Abstract:
OBJECTIVE:In a previous report, we described the results of a randomized, controlled trial that evaluated the potential of raloxifene to induce or exacerbate hot flushes. Here, we provide additional analyses that were undertaken to identify potential predictors of hot flushes and to assess the clinical usefulness of various therapeutic strategies for the reduction of hot flushes in postmenopausal women who receive raloxifene therapy. STUDY DESIGN:In this randomized, double-blind, placebo-controlled study, 487 unselected postmenopausal women were assigned randomly to receive treatment for 8 months with raloxifene, which was administered either at a dose of 60 mg/d every other day for 2 months followed by 60 mg/d (slow-dose escalation) or 60 mg/d throughout (raloxifene), or placebo. Data on the number, duration, intensity, and severity of hot flushes and awakenings because of night sweats were collected. Logistic regression models were used to examine the predictive value of various demographic and menopausal factors on the development or worsening of hot flushes. RESULTS:At baseline, 40.4% of all randomly assigned patients had hot flushes. The mean number of hot flushes (3-5 per week) was low. Fewer years postmenopause, surgical menopause, and previous estrogen or estrogen/progestin therapy were significant predictors of hot flushes at baseline but were not predictive of incident hot flushes during treatment with raloxifene. Of the women who received raloxifene therapy who had pre-existing hot flushes at baseline, 36% women had none at the end point. Early postmenopause and surgical menopause were significant predictors of a biologically relevant increase in hot flushes (>/=14 flushes/week). Early postmenopause, previous estrogen/progestin therapy, high body mass index, and greater duration of hot flushes at baseline were significant predictors of the need for symptomatic treatment. After 2 months of treatment, women in early postmenopause had significantly more hot flushes with raloxifene therapy than with slow-dose escalation ( P = .042), whereas there was no significant difference between raloxifene therapy and slow-dose escalation among women in later postmenopause. In the 50 patients who requested symptomatic treatment during the study, phytohormones or veralipride did not reduce the number of hot flushes markedly. CONCLUSION:A shorter time since menopause and surgical menopause are important predictors of hot flushes both before and during treatment with raloxifene. Previous estrogen/progestin therapy also increases the risk of hot flushes at baseline. For women in early postmenopause, slow-dose escalation of raloxifene therapy may be a suitable therapeutic strategy for the reduction of the risk of hot flushes.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Aldrighi JM,Quail DC,Levy-Frebault J,Aguas F,Kosian K,Garrido L,Bosio-Le Goux B,Saráchaga M,Graebe A,Niño AJ,Nickelsen Tdoi
10.1016/j.ajog.2004.04.042subject
Has Abstractpub_date
2004-12-01 00:00:00pages
1979-88issue
6eissn
0002-9378issn
1097-6868pii
S0002937804004612journal_volume
191pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::The term microinvasive carcinoma is inappropriate when applied to all vulvar cancers less than or equal to 5 mm thick because approximately 50% of vulvar carcinomas are no thicker than 5 mm and 20% of those superficial tumors metastasize to the lymph nodes. The significant predictors of groin node metastases in patien...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90132-3
更新日期:1987-05-01 00:00:00
abstract::Previous studies in breast and bladder cancer have suggested that epidermal growth factor receptor is expressed by only a proportion of cancers and is associated with poor clinical outcome. We used a monoclonal antibody specifically reactive with the extracellular domain of the epidermal growth factor receptor to loca...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)80044-x
更新日期:1991-02-01 00:00:00
abstract::A randomized prospective trial study was developed to determine the diagnostic value of the fetal biophysical profile in relationship to the nonstress test. The diagnostic values of these tests were assessed in terms of the incidence of abnormal outcome. In addition comparisons between the positive and negative predic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-11-15 00:00:00
abstract:OBJECTIVE:The study was performed to examine the satisfaction of a specific population of oncology patients with their physicians and to quantify its association with characteristics of their disease. STUDY DESIGN:A descriptive design was used in which patients attending a weekend cancer support retreat completed the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.281
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:We compared demographic characteristics of first-year residents entering obstetrics/gynecology with those entering primary care and surgery. STUDY DESIGN:We analyzed first-year residents from the 1997-2004 National Graduate Medical Education Census. Multivariable logistic regression models identified indepen...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.07.031
更新日期:2007-11-01 00:00:00
abstract::Platelet-poor plasma from 13 nonpregnant, 33 normally pregnant, and eight preeclamptic women was incubated with prostacyclin. The ability of platelet-poor plasma to diminish the antiaggregatory effect of prostacyclin was assessed by measuring this effect on arachidonic acid-induced platelet aggregation. Platelet aggre...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90370-x
更新日期:1987-04-01 00:00:00
abstract::A retrospective study of 56 patients treated for carcinoma in situ of the vulva over a 24-year period has shown a relative increase in the occurrence of this neoplasm. Only 6.7% of patients in the first 14 years of the study period were less than 35 years of age, as compared with 29.3% in the last decade. In the earli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90669-0
更新日期:1984-11-15 00:00:00
abstract:OBJECTIVES:This study was undertaken to determine the relief of climacteric symptoms by vaginal rings delivering estradiol and to monitor estrogen levels. STUDY DESIGN:Rings releasing in vitro either 60 or 140 microg/d estradiol were used by 35 women who had undergone hysterectomy for each dose level. Hot flash and ni...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-9378(99)70383-2
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:Our purpose was to test the effects of terbutaline on uterine electric and contractile responses to prostaglandin E2. STUDY DESIGN:In five late-gestation ewes, prostaglandin E2 (22.9 +/- 2.3 micrograms/min for 3 minutes) was given twice at 30-minute intervals during control. Terbutaline sulfate (2 micrograms...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91864-7
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine the range of normal fetal nasal width by ultrasonography, which may be beneficial for detection of trisomy 21 and other chromosomal abnormalities. We hypothesize that a wide, saddle-shaped nose, which is one of the clinical neonatal anatomic features of trisomy 21, can be ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70279-5
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to compare surgical techniques for the primary repair of obstetric anal sphincter lacerations. STUDY DESIGN:Patients with complete third- or fourth-degree lacerations were recruited and randomly assigned to either an end-to-end or overlapping repair. Data collection included demogra...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ajog.2004.11.045
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:In vitro fertilization (IVF) is considered a generally safe procedure, although associated with a higher incidence of preterm birth. The literature is inconsistent about the psychological impact of IVF, and we found no reports about outcome in late preterm (LPT) children. Our objective was to study neuropsych...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.06.041
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the rates of recurrence, persistence, and progression of cervical intraepithelial neoplasia in women who were seropositive for human immunodeficiency virus after excisional therapy with and without highly active antiretroviral therapy. STUDY DESIGN:The records of 118 women with c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.111103
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate use of light-induced autofluorescence for measuring changes in collagen of cervical connective tissue during gestation. STUDY DESIGN:In a conventional laboratory setting light-induced autofluorescence from the cervix of Charles-Dawley timed pregnant rats was measured in v...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90648-7
更新日期:1995-11-01 00:00:00
abstract::Primary cancers of the vagina are rare. They comprise 1% to 2% of all gynecologic malignancies and occur predominantly in older women. The diagnosis of primary carcinoma of the vagina requires that the cervix and vulva be intact and that no clinical evidence of other primary tumors exist. Approximately 90% of all vagi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(12)90738-3
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVES:Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging. STUDY DESIGN:Twenty patients with advanced stage IIB or III...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90080-3
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to document vascular reactivity in both phases of normal menstrual cycles and anovulatory cycles of women receiving oral contraceptives and to compare vascular reactivity of women in the follicular phase of the normal menstrual cycle with that of men of a similar age group. STUDY DE...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.114502
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether amniotic fluid levels of glial acidic fibrillary protein (GFAP) would reflect myelomeningocele-related neurodegeneration in the rat model of retinoic acid-induced myelomeningocele, which is a model that is very similar to human myelomeningocele and develops...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.09.032
更新日期:2011-02-01 00:00:00
abstract::To determine whether epidural anesthesia during labor affects maternal circulating catecholamines, blood samples were obtained from 15 patients at the peak of and immediately after two consecutive painful contractions. A lumbar epidural local anesthetic without epinephrine was then administered. After the onset of ana...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90076-5
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to investigate whether the sensitivity of myometrial cells to oxytocin is affected by prolonged exposure to oxytocin antagonists. STUDY DESIGN:Tissue slices or cultured myometrial cells were exposed to peptides in vitro. Myometrial activation was studied by measuring the formation of inositol...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90414-6
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effects of isradipine, a dihydropyridine calcium channel blocker, on mother and fetus in the treatment of hypertensive disorders of pregnancy. STUDY DESIGN:The investigation was performed as a two-group, parallel, double-blind multicenter study of isradipine versus placebo. Fifty...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(95)90357-7
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:We sought to determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation and virtual organ computer-aided analysis. STUDY DESIGN:A cross-sectional study was performed in fetuses with umbilical artery pulsatility index...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.11.043
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:We sought to quantify the gestational age-specific morbidity of black vs white neonates. STUDY DESIGN:This was a population-based retrospective cohort study of singleton live births in Ohio from 2006 through 2007. The primary outcome was a composite of adverse neonatal outcomes of ≥ 1 morbidity: Apgar score ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.12.017
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:We sought to investigate the safety and efficacy of laparoscopic incidental appendectomy during laparoscopic surgery for endometrioma. STUDY DESIGN:We conducted a retrospective study of 356 patients undergoing laparoscopic surgery for endometrioma with appendectomy (appendectomy group, n = 172) or not (nonap...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.08.042
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:We quantified the impact of chorioamnionitis on both the white and gray matter structures of the preterm ovine central nervous system (CNS). STUDY DESIGN:The CNS was studied at 125 days of gestation, either 2 or 14 days after the intraamniotic administration of 10 mg of lipopolysaccharide (LPS) (Escherichia ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.12.003
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to biomechanically characterize and compare human, porcine, equine, and ovine fetal membranes. STUDY DESIGN:Noncontact metrology was used for topographic analyses. Uniaxial tensile testing was performed to resolve specific biomechanical values. Puncture force and radial stresses...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.003
更新日期:2011-04-01 00:00:00
abstract::Much has been written about the need for help for the overworked obstetrician. Two obstetricians delivering over 500 babies annuallay had insufficient time for their gynecology practice. Two nurse-midwives were employed and in the first year they delivered 61 per cent of those patients who delivered vaginally. All nor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90940-0
更新日期:1975-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the incidence of birth injury in a cohort of macrosomic infants (birth weight >4000 gm) and analyze the association between persistent injury and delivery method. STUDY DESIGN:Deliveries of 2924 macrosomic infants were reviewed. Outcomes were compared with those of 16,711 infants...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70435-6
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:We determined developmental and labor-related changes in 11beta-hydroxysteroid (HSD) 1 and 2 expression in baboon placentas during the final third of gestation and labor. We examined whether maternal glucocorticoid administration alters placental 11beta-HSD 2 expression. STUDY DESIGN:Maternal and fetal plasm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.62
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to investigate a possible ionic basis linking pregnancy and gestational diabetes with the vascular disorders associated with them. STUDY DESIGN:We used phosphorus 31 nuclear magnetic resonance spectroscopy and magnesium- and calcium-specific ion electrodes to measure erythrocyte intracellular...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90035-7
更新日期:1995-03-01 00:00:00