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Ulipristal acetate

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https://www.readbyqxmd.com/read/28929861/ulipristal-acetate-and-extracellular-matrix-production-in-human-leiomyomas-in-vivo-a-laboratory-analysis-of-a-randomized-placebo-controlled-trial
#1
Jeris Cox, Minnie Malik, Joy Britten, Terrence Lewis, William H Catherino
In a prior randomized controlled study, patients treated with ulipristal acetate (UPA) or placebo for 3 months had a decrease in leiomyoma size. A total of 10 patients' tissue samples (5 placebo and 5 treated with 10 mg/d UPA) that underwent hysterectomy and tissue preservation were identified from this study. Quantitative real-time reverse transcriptase polymerase chain reaction and Western blotting were used to assess fold gene and protein expression of extracellular membrane (ECM) proteins: collagen 1A (COL1A), fibronectin (FN1), and versican (VCAN) of the samples...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28919823/updated-approaches-for-management-of-uterine-fibroids
#2
REVIEW
Aymara Mas, Marta Tarazona, Joana Dasí Carrasco, Gloria Estaca, Ignacio Cristóbal, Javier Monleón
Uterine anatomy and uterine fibroids (UFs) characteristics have been classically considered as almost a unique issue in gynecology and reproductive medicine. Nowadays, the management of UF pathology is undergoing an important evolution, with the patient's quality of life being the most important aspect to consider. Accordingly, surgical techniques and aggressive treatments are reserved for only those cases with heavy symptomatology, while the clinical diagnostic based on size and number of UFs remains in a second plane in these situations...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28919793/burden-of-uterine-fibroids-in-italy-epidemiology-treatment-outcomes-and-consumption-of-health-care-resources-in-more-than-5-000-women
#3
Marco Chiumente, Mauro De Rosa, Andrea Messori, Enrica Maria Proli
BACKGROUND AND PURPOSE: Epidemiological studies on uterine fibroids (UFs) are mostly based on surveys or analyses of small samples of patients. In 50% of women, the quality of life is worsened by disease-related symptoms; furthermore, treatments imply a remarkable health care cost. The aim of this observational study was to analyze a large sample of Italian patients with UFs and to assess the epidemiology, the appropriateness of treatments, and the consumption of disease-related resources...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28914672/endometrial-changes-in-surgical-specimens-of-perimenopausal-patients-treated-with-ulipristal-acetate-for-uterine-leiomyomas
#4
Francisco F Nogales, Vicente Crespo-Lora, Nelly Cruz-Viruel, Clara Chamorro-Santos, Christine Bergeron
Ulipristal acetate (UPA) is used to treat leiomyomas, and its effect on the endometrium has been studied in biopsy material. Reversible histologic modifications were found, named progesterone receptor modulators-associated endometrial changes (PAEC). However, hysterectomies from patients treated with UPA have not been analyzed. For the first time, we examined surgical specimens from 100 leiomyoma-treated patients for UPA-related endometrial changes. We analyzed the distribution of lesions, involution after treatment, and the relationship between type and extent of lesions and dosage...
September 13, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28900897/ulipristal-acetate-a-review-in-symptomatic-uterine-fibroids
#5
Karly P Garnock-Jones, Sean T Duggan
Oral ulipristal acetate (Esmya(®); Fibristal(®)), a synthetic selective progesterone receptor modulator, is the first selective progesterone modulator to be approved for the treatment of uterine fibroids. It was initially approved for the preoperative treatment of moderate to severe uterine fibroid symptoms in women of reproductive age. Recently, the indication was extended in the EU to include the intermittent treatment of moderate to severe uterine fibroid symptoms. This narrative review summarizes pharmacological, efficacy and tolerability data relevant to the preoperative and intermittent use of ulipristal acetate in patients with symptomatic uterine fibroids...
September 12, 2017: Drugs
https://www.readbyqxmd.com/read/28871011/economic-impact-of-ulipristal-acetate-on-surgical-procedures-for-uterine-fibroids-in-france
#6
Hervé Fernandez, Olivier Jourdain, Vincent Villefranque, Matthieu Lehmann, Antoine Lafuma, Matthieu Trancart
OBJECTIVE: To assess the budget impact of using ulipristal acetate (UPA) 5 mg to treat women with uterine fibroids (UF) causing moderate to severe symptoms. DESIGN: We modelled trends in the number of surgical procedures for symptomatic UF, with and without the use of UPA for preoperative or intermittent treatment and assessed the budget impact of UPA use from the French national healthcare insurance system perspective. SETTING: A French national hospital database (PMSI) that records admissions and relative procedures to public and private hospitals...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28854585/sperm-chemorepulsion-a-supplementary-mechanism-to-regulate-fertilization
#7
H A Guidobaldi, M Cubilla, A Moreno, M V Molino, L Bahamondes, L C Giojalas
STUDY QUESTION: Are human spermatozoa able of chemorepulsive behaviour? SUMMARY ANSWER: Capacitated human spermatozoa are able to be chemorepelled by synthetic Progesterone Receptor Ligands (sPRL, known as contraceptives) and zinc (a cation released by the oocyte upon fertilization). WHAT IS KNOWN ALREADY: Moving cells can be oriented towards or against a molecular gradient, processes called chemoattraction and chemorepulsion, respectively, which have been described in unicellular organisms such as amoebas and bacteria, to organismic cells such macrophages and developmental cells...
August 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28780215/knowledge-of-and-interest-in-the-copper-intrauterine-device-among-women-seeking-emergency-contraception
#8
Christine Edwards, Dilzayn Panjwani, Ciara Pendrith, Anna Ly, Sheila Dunn
OBJECTIVE: Emergency contraception (EC) includes hormonal pills (levonorgestrel or ulipristal acetate) and the copper IUD (Cu-IUD). The Cu-IUD is more effective for EC than hormonal pills but remains underused, possibly because of lack of knowledge or interest. The objective of this study was to examine knowledge of and interest in the Cu-IUD for EC among Canadian women seeking EC. METHODS: The study used a cross-sectional convenience survey of English-speaking women presenting for EC at two sexual health clinics in Toronto...
August 2, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28766313/interventions-for-emergency-contraception
#9
REVIEW
Jie Shen, Yan Che, Emily Showell, Ke Chen, Linan Cheng
BACKGROUND: Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012. OBJECTIVES: To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28752929/progesterone-mediated-angiogenic-activity-of-endothelial-progenitor-cell-and-angiogenesis-in-traumatic-brain-injury-rats-were-antagonized-by-progesterone-receptor-antagonist
#10
Peng Yu, Shengjie Li, Zhifei Zhang, Xiaolong Wen, Wei Quan, Qilong Tian, Chuang Gao, Wanqiang Su, Jianning Zhang, Rongcai Jiang
OBJECTIVES: Progesterone (P4) has the potential therapeutic effects for traumatic brain injury (TBI) whose recovery depended on the enhanced angiogenesis. Endothelial progenitor cell (EPC) plays an essential role in vascular biology. We previously demonstrated that P4 administration improved circulating EPC level and neurological recovery of rat with TBI. Here, we hypothesized that P4 augmented angiogenic potential of EPC and the angiogenesis-related neurorestoration after TBI through classical progesterone receptor (PR)...
October 2017: Cell Proliferation
https://www.readbyqxmd.com/read/28742263/progesterone-receptor-modulators-for-endometriosis
#11
REVIEW
Jing Fu, Hao Song, Min Zhou, Huili Zhu, Yuhe Wang, Hengxi Chen, Wei Huang
BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (glands and stroma) outside the uterine cavity. This condition is oestrogen-dependent and thus is seen primarily during the reproductive years. Owing to their antiproliferative effects in the endometrium, progesterone receptor modulators (PRMs) have been advocated for treatment of endometriosis. OBJECTIVES: To assess the effectiveness and safety of PRMs primarily in terms of pain relief as compared with other treatments or placebo or no treatment in women of reproductive age with endometriosis...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#12
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
September 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28730840/the-safety-of-available-and-emerging-options-for-emergency-contraception
#13
Jessica K Lee, Eleanor Bimla Schwarz
Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expert Opinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown...
July 21, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28730656/spontaneous-pregnancy-during-ulipristal-acetate-treatment-of-giant-uterine-leiomyoma
#14
Z Hrgovic, D Habek, J Cerkez Habek, I Hrgovic, S Jerkovic Gulin, D Gulin
WHAT IS KNOWN AND OBJECTIVE: Ulipristal acetate, a progesterone receptor modulator, pharmacologically inhibits endometrial proliferation and thereby prevents pregnancy. It is primarily used as emergency contraception, but also for the treatment of fibroids in women of reproductive age. There have been no published cases of pregnancy, while on therapy with ulipristal acetate. CASE DESCRIPTION: In this article, we present a case report of spontaneous pregnancy during ulipristal acetate therapy...
July 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28721311/from-kaua-i-to-hawai-i-island-interisland-differences-in-emergency-contraceptive-pill-availability
#15
Holly Bullock, Mary Tschann, Jennifer Elia, Bliss Kaneshiro, Jennifer Salcedo
Emergency contraceptive pills (ECPs) are medications used after unprotected intercourse, underprotected intercourse, or sexual assault to decrease the risk of pregnancy. Availability of ECPs in Hawai'i's retail pharmacies was last assessed in 2007, following over-the-counter access to levonorgestrel ECPs (LNG-ECP) for women age 18 years or older and prior to U.S. Food and Drug Administration (FDA) approval of prescription-only ulipristal acetate (UPA). We conducted a county-by-county subanalysis from a larger observational population-based study on statewide availability of ECPs in Hawai'i's pharmacies...
July 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28676450/real-world-data-of-197-patients-treated-with-ulipristal-acetate-for-uterine-fibroids-premya-study-french-population-main-outcomes
#16
H Fernandez, P Descamps, M Koskas, P Lopès, J L Brun, E Darai, A Agostini
OBJECTIVES: To characterize and describe treatment with ulipristal acetate (UPA) in a preoperative setting and to evaluate the safety, effectiveness, and Health Related Quality of Life (HRQoL) outcomes in a French population treated according to standard clinical practice. MATERIALS AND METHODS: Multicentre, prospective, non-interventional study (PREMYA) of patients diagnosed with moderate to severe symptoms of uterine fibroids and undergoing a preoperative treatment with UPA 5mg (Esmya(®))...
July 1, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28663249/quick-starting-hormonal-contraception-after-using-oral-emergency-contraception-a-systematic-review
#17
REVIEW
Lauren Ee Murphy, Zhong E Chen, Valerie Warner, Sharon T Cameron
INTRODUCTION: Unprotected intercourse after oral emergency contraception (EC) significantly increases pregnancy risk. This underlies the importance of promptly starting effective, ongoing contraception - known as 'quick starting'. However, theoretical concern exists that quick starting might interact with EC or hormonal contraception (HC) potentially causing adverse side effects. METHOD: A systematic review was conducted, evaluating quick starting HC after oral EC [levonorgestrel 1...
June 29, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28647614/inefficiency-of-ulipristal-acetate-on-uterus-leiomyomas-as-an-additional-sign-to-suspect-leiomyosarcoma
#18
P Kadhel, M Smail, D Borja De Mozota
The unexpected diagnosis of a leiomyosarcoma from a surgical specimen of a presumed leiomyoma is rare, but with deleterious consequences, especially if morcellation techniques are used. There are currently no effective methods for such a preoperative diagnosis. Ulipristal acetate has demonstrated efficacy for the preoperative treatment of leiomyomas, but not for all patients. We report two cases of leiomyosarcomas in patients treated with ulipristal acetate for a presumed leiomyoma. We propose that ineffective ulipristal acetate treatment may indicate a population in which uterine leiomyosarcoma is more prevalent...
June 21, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28631712/-the-molecular-mechanisms-and-morphological-manifestations-of-leiomyoma-reduction-induced-by-selective-progesterone-receptor-modulators
#19
T A Demura, Z V Revazova, E A Kogan, L V Adamyan
AIM: to investigate the molecular mechanisms and morphological substrate of reduced uterine leiomyoma in patients receiving the selective progesterone receptor modulator (SPRM) ulipristal acetate for 3 months, by estimating the immunohistochemical expression of the markers steroid receptor coactivator 1 (SRC-1), nuclear receptor corepressor 1 (NCoR-1), ER, PgR, Ki-67, p16, TGF-β, and VEGF in tumor tissue. SUBJECTS AND METHODS: The investigation enrolled 75 women with uterine leiomyoma, menorrhagias, and anemia...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28570936/a-uplc-ms-ms-method-for-the-quantitation-of-ulipristal-acetate-in-human-serum
#20
Renu Nandakumar, Piyapa Praditpan, Carolyn L Westhoff, Serge Cremers
The progesterone receptor modulator, Ulipristal acetate (UPA) has proven to be an effective emergency contraceptive. Conflicting data has been reported that suggests different efficacy of the drug in different populations, which may be explained by the systemic exposure to the drug. A UPLC-MS/MS method was developed and validated for the accurate and sensitive measurement of UPA in human serum to address this matter. UPA was extracted from human serum using liquid-liquid extraction with a combination of hexane and dichloromethane...
August 1, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
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