Fracture history of healthy premenopausal women is associated with a reduction of cortical microstructural components at the distal radius

Bone ◽  
2013 ◽  
Vol 55 (2) ◽  
pp. 377-383 ◽  
Author(s):  
T. Chevalley ◽  
J.P. Bonjour ◽  
B. van Rietbergen ◽  
S. Ferrari ◽  
R. Rizzoli
Author(s):  
Ryosuke Takeda ◽  
Abigail S.L. Stickford ◽  
Stuart A. Best ◽  
Jeung-Ki Yoo ◽  
Yu-Lun Liu ◽  
...  

Excessive salt intake is considered a risk factor for the development of hypertension. Additionally, aberrant neuro-circulatory responses to a cold stimulus are associated with an increased risk of hypertension. This study aimed to determine whether salt loading versus salt reduction would impact hemodynamic and sympathetic neural responses during the cold pressor test (CPT) in premenopausal women with a history of normal pregnancy. Nine healthy premenopausal women [42±3 (SD) yr] were given a standardized isocaloric high salt (HS; 250 mEq sodium/day) or low salt (LS; 50 mEq sodium/day) diet for 1-week each (~2 months apart with the order randomized), while water intake was ad libitum. Laboratory testing was performed following each HS and LS period in the mid-luteal phase of the menstrual cycle. Subjects were in the supine position and beat-by-beat blood pressure (BP), heart rate (HR) and muscle sympathetic nerve activity (MSNA) were continuously measured during 1-minute baseline followed by 2-minute CPT and 3-minute recovery. BP and HR increased during the CPT (both P<0.001); the responses were similar between HS and LS. MSNA increased during the CPT, but the increment (D) was greater during HS than LS (29±6 vs. 15±4 bursts/min; P<0.001). The transduction of MSNA for vasoconstriction during the CPT was lower in HS (P<0.05). Thus, salt loading augments sympathetic neural reactivity to the cold stimulus with similar pressor responses compared to salt reduction, which may be attributed to the blunted neurovascular transduction ─ a compensatory mechanism for hemodynamic homeostasis in premenopausal women with a history of normal pregnancy.


2021 ◽  
Vol 104 (5) ◽  
pp. 709-714

Objective: To determine the rate of oophorectomy and associated factors at the time of hysterectomy in premenopausal women with benign diseases. Materials and Methods: The medical records of the premenopausal women that underwent hysterectomy with or without oophorectomy due to benign gynecologic conditions between January 1, 2012 and December 31, 2017 at Khon Kaen University Hospital (Thailand) were retrospectively reviewed. The data collected included age, BMI, parity, indication for surgery, family history of carcinoma, route of hysterectomy, procedure, specialization of the surgeon, operative notes, and histopathological reports of the ovaries. Results: Six hundred thirty-eight subjects underwent hysterectomy due to benign gynecologic conditions. Bilateral salpingo-oophorectomy (BSO) was performed in 57.37% (366) of the cases. In 81.97% (300) of these cases, either one or both patient’s ovaries were grossly normal. The rate of prophylactic oophorectomy among all cases was 47.02% (300 in 638). The strongest associated factor with BSO was age (odds ratio 8.421, 95% CI 5.488 to 12.921). Other associated factors were irregular menstrual history, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. No cases of ovarian cancer were found. Conclusion: Nearly half of premenopausal women that underwent hysterectomy due to benign conditions underwent prophylactic oophorectomy. Associated factors were age, irregular menstruation, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. Keywords: Hysterectomy, Premenopausal women, Prophylactic oophorectomy


2016 ◽  
Vol 21 (03) ◽  
pp. 307-312 ◽  
Author(s):  
Young Ho Shin ◽  
Hyun Sik Gong

Distal radius fracture (DRF) is the most common upper extremity fracture in the elderly. Patients with a DRF have a two to fourfold higher risk of a subsequent fracture than those with no history of fractures, and DRFs occur on average 15 years earlier than hip fractures. Therefore, patients with a DRF offer physicians an important opportunity to diagnose and treat osteoporosis to prevent a secondary fracture. In this review, we provide recent update in the diagnosis and treatment of bone frailty in patients with a DRF.


2020 ◽  
Vol 319 (3) ◽  
pp. H571-H581
Author(s):  
Ryosuke Takeda ◽  
Abigail S. Stickford ◽  
Stuart A. Best ◽  
Jeung-Ki Yoo ◽  
Qi Fu

This is the first study to demonstrate that MBPS and ambulatory BP were not affected by salt intake despite a significant change in sympathetic outflow in healthy premenopausal women with a history of normal pregnancy. This may be due to compensatory adaptations in MSNA and sympathetic vascular transduction during salt reduction versus salt loading.


BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Olivia Moran ◽  
Andrea Eisen ◽  
Rochelle Demsky ◽  
Kristina Blackmore ◽  
Julia A. Knight ◽  
...  

Abstract Background Mammographic density is one of the strongest risk factors for breast cancer. In the general population, mammographic density can be modified by various exposures; whether this is true for women a strong family history is not known. Thus, we evaluated the association between reproductive, hormonal, and lifestyle risk factors and mammographic density among women with a strong family history of breast cancer but no BRCA1 or BRCA2 mutation. Methods We included 97 premenopausal and 59 postmenopausal women (age range: 27-68 years). Risk factor data was extracted from the research questionnaire closest in time to the mammogram performed nearest to enrollment. The Cumulus software was used to measure percent density, dense area, and non-dense area for each mammogram. Multivariate generalized linear models were used to evaluate the relationships between breast cancer risk factors and measures of mammographic density, adjusting for relevant covariates. Results Among premenopausal women, those who had two live births had a mean percent density of 28.8% vs. 41.6% among women who had one live birth (P=0.04). Women with a high body weight had a lower mean percent density compared to women with a low body weight among premenopausal (17.6% vs. 33.2%; P=0.0006) and postmenopausal women (8.7% vs. 14.7%; P=0.04). Among premenopausal women, those who smoked for 14 years or longer had a lower mean dense area compared to women who smoked for a shorter duration (25.3cm2 vs. 53.1cm2; P=0.002). Among postmenopausal women, former smokers had a higher mean percent density (19.5% vs. 10.8%; P=0.003) and dense area (26.9% vs. 16.4%; P=0.01) compared to never smokers. After applying the Bonferroni correction, the association between body weight and percent density among premenopausal women remained statistically significant. Conclusions In this cohort of women with a strong family history of breast cancer, body weight was associated with mammographic density. These findings suggest that mammographic density may explain the underlying relationship between some of these risk factors and breast cancer risk, and lend support for the inclusion of mammographic density into risk prediction models.


2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Joao L. Cunha-Borges ◽  
Guillermo Meléndez Mier ◽  
Noemí Casas ◽  
Adriana Medina ◽  
Jose Fernando Molina ◽  
...  

Abstract Background Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America. Methods We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico. Results The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40–94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were − 3.02 (1.23) at the lumbar spine and − 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline. Conclusions This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.


2010 ◽  
Vol 4 ◽  
pp. BCBCR.S5248 ◽  
Author(s):  
Megumi Kuchiki ◽  
Takaaki Hosoya ◽  
Akira Fukao

We investigated the relationship between mammary gland volume (MGV) of the breast as measured with three-dimensional chest computed tomography (CT) and breast cancer risk. Univariate analysis was used to assess the relationship between MGV and known risk factors in 427 healthy women. A case control study (97 cases and 194 controls) was conducted to assess breast cancer risk. MGV was significantly smaller for postmenopausal women than for premenopausal women, and was significantly larger for women with a family history of breast cancer than for women without. MGV, body mass index (BMI), and rate of family history of breast cancer were significantly higher among breast cancer patients than among healthy women, and number of deliveries was significantly lower among breast cancer patients. In postmenopausal women, age at menarche was significantly younger for breast cancer patients. MGV correlated well with breast cancer risk factors. The highest odds ratio was 4.9 for premenopausal women with the largest MGV. Regardless of menopausal status, the greater the MGV, the higher the odds ratio. Our results constitute the first reliable data on the relationship between MGV and breast cancer obtained through exact volume analysis.


2000 ◽  
Vol 6 (1) ◽  
pp. 19-22
Author(s):  
Andrew Prentice

Endometriosis is an oestrogen sensitive condition, leading to reluctance to prescribe hormone replacement therapy. Treatment of endometriosis either medically with gonadotrophin releasing hormone analogues or with surgery involving bilateral oophorectomy leads to oestrogen deficiency. While this may lead to vasomotor symptoms, the consequence which has been of most concern is a reduction in bone mass. Repeated courses of gonadotrophin releasing hormone analogues may mean that women with endometriosis enter the menopause with a below average bone density. Thus, there is a place for hormone replacement therapy both as add-back therapy in premenopausal women receiving gonadotrophin releasing hormone analogues, and in postmenopausal women with a past history of endometriosis. Addback therapy with continuous combined regimes and tibolone do not prevent disease resolution in the hypogonadal patient. The evidence regarding the use of hormone replacement therapy in patients with a history of endometriosis is poor, but suggests that we could be less conservative than we have been.


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