Browsing by Author "Pandurevic, S. (57198424533)"

Purpose: Ovarian and adrenal aging leads to a progressive decline in androgen levels and deleterious effects on the quality of life. Despite this, specific replacement is not routinely recommended in the management of women with a physiological or pathological decline in their production, mainly due to the lack of long-term follow-up safety data. The purpose of this paper was to meta-analyze and summarize the existing data about hormonal profile changes in menopausal women receiving androgen replacement treatments. Full-text articles published through May 30, 2018 were found via MEDLINE and Embase and selected according to the strict inclusion criteria. Methods: Randomized clinical trials and case–control studies were enrolled. Studies not reporting steroid serum levels or not providing a control group were excluded from the analysis. Studies enrolling women with genetic defects or severe chronic systemic diseases were excluded. 113 papers fulfilled the inclusion criteria and 56 papers were included in the analysis. Desired data were compiled and extracted by independent observers. Results: Androgen administration increases E1, E2, testosterone, DHEA and DHEAS serum levels, and reduces SHBG. However, the E1 and E2 increase is evident only when DHEA is administered. Conclusions: Whatever androgen formulation we choose in postmenopausal women, the end result is a rise in testosterone serum levels. However, DHEA regimen is also associated with an increased estrogenic availability. This might be crucial when choosing the best possible treatment for each patient individually taking into consideration if potential benefits outweigh the risks. © 2020, Italian Society of Endocrinology (SIE).

Purpose: Ovarian and adrenal aging leads to a progressive decline in androgen levels and deleterious effects on the quality of life. Despite this, specific replacement is not routinely recommended in the management of women with a physiological or pathological decline in their production, mainly due to the lack of long-term follow-up safety data. The purpose of this paper was to meta-analyze and summarize the existing data about hormonal profile changes in menopausal women receiving androgen replacement treatments. Full-text articles published through May 30, 2018 were found via MEDLINE and Embase and selected according to the strict inclusion criteria. Methods: Randomized clinical trials and case–control studies were enrolled. Studies not reporting steroid serum levels or not providing a control group were excluded from the analysis. Studies enrolling women with genetic defects or severe chronic systemic diseases were excluded. 113 papers fulfilled the inclusion criteria and 56 papers were included in the analysis. Desired data were compiled and extracted by independent observers. Results: Androgen administration increases E1, E2, testosterone, DHEA and DHEAS serum levels, and reduces SHBG. However, the E1 and E2 increase is evident only when DHEA is administered. Conclusions: Whatever androgen formulation we choose in postmenopausal women, the end result is a rise in testosterone serum levels. However, DHEA regimen is also associated with an increased estrogenic availability. This might be crucial when choosing the best possible treatment for each patient individually taking into consideration if potential benefits outweigh the risks. © 2020, Italian Society of Endocrinology (SIE).

Current guidelines for follow-up after resection of colorectal cancer (CRC) recommend regular measurements of carcinoembryogenic antigen (CEA) and imaging tests. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are currently primary imaging modalities, while the role of fluorine-18-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), which is recommended in patients with negative MDCT and increased CEA, is still uncertain. Our aim was to compare diagnostic performance and prognostic significance of18F-FDG PET/CT with MRI and tumor markers CEA and carbohydrate antigen 19-9 (CA 19-9) in detection of recurrent CRC. This prospective study included 35 patients with resected CRC, referred to18F-FDG PET/CT examination for suspected recurrence. During median follow-up of 24.4±1.5 months18F-FDG PET/CT and MRI results and tumor marker levels were compared with findings of histopathological examination or with results of clinical and imaging follow-up. Management plan before the18F-FDG PET/CT scan was considered and compared to the final treatment decision. The sensitivity, specificity, positive and negative predictive value and accuracy of18F-FDG PET/CT and MRI in detection of recurrent colorectal cancer in patient-based analysis were 92.6%, 75%, 92.6%, 75% and 88.6%, and 65.4%, 66.7%, 85%, 40% and 65.7%, respectively. In lesion-based analysis the sensitivity of18F-FDG PET/CT and MRI was 83.1% and 68.2%, respectively. The overall accuracy of CEA and CA 19-9 in recurrence detection was 48.6% and 54.3%, respectively. PET/CT induced therapy alterations in 13/35 (37.1%) patients. Progression was observed in 16/35 patients during follow-up, with significantly lower risk of progression in patients with treatment changes based on PET findings (Multivariate Cox regression; p=0.017). In addition, elevated CA 19-9 levels in time of PET scan and male gender carried significantly higher risk of progression (p=0.007 and p=0.016, respectively). Kaplan-Meier Log rank test showed significantly longer progression-free survival time in patients who had treatment plan changed based on PET/CT (p=0.046). We can conclude that18F-FDG PET/CT showed better sensitivity and accuracy compared to MRI in detection of recurrent colorectal cancer, with much better sensitivity compared to CEA and CA 19-9. Patients with treatment changes based on18F-FDG PET/CT had significantly better prognosis and longer progression-free survival, while elevated values of CA 19-9 and male gender were associated with worse prognosis. © 2017, Cancer Research Institute Slovak Acad. of Sciences. All rights reserved.