injeção de GnRH, 7 dias depois uma aplicação de prostaglandina (PGF) e 48 horas mais tarde, as IATF e outra aplicação de GnRH. Quatorze dias após iniciou-se repasse com 2 touros, por mais 45 dias. O Experimento 3 avaliou o efeito da suplementação com progestágeno (acetato de medroxi-progesterona; MAP) ou progesterona, anteriormente a um protocolo para IATF, e verificou o efeito de características associadas à reprodução de novilhas, e de distintos manejos alimentares sobre as taxas de prenhez. Utilizaram-se 102 novilhas Angus, cruzas Angus e Braford, 22-24 meses, peso médio 241 kg e CC mínima de 2,5. Pesagens a cada 30 dias, a partir dos 60 dias anteriores aos serviços e ultra-som para o status ovariano (1-3). Quarenta e cinco dias antes da estação foram divididas em 2 grupos, Sem Suplementação, com 27 novilhas exclusivamente sobre pastagem natural, e Com Suplementação, com 75 novilhas consumindo 1% do peso em concentrado. Coletas de sangue para dosagem de progesterona. Grupos novamente divididos em 3, para receber dispositivo com progesterona, ou uma esponja intravaginal com MAP, ambos por 10 dias. O grupo Controle não recebeu nenhum tratamento. Na retirada dos implantes, todas as novilhas receberam PGF, e 4 dias depois, foram a um protocolo para IATF, com 2 mg de benzoato de estradiol na colocação de uma esponja com MAP. Sete dias depois, a esponja foi retirada, sendo aplicada PGF, seguindo-se nova aplicação de BE 24 horas depois, e IATF 52-56 horas após a PGF. Observação de estros 2 vezes por dia, desde a PGF até a IATF. Passados 14 dias, iniciou repasse por 4 touros, durante 45 dias. O Experimento 4 avaliou o efeito da suplementação de novilhas de corte com gammaorizanol, sobre o desempenho reprodutivo, assim como o efeito de outras características sobre a reprodução. Utilizaram-se 84 novilhas Angus, Hereford, Braford e Angus x Hereford, com 24 meses, peso médio de 283 kg e CC ≥ 3. Pesagens a cada 30 dias, desde 60 dias antes até o início dos serviços, coletas de sangue para dosagem de progesterona. Duas avaliações da espessura de gordura subcutânea, sobre a região P8 por ultra-som, com intervalo de 30 dias. Animais foram divididos em 2 grupos: Tratamento, que recebeu desde 45 dias antes até o início da estação reprodutiva, 150 ml/dia de gamma-orizanol junto à 1 kg de concentrado; e Controle, com 150 ml/dia de melaço, junto à 1 kg do mesmo concentrado. Observações de estros 2 vezes/dia e IA. Dez dias após aplicou-se PGF a todas ainda não observadas em estro, prosseguindo-se a observação e IA por mais 25 dias. Após, repasse por 2 touros por 45 dias. Diagnósticos de gestação por ultra-som, 30 dias após as IATF ou IA, e novamente, 30 dias depois de retirados os touros. No experimento 1, a porcentagem de prenhez na primeira estação reprodutiva foi semelhante para os 2 grupos. Entretanto, a repetição de crias nas primíparas do grupo Tratamento foi significativamente maior. No Experimento 2, não foram observadas diferenças entre as taxas de prenhez à IATF e final, e conforme a idade e o status ovariano. No Experimento 3, taxas de estro superiores para o grupo Progesterona em relação ao Progestágeno e Controle. Entretanto, taxas de prenhez semelhantes entre os grupos. Foi encontrada diferença entre o peso 24 dias antes dos serviços, para as novilhas que emprenharam em relação às que permaneceram vazias e para os pesos das novilhas ao final da temporada. As novilhas com status ovariano 2 e 3 foram mais pesadas em relação ao 1, mas as taxas de prenhez não diferiram com o status ovariano. O concentrado proporcionou superior GMD para o grupo Com Suplementação, mas sem diferenças para as taxas de prenhez. No Experimento 4, taxas de prenhez semelhantes para Tratamento e Controle. Novilhas prenhas foram as que acumularam maior quantidade de gordura na região P8. Concluindo, o manejo com sincronização de estros e IATF na primeira estação reprodutiva em novilhas, apesar de apresentar índices idênticos de prenhez ao final da temporada, proporcionou diferença significativa nos índices de prenhez na segunda estação. O pré-tratamento com norgestomet não proporcionou superiores taxas de prenhez em novilhas. Da mesma forma, o priming com progesterona ou MAP, não proporcionou taxas de prenhez superiores, assim como a utilização de suplementação alimentar. O peso corporal antes ou dos serviços, foi superior para as novilhas que emprenharam. Novilhas com status ovariano 2 e 3, foram mais pesadas. O fornecimento de gamma-orizanol não proporcionou superiores taxas de prenhez ou peso corporal, entretanto, novilhas que resultaram prenhas, acumularam maior quantidade de gordura antes da estação reprodutiva. / Experiment 1 verified the effect of an estrus synchronization protocol in heifers on parturition chronology and primiparous reproductive performance. 194 Hereford and Braford heifers were divided into 2 groups: Treatment group, submitted to an estrus observation and synchronization to fixed-time artificial insemination (FTAI) protocol; and Control group, submitted to a conventional artificial insemination (AI) management. All groups were submitted to a bull’s clean-up period. Experiment 2 evaluated the norgestomet (NOR) priming effect, before a fixed-time artificial insemination protocol (FTAI) in heifers, on pregnancy rates, as well as the effects of reproductive related characteristics. 74 Angus and cross-bred heifers, 18 and 24 months old, with 276 kg of body weight, body condition score (BCS) minimum of 3 (1- 5), and ovarian status evaluated by US. Only the 2 or 3 class heifers were used (1-3). Heifers were weighted at 30 days intervals, starting 60 days before the reproductive period. Blood was collected for progesterone assay. Heifers were divided in 2 groups: Treatment group, that received an ear implant with 6 mg of NOR, in the right ear, removing it 14 days after; and Control group, did not receive the implant. Ten days after the implants removal, all heifers were submitted to FTAI protocol, which including a GnRH i.m. injection, 7 days after the prostaglandin (PGF) aplication, and 48 hours later, FTAI and a second GnRH injection. Fourteen days later, started a clean-up period with 2 bulls, for 45 days more. Experiment 3 evaluated the progestin (medroxiprogesterone acetate; MAP) or progesterone suplementation effect, before a FTAI protocol, and evaluated the effects of reproductive associated characteristics in heifers, and feeding managements over pregnancy rates. 102 Angus, cross-bred Angus and Braford heifers, 22-24 months old were used, with an average body weight of 241 kg, and a minimum BCS of 2,5. Heifers were weighted at 30 days intervals, starting 60 days before the breeding period and an ecography was performed to evaluate ovarian status. Fourty five days before the season, heifers were divided into 2 groups. Without Suplementation group, with 27 heifers, only over natural pastures, and With Suplementation group, with 75 heifers receiving suplementation (72% TDN and 15% GP) about 1% body weight. Blood was collected for progesterone assay. Groups were again divided into 3, to receive a progesterone device or an intravaginal MAP sponge, for 10 days. The Control group, not received the treatment. At the implants removal, all heifers received PGF, and 4 days later were submitted to a FTAI protocol, with 2 mg estradiol benzoate with an intravaginal MAP sponge aplication. Seven days later, the sponge was removed, and PGF was injected, with a new EB injection, 24 hours later, and FTAI 52-56 hours after PGF. Estrus was observed from PGF injection to FTAI. A clean-up period started 14 days after with 4 bulls, for more 45 days. Experiment 4 evaluated the gamma-orizanol suplementation effects and other reproductive associated characteristics on fertility of beef heifers. 84 Angus, Angus x Hereford, Hereford and Braford heifers, 24 months old were used, with an average body weight of 283 kg and BCS ≥ 3. Heifers were weighted at 30 days intervals, to register ADG, and blood samples were collected for progesterone assay. Two subcutaneous fat thickness ecographic evaluations were performed at P8 region, with a 30 days interval. Animals were divided into 2 groups: Treatment group, that received 150 ml/day of gammaorizanol with 1 kg of concentrate since 45 days before the reproductive season start ; and Control group, with 150 ml/day of molasses with 1 kg of concentrate during the same period. Estrus control was done twice for day with AI of estrous heifers. Ten days later PGF was applied to all heifers that did not show estrus. The AI management continued for 25 days. In sequence, a clean-up period with 2 bulls was performed for 45 days. Gestational diagnostics by ecography at 30 days after FTAI, and again at 30 days after bulls removal. In experiment 1, pregnancy rates were similar between groups after first reproductive season. However, the repetition of Treatment group was significantly higher. In Experiment 2, were not observed differences between groups in FTAI and final pregnancy rates, without differences for age or ovarian status In Experiment 3, Progesterone group presented the higher estrus rates than Progestin and Control groups. However, were not observed differences in pregnancy rates among the groups. At the same experiment, difference on weights before mating was found between the heifers that became pregnant compared to heifers that stayed non pregnant. Heifers with ovarian status 2 and 3 had higher average weight than heifers with status 1. The suplementation enhanced ADG in the With Suplementation group, but it did not produce differences on pregnancy rates. In Experiment 4, pregnancy rates were similar between groups. Heifers which became pregnant acumulated more fat amount in P8 region, during the treatment period. In conclusion, the first breeding season management with synchronization to FTAI in heifers, since being presented identical final pregnancy rates, produced signifficative differences on pregnancy rates in the second breeding season. The priming with norgestomet did not enhance pregnancy rates in beef heifers, as well the progesterone or progestin primings and the different feeding managements. Heifers with ovarian status 2 and 3, had higher body weights. Gamma-orizanol supplementation did not enhanced pregnancy rates, ADG neither body weight. Heifers that became pregnant, acumulated more fat amount on P8 region before the reproductive season.

Orientador: Luis Guillermo Bahamondes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T02:46:23Z (GMT). No. of bitstreams: 1 Modesto_WaleskaOliveira_D.pdf: 13141867 bytes, checksum: 9829c0f68d8c82bcf73f017f9a8b6ab3 (MD5) Previous issue date: 2014 / Resumo: A diminuição da densidade mineral óssea (DMO), o ganho do peso e as alterações nos padrões de sangramento são frequentemente associados ao uso dos métodos de somente progestágeno. Aspectos não completamente elucidados quanto ao momento e tempo de ocorrência podem prejudicar a continuação e ocasionar descontinuação prematura ou induzir morbidades. Objetivos: Avaliar a DMO, ganho do peso e taxas de descontinuação por transtornos de sangramento dos métodos de somente progestágenos. Sujeitos e Métodos: realizaram-se quatro estudos sobre a influência do acetato de medroxiprogesterona de depósito (AMPD): A) sobre a DMO e a composição corporal (CC) de suas usuárias a partir dos 12 meses até os 23 anos de uso; B) sobre ganho de peso em usuárias do AMPD, do sistema liberador de levonorgestrel (SIU-LNG) e do dispositivo intra-uterino com cobre (DIU) até 10 anos de uso, C) sobre a influência do implante liberador de etonogestrel (ENG) na DMO e na CC até 24 meses de seguimento e D) avaliamos a influência de diferentes orientações em relação aos distúrbios do sangramento nas taxas de continuação das usuárias de SIU-LNG, implante liberador de ENG e DIU. Resultados: a DMO aos 12 meses de uso do AMPD foi menor na coluna lombar quando comparadas a usuárias de DIU e aos 10 anos de uso 29,8% das usuárias do AMPD apresentaram osteoporose comparado a 2,4% das usuárias de DIU. Na CC, observou-se que, aos 12 meses, ocorreu um aumento de 2Kg de massa gorda e 2% na porcentagem de massa gorda nas usuárias de AMPD, porém, a longo prazo, não houve diferença na quantidade de massa gorda quando comparadas à usuárias de DIU. O peso aumentou ao final do primeiro ano em 1,3Kg, 0,7Kg e 0,2Kg e, aos 10 anos, em 6,6Kg, 4,0Kg e 4,9Kg nas usuárias de AMPD, SIU-LNG e DIU, respectivamente. Nas usuárias do implante liberador de ENG ocorreu uma diminuição da DMO da coluna lombar aos 12 meses e um aumento de 2% a 2,7% da massa gorda aos 12 e 24 meses comparadas à usuárias de DIU. Mulheres que receberam orientações de rotina ou intensivas quanto ao padrão de sangramento esperado não mostraram diferenças significativas nas taxas de descontinuação do SIU-LNG, do implante liberador de ENG e do DIUT. Conclusões: O uso do AMPD ocasionou uma diminuição na DMO no primeiro ano de uso, essa diminuição foi progressiva e aumentou a prevalência de osteoporose em longo prazo. Usuárias do AMPD, SIU-LNG e DIU apresentaram ganho do peso aos 10 anos de uso, sendo maior em usuárias de AMPD. A massa gorda aumentou no primeiro ano de uso do AMPD, porém, não foi significante em longo prazo quando comparada à usuárias do DIU. Em usuárias do implante liberador de ENG foi encontrado um ganho do peso e da massa gorda aos 24 meses e uma diminuição da DMO após 12 meses. As estratégias de orientação de rotina e intensivas não apresentaram diferenças nas taxas de continuação das usuárias do implante liberador de ENG , SIU-LNG e DIU / Abstract: The decrease in bone mineral density (BMD), weight gain and changes in uterine bleeding patterns are often associated with the use of progestin-only methods. Aspects not still elucidated and the moment of occurrence could harm the continuation and provoke premature discontinuation or induce morbidities. Objectives: To evaluate BMD, weight gain and discontinuation rates for bleeding disturbances of progestin-only methods. Subjects and Methods: Four studies were conducted with depot medroxyprogesterone acetate (DMPA) users: A) regarding BMD and body composition (BC) from 12 months to 23 years of use; B) on weight gain among DMPA users, the levonorgestrel-releasing intrauterine system (LNG-IUS) and cooper-intrauterine device (IUD) up to 10 years of use; C) on the influence of the etonogestrel-releasing implant (ENG) upon BMD and BC up to 24 months of follow-up; and D) to evaluate the influence of two counseling strategies regarding to bleeding disorders in continuation rates of the users of the LNG-IUS, ENG-implant and IUD. Results: BMD after 12 months of DMPA use was lower at the lumbar spine compared to IUD users and 29.8% has osteoporosis among those women who had used DMPA for 10 years or more compared to 2.4% of IUD users. Regarding BC, at 12 months of use it was observed, an increase of 2 kg of fat mass and 2% in the percentage of fat mass in DMPA users; however, in the long-term use, there was no difference in the amount of fat mass compared to IUD users. The weight increased at the end of the first year was 1.3kg, 0.7kg and 0.2kg and, at 10 years, was 6.6kg, 4.0kg and 4.9kg among DMPA-, LNG-IUS- and IUD-users, respectively. Users of the ENG-implant showed a decrease in BMD at lumbar spine after 12 months of use and an increase of 2% to 2.7% of fat mass at 12 and 24 months when compared to IUD-users. Women who received routine or "intensive" counseling about the expected bleeding patterns showed no significant differences regarding the rates of discontinuation of LNG-IUS, ENG-implant and IUD. Conclusions: Users of DMPA showed a decrease in BMD at the end of the first year of use, the decrease was progressive and an increased prevalence of osteoporosis in the long-term use was observed. DMPA, LNG-IUS and IUD users showed weight gain after 10 years of use, higher in DMPA users. Fat mass increased in the first year of DMPA use; however, was not significant in the long-term when compared to IUD-users. In ENG-implant users it was found a weight gain and increase of fat mass at 24 months and a reduction in BMD after 12 months of use. The routine and "intensive" counseling showed no differences in rates of continuation in ENG-implant, LNG-IUS- and IUD-users / Doutorado / Fisiopatologia Ginecológica / Doutora em Ciências da Saúde

RESUMO STOCCO, B. Avaliação do efeito de contraceptivos hormonais sobre a hemostasia. 2011. 92f. Dissertação (Mestrado). Faculdade de Ciências Farmacêuticas de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2011. Introdução: Mais de 100 milhões de mulheres no mundo fazem uso de métodos contraceptivos hormonais. Apesar de seu desejado efeito na contracepção, sua metabolização ocorre no fígado estimulando a síntese de proteínas plasmáticas, dentre elas, as que controlam os sistemas de coagulação e fibrinólise, conferindo um estado de hipercoagulabilidade em suas usuárias. A literatura aponta também alterações no metabolismo dos lipídios e carboidratos, além de modular a expressão de moléculas de adesão presentes no endotélio. Para combater os efeitos indesejáveis destes medicamentos, baixas concentrações de estrógenos e diferentes progestágenos foram introduzidos, pois, a estes últimos é conferida a atividade anti estrogênica destas formulações. Estudos independentes sugerem que progesteronas de terceira e quarta geração possuem atividade anti-estrogênica menor em relação as de segunda geração. Objetivos: avaliar a ocorrência de alterações hemostáticas, analisar o perfil lipídico e quantificar moléculas de adesão no soro ou plasma da população feminina brasileira usuária de contraceptivos orais de segunda e quarta gerações. Materiais e Métodos: 70 participantes distribuídas em quatro grupos a saber : grupo I (controle- 20 pacientes); grupo II (DRSP/30EE- 20 pacientes); grupo III (DRSP/20EE- 16 pacientes) e grupo IV (LNG/30EE-14 pacientes). Foram avaliados os seguintes parâmetros: TP, Fator VII, TTPA, Fator XII, Fibrinogênio, Fator 1+2, Proteína C, Proteína S, Antitrombina, D dímeros, PAI 1, VCAM, ICAM, E- selectina, HDL, LDL,VLDL, Colesterol total e Triglicérides. Resultados e discussões: grupo II promoveu diminuição em TP e Prot. S; e aumento em HDL,VLDL,Col. total e TG; grupo III diminuiu TP, TTPA, Prot.S, ICAM e VCAM ; e aumentou Fibrinogênio, D-dímeros, HDL,VLDL,Col. total e TG e grupo IV diminuiu TP, Prot.C e aumentou ICAM e VCAM. Conclusões: Dos medicamentos estudados apontamos que: o grupo II promoveu alterações significativas no perfil lipídico caracterizando um estado pró-trombótico, apesar de apresentar o maior aumento nos valores de HDL e poucas alterações associadas à hipercoagulabilidade; o grupo III promoveu o maior número de alterações hipercoagulantes, alterou também perfil lipídico contribuindo para um estado pró- trombótico, embora tenha apresentado proteção endotelial e o grupo IV foi o medicamento que promoveu melhor proteção endotelial, não alterou perfil lipídico e ocasionou poucas alterações associadas à hipercoagulabilidade / Introduction: More than 100 million women in the world make use of hormonal contraceptives. In spite of its desired effect on contraception, its metabolization occurs at liver, estimulating the synthesis of the plasmatic proteins, among them, the ones that control the coagulation system and fibrinolysis, confering a hypercoagulability state in their users. The literature also points changes in the metabolism of lipids and carbohydrates, besides modulate the expression of adhesion molecules present in the endothelium. Trying to combat undesirable effects of these drugs, low concentrations of estrogen and different progestogens were introduced, because, the antiestrogenic activity of these drugs is assigned to the progesterone used. Independent papers suggest that third and fourth generation progesterones have a smaller antiestrogenic activity in relation to the second generation one. Objectives: evaluate the occurrence of hemostatic alterations, analyze the lipid profile and quantify adhesion molecules in serum or plasma on the Brazilian female population who is user of contraceptives from second and fourth generation. Material and Methods: 70 participants were distributed into four groups: group I (control- 20 patients); group II (DRSP/30EE- 20 patients); group III (DRSP/20EE- 16 patients) and group IV (LNG/30EE- 14 patients). From these were assessed the following parameters: PT, Factor VII, APTT, Factor XII, Fibrinogen, Factor 1+2, Protein C, Protein S, Antithrombin, Ddimmers, PAI 1,VCAM, ICAM, E- selectin, HDL, LDL, VLDL, Total Cholesterol and Triglycerides.Results and discussion: group II promoted a decrease in PT and Prot.S; and an increase in HDL,VLDL, Total cholesterol and TG; group III decreased PT, APTT, Prot.S, ICAM and VCAM ; and increased Fribrinogen, D- dimers, HDL,VLDL,Total Cholesterol and TG and group IV decreased PT, Prot.C and increased ICAM and VCAM.Conclusions: among the drugs studied we aim that: the group II promoted significant changes in lipid profile featuring a pro- thrombotic state, in spite of presented the highest increase in the levels of HDL and few alterations associated to hypercoagulability; group III promoted the biggest number of hypercoagulability alterations, this drug also changed the lipid profile contributing to a pro-thrombotic state, although it has presented endothelial protection and the group IV it was the drug that promoted the best endothelial protection, did not change lipid profile and caused few alterations associated with hypercoagulability

RESUMO STOCCO, B. Avaliação do efeito de contraceptivos hormonais sobre a hemostasia. 2011. 92f. Dissertação (Mestrado). Faculdade de Ciências Farmacêuticas de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2011. Introdução: Mais de 100 milhões de mulheres no mundo fazem uso de métodos contraceptivos hormonais. Apesar de seu desejado efeito na contracepção, sua metabolização ocorre no fígado estimulando a síntese de proteínas plasmáticas, dentre elas, as que controlam os sistemas de coagulação e fibrinólise, conferindo um estado de hipercoagulabilidade em suas usuárias. A literatura aponta também alterações no metabolismo dos lipídios e carboidratos, além de modular a expressão de moléculas de adesão presentes no endotélio. Para combater os efeitos indesejáveis destes medicamentos, baixas concentrações de estrógenos e diferentes progestágenos foram introduzidos, pois, a estes últimos é conferida a atividade anti estrogênica destas formulações. Estudos independentes sugerem que progesteronas de terceira e quarta geração possuem atividade anti-estrogênica menor em relação as de segunda geração. Objetivos: avaliar a ocorrência de alterações hemostáticas, analisar o perfil lipídico e quantificar moléculas de adesão no soro ou plasma da população feminina brasileira usuária de contraceptivos orais de segunda e quarta gerações. Materiais e Métodos: 70 participantes distribuídas em quatro grupos a saber : grupo I (controle- 20 pacientes); grupo II (DRSP/30EE- 20 pacientes); grupo III (DRSP/20EE- 16 pacientes) e grupo IV (LNG/30EE-14 pacientes). Foram avaliados os seguintes parâmetros: TP, Fator VII, TTPA, Fator XII, Fibrinogênio, Fator 1+2, Proteína C, Proteína S, Antitrombina, D dímeros, PAI 1, VCAM, ICAM, E- selectina, HDL, LDL,VLDL, Colesterol total e Triglicérides. Resultados e discussões: grupo II promoveu diminuição em TP e Prot. S; e aumento em HDL,VLDL,Col. total e TG; grupo III diminuiu TP, TTPA, Prot.S, ICAM e VCAM ; e aumentou Fibrinogênio, D-dímeros, HDL,VLDL,Col. total e TG e grupo IV diminuiu TP, Prot.C e aumentou ICAM e VCAM. Conclusões: Dos medicamentos estudados apontamos que: o grupo II promoveu alterações significativas no perfil lipídico caracterizando um estado pró-trombótico, apesar de apresentar o maior aumento nos valores de HDL e poucas alterações associadas à hipercoagulabilidade; o grupo III promoveu o maior número de alterações hipercoagulantes, alterou também perfil lipídico contribuindo para um estado pró- trombótico, embora tenha apresentado proteção endotelial e o grupo IV foi o medicamento que promoveu melhor proteção endotelial, não alterou perfil lipídico e ocasionou poucas alterações associadas à hipercoagulabilidade / Introduction: More than 100 million women in the world make use of hormonal contraceptives. In spite of its desired effect on contraception, its metabolization occurs at liver, estimulating the synthesis of the plasmatic proteins, among them, the ones that control the coagulation system and fibrinolysis, confering a hypercoagulability state in their users. The literature also points changes in the metabolism of lipids and carbohydrates, besides modulate the expression of adhesion molecules present in the endothelium. Trying to combat undesirable effects of these drugs, low concentrations of estrogen and different progestogens were introduced, because, the antiestrogenic activity of these drugs is assigned to the progesterone used. Independent papers suggest that third and fourth generation progesterones have a smaller antiestrogenic activity in relation to the second generation one. Objectives: evaluate the occurrence of hemostatic alterations, analyze the lipid profile and quantify adhesion molecules in serum or plasma on the Brazilian female population who is user of contraceptives from second and fourth generation. Material and Methods: 70 participants were distributed into four groups: group I (control- 20 patients); group II (DRSP/30EE- 20 patients); group III (DRSP/20EE- 16 patients) and group IV (LNG/30EE- 14 patients). From these were assessed the following parameters: PT, Factor VII, APTT, Factor XII, Fibrinogen, Factor 1+2, Protein C, Protein S, Antithrombin, Ddimmers, PAI 1,VCAM, ICAM, E- selectin, HDL, LDL, VLDL, Total Cholesterol and Triglycerides.Results and discussion: group II promoted a decrease in PT and Prot.S; and an increase in HDL,VLDL, Total cholesterol and TG; group III decreased PT, APTT, Prot.S, ICAM and VCAM ; and increased Fribrinogen, D- dimers, HDL,VLDL,Total Cholesterol and TG and group IV decreased PT, Prot.C and increased ICAM and VCAM.Conclusions: among the drugs studied we aim that: the group II promoted significant changes in lipid profile featuring a pro- thrombotic state, in spite of presented the highest increase in the levels of HDL and few alterations associated to hypercoagulability; group III promoted the biggest number of hypercoagulability alterations, this drug also changed the lipid profile contributing to a pro-thrombotic state, although it has presented endothelial protection and the group IV it was the drug that promoted the best endothelial protection, did not change lipid profile and caused few alterations associated with hypercoagulability

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