ABSTRACT Objective The aim of this study was to evaluate the efficacy of a self-assessment questionnaire for hirsutism using the latest cutoff values recommended by the Endocrine Society (ES) for Latin-American women and by the European Society for Human Reproduction and Embryology (ESHRE). Subject and methods Female premenopausal outpatients (n = 188) completed a self-assessment questionnaire, scoring hair presence across the nine areas evaluated by the modified Ferriman-Gallwey (mFG) scale. The results were compared with clinician-assessed scores rated independently by two trained physicians. Scores in the Hirsuta questionnaire, derived from self-assessment of five areas of the mFG scale, were also evaluated. Results The ethnic composition of the sample was as follows: 23.1% white, 25.8% black, 48.9% mixed, and 2.1% other backgrounds (Indigenous, Asian). The participants had age and BMI of (mean ± standard deviation) 33.7 ± 9.9 years and 29.8 ± 7.21 kg/m2, respectively. The most common areas of excessive hair growth were the chin, upper and lower abdomen, and thighs. Relative to clinician-assessed mFG scores, self-assessed mFG scores had an accuracy of 80% using ES criteria for hirsutism diagnosis, with a sensitivity of 95.45%, specificity of 56.25%, positive predictive value of 30.10%, and negative predictive value of 98.40%. Self-assessed mFG had lower accuracy (71%) for diagnosing hirsutism when the ESHRE criteria were applied. Conclusions Self-assessed mFG had low specificity, limiting its application. The results of this study do not support the use of the self-assessed mFG or Hirsuta scores for diagnosing hirsutism in a clinical setting, although both scoring systems may be useful for screening hirsutism in epidemiological studies. selfassessment self assessment (ES LatinAmerican Latin American ESHRE. . (ESHRE) n 188 FerrimanGallwey Ferriman Gallwey (mFG scale clinicianassessed clinician assessed physicians follows 231 23 1 23.1 white 258 25 8 25.8 black 489 48 9 48.9 mixed 21 2 2.1 Indigenous, Indigenous (Indigenous Asian. Asian Asian) mean deviation 337 33 7 33. 99 9. 298 29 29. 721 7.2 kgm2 kgm kg m2 m kg/m2 respectively chin abdomen thighs selfassessed 80 diagnosis 9545 95 45 95.45% 5625 56 56.25% 3010 30 10 30.10% 9840 98 40 98.40% Selfassessed Self 71% 71 (71% applied application setting studies (ESHRE 18 23. 25. 4 48. 2. 3 72 7. kg/m 954 95.45 562 5 56.25 301 30.10 984 98.40 (71 95.4 56.2 30.1 98.4 (7 95. 56. 30. 98. (

O objetivo deste trabalho foi verificar o efeito da Angiotensina II (Ang II) sobre a esteroidogenese nas células da teca bovina, cultivadas in vitro. Para isso, células da teca bovina foram obtidas de folículos maiores que 10 mm de diâmetro de ovários oriundos de abatedouro e submetidas a diferentes tratamentos em uma sequência de experimentos. No experimento 1, o perfil de expressão do RNAm de CYP17A1 foi avaliado nas células da teca em resposta ao LH (10ng ml-1) e/ou Ang II (0,1µM) em diferentes momentos de tratamento. No experimento 2, foi investigado o efeito dose-resposta de Ang II (0,001; 0,1 e 10µM), acrescido de insulina (100ng ml-1) e LH (100ng ̸ml) sobre a esteroidogênese nas células da teca bovina. O experimento 3 explorou os possíveis efeitos da Ang II por meio do tratamento de células da teca com saralasina (antagonista dos receptores da Ang II). Após 24 horas, nos experimentos 2 e 3, o meio de cultura foi coletado e avaliado quanto aos níveis de testosterona e androstenediona pela técnica de HPLC. Em paralelo, a expressão gênica de enzimas-chave da esteroidogênese (HSD3B2, CYP11A1, CYP17A1) e STAR foi avaliada por qRT-PCR. Não se observou diferença na produção de testosterona e androstenediona entre controle e grupos tratados, bem como, na expressão do RNAm para os genes estudados. Em conclusão, nossos resultados não demonstraram um papel da Ang II sobre a esteroidogenese nas células da teca bovina

The main objective of this study was to detect the steroidogenic effects of Ang II in bovine theca cells in vitro. Bovine theca cells were obtained from follicles (larger than 10mm of diameter) collected from a local abattoir and submitted to different treatments in a sequence of experiments. In experiment 1, CYP17A1 mRNA profile was evaluated in LH- (10ng ml-1) and Ang II-treated (0.1µM) theca cells. In experiment 2, a dose-response effect of Ang II (0.001; 0.1 e 10µM) plus insulin (100ng ml-1) and LH (100ng ml-1) was evaluated on steroidogenesis of bovine theca cells. Experiment 3 explored the effects of saralasin (an antagonist of Ang II receptors) on steroid production and steroidogenic enzymes regulation in theca cells. After 24 hours, culture media from experiments 2 and 3 was collected to evaluate testosterone and androstenedione levels by High-Performance Liquid Chromatography. In parallel, mRNA levels of key steroidogenic enzymes (HSD3B2, CYP11A1, CYP17A1) and STAR were assessed by RT-PCR. There was no difference in testosterone and androstenedione production between treated and controls groups, as well as in mRNA levels of the evaluated genes. In conclusion, the results suggest that Ang II does not regulate steroidogenesis in bovine theca cells

Acreditava-se que pessoas obesas estavam protegidas contra fraturas. No entanto, um estudo realizado no Reino Unido (2010) encontrou uma proporção surpreendentemente alta de obesidade entre as mulheres na pós-menopausa que se consultaram em uma Clínica de Fraturas Ósseas. Da mesma maneira, o estudo GLOW (2011) observou prevalência e incidência semelhantes de fraturas em mulheres na pós-menopausa obesas e não obesas. Posteriormente, vários outros estudos têm demonstrado a importância da obesidade na epidemiologia de fraturas. Mulheres obesas têm maior risco de fratura no tornozelo, na perna, no úmero e na coluna vertebral e têm menor risco de fratura de punho, quadril e pelve quando comparadas às mulheres não obesas. A associação entre fraturas múltiplas de costelas e obesidade foi descrita em homens. Além disso, as quedas parecem desempenhar um papel importante na patogênese de fraturas em pacientes obesos. O algoritmo FRAX parece ser uma ferramenta útil na predição do risco de fraturas em indivíduos obesos. Indivíduos obesos são menos propensos a receber tratamento preventivo para as fraturas ósseas e, quando sofrem uma fratura óssea, sua internação costuma ser mais longa do que a internação de indivíduos magros. A qualidade de vida dos indivíduos obesos é menor antes e depois da fratura. Não obstante, a eficácia de terapias antirreabsorção não está bem estabelecida em pessoas obesas. Este último é um campo para pesquisas futuras.

Until recently obesity was believed to be protective against fractures. However, a report from a Fracture Liaison Clinic in the UK (2010) reported a surprisingly high proportion of obese postmenopausal women attending the clinic with fractures, and in the GLOW study (2011), a similar prevalence and incidence of fractures in obese and non-obese postmenopausal women was observed. Subsequently, other studies have demonstrated the importance of obesity in the epidemiology of fractures. Obese women are at increased risk of fracture in ankle, leg, humerus, and vertebral column and at lower risk of wrist, hip and pelvis fracture when compared to non-obese women. In men, it has been reported that multiple rib fractures are associated with obesity. Furthermore, falls appear to play an important role in the pathogenesis of fractures in obese subjects. Regarding hip fracture and major fractures, the FRAX algorithm has proven to be a useful predictor in obese individuals. Obese people are less likely to receive bone protective treatment; they have a longer hospital stay and a lower quality of life both before and after fracture. Moreover, the efficacy of antiresorptive therapies is not well established in obese people. The latter is a field for future research.