Severity: Warning
Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 143
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 143
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 209
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3098
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 574
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 488
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Severity: Warning
Message: Attempt to read property "Count" on bool
Filename: helpers/my_audit_helper.php
Line Number: 3100
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3100
Function: _error_handler
File: /var/www/html/application/controllers/Detail.php
Line: 574
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 488
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
The hormone-replacement therapy for menopause has recently become matter of debate, especially after the first large randomized controlled trials failed to confirm the potential benefits on cardiovascular risk suggested by previous observational studies. On the contrary, the treatment has tuned out as to be potentially harmful, increasing the risk of stroke and of venous thromboembolism, without any benefit on coronary heart disease. Some factors, such as cardiovascular comorbidity, age and the time of treatment initiation since menopause, influence the clinical response to HRT, so that it can be considered relatively safe only in younger women, asymptomatic for cardiovascular disease and within 10 years from menopause. Evidences from studies on surrogate endpoints, including levels of the independent risk factors for atherosclerosis, suggest both beneficial and detrimental effects of female hormones on different steps of the process of plaque development, although with differences among different treatment regimens, depending on the type of estrogen and progestin employed, the dosage and the route of administration. Regimens including natural progestogens and using transdermal route, but, above all, Selective Estrogen Receptor Modulators (SERMs) such as raloxifene, are promising alternative to the oral estrogen-progestin treatment experimented in most trials, although no specific regimen can be considered completely safe. So, the updated guidelines on menopause management recommend a careful balance of risks and benefits for selection of women for therapy on an individual basis.
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