Papers by PAULINA VILLASECA DELANO
Faculty of Economics, Universite Catholique de Louvain (UCL Mons), Mons, Belgium and Department o... more Faculty of Economics, Universite Catholique de Louvain (UCL Mons), Mons, Belgium and Department of Psychiatry, Faculty of Medicine, The University of Melbourne, Australia; Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; Applied Cognitive Research, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK; Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, Illinois; USA; Departments of Health Research and Policy (Epidemiology) and of Neurology and Neurological Sciences, Stanford University, Stanford, California, USA
Climacteric, 2018
Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are... more Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are at high risk of developing breast and ovarian cancers. Hereditary breast and ovarian cancers due to BRCA pathogenic mutations occur at earlier ages: mean age 43 years at diagnosis of breast cancer for BRCA1 mutations; onset of ovarian cancer up to 10-21% by age 50 years. Preventive strategies are then defined in the reproductive years. The National Comprehensive Cancer Network (NCCN) guidelines define that BRCA1/2 genetic testing should begin with the affected cancer individual (BRCA1/2 full sequencing); then, family members should be tested for the specific gene mutation found. A woman known to be a carrier needs a strict specific surveillance strategy to achieve early diagnosis. The NCCN proposes breast imageneological surveillance beginning at age 25 years; ovarian surveillance beginning at age 30-35 years. Concomitantly, risk-reducing strategies should be analyzed: surgical or pharmacological. When prophylactic bilateral salpingo-oophorectomy is performed before menopause, estrogen replacement therapy could be required. For BRCA, we review the risks of cancer in mutations carriers, criteria for genetic testing, surveillance and risk-reduction strategies, and the safety of prescribing hormone therapy when needed.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1990
Climacteric, Jan 9, 2019
Postmenopausal hyperandrogenism constitutes a very rare condition of tumoral or non-tumoral origi... more Postmenopausal hyperandrogenism constitutes a very rare condition of tumoral or non-tumoral origin primarily residing either in the ovary or in the adrenal glands. We present herein two cases with this condition; one with abnormal postmenopausal genital bleeding and mild increase in facial hair, and the second with slow-developing hirsutism and virilization. Both cases shared a notorious increase in libido. The laboratory tests showed high levels of testosterone (>100 ng/ml). A normal value of dehydroepiandrosterone sulfate and a normal cortisol level at 9 am after 1 mg of dexamethasone administered at midnight (Nugent test) made an adrenal etiology very unlikely. On the other hand, a high level of inhibine B oriented to an ovarian source. Transvaginal sonography failed to demonstrate an ovarian tumor, but an abdominal and pelvic computed tomography scan or magnetic resonance imaging detected an ovarian tumor and normal adrenal glands. A laparoscopic oophorectomy was performed, and the histological study demonstrated a steroidal cell tumor in the first case and a Leydig cell tumor in the second.
Climacteric, Oct 8, 2018
Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are... more Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are at high risk of developing breast and ovarian cancers. Hereditary breast and ovarian cancers due to BRCA pathogenic mutations occur at earlier ages: mean age 43 years at diagnosis of breast cancer for BRCA1 mutations; onset of ovarian cancer up to 10-21% by age 50 years. Preventive strategies are then defined in the reproductive years. The National Comprehensive Cancer Network (NCCN) guidelines define that BRCA1/2 genetic testing should begin with the affected cancer individual (BRCA1/2 full sequencing); then, family members should be tested for the specific gene mutation found. A woman known to be a carrier needs a strict specific surveillance strategy to achieve early diagnosis. The NCCN proposes breast imageneological surveillance beginning at age 25 years; ovarian surveillance beginning at age 30-35 years. Concomitantly, risk-reducing strategies should be analyzed: surgical or pharmacological. When prophylactic bilateral salpingo-oophorectomy is performed before menopause, estrogen replacement therapy could be required. For BRCA, we review the risks of cancer in mutations carriers, criteria for genetic testing, surveillance and risk-reduction strategies, and the safety of prescribing hormone therapy when needed.
Climacteric, Sep 3, 2015
A number of health and lifestyle factors are thought to contribute to cognitive decline associate... more A number of health and lifestyle factors are thought to contribute to cognitive decline associated with age but cannot be easily modifi ed by the individual patient. We identifi ed 12 individually modifi able interventions that can be implemented during midlife or later with the potential to ameliorate cognitive aging. For ten of these, we used PubMed databases for a systematic review of long-duration (at least 6 months), randomized, controlled trials in midlife and older adults without dementia or mild cognitive impairment with objective measures of neuropsychological performance. Using network meta-analysis, we performed a quantitative synthesis for global cognition (primary outcome) and episodic memory (secondary outcome). Of 1038 publications identifi ed by our search strategy, 24 eligible trials were included in the network meta-analysis. Results suggested that the Mediterranean diet supplemented by olive oil and tai chi exercise may improve global cognition, and the Mediterranean diet plus olive oil and soy isofl avone supplements may improve memory. Effect sizes were no more than small (standardized mean differences 0.11-0.22). Cognitive training may have cognitive benefi t as well. Most individually modifi able risk factors have not yet been adequately studied. We conclude that some interventions that can be self-initiated by healthy midlife and older adults may ameliorate cognitive aging.
Climacteric, May 9, 2018
Abstract Objective: To investigate awareness in Latin America, knowledge of postmenopausal vagina... more Abstract Objective: To investigate awareness in Latin America, knowledge of postmenopausal vaginal atrophy was evaluated in a sample of women from this region. Methods: A total of 2509 postmenopausal women aged 55–65 years, resident in Argentina, Brazil, Chile, Colombia and Mexico, completed a structured online questionnaire. Results: Over half the surveyed population (57%) reported experiencing symptoms of vaginal atrophy. Only 6% of the overall cohort attributed symptoms of vaginal atrophy directly to the condition, and 71% did not consider the condition to be chronic, resulting in many women not accessing effective therapy. Half the women (49%) affected by vaginal atrophy had used lubricating gels and creams; 36% had used some form of local hormone treatment. To understand symptoms and/or treatment options for vaginal discomfort, the majority of survey participants (92%) were willing to seek advice from health-care professionals; most (61%) felt/would feel comfortable talking to their doctor about this. Conclusion: Many women in Latin America lack knowledge of postmenopausal vaginal atrophy, not appreciating the chronic nature of the condition, and may benefit from dialog initiated by health-care professionals to facilitate greater understanding and increased awareness of the availability of effective treatment.
ARS MEDICA Revista de Ciencias Médicas, 2017
El presente artículo corresponde a un archivo originalmente publicado en el Boletín de la Escuela... more El presente artículo corresponde a un archivo originalmente publicado en el Boletín de la Escuela de Medicina, actualmente incluido en el historial de Ars Medica Revista de ciencias médicas. El contenido del presente artículo, no necesariamente representa la actual línea editorial. Para mayor información visitar el siguiente vínculo:
Frontiers in Endocrinology
Late onset Alzheimer´s disease (AD) is a neurodegenerative disease with gender differences in its... more Late onset Alzheimer´s disease (AD) is a neurodegenerative disease with gender differences in its onset and progression, being the prevalence predominant in women and at an earlier age than in men. The pathophysiology of the menopausal condition has been associated to this dementia, playing major roles regarding both endocrine and glucose metabolism changes, amongst other mechanisms. In the current review we address the role of estrogen deficiency in the processes involved in the development of AD, including amyloid precursor protein (APP) processing to form senile plaques, Tau phosphorylation forming neurofibrillary tangles, Wnt signaling and AD neuropathology, the role of glucose brain metabolism, Wnt signaling and glucose transport in the brain, and our research contribution to these topics.
Rev Chil Endocrinol Diabetes, Apr 1, 2010
Rev Med Chile, May 1, 1998
Revista médica de Chile, 1998
Estradiol (E2) has a potent antioxidant effect on low density lipoproteins (LDL) in vitro and in ... more Estradiol (E2) has a potent antioxidant effect on low density lipoproteins (LDL) in vitro and in vivo, which could be important in explaining the cardioprotective effect of hormone replacement therapy (HRT) in post menopausal women. Estriol (E3), on the other hand, is a weak estrogen with low metabolic effects on different tissues, and at present no cardioprotective effect has been attributed to this steroid. To study the antioxidant effect of E3 on LDL and to compare it with the potent antioxidant action exhibited by E2. After LDL was isolated by ultra centrifugation from plasma of 12 healthy untreated post menopausal women, it was divided into aliquots containing 0.5 mg of LDL protein. Estriol and E2 in doses of 0, 1, 5, 15 and 50 microM were incubated with different aliquots of LDL. CuSO4 15 microM was added to each aliquot to induce an oxidative stress. The aliquots were then incubated during 4 hours at 37 degrees C. Malonaldehyde (MDA) was measured as a marker of LDL oxidation,...
Revista chilena de obstetricia y ginecología, 1984
256 pregnant women were studied for the presence of Neisseria gonorrhea in the endocervical canal... more 256 pregnant women were studied for the presence of Neisseria gonorrhea in the endocervical canal of the uterus. Those who had positive cultures also had cultures taken from the rectum and the pharynx before administering treatment. 7 days after treatment, control cultures were taken to confirm the effectiveness of the therapy. The cultures were taken at the Diagnostic Center of the Catholic University of Chile. The treatment consisted of two intramuscular doses of a mixture of clemizol penicillin (400,000 IU) and penicillin sodium (3,600,000 IU). The prevalence of endocervical infection for gonorrhea amounted to 4 cases (1.56%). They presented bacteria in the rectum and one of them presented bacteria in the pharynx. All cultures were negative 7 days after treatment. There were significantly fewer first-trimester pregnancy cases (58) compared to second-trimester (90) and third-trimester (108) cases. There were 116 primiparas and 140 multiparas. As to the couples, 65.6% of the female population and 61.3% of the male population was concentrated in the 21-30 age group. 87.9% of the population was married; 11.3% was single; and 0.8% was widowed. 48.9% of the pregnant women were exclusively housewives; 23.9% were employed in technical or university professions; 7.4% were engaged in commerce; 3.9% were employees; 4.7% were students; and 1.9% were laborers. Their average age was 26.4 years, while the average age of the healthy population was 26.7 years.
Revista médica de Chile, 1996
The effects of different therapies on bone loss rate can be measured using biochemical markers of... more The effects of different therapies on bone loss rate can be measured using biochemical markers of bone resorption such as urinary hydroxyproline. To study the effects of hormone replacement therapy on urinary hydroxyproline in postmenopausal women. Eighty three postmenopausal women without hormone replacement therapy, 54 postmenopausal women receiving hormone replacement therapy and 16 premenopausal women (considered as the control group) were studied. Hydroxyproline was measured in an early morning urine sample, after one day of diet without meat or gelatin. Urinary hydroxyproline in premenopausal women was 33.7 +/- 7.9 mg/g creatinine. The figure for postmenopausal women with hormonal replacement therapy was 33.7 +/- 5.9 mg/g creatinine. Postmenopausal women without replacement therapy had an urinary hydroxyproline of 47.4 +/- 8.5 mg/g creatinine, significantly higher than that of premenopausal and supplemented women. In 21 postmenopausal women, hydroxyproline was measured before ...
Environmental Research, 2021
Everyday use chemicals have been demonstrated to be endocrine disruptors. Since normal thyroid fu... more Everyday use chemicals have been demonstrated to be endocrine disruptors. Since normal thyroid function during pregnancy is transcendental for the neurodevelopment of the offspring, knowledge of endocrine disrupting chemicals (EDC) is of main importance. The aim of our study is to recognize and describe EDC actions in pregnant women and focus on neurodevelopmental processes that can lead to neurotransmitter imbalance and cognitive impairment, and the possible clinical outcomes in the newborn and child. We searched PubMed databases for animal studies and clinical trials evaluating chemicals recognized as thyroid disruptors -perchlorate, phthalates, bisphenol A-, as well as chemicals with potential thyroid disruption activity -parabens, pesticides and persistent organic pollutants, on thyroid hormones (THs) levels and their bioavailability during pregnancy, and the outcome in newborns, infants and children. We also exhibit evidence from worldwide cohort studies to this regard. The publications reviewed show: 1) known endocrine disruptors have an association with hormonal thyroid levels, where an effect of increase or decrease in TH concentrations has been reported depending on the chemical exposed 2) associations between TH, EDCs and neurocognitive disorders have been addressed, such as ADHD, though no conclusive impact on potential related disorders as autism has been established, 3) perchlorate has demonstrated effects on thyroid levels on iodine uptake. In conclusion, detrimental risks and long-term consequences after in-utero exposure to EDCs are being reported in several cohort studies and further research must be conducted to establish a well-known cause-effect association.
Uploads
Papers by PAULINA VILLASECA DELANO