BACKGROUND & AIMS: :The effect of ascorbic acid on iron retention from a diet with predicted low iron bioavailability (containing minimal meat and ascorbic acid) was investigated in iron-depleted premenopausal women. Eleven women were depleted of storage iron (indicated by serum ferritin) through a combination of diet (5.0 mg Fe/2000 kcal for 67-88 d) and phlebotomy. They then consumed a diet containing 13.7 mg Fe/2000 kcal, supplemented with placebo or ascorbic acid three times daily (1500 mg total) with meals for 5.5 wk. Ascorbic acid improved apparent iron absorption (balance method) [38 +/- 2% (means +/- SEM) vs 27 +/- 2%]. Ascorbic acid also improved hemoglobin, erythrocyte protoporphyrins, and serum iron but not hematocrit, serum ferritin, iron-binding capacity, or transferrin saturation. In iron-depleted women consuming a diet with predicted poor iron availability, ascorbic acid supplementation enhanced body iron retention for 5.5 wk.

背景与目标： : 在铁缺乏的绝经前妇女中，研究了抗坏血酸对铁生物利用度较低 (含有最少的肉和抗坏血酸) 饮食中铁保留的影响。通过饮食 (5.0 mg Fe/2000 kcal，治疗67-88 d) 和放血术，11名妇女耗尽了储存铁 (由血清铁蛋白指示)。然后，他们食用含有13.7 mg Fe/2000 kcal的饮食，补充有安慰剂或抗坏血酸，每天三次 (总共1500 mg)，并进餐5.5周。抗坏血酸改善了铁的表观吸收 (平衡法) [38 +/- 2% (平均值 +/- SEM) 对27 +/- 2%]。抗坏血酸还可以改善血红蛋白，红细胞原卟啉和血清铁，但不能改善血细胞比容，血清铁蛋白，铁结合能力或转铁蛋白饱和度。在消耗铁的女性中，饮食中预计铁利用率较差，抗坏血酸补充剂可提高5.5周的体内铁保留率。

BACKGROUND & AIMS: BACKGROUND:Evidence-based guidelines recommend limited perioperative diagnostic imaging for new breast cancer diagnoses. For patients aged >65 years, conventional imaging use (mammography, plain radiographs, and ultrasound) has remained stable, whereas advanced imaging (computed tomography [CT], nuclear medicine scans [positron emission tomography/bone scans], and magnetic resonance imaging [MRI]) use has increased. In this study, the authors evaluated traditional and advanced imaging use among younger patients (aged ≤ 65 years) undergoing breast cancer surgery. METHODS:The MarketScan Commercial Claims and Encounters Research Database from 2005 through 2008 was analyzed to evaluate the use of conventional and advanced diagnostic imaging associated with surgery for ductal carcinoma in situ (DCIS) or stage I through III invasive breast cancer. RESULTS:The study cohort included 52,202 women (13% with DCIS and 87% with stage I-III breast cancer). The proportion of patients undergoing conventional imaging remained stable, whereas the average number of conventional imaging tests per patient increased from 4.21 tests in 2005 to 4.79 tests per patient in 2008 (P < .0001). For advanced imaging, the proportion of women who underwent imaging increased from 48.8% in 2005 to 68.8% in 2008 (P < .0001), as did the number of tests per patient (from 1.53 tests in 2005 to 1.98 tests in 2008; P < .0001). MRI examinations accounted for nearly all of the increase in advanced imaging. Patients who underwent MRI examinations received significantly more traditional imaging tests compared with to those who did not, indicating that these tests are additive and are not replacing traditional imaging. CONCLUSIONS:The current results demonstrate that the use of perioperative breast MRI has increased among women aged <65 years. Further study is indicated to determine whether the benefits of this procedure justify increased use.

背景与目标：

BACKGROUND & AIMS: :Nut consumption is associated with a reduced risk of type 2 diabetes mellitus (T2DM). The aim of the present study was to assess the effects of adding peanuts (whole or peanut butter) on first (0-240 min)- and second (240-490 min)-meal glucose metabolism and selected gut satiety hormone responses, appetite ratings and food intake in obese women with high T2DM risk. A group of fifteen women participated in a randomised cross-over clinical trial in which 42·5 g of whole peanuts without skins (WP), peanut butter (PB) or no peanuts (control) were added to a 75 g available carbohydrate-matched breakfast meal. Postprandial concentrations (0-490 min) of glucose, insulin, NEFA, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), appetitive sensations and food intake were assessed after breakfast treatments and a standard lunch. Postprandial NEFA incremental AUC (IAUC) (0-240 min) and glucose IAUC (240-490 min) responses were lower for the PB breakfast compared with the control breakfast. Insulin concentrations were higher at 120 and 370 min after the PB consumption than after the control consumption. Desire-to-eat ratings were lower, while PYY, GLP-1 and CCK concentrations were higher after the PB intake compared with the control intake. WP led to similar but non-significant effects. The addition of PB to breakfast moderated postprandial glucose and NEFA concentrations, enhanced gut satiety hormone secretion and reduced the desire to eat. The greater bioaccessibility of the lipid component in PB is probably responsible for the observed incremental post-ingestive responses between the nut forms. Inclusion of PB, and probably WP, to breakfast may help to moderate glucose concentrations and appetite in obese women.

背景与目标： : 食用坚果与降低2型糖尿病 (T2DM) 的风险相关。本研究的目的是评估添加花生 (全或花生酱) 对第一 (0-240分钟) 和第二 (240-490分钟) 膳食葡萄糖代谢和选定的肠道饱腹激素反应的影响，高T2DM风险肥胖女性的食欲等级和食物摄入。一组15名妇女参加了一项随机交叉临床试验，其中将42·5克不含皮 (WP)，花生酱 (PB) 或无花生 (对照) 的全花生添加到75克可用的碳水化合物匹配早餐中。在早餐治疗和标准午餐后，评估餐后葡萄糖，胰岛素，NEFA，胰高血糖素样肽-1 (GLP-1)，肽YY (PYY)，胆囊收缩素 (CCK)，食欲感和食物摄入量的浓度 (0-490分钟)。与对照早餐相比，PB早餐的餐后NEFA增量AUC (IAUC) (0-240分钟) 和葡萄糖IAUC (240-490分钟) 响应较低。PB消耗后120和370分钟的胰岛素浓度高于对照消耗后的胰岛素浓度。与对照摄入量相比，摄入PB后的饮食欲望等级较低，而PYY，GLP-1和CCK浓度较高。WP导致了类似但不显著的影响。早餐中添加PB可降低餐后葡萄糖和NEFA的浓度，增强肠道饱腹激素的分泌并降低进食欲望。PB中脂质成分的更大的生物可及性可能是观察到的坚果形式之间摄入后的增量反应的原因。在早餐中加入PB (可能是WP) 可能有助于减轻肥胖女性的葡萄糖浓度和食欲。

BACKGROUND & AIMS: OBJECTIVE:Breast-feeding is associated with maternal health, such as electrolyte metabolism, lipid profile and body component change. The aim of this study was to evaluate the relationship between duration of breast-feeding and obesity in postmenopausal women. METHODS:We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012, a cross-sectional study in a Korean population. A total of 6621 postmenopausal women were analyzed. RESULTS:Body mass index and waist circumference were greater in women who had breast-fed for 6 months or more than in those who had not (BMI: 23.7±0.1 vs 24.5±0.1, P<0.0001; WC: 80.6±0.4 vs 82.8±0.3, P<0.001). This association persisted after adjustment for confounding factors (BMI: odds ratio[OR]1.54, 95% confidence interval[CI] 1.19-2.0; WC: OR1.67, 95% CI 1.29-2.17). The duration of breast-feeding tended to increase with increasing BMI and WC (P for trend, 0.001 for each). The proportions of women with greater BMI and WC increased with increasing duration of breast-feeding (27.3% in ≤6 months vs 41.2% in >18months, P<0.0001). CONCLUSION:The results of this study suggest that prolonged breast-feeding may be associated with greater BMI and WC among postmenopausal women.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Many women with hormone receptor-positive breast cancer discontinue effective aromatase inhibitor (AI) treatment due to joint symptoms. METHODS:We conducted a single-arm, open-label, phase II study evaluating glucosamine-sulfate (1,500 mg/day) + chondroitin-sulfate (1,200 mg/day) for 24 weeks to treat joint pain/stiffness in postmenopausal women with early stage breast cancer who developed moderate-to-severe joint pain after initiating AIs. The primary endpoint was improvement in pain/stiffness at week 24 assessed by the Outcome Measure in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria. Secondary endpoints assessed changes in pain, stiffness, and function using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index for hips/knees and the Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH) for hands/wrists. The Brief Pain Inventory (BPI) assessed pain interference, severity, and worst pain. RESULTS:Of 53 patients enrolled, 39 were evaluable at week 24. From baseline to week 24, 46 % of patients improved according to OMERACT-OARSI criteria. At week 24, there were improvements (all P < 0.05) in pain and function as assessed by WOMAC and M-SACRAH, and in pain interference, severity, and worst pain as assessed by BPI. Estradiol levels did not change from baseline. The most commonly reported side effects were headache (28 %), dyspepsia (15 %), and nausea (17 %). CONCLUSIONS:In this single-arm study, 24 weeks of glucosamine/chondroitin resulted in moderate improvements in AI-induced arthralgias, with minimal side effects, and no changes in estradiol levels. These results suggest a need to evaluate efficacy in a placebo-controlled trial.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. STUDY DESIGN:In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265). The study population was followed until 2013. A total of 364 553 mother-firstborn-offspring pairs were analyzed. Sixty-one women with Marfan syndrome became mothers. Women with Marfan syndrome were also compared to 543 healthy controls. RESULTS:Women with Marfan syndrome were more often born preterm (p<0.001), small-for-gestational age (p<0.001), and delivered by cesarean section (p=0.001). Women with Marfan syndrome had no increased risk of giving birth by cesarean section (p=0.079). No increased neonatal risks in their children were found. Women with Marfan syndrome were less likely to give birth than those without (p<0.001). There were no maternal deaths. CONCLUSIONS:Women with Marfan syndrome were more likely to be born preterm, SGA and by cesarean section. These increased risks of preterm birth and SGA babies were not found in connection with their own first childbirth. Pregnancies with known fetal Marfan syndrome have to be carefully monitored. The results are important for obstetricians giving preconception counseling and treating women with Marfan syndrome. Further studies are needed to evaluate risks during pregnancy and long-term effects of pregnancy on the cardiovascular status of women with Marfan syndrome.

背景与目标：

BACKGROUND & AIMS: :In a previous study it was shown that lower factor XI (FXI) levels in women with heavy menstrual bleeding (HMB). Our aim was to determine the single-nucleotide variants (SNVs) in the F11 gene in women with HMB. In addition, an extensive literature search was performed to determine the clinical significance of each SNV. Patients referred for HMB (PBAC-score >100) were included. With direct sequencing analysis of all 15 exons and flanking introns of the F11 gene, 29 different non-structural SNVs were detected in 49 patients with HMB. Interestingly, most of these SNVs have previously been associated with venous thrombosis instead of bleeding. These findings have not helped to elucidate the molecular basis of HMB. They also question the specificity of previously reported F11 variations in patients with thrombosis. More studies are needed to explain the lower FXI levels seen in patients with HMB. IMPACT STATEMENT Women with mild deficiencies of factor XI (FXI) (< 70%) are prone to excessive bleeding during menstruation. Bleeding manifestations are not well correlated with plasma FXI levels and bleeding episodes can vary widely among patients with similar low FXI levels. In a previous study we showed that women with heavy menstrual bleeding (HMB) had normal, but on average, lower levels of FXI than controls. In light of these findings, we performed F11 gene analysis to determine the single-nucleotide variants (SNVs) in women with HMB and performed an extensive literature search to determine the clinical significance of each SNV. By direct sequencing analysis of the F11 gene we found 29 different non-structural SNVs in 49 women with heavy menstrual bleeding. Remarkably, a number of these SNVs have previously been implicated in thrombosis. These findings have not helped to elucidate the molecular basis of lower FXI levels in HMB. They also question the specificity of previously reported F11 variations in patients with thrombosis. More studies are needed to explain the lower FXI levels seen in patients with HMB.

背景与目标： : 在先前的研究中，显示月经大量出血 (HMB) 女性的因子XI (FXI) 水平较低。我们的目的是确定HMB女性F11基因中的单核苷酸变体 (snv)。此外，还进行了广泛的文献检索，以确定每种SNV的临床意义。纳入HMB转诊的患者 (PBAC评分> 100)。通过对F11基因的所有15个外显子和侧翼内含子的直接测序分析，在49例HMB患者中检测到29种不同的非结构性snv。有趣的是，这些snv中的大多数以前都与静脉血栓形成有关，而不是出血。这些发现无助于阐明HMB的分子基础。他们还质疑先前报道的F11变异在血栓形成患者中的特异性。需要更多的研究来解释HMB患者中较低的FXI水平。影响声明轻度缺乏因子XI (FXI) (<  70%) 的女性在月经期间容易出血过多。出血表现与血浆FXI水平没有很好的相关性，在FXI水平相似的患者中，出血发作可能有很大差异。在先前的研究中，我们表明，月经大量出血 (HMB) 的女性FXI水平正常，但平均而言，低于对照组。根据这些发现，我们进行了F11基因分析以确定HMB女性的单核苷酸变异体 (SNV)，并进行了广泛的文献检索以确定每种SNV的临床意义。通过对F11基因的直接测序分析，我们在49名月经大量出血的女性中发现了29种不同的非结构性snv。值得注意的是，这些snv中的许多以前都与血栓形成有关。这些发现无助于阐明HMB中FXI水平较低的分子基础。他们还质疑先前报道的F11变异在血栓形成患者中的特异性。需要更多的研究来解释HMB患者中较低的FXI水平。

BACKGROUND & AIMS: :We explored the attitudes of women at midlife to web-based interventions for promoting physical activity. 145 women volunteered to participate in one of four online forums. The forums were for four major racial/ethnic groups. 90 volunteers were recruited for the online forums (29 Whites, 23 Hispanics, 21 African Americans, and 17 Asians). Two sets of topics on attitudes to physical activity and racial/ethnic contexts were used. Each topic had some introductory questions and related prompts, and these were posted on the online forum sites in a serial fashion during the six-month period. We used a thematic analysis. Four major themes emerged: (1) 'a matter of the source of the information'; (2) 'I can pace myself'; (3) 'lack of interpersonal interactions'; and (4) 'culture-specificity and low cost.' The women in all ethnic groups thought that the source of the information was much more important than the medium of the information (e.g. web-based, booklet or face-to-face). They liked the self-controllability in web-based interventions. They preferred web-based interventions to other types of interventions because of easy accessibility, but they were concerned about lack of interpersonal interaction. None of the White or African American women indicated the need for culture-specificity in web-based interventions, but Hispanic and Asian women indicated that culture-specific interventions should be provided. Web-based interventions appear to have several advantages over conventional approaches to promoting physical activity.

背景与目标： : 我们探讨了中年妇女对基于网络的干预措施以促进体育锻炼的态度。145妇女自愿参加四个在线论坛之一。论坛面向四个主要种族/族裔群体。在线论坛招募了90名志愿者 (29名白人，23名西班牙裔，21名非裔美国人和17名亚洲人)。使用了两套关于体育活动态度和种族/族裔背景的主题。每个主题都有一些介绍性问题和相关提示，这些问题在六个月内以连续方式发布在在线论坛网站上。我们使用了主题分析。出现了四个主要主题 :( 1) “信息来源问题”; (2) “我可以调整自己”; (3) “缺乏人际互动”; (4) “文化特殊性和低成本”。所有种族的妇女都认为信息的来源比信息的媒介 (例如基于网络的，小册子或面对面的) 重要得多。他们喜欢基于网络的干预中的自我控制性。由于易于访问，他们更喜欢基于网络的干预措施，而不是其他类型的干预措施，但他们担心缺乏人际互动。在基于网络的干预措施中，没有白人或非洲裔美国妇女表示需要文化特异性，但是西班牙裔和亚裔妇女表示应提供针对文化的干预措施。与传统的促进体育锻炼的方法相比，基于网络的干预似乎具有几个优势。

BACKGROUND & AIMS: :Menopausal hormone treatment (MHT) may limit progression of cardiovascular disease (CVD) but poses a thrombosis risk. To test targeted candidate gene variation for association with subclinical CVD defined by carotid artery intima-media thickness (CIMT) and coronary artery calcification (CAC), 610 women participating in the Kronos Early Estrogen Prevention Study (KEEPS), a clinical trial of MHT to prevent progression of CVD, were genotyped for 13,229 single nucleotide polymorphisms (SNPs) within 764 genes from anticoagulant, procoagulant, fibrinolytic, or innate immunity pathways. According to linear regression, proportion of European ancestry correlated negatively, but age at enrollment and pulse pressure correlated positively with CIMT. Adjusting for these variables, two SNPs, one on chromosome 2 for MAP4K4 gene (rs2236935, β = 0.037, P value = 2.36 × 10(-06)) and one on chromosome 5 for IL5 gene (rs739318, β = 0.051, P value = 5.02 × 10(-05)), associated positively with CIMT; two SNPs on chromosome 17 for CCL5 (rs4796119, β = -0.043, P value = 3.59 × 10(-05); rs2291299, β = -0.032, P value = 5.59 × 10(-05)) correlated negatively with CIMT; only rs2236935 remained significant after correcting for multiple testing. Using logistic regression, when we adjusted for waist circumference, two SNPs (rs11465886, IRAK2, chromosome 3, OR = 3.91, P value = 1.10 × 10(-04); and rs17751769, SERPINA1, chromosome 14, OR = 1.96, P value = 2.42 × 10(-04)) associated positively with a CAC score of >0 Agatston unit; one SNP (rs630014, ABO, OR = 0.51, P value = 2.51 × 10(-04)) associated negatively; none remained significant after correcting for multiple testing. Whether these SNPs associate with CIMT and CAC in women randomized to MHT remains to be determined.

背景与目标： : 更年期激素治疗 (MHT) 可能会限制心血管疾病 (CVD) 的进展，但会带来血栓形成的风险。为了测试与颈动脉内膜中层厚度 (CIMT) 和冠状动脉钙化 (CAC) 定义的亚临床CVD相关的靶向候选基因变异，610参加Kronos早期雌激素预防研究 (KEEPS) 的妇女，MHT预防CVD进展的临床试验，在抗凝剂，促凝剂，纤溶或先天免疫途径的764基因内对13,229单核苷酸多态性 (snp) 进行基因分型。根据线性回归，欧洲血统的比例呈负相关，但入学年龄和脉压与CIMT呈正相关。调整这些变量，两个snp，一个在2号染色体上的MAP4K4基因 (rs2236935，β = 0.037，p值 = 2.36 × 10(-06))，一个在5号染色体上的IL5基因 (rs739318，β = 0.051，p值 = 5.02 × 10(-05))，与CIMT呈正相关; CCL5 17号染色体上的两个snp (rs4796119，β = -0.043，p值 = 3.59 × 10(-05); rs2291299，β = -0.032，p值 = 5.59 × 10(-05)) 与CIMT呈负相关; 校正多重测试后，只有rs2236935仍然显著。使用逻辑回归，当我们调整腰围时，两个snp (rs11465886，IRAK2，3号染色体，OR = 3.91，p值 = 1.10 × 10(-04); 和rs17751769，SERPINA1，14号染色体，OR = 1.96，p值 = 2.42 × 10(-04)) 与> 0 Agatston单位的CAC评分呈正相关; 1个SNP (rs630014，ABO，OR = 0.51，p值 = 2.51 × 10(-04)) 呈负相关; 校正多重测试后无显著。这些snp是否与CIMT和CAC相关，在随机分配到MHT的女性中仍有待确定。

BACKGROUND & AIMS: :Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.

背景与目标： : 筛查计划可以减轻疾病负担，但是，它们可能与焦虑水平升高有关。遗传性非息肉病性结直肠癌 (HNPCC) 发生子宫内膜癌和卵巢癌的风险增加。目前尚无前瞻性证据支持在HNPCC中筛查妇科疾病，但是，目前的建议包括使用超声和子宫内膜活检。这项研究评估了筛查妇科癌症对自我报告的焦虑，抑郁和健康观念的影响。来自HNPCC家庭的女性 (n = 26) 在接受经阴道超声，门诊/办公室宫腔镜检查，子宫内膜活检和卵巢肿瘤标志物评估 (CA125) 进行筛查之前，完成了医院焦虑和抑郁量表和ShortForm36v2问卷。在筛选后的3个月和6个月 (15/26) 完成相同的问卷。与其他人群相比，参加妇科筛查的HNPCC家庭中的女性在基线时没有过度的焦虑或抑郁症状。筛查过程和假阳性筛查结果对焦虑抑郁症状或健康感知无显著影响。我们得出的结论是，在这个小型研究组的分析局限性内，在HNPCC中筛查妇科疾病似乎与任何心理疾病无关。

BACKGROUND & AIMS: :Lack of applicable safety data has effected an ease in federal restriction on the inclusion of women in clinical trials, particularly because: (1) they consume more prescription and over-the-counter medications than do men; (2) most require some type of drug therapy during pregnancy; and (3) many drugs that have been withdrawn from the market had higher health risks for women. The desire for more women-specific data prompted the Women's Health Initiative (WHI) studies, which reported an unfavorable risk-benefit relationship for hormone replacement therapy (HRT), as well as no significant reduction in disease or fracture risk with calcium and vitamin D supplementation but possible kidney stone development. Although the health risks were minimal, physicians feared any possible litigation involved with the use of HRT and were concerned with any possible adverse effects from calcium supplementation, and therefore altered their prescribing practices. Women, fearing any long-term health risks, also began seeking alternative treatments. However, the safety of these alternative therapies may be questionable, because they often are not subjected to extensive scrutiny and do not require federal approval. Alternative prescription drug treatments may have long-term adverse consequences that will only become evident with years of use. It is important to recognize that over-generalization and extrapolation of data may deny appropriate treatment to certain subgroups of women who may benefit.

背景与目标： : 缺乏适用的安全性数据已使联邦政府对将女性纳入临床试验的限制变得容易，特别是因为 :( 1) 她们比男性服用更多的处方药和非处方药; (2) 大多数人在怀孕期间需要某种类型的药物治疗; (3) 许多已退出市场的药物对女性的健康风险更高。对更多针对女性的数据的渴望促使了妇女健康倡议 (WHI) 的研究，该研究报告了激素替代疗法 (HRT) 的不利风险-收益关系，并且钙和维生素d补充剂没有显着降低疾病或骨折风险，但可能会发展肾结石。尽管健康风险很小，但医生担心与使用HRT有关的任何可能的诉讼，并担心钙补充剂可能产生的不利影响，因此改变了他们的处方做法。担心任何长期健康风险的女性也开始寻求替代疗法。但是，这些替代疗法的安全性可能值得怀疑，因为它们通常不受广泛审查，也不需要联邦批准。替代处方药治疗可能会产生长期的不良后果，只有在使用多年后才会变得明显。重要的是要认识到，数据的过度概括和推断可能会拒绝对可能受益的某些妇女亚组进行适当的治疗。

BACKGROUND & AIMS: PURPOSE:The purpose of this study was to assess demographic characteristics of women prescribed beta-blocker (beta-blocker) medication and compare to those not using beta-blocker medication, and to determine if there are differences in depression and fatigue among women who used beta-blockers compared to nonusers 6-12 months after myocardial infarction (MI). DATA SOURCES:This was a descriptive cross-sectional study of 84 women (61 using beta-blockers and 23 not using beta-blockers) aged 65 and older who were 6-12 months post-MI. Women had their height and weight measured and completed a Demographic Health Form, the Geriatric Depression Scale, and the Revised Piper Fatigue Scale (RPFS). CONCLUSIONS:While most of the women were taking beta-blockers after MI (74%), significantly fewer Black women were taking beta-blockers (chi(2) = 5.086, p = 0.032). Most of the beta-blocker users were overweight or obese. There were no significant differences in age, t(82) = 0.7, p = 0.486; body mass index, t(82) = 0.76, p = 0.445; income, chi(2)(df = 2) = 3.219, p = 0.075; mean depression, t(82) = 1.648, p = 0.103; or fatigue scores, t(82) = 0.993, p = 0.324, between beta-blocker users and nonusers. More of those not taking beta-blockers reported fatigue with significantly higher fatigue in the affective meaning dimension of the RPFS, t(82) = 2.272, p = 0.03. IMPLICATIONS FOR PRACTICE:beta-Blocker medication continues to be underutilized in older women. Because no difference was noted in fatigue and depression in the two groups, these may mean that these side effects are not barriers in prescribing this medication post-MI. Nurse practitioners are in pivotal positions to monitor the ongoing physiological and psychological sequelae post-MI and implement interventions to improve their outcomes.

背景与目标：

BACKGROUND & AIMS: :In Austria, microcensus surveys on self-reported morbidity are carried out at regular intervals every ten years, generally by the Federal Statistic Centre. In the following, we describe an epidemiological observational service which could be regarded as an additional public health instrument. This service is termed "health monitor", and the SERMO (self-reported morbidity) study is the scientific project associated with it. The "health monitor" data provide information on the prevalence of various illnesses and impairment, characteristics and variables of background morbidity by repeated short-term representative surveys on self-reported morbidity. The health monitor permits continual observation of the background morbidity of an entire population, while scientific questions pertaining to the SERMO study can be investigated via the health monitor data base. Self-reported morbidity data provide important information about the health of a general population, in addition to clinical and mortality data, and help to make decisions in health policy. By collecting informations (e.g. nearly every month) on background morbidity, "health monitor" and SERMO project could complement other Austrian public health systems to measure the overall health of the population in general.

背景与目标： : 在奥地利，一般由联邦统计中心每十年定期进行一次自我报告发病率的微普查调查。在下文中，我们描述了一种流行病学观察服务，可以将其视为一种额外的公共卫生工具。这项服务被称为 “健康监视器”，SERMO (自我报告的发病率) 研究是与之相关的科学项目。“健康监测” 数据通过对自我报告的发病率进行反复的短期代表性调查，提供了有关各种疾病的患病率和损害，背景发病率的特征和变量的信息。健康监测仪允许持续观察整个人群的背景发病率，而与SERMO研究有关的科学问题可以通过健康监测仪数据库进行调查。自我报告的发病率数据除了临床和死亡率数据外，还提供了有关普通人群健康的重要信息，并有助于制定卫生政策。通过收集有关背景发病率的信息 (例如几乎每个月)，“健康监测” 和SERMO项目可以补充其他奥地利公共卫生系统，以衡量总体人口的总体健康状况。

BACKGROUND & AIMS: :The objective of this study was to answer the question of whether a double instead of triple embryo transfer strategy in patients over 38 years would substantially reduce the number of multiple pregnancies while maintaining the chance of a term live birth at an acceptable level. A randomized controlled two-centre trial was performed. Forty-five patients, 38 years or older, were randomized. Double embryo transfer over a maximum of four cycles (DET group) or triple embryo transfer over a maximum of three cycles (TET group) was performed. The cumulative term live birth rate was 47.3% after four cycles in the DET group and 40.5% after three cycles in the TET group. The difference between the DET and the TET group was 6.8% in favour of the DET group (95% CI -25 to 38). The multiple pregnancy rates in the DET and TET group were 0% (95% CI 0 to 24) and 30% (95% CI 7 to 65) respectively (P = 0.05). In the DET patients, the mean number of treatment cycles was 2.9 compared with 2.1 in the TET group (P = 0.01). In women of 38 years and older, double embryo transfer after IVF may result in similar cumulative term live birth rates compared with triple embryo transfer, provided that a higher number of treatment cycles is accepted.

背景与目标： : 这项研究的目的是回答以下问题: 在38岁以上的患者中采用双重而不是三重胚胎移植策略是否会大大减少多胎妊娠的数量，同时将足月活产的机会保持在可接受的水平。进行了一项随机对照的两中心试验。45名38岁或以上的患者被随机分组。进行了最多四个周期的双胚胎移植 (DET组) 或最多三个周期的三胚胎移植 (TET组)。在DET组中，在四个周期后47.3% 累积足月活产率，在TET组中，在三个周期后40.5%。DET和TET组之间的差异6.8% 有利于DET组 (95% CI -25至38)。DET组和TET组的多次妊娠率分别为0% (95% CI 0 ~ 24) 和30% (95% CI 7 ~ 65) (P = 0.05)。在DET患者中，平均治疗周期数与TET组的2.1相比2.9 (P = 0.01)。在38岁及以上的女性中，如果接受更多的治疗周期，IVF后的双胚胎移植可能会导致与三胚胎移植相似的累积足月活产率。

BACKGROUND & AIMS: :The effect of body mass index (BMI) and obesity on apolipoprotein (apo) A-I levels and kinetics was examined by gender. Apo A-I kinetics were determined with a primed, constant infusion of deuterated leucine in the fed state in 19 men and 13 postmenopausal women. Compared with nonobese men, nonobese women had a higher level of high-density lipoprotein cholesterol (HDL-C) and apo A-I due to a 48% higher apo A-I production rate (PR) (P = .05). Obesity had no significant effects on apo A-I kinetics in women. In contrast, compared with nonobese men, obese men had a 9% lower apo A-I level due to a 64% higher fractional catabolic rate (FCR) partially offset by a 47% higher PR. Obese women had a 52% higher HDL-C than obese men (50 vs 33 mg/dL, respectively; P = .012), a finding related to the faster apo A-I FCR in obese men. BMI was directly correlated with apo A-I FCR (r = 0.84, P < .001) and PR (r = 0.79, P < .001) in men but not in women. Sixty-two percent of the variability in PR and 71% of the variability in FCR were due to BMI in men and only 3% and 23%, respectively, in women. In conclusion, BMI has a significant effect on apo A-I PR and FCR in men but not in women.

背景与目标： : 通过性别检查了体重指数 (BMI) 和肥胖对载脂蛋白 (apo) A-I水平和动力学的影响。在19名男性和13名绝经后女性中，通过在进食状态下持续不断地输注氘代亮氨酸来确定Apo A-I动力学。与非肥胖男性相比，非肥胖女性的高密度脂蛋白胆固醇 (hdl-c) 和apo a-I水平较高，原因是apo A-I的生产率 (PR) 48% 较高 (P = .05)。肥胖对女性的apo A-I动力学没有显着影响。相反，与非肥胖男性相比，肥胖男性的apo a-I水平9% 较低，这是由于64% 较高的分解代谢率 (FCR) 部分被47% 较高的PR抵消。肥胖女性的hdl-c比肥胖男性高52% (分别为50 vs 33 mg/dL; P = .012)，这一发现与肥胖男性的apo a-I FCR更快有关。BMI与男性的apo A-I FCR (r = 0.84，P <.001) 和PR (r = 0.79，P <.001) 直接相关，而女性则不相关。PR变异性的60 2% 和FCR变异性的71% 是由于男性的BMI，而女性分别只有3% 和23%。总之，BMI对男性的apo a-I PR和FCR有显着影响，而女性则没有。