摘要:

Coffee is the most commonly used drug in the United States. The medical literature is conflicted regarding the harmful effects of coffee and caffeine. Because the articles that have appeared are so different, a formal meta-analysis is not the ideal way to summarize the data. However, this literature review suggests that coffee does not have an appreciable effect on hyperlip-idemia, hypertension, ischemic heart disease, or cancer. The effects of decaffeinated coffee are much less well-defined, and there is little rationale for recommending that patients switch to decaffeinated coffee. A less appreciated problem with caffeine is that it may increase the risk of osteoporosis and hip fracture. KEY INDEXING TERMS: Coffee; Caffeine; Ischemic heart disease; Hyperlipidemia; Hypertension. [Am J Med Sci 1994;308(1):49–57.]

ISSN:0002-9629    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Clinical databases consist of observational data collected on patients who meet specific criteria. The uses of these databases depend on whether the observations are drawn from a single institution, multiple clinical centers, or are population-based. Single institution databases frequently are used to profile patient accrual. In cases of rare diseases or unusual procedures, multicenter databases are required to amass sufficient information for study. Multicenter databases can be used to address issues related to intercenter variation and to develop statistical models to predict outcome based on prognostic factors. Population-based databases are required to assess incidence, prevalence, and mortality rates of disease. Although the inferences that can be drawn from observational data are limited by selection bias, clinical databases are valuable tools in planning clinical research. Clearly, however, resources are required to develop and maintain clinical databases. In an era when much research funding is directed at hypothesis-driven research, the importance of these clinical databases in developing clinical research hypotheses should not be overlooked.

ISSN:0002-9629    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Women live nearly one third of their lives after ovarian function has ceased. The implications of menopause for both health and disease as well as the risks and benefits of hormonal replacement therapy are important considerations in the management of postmeno-pausal women. The author discusses the relation between menopause and coronary heart disease (CHD) risk and evaluates the risks and benefits of hormonal replacement therapy from a cardiologist's perspective. During menopause, there are changes in the lipid profile that favor the development of CHD. In addition, there is convincing evidence that the risk of CHD increases with surgical menopause and that natural menopause also may signal a period of increasing risk. Data from angiographic and prospective studies suggest that a reduction in CHD risk is associated with estrogen use in postmenopausal women and that a large part of the beneficial effect of estrogen on CHD risk is through changes in the lipid profile. The benefit of hormonal replacement therapy for reduced risk of CHD, however, must be viewed in the setting of the overall risks and benefits of hormonal replacement therapy for each individual patient.

ISSN:0002-9629    

出版商:OVID    

年代:1994

数据来源: OVID