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AbortionMedical abortion and the risk of subsequent adverse pregnancy outcomes.The long-term risk of surgical abortion in the first trimester is well established. Limited information is available regarding the effects of medical abortion on subsequent pregnancies. There are three available regimens for medical abortion: misoprostol alone, methotrexate followed by misoprostol, mifepristone followed by misoprostol.
Acute myocardial infarction (AMI)Gender differences, AMI treatment, percutaneous coronary intervention (PCI).Women with AMI have a higher hospital mortality rate then men. Data were analysed from 74,389 patients with discharge diagnosis of AMI, 30% of whom were women. Women were older and had higher rates of hospital mortality (14.8% vs 6.1%: p< 0.0001) but underwebt fewer procedures than men.
Acute myocardial infarction (AMI)Differential expression of cardiac biomarkers by gender in patients with unstable angina/non ST elevation myocardial infarction.Diagnosis of coronary artery disease in women is more difficult because of lower specificity of symptoms and diagnostic accuracy of noninvasive testing. The authors sought to examine the relationship between gender and cardiac biomarkers (cardiac troponins, brain natriuretic peptide [BNP], high sensitivity C-reactive protein [hs CRP]) in patients enrolled in the Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive or Conservative Strategy (TACTICS)-TIMI 18 study
AgingEffect of aging on the cardiovascular regulatory systems in healthy women.The authors studied the effect of healthy aging on the cardiovascular homeostatic mechanism in premenopausal and postmenopausal women with similar estrogen levels.
AgingGender, health, and aging 
Aging male heart The aging male heart: myocardial triglyceride (TG) content as independent predictor of diastolic function.The aim of the study was to evaluate the association between aging and myocardial TG content and to determine the effect of myocardial TG content on heart function using MRS (H-magnetic resonance spectroscopy) and MRI (magnetic resonance imaging) techniques.
BoneSex hormone status may modulate rate of expansion of proximal femur diameter in older women alongside other skeletal regulators.Little is know of associations between hip geometry and skeletal regulators. This is important because geometry is a determinant of both hip function and resistence to fracture. The aim of this study was to determine the effects of sex hormone status and other candidate regulators on hip geometry and strength.
BoneBone loss and bone size after menopause.The aim of the study was to determine whether menopause is followed by endosteal resorption and periosteal apposition, and if so, whether geometric changes in bone were associated with the post-menopausal serum estradiol levels. The second aim was was to see if periosteal apposition compensated for the decrease in tissue mineral content and whether a strength index that accounts for both tissue density and geometric properties might be a better predictor than bone meneral density alone of future fracture of the distal radius.
BoneVolimetric and areal bone mineral density measures are associated with cardiovascular disease in older men and women: the Health, Aging and Body Composition Study.The associations of volumetric (vBMD) and areal (aBMD) bone mineral density measures with prevalent cardiovascular disease (CVD) and subclinical peripheral arterial disease (PAD) were investigated in a cohort of older men and women enrolled in the Health, Aging and Body Composition Study.
BoneRisk of fracture in women with type 2 diabetes. Some but not all studies have shown higher rates of fracture in individuals with type 2 diabetes. To determine the risk of fracture in postmenopausal women with type 2 diabetes and determine whether risk varies by fracture site, ethnicity, and baseline bone density.
BoneInfluence of menopause, aging, and gender on the cleavage of type II collagen in cartilage in relationship to bone turnover.The aim of this study was to explore the possibility that menopause might change cartilage turnover as well as bone turnover. The authors also examined age and gender to estimate the independent influences of these parameters together with menopause on catilage and bone turnover.
Breast Histologic changes in the breast with menopausal hormone therapy use: correlation with breast density, estrogen receptor, progesterone receptor, and proliferation indices.Use of hormone therapy (HT) during menopause and mammographic breast density are both associated with an increased risk of breast cancer. Mammographic breast density seems to be a biomarker for breast cancer risk. Mammographic breast density is a strong predictor of risk of breast cancer developing over the ensuing 10 to 15 years of follow up in postmenopausal women. This retrospective study systematically compared mammographic density with histology in women receiving or not receiving menopausal HT.
Breast and colorectal cancersGenomic landscapes of human breast and colorectal cancers.Human cancer is caused by the accumulation of mutations in oncogenes and tumor suppressor genes. To catalog the genetic changes that occur during tumorigenesis, the authors isolated DNA from 11 breast and 11 colorectal tumors and determined the sequences of the genes in the Reference Sequence database in these samples. Based on analysis of exons representing 20,857 transcripts from 18,191 genes, the authors conclude that the genomic landscapes of breast and colorectal cancers are composed of a handful of commonly mutade gene "mountains" and a much larger number of gene "hills" that are mutated at low frequency.
Breast cancerBRCA1 (185delAG and 5382insC) or a BRCA2 (6174delT) mutation. Breast cancer is the leading cause of all deaths from cancer among Israeli women. Approximately 3,800 women receive the diagnosis of breast cancer annually in this population; in 28% of these women, breast cancer is diagnosed before the age of 50 years. To clarify the influence of these mutations on the outcome in breast cancer, the authors evaluated 10-year survival rates in a national cohort of Israeli women whose breast cancer had been diagnosed in 1987 or 1988.
Breast cancerGenes, cancer risks, and clinical outcomes.Editorial
Breast cancerInherited predisposition to breast cancer.Tab 1 (Genes known to be associated with a hereditory predisposition to breast cancer); Tab 2 (Models commonly used to predict the risk of breast cancer and the probability of detecting a BRCA mutation). Family history is the main determinant of risk, but reproductive history is also important.
Breast cancerSpecial report on decrease in breast cancer incidence in 2003 in the United States.Regression analysis showed that the decrease in breast cancer incidence began in mid-2002 and had begun to level off by mid-2003. A comparison of incidence rates in 2001 with those in 2004 showed that the decrease in annual aged-adjusted incidence was 8.6%. The decrease was evident only in women who were 50 years of age or older and was more evident in cancers that were estrogen-receptor-positive (14.7%) than in those that were estrogen-receptor-negative (1.7%). Changes in reproductive factors, in the use of menopausal hormone replacement therapy, in mammographic screening, in environmental exposures, and in diet have all been proposed to explain the trend.
Breast cancerPrimary prevention of breast cancer: new approaches.Abstract. Lifestyle changes (regular exercise, ? body weight, and alchohol intake, ? dietary folate) might reduce the risk of breast cancer. Tamoxifen and raloxifene reduce the risk of breast cancer but have potential adverse effects (tamoxifen causes endometrial cancer and cataracts; both increase the risk of venous thromboembolism; both sometimes cause hot flushes and arthralgias; raloxifene also reduces the risk of vertebral, but not the risk of other types of fractures) and therefore should be considered by women at high risk of breast cancer. Breast density (relative amounts of fat and lean tissue in a breast) is a strong risk factor for breast cancer; assessment of breast density can be combined with risk to estimates of a woman's risk of breast cancer. The author proposes that a woman's risk of breast cancer be assessed along with her screening mammogram with consideration of chemoprevention for those at high risk.
Breast cancerA decline in breast cancer incidence.Correspondence
Breast cancerUse of luteinising-hormone-releasing hormone agonist as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials.Several trials have been done to assess the role of luteinising-hormone-releasing hormone (LHRH) agonist, in the adjuvant treatment of premenopausal patients with breast cancer. The authors did a meta-analysis based on individual patient data to present an updated overview of the evidence, dealing only with trials in which LHRH agonists were assessed, and focusing on results for patients known to be hormone-receptor-positive. The main endpoints were recurrence and death after recurrence.
Breast cancerHER2 and response to paclitaxel in node-positive breast cancer.HER2 positivity predicts a benefit from adjuvant doxorubicin doses above standard levels, from the addition of paclitaxel after adjuvant chemotherapy with doxorubicin plus cyclophosphamide, or from both.
Breast cancerEditorialAdjuvant therapy for breast cancer is a major therapeutic advance that has had a considerable effect on prolonging disease-free and overall survival. Not all patients benefit from adjuvant therapy and certain types of adjuvant therapy are not appropriate for some patients. Adjuvant chemotherapy that includes alkylating agents, antimetabolites, anthracyclines, and taxanes in various combinations has contributed to the overall improvement in outcomes among women with operable breast cancer.
Breast cancerBreast cancer stromal cells with TP53 mutations and nodal metastases.TP 53 is the most commonly mutated gene in human neoplasms. In this study the authors hypothesized that mutational inactivation of the tumor suppressor gene TP 53 and genomic alterations in stromal cells of a tumor's microenvironment contribute to the clinical outcome.
Breast cancerStromal effects in breast cancer.Focus on research.
Breast cancerAdjuvant chemotherapy in oestrogen-receptor-poor breast cancer: patient-level meta-analysis of randomised trials.If the excised primary tumour has few oestrogen receptors (ER-poor) then the 5-year recurrence rate is high and hormonal therapy has little effect on it. The long-term effects of adjuvant polychemotherapy regimens in ER-poor breast cancer and the extent to which these effects are modified by age or tamoxifen use, can be assessed by an up-dated meta-analysis of individual patient data from randomised trials.
Breast cancer"Westernizing" women's risk? Breast cancer in lower income countries.Perspective
Breast cancerPaclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer.Laboratory and clinical evidence supports the central role of angiogenesis in the progression of breast cancer. The authors compared the efficacy and safety of paclitaxel with that of paclitaxel plus bevacizumab, a monoclonal antibody against vascular endothelial growth factor as initial treatment for metastatic breast cancer.
Breast cancerWeekly paclitaxel in the adjuvant treatment of breast cancer.Adjuvant chemotherapy substantially reduces the risk of recurrence and death among women with operable breast cancer. The authors compared the efficacy of two different taxanes, docetaxel and paclitaxel, given either weekly or every 3 weeks, in the adjuvant treatment of breast cancer.
Breast imaging Editorial.
CancerRisk of cancer after blood transfusion To investigate the possible risk of cancer transmission from blood donors to recipients through blood transfusion.
Cancer and oral contraceptivesCancer risk among users of oral contraceptives: cohort data from the Royal College of General Practitioner's oral contraception study.To examine the absolute risks or benefits on cancer associated with oral contraception, using incident data.
Cardiovascular differencesMolecular and cellular basis of cardiovascular gender differences.1) Women develop heart disease later in life than men. This difference has been attribuited to the loss of female sex steroid hormones at the time of menopause, but the biological explanations for gender differences in cardiovascular diseases are more complex. 2) Vascular tone and blood pressure. Hormone-dependent gender differences exist in vascular function. Estrogens cause vasodilatation through both rapid increases in NO production and induction of NOS genes. 3) Lipids. HRT has antiatherogenic effects on lipids, lowering LDL and raising HDL and TG. 4) Hemostasis and thrombosis. HRT causes an increase in venous thromboembolic events; oral HRT and contraceptives increase levels of Factor VII, but decrease circulating fibrinogen and plasminogen activator inhibitor-1. 5) Evolution of atherosclerosis and the timing of HRT. Observational studies consistently show that CVD risk decreases with HRT use and increases with premature menopause, supporting evidence that estrogen/progesterone loss and/or unopposed androgen promotes postmenopausal CVD. In contrast the WHI and other randomized trials of HRT fail to show an HRT effect in lowering cardiovascular events. The age at which women initiate HRT is critical. 6) Cardiovascular effects of testosterone. Androgen replacement therapy (ART) studies suggest a beneficial cardiovascular effect, epecially on vasomotion. ART can improve cardiac ischemic indices in men, but not ischemia caused by peripheral arterial disease. Exogenous androgens lower HDL and Lp(a) with only modest effects on LDL. 7) Gender differences in heart. Cardiac contractility is greater in healthy women than in age-matched men, and HRT in women decreases contractility. As men and women age, myocardial mass is better preserved in women, which may be related to differences in cardiac expression of glycolytic and mitochondrial metabolic enzymes. Gender differences also exist in cardiac electrophysiological function and both inherited and acquired abnormalities of the heart muscle. Some familial hypertrophic cardiomyopathies are more severe in males than in females.
Cardiovascular risk - Reynolds Risk ScoreDevelopment and validation of improved algorithms for the assessment of global cardiovascular risk in women.To develop and validate cardiovascular risk algorithms for women based on a large panel of traditional and novel risk factors.
Cardiovascular systemThe protective effects of estrogen on the cardiovascular system. This article reviews recent information about the mechanism by which estrogen provides protection against vascular disease and the clinical importance of this mechanism.
Cervical cancerEffect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India.Cervical cancer is the most common cancer among women in developing countries. The authors assessed the effect of screening using visual inspection with 4% acetic acid (VIA) on cervical cancer incidence and mortality in a cluster randomised controlled trial in India.
Cervical cancerCervical cancer and hormonal contraceptives.Invasive cancer of the uterine cervix is the second most common cancer (after breast cancer) in women in less developed countries, accounting for about 15% of all cancers and the seventh most common in more developed countries, accounting for 4% of cancers. Combined oral contraceptives are classified by the International Agency for Research on Cancer (IARC) as a cause of cervical cancer. Incidence of cervical cancer increases with age, the public-health implications of this association depend largely on the persistence of effects long after use of oral contraceptives has ceased. Information from 24 studies worldwide investigates th association between cervical carcinoma and pattern of oral contraceptive use.
Cervical cancerCervical cancer and hormonal contraceptives.Correspondence
Cervical cancerHPV DNA versus Papanicolaou screening tests for cervical cancer.To determine whether testing for DNA of oncogenic HPV is superior to the Papanicolaou (Pap) test for cervical cancer screening.
Cervical cancerHPV and Papanicolaou tests to screen for cervical cancer.Screening for cervical cancer by Pap has reduced the incidence of invasive cervical cancer in many countries. HPV is the major cause of cervical cancer. Screening for HPV increases the sensitivity of detection of high grade (grade 2 or 3) cervical intraepithelial neoplasia. Protection against future high grade cervical epithelial neoplasia or cervical cancer is unknown.
Cervical cancerMolecular screening for cervical cancer.Editorial
Cervical cancerHPV DNA for detection of cervical intraepithelial neoplasia grade 3 and cancer.Tests for DNA of HPV have a higher sensitivity for cervical intraepithelial neoplasia grade 3 or worse (CIN3+) than does cytological testing. The aim was to determine whether the effectiveness of cervical screening improves when HPV DNA testing is implementaed.
CHDAlcohol consumption, TaqIB polymorphism of cholesteryl ester transfer protein, high density lipoprotein cholesterol, and risk of coronary heart disease in men and women.To investigate the importance of alcohol intake and the CETP (cholesteryl ester transfer protein) TaqIB SNP (single nucleotide polymorphism) in relation to levels of HDL and risk of CHD more definitively.
CHDHormone therapy and coronary heart disease in young women.The Women's Health Initiative (WHI) randomized controlled trial (RCT) found increased cororonary heart disease in postmenopausal women treated with estrogen and progestin hormone therapy (HT); mean age of the women in this trial was 63.3 years and 21% were older than age 70. It is unresolved whether HT might prevent coronary heart disease in younger women.
CholesterolHead to Head. Should women be offered cholesterol lowering drugs to prevent cardiovascular disease?Yes. Scott M Grundy
CholesterolHead to Head. Should women be offered cholesterol lowering drugs to prevent cardiovascular disease?No. Malcom Kendrick
Congenital heart diseaseGender and outcome in adult congenital heart disease.Abundant evidence exixts regarding gender differences in the incidence of congenital heart defects at birth, but the impact of gender on the prognosis in adult congenital heart disease is unclear.
C-reactive protein (CRP)The effect of including C-reactive protein in cardiovascular risk prediction models for women.To develop and compare global cardiovascular risk prediction models with and without hsCRP.
Drug-drug interactionTraditional nonsteroidal anti-inflammatory drugs and postmenopausal hormone therapy.To identify an interaction between hormone therapy (HT) and COX inhibition the authors measured the association between concomitant nonsteroidal anti-inflammatory drugs (NSAIDs), excluding aspirin, in peri-and postmenopausal women on HT and the incidence of myocardial infarction in a population-based epidemiological study.
Ductal carcinomaMRI for diagnosis of pure ductal carcinoma in situ.The aim was to investigate the sensitivity with which ductal carcinoma in situ (DCIS) is diagnosed by mammography and by breast MRI and to compare the biological profiles of DCIS detected by mammography with those detected by breast MRI.
Ductal carcinomaDuctal carcinoma in situ and breast MRI.Comment
Estrogen therapy (ET)Timing of estrogen therapy (ET) after ovariectomy dictates the efficacy of its neuroprotective and antiinflammatory actions.Despite numerous studies demonstrating cardio- and cerebrovascular benefits of ET, recent results from the Women Estrogen Stroke Trial (WEST) and the Women's Health Initiative (WHI) reported that ET afforded no benefit or increased the risk for stroke. One prominent feature that follows stroke injury is massive central and peripheral inflammatory responses. The goal of this study was to reevaluate the circumstances under which 17 ß-estradiol (E2) provides benefits against ischemic stroke and to decipher the mechanism of its action in an attempt to explain reported inconsistent effects of E2 in stroke injury.
ExerciseThe prognostic value of a nomogram for exercise capacity in women.The aim was to construct a nomogram to permit determination of predicted exercise capacity for age in women and to assess the predictive value of the nomogram with respect to survival. Exercise capacity can be estimated by performing a symptom-limited stress test. Exercise capacity was measured in metabolic equivalents (MET).
Heart rate variabilty (HRV) and cognitive impairment Association between reduced HRV and cognitive impairment in older disabled women in the community.This study examines the independent association between HRV, a marker of cardiac autonomic function, and cognitive impairment (MMS<24).
Hormonal contraceptionHormonal contraception in women of older reproductive age. Healthy, lean women of older reproductive age who are nonsmokers can safely use combination estrogen-progestin contraceptives. Benefits include effective contraception and reductions in irregular bleeding and vasomotor symptoms associated with the perimenopausal transition. Available epidemiologic data also suggest potential long-term benefits including reductions in the risks of fractures among postmenopausal women and of ovarian, endometrial, and colorectal cancer. For women of older reproductive age who are obese, smoke cigarettes, or have hypertension, diabetes, or migraine headaches, the cardiovascular risks associated with combination oral contraceptives are considered to outweigh the benefits. For these women, reasonable options include progestin-only and intrauterine contraceptive methods as well as barrier contraceptives and sterilization.
Hormone replacement therapy (HRT)Women's Health Initiative (WHI); WHI Coronary-Artery Calcium Study - WHI-CACS WHI estrogen-only trial- WHI CEE.Editorial
Hormone replacement therapy (HRT)Coronary-Artery calcificationCalcified plaque in coronary arteries is a marker for atheromatous-plaque burden and is predictive of future risk of cardiovascular events. The relationship between estrogen therapy and coronary-artery calcium has been examined in the context of a randomized clinical trial. Computed tomography of the heart has been performed in 1,064 women aged 50 to 59 years at randomization. Imaging was conducted at 28 of 40 centers after a mean of 7.4 years of treatment and 1.3 years after the trial was completed (8.7 years after randomization). Coronary-artery calcium (or Agatston) scores were measured at a central reading center without knowledge of randomization status.
Hormone replacement therapy (HRT)HRT in the primary prevention of cardiovascular disease.Abstract. Epidemiological studies show good evidence for both primary and secondary preventive effects of HRT in women. The conclusion of all these studies is that HRT produces a reduced risk in CHD on the order of around 40%. Similary, some, but not all, randomised clinical studies using surrogate markers of CHD have shown beneficial effects of HRT in healthy postmenopausal women. A large randomised placebo-controlled trial of one HRT regimen using hard clinical end points of CHD failed to show an overall benefit. There are a number of mechanisms through which HRT produces benefits for the cardiovascular system. Oral estrogens reduce LDL cholesterol, increse HDL cholesterol and triglycerides. Estradiol increases pancreatic insulin secretion, insulin sensitivity, and insulin elimination. Estrogen affects coagulation and fibrinolysis, increasing both pro-coagulant and fibrinolytic activity. Estrogen has direct effects on arteries through various genomic and non-genomic mechanisms. These include effects on the vascular endothelium, on ion channels, and on the renin-angiotensin-aldosterone system.
Hormone therapy (HT)Evolving practice patterns and attitudes toward hormone therapy of obstetrician-gynecologistsThe objective of this study was to examine the opinions and prescribing practices of obstetrician-gynecologists regarding HT. Surveys were sent to 2,500 randomly selected American College of Obstetrics and Gynecology fellows during December 2004 to March 2005 and their responses are compared with those from a survey conducted in November to December 2003.
Hot flashesAcupuncture for postmenopausal hot flashesTo determine whether individually tailored acupuncture is an effective treatment option for reducing postmenopausal hot flashes and improving quality of life.
HPVHuman papillomavirus DNA versus Papanicolaou screening tests for cervical cancer.Correspondence
HRTHot flash severity in hormone therapy users/nonusers across the menopausal transition.To examine the pattern of and factors that influence hot flash severity across the menopausal transition (MT) and early postmenopause (PM).
HRTEstradiol valerate/dienogest on hot flushes in postmenopausal women.To evaluate the effects of an estrogen-reduced, continuous combined HRT containing 1 mg estradiol valerate (1EV) and 2 mg dienogest ("DNG) on the number of moderate and severe hot flushes.
HyperinsulinemiaNeurovascular and hemodynamic responses to hyperinsulinemia in healthy postmenopausal women.The objective of the present study was to investigate, in healthy postmenopausal women without hormone therapy, the neurovascular and hemodynamic responses to acute hyperinsulinemia produced by a euglicemic-hyperinsulinemic clamp. The authors hypothesized that insulin infusion would produce sympathetic activation and vasodilatation, resulting in a increase in heart rate and systolic blood pressure, but no change in diastolic blood pressure.
IncidenceFavorable cardiovascular risk profile and 10-year coronary heart disease incidence.The aims of this study were to assess further the relation of low risk to coronary heart risk and implications for prevention.
MammographyEffect of cost sharing on screening mammography in Medicare health plans.Policies that increase patients' share of health care expenses decrease the use of discretionary health services but also may reduce the use of important preventive care such as mammography. Breast cancer is the second leading cause of cancer-related death among women and most commonly occurs among older women. Because regular screening can reduce morbidity from breast cancer, clinical guidelines developed by U.S. Preventive Services Task Force and the American Cancer Society recommend regular screening mammography for women over 50 years of age. Although rates of breast cancer screening increase substantially during the 1990s, two recent studies reported a decline in the use of mammography from 2000 to 2005. This study assessed the extent to which elderly women forgo this recommended preventive service when faced with cost sharing.
MenopauseManagement of menopausal symptoms.Women in the menopausal transition commonly report a variety of symptoms, including vasomotor symptoms (hot flushes and night sweats), vaginal symptoms (dryness, discomfort, itching, dyspareunia), urinary incontinence, trouble sleeping, sexual dysfunction, depression, anxiety, labile mood, memory loss, fatigue, headache, joint pains, and weight gain. Only vasomotor symptoms, vaginal symptoms, and touble sleeping are consistently associated with the menopausal transition.
MenopauseEstrogen and progestogen use in peri-postmenopausal women: position statement of the North American Menopause Society.The overall objective of these position statements was to make recommendations to both clinicians and the lay public about the appropriate role of HT for peri- and postmenopausal women. The primary goal was to evaluate the risk-benefit ratio of peri-menopause and estrogen-progestogen therapy (EPT) for both disease prevention and treatment of menopause-related symptoms.
MenopauseManagement of menopause related symptoms. National Institutes of Health. State-of-the-Science Conference Statement: Management of Menopause Related SymptomsIdentify menopausal symptoms and assess treatments for them on the basis of existing scientific evidence
MenopauseDeterminants of age at menopause in women attending menopause clinics in ItalyEarly age at menopause is a major determinant of the lifetime risks of cardiovascular diseases, osteoporosis, and less markedly of breast and genital tract cancers. Thus a definition of the determinants of age at menopause has potential speculative interest as a means of identifying women and quantifying the risk for these conditions. The authors analysed the mean age at menopause and its determinants in about 31,000 women attending menopause clinics in Italy.
MenopauseEfficacy of an herbal product containing isoflavones and other plant extracts on menopausal neurovegetative symptoms and some plasma lipid blood levelsThe aim of the study was to control the clinical efficacy of a product containing isoflavones coming from different plants in combination with some other vegetable extracts on menopause symptoms and on plasma lipids profile.
MenopauseChanges in serum cytokine concentrations during the menopausal transition.The aim of this study was to clarify the changes in serum concentrations of 17 cytokines (IL-1ß; IL-2; IL-4; IL-5; IL-6; IL-7; IL-8; IL-10; IL-12; IL-13; IL-17; TNF-a; granulocyte colony-stimulating factor-G CSF; granulocyte/macrophage colony-stimulating factor-GM CSF; INF-?; macrophage inflammatory protein MIP-1ß; monocyte chemotactic protein MCP-1) in healthy women during the menopausal transition by using a multiplex cytokine assay and to clarify the associations of these cytokines with serum estradiol concentration.
MenopauseAlterations in the human brain in menopause.Abstract. In a series of studies the authors showed that menopause in women causes alterations not only in the neuronal expression of estrogen receptors (ER) a and ß, but also in local estrogen production in several brain areas and in the rate of neuronal metabolism. Although such changes are brain region-specific there seems to be no evidence for a decrease in neuronal metabolic rate. In the supraoptic nucleus (SON) they found that neuronal metabolic activity, as judged from the Golgi apparatus and cell size, was markedly enhanced in women after menopause accompanied by an increase in ERa and a decrease in ERß. Similar changes were noted in the medial mamillary nucleus and in the hippocampus that are involved in the regulation of learning and menory. The authors aimed at determining whether in addition to the canonical ERa and ERß, estrogen receptor splice variants lacking entire exons may also be involved in the menopause associated changes in the human brain.
Menstrual cycleInfluence of menstrual cycle on cardiac performance.The aim of this study was to investigate the relationship between endogenous sex hormone levels and myocardial performance during two different phases of menstrual cycle. Myocardial performance index (MPI) was defined as the sum of isovolumic contraction (ICT) and isovolumic relaxation time (IRT) divided by ejection time (ET), which is a powerful index of systolic and diastolic functions at the same time.
MortalityRelative and absolute gender gap in all-cause mortality in Europe and the contribution of smoking.This study had two objectives:1) to assess the relation between the absolute and relative gender gap in mortality and the overall levels of mortality rates; 2) to evaluate the contribution of tobacco, using the indirect estimates of mortality attributable to smoking.
Myocardial ischemiaGender-based differences in mechanisms of protection in myocardial ischemia-reperfusion injury.Review
MyomectomyCan myomectomy be suggested for perimenopausal women before administering hormone replacement therapy?The purpose of the present study was to compare perioperative morbidity, duration of hospital stay between perimenopausal women who underwent abdominal myomectomy and matched, selected control group of perimenopausal patients treated by hysterectomy and determine the recurrence of leiomyomata and/or symptoms after myomectomy continued with HRT.
OsteopeniaOsteopenia / OsteoporosisTab 1 (WHO diagnostic categories of bone mineral density); Tab 2 (Risk factors for osteoporosis and fracture in white postmenopausal women); Tab 3 (Relative risk of hip fracture according to key clinical risk factors after adjustment for age and BMD); Tab 4 (Lifestyle measures recommended for patients with osteopenia); Tab 5 (Medications approved by FDA for the prevention of osteoporosis). Osteoporosis is defined as a T score -2.5 or lower; osteopenia as a T score that is higher than -2.5 but less than -1. The risk of fracture is greater among patients with osteopororsis than among those with osteopenia.
OsteoporosisOnce-yearly zoledronic acid for treatment of postmenopausal osteoporosis.In this study annual infusions of zoledronic acid (5 mg) for 3 years were evaluated to determine whether they reduced the risk of vertebral, hip, and other types of fracture.
OsteoporosisOnce-yearly zoledronic acid for treatment of postmenopausal osteoporosis.Correspondence
OsteoporosisTeriparatide or alendronate in glucocorticoid-induced osteoporosis.Glucocorticoid-induced osteoporosis is the most common cause of secondary osteoporosis. To compare the effects of recombinant teriparatide (recombinant parathyroid hormone) with those of alendronate for the treatment of patients with osteoporosis who have had long-term exposure to glucocorticoids and are at high risk for fracture.
OsteoporosisAnabolic therapy in glucocorticoid-induced osteoporosis.Editorial
Ovarian cancerEditorialThe effect of oral contraceptives on cancer risk is more complex. Whilst being shown to decrease the risk of ovarian and endometrial cancers, oral contraceptives may increase the risk of breast and cervical cancers. However the best evidence on the net effect of oral contraceptives shows a reduction in risk of cancers. The authors strongly endorse more widespread over-the-counter access to a preventive agent that can not only prevent cancers but also demonstrably save the lives of tens of thousands of women
Ovarian cancerCommentThe Collaborative Group's new analysis provides useful insights into the association with ovarian cancer histology. The protective effect was largely the same for epithelial and non-epithelial tumours, although there was less evidence that oral contraceptive use prevents mucinous ovarian cancer, which accounts for fewer than 15% of all incident cases. oral contraceptives are not the only exogenous source of hormones that might influence ovarian cancer risk in women. The influences of exogenous hormones on the risk of ovarian cancer differ either side of menopause. In premenopausal years, use of oral contraceptives could help to decrease the number of cells that are likely to become malignant over a lifetime, whereas HRT after menopause could have a carcinogenic effect. As for the link between oral contraceptives and ovarian cancer, today's collaborative analysis brings unequivocal good news. Women and their health-care providers are once again at a balancing act of judging risks versus benefits.
Ovarian cancer Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 woemn with ovarian cancer and 87,303 controls.Oral contraceptives were introduced almost 50 years ago and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer but the eventual public health effects of this reduction will depend on how long the protection lasts after use ceases. To investigate the relation between use of oral contraceptives and the subsequent risk of ovarian cancer, data for individual women from 45 epidemiological studies of ovarian cancer have been brought together, checked and analysed centrally.
Ovarian cancer (OC)Hormone replacement therapy (HRT)948,756 postmenopausal women from the UK Million Women Study who did not have previous cancer or bilateral oophorectomy were followed-up for an avarage of 5.3 years for incident ovarian cancer and 6.9 years for death.
Ovarian cancer (OC)Hormone replacement therapy (HRT)Editorial
PapillomavirusEfficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials.Vulval and vaginal cancers are preceded by high-grade vulval intraepithelial neoplasia (VIN 2-3) and vaginal intraepithelial neoplasia (VaIN 2-3). The aim was to do a combined analysis of three randomised clinical trials to assess the effect of a prophylactic quadrivalent HPV vaccine on the incidence of these diseases.
PapillomavirusHuman papillomavirus (HPV) and cervical cancer.Cervical cancer is the second most common cancer in women worldwide. Persistent infection with one of about 15 genotypes of carcinogenic human papillomavirus (HPV) causes almost all cases. There are 4 major steps in cervical cancer development: infection of metaplastic epithelium at the cervical transformation zone, viral persistence, progression of persistently infected epithelium to cervical precancer, and invasion through the basement membrane of the epithelium. Infection is common in young women in their first decade of sexual activity. Persistent infections and precancer are established from less than 10% of new infections. Invasive cancer arises over many years, even decades, in a minority of women with precancer, with a peak or plateau in risk at about 35-55 years of age. Each genotype of HPV acts as an independent infection, with differing carcinogenic risks linked to evolutionary species. The new HPV-oriented model of cervical carcinogenesis should gradually replace older morphological models based only on cytology and hystology. If applied wisely, HPV-related technology can minimise the incidence of cervical cancer and the morbidity and mortality it causes, even in low-resource settings.
Pelvic organ prolapse (POP)Association of pelvic organ prolapse and fractures in postmenopausal women: analysis of baseline data from the Women's health Initiative Estrogen Plus Progestin trial.On the basis of a prespecified hypothesis that women with pelvic organ prolapse (POP) may experience a higher likelihood of bone fractures due to defective tissue collagen compared with women without prolapse, the authors have conducted this current study to evaluate whether there is an association between fracture after age 55 and POP.
Postmenopausal hormone therapyPostmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause.The timing of initiation of hormone therapy may influence its effect on cardiovascular disease. The objective of this study was to explore whether the effects of hormone therapy on risk of cardiovascular disease vary by age or years since menopause began.
PreventionPrimary prevention of coronary heart disease in women through diet and lifestyle.The authors assessed the effect of a combination of lifestyle practices on the risk of coronary heart disease. Specifically the authors estimated the proportion of coronary events that coul be prevented by adherence to a set of dietary and behavioral guidelines. Also they evaluated the effect of the practices on the risk of stroke.
Prevention Evidence-based guidelines for cardiovascular disease. Prevention in women: 2007 update.AHA Guidelines
Prevention Medical and surgical treatments vs changes in cardiovascular risk factors.The authors examined how much of the decrease in coronary heart disease mortality in England and Wales between 1981 and 2000 could be attributed to medical and surgical treatments and how much to changes in cardiovascular risk factors.
Prevention Medical and surgical treatments vs changes in cardiovascular risk factors.The authors sought to determine how much of the decrease in coronary heart disease mortality rates in New Zealand can be attributed to "evidence-based" medical and surgical treatments and how much can be attributed to cardiovascular risk factor reductions.
Prevention Medical and surgical treatments vs changes in cardiovascular risk factors.This study estimates the extent to which changes in the main coronary risk factors (serum cholesterol concentration, blood pressure and smoking) may explain the decline in mortality from ischaemic heart disease and to evaluate the relative importance of change in each of these risk factors.
ProgesteroneProgesterone and the risk of preterm birth among women with a short cervix.A multicenter, randomized trial to evaluate the effect of vaginal progesterone on the incidence of spontaneous early preterm delivery in asymptomic women found at routine mid-trimester screening to have a short cervix (15 mm or less).
Screening mammographyInfluence of computer-aided detection on performance of screening mammographyComputer-aided detection identifies suspicious findings on mammograms to assist radiologists. It has been disseminated into practice, but its effect on the accuracy of interpretation is unclear.
StrokeFolic acid supplementation and stroke The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. The aim of meta-analysis is to assess the efficacy of folic acid supplementation in the prevention of stroke.
Stroke incidenceLow profile risk and 10-year stroke incidence in women and men.Most data on low risk relate to coronary heart disease, not stroke. The possibility that low risk protects against stroke is important, since stroke remains a major cause of morbidity, disabilty, and death worldwide.
TobaccoCause of death For the first time ever the world's leading cause of death is a man made substance: tobacco.
TobaccoCause of death For the first time ever the world's leading cause of death is a man made substance: tobacco.
TuberculosisWomen with suspected tubercolosis are less likely to test smear positive than are men.Submission of poor-quality sputum specimens by women might be one reason for the difference. The trial is to assess the effect of sputum-submission instructions on female patients.
Urinary incontinence in womenSeminar on therapeutic options of urinary incontinence.Urinary incontinence is common in women, but is under-reported and under-treated. Urine storage and emptying is a complex coordination between the bladder and urethra, and disturbances in the system due to childbirth, aging, or other medical conditions can lead to urinary incontinence. The two main types of incontinence in women, stress urinary incontinence and urge urinary incontinence, can be evaluated by history and simple clinical assessment available to most primary care physicians. There is a wide range of therapeutic options, but the recent proliferation of new drug tratments and surgical devices for urinary incontinence have had mixed results; direct-to-consumer advertising has increased public awareness of the problem of urinary incontinence, but many new products are being introduced without long-term assessment of their safety and efficacy.
Urinary incontinence in womenHysterectomy and risk of stress-urinary-incontinence surgery.Hysterectomy for benign indications has been associated with an increased risk for lower-urinary-tract sequela. In the USA 600,000 procedures are undertaken every year, of which 90% are done for benign indications. Female stress urinary incontinence, defined as involuntary leakage of urine on effort or exertion, has a population-based prevalence of nearly 40% in most industrialised countries. The primary aim of this nationwide, population-based, cohort study was to assess short-term and long-term risk for stress-urinary-incontinence surgery after hysterectomy for benign indications.
Urinary incontinence in womenDoes hysterectomy cause urinary incontinence?Comment
Urinary incontinence in womenUrinary stress incontinence in women.The loss of urine while coughing, sneezing, or engaging in physical activity is characteristic of stress incontinence. A physical examination is important, including a cough stress test and urinalysis and assessment of post-void residual volume of urine. Assuming the urinalysis results and the residual volumes are normal, the author would instruct the patient in behavioral changes and pelvic-floor exercises. Weight loss may reduce incontinence symptoms. For times when the woman is physically active an incontinence pessary may be helpful. Surgical treatment as an alternative to behavioral or device therapies is also important.
Vaccine against papillomavirusHPV type 16 and HPV type 18 account for 76% or more of cases of cervical cancer worldwide. The aim of this prespecified interim analysis of phase III double-blind, randomised controlled trial is to assess the efficacy of this vaccine against CIN2, CIN3, adenocarcinoma in situ, and invasive carcinoma associated with HPV16 or HPV18 - a surrogate endpoint for cervical cancer - and against persistent infections with HPV16, HPV18, and other oncogenic HPV types.
Vitamin D (Vit D)Vit D and its implications for muscoloskeletal health in women: an update.Vit D is a hormone that controls phosphorus, calcium and bone metabolism, and neuromuscular function. The ideal healthy blood levels of 25-hydroxyvitamin D are controversial, although a range from 30 to 60 ng/mL is widely accepted.