Pub Date : 2001-11-01DOI: 10.1089/152460901753285750
J. Mcfarlane, R. Hughes, M. Nosek, J. Groff, Nancy Swedlend, P. Mullen
An interview questionnaire was presented to a multiethnic sample of 511 women, age 18-64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen-Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities.
{"title":"Abuse assessment screen-disability (AAS-D): measuring frequency, type, and perpetrator of abuse toward women with physical disabilities.","authors":"J. Mcfarlane, R. Hughes, M. Nosek, J. Groff, Nancy Swedlend, P. Mullen","doi":"10.1089/152460901753285750","DOIUrl":"https://doi.org/10.1089/152460901753285750","url":null,"abstract":"An interview questionnaire was presented to a multiethnic sample of 511 women, age 18-64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen-Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90462703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-11-01DOI: 10.1089/152460901753285787
Noella A. Misquita, D. Davis, C. Dobrovolny, Alice S. Ryan, K. E. Dennis, Barbara J. Nicklas
This study examines the applicability of using three standard criteria (age-predicted maximal heart rate [HRmax], respiratory exchange ratio [RER>1.10], and plateau in oxygen uptake [Vo(2)] for the measurement of maximal oxygen consumption (Vo(2)max) in postmenopausal women. One hundred eight postmenopausal (60 +/- 6 years), overweight and obese (body mass index [BMI] = 33 +/- 4 kg/m(2)), sedentary (Vo(2)max = 19 +/- 3 ml/kg/min) women underwent one exercise test (Bruce protocol), and 71 of these women underwent a second test (modified Balke protocol). On test 1, 69 (64%) women achieved age-predicted HRmax, 61 (57%) reached an RER>1.10, and 16 (15%) achieved a plateau in Vo(2) (<2 ml/kg/min change). Women who reached age-predicted HRmax and reached an RER of at least 1.10 had a higher peak Vo(2) (p <0.01) than women who did not meet these criteria. There was no difference in the highest V02 obtained between women who did and did not achieve a plateau in Vo(2) during test 1 (p = 0.55). Resting HR, HRmax, and RER were similar between the two tests. On average, peak Vo(2) was higher on the second test (p <0.01). However, Vo(2)max was not different between exercise tests in women who achieved at least two of the three criteria on both tests (n = 24; test 1, 19.4 +/- 3.4; test 2: 19.8 +/- 3.7 ml/kg/min; p = NS). In addition, Vo(2)max was similar between the two exercise tests in 14 women who reached a plateau on the second test but did not reach a plateau on the first test (19.2 +/- 3.3 vs. 19.6 +/- 4.2 ml/kg/min; p = NS). We conclude that achievement of a plateau in Vo(2) is not a necessary criterion for a valid measurement of Vo(2)max in overweight and obese, sedentary, postmenopausal women.
{"title":"Applicability of maximal oxygen consumption criteria in obese, postmenopausal women.","authors":"Noella A. Misquita, D. Davis, C. Dobrovolny, Alice S. Ryan, K. E. Dennis, Barbara J. Nicklas","doi":"10.1089/152460901753285787","DOIUrl":"https://doi.org/10.1089/152460901753285787","url":null,"abstract":"This study examines the applicability of using three standard criteria (age-predicted maximal heart rate [HRmax], respiratory exchange ratio [RER>1.10], and plateau in oxygen uptake [Vo(2)] for the measurement of maximal oxygen consumption (Vo(2)max) in postmenopausal women. One hundred eight postmenopausal (60 +/- 6 years), overweight and obese (body mass index [BMI] = 33 +/- 4 kg/m(2)), sedentary (Vo(2)max = 19 +/- 3 ml/kg/min) women underwent one exercise test (Bruce protocol), and 71 of these women underwent a second test (modified Balke protocol). On test 1, 69 (64%) women achieved age-predicted HRmax, 61 (57%) reached an RER>1.10, and 16 (15%) achieved a plateau in Vo(2) (<2 ml/kg/min change). Women who reached age-predicted HRmax and reached an RER of at least 1.10 had a higher peak Vo(2) (p <0.01) than women who did not meet these criteria. There was no difference in the highest V02 obtained between women who did and did not achieve a plateau in Vo(2) during test 1 (p = 0.55). Resting HR, HRmax, and RER were similar between the two tests. On average, peak Vo(2) was higher on the second test (p <0.01). However, Vo(2)max was not different between exercise tests in women who achieved at least two of the three criteria on both tests (n = 24; test 1, 19.4 +/- 3.4; test 2: 19.8 +/- 3.7 ml/kg/min; p = NS). In addition, Vo(2)max was similar between the two exercise tests in 14 women who reached a plateau on the second test but did not reach a plateau on the first test (19.2 +/- 3.3 vs. 19.6 +/- 4.2 ml/kg/min; p = NS). We conclude that achievement of a plateau in Vo(2) is not a necessary criterion for a valid measurement of Vo(2)max in overweight and obese, sedentary, postmenopausal women.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88308096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-11-01DOI: 10.1089/152460901753285796
C. Crandall
As a whole, groups of women who gain more bone mineral density (BMD) on antiresorptive medications experience greater fracture protection, although the relationship is not clear on the individual level. A literature search (Medline 1966 to present) for randomized, controlled trials was performed with keywords serial bone density, osteoporosis, dual-energy x-ray absorptiometry, fracture, alendronate, risedronate, calcitonin, estrogen replacement therapy, and raloxifene. Also, reference lists and tables of contents from journals were searched manually for additional relevant randomized controlled trials. Trials were 2-3 years in duration, and the number of subjects ranged from 670 to 3954. Medications analyzed include alendronate, either 5 mg/day or 5 mg/day, followed by 10 mg/day; raloxifene, 60 or 120 mg/day; and combination hormone replacement therapy (HRT) of four different regimen types. There have been no controlled studies showing that change in treatment based on serial bone density measurement results in improved patient outcomes. Whereas studies have shown changes in BMD during antiresorptive therapy to be predictive of fracture reduction in groups of patients, their utility in individual patients remains inconclusive. Osteoporotic women who lose BMD in the first year of alendronate or raloxifene use will likely gain BMD in the second year of treatment, illustrating regression to the mean. Effective medication for osteoporosis should not be changed solely because of BMD loss occurring after the first year of treatment. Young, healthy, postmenopausal women taking commonly prescribed doses of estrogen or estrogen/progestin (HRT) rarely lose BMD. Bone loss over the first 12 months of HRT is independent of bone loss in the next 24 months. If bone is not lost in the first 12 months of HRT, there is a significant chance that bone density will be lost later in treatment. Half of placebo-treated women do not lose BMD over 3 years. Treatment should be continued in patients who initially lose bone density on therapy because most will gain density with continued treatment and end in gaining bone overall. Also, patients who gain large amounts of bone in the first year and lose in the second year are not necessarily failing therapy but rather may be showing that a random error in the earlier bone density change corrects itself later. Loss of BMD with alendronate, raloxifene, or combination conjugated equine estrogen/ medroxyprogesterone acetate is likely to convert to gain in BMD. More research is needed to confirm that this regression to the mean may apply to all densitometry techniques, antiresorptives, age groups, and genders.
{"title":"The role of serial bone mineral density testing for osteoporosis.","authors":"C. Crandall","doi":"10.1089/152460901753285796","DOIUrl":"https://doi.org/10.1089/152460901753285796","url":null,"abstract":"As a whole, groups of women who gain more bone mineral density (BMD) on antiresorptive medications experience greater fracture protection, although the relationship is not clear on the individual level. A literature search (Medline 1966 to present) for randomized, controlled trials was performed with keywords serial bone density, osteoporosis, dual-energy x-ray absorptiometry, fracture, alendronate, risedronate, calcitonin, estrogen replacement therapy, and raloxifene. Also, reference lists and tables of contents from journals were searched manually for additional relevant randomized controlled trials. Trials were 2-3 years in duration, and the number of subjects ranged from 670 to 3954. Medications analyzed include alendronate, either 5 mg/day or 5 mg/day, followed by 10 mg/day; raloxifene, 60 or 120 mg/day; and combination hormone replacement therapy (HRT) of four different regimen types. There have been no controlled studies showing that change in treatment based on serial bone density measurement results in improved patient outcomes. Whereas studies have shown changes in BMD during antiresorptive therapy to be predictive of fracture reduction in groups of patients, their utility in individual patients remains inconclusive. Osteoporotic women who lose BMD in the first year of alendronate or raloxifene use will likely gain BMD in the second year of treatment, illustrating regression to the mean. Effective medication for osteoporosis should not be changed solely because of BMD loss occurring after the first year of treatment. Young, healthy, postmenopausal women taking commonly prescribed doses of estrogen or estrogen/progestin (HRT) rarely lose BMD. Bone loss over the first 12 months of HRT is independent of bone loss in the next 24 months. If bone is not lost in the first 12 months of HRT, there is a significant chance that bone density will be lost later in treatment. Half of placebo-treated women do not lose BMD over 3 years. Treatment should be continued in patients who initially lose bone density on therapy because most will gain density with continued treatment and end in gaining bone overall. Also, patients who gain large amounts of bone in the first year and lose in the second year are not necessarily failing therapy but rather may be showing that a random error in the earlier bone density change corrects itself later. Loss of BMD with alendronate, raloxifene, or combination conjugated equine estrogen/ medroxyprogesterone acetate is likely to convert to gain in BMD. More research is needed to confirm that this regression to the mean may apply to all densitometry techniques, antiresorptives, age groups, and genders.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73165446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636550
M. L. Etten, James C. Anthony
Recent studies in the United States suggest that male-female differences in the prevalence of drug use may result from sex differences in opportunities to use drugs rather than from differences in the likelihood of making a transition into drug use once an opportunity has occurred. That is, men have more opportunities to try drugs, but women appear to be just as likely as men to initiate drug use when given the opportunity to do so. This paper examines whether this general observation holds for subgroups defined by age or birth cohort, race/ethnicity, geographic region, and urban status. We analyzed data from the 1991, 1992, and 1993 National Household Surveys on Drug Abuse. We found general consistency across the subgroups studied. Males were more likely than females to have opportunities to use drugs, but the sexes were equally likely to make a transition into drug use once an opportunity had occurred to try a drug. The implications of this evidence are discussed in relation to the epidemiology and prevention of drug use and with respect to future research on sex and gender differences in drug involvement.
{"title":"Male-female differences in transitions from first drug opportunity to first use: searching for subgroup variation by age, race, region, and urban status.","authors":"M. L. Etten, James C. Anthony","doi":"10.1089/15246090152636550","DOIUrl":"https://doi.org/10.1089/15246090152636550","url":null,"abstract":"Recent studies in the United States suggest that male-female differences in the prevalence of drug use may result from sex differences in opportunities to use drugs rather than from differences in the likelihood of making a transition into drug use once an opportunity has occurred. That is, men have more opportunities to try drugs, but women appear to be just as likely as men to initiate drug use when given the opportunity to do so. This paper examines whether this general observation holds for subgroups defined by age or birth cohort, race/ethnicity, geographic region, and urban status. We analyzed data from the 1991, 1992, and 1993 National Household Surveys on Drug Abuse. We found general consistency across the subgroups studied. Males were more likely than females to have opportunities to use drugs, but the sexes were equally likely to make a transition into drug use once an opportunity had occurred to try a drug. The implications of this evidence are discussed in relation to the epidemiology and prevention of drug use and with respect to future research on sex and gender differences in drug involvement.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89454166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636523
Rengin Güzel, E. Kozanoğlu, F. Guler-Uysal, S. Soyupak, T. Sarpel
The aim of the study is to compare vitamin D status and bone mineral density (BMD) in veiled and unveiled healthy Turkish women of reproductive age. Thirty young to middle-aged volunteer veiled women and 30 age-matched control subjects with western clothing habits were enrolled in the study. The two groups had similar dietary habits, body mass index (BMI) distribution, and gestational history. Physical and laboratory examinations were performed to rule out any disease that could affect bone metabolism. Serum 25-hydroxyvitamin D (25-OHD) levels were measured, and BMD of the spine and hip were investigated by dual energy x-ray absorptiometry (DEXA). The mean age of dressing the veil was 15.7 +/- 6.13 years, and 66.7% of the veiled women claimed that they were not ever exposed to direct sunlight, as they were leading an indoor life. Compared with the control group, veiled women were less educated and physically less active (p < 0.001 and p < 0.05, respectively). 25-OHD levels were positively correlated with exposure to sunlight and negatively correlated with the duration of being veiled. None of the veiled women had vitamin D insufficiency, but their mean 25-OHD concentration (33.1 +/- 16 ng/ml) was significantly lower than that of controls (53.9 +/- 27.3 ng/ml) (p < or = 0.001), and serum alkaline phosphatase (ALP) levels were higher (p < 0.01). Differences in the absolute BMD values at the spine and hip were not statistically significant, but the mean Z value at the lumbar spine was significantly lower in the veiled subjects (p < 0.05). Veiled women have low 25-OHD status, and vitamin D supplementation should strictly be advised to these women for the prevention of osteomalacia and osteoporosis.
{"title":"Vitamin D status and bone mineral density of veiled and unveiled Turkish women.","authors":"Rengin Güzel, E. Kozanoğlu, F. Guler-Uysal, S. Soyupak, T. Sarpel","doi":"10.1089/15246090152636523","DOIUrl":"https://doi.org/10.1089/15246090152636523","url":null,"abstract":"The aim of the study is to compare vitamin D status and bone mineral density (BMD) in veiled and unveiled healthy Turkish women of reproductive age. Thirty young to middle-aged volunteer veiled women and 30 age-matched control subjects with western clothing habits were enrolled in the study. The two groups had similar dietary habits, body mass index (BMI) distribution, and gestational history. Physical and laboratory examinations were performed to rule out any disease that could affect bone metabolism. Serum 25-hydroxyvitamin D (25-OHD) levels were measured, and BMD of the spine and hip were investigated by dual energy x-ray absorptiometry (DEXA). The mean age of dressing the veil was 15.7 +/- 6.13 years, and 66.7% of the veiled women claimed that they were not ever exposed to direct sunlight, as they were leading an indoor life. Compared with the control group, veiled women were less educated and physically less active (p < 0.001 and p < 0.05, respectively). 25-OHD levels were positively correlated with exposure to sunlight and negatively correlated with the duration of being veiled. None of the veiled women had vitamin D insufficiency, but their mean 25-OHD concentration (33.1 +/- 16 ng/ml) was significantly lower than that of controls (53.9 +/- 27.3 ng/ml) (p < or = 0.001), and serum alkaline phosphatase (ALP) levels were higher (p < 0.01). Differences in the absolute BMD values at the spine and hip were not statistically significant, but the mean Z value at the lumbar spine was significantly lower in the veiled subjects (p < 0.05). Veiled women have low 25-OHD status, and vitamin D supplementation should strictly be advised to these women for the prevention of osteomalacia and osteoporosis.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85158924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636569
N. Rehan, A. Inayatullah, I. Chaudhary
A study of the characteristics of Pakistani women seeking abortion and a profile of abortion clinics was conducted in 32 abortion clinics in three provincial capitals of the country. All 452 women who had their pregnancies terminated between October and December 1997 were interviewed. Except for 39 women (8.6%), all study subjects were married. A majority of the women (36.6%) were aged >35 years, 61.0% had given birth to > or =5 children, and 40.2% were illiterate. The predominant reasons for abortion were "too many children" (64.4%), contraceptive failure (20.3%), premarital affairs (8.6%), medical reasons (5.4%), and extramarital affairs (1.3%). Nearly two thirds of the abortions were induced by inadequately trained persons. Only 22% of the abortion clinics met the World Health Organization (WHO) standards required for safe termination of pregnancy. At all these clinics, the procedure used to terminate the pregnancy was dilatation and curettage (D&C). Only one clinic was using manual vacuum aspiration (MVA). Induced abortion seems to be fairly common among married women of high parity, advanced age, and low educational status. Keeping in view the large number of terminations, new medical and surgical techniques of pregnancy termination should be introduced to those already providing abortion services.
{"title":"Characteristics of Pakistani women seeking abortion and a profile of abortion clinics.","authors":"N. Rehan, A. Inayatullah, I. Chaudhary","doi":"10.1089/15246090152636569","DOIUrl":"https://doi.org/10.1089/15246090152636569","url":null,"abstract":"A study of the characteristics of Pakistani women seeking abortion and a profile of abortion clinics was conducted in 32 abortion clinics in three provincial capitals of the country. All 452 women who had their pregnancies terminated between October and December 1997 were interviewed. Except for 39 women (8.6%), all study subjects were married. A majority of the women (36.6%) were aged >35 years, 61.0% had given birth to > or =5 children, and 40.2% were illiterate. The predominant reasons for abortion were \"too many children\" (64.4%), contraceptive failure (20.3%), premarital affairs (8.6%), medical reasons (5.4%), and extramarital affairs (1.3%). Nearly two thirds of the abortions were induced by inadequately trained persons. Only 22% of the abortion clinics met the World Health Organization (WHO) standards required for safe termination of pregnancy. At all these clinics, the procedure used to terminate the pregnancy was dilatation and curettage (D&C). Only one clinic was using manual vacuum aspiration (MVA). Induced abortion seems to be fairly common among married women of high parity, advanced age, and low educational status. Keeping in view the large number of terminations, new medical and surgical techniques of pregnancy termination should be introduced to those already providing abortion services.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81367116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636442
P. Greenberger
{"title":"Scientists need to coordinate research to produce better patient care.","authors":"P. Greenberger","doi":"10.1089/15246090152636442","DOIUrl":"https://doi.org/10.1089/15246090152636442","url":null,"abstract":"","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76206055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636451
A. Malarcher, M. Casper, D. M. Matson Koffman, J. Brownstein, J. Croft, G. Mensah
{"title":"Women and cardiovascular disease: addressing disparities through prevention research and a national comprehensive state-based program.","authors":"A. Malarcher, M. Casper, D. M. Matson Koffman, J. Brownstein, J. Croft, G. Mensah","doi":"10.1089/15246090152636451","DOIUrl":"https://doi.org/10.1089/15246090152636451","url":null,"abstract":"","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74188350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636497
J. Lin, D. Thompson
Premenstrual syndrome (PMS) affects 20%-50% of all women. Premenstrual dysphoric disorder (PMDD), which can be conceptualized as a more severe variant of PMS, can affect 3%-9% of all women. Because a significant number of women suffer from premenstrual disorders and afflicted women may spend up to half the month suffering from symptoms, it is important to identify and provide effective treatment for such women. Historically, it has been difficult to distinguish premenstrual disorders from other depressive disorders, given the high comorbidity of the two disorders. Most studies attempt to remove this confounding factor by excluding women with concurrent depressive disorders. Despite the difficulties and limitations inherent in studying treatments for premenstrual disorders, most investigations support the use of serotonin agents in treating PMDD.
{"title":"Treating premenstrual dysphoric disorder using serotonin agents.","authors":"J. Lin, D. Thompson","doi":"10.1089/15246090152636497","DOIUrl":"https://doi.org/10.1089/15246090152636497","url":null,"abstract":"Premenstrual syndrome (PMS) affects 20%-50% of all women. Premenstrual dysphoric disorder (PMDD), which can be conceptualized as a more severe variant of PMS, can affect 3%-9% of all women. Because a significant number of women suffer from premenstrual disorders and afflicted women may spend up to half the month suffering from symptoms, it is important to identify and provide effective treatment for such women. Historically, it has been difficult to distinguish premenstrual disorders from other depressive disorders, given the high comorbidity of the two disorders. Most studies attempt to remove this confounding factor by excluding women with concurrent depressive disorders. Despite the difficulties and limitations inherent in studying treatments for premenstrual disorders, most investigations support the use of serotonin agents in treating PMDD.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75189810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-10-01DOI: 10.1089/15246090152636488
Carolyn J. Crandall
This analysis reviews clinical trials of the efficacy and safety of tolterodine for use in overactive bladder. It also compares the safety and efficacy of tolterodine and previously available pharmacotherapy. The MEDLINE database (1966 to present) was searched for all English language randomized controlled trials with keyword tolterodine. The search retrieved 10 randomized controlled trials involving tolterodine. Studies ranged from 2 to 12 weeks in duration. Nine trials studied tolterodine vs. placebo, 6 compared tolterodine vs. oxybutynin, 6 compared different doses of tolterodine, and 1 compared immediate-release and extended-release tolterodine. Doses of tolterodine were 0.5-4 mg bid or 4 mg extended-release daily, and doses of oxybutynin were 5 mg bid or tid. All studies found a benefit of tolterodine over placebo in decreasing symptoms of overactive bladder. Parameters significantly improved by tolterodine include number of voids per day, urine volume per void, number of incontinent episodes per day, pad use, maximal cystometric capacity, residual volume, volume at first detrusor contraction, and volume at normal desire to void. Tolterodine 2 mg bid was consistently of equal efficacy as oxybutynin 5 mg tid. Adverse events with both medications were mostly dose-related autonomic nervous system events. The most common adverse event was dry mouth, which was both more frequent and more severe with oxybutynin 5 mg tid than with tolterodine 2 mg bid. Dry mouth did not generally result in discontinuation of medication with either drug. Most drug withdrawal was because of blurred vision or headache. Tolterodine 2 mg bid caused less dose reduction, patient withdrawal, and adverse events, especially dry mouth, compared with oxybutynin 5 mg tid. A single trial found tolterodine extended-release 4 mg/day to have improved efficacy for decreasing urge incontinence episodes along with lower frequency of dry mouth vs. immediate-release tolterodine 2 mg bid. At 4 mg bid, tolterodine caused urinary retention. Neither drug significantly altered any laboratory tests, nor was there clear evidence of electrocardiographic abnormalities induced by either drug. In all randomized controlled trials to date, tolterodine 2 mg bid is an equally effective alternative to oxybutynin 5 mg tid, while causing less intense and less frequent dry mouth or need for treatment withdrawal.
{"title":"Tolterodine: a clinical review.","authors":"Carolyn J. Crandall","doi":"10.1089/15246090152636488","DOIUrl":"https://doi.org/10.1089/15246090152636488","url":null,"abstract":"This analysis reviews clinical trials of the efficacy and safety of tolterodine for use in overactive bladder. It also compares the safety and efficacy of tolterodine and previously available pharmacotherapy. The MEDLINE database (1966 to present) was searched for all English language randomized controlled trials with keyword tolterodine. The search retrieved 10 randomized controlled trials involving tolterodine. Studies ranged from 2 to 12 weeks in duration. Nine trials studied tolterodine vs. placebo, 6 compared tolterodine vs. oxybutynin, 6 compared different doses of tolterodine, and 1 compared immediate-release and extended-release tolterodine. Doses of tolterodine were 0.5-4 mg bid or 4 mg extended-release daily, and doses of oxybutynin were 5 mg bid or tid. All studies found a benefit of tolterodine over placebo in decreasing symptoms of overactive bladder. Parameters significantly improved by tolterodine include number of voids per day, urine volume per void, number of incontinent episodes per day, pad use, maximal cystometric capacity, residual volume, volume at first detrusor contraction, and volume at normal desire to void. Tolterodine 2 mg bid was consistently of equal efficacy as oxybutynin 5 mg tid. Adverse events with both medications were mostly dose-related autonomic nervous system events. The most common adverse event was dry mouth, which was both more frequent and more severe with oxybutynin 5 mg tid than with tolterodine 2 mg bid. Dry mouth did not generally result in discontinuation of medication with either drug. Most drug withdrawal was because of blurred vision or headache. Tolterodine 2 mg bid caused less dose reduction, patient withdrawal, and adverse events, especially dry mouth, compared with oxybutynin 5 mg tid. A single trial found tolterodine extended-release 4 mg/day to have improved efficacy for decreasing urge incontinence episodes along with lower frequency of dry mouth vs. immediate-release tolterodine 2 mg bid. At 4 mg bid, tolterodine caused urinary retention. Neither drug significantly altered any laboratory tests, nor was there clear evidence of electrocardiographic abnormalities induced by either drug. In all randomized controlled trials to date, tolterodine 2 mg bid is an equally effective alternative to oxybutynin 5 mg tid, while causing less intense and less frequent dry mouth or need for treatment withdrawal.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78913194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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