Journal of women's health
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Journal of women's health · Dec 2004
Comparative StudyConsistency in efficacy and safety of ezetimibe coadministered with statins for treatment of hypercholesterolemia in women and men.
Women are often not treated as aggressively as men to control levels of low-density lipoprotein cholesterol (LDL-C), despite evidence that women and men realize comparable cardiovascular benefit from lipid-lowering therapy. Statins are the most effective drugs currently available for treating hypercholesterolemia. Despite the impressive cholesterol-lowering capacity of statins, however, many patients on statin therapy fail to reach established target levels of LDL-C. The cholesterol absorption inhibitor, ezetimibe, blocks the intestinal absorption of dietary and biliary cholesterol, a mechanism of action complementary to that of statins, which inhibit hepatic cholesterol synthesis. Ezetimibe coadministered with statins produces significant incremental reductions in LDL-C compared with statin monotherapy. ⋯ Ezetimibe plus statin was more effective than statin alone in improving the lipid profile of patients with hypercholesterolemia and was equally efficacious in women and men. Ezetimibe plus statin was well tolerated and had a favorable safety profile in both patient subgroups. Ezetimibe coadministered with statins, a dual inhibition treatment strategy that targets both cholesterol absorption and synthesis, is an effective therapeutic option for women with hypercholesterolemia.
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Journal of women's health · Nov 2004
The impact of the Women's Health Initiative on hormone replacement therapy in a Medicaid program.
Observational studies suggest that hormone replacement therapy (HRT) reduces women's risk of cardiovascular disease (CVD). However the Women's Health Initiative (WHI) HRT arm was stopped early because of increased risk of CVD, stroke, pulmonary embolism, and breast cancer. Evaluating HRT-prescribing patterns in relation to the release of the WHI will help determine if these study results have influenced the use of HRT. ⋯ The WHI influenced all types of HRT use among postmenopausal women in a Medicaid program. Administrative claims data can be a useful tool for monitoring an immediate impact of national guidelines or a national level outcomes trial.
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Journal of women's health · Oct 2004
An analysis of the determinants of maternal mortality in sub-Saharan Africa.
To establish what population characteristics affect the high maternal mortality rate in the sub-Saharan Africa region and to propose possible solutions to reduce this rate. ⋯ The availability of skilled delivery personnel, life expectancy, national economic wealth, and health expenditure per capita predict the maternal mortality rate of a country. Based on these findings, it is recommended that structural arrangements be made to train skilled health personnel to take care of maternal health problems. In view of the high cost of training physicians, middle-level health personnel may offer an affordable alternative to handle emergency obstetrical cases to address the shortage of physicians. In addition, the allocation of adequate resources to the health sector could improve maternal mortality. The economic wealth of a country and life expectancy at birth are less modifiable through short-term specific interventions. Additionally, it is recommended that country-specific interventions are needed to correct the problem of lack of critical data for analysis.
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Journal of women's health · Sep 2004
ReviewProphylactic bilateral mastectomy for breast cancer prevention.
Prophylactic bilateral mastectomy, or preventive removal of the breasts, is an option for women who are at increased risk of developing breast cancer. Among the highest risk groups are those women with a significant family history of breast cancer and those with a known genetic predisposition to the disease. There are many issues surrounding prophylactic mastectomy. ⋯ However, women who choose prophylactic mastectomy may differ compared with those who do not. The results may not be generalizable to all high-risk women. Counseling of high-risk women, specifically those with a BRCA1 or BRCA2 mutation, should include a discussion of prophylactic mastectomy, including the medical and psychosocial risks and benefits.
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Journal of women's health · Sep 2004
Fatal and nonfatal unintentional injuries in adult women, United States.
Although we know that injury death rates are lower for women than for men at all ages, we still have a long way to go in exploring the impact of unintentional injuries on women's lives. This paper reviews the leading causes of unintentional injury death and nonfatal injuries for adult women. It also explores selected activities of the Division of Unintentional Injury Prevention (CDC's National Center for Injury Prevention). ⋯ Unintentional injury creates an enormous burden on the lives of women. Moving forward in reducing the burden of unintentional injury requires assessing and understanding the impact of these injuries on the lives of women. Further work is needed to develop a strong context and framework for research and dissemination.