ALBERT

Beschreibung: Postmenopausal women have an increased risk of cardiovascular disease, and heart disease is the leading cause of death in postmenopausal American women. Conventional hormone replacement therapy has been shown to result in an increase in thrombotic events in large prospective clinical trials including HERS I, and the recently halted Women’s Health Initiative. One possible mechanism for this observed increase is the unfavorable net effects of conjugated equine estrogens and medroxyprogesterone acetate on the hemostatic balance and inflammatory factors. An estimated 50 million American women are peri or postmenopausal and clinical therapies for menopausal symptoms remain a significant challenge in light of the known thrombotic risks. In this prospective blinded study, we examined the short-term effect of topical progesterone cream on menopausal symptom relief in 30 healthy postmenopausal women. Potential adverse effects of topical progesterone on hemostatic and inflammatory factors and cortisol levels were also examined. Subjects were randomized to first receive either 20 mg of topical progesterone cream or placebo cream for 4 weeks. Following a subsequent 4-week washout period, subjects were crossed over to either placebo cream or active drug for an additional 4-week period. In each case, progesterone and cortisol levels were monitored by salivary sampling. Baseline values, 4-week follow-up values and end-of-study values were also obtained for the Greene Climacteric Scale, total factor VII:C, factor VIIa, factor V, fibrinogen, antithrombin, PAI-1, CRP, TNFα, and IL-6. For subjects receiving 20 mg of topical progesterone cream for 4 weeks, Greene Climacteric Scale scores were consistently and significantly improved (decreased) over baseline, demonstrating significant relief from menopausal symptoms. In addition, in a subpopulation of hypercortisolemic women, topical progesterone was associated with a favorable decrease in nocturnal cortisol. Surprisingly, and in sharp contrast to earlier studies with conventional hormone replacement therapy, topical progesterone had no effect on any of the hemostatic components examined: total factor VII:C, factor VIIa, factor V, fibrinogen, antithrombin, and PAI-1 levels were all unchanged. Levels of CRP, TNFα and IL-6 also remained unchanged. From this study we conclude that administration of topical progesterone cream at a daily dose of 20 mg significantly relieves menopausal symptoms in postmenopausal women without adversely altering prothrombotic potential. Since the thrombotic complications that are typically observed with conventional hormone replacement therapy do not seem to occur with topical progesterone, this treatment should be seriously considered as an effective and safe alternative clinical therapy for women suffering from menopausal symptoms.

Beschreibung: Meeting of the Caribbean Climate Modelling Consortium; Kingston, Jamaica, 25 July 2018

Beschreibung: The Columbia Climate Center, in partnership with World Wildlife Fund, Woods Hole Research Center, and Arctic 21, held a workshop titled A 5 C Arctic in a 2 C World on July 20 and 21, 2016. The workshop was co-sponsored by the International Arctic Research Center (University of Alaska Fairbanks), the Arctic Institute of North America (Canada), the MEOPAR Network (Marine Environmental Observation, Prediction, and Response), and the Future Ocean Excellence Cluster. The goal of the workshop was to advance thinking on the science and policy implications of the temperature change in the context of the 1.5 to 2 C warming expected for the globe, as dis- cussed during the 21st session of the Conference of the Parties of the United Nations Framework Convention on Climate Change at Paris in 2015. For the Arctic, such an increase means an antic- ipated increase of roughly 3.5 to 5 C. An international group of 41 experts shared perspectives on the regional and global impacts of an up to +5 C Arctic, examined the feasibility of actively lowering Arctic temperatures, and considered realistic timescales associated with such interventions. The group also discussed the science and the political and governance actions required for alternative Arctic futures.