ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This review emphasizes that the obstetrician-gynecologist is in the optimum position in the health care system to effect the reduction of the burden of heart disease through prevention. As a team leader, many obstetricians/gynecologists become armed with an understanding modeled on the lifestyles of the patients they come in contact with; thus, leaching prevention has an enormous ripple effect. Changes at menopause, states of endocrine aberration, and benefits and risks of hormone substitution need to be understood in conjunction with all other potentially modifiable and nonmodifiable risk factors. Integrating behavior modifications is the key to prevention as part of the regular visit.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To determine the acute and follow-up effects of 4 months of health and fitness education with and without exercise training, 182 sedentary, obese. 60− to 70-year-old women were randomly assigned to the following groups: fitness education (ED. n - 70). fitness education with aerobic training (EX. n = 76), and control (CO. n = 36). Assessments of aerobic power using a submaximal bicycle test, body composition, using the sum of three skinlfolds. and body mass index (BMI) were made before and after the 4-month intervention and at a 3− and 6-month follow-up. Both EX and ED decreased body fat levels (vs. CO) over the course of the study (p < 0.05), with EX showing a slightly greater percent decrease over baseline levels (5.9% vs. 3.7%). Also observed were significant improvements in aerobic power and BMI (both p < 0.001) for EX compared to ED and CO. The average EX and ED exercise adherence levels after 4 months and at the 3-month and 6-month follow-ups were 94%. 75%. and 68%. respectively. These findings suggest that, for the most part, long-term success of a fitness education program for older women is more likely if a supervised exercise training component is included.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The purpose of this study was to assess whether women with vasomotor symptoms more often have had premenstrual symptoms than women without vasomotor complaints. Furthermore, the aim was to assess whether there was a correlation between the prevalence of women's vasomotor symptoms and their mothers symptoms. A postal questionnaire was sent to all 1,324 women aged 55 and 56 years in the community of Linköping, Sweden. Furthermore, a semistructured interview was undertaken with 33 postmenopausal women: 16 women with pronounced vasomotor symptoms and a control group of 17 women who had never had vasomotor symptoms. Questions were asked about previous premenstrual symptoms and current as well as previous vasomotor complaints. The women were also asked about their mothers' vasomotor complaints. The questionnaire was returned from 84.7% of the women. There was a significant positive association between vasomotor symptoms and previous premenstrual symptoms. Previous moderate to severe premenstrual symptoms were reported by 49% of the women who had moderate to severe vasomotor symptoms and only by 24% of the women who had experienced no or only slight vasomotor symptoms (X2= 69.6; p << 0.001). Women who had vasomotor symptoms reported that their mothers had suffered from vasomotor complaints significantly more often than women without symptoms. This was the case in both the questionnaire study and in the interview. We propose that a contributing factor to the association between premenstrual symptoms and postmenopausal vasomotor symptoms may be that women with these symptoms are more sensitive to, or have more pronounced, neurotransmittor changes in the hypothalamus. Furthermore, we found a positive association between the prevalence of vasomotor symptoms in women and their mothers. This may also support the hypothesis that some women are more sensitive to hypothalamic changes, although many other reasons, like recall bias, are possible.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In this prospective study, the relationship between biochemical markers of bone turnover and changes in bone mass of the lumbar spine and proximal femur were evaluated. Thirty-two postmenopausal women were randomly assigned to either conjugated equine estrogen (0.625 mg) and medroxyprogesterone acetate (5.0 mg. synthetic E/P, n = 15) or micronized 17-β estradiol (1.0 mg) and micronized progesterone (200 mg. micronized E/P, n = 17) administered daily and continuously for 13 cycles. Demographic and baseline hormonal profiles did not differ (p > 0.05) between the groups. Osteocalcin. bone-specific alkaline phosphatase. type 1 procollagen peptide. and crosslinked N-terminal telopeptide of type 1 collagen were measured in both serum and urine, and bone mineral density was assessed prior to and after the 13-cycle treatment period. Lumbar (L2-L4) bone density improved (p < 0.01) by 5.0% and 3.8% in both the synthetic E/P and micronized E/P groups, respectively. Proximal femur bone density improved by 2.6% (p < 0.05) and 3.1% (p < 0.01) in the synthetic and micronized E/P groups, respectively. Overall. markers of bone turnover decreased 18–47% in both treatment groups (p < 0.01). Specifically, markers of formation decreased: serum osteocalcin by 46.8% and 19.5%. bone-specific alkaline phosphatase by 42.9% and 18.9%. and type 1 procollagen peptide by 25.8% and 29.0% in the synthetic E/P and micronized E/P groups, respectively. Rates of bone resorption, as determined by crosslinked N-terminal telopeptide of type I collagen levels, were reduced by 46.4% and 43.4% in the synthetic E/P and micronized E/P groups, respectively. Among the markers, baseline values for type I collagen peptide were correlated with changes in bone mineral density at the lumbar spine (r = 0.399. p < 0.026) and proximal femur (r = 0.387. p < 0.05). The percent change from baseline levels of type 1 collagen peptide was correlated (r = 0.381. p < 0.035) with change in bone mineral density at the proximal femur only. These data suggest that postmenopausal women with high bone turnover rates, as indicated by increased type I procollagen peptide levels, may be more sensitive to HRT as demonstrated by increased bone mineral density of the lumbar spine and proximal femur. Moreover, hormonal preparation does not appear to have differential effects on markers of bone metabolism and bone mass.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Bone mass measurements were performed in a group of 100 healthy women (ages 22–74 years) with both a densitometric technique measuring ultrasound bone velocity (UBV) at the distal metaphyses of the first phalanges of the hand and single-photon absorptiometry (SPA) applied at the distal forearm and ultradistal radius. A significant (p < 0.00001) difference was found in both UBV and bone mineral density (BMD) values between premenopausal and postmenopausal women. Simple regression analysis showed a highly significant relationship (p < 0.0001) between UBV measured at proximal phalanges and BMD measured at the distal forearm (r = 0.693) and ultradistal radius (r = 0.643). There was no correlation between age and both UBV and BMD in premenopausal women. By contrast, a significant correlation was found between UBV and age in postmenopausal women (p < 0.0001: r = 0.510). A similar correlation with age was found for BMD measured at the distal forearm (p < 0.0001; r = 0.458) and ultradistal radius (p < 0.0002: r = 0.435). Changes of UBV were also significantly related to years since menopause (p < 0.0001: r = 0.526). as were BMD variations at the distal forearm (p <: 0.0001; r = 0.451) and ultradistal radius (p < 0.008: r = 0.402). The reproducibility of the methods (coefficient of variation) was 0.46% for UBV and 0.92% for SPA. Our findings seem to indicate that UBV measured at the phalanges may have the same clinical applications as BMD measured at the distal forearm and ultradistal radius.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Most studies of midlife women consist of samples between 40 and 60 years of age and describe their menopausal symptom experience as if it were one homogeneous group across two decades of life. Very little is known about the health and symptom experience of midlife women as They enter midlife or experience menopause. Therefore, the purpose of this paper is to describe and contrast selected symptoms, health status, and health care utilization of midlife women by 5-year increments from the age of 40 to 60 years. The subsample of 266 women selected for this paper were participants in a health survey study of 760 employed nurses. Those who were taking hormones, regardless of age, experienced the greatest symptoms. Menstrual cycle irregularity, hot flashes, surgically induced menopause, and use of hormones was prevalent in the 40− to 45-year-old group. Symptoms of fatigue, depression, and sleep disturbance did not differ significantly by age group.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Fifty-seven women attending a menopause clinic were evaluated for psychological, social, and sexual aspects of postmenopause through a self-administered questionnaire given at 6-month intervals. The women were put on either estradiol valerate/cyproterone acetate or conjugated estrogen/medroxyprogesterone acetate combinations or no treatment. After 12 months, the Psychiatric Symptom Index global and anxiety scores improved significantly in both treatment groups but not in the control group. The depression score improved in both treated groups but did not reach statistical significance in the estradiol valerate/cyproterone acetate group. Cognition and hostility scores improved in all groups during the trial but the improvement in the treated groups was not different from that observed in the control group. Health parameters remained constant and stress did not change significantly. Sexual parameters remained unchanged. This study shows that hormonal replacement therapy plays a role in the improvement of psychological aspects of menopause.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Breast cancer incidence rates for women in the United States are among the highest in the world, yet methods to reduce disease risk have yet to be fully developed. Etiologic theories have focused on estrogens because of the numerous menstrual and reproductive risk factors for the disease. Many breast cancer risk factors that are believed to operate through an estrogen pathway arc culturally or personally determined by a woman's lifestyle. In an effort to reduce risk, however, few of these factors are easily modifiable, with the exception of physical activity. The biologic plausibility of physical activity as a potential preventive strategy is discussed. The epidemiologic literature on physical activity in relation to breast cancer risk is critically reviewed. Attention is given to issues in assessment of physical activity that cloud interpretation of these studies, namely types of physical activity (recreational versus nonrecreational); classification of physical activity levels (intensity, duration, and frequency): timing of physical activity (adolescent versus adult); validity and reliability of physical activity instruments: confounding; and identification of high risk groups (pre- versus postmenopausal women). Given the methodological limitations of the 11 studies published to date, it is unclear whether physical activity reduces risk, or whether risk varies with intensity or timing of exposure. However, two of the three most recent, better conducted studies suggest that recreational physical activity may reduce breast cancer risk among premenopausal women by 40 60%.

ISSN:1072-3714    

出版商:OVID    

年代:1996

数据来源: OVID