1,721,455 research outputs found
Osteoporosis management in patients with breast cancer : EMAS position statement
No full textAromatase inhibitors (AIs) are the first-line recommended standard of care for postmenopausal estrogen receptor-positive breast cancer. Because they cause a profound suppression of estrogen levels, concerns regarding their potential to increase the risk of fracture were rapidly raised. There is currently a general consensus that a careful baseline evaluation is needed of the risk of fracture in postmenopausal women about to start treatment with AIs but also in all premenopausal women with early disease. Bisphosphonates have been shown in several phase III trials to prevent the bone loss induced by cancer treatment, although no fracture data are available. Even though they do not have regulatory approval for this indication, their use must be discussed with women at high risk of fracture. Accordingly, several guidelines recommend considering treatment in women with a T-score â¤â2 or those with two or more clinical risk factors. Moreover, recent data suggest that bisphosphonates, especially intravenous zoledronic acid, may have an anticancer effect, in that they reduce bone recurrence as well as extra-skeletal metastasis and breast cancer mortality in postmenopausal women. The anti-RANK ligand antibody denosumab is also emerging as a new adjuvant therapeutic option to prevent AI-induced bone loss. It has been shown to extend the time to first fracture in postmenopausal women treated with AIs. Several issues still need to be addressed regarding the use of these different agents in an adjuvant setting. The purpose of this position statement is to review the literature on antifracture therapy and to discuss the current guidelines for the management of osteoporosis in women with early breast cancer
A model of care for healthy menopause and ageing: EMAS position statement
No full textWorldwide, the number of menopausal women is increasing. They present with complex medical issues that lie beyond the traditional scope of gynaecologists and general practitioners (GPs). The European Menopause and Andropause Society (EMAS) therefore provides a holistic model of care for healthy menopause (HM). The HM healthcare model's core consists of a lead clinician, specialist nurse(s) and the woman herself, supported by an interdisciplinary network of medical experts and providers of alternative/complementary medicine. As HM specialist teams are scarce in Europe, they are also responsible for structuring and optimizing processes in primary care (general gynaecologists and GPs) and secondary care (HM specialists). Activities for accreditation of the subspecialty Women's Health are encouraged
EMAS recommendations for conditions in the workplace for menopausal women.
Full text linkWomen form a large part of many workforces throughout Europe. Many will be working throughout their menopausal years. Whilst the menopause may cause no significant problems for some, for others it is known to present considerable difficulties in both their personal and working lives. During the menopausal transition women report that fatigue and difficulties with memory and concentration can have a negative impact on their working lives. Furthermore, hot flushes can be a source of embarrassment and distress. Some consider that these symptoms can impact on their performance. Greater awareness among employers, together with sensitive and flexible management can be helpful for women at this time. Particular strategies might include: fostering a culture whereby employees feel comfortable disclosing health problems, allowing flexible working, reducing sources of work-related stress, providing easy access to cold drinking water and toilets, and reviewing workplace temperature and ventilation
The relationship between the dietary inflammatory index and risk of total cardiovascular disease, ischemic heart disease and cerebrovascular disease: findings from an Australian population-based prospective cohort study of women
No full textBackground and aims Recently, a pro-inflammatory diet based on a dietary inflammatory index (DII) has been related to higher CVD risk in general population, but this has not been investigated among women. Methods We investigated the relationship between DII and risk of total CVD and CVD subgroups (myocardial infarction, ischemic heart disease, stroke and cerebrovascular disease) in a prospective cohort of 6972 Australian women aged 50–55 years at baseline in 2001. We used clinical and procedure information from inpatient hospital separation registries, information on use of health care services, and from the causes-of-death registry to ascertain CVD outcomes during 11-year follow up. The association between baseline DII score and cardiovascular endpoints was analysed through cox-regression, with correction for demographic and cardiovascular risk factors. Results We identified 335 incident cases of CVD and 191 cases of ischaemic heart disease (including 69 myocardial infarctions) and 59 cases of cerebrovascular disease (including 40 cases of stroke). A statistically significant higher risk of myocardial infarction was observed in analyses using DII scores as a continuous variable with a hazard ratio of 1.46 (95% confidence interval 1.12–1.89), but this was attenuated by further adjustment for other known cardiovascular risk factors. No association was found for total CVD, ischaemic heart diseases, or cerebrovascular disease. Conclusions There was no statistically significant association between the dietary inflammatory index and risk of total cardiovascular disease, ischemic heart disease, myocardial infarction, cerebrovascular disease or stroke in this population of mid-aged Australian women. Associations were not different for postmenopausal women
Air pollution exposure and incidence of cardiometabolic diseases:Exploring the modifying role of dietary antioxidant intake in adults
No full textWhile the antioxidative potential of certain vitamins and minerals in cardio-protection has garnered increasing interest, their ability to attenuate associations between air pollution exposure and cardiometabolic diseases (CMDs) remains unexplored. This study examined the associations of air pollution (particulate matter including ultrafine particles (UFP), and nitrogen oxides, including NO2 and NOx) and six dietary antioxidants with incident non-fatal CMDs in 30,519 EPIC-NL study participants. Data on CMD incidence (total cardiovascular disease (CVD), acute myocardial infarction (AMI), coronary heart disease (CHD) and heart failure (HF)) and Type 2 Diabetes Mellitus (T2DM) diagnoses were obtained from medical registries. Annual average ambient concentrations of air pollutants at the participants’ baseline residential addresses were predicted using land use regression models. Dietary intake of antioxidants was assessed via a food frequency questionnaire. Multivariable Cox regression models were used to explore associations. Exposures to NO2 and UFP were associated with elevated HF risk (Hazard Ratio (HR) (95 % CI): 1.24 (1.00, 1.54) and 1.69 (1.04, 2.76), respectively). Higher beta-carotene intake was associated with reduced risk of total CVD and CHD incidence (HR (95 % CI): 0.94 (0.89, 0.99) and 0.92 (0.84, 0.99), respectively), whereas, in general, antioxidant intake was positively associated with incident T2DM. Interaction analyses indicated some variability in CMD risk by antioxidant intake, but none of these interactions remained significant after correcting for multiple comparisons. These findings indicate that the associations of air pollution with incident CMD do not differ by dietary antioxidant intake.</p
Sex hormone-binding globulin may explain sex differences for glucose homeostasis and incidence of type 2 diabetes: the KORA study.
Full text linkResearch has indicated that sex hormone-binding globulin (SHBG) is associated with glucose homeostasis and may play a role in the etiology of type 2 diabetes (T2D). While it is unclear whether SHBG may mediate sex differences in glucose control and subsequently, incidence of T2D. We used observational data from the German population-based KORA F4 study (n = 1937, mean age: 54 years, 41% women) and its follow-up examination KORA FF4 (median follow-up 6.5 years, n = 1387). T2D was initially assessed by self-report and validated by contacting the physicians and/ or reviewing the medical charts. Mediation analyses were performed to assess the role of SHBG in mediating the association between sex (women vs. men) and glucose- and insulin-related traits (cross-sectional analysis) and incidence of T2D (longitudinal analysis). After adjustment for confounders, (model 1: adjusted for age; model 2: model 1 + smoking + alcohol consumption + physical activity), women had lower fasting glucose levels compared to men (β = -4.94 (mg/dl), 95% CI: -5.77, -4.11). SHBG levels were significantly higher in women than in men (β = 0.47 (nmol/l), 95% CI:0.42, 0.51). Serum SHBG may mediate the association between sex and fasting glucose levels with a proportion mediated (PM) of 30% (CI: 22-41%). Also, a potential mediatory role of SHBG was observed for sex differences in incidence of T2D (PM = 95% and 63% in models 1 and 2, respectively). Our novel findings suggest that SHBG may partially explain sex-differences in glucose control and T2D incidence
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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