Migrän är en återkommande form av huvudvärk som förmodas bero på hormonella, genetiska och miljörelaterade faktorer. Migrän finns i olika former men detta arbete fokuserar främst på migrän med aura och migrän utan aura. Det utmärkande för migrän med aura är neurologiska störningar som oftast uppstår innan attacken och kan yttra sig i form av tillexempel synstörningar. Det är en komplex sjukdom och uppkomsten är inte helt klarlagd. Smärtan som uppstår i samband med en migränattack förmodas bero på aktivering av det trigeminovaskulära systemet. Migrän anses som den 8:e mest betungande sjukdomen i världen och livskvalitén påverkas ofta negativt hos de individer som lider av migrän. Under en migränattack är det många individer som inte klarar av skol- eller jobbdagen, blir ofta sängliggande och sociala aktiviteter påverkas negativt. Behandlingsformer av migrän delas ofta upp i förebyggande eller anfallskuperande metoder och syftet med behandlingen är att hindra migränattackerna eller häva en pågående attack. Det förekommer både standardbehandling i form av tillexempel NSAID och triptaner. Dessutom finns det hormonell behandling som profylax i mensrelaterad migrän i form av olika hormoner. En stark riskfaktor för att drabbas av migrän är att ha släktingar som är lidande och ärftligheten kan vara så hög som 50%. Kvinnor drabbas oftare än män och bakgrunden till detta kan vara hormonella förändringar i kvinnokroppen, ofta sjunkande halter av östrogen. Denna litteraturstudie granskar sex artiklar, fyra om genetiska variationer vid migrän och två som berör hormonell behandling och migrän. Granskade artiklar visar att det finns en genetisk koppling till migrän, men det behövs fler studier för att få klarare och tydligare resultat. Några gener är länkade till både migrän med och utan aura, medan några är starkare i den ena formen av migrän. Resultat huruvida hormonell behandling kan ha en positiv effekt vid migrän är något klarare. / Migraines are a recurrent form of headache believed to be caused by hormonal, genetic and environmental factors. Migraines exist in different forms, but in this work, focuse is mainly on migraines with aura and migraines without aura. The characteristics of migraines with aura are neurological disorders that usually occur before the attack and can be expressed in the form of visual disturbances. It is a complex disease and the cause is not entirely clear. The pain that occurs in connection to a migraine attack is believed to be due to activation of the trigeminovascular system. Migraines are considered the 8th most burdensome disease in the world and the quality of life is often negatively affected in individuals suffering from migraines. During a migraine attack, many individuals fail to attend to school or to work, get often bedridden and social activities are adversely affected. Means of treatment of migraines are often divided into preventive or emergency methods and the purpose of both methods is to prevent migraine attacks. There are both standard treatments in the form of for example triptans and NSAIDs and there are hormonal treatments in the form of different hormones, such as estrogens. A strong risk factor for migraines is to have relatives who are suffering, the heredity may be as high as 50%. Women suffer more often than men and the background to this can be hormonal changes in the female body, often decreasing levels of estrogen. This literature review examines six articles, four on the link between genetics and migraine and two on hormonal treatment and migraine. Examined articles show that there is a genetic link to migraines, but more research is needed to get clearer results. Some genes are linked to both migraines with and without aura, while some are stronger in one form of migraine. There are some clearer indications that hormonal treatment may have a positive effect on migraines.

Bakgrund: Endometrios är en av de vanligaste gynekologiska sjukdomarna som drabbar cirka tio procent av den kvinnliga befolkningen i fertil ålder. Sjukdomen är kronisk och associerad med ohälsa samt försämrad livskvalitet hos kvinnor. Hormonell behandling är idag en vanlig behandlingsmetod som även den kan ha en inverkan på kvinnors livskvalitet. Syfte: Att undersöka kvinnors upplevda livskvalitet med hormonell behandling vid endometrios. Metod: En litteraturstudie där 12 kvantitativa originalartiklar granskades och där resultatet sammanställdes och analyserades med en innehållsanalys. Resultat: Majoriteten av de artiklar som ingick i litteraturstudien visade en förbättrad upplevd livskvalitet med hormonell behandling för kvinnor med endometrios. Den upplevda livskvaliteten förbättrades fysisk, psykisk, socialt och sexuellt oberoende av de biverkningar som redovisades. Endast två artiklar visade antingen försämrad eller oförändrad livskvalitet. Slutsats: Endometrios leder till en minskad livskvalitet hos kvinnor som lider av sjukdomen och hormonell behandling kan förbättra livskvaliteten fysisk, psykisk, socialt och sexuellt hos dessa kvinnor oberoende av de biverkningar som förekom. / Background: Endometriosis is one of the most common gynecological diseases affecting approximately ten percent of the female population of reproductive age. It is a chronic disease associated with illness and impaired quality of life among women. A common method of treatment today is hormonal treatment which also has an impact in women's quality of life. Aim: To examine perceived quality of life among women with endometriosis receiving hormonal treatment. Method: A literature review where 12 original articles with quantitative method where reviewed and the results analysed with content analysis. Results: The majority of the included articles showed an improved quality of life among women with endometriosis receiving hormonal treatment. Regardless of the side effects from the hormonal treatment the quality of life was improved in the physical, psychological, social and sexual areas. Only two articles showed either impaired or unchanged quality of life. Conclusion: Endometriosis leads to impaired quality of life in women with the disease and hormonal treatment may improve the quality of life physical, psychological, social and sexual among these women regardless of the side effects that occurred.

Made available in DSpace on 2015-03-26T13:46:58Z (GMT). No. of bitstreams: 1 texto completo.pdf: 218770 bytes, checksum: 9a15de33de9a4b5b4fdd2591fd0a1d8c (MD5) Previous issue date: 2008-09-26 / The objective of this work was to check the exogenous estrogen, in early phase of estrous cycle, on the range of estrus reduction. The experiment was conducted in Campo Experimental Santa Mônica (CESM). Sixteen Holsteinzebu crossbred cows were used, distributed in two groups, according to the used hormone (estradiol). These animals had body score ≥ 3,0 (scale of 1 to 5), were non-lactating, with average live weight of 458 kg. Animals cycling regularly were selected by gynecological exam (rectal palpation and vaginoscopic examination). The animals without any clinical or reproductive alterations were used in the experiment. The cows were casually included in their treatments. Treatment 1: eight cows received 2,5 mL of estradiol cipionate at the first day of the estrous cycle (considering day 0 the estrus day), intramuscularly (IM) injected into the hip region, with a 25 X 0,7 mm needle. Treatment 2 (control): eight cows without treatment constituted the control group. The expression of estrus was monitored visually during one hour, three times a day. The ultrasound scans were conducted via transrectal. The measurements began at the estrus day and were done daily in the morning by a single operator. The diameters of the biggest and the second biggest follicles in each ovary were registered. The morphologic characteristics of the corpus luteum were evaluated daily during the estrous cycle, measuring the crosssectional area (cm2). The blood collections for the measurements of the levels of progesterone began at the estrus day (0 day) and were conducted once every three days until the next estrus day. All the animals that received estrogen at the first day after the estrus showed the estrus signals (psychics, turgid uterus and abundant mucus) the next day. It was observed that six animals showed these signals for two consecutive days. This reduction of the range of estrus for two days can promote the elimination of uterus bacteria (if present), enhancing, consequently, the reproductive capacity. It s known that some estrus alterations can promote the elimination of in-uterus infections (clinical or sub clinical), and the reduction of the range of estrus is indicated for the treatment of such diseases. Except for the day of the first follicular wave emergence, all the other studied variables (number and wave length, characteristics of dominant and subordinate follicles and the parameters related to the corpus luteum and progesterone production) weren t affected by the application of estrogen the day after the estrus. In this experiment, the follicular dynamic of the crossbred cows (Holstein X Zebu) showed a two or three follicular wave growth pattern, regardless of the treatment with estrogen and was the same to the treated and control groups (37,5% with two wave cycles and 62,5% with three wave cycles). The application of estradiol cipionate in crossbred cows (Holstein X Zebu) the day after the natural estrus promote the emergence of estrus sign (psychic, turgid uterus and abundant mucus) two days after the natural estrus, without affecting the next estrous cycle. / O objetivo do presente trabalho foi verificar o efeito do estrógeno exógeno, em fase precoce do ciclo estral, na redução do intervalo de estros. O experimento foi conduzido no Campo Experimental de Santa Mônica (CESM). Foram utilizadas 16 vacas mestiças holandês-zebu, distribuídas em dois grupos em função do hormônio utilizado (estradiol). Estes animais apresentavam escore corporal ≥ 3,0 (escala de 1 a 5), não-lactantes, com peso vivo médio de 458 Kg. Animais estavam ciclando regularmente, foram selecionados por meio de exame ginecológico (palpação retal e vaginoscopia), sendo utilizados no experimento aqueles sem qualquer alteração clinica ou reprodutiva. As vacas foram incluídas ao acaso nos respectivos tratamentos. Tratamento 1: oito vacas receberam 2,5 mL de Cipionato de estradiol no 1º dia do ciclo estral, via intramuscular (IM), na região da garupa, com agulha 25 X 0,7 mm, (considerando dia 0 o dia do estro). Tratamento 2 (Testemunha): oito vacas sem tratamento constituíram o grupo controle. A manifestação de estro foi monitorada visualmente durante uma hora por três vezes ao dia. Os exames ultra-sonográficos foram realizados por via transretal. As medições tiveram inicio no dia do estro e foram feitas diariamente pela manhã, por um único operador. Foram registrados o diâmetro máximo do maior e do segundo maior folículo presente em cada ovário. As características morfológicas do corpo lúteo foram avaliadas diariamente ao longo do ciclo estral, medindo-se a área da seção transversal (cm2). As coletas de sangue para as dosagens de progesterona tiveram início no dia do estro (dia 0) e foram realizadas a cada três dias até o próximo estro. Todos os animais que receberam estrógeno no 1o dia após o estro, manifestaram os sinais característicos de estro (psíquicos, útero túrgido e muco abundante) um dia após o tratamento. Verificou-se ainda que seis desses animais apresentaram esses sinais por dois dias consecutivos. Esta redução do intervalo de estro para apenas dois dias pode favorecer a eliminação de bactérias do útero (quando presentes), aumentando, consequentemente, a eficiência reprodutiva. Sabe-se que algumas alterações que ocorrem no estro podem favorecer a eliminação de infecções uterinas (clinícas ou subclínicas), sendo que a redução no intervalo desses é indicada para tratamento destas patologias. Excetuando o dia da emergência da 1a onda folicular, todas as outras variáveis estudadas (número e comprimento de ondas, características dos folículos dominantes e subordinados, assim como os parâmetros relacionados ao corpo lúteo e produção de progesterona) não foram afetadas pela aplicação de estrógeno um dia após o estro. o presente experimento, a dinâmica folicular das vacas mestiças (Holandês X Zebu) apresentou padrão de duas ou três ondas de crescimento folicular, independente do tratamento com estrógeno, sendo a mesma para os animais do grupo tratado e controle (37,5 de ciclos com duas ondas e 62,5% com três). A aplicação de Cipionato de Estradiol em vacas mestiças (Hol X Zebu), um dia após o estro natural promove o aparecimento de sinais de estro (psíquicos, útero túrgido e muco abundante) dois dias após o estro natural, sem afetar o ciclo estral subseqüente.

Arapaima gigas is the largest scaled freshwater fish in the world reaching over 250 kg. With growth rates of 10 kg+ within 12 months, A. gigas is considered as a promising candidate species for aquaculture development in South America. However, the lack of reproductive control in captivity is hindering the industry expansion. The work carried out in this doctoral thesis therefore aimed to better understand the species’ reproductive physiology, develop tools to identify gender and monitor gonad development, test hormonal therapies to induce ovulation and spawning and characterise the cephalic secretion for its potential roles in pheromone release and during parental care. Initially, a genomic study investigated the overall extent of polymorphism in A. gigas, which was found to be surprisingly low, with only 2.3 % of identified RAD-tags (135 bases long) containing SNPs. Then, a panel with 293 single nucleotide polymorphism (SNP) was used to characterise the genetic diversity and structure of a range of Amazon populations. Results revealed populations from the Amazon and Solimões appeared to be genetically different from the Araguaia population, while Tocantins population comprised individuals from both stocks. This data provided a tool for broodstock identification and future management. The PhD then aimed to evaluate the effects of slow-release mGnRH implants and different broodstock size pairings on maturation and spawning. Results showed that the implants stimulated the brain-pituitary-gonad axis resulting in increased plasma levels of testosterone (females) and 11-ketotestosterone in males, respectively regardless of pairing sizes. However, no spawning was observed. Results also showed the release of sex steroids with potential pheromonal action through the cephalic secretion, a biological fluid released from the adult head along the reproductive period. Thereafter, a non-surgical field endoscopy method was developed and validated for ovarian assessment and gender identification. The method was then used to describe the female gonopore and obtain biopsy of the ovary through cannulation which allowed the description of oogenesis in A. gigas. Importantly, oocytes obtained by cannulation confirmed that adult females under investigation were maturing with oocytes in final maturation stage but failed to ovulate/spawn. Another hormonal induction trial was therefore performed in which a combination of GnRHa (mGnRHa/sGnRHa) was used by injection to induce ovulation and spawning in selected maturing females with effects on oocyte maturation monitored post-induction through biopsy. However, this trial appeared to not be successful at inducing ovulation or spawning. Finally, the peptidome and proteome of the cephalic secretion was further characterised through the comparison between parental and non-parental fish. Results highlighted the complex role of this biological fluid including potential roles on the developing offspring during the parental care period. Overall, this doctoral thesis provided new basic and applied data on A. gigas reproduction and tools that can be used in future studies to better understand the environmental and hormonal control of oogenesis and spawning.

Adjuvant hormonal therapy has been demonstrated to be able to delay disease progression in nonmetastatic prostate cancer. To date, however, a favorable impact on survival has only been demonstrated in lymph-node-positive disease and in external-beam radiotherapy series with locally advanced and probably mainly micrometastatic tumors. The Bicalutamide Early Prostate Cancer Program is the largest study under way to define the role of adjuvant treatment in early prostate cancer and identify subgroups of patients likely to benefit from immediate hormonal therapy. At the time of the most recently published analysis, the risk of objective clinical progression was significantly reduced in the bicalutamide arm (hazards ratio 0.58, 95% confidence interval 0.51–0.66, p < 0.0001). However, further maturation of data is needed to see whether this difference will lead to a survival advantage. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2018-02-19T18:29:22Z No. of bitstreams: 2 Dissertação - Edmêe Aparecida Fleury Curado - 2017.pdf: 2300652 bytes, checksum: ae7a412a9c9e2fff2ee8706032b1b995 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-02-20T11:03:42Z (GMT) No. of bitstreams: 2 Dissertação - Edmêe Aparecida Fleury Curado - 2017.pdf: 2300652 bytes, checksum: ae7a412a9c9e2fff2ee8706032b1b995 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-02-20T11:03:42Z (GMT). No. of bitstreams: 2 Dissertação - Edmêe Aparecida Fleury Curado - 2017.pdf: 2300652 bytes, checksum: ae7a412a9c9e2fff2ee8706032b1b995 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-10-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Due to the current trade and technology used in equine breeding, there is a search for effective reproductive methods, seeking to optimize the resources provided by the animal and the environment. Hormonal mare characteristics already known and used with a positive reproductive effect, such as the use of equine pituitary extract (EPE) to induce ovulation, may be better employed if we eliminate the heterogenicity of the samples at the moment of collection. This experiment was conducted with the objective of inducing estrus and ovulation in mares at the end of the mating season, with the use of EPE collected separately at different times of the year - summer and winter. The protocols were 14 cross bred mares, of which 7 were submitted to treatment with EPE collected in the summer and the others with EPE collected in the winter. All of these animals were initially treated as a control group, that is, being monitored daily for ovarian, uterine and behavioral changes from the start of the breending season. From the beginning of March 2017 (03/03/2017), these animals were randomly assigned to one of the treatments, which consisted of an intramuscular application of 125 IU EPE every 12 hours, until one or more more follicles with 34/35 mm, when each one received a single intravenous EPE application containing 500 IU to induce ovulation. The only difference between the groups was the EPE collection season. The results obtained in this experiment allowed to conclude that the reduction of the light incidence after the summer solstice reduces the diameter of the ovulatory follicle. In addition, EPE-summer was more effective when used with the objective of maintaining follicular growth in mares during the end of the breeding season, resulting in larger ovulatory follicles. / Devido ao atual comércio e tecnologia empregada na criação de equinos, existe procura por métodos reprodutivos efetivos, buscando a otimização dos recursos proporcionados pelo animal e pelo ambiente. Caracteristicas hormonais da égua já conhecidas e usadas com efeito reprodutivo positivo, como o uso do extrato de pituitária equina (EPE) para induzir ovulação, pode ser melhor empregado se eliminarmos a heterogenicidade das amostras no momento da coleta. Este experimento foi conduzido com o objetivo de induzir o estro e a ovulação em éguas no final da estação de monta, com o uso de EPE coletado separadamente em diferentes épocas do ano - verão e inverno. Foram submetidas aos protocolos, 14 éguas sem raça definida, sendo 7 delas submetidas ao tratamento com EPE coletado no verão e as outras com EPE coletado no inverno. Todos estes animais foram inicialmente tratados como grupo controle, isto é, sendo monitoradas diariamente quanto as modificações ovarianas, uterinas e comportamentais, desde o início da Estação de Monta. A partir do início de março de 2017 (03/03/2017), estes animais foram randomicamente dividos para um dos tratamentos, que consistiram em uma aplicação por via intramuscular de 125 UI de EPE a cada 12 horas, até a verificação de um ou mais folículos com 34/35 mm, quando então cada uma recebia uma única aplicação de EPE via endovenosa contendo 500 UI, para induzir a ovulação, sendo a única diferença entre os grupos a época de coleta do EPE. Os resultados obtidos neste experimento permitiram concluir que a redução da incidência luminosa após o solstício de verão reduz o diâmetro do folículo ovulatório. Além de que o EPE-verão foi mais eficaz quando utilizado com o objetivo de manter o crescimento folicular em éguas durante o final da estação reprodutiva, resultando em folículos ovulatórios maiores.

Adjuvant hormonal therapy has been demonstrated to be able to delay disease progression in nonmetastatic prostate cancer. To date, however, a favorable impact on survival has only been demonstrated in lymph-node-positive disease and in external-beam radiotherapy series with locally advanced and probably mainly micrometastatic tumors. The Bicalutamide Early Prostate Cancer Program is the largest study under way to define the role of adjuvant treatment in early prostate cancer and identify subgroups of patients likely to benefit from immediate hormonal therapy. At the time of the most recently published analysis, the risk of objective clinical progression was significantly reduced in the bicalutamide arm (hazards ratio 0.58, 95% confidence interval 0.51–0.66, p < 0.0001). However, further maturation of data is needed to see whether this difference will lead to a survival advantage. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

This study examines the production and the introduction of a fertility treatment which gained great attention both in Sweden and internationally during the 1960s. In the procedure, hormones were extracted from human pituitary glands which had been collected from autopsies. After this, the hormones were purified and injected into the female patients as a treatment for certain kinds of sterility. Carl Gemzell, professor of obstetrics and gynecology at Uppsala University, was a key figure in the development of the treatment. He was described by the media as a medical pioneer and later became one of Sweden’s most famous doctors and scientists. The fertility treatment also gained a lot of attention in the media as ”the miracle drug that made barren women pregnant”, especially since it often resulted in multiple pregnancies. In the 1960s, pregnancies with quadruplets, quintuplets, sextuplets and even septuplets became world sensations. By using the sociology of expectations as theoretical approach, which focuses on the performativity of expectations and visions in science production, this study aims to investigate how expectations of an effective fertility method were articulated in both the scientific sphere and in the media. This of course also relates to how the risks of the multiple pregnancies were dealt with. The analysis is divided into three chapters, where the first chapter examines the politics of science in Sweden during the post-war period and how Gemzell’s work in Uppsala generated expectations of a scientific milieu on the front line of fertility research. The next chapter is focused on the media’s interest in Gemzell and how he became a celebrity. A central argument for the study is that his public status helped to create scientific credibility for the treatment, especially among the public. The final chapter focuses on the media reporting about the multiple pregnancies. They were often treated as sensations, which was somewhat paradoxical as they were hazardous and frequently resulted in the death of the premature children.