Clinical medicine insights. Women's health最新文献

Since the first Pharmacopoeia under the title "De Materia Medica," the importance of the utilization of plants and herbs has been an invaluable medicinal tool successfully employed for strengthening the immune system for combating a number of diseases in general, or assisting fertility and reproductive issues in particular. The beneficial use of herbal extracts, constituting the basis of modern medicines, is lately under the shadow of Codex Alimentarius that threatens, if not properly applied, serious immunity features rendering the host defenseless for intercepting harmful invaders, one of which is the mesenchymal endometriotic stem cell causing endometriosis.

Objective: The link between central adiposity and osteopenia has not been extensively studied in Latina women. In particular, the association between abdominal weight and bone mineral content (BMC) and bone mineral density (BMD), independent of total weight and aerobic capacity, remains uncertain, especially in overweight and obese individuals.

Methods: Trunk weight, total body fat mass, fat-free mass, BMC, and BMD of 33 premenopausal Latina women age 22 to 51 years from Los Angeles, California were measured using dual-energy X-ray absorptiometry (DXA). Waist circumference (WC) was measured without clothing at the smallest circumference of the torso. Peak aerobic capacity (peak VO2) was determined by treadmill ergometry with direct measurement of oxygen consumption.

Results: Partial correlations controlling for total body fat mass, fat-free mass, and peak VO2 revealed a significant inverse relationship between BMC and WC (r = -0.54, P < 0.05) but not between BMD and WC (r = -0.18, P = 0.41). Similarly, while controlling for total body fat, fat-free mass, and peak VO2, BMC was inversely associated with trunk fat (r = -0.75, P < 0.001), with trunk lean (r = -0.61, P < 0.05) and with total trunk weight (r = -0.75, P < 0.001); results were non-significant for BMD. When these analyses were repeated separately in overweight (n = 10) versus in the obese (n = 18) women, inverse relationships between BMC and trunk fat as well as between BMC and total trunk weight became stronger in the obese compared with the overweight women.

Conclusion: Although general obesity may prevent osteoporosis, these findings suggest that abdominal obesity (ie, trunk weight) specifically and independently may adversely influence bone mass.

Objective: Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy.

Methods: A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding.

Results: Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman's characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation.

Conclusion: To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies.

Breast cancer is the most frequently diagnosed malignancy in women, with over 200,000 new cases diagnosed each year. Adjuvant systemic endocrine therapy has demonstrated its benefits in reducing the risk of occult micro metastatic infiltration by preventing breast cancer cells from receiving endogenous estrogen stimulation. Initial adjuvant treatment with an aromatase inhibitor (AI) is considered the standard of care for most postmenopausal women with node-positive and high-risk node-negative estrogen receptor (ER)-positive breast cancer. Aromatase inhibitors (AIs) are generally preferred over tamoxifen due to their effectiveness in preventing breast cancer recurrence post surgery and when tamoxifen side effects are to be avoided. When compared with tamoxifen, AIs are associated with significantly improved disease-free survival, however no OS advantage has been noted. Potential toxicities such as bone loss, dyslipidemia, musculoskeletal and cardiovascular health issues should be taken into consideration when AIs are to be used.

Objective: This article summarizes the process of developing and evaluating a series of alcohol educational leaflets with pregnant women.

Methods: Four group interviews were conducted with a total of 33 pregnant women.

Results: The copy, font, and color should be tailored to pregnant women. Scientifically compelling information was preferred; the use of too many colors and objects was considered distracting and reducing the seriousness of the information. The facts presented through a patient's photo of fetal alcohol syndrome and a graph impressed the participants, since they were tired of the illustrations found in many other materials. Pregnant women who are interested and motivated to learn about alcohol consumption valued the quality of the information, rather than visual appeal.

Conclusions: Testing a draft leaflet with the target population before final development and dissemination is a critical component of an educational outreach effort. Incorporating feedback can help enhance the quality of the end product.