RESUMEN

Few studies have examined women's perspectives on their health and priorities in older age. In the current study, we administered a cross-sectional survey to women aged ≥60 years, recruited at a large community event in 2019. Participants (N = 303; mean age = 68 years) reported up to three 12-month life goals in open-text fields (N = 1,053 goals). Our qualitative analysis identified 25 themes under four domains: Health and Wellness (n = 339 goals), Work and Leisure (n = 316 goals), Relationships (n = 199 goals), and Personal Growth (n = 170 goals). The most frequent themes pertained to family relationships, travel, staying healthy, and physical activity. Findings did not vary by participants' comorbidity status. Women have diverse aspirations as they age, including nurturing relationships, acquiring novel skills and experiences, and maintaining overall health and wellness. Gerontological nurses can better meet the needs of this population by expanding their awareness of patients' life goals and partnering with women to optimize health to achieve these goals. [Journal of Gerontological Nursing, 48(12), 25-33.].

Asunto(s)

Enfermería Geriátrica , Geriatría , Humanos , Femenino , Anciano , Estudios Transversales , Objetivos , Ejercicio Físico

RESUMEN

BACKGROUND: Consumption of green tea has been associated with reduced risk of breast cancer. Hormonal modulation has been suggested as one of the potential underlying mechanisms; however, it has yet to be fully elucidated in large, long-term human clinical trials. OBJECTIVE: We investigated the effects of decaffeinated green tea extract (GTE) on circulating sex hormones and insulin-like growth factor (IGF) proteins. METHODS: We conducted a placebo-controlled double-blind randomized clinical trial recruiting from 8 clinical centers in Minnesota. Participants were 538 healthy postmenopausal women randomly assigned to the GTE group (463 completed the study; mean age = 60.0 y) and 537 to the placebo group (474 completed; mean age = 59.7 y). Women in the GTE group orally took 4 decaffeinated capsules containing 1315 mg total catechins including 843 mg epigallocatechin-3-gallate daily for 1 y, whereas women in the placebo group took similar capsules containing no tea catechins. Blood sex hormones (estrone, estradiol, androstenedione, testosterone, and sex hormone-binding globulin) and IGF proteins (IGF-1 and IGF binding protein-3) were quantified at baseline and months 6 (for IGF proteins only) and 12, and were assessed as secondary outcomes of the study using a mixed-effect repeated-measures ANOVA model. RESULTS: Women in the GTE group had significantly higher blood total estradiol (16%; P = 0.02) and bioavailable estradiol (21%; P = 0.03) than in the placebo group at month 12. There was a statistically significant interaction between GTE supplementation and duration of treatment on estradiol and bioavailable estradiol (both Ps for interaction = 0.001). The catechol-O-methyltransferase genotype did not influence blood sex hormones before or after GTE supplementation. The circulating concentrations of IGF proteins were comparable between GTE and placebo groups at all 3 time points. CONCLUSION: These results suggest that a 12-mo GTE supplementation significantly increases circulating estradiol concentrations in healthy postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00917735.

Asunto(s)

Neoplasias de la Mama , Catequina/farmacología , Hormonas Esteroides Gonadales/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Extractos Vegetales/farmacología , Té/química , Anciano , Catequina/química , Suplementos Dietéticos , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Extractos Vegetales/química , Posmenopausia

RESUMEN

OBJECTIVES: Fibromyalgia syndrome (FMS) is a chronically painful condition whose symptoms are widely reported to be exacerbated by stress. We hypothesized that female patients with FMS differ from pain-free female controls in their sympathetic responses, a fact that may unmask important biomarkers and factors that contribute to the etiology of FMS. MATERIALS AND METHODS: In a pilot study, blood pressure (BP), skin temperature, thermogenic activity, circulating glucose, and pain sensitivity of 13 individuals with FMS and 11 controls at room temperature (24°C) were compared with that after exposure to cold (19°C). RESULTS: When measured at 24°C, BP, skin temperature, blood glucose, and brown adipose tissue (BAT) activity, measured using F-fluorodeoxyglucose positron-emission tomography/computed tomography, did not differ between controls and individuals with FMS. However, after cold exposure (19°C), BP and BAT activity increased in controls but not in individuals with FMS; skin temperature on the calf and arm decreased in controls more than in individiuals with FMS; and circulating glucose was lower in individiuals with FMS than in controls. Pain sensitivity did not change during the testing interval in response to cold. DISCUSSION: The convergence of the effect of cold on 4 relatively simple measures of thermogenic, cardiovascular, and metabolic activity, each regulated by sympathetic activity, strongly indicate that individuals with FMS have impaired sympathetic responses to stress that are observable and highly significant even when measured in extraordinarily small sample populations. If insufficient sympathetic responses to stress are linked to FMS, stress may unmask and maximize these potential clinical biomarkers of FMS and be related to its etiology.

Asunto(s)

Fibromialgia/diagnóstico , Umbral del Dolor/fisiología , Estrés Fisiológico/fisiología , Sistema Nervioso Simpático/fisiopatología , Tejido Adiposo Pardo/diagnóstico por imagen , Adolescente , Adulto , Biomarcadores , Glucemia , Presión Sanguínea/fisiología , Frío , Femenino , Fibromialgia/diagnóstico por imagen , Fibromialgia/fisiopatología , Humanos , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Temperatura Cutánea/fisiología , Adulto Joven

RESUMEN

BACKGROUND: Postmenopausal symptomatology has not been elucidated in large, long-term human clinical trials. Our objective was to measure quality of life in postmenopausal women aged 50-70 years. METHODS: A Menopause-Specific Quality of Life-Intervention (MENQOL) questionnaire was completed by women enrolled in the Minnesota Green Tea Trial (n=932) to assess vasomotor, physical, sexual, and psychosocial symptoms in the years following menopause. Responses were coded; mean overall and domain scores ranged from 1 to 8. A higher score indicated more severe symptoms. RESULTS: Mean overall MENQOL scores were highest in women aged 50-54.9 years. A pattern of reduced symptom severity with increasing age was observed overall and within each domain. Women aged 50-54.9 years had more severe night sweats and sweating than other age groups (P≤0.001) and more severe hot flashes than women aged≥60years (P≪0.001). No differences between age groups were seen on mean score in the Sexual domain. Compared with women aged 50.0-54.9 years (the reference group), study participants aged 60-64.9 and≥65years had lower MENQOL scores in the Psychosocial domain (P=0.029 and P≪0.001). Women aged 50-54.9 years had more severe symptoms related to negative mood than women ≥65 years (P≤0.009). Compared with women aged 50-54.9 years, those in the age groups 60-64.9 and≥65 years had lower scores for "poor memory" (2.98±1.75 and 2.66±1.68 vs. 3.43±1.87, P≪0.001). Women≥65 years reported lower scores for "feeling tired or worn out", "difficulty sleeping", and "lack of energy" than all other age groups (P≤0.003). CONCLUSION: The findings of this descriptive analysis of postmenopausal women may help clinicians counsel women about expectations and treatment options to address menopause-associated symptoms and the relationship between postmenopausal symptoms and overall health.

Asunto(s)

Posmenopausia/fisiología , Calidad de Vida , Anciano , Fatiga , Femenino , Sofocos , Humanos , Persona de Mediana Edad , Minnesota , Trastornos del Sueño-Vigilia , Encuestas y Cuestionarios , Sudoración , Té

RESUMEN

Epidemiologic and animal studies suggest a protective role of green tea against breast cancer. However, the underlying mechanism is not understood. We conducted a randomized, double-blinded, placebo-controlled phase II clinical trial to investigate whether supplementation with green tea extract (GTE) modifies mammographic density (MD), as a potential mechanism, involving 1,075 healthy postmenopausal women. Women assigned to the treatment arm consumed daily 4 decaffeinated GTE capsules containing 1,315 mg total catechins, including 843 mg epigallocatechin-3-gallate (EGCG) for 12 months. A computer-assisted method (Madena) was used to assess MD in digital mammograms at baseline and month 12 time points in 932 completers (462 in GTE and 470 in placebo). GTE supplementation for 12 months did not significantly change percent MD (PMD) or absolute MD in all women. In younger women (50-55 years), GTE supplementation significantly reduced PMD by 4.40% as compared with the placebo with a 1.02% PMD increase from pre- to postintervention (P = 0.05), but had no effect in older women (Pinteraction = 0.07). GTE supplementation did not induce MD change in other subgroups of women stratified by catechol-O-methyltransferase genotype or level of body mass index. In conclusion, 1-year supplementation with a high dose of EGCG did not have a significant effect on MD measures in all women, but reduced PMD in younger women, an age-dependent effect similar to those of tamoxifen. Further investigation of the potential chemopreventive effect of green tea intake on breast cancer risk in younger women is warranted. Cancer Prev Res; 10(12); 710-8. ©2017 AACR.

Asunto(s)

Densidad de la Mama/efectos de los fármacos , Neoplasias de la Mama/prevención & control , Suplementos Dietéticos , Extractos Vegetales/farmacología , Té/química , Anciano , Anticarcinógenos/farmacología , Antioxidantes/administración & dosificación , Índice de Masa Corporal , Mama/efectos de los fármacos , Catequina/análogos & derivados , Catequina/farmacología , Catecol O-Metiltransferasa/genética , Método Doble Ciego , Femenino , Genotipo , Humanos , Mamografía , Persona de Mediana Edad , Posmenopausia , Tamoxifeno/farmacología

RESUMEN

Liver injury effects of green tea-based products have been reported in sporadic case reports. However, no study has examined systematically such adverse effects in an unbiased manner. We examined the potential effects of a high, sustained oral dose of green tea extract (GTE) on liver injury measures in a randomized, placebo-controlled, double-blinded phase II clinical trial, which enrolled 1,075 women with the original aim to assess the effect of daily GTE consumption for 12 months on biomarkers of breast cancer risk. The current analysis examined the effect of GTE consumption on liver injury in 1,021 participants (513 in GTE and 508 in placebo arm) with normal baseline levels of liver enzymes. Among women in the GTE arm, alanine aminotransferase (ALT) increased by 5.4 U/L [95% confidence interval (CI), 3.6-7.1] and aspartate aminotransferase increased by 3.8 U/L (95% CI, 2.5-5.1), which were significantly higher than those among women in the placebo arm (both P < 0.001). Overall, 26 (5.1%) women in GTE developed moderate or more severe abnormalities in any liver function measure during the intervention period, yielding an OR of 7.0 (95% CI, 2.4-20.3) for developing liver function abnormalities as compared with those in the placebo arm. ALT returned to normal after dechallenge and increased again after one or more rechallenges with GTE. The rise-fall pattern of liver enzyme values following the challenge-dechallenge cycles of GTE consumption strongly implicates the effect of high-dose GTE on liver enzyme elevations. Cancer Prev Res; 10(10); 571-9. ©2017 AACR.

Asunto(s)

Enfermedad Hepática Inducida por Sustancias y Drogas/sangre , Suplementos Dietéticos/efectos adversos , Hígado/efectos de los fármacos , Extractos Vegetales/efectos adversos , Té/química , Anciano , Alanina Transaminasa/sangre , Antioxidantes/efectos adversos , Aspartato Aminotransferasas/sangre , Biomarcadores de Tumor/sangre , Neoplasias de la Mama/sangre , Neoplasias de la Mama/prevención & control , Catequina/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Método Doble Ciego , Femenino , Humanos , Hígado/enzimología , Pruebas de Función Hepática , Persona de Mediana Edad , Placebos , Extractos Vegetales/química , Estados Unidos

RESUMEN

Context • Strontium ranelate is an approved prescription medication for the treatment of osteoporosis in Europe. In the United States, the only available forms of strontium are those that are nonprescription, dietary supplements. Some patients with osteoporosis use those products because they prefer an alternate treatment to conventional therapy. Currently, no controlled trials have been conducted on the effectiveness of the supplements for treating osteoporosis. Objective • The study intended to examine how one woman responded to the use of strontium chloride. Design • This was a retrospective case study. Setting • The woman in the case study was a patient in an academic urban women's health clinic in Minneapolis, MN, USA. Participant • The participant was a postmenopausal woman with a history of vertebral fracture. Intervention • The participant took 680 mg daily of strontium chloride for 2.5 y. Outcome Measures • The patient had begun receiving dual-energy X-ray absorptiometry (DXA) scans in 2004 and continued to receive follow-up scans every 2 y. After beginning strontium therapy in December 2011, she received DXA scans in March 2012 and May 2014. Results • During the study, the analysis of the patient's DXA scans showed a positive increase in the bone mineral density (BMD) of her vertebrae and her right hip and maintenance of her BMD in her left hip. Conclusions • Although the current case report does not provide enough evidence to conclude that US dietary supplements of strontium are effective in preventing fractures, it demonstrates a positive experience for one patient.

Asunto(s)

Conservadores de la Densidad Ósea/uso terapéutico , Osteoporosis Posmenopáusica/tratamiento farmacológico , Estroncio/uso terapéutico , Anciano , Densidad Ósea , Femenino , Humanos , Compuestos Organometálicos , Osteoporosis , Estudios Retrospectivos

RESUMEN

Understanding the impact interprofessional teamwork has on patient outcomes is of great interest to health care providers, educators, and administrators. This article describes one clinical team, Women's Health Specialists, and their implementation of an interprofessional health intervention course: "Mindfulness and Well-being: The Mature Woman" (MW: MW) to support mature women's health needs in midlife (age 40-70 years) and empower patient involvement in self-care. The provider team works to understand how their interprofessional education and collaborative practice (IPECP) interventions focused on supporting midlife women are associated with improved quality and clinical outcomes. This case study describes the work of the Women's Health Specialists clinic in partnership with the National Center for Interprofessional Education and Collaborative Practice to study the impact an interprofessional team has on the health needs of women in midlife. This article summarizes the project structure, processes, outputs, and outcomes. Data collection, analysis, strategy, and next steps for future midlife women's projects are also discussed.

Asunto(s)

Educación Profesional , Grupo de Atención al Paciente , Salud de la Mujer , Adulto , Anciano , Necesidades y Demandas de Servicios de Salud , Humanos , Relaciones Interprofesionales , Persona de Mediana Edad , Poder Psicológico , Mejoramiento de la Calidad , Autocuidado

RESUMEN

PURPOSE: The Minnesota Green Tea Trial (MGTT) was a randomized, placebo-controlled, double-blinded trial investigating the effect of daily green tea extract consumption for 12 months on biomarkers of breast cancer risk. METHODS: Participants were healthy postmenopausal women at high risk of breast cancer due to dense breast tissue with differing catechol-O-methyltransferase (COMT) genotypes. The intervention was a green tea catechin extract containing 843.0 ± 44.0 mg/day epigallocatechin gallate or placebo capsules for 1 year. Annual digital screening mammograms were obtained at baseline and month 12, and fasting blood and 24-h urine samples were provided at baseline and at months 6 and 12. Primary endpoints included changes in percent mammographic density, circulating endogenous sex hormones, and insulin-like growth factor axis proteins; secondary endpoints were changes in urinary estrogens and estrogen metabolites and circulating F2-isoprostanes, a biomarker of oxidative stress. RESULTS: The MGTT screened more than 100,000 mammograms and randomized 1,075 participants based on treatment (green tea extract vs. placebo), stratified by COMT genotype activity (high COMT vs. low/intermediate COMT genotype activity). A total of 937 women successfully completed the study and 138 dropped out (overall dropout rate = 12.8 %). CONCLUSIONS: In this paper we report the rationale, design, recruitment, participant characteristics, and methods for biomarker and statistical analyses.

Asunto(s)

Biomarcadores/metabolismo , Neoplasias de la Mama/prevención & control , Mama/anatomía & histología , Mamografía , Té , Antioxidantes/administración & dosificación , Catequina/administración & dosificación , Catequina/análogos & derivados , Catecol O-Metiltransferasa/genética , Método Doble Ciego , Estrógenos/orina , F2-Isoprostanos/sangre , Femenino , Genotipo , Hormonas Esteroides Gonadales/sangre , Humanos , Factor I del Crecimiento Similar a la Insulina/metabolismo , Persona de Mediana Edad , Minnesota , Estrés Oxidativo , Factores de Riesgo

RESUMEN

Green tea is thought to provide health benefits, though adverse reactions to green tea extract (GTE) have been reported. We conducted a randomized, double-blind, placebo-controlled study of GTE on breast cancer biomarkers, including mammographic density, in which 1075 postmenopausal women were randomly assigned to consume GTE containing 843 mg (-)-epigallocatechin-3-gallate (EGCG) or placebo daily for one year. There were no significant differences in % of women with adverse events (AEs, 75.6% and 72.8% of the GTE group and placebo group, respectively) or serious AEs (2.2 % and 1.5% of GTE and placebo groups, respectively). Women on GTE reported significantly higher incidence of nausea (P < 0.001) and dermatologic AEs (P = 0.05) and significantly lower diarrhea incidence (P = 0.02). More women in the GTE group experienced an alanine aminotransferase (ALT) elevation compared with placebo group (n = 36, (6.7%) vs. n = 4, (0.7%); P < 0.001). There were no statistically significant differences between groups in frequencies of other AEs. Overall, AEs were mainly mild and transient, indicating that daily consumption of GTE containing 843 mg EGCG is generally well tolerated by a group of predominantly Caucasian postmenopausal women. However, 6.7% of GTE consumers experienced ALT elevations, with 1.3% experiencing ALT-related serious AEs.

Asunto(s)

Anticarcinógenos/efectos adversos , Antioxidantes/efectos adversos , Neoplasias de la Mama/prevención & control , Camellia sinensis/química , Suplementos Dietéticos/efectos adversos , Extractos Vegetales/efectos adversos , Hojas de la Planta/química , Anciano , Anticarcinógenos/uso terapéutico , Antioxidantes/química , Antioxidantes/uso terapéutico , Biomarcadores/sangre , Densidad de la Mama , Neoplasias de la Mama/sangre , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Catequina/efectos adversos , Catequina/análogos & derivados , Catequina/análisis , Catequina/uso terapéutico , Suplementos Dietéticos/análisis , Método Doble Ciego , Femenino , Manipulación de Alimentos , Insuficiencia Hepática/etiología , Insuficiencia Hepática/fisiopatología , Humanos , Glándulas Mamarias Humanas/anomalías , Persona de Mediana Edad , Minnesota/epidemiología , Extractos Vegetales/química , Extractos Vegetales/uso terapéutico , Radiografía , Factores de Riesgo , Índice de Severidad de la Enfermedad

RESUMEN

Introduction. Orally administered preparations from the Trametes versicolor (Tv) mushroom have been hypothesized to improve immune response in women with breast cancer after standard chemotherapy and radiotherapy. Methods. A phase I, two-center, dose escalation study was done to determine the maximum tolerated dose of a Tv preparation when taken daily in divided doses for 6 weeks after recent completion of radiotherapy. Eleven participants were recruited and nine women completed the study. Each cohort was comprised of three participants given one of three doses of Tv (3, 6, or 9 grams). Immune data was collected pre- and postradiation, at 3 on-treatment time points and after a 3-week washout. Results. Nine adverse events were reported (7 mild, 1 moderate, and 1 severe), suggesting that Tv was well tolerated. Immunological results indicated trends in (1) increased lymphocyte counts at 6 and 9 grams/day; (2) increased natural killer cell functional activity at 6 grams/day; (3) dose-related increases in CD8(+) T cells and CD19(+) B cells , but not CD4(+) T cells or CD16(+)56(+) NK cells. Conclusion. These findings show that up to 9 grams/day of a Tv preparation is safe and tolerable in women with breast cancer in the postprimary treatment setting. This Tv preparation may improve immune status in immunocompromised breast cancer patients following standard primary oncologic treatment.

RESUMEN

CONTEXT: Tibetan medicine offers an ancient, timely model for the promotion of health and treatment of disease by teaching individuals to make healthy lifestyle choices. This holistic model consists of analyzing one's unique constitution and recommending supportive lifestyle modifications. An experienced Tibetan medicine practitioner is the gold standard for constitutional assessment. Because few Tibetans practice Tibetan medicine in the United States, research-based tools with content and criterion validity are needed for self-assessment. OBJECTIVE: To test the validity of and refine the Constitutional Self-Assessment Tool (CSAT) and Lifestyle Guidelines Tool (LGT). DESIGN: Mixed methods pilot study conducted in three phases. SETTING: Tibetan Medical Institute (TMI) of His Holiness the Dalai Lama, Dharamsala, India and the University of Minnesota, a U.S. research University. PARTICIPANTS: Six TMI senior faculty; 88 students at the university. METHODS: Phase 1: TMI faculty evaluated the tools' content validity. Phase 2: 59 students completed the CSAT, had a Tibetan medicine consultation, completed the LGT, and answered qualitative questions. Phase 3: 29 students studying Tibetan medicine followed a modified phase 2 method. Quantitative and phenomenological analyses were performed to investigate the CSAT's criterion validity (agreement of CSAT results and consultations) and refine the tools. RESULTS: The tools were shown to have high content validity. Phase 2 CSAT had 51% agreement and 0.24 kappa statistic, suggesting fair criterion validity. Phase 3-refined CSAT had 76% agreement and 0.50 kappa statistic, suggesting moderate criterion validity. CONCLUSION: The refined CSAT and LGT in Appendix A and B demonstrate the potential for additional research and use in integrated care.

Asunto(s)

Guías como Asunto , Conductas Relacionadas con la Salud , Salud Holística , Estilo de Vida , Medicina Tradicional Tibetana/métodos , Autoevaluación (Psicología) , Adulto , Anciano , Constitución Corporal , Docentes , Femenino , Humanos , India , Medicina Integrativa/métodos , Masculino , Persona de Mediana Edad , Minnesota , Proyectos Piloto , Derivación y Consulta , Estudiantes , Adulto Joven

Asunto(s)

Ginecología/tendencias , Obstetricia/tendencias , Servicios de Salud para Mujeres/tendencias , Terapias Complementarias/estadística & datos numéricos , Femenino , Predicción , Necesidades y Demandas de Servicios de Salud/tendencias , Salud Holística/tendencias , Humanos , Minnesota , Dinámica Poblacional , Servicios Preventivos de Salud/tendencias , Revisión de Utilización de Recursos/tendencias

RESUMEN

OBJECTIVE: Vitamin D deficiency and mood disorders are both prevalent among the elderly. We evaluated the association between vitamin D intake and mental health-related quality of life (QOL) among elderly women participating in a large population-based study. STUDY DESIGN: This study was a cross-sectional analysis of the Iowa Women's Health Study, a prospective study of cancer risk factors among post-menopausal women in Iowa that began in 1986. Additional survey data was collected from the cohort members in 1987, 1989, 1992, 1997, and 2004. Data for this analysis came from the 2004 questionnaire. MAIN OUTCOME MEASURE: Mental health-related QOL was assessed using five scales from the Medical Outcomes Study 36-item Short-form Health Survey. QOL scores were analyzed as continuous variables using linear regression, controlling for age, energy intake, BMI, education, smoking, living arrangement, antidepressant usage, comorbidity history, and physical activity. RESULTS: Low vitamin D intake (<400 IU/day) was associated with poorer QOL scores compared to women with higher intake (≥400 IU/day). Differences in QOL scores by vitamin D intake group were attenuated with multivariable adjustment, but a significant overall association between vitamin D and QOL scores persisted. Further adjustment for physical activity attenuated all differences as well as the overall association between vitamin D and QOL scores. CONCLUSIONS: Women who consumed <400 IU/day of vitamin D had significantly lower mental health-related QOL compared to those who consumed ≥400 IU/day. Meeting dietary vitamin D recommendations is a potential method for improving QOL among the elderly.

Asunto(s)

Fenómenos Fisiológicos Nutricionales del Anciano/efectos de los fármacos , Salud Mental/estadística & datos numéricos , Calidad de Vida/psicología , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Anciano , Anciano de 80 o más Años , Estudios Transversales , Dieta/estadística & datos numéricos , Femenino , Estado de Salud , Humanos , Iowa/epidemiología , Estilo de Vida , Salud de la Mujer/estadística & datos numéricos

RESUMEN

In this study, ascorbate (Asc) and glutathione (GSH) concentrations were quantified noninvasively using double-edited (1)H MRS at 4 T in the occipital cortex of healthy young [age (mean ± standard deviation) = 20.4 ± 1.4 years] and elderly (age = 76.6 ± 6.1 years) human subjects. Elderly subjects had a lower GSH concentration than younger subjects (p < 0.05). The Asc concentration was not significantly associated with age. Furthermore, the lactate (Lac) concentration was higher in elderly than young subjects. Lower GSH and higher Lac concentrations are indications of defective protection against oxidative damage and impaired mitochondrial respiration. The extent to which the observed concentration differences could be associated with physiological differences and methodological artifacts is discussed. In conclusion, GSH and Asc concentrations were compared noninvasively for the first time in young vs elderly subjects.

Asunto(s)

Ácido Ascórbico/metabolismo , Glutatión/metabolismo , Espectroscopía de Resonancia Magnética/métodos , Lóbulo Occipital/anatomía & histología , Lóbulo Occipital/metabolismo , Anciano , Anciano de 80 o más Años , Animales , Humanos , Ácido Láctico/metabolismo , Adulto Joven

RESUMEN

OBJECTIVE: The aim of this study was to assess the efficacy of TU-025, keishibukuryogan, a Japanese prescription herbal medicine used for hot flash management, in American women. METHODS: This randomized, double-blind, placebo-controlled, phase II trial enrolled 178 postmenopausal women aged 45 to 58 years with a Mayo hot flash score greater than 28 per week who met other inclusion criteria. After a 1-week placebo run-in period, participants were randomly assigned placebo, or 7.5 g/day, or 12.5 g/day groups, for 12 weeks. Primary and secondary outcomes were measured using the Mayo Clinic Hot Flash Diary, the Greene Climacteric Index, and the Pittsburgh Sleep Quality Index. RESULTS: At 3 months, hot flash scores, climacteric symptoms, and sleep quality improved by 34% in the placebo group, 40% in the 7.5 g/day group, and 38% in the 12.5 g/day group. (P < 0.001). However, the differences in changes between groups were not statistically significant (P = 0.990). Diarrhea unexpectedly developed in 20% of participants receiving active medication. CONCLUSIONS: For American women, unlike the clinical experience for Japanese women, TU-025 did not significantly reduce the frequency and severity of hot flash symptoms, improve climacteric symptoms, or benefit sleep quality. This study identified several potentially significant methodological factors to be considered in future scientific assessments of traditional Asian medicines.

Asunto(s)

Medicamentos Herbarios Chinos/administración & dosificación , Sofocos/tratamiento farmacológico , Fitoterapia/métodos , Posmenopausia/efectos de los fármacos , Índice de Severidad de la Enfermedad , Método Doble Ciego , Medicamentos Herbarios Chinos/farmacología , Femenino , Indicadores de Salud , Sofocos/prevención & control , Humanos , Plantas Medicinales , Calidad de Vida , Resultado del Tratamiento

RESUMEN

Until now, the lack of a means to detect a deficiency or to measure the pharmacologic effect in the human brain in situ has been a hindrance to the development of antioxidant-based prevention and treatment of dementia. In this study, a recently developed (1) H MRS approach was applied to quantify key human brain antioxidant concentrations throughout the course of an aggressive antioxidant-based intervention. The concentrations of the two most abundant central nervous system chemical antioxidants, vitamin C and glutathione, were quantified noninvasively in the human occipital cortex prior to and throughout 24 h after bolus intravenous delivery of 3 g of vitamin C. Although the kinetics of the sodium-dependent vitamin C transporter and physiologic blood vitamin C concentrations predict theoretically that brain vitamin C concentration will not increase above its homeostatically maintained level, this theory has never been tested experimentally in the living human brain. Therefore, human brain vitamin C and glutathione concentrations were quantified noninvasively using MEGA-PRESS double-edited (1) H MRS and LCModel. Healthy subjects (age, 19-63 years) with typical dietary consumption, who did not take vitamin supplements, fasted overnight and then reported for the measurement of baseline antioxidant concentrations. They then began controlled feeding which they adhered to until after vitamin C and glutathione concentrations had been measured at 2, 6, 10 and 24 h after receiving intravenous vitamin C. Two of the twelve studies were sham controls in which no vitamin C was administered. The main finding was that human brain vitamin C and glutathione concentrations remained constant throughout the protocol, even though blood serum vitamin C concentrations spanned from the low end of the normal range to very high.

Asunto(s)

Antioxidantes/metabolismo , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/farmacología , Encéfalo/metabolismo , Espectroscopía de Resonancia Magnética/métodos , Adulto , Ácido Ascórbico/sangre , Ácido Ascórbico/metabolismo , Femenino , Glutatión/metabolismo , Humanos , Inyecciones Intravenosas , Masculino

RESUMEN

The request and use of nonpharmacologic interventions and complementary and alternative medicine (CAM) in cancer survivors is increasing. Given the large number of breast cancer survivors and the multiple treatment-related symptoms they endure, it is important for physicians to be aware of the evidence supporting nonpharmacologic therapies. Several studies evaluating such interventions have demonstrated improved overall quality of life (QOL). For other symptoms, the literature is limited but growing. We summarize the evidence to support complementary and alternative therapies for the major symptoms in breast cancer survivors.

Asunto(s)

Neoplasias de la Mama/rehabilitación , Terapias Complementarias/métodos , Calidad de Vida , Artralgia/terapia , Trastornos del Conocimiento/terapia , Fatiga/terapia , Femenino , Sofocos/terapia , Humanos , Síndromes de Neurotoxicidad/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Sobrevivientes

RESUMEN

OBJECTIVE: To evaluate the effectiveness of vitamin E, evening primrose oil (EPO), and the combination of vitamin E and EPO for pain control in women with cyclical mastalgia. PROCEDURE: A double-blind, randomized, placebo-controlled trial was conducted at two U.S. academic medical centers. Eighty-five women with premenstrual cyclical breast discomfort were enrolled. Participants were randomly assigned to one of four six-month oral treatments: vitamin E (1,200 IU per day), EPO (3,000 mg per day), vitamin E (1,200 IU per day) plus EPO (3,000 mg per day), or double placebo. The primary outcome measure was change in breast pain, measured by the modified McGill Pain Questionnaire at enrollment and at six months. RESULTS: Forty-one patients completed the study. Intent-to-treat analysis (pretesting and post testing) showed a difference in worst-pain improvement with the treatments EPO (p=0.005), vitamin E (p=0.04), and EPO plus vitamin E (p=0.05), but no difference with placebo (p=0.93). Results from two-sample t-test showed a nonsignificant decrease in cyclical mastalgia individually for the three treatment groups compared with the placebo group (EPO, p=0.18; vitamin E, p=0.10; and EPO plus vitamin E, p=0.16). The data were also analyzed with the separation test by Aickin, which showed a trend toward a reduction of cyclical mastalgia with vitamin E and EPO individually and in combination. CONCLUSION: Daily doses of 1,200 IU vitamin E, 3,000 mg EPO, or vitamin E and EPO in combination at these same dosages taken for six months may decrease the severity of cyclical mastalgia.

Asunto(s)

Antioxidantes/administración & dosificación , Enfermedades de la Mama/tratamiento farmacológico , Ácidos Linoleicos/administración & dosificación , Dolor/tratamiento farmacológico , Aceites de Plantas/administración & dosificación , Vitamina E/administración & dosificación , Ácido gammalinolénico/administración & dosificación , Adulto , Enfermedades de la Mama/complicaciones , Distribución de Chi-Cuadrado , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Persona de Mediana Edad , Oenothera biennis , Dolor/complicaciones , Dimensión del Dolor , Proyectos Piloto , Placebos , Resultado del Tratamiento , Adulto Joven

RESUMEN

Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.

Asunto(s)

Salud Holística , Medicina Integrativa/tendencias , Predicción , Humanos , Minnesota