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  1. Article ; Online: Best practices for reporting survey-based research.

    Hill, Jeffery / Chuko, Jonathan / Ogle, Kathleen / Gottlieb, Michael / Santen, Sally A / Artino, Anthony R

    AEM education and training

    2024  Volume 8, Issue 1, Page(s) e10929

    Language English
    Publishing date 2024-02-08
    Publishing country United States
    Document type Journal Article
    ISSN 2472-5390
    ISSN (online) 2472-5390
    DOI 10.1002/aet2.10929
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Managing vasomotor symptoms in women after cancer.

    Pinkerton, J V / Santen, R J

    Climacteric : the journal of the International Menopause Society

    2019  Volume 22, Issue 6, Page(s) 544–552

    Abstract: Women with estrogen-sensitive cancer or survivors of these neoplasms are generally not candidates for systemic menopausal hormone therapy or tibolone for the treatment of bothersome vasomotor symptoms (hot flashes or night sweats). However, menopausal ... ...

    Abstract Women with estrogen-sensitive cancer or survivors of these neoplasms are generally not candidates for systemic menopausal hormone therapy or tibolone for the treatment of bothersome vasomotor symptoms (hot flashes or night sweats). However, menopausal symptoms negatively affect quality of life and need to be addressed by clinicians. For mild vasomotor symptoms, optimizing lifestyle changes or mind-brain behavior may be sufficient. For women with moderate to severe vasomotor symptoms unresponsive to these measures, non-hormone pharmacologic therapy may be needed. Randomized controlled trials have shown efficacy for vasomotor symptoms with selective serotonin reuptake inhibitors (paroxetine, citalopram, and escitalopram) and serotonin-norepinephrine reuptake inhibitors (venlafaxine and desvenlafaxine), as well as gabapentin, pregabalin, and clonidine. Therapies in development include neurokinin B inhibitors (neurokinin 3 receptor), stellate ganglion blockade, and a natural estrogen, estetrol. Individualizing therapy is important. As the physiology of menopausal hot flashes becomes better understood, it will drive development of future non-hormone pharmacotherapies.
    MeSH term(s) Cancer Survivors ; Female ; Hot Flashes/drug therapy ; Humans ; Menopause ; Randomized Controlled Trials as Topic ; Serotonin Uptake Inhibitors/therapeutic use
    Chemical Substances Serotonin Uptake Inhibitors
    Language English
    Publishing date 2019-05-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1469153-x
    ISSN 1473-0804 ; 1369-7137
    ISSN (online) 1473-0804
    ISSN 1369-7137
    DOI 10.1080/13697137.2019.1600501
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5245: Show issues Location:
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  3. Article ; Online: Vaginal administration of estradiol: effects of dose, preparation and timing on plasma estradiol levels.

    Santen, R J

    Climacteric : the journal of the International Menopause Society

    2015  Volume 18, Issue 2, Page(s) 121–134

    Abstract: Context: The use of systemic estrogens for the treatment of menopausal symptoms has declined by approximately 80% following the initial publication of the Women's Health Initiative in 2002. Current attention focuses on vaginal estrogen as a local ... ...

    Abstract Context: The use of systemic estrogens for the treatment of menopausal symptoms has declined by approximately 80% following the initial publication of the Women's Health Initiative in 2002. Current attention focuses on vaginal estrogen as a local therapeutic means to achieve control of symptoms due to vulvovaginal atrophy without increasing plasma estradiol levels. A key issue is whether or not vaginally administered estrogens are absorbed and produce systemic effects.
    Evidence acquisition: Medline and PubMed were searched for relevant English-language articles using pertinent key words. The bibliographies of the pertinent articles were then read to identify further relevant articles.
    Evidence synthesis: Several confounding factors influenced the data analysis including: (1) estradiol assay sensitivity and specificity; (2) acute versus chronic absorption; (3) delivery systems, doses, timing, and formulation; and (4) effect of atrophic versus mature vaginal mucosa on absorption. Each preparation was associated with acute estradiol absorption with peaks at approximately 8 h and return to baseline at 12 h. Low-dose vaginal estrogen, arbitrarily defined as the 7.5-μg vaginal ring and 10-μg tablet, increased plasma estradiol levels during chronic administration but not above the normal range of ≤ 20 pg/ml. Surprisingly, these increments were associated with systemic effects to lower plasma levels of low density lipoprotein cholesterol and bone resorption rates. Intermediate doses (i.e. 25 μg estradiol or 0.3 mg conjugated equine estrogen) resulted in plasma estradiol levels approaching or exceeding 20 pg/ml. The higher doses (50-2000 μg estradiol or 0.625-2.5 mg conjugated equine estrogen) resulted in premenopausal levels of estrogen.
    Conclusions: Low-dose vaginal estrogen appears to be an effective strategy for managing women whose symptoms result from vulvovaginal atrophy. These regimens limit but do not completely eliminate systemic absorption. Low-doses regimens should be preferred clinically to intermediate- or high-dose methods.
    MeSH term(s) Administration, Intravaginal ; Atrophy ; Dose-Response Relationship, Drug ; Estradiol/administration & dosage ; Estradiol/blood ; Estradiol/pharmacokinetics ; Estrogens, Conjugated (USP)/administration & dosage ; Female ; Humans ; MEDLINE ; Sensitivity and Specificity ; Time Factors ; Vagina/drug effects ; Vagina/metabolism ; Vagina/pathology
    Chemical Substances Estrogens, Conjugated (USP) ; Estradiol (4TI98Z838E)
    Language English
    Publishing date 2015-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1469153-x
    ISSN 1473-0804 ; 1369-7137
    ISSN (online) 1473-0804
    ISSN 1369-7137
    DOI 10.3109/13697137.2014.947254
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Educator's blueprint: A how-to guide on survey administration.

    Ogle, Kathleen Y / Hill, Jeffery / Santen, Sally A / Gottlieb, Michael / Artino, Anthony R

    AEM education and training

    2023  Volume 7, Issue 5, Page(s) e10906

    Abstract: In this paper, we take the lessons learned from designing a survey and collecting validity evidence and prepare to administer the survey for research. We focus specifically on how researchers can reach individuals in the target population, methods of ... ...

    Abstract In this paper, we take the lessons learned from designing a survey and collecting validity evidence and prepare to administer the survey for research. We focus specifically on how researchers can reach individuals in the target population, methods of contact and engagement, evidence-informed factors that enhance participation, and recommendations for follow-up with nonrespondents. We also discuss the challenges of survey administration and provide guidance for navigating low response rates. Surveys are a common tool used to evaluate educational initiatives and collect data for all types of research. However, many clinician educators conducting survey-based evaluation and research may struggle to efficiently administer their survey. As a result, they often struggle to obtain appropriate response rates and thus may have difficulty publishing their survey results. Previous papers in this series focused on the initial steps of survey development and validation, but it is equally important to understand how best to administer your survey to obtain meaningful responses from a representative sample.
    Language English
    Publishing date 2023-09-15
    Publishing country United States
    Document type Journal Article
    ISSN 2472-5390
    ISSN (online) 2472-5390
    DOI 10.1002/aet2.10906
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cause or prevention of breast cancer with estrogens: analysis from tumor biologic data, growth kinetic model and Women's Health Initiative study.

    Santen, R J / Yue, W

    Climacteric : the journal of the International Menopause Society

    2018  Volume 22, Issue 1, Page(s) 3–12

    Abstract: The existing medical literature suggests that estrogens may cause breast cancer but, paradoxically, can also prevent this neoplasm under specific circumstances. Appropriate interpretation of this complex data requires an understanding of emerging ... ...

    Abstract The existing medical literature suggests that estrogens may cause breast cancer but, paradoxically, can also prevent this neoplasm under specific circumstances. Appropriate interpretation of this complex data requires an understanding of emerging concepts of tumor biology. A substantial body of data, including animal models and epidemiologic studies, suggests that estrogens contribute to the development of breast cancer. Additionally, pre-clinical experiments indicate that the responsible mechanisms include both estrogen receptor α-dependent and -independent effects (ERα-dependent and ERα-independent effects). We recently developed two models to describe the growth kinetics of occult breast tumors, one based on autopsy studies and tumor doubling time and the other, computer-based. Validation of the models involved comparison of the predicted incidence of breast cancer with the actual incidence in population-based studies. Utilization of these models allowed us to determine that 16 years on average are required for tumors to undergo the 30 doubling times necessary for the occult tumors to reach the threshold for clinical detection. These models suggest that menopausal hormone therapy with estrogen plus a progestogen in the Women's Health Initiative (WHI) study accelerated the doubling time of occult, pre-existing tumors from 200 to 150 days and thus, increased the rate of tumor diagnosis. Based on estrogen-induced apoptosis data, the model accurately predicted the prevention of diagnosed breast cancer in the estrogen-alone arm of the WHI. Notably, pre-clinical studies demonstrated that conjugated equine estrogen, as used in the WHI, has unique, pro-apoptotic properties compared to the anti-apoptotic effects of estradiol, a finding providing an explanation for the reduction in breast cancer with conjugated equine estrogen.
    MeSH term(s) Animals ; Apoptosis ; Breast Neoplasms/chemically induced ; Breast Neoplasms/prevention & control ; Disease Models, Animal ; Estradiol/pharmacology ; Estrogen Replacement Therapy/adverse effects ; Estrogens/pharmacology ; Female ; Horses ; Humans ; Kinetics ; Models, Biological ; Women's Health
    Chemical Substances Estrogens ; Estradiol (4TI98Z838E)
    Language English
    Publishing date 2018-11-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1469153-x
    ISSN 1473-0804 ; 1369-7137
    ISSN (online) 1473-0804
    ISSN 1369-7137
    DOI 10.1080/13697137.2017.1388364
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5245: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Role of ERα and aromatase in juvenile gigantomastia.

    Santen, Richard J / Karaguzel, Gulay / Livaoglu, Murat / Yue, Wei / Cline, J Mark / Ratan, Aakrosh / Sasano, Hironobu

    The Journal of clinical endocrinology and metabolism

    2024  

    Abstract: ... EGF-R, IGF-IR β, and p-EGFR. Immunohistochemical analyses for aromatase, ERα and β, PGR, Ki67 ...

    Abstract Context: Approximately 150 patients with juvenile gigantomastia have been reported in the literature but the underlying biologic mechanisms remain unknown.
    Objective: Conduct extensive clinical, biochemical, immunochemical, and genetic studies in three patients with juvenile gigantomastia to determine causative biologic factors.
    Design: We examined clinical effects of estrogen by blockading estrogen synthesis or its action. Breast tissue aromatase expression and activity were quantitated in one patient and five controls. Other biochemical markers including ERα, Cyclin D1 and E, p-RB, p-MAPK, p-AKT, BCL-2, EGF-R, IGF-IR β, and p-EGFR. Immunohistochemical analyses for aromatase, ERα and β, PGR, Ki67, sulfotransferase, estrone sulfatase, and 17βHD were performed in all three patients. The entire genome of the mother, father, and patient in the three families was sequenced.
    Results: Blockade of estrogen synthesis or action in patients resulted in demonstrable clinical effects. Biochemical studies on fresh frozen tissue revealed no differences between patients and controls, presumably due to tissue dilution from the large proportion of stroma. However, Immunohistochemically analysis of ductal breast cells in the three patients revealed a high percent of ERα (i.e. 64.1 ± 7.8% vs normal women 9.6% -range 2.3-15%); aromatase score of 4 (76-100% of cells positive) versus 30.4 ± 5.6%); PgR (69.5 ± 15.2% versus 6.0% -range 2.7-11.9%) and Ki67 (23.7 ± 0.54% versus 4.2%). Genetic studies were inconclusive though some intriguing variants were identified.
    Conclusion: The data implicate an important biologic role for ERα to increase tissue sensitivity to estrogen and aromatase to enhance local tissue production as biologic factors involved in juvenile gigantomastia.
    Language English
    Publishing date 2024-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/clinem/dgae019
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    Uh III Zs.134: Show issues Location:
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  7. Article: Acquired hypothalamic dysfunction in childhood: 'what do patients need?' - an Endo-ERN survey.

    van Roessel, I M A A / de Graaf, J P / Biermasz, N R / Charmandari, E / van Santen, H M

    Endocrine connections

    2023  Volume 12, Issue 10

    Abstract: Objective: Hypothalamic dysfunction is a rare condition and can be encountered in patients who have been diagnosed or treated for a suprasellar brain tumor. Due to its rarity, the signs and symptoms of hypothalamic dysfunction may be difficult to ... ...

    Abstract Objective: Hypothalamic dysfunction is a rare condition and can be encountered in patients who have been diagnosed or treated for a suprasellar brain tumor. Due to its rarity, the signs and symptoms of hypothalamic dysfunction may be difficult to recognize, leading to delayed diagnosis of the suprasellar brain tumor or to difficulties in finding the health-care expertise for hypothalamic dysfunction after tumor treatment. To improve the care and outcome of patients with acquired hypothalamic dysfunction, professionals are required to understand the patient's needs.
    Design: A worldwide online survey was distributed from April 2022 to October 2022 to patients with childhood-onset hypothalamic dysfunction (as reported by the patient) following a brain tumor.
    Methods: Patients were notified about the survey through patient advocacy groups, the SIOPe craniopharyngioma working group and the Endo-ERN platform.
    Results: In total, 353 patients with hypothalamic dysfunction following craniopharyngioma (82.2%), low-grade glioma (3.1%) or a pituitary tumor (8.2%) or caregivers responded to the survey. Sixty-two percent had panhypopituitarism. Obesity (50.7%) and fatigue (48.2%) were considered the most important health problems. Unmet needs were reported for help with diet, exercise and psychosocial issues. Patients' suggestions for future research include new treatments for hypothalamic obesity and alternative ways for hormone administration.
    Conclusions: According to the patient's perspective, care for acquired hypothalamic dysfunction can be improved if delivered by experts with a holistic view of the patient in a multidisciplinary setting with a focus on quality of life. Future care and research on hypothalamic dysfunction must integrate the patients' unmet needs.
    Significance statement: Patients with hypothalamic dysfunction may experience a variety of symptoms, which are not always adequately recognized or addressed. In previous papers, the perspective of caregivers of children with craniopharyngioma has been reported (Klages et al. 2022, Craven et al. 2022). Now we address the patients' perspective on acquired hypothalamic dysfunction using an Endo-ERN global survey. According to the patients' perspective, care can be improved, with needs for improvement in the domains of obesity, fatigue and lifestyle. Research may focus on ways to improve hypothalamic obesity and alternative ways for hormone administration. Ideally, care should be delivered by doctors who have a holistic view of the patient in a multidisciplinary expert team. The results of this study can be used to formulate best practices for clinical care and to design future research proposals.
    Language English
    Publishing date 2023-09-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668428-7
    ISSN 2049-3614
    ISSN 2049-3614
    DOI 10.1530/EC-23-0147
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Educator's blueprint: A how-to guide for survey design.

    Hill, Jeffery / Ogle, Kathleen / Santen, Sally A / Gottlieb, Michael / Artino, Anthony R

    AEM education and training

    2022  Volume 6, Issue 4, Page(s) e10796

    Abstract: Surveys are ubiquitous in medical education. They can be valuable for assessment across a wide range of applications and are frequently used in medical education research. This Educator's Blueprint paper reviews the best practices in survey design with a ...

    Abstract Surveys are ubiquitous in medical education. They can be valuable for assessment across a wide range of applications and are frequently used in medical education research. This Educator's Blueprint paper reviews the best practices in survey design with a focus on survey development. Key components of the survey design process include determining whether a survey is the right tool, using an intentional approach to content development, and following best practices in item writing and formatting. These processes are meant to help educators and researchers design better surveys for making better decisions.
    Language English
    Publishing date 2022-08-23
    Publishing country United States
    Document type Journal Article
    ISSN 2472-5390
    ISSN (online) 2472-5390
    DOI 10.1002/aet2.10796
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Intensive, telemedicine-based, self-management program for rural, underserved patients with diabetes mellitus: Re-entry of retired endocrinologists into practice.

    Santen, Richard J / Nass, Ralf / Cunningham, Cindy / Horton, Carla / Yue, Wei

    Journal of telemedicine and telecare

    2022  , Page(s) 1357633X221106041

    Abstract: Introduction: Endocrinology workforce data demonstrate a substantial gap in the number of practicing endocrinologists, a phenomenon particularly affecting patients with diabetes in rural, financially challenged, underserved areas. We evaluated the ... ...

    Abstract Introduction: Endocrinology workforce data demonstrate a substantial gap in the number of practicing endocrinologists, a phenomenon particularly affecting patients with diabetes in rural, financially challenged, underserved areas. We evaluated the concept that retired endocrinologists could re-enter practice part time and utilize telemedicine in collaboration with personnel in Federally Qualified Community Health Center clinics to conduct an intensive self-management program and provide 6-month concurrent care for patients with diabetes.
    Methods: The program involved intensive glucose control measures and education in diabetes, nutrition, and lifestyle changes over a 6-month period. Key elements included comprehensive initial telehealth evaluations, frequent phone calls, and collaboration with certified diabetes care and education specialists, referring providers, referring-clinic staff, and the University of Virginia Telehealth Center.
    Results: The mean A1C in the 139 patients completing the 6-month self-management program decreased from 10.3 ± 1.94% to 7.78 ± 1.51%
    Discussion: This program resulted in improved A1C levels of patients with diabetes in rural, financially challenged, underserved areas; met recidivism goals; and provided a practical template to reduce the workforce gap of endocrinologists in those areas.
    Language English
    Publishing date 2022-06-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1340281-x
    ISSN 1758-1109 ; 1357-633X
    ISSN (online) 1758-1109
    ISSN 1357-633X
    DOI 10.1177/1357633X221106041
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  10. Article ; Online: Simplifying the Interconnected Alphabet Soup of Medical Education.

    Santen, Sally A / Foster, Kenneth W / Hemphill, Robin R / Christner, Jenny / Mejicano, George

    Academic medicine : journal of the Association of American Medical Colleges

    2022  Volume 97, Issue 5, Page(s) 760

    MeSH term(s) Education, Medical ; Humans
    Language English
    Publishing date 2022-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000004440
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