很急!請問有沒有人可以幫我免費翻譯QQ - 翻譯

各位大家好，因為我自己的時間管理最近比較不好，今天5點以前，我需要交出一篇英文
翻譯，只是要做報告用的，可是等一下又要去工作，真的沒時間翻了(崩潰)
請問有沒有好心人，可以幫我翻一下QQ

謝謝，感激不盡!!



文章如下:
OTHER POSSIBLE RISKS — Estrogen therapy may be associated with increases in
the incidence of gallbladder disease, bronchospasm, ovarian cancer, systemic
lupus erythematosus, and the Raynaud phenomenon. The data are insufficient
for epilepsy.
Urinary incontinence — Estrogen may alleviate dyspareunia, recurrent
cystitis, and vaginal/urethral atrophy and inflammation in postmenopausal
women. However, both the Heart and Estrogen/progestin Replacement Study
(HERS) and Women’s Health Initiative (WHI) trials have reported that oral
hormone therapy worsens incontinence. Thus, oral estrogen with or without
progestin should not be prescribed for this indication. Of note, extremely
low doses of unopposed transdermal estrogen (0.014 mg/day) do not appear to
increase the risk of urinary incontinence [99]. (See "Treatment and
prevention of urinary incontinence in women", section on 'Other medications'.)
The use of topical vaginal estrogen therapy for urogenital atrophy symptoms
is discussed separately. (See "Treatment of vaginal atrophy".)
Bronchospasm — Estrogen therapy may be associated with the onset of asthma.
In the Nurses' Health Study, for example, the relative risk of new-onset
asthma in 36,094 postmenopausal women followed for 10 years was significantly
greater in women taking estrogen as compared with those who were not
(relative risk 1.5) [100]. This increased risk was dose-related; it was
statistically significant only at a dose greater than 0.625 mg/day of
conjugated estrogens, probably because of the small numbers of women studied.
Data are conflicting on whether estrogen therapy in postmenopausal asthmatic
women causes a worsening of airway function. In one study of 15
postmenopausal women with mild to moderate asthma, the estrogen-treated women
had subclinical worsening of disease activity (as measured by peak expiratory
flow and spirometry) [101]. In contrast, in a second study of 20
postmenopausal asthmatic women there were no differences in measures of
airway obstruction after stopping and restarting estrogen therapy [102].
Thus, while estrogen is not contraindicated in women with obstructive lung
disease, clinicians should be aware of the possibility of worsening
bronchospasm. Furthermore, estrogen may be considered as an etiologic factor
in women who develop asthma during therapy.
Systemic lupus erythematosus — Estrogen appears to increase the risk of
developing systemic lupus erythematosus [103]. A report from the Nurses'
Health Study found a relative risk of 2.5 for current estrogen therapy and a
nonsignificant risk of 1.8 for past estrogen therapy compared with women who
had never received estrogen [104]. The risk was related to the duration of
estrogen therapy. (See "Epidemiology and pathogenesis of systemic lupus
erythematosus".)
Postmenopausal estrogen use may increase the risk of flare in women with
established lupus, but these flares tend to be mild-to-moderate, not severe.
This is discussed in detail elsewhere. (See "Menstrual function, menopause,
and hormonal contraceptives in women with systemic lupus erythematosus",
section on 'Menopause'.)
Uterine leiomyomas — Use of postmenopausal hormone therapy in the
post-reproductive years may cause some women with leiomyomas to continue to
have symptoms after menopause. The risk of symptoms may depend, in part, on
the location of the fibroid (higher if submucosal [105]) and type of estrogen
preparation (higher with transdermal estrogen in some studies [106,107] but
not others [108]).
A systematic review including five randomized controlled trials found that
postmenopausal hormone therapy caused myoma growth, but this typically
occurred without clinical symptoms [109]. These findings were confirmed in a
subsequent prospective study [110]. Thus, presence of leiomyomas is not a
contraindication to postmenopausal hormone therapy nor associated with new
symptomatic fibroids in most women.
Epilepsy — In a report of 42 menopausal women with epilepsy, hormone therapy
(HT) was associated with an increase in seizure frequency [111]. Although
these data arenot sufficient to recommend that women with seizures not be
offered HT, the indications for hormone replacement have diminished
substantially since publication of the WHI. Women with seizures who are
treated should be monitored carefully.
Dry eye syndrome — A large observational study demonstrated an increased
risk of dry eye syndrome in postmenopausal women on unopposed estrogen or
combined estrogen-progestin therapy compared with nonusers (relative risk
[RR] 1.69 and 1.29; 95% CI 1.49-1.91 and 1.13-1.48, respectively) [112]. This
may reflect an effect of estrogen on the tear film. (See "Dry eyes".)
Nephrolithiasis — Menopause may increase urinary calcium excretion, an
important risk factor for the development of calcium-containing kidney stones
[113]. However, the magnitude of the increase is still unclear. In contrast,
exogenous estrogen therapy may decrease urinary calcium excretion. Although
one might anticipate an increased risk of nephrolithiasis with menopause and
a decreased risk with estrogen therapy, data that address this question have
been inconsistent:
●In the Nurses’ Health Study, a prospective cohort study, natural menopause
was not associated with an increased risk of nephrolithiasis [114]. In
addition, postmenopausal estrogen users, when compared with nonusers, did not
have a lower risk of nephrolithiasis.
●Data from the WHI, the only randomized trial to address this question,
suggest that estrogen therapy may increase the risk of nephrolithiasis [115].
In a post-hoc analysis of the two hormone therapy trials, kidney stone data
was obtained by patient self-report. After adjusting for age, body mass
index, prior hormone therapy, use of coffee or thiazide diuretics, there was
a small excess risk of kidney stones in the hormone groups compared with
placebo (39 versus 34/10,000 person years; hazard ratio 1.21).
The reasons for these discrepant findings are unclear. However, the incidence
rates of kidney stones in the WHI were nearly three times higher than in the
Nurses’ Health Study (which included only cases with symptomatic stones)
[114]. In addition, women taking estrogen were more likely to develop
gallstones [61], and imaging studies to evaluate the gallbladder would
identify asymptomatic kidney stones. Given the small absolute risk reported
in this study (five additional cases per 10,000 person years), we do not
consider nephrolithiasis to be a major consideration in deciding whether to
take short-term hormone therapy for menopausal symptoms (see 'Gallbladder
disease'above).
OTHER ISSUES
Weight — Although women are often concerned that taking postmenopausal
hormone therapy will exacerbate the weight gain that occurs in midlife, a
meta-analysis of 28 trials in 28,559 women found no evidence of an effect of
unopposed oestrogen or combined oestrogen-progestin on body weight or body
mass index [116].
Women with primary ovarian insufficiency (premature ovarian failure) — Data
from the Women’s Health Initiative (WHI) should not be extrapolated to women
with primary ovarian insufficiency (premature ovarian failure; menopause
before age 40 years) in whom postmenopausal hormone therapy is generally
initiated at a younger age. In otherwise healthy women with primary ovarian
insufficiency, we continue their postmenopausal hormone therapy until the
average age of menopause, approximately age 50 to 51 years. At that point,
the same discussion of potential risks and benefits of postmenopausal hormone
therapy should take place.
Androgen therapy — The use of exogenous androgen therapy in peri- and
postmenopausal women is reviewed separately. (See "Androgen production and
therapy in women" and "Sexual dysfunction in women: Management", section on
'Androgens'.)
EXPERT GROUPS — Most expert groups agree that hormone therapy is indicated
for the management of menopausal symptoms, but not for the primary or
secondary prevention of cardiovascular disease or dementia [7,117-119]. Some
groups suggest that hormone therapy may be reasonable for women with
osteoporosis who cannot take non-estrogen therapies [5,117].
INFORMATION FOR PATIENTS — UpToDate offers two types of patient education
materials, “The Basics” and “Beyond the Basics.” The Basics patient
education pieces are written in plain language, at the 5th to 6th grade
reading level, and they answer the four or five key questions a patient might
have about a given condition. These articles are best for patients who want a
general overview and who prefer short, easy-to-read materials. Beyond the
Basics patient education pieces are longer, more sophisticated, and more
detailed. These articles are written at the 10th to 12th grade reading level
and are best for patients who want in-depth information and are comfortable
with some medical jargon.
Here are the patient education articles that are relevant to this topic. We
encourage you to print or e-mail these topics to your patients. (You can also
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patient info” and the keyword(s) of interest.)


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