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The aim of the present study was to investigate the impact of anastrozole and letrozole supplementation following surgically induced menopause on bone metabolism and biomechanical properties. A total of 45 Wistar rats underwent ovariectomy and were then randomly allocated to receive no treatment, anastrozole or letrozole. At 2 and 4 months following the initiation of the present study, the serum levels of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) were determined, and the animals were sacrificed at the end of the 4-month period to assess the biomechanical properties of the femoral bones. The applied force and the deflection of the central section were recorded during the test. Taking advantage of these quantities, the fracture force, the stiffness of the bone and the energy absorbed until fracture were determined. At 2 months following the initiation of the experimental protocol, the mean OPG levels were significantly increased in the control group compared with the anastrozole-treated group (P

Objective To investigate the effects of pentoxifylline, on vascular endothelial growth factor (VEGF)-C and flk-1 expression in the rat endometriosis model. Design Prospective, randomized, placebo-controlled study. Setting Academic institution. Animal(s) Twenty Wistar rats with surgically induced endometriosis. Intervention(s) Animals were evaluated after surgical induction of endometriosis and random allocation to a group that received pentoxifylline and a control group that received NaCl 0.9%, for 3 weeks. At the end of the treatment period the animals were killed and the implants evaluated macroscopically as well as by immunohistochemistry. Main Outcome Measure(s) Morphologic changes of the endometriotic implants; and evaluation of VEGF-C and flk-1 expression by a semiquantitative analysis (HSCORE) for the intensity of immunohistochemical reactivity. Result(s) A significant reduction was observed in the mean volume of the endometriotic implants per animal in the treatment group as compared with the control group. There was a significant reduction not only in the mean volume of implants per animal but also in the mean number of implants per animal after treatment. By immunohistochemical evaluation (HSCORE), there was a significant reduction in VEGF-C expression after treatment in all areas examined. A significant reduction of flk-1 expression was also noted in the glandular compartment after treatment but not in the epithelial surface or stroma. Conclusion(s) Pentoxifylline may cause suppression of endometriotic lesions by suppressing angiogenesis through VEGF-C and flk-1 expression.

Objective To compare the efficacy of letrozole to recombinant FSH for ovarian stimulation combined with IUI in a group of patients that had failed to conceive after clomiphene citrate (CC) and IUI. Design Prospective randomized trial with human subjects. Setting University-based fertility center. Patient(s) Fifty couples with unexplained infertility that failed to conceive after three cycles of CC combined to IUI. Intervention(s) Couples were randomized to undergo superovulation either with letrozole or with recombinant FSH combined to IUI. Main Outcome Measure(s) Clinical pregnancy per cycle of treatment and clinical pregnancy per couple. Result(s) Pregnancy rate (PR) per cycle was 8.9% in the letrozole group as compared with 14% in the gonadotropin IUI group. This resulted in a cumulative PR per couple of 24% versus 36% and a take home baby rate of 20% versus 28%. Endometrial thickness was significantly lower in the letrozole group (7.1 ± 2.3 vs 8.6 ± 1.8). Conclusion(s) Ovarian stimulation with letrozole is associated with acceptable PRs compared with gonadotropin with significant less cost, risks, and patient inconvenience.

Anastrazole and Letrozole are used as endocrine therapy for breast cancer patients. Previous studies suggested a possible association with metabolic and liver adverse effects. Their results are conflicting. Fifty-five 4-week-old female Wistar rats were allocated in 4 groups 1) ovariectomy control (OC), 2) ovariectomy-Anastrazole (OA) 3) ovariectomy -Letrozole (OL), 4) control. Serum glucose, cholesterol, triglycerides, HDL-c and LDL-c were measured at baseline, 2 and 4 months. At the end, the animals‘ liver were dissected for pathology. At 4 months, total cholesterol differed among the OC and OL groups (p = 0.15) and the control and OL groups (p = 0.12). LDL-C differed between the control and OC groups (p = 0.015) as well as between the control and OA (p =0 .015) and OL groups (p = 0.002). OC group triglycerides, differed from those of the OL group (p =0 .002) and the control group (p = 0.007). The OA also significantly differed from the OL (p = 0.50). Liver pathology analysis revealed differences among groups with favored mild steatosis and ballooning. Anastrazole and Letrozole seem to negatively influence the lipid profile in our experimental model. This information should be taken in caution by medical oncologists when addressing patients with altered lipid metabolism.

Objective To compare the effects of 2.5 mg letrozole with those of 1 mg anastrazole daily on the hormonal and semen profiles of a subset of infertile men with low T/E 2 ratios. Design Prospective, nonrandomized study. Setting Reproductive medicine clinic. Patient(s) The study group consisted of 29 infertile men with a low serum T/E 2 ratio ( Intervention(s) Patients were divided into two groups. Group A included 15 patients treated with 2.5 mg letrozole orally once daily for 6 months, and Group B consisted of 14 patients treated with 1 mg anastrazole orally every day for 6 months. Main Outcome Measure(s) Hormonal evaluation included measurement of serum FSH, LH, PRL, T, and E 2 . In all sperm analyses pretreatment and posttreatment total motile sperm counts (ejaculate volume × concentration × motile fraction) were evaluated. Result(s) The use of aromatase inhibitors (either letrozole or anastrazole) in cases of infertile men with low T/E 2 ratios improved both hormonal and semen parameters. Conclusion(s) This study suggests that some men with severe oligospermia, low T levels, and normal gonadotropin concentration may have a treatable endocrinopathy.

Substantial histopathology data provide evidence that endometriosis might be viewed as a precursor lesion of endometrioid and clear cell carcinoma of the ovary, via intermediary atypical borderline lesions. Also, genes involved in both endometriosis and epithelial ovarian cancer have been shown to play a role in the pathogenesis of endometriosis-associated ovarian carcinoma.A retrospective study of 17 cases of ovarian carcinomas associated with endometriosis, diagnosed between 2000 and 2009, at Aretaieion Hospital of University of Athens, is presented. 10/17 cases in this study (58.8%) were clear cell carcinomas (CCC), 6/17 cases (35.3%) were endometrioid adenocarcinomas (EAC) and 1/17 cases (5.9%) was a serous carcinoma associated with ovarian endometriosis. Patients's age was 27-76 years (mean age 58 years). Typical ovarian endometriosis was documented in 8/17 (47%) of the tumors. In 9/17 cases, areas of fibrosis or cystic lesions infiltrated by iron-laden macrophages and endometrial-like stroma, consistent with endometriosis, were observed.In comparison with common epithelial ovarian cancers, CCC and EACs of the ovary were presented at earlier stages. Cytoreductive surgical treatment is critical in order to plan appropriate post-operative management.

Objective: The purpose of this study was to examine the effects of Hormone Replacement Therapy (HRT) on plasma lipoprotein levels, bone mass and the endometrium. Methods: Thirty healthy women were enrolled in the study for climacteric symptoms and received a combination of 17‚estradiol and norethisterone acetate continuously for 2 years. An untreated group, consisting of 25 healthy postmenopausal women presenting the same symptoms and not willing to receive HRT, were also studied and served as controls. Plasma lipoprotein levels, bone mineral density as well as thickness of the endometrium measured by ultrasound and biopsy of the endometrium were evaluated at baseline and after 1 and 2 years. There were no differences between the two groups regarding clinical and demographic baseline data. Results: After 2 years of HRT, total cholesterol and LDL-cholesterol levels were significantly reduced (p

A 26-year-old pregnant woman was admitted to our institution running her 30 weeks of gestation. The patient had a past history of total thyroidectomy cause of a thyroid papillary carcinoma and presented with increased supraphysiological TSH levels under 250 microg T4, while slightly hyperthyroid, from the clinical point of view. Partial resistance to thyroid replacement therapy or TSH-secreting tumour was evoked. Pituitary MRI revealed a pituitary enlargement without excluding a pituitary adenoma. To avoid further stress on pituitary a caesarean section was performed at 38 weeks of gestation. MRI 7 months later was normal, while the patient remained under high doses of T4 replacement therapy and TSH was found at the upper limits of normalcy, while T3, T4 and FTI were above normalcy.We conclude that, in the absence of thyroid gland, high TSH levels due to thyroid hormone resistance could be erroneously attributed to a pituitary TSH secreting tumour, when associated with a pregnancy-related pituitary enlargement.