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Santiago Palacios

Publications and source records attributed to Santiago Palacios.

At least 19 recordsLinked to original sources
PubMed2006

Spanish post-menopausal women's viewpoints on hormone therapy.

OBJECTIVE: The purpose of this study was to identify women's socio-demographic and climacteric factors, as well as other variables related to health care, associated with the prescription of the treatment during menopause and to investigate the prevalence of certain conditioning factors in early discontinuation in women aged 40-65 years in a population of post-menopausal women in Spain. STUDY DESIGN: Cross-sectional survey. SETTING: Four of the most inhabited cities in Spain (Madrid, Barcelona, Seville and Valencia). POPULATION: A total of 270 symptomatic post-menopausal women. METHODS: A personal interview with a semi-structured questionnaire specifically designed to collect information on treatments for climacteric-related complaints. MAIN OUTCOME MEASURES: The reasons for HRT, the evaluation of alternative therapies, the reasons for choosing one therapy or another and reasons for discontinuation. RESULTS: Of all the subjects included, 180 were still taking any type of treatment and 90 were former HRT users or had never used HRT. Among the latter, 43% of women expressed fear of the side effects and 38% gave the risk of breast cancer as the main reason for not using HRT. Of them, 58% receive phytoestrogens. Media and negative data from medical journals influenced this attitude in 67% of the women. On the other hand, only 9.4% of HRT users were reluctant to receive the therapy and the main reasons for maintaining HRT were its efficacy against climacteric symptoms, medical prescription and life quality. CONCLUSIONS: Side effects and fear of cancer were the most common reasons for not using HRT; and medical prescription, symptomatic improvement and quality of life were the main reasons for using it. Negative data from journals have an important effect on women's attitudes to HRT.

Adult↗
PubMed2006

Advances in hormone replacement therapy with drospirenone, a unique progestogen with aldosterone receptor antagonism.

Unlike other currently available progestogens, drospirenone (DRSP) has a pharmacological profile, which closely mimics that of endogenous progesterone, most notably potent anti-aldosterone and anti-androgenic effects. Consequently, DRSP, when combined with 17beta-estradiol (E2) as hormone replacement therapy (HRT), offsets E2-related water and sodium retention by blocking the mineralocorticoid receptor. This review evaluates the potential benefits offered by DRSP as the progestin component of HRT with respect to its anti-aldosterone activity, which translates into positive effects on body weight and blood pressure in clinical trials of continuous, combined E2/DRSP in post-menopausal women. In a 1-year, large-scale, randomised, controlled trial, E2 1 mg/DRSP 2 mg significantly decreased mean body weight by 1.2 kg versus baseline (P<0.001), whereas patients receiving E2 1 mg gained weight. E2 1 mg/DRSP 2 mg also significantly lowered mean systolic blood pressure (SBP) by 9.0 mmHg from baseline (P<0.05) versus 3.7 mmHg in the E2 1 mg group (P=0.220) in a sub-group of hypertensive women. In addition, E2/DRSP was not associated with hyperkalaemia (potassium > or =5.5 meq/L) irrespective of concomitant use of ACE inhibitors, angiotensin II receptor antagonists or non-steroidal anti-inflammatory drugs, and co-morbid diabetes mellitus. In summary, as well as effectively treating climacteric symptoms, DRSP 2 mg combined with E2 1 mg has shown positive effects on body weight and blood pressure in clinical trials, most likely due to DRSP's anti-aldosterone properties. This combination may therefore offer an alternative therapeutic option with additional benefits beyond current HRT agents for symptomatic post-menopausal women.

Androstenes↗
PubMed2006

The prescription of hormone replacement therapy in Spain: differences between general practitioners and gynaecologists.

OBJECTIVES: The purpose of this study was to determine the frequency with which hormone replacement therapy (HRT) was prescribed and to identify physician-related factors associated with the prescription of HRT in Spain. STUDY DESIGN: A descriptive cross-sectional survey based on a personal interview with a structured questionnaire was conducted in April 2005 with physicians aged 25-65 years. A total of 2700 doctors were asked to participate in this prospective study (1350 GY and 1350 GP). This number included 270 gynaecologists (GY group) and 270 general practitioners (GP group). RESULTS: Only 10% of gynaecologists and 19.4% of GPs had never prescribed HRT. The reasons given for not prescribing HRT were adverse effects and the fear of cancer among GPs and adverse effects and social alarm in the GY group. Phytoestrogens were the most commonly used alternative; however, GPs were more willing to use antidepressants and benzodiazepines than GYs. The frequency of HRT prescription in symptomatic women was significantly higher among GYs. The main reasons for prescribing HRT were climacteric complaints and improvement in life quality for GYs and, climacteric complaints and the prevention of osteoporosis for GPs. Seventy-eight percent of GYs prescribing hormones referred a high degree of satisfaction with HRT, whereas only 50% of GPs expressed a similar attitude. CONCLUSIONS: Concern for HRT prescription in Spain is high. Adverse effects and the fear of cancer are negative conditioning factors in the prescription of HRT, whereas climacteric complaints, quality of life and the prevention of osteoporosis are positive conditioning factors. GYs are more willing to use HRT than GPs. This contrast may reflect the indecision of GPs regarding the preventive value of HRT.

Adult↗
PubMed2006

Neuroprotective effects of soy phytoestrogens in the rat brain.

Soy extracts are widely used as an alternative to hormone replacement therapy for the treatment of menopausal symptoms. Soy phytoestrogens, such as genistein, may act on the nervous system, affecting mood, cognitive function and behavior. In addition, several studies suggest that soy phytoestrogens are neuroprotective. The hypothesis of the present study was that soy extracts may exert neuroprotection and that this effect is mediated by phytoestrogens such as genistein. To test this hypothesis we assessed whether an acute administration of soy extract or genistein in vivo affects hippocampal neuronal loss induced by the systemic administration of kainic acid to adult Wistar female rats. One week after ovariectomy, animals received one intraperitoneal injection of soy extract (0.2, 1, 2 or 20 mg/kg), one injection of genistein (0.1, 1 or 10 mg/kg) or one injection of vehicle. Thirty minutes later, all animals received one intraperitoneal injection of kainic acid (7 mg/kg) or vehicle. One week after the injections, all animals were fixed by perfusion and the number of Nissl-stained neurons in the hilus of the dentate gyrus was estimated by the optical disector method. Administration of soy extract, even at high doses, did not induce neuronal loss and did not increase neuronal degeneration after kainic acid injury. On the contrary, soy extract at doses ranging from 1 to 20 mg/kg prevented neuronal loss induced by kainic acid. Genistein showed neuroprotective effects only at high dose (10 mg/kg), suggesting that other components in the soy extract are involved in the neuroprotective effect.

Animals↗
PubMed2005

Available medical choices for the management of menopause.

The age at which menopause occurs is a critical factor in the magnitude of its consequences. Most of the medium-to-long-term effects of oestrogen deprivation depend on their duration. The timing of the last menstruation is therefore important, but hypoestrogenic amenorrhoea during the reproductive age is also a relevant factor in the evaluation of individual risks. In recent years, moving post-menopausal women from the lowest point of ovarian hypofunction has been the most important motivation for developing guidelines for the hormonal management of menopause. However, recent data suggest that this may be associated with an unacceptable increase in morbidity in a number of women. Concerns about long-term hormone replacement therapy (HRT) at menopause have recently enhanced interest in a group of molecules that act on the oestrogen receptor with selective effects, known as selective oestrogen receptor modulators (SERMs). Of these, Raloxifene has been approved for the treatment and prevention of osteoporosis, and exhibits a pattern of actions particularly well matched to the needs and concerns of post-menopausal women. Further studies on SERMs may open up new vistas in patient-specific management of post-menopausal health. Finally, debates on the specific health consequences of menopause deal mainly with the risk of chronic disease. Gynaecologists and other health professionals would be advised to develop intervention strategies at menopause according to the continuum of a woman's life, beginning at the post-menarche and extending into later life.

Bone Density Conservation Agents↗
PubMed2005

Menopausal transition in Movima women, a Bolivian Native-American.

BACKGROUND: Although it is well accepted that socio-cultural influences may affect the onset of menopause and the symptoms experienced, there are scant data related to native indigenous populations. OBJECTIVE: Our purpose was to study in a native population of South America (The Movima, Bolivia) the menopausal transition. SUBJECTS AND METHODS: In this cross-sectional survey a total of 125 Movima women between 35 and 54 years old was included. All of them answered a questionnaire and a face-to-face interview focused on the menopausal experiences of middle-aged Movima women and additionally, history and physical examination, demographic and socio-economic information were obtained. RESULTS: The onset of natural menopause in the Movima was at 42.3+/-6.17 years. Loss of libido was the main complaint of the menopause, occurring in a 51% of interviewed women, hot flushes in a 45%, genital itching in a 40.8% and dyspareunia in a 40% were also frequently reported. CONCLUSION: This is the first data recorded on menopausal transition of the Movima natives. The age of menopause and the symptoms experienced are different to those from women of developed countries. Data related to minority groups are important to adapt the health system to their particular requirements.

Adult↗
PubMed2005

Low-dose, vaginally administered estrogens may enhance local benefits of systemic therapy in the treatment of urogenital atrophy in postmenopausal women on hormone therapy.

BACKGROUND: When genital atrophy exists, systemic hormone therapy (HT) has a timing until to induce vaginal proliferation and symptomatic relieve. Thus, in order to obtain a prompt improvement, the association of local therapy acting on the genital epithelium to the systemic treatment should be considered. OBJECTIVE: To evaluate the effects of a combined therapy consisting of vaginal estriol with transdermal 17-beta-estradiol (50 microg/day) plus medroxyprogesterone acetate (5 mg/day) per os in shortening the period of uro-genital symptoms. SUBJECTS AND METHODS: In a randomized, double blind, controlled with placebo study, 27 women with climacteric symptoms and atrophic vaginitis were treated for 4 months with HT plus vaginal estriol 0.5 mg/day (group E) or placebo (group P). Patients use the local medication daily for the first 3 weeks and twice-weekly thereafter. Before entering in the study, patients were asked about HT and selected for inclusion. In the first visit, electible patients after written informed consent were randomized to receive HT plus local estriol or placebo. All the subjects had baseline studies, including medical history, physical examination, blood and urine analysis. In order to evaluate the effect of local treatment on urinary and genital symptoms, a score for genital, urinary and colposcopic complaints (0 minimum-100 maximum) was developed. This score and Blatt-Kuperman were recorded and performed in every control. RESULTS: There were no differences on climacteric symptoms relief between the two groups. Additionally, the improvement in urinary symptoms at the end of the study was similar for both groups (from 16.5 +/- 6.1 to 8.5 +/- 2.4 for E group and from 15.8 +/- 7.8 to 8.8 +/- 2.7 for P group; P < 0.01 versus basal); however, those women in group E reached significant improvement on urinary complaints since the first month of treatment. Additionally, a significant difference between E and P was observed at months 2 and 3, although no differences were detected at the end of the study. Papanicolaou smear showed reactive or reparative changes and karyopyknotic index exhibited a significant increase in superficial cells in both groups and at the end of the study. CONCLUSIONS: Adding vaginal estriol to HRT may shorten the latency period for urinary symptoms.

Administration, Cutaneous↗
PubMed2005

[Hyperkeratotic vascular malformations. Presentation of three cases].

Hyperkeratotic vascular malformations (verrucous hemangiomas) are infrequent vascular lesions present from birth. Initially, they are reminiscent of port wine stains or childhood hemangioma, but over time they gradually take on their typical warty and hyperkeratotic appearance. These changes are probably due to trauma, scratching and bleeding episodes. Because the lesion is deep and goes beyond the clinical lesion, treatment is difficult and involves many recurrences. We present three cases of this vascular malformation, in two males aged 45 and 62 and a 30-year-old female. All three had the lesion from birth, and presented with frequent bleeding episodes.

Adult↗
PubMed2004

Prevention of postmenopausal bone loss by pulsed estrogen therapy: comparison with transdermal route.

OBJECTIVE: To compare the efficacy of pulsed estrogen therapy following intranasal 17beta-estradiol (E2) (S21400) with patch E2 in preventing postmenopausal bone loss and on bone turnover. METHODS: In this multinational open study, 361 postmenopausal women aged 51.5 (S.D. 4.6) years were treated with S21400 300 microg per day or patch E2 (delivering 50 microg per day), two patches per week, for 56 weeks. Bone mineral density (BMD) was assessed at the spine and hip using dual X-ray absorptiometry at baseline and week 56 (W56). Bone turnover markers (osteocalcin, bone alkaline phosphatase, urinary type I collagen C-telopeptides) were measured at baseline and weeks 12, 28 and 56. RESULTS: Spine and hip bone mineral density significantly increased in both groups (P < 0.001 versus baseline). Mean (S.D.) percent increases were 2.1 (3.0) at the spine (both groups), and 1.2 (2.4) and 1.1 (2.2) at the hip in the S21400 and patch E2 groups, respectively. Bone mineral density also significantly increased (P < 0.001 versus baseline) in osteopenic patients following S21400 and patch E2: 3.1 (3.5) and 2.4 (3.5) at the spine, and 2.0 (2.6) and 1.2 (2.7) at the hip, respectively. Bone metabolism was normalized at week 56 with a significant decrease (P < 0.001) from baseline in all markers: 56% and 53% for type I collagen C-telopeptides, and 24% and 25% for osteocalcin in the S21400 and patch E2 groups, respectively. CONCLUSION: Pulsed estrogen therapy was as effective in normalizing bone turnover and preventing postmenopausal bone loss as a reservoir patch.

Administration, Cutaneous↗
PubMed2004

[Health-related quality of life in the Spanish women through and beyond menopause. Development and validation of the Cervantes Scale].

BACKGROUND AND OBJECTIVE: There are numerous health-related quality of life questionnaires but only a few are specific for the menopause. The objective of this study was to develop and validate a specific scale, the Cervantes Scale, for menopause in Spanish women. SUBJECTS AND METHOD: This cross-sectional study included a pilot phase, construction of the questionnaire, validation, and test-retest reliability. A population-based sample of 2,274 women ponderated by age groups and education levels was used in the validation phase. Internal consistency was assessed with the Cronbach's alpha analysis. RESULTS: The final questionnaire included 31 items ("menopause and health" with 15 items made up of vasomotor symptoms, health and aging, "sexuality" with 4 items, "couple relationship" with 3 items and "psychical domain" with 9 items). The Cronbach's (coefficient of the scale was 0.9092. The correlation coefficient of the test-retest was r=0.847 (p<.001). The Cervantes Scale is short, easy to administer (about 7 minutes), has a minimal score of 0 and a maximal score of 155 (from better to worse quality of life) and scores can be compared to reference values in younger women and women of the same age. CONCLUSIONS: The Cervantes Scale is included in the new generation of instruments of health-related quality of life specific for the menopause and is intended to be used in Spanish women aged between 45 and 64 years.

Cross-Sectional Studies↗
PubMed2004

Raloxifene is not associated with biologically relevant changes in hot flushes in postmenopausal women for whom therapy is appropriate.

OBJECTIVES: Raloxifene is approved for the treatment and prevention of postmenopausal osteoporosis. Previous studies have described a raloxifene-associated increase in hot flushes, reported as adverse events. This study was undertaken to provide a detailed evaluation of the potential of raloxifene to induce or exacerbate hot flushes in postmenopausal women. STUDY DESIGN: In this double-blind, placebo-controlled, parallel group multicenter study, 487 postmenopausal women were randomized to receive 8 months of treatment with either raloxifene (RLX) at the recommended dose of 60 mg/day, or by slow-dose escalation for the first 2 months, followed by the standard dose for the rest of the study (SDE), or placebo (PL). The frequency, duration, intensity, severity, and impact of hot flushes were measured. RESULTS: With 3-5 hot flushes per week, the mean number at baseline was low. During treatment, it increased by <1 hot flush/week in both active treatment groups and decreased by <1 hot flush/week with PL. The high proportion ( approximately 60%) of asymptomatic patients at baseline had increased further by the end of treatment in all groups. The proportion of women whose pre-existing hot flushes abated during treatment was significantly greater with SDE (P=.005) and PL (P=.050), but not with RLX, when compared with the proportion with treatment-emergent flushes. There were no statistically significant between-group differences in the distribution of the number of hot flushes after 2 months of treatment. At end point, there were no significant differences between SDE and either RLX or PL, but the difference between RLX and PL was statistically significant (P=.035). There were no significant between-group differences in the hot flush impact scores, in treatment satisfaction, and in the proportion of patients requesting symptomatic treatment to alleviate hot flushes. CONCLUSION: In a postmenopausal population meeting the criteria for the prescription of RLX, the overall effect of the drug on hot flushes is low. Previous studies using adverse event reports have overestimated the importance of hot flushes in postmenopausal women during treatment with RLX. Slow-dose escalation seems to decrease the number of symptomatic patients further and may be a useful strategy in women reporting flushes when starting RLX.

Aged↗
PubMed2002

Leukocytoclastic vasculitis presenting as an erythema gyratum repens--like eruption on a patient with systemic lupus erythematosus.

Cutaneous leukocytoclastic vasculitis is a common finding among patients with systemic lupus erythematosus, although the clinical appearance of the lesions varies. We report the case of a 38-year-old woman with systemic lupus erythematosus who had leukocytoclastic vasculitis with peculiar clinical morphologic features of the cutaneous lesions. They consisted of figured erythema closely resembling erythema gyratum repens. We discuss the differential diagnosis with other annular eruptions.

Adult↗