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At least 253 records · Page 14Linked to original sources
PubMed1983

Adenocarcinoma of the endometrium following prolonged use of an intrauterine device.

An Extremely rare case with the endometrial carcinoma induced by the prolonged (for 20 years) use of IUD (Oota Ring) was reported. The patient was a 57-year-old woman who visited our clinic claiming spotting, and the cancer was revealed by a D & C examination. Since no high risk factors for endometrial carcinogenesis were noted in this patient, it was inferred that prolonged use of IUD played an important role as a cocarcinogen. In particular, the mechanical action of the inserted IUD was thought to be responsible for carcinogenesis. The inflammatory reactions observed in the tumor tissues were considered to be the secondary changes induced by carcinoma.

Adenocarcinoma↗
PubMed1996

Cost effectiveness analysis of drug therapies for rheumatoid arthritis.

We know very little about the relative cost effectiveness of commonly used drug treatments for rheumatoid arthritis (RA), largely due to difficulty obtaining appropriate data and the complexity of the required analysis. There is growing interest in combination therapy for RA. However, it is unclear whether combination therapy will be associated with increased benefit compared to monotherapy, and whether the degree of benefit will offset the anticipated increased costs. We show 3 specific examples derived from a longitudinal database of adults with RA in which we compare the cost effectiveness of longterm drug regimens. Functional status serves as our measure of effectiveness, and we use a conservative estimate of the total annual cost of drug therapy. We also consider the analytic complexity of differences in baseline disease activity. These examples illustrate that in addition to variability in baseline disease activity, there is also substantial variability over time in both effectiveness and costs associated with drug treatment. This variability underscores the importance of considering both the relative effectiveness and costs when making treatment decisions. To make progress in the area of cost effectiveness of longterm treatments for RA and other chronic conditions, it is essential that studies of treatment continue for sufficiently long periods and that relevant cost information be collected in conjunction with measures of effectiveness.

Aged↗
PubMed2006

Evolution of antinuclear antibodies and clinical patterns in patients with active rheumatoid arthritis with longterm infliximab therapy.

OBJECTIVE: To investigate the effect of longterm infliximab therapy on serum levels of fluorescent antinuclear and anti-double and single-stranded DNA antibodies (FANA, anti-dsDNA, anti-ssDNA) in patients with rheumatoid arthritis (RA), and their possible association with clinical evolution. METHODS: Sera from 58 RA patients, treated for one to 3 years with infliximab, were retrospectively analyzed. Matched control groups were RA patients treated with corticosteroids or methotrexate. FANA were tested using HEp-2 cells, and anti-dsDNA and anti-ssDNA IgG by ELISA. After 28 months of infliximab therapy, clinical status was evaluated in 43/58 patients with uninterrupted therapy and associations with autoantibody levels were investigated. Data were documented for patients who discontinued infliximab. RESULTS: Over the 3 year period, significant increases in FANA and anti-ssDNA IgG levels were observed in infliximab treated patients (p < 0.001 and p < 0.01, respectively). In 43 patients with an uninterrupted infliximab regimen, association was found between high FANA (>or= 1/1280) and lower age (p = 0.048) and patient's assessment of infliximab's efficacy (p = 0.014). Three patients developed anti-dsDNA IgG, preceded by high anti-ssDNA IgG levels, and one of them developed a lupus-like syndrome. Neither the initial presence of high FANA levels nor their increase >or= 1/1280 was significantly associated with discontinuation of infliximab. In contrast, at baseline (p = 0.0012) and at the time of infliximab discontinuation (p = 0.0078), anti-ssDNA IgG (>or= 500 arbitrary units) were more frequent in 7 patients who stopped infliximab due to skin or systemic anaphylactoid reactions. CONCLUSION: Monitoring of serum FANA, anti-dsDNA, and anti-ssDNA IgG antibodies provided predictors of lupus-like symptoms and/or anaphylactoid reactions in patients with RA.

Antibodies, Antinuclear↗
PubMed1997

No loss of biomechanical effects after withdrawal of short-term PTH treatment in an aged, osteopenic, ovariectomized rat model.

The aim of the study was to assess the biomechanical effects of short-term PTH treatment and withdrawal on bone mass and strength in an aged, osteopenic, ovariectomized (ovx) rat model. Additionally, the effect of sequential therapy with PTH and the bisphosphonate, risedronate, the effect of longterm PTH monotherapy, and the effect of long-term risedronate monotherapy were assessed. 96 4-month-old rats were randomized into nine groups. Eight groups were ovariectomized and one group was sham operated. 12 months after surgery, treatment regimens were initiated (OW) and were continued for either 2 weeks (2 W) or 12 weeks (12 W). The treatment regimens were as follows: (1) baseline ovx (OW); (2) ovx-saline (2 W); (3) ovx-PTH 1-34 (2 W); (4) intact-saline (12 W); (5) ovx-saline (12 W); (6) ovx-risedronate (12 W); (7) ovx-PTH 1-34 (12 W); (8) ovx-PTH 1-34 (2 W), followed by pause (10 W); and (9) ovx-PTH 1-34 (2 W), accompanied by risedronate (12 W). The effect of therapy (endpoint) was measured at three skeletal sites: vertebral bodies; femoral cortical bone; and femoral necks. The results revealed an anabolic, time-dependent effect of PTH 1-34 at all skeletal sites. No loss of anabolic effect was observed 10 weeks after discontinuation of 2 week PTH treatment in this rat model. Risedronate given in sequential therapy with PTH produced no significant effect on biomechanical properties at any skeletal sites when compared with 2 week PTH followed by a 10 week pause. However, when risedronate was given alone, a positive effect was seen at the vertebral site after a 12 week treatment. On the basis of this study with short-term PTH treatment of aged, osteopenic, ovariectomized rats, there seemed to be a significant effect of PTH on the biomechanical properties and no loss of effect even 10 weeks after PTH withdrawal.

Aging↗
PubMed1983

Shortterm "escape" and longterm "drift." The dissipation effects of the beta adrenergic blocking agents.

The dissipation phenomena associated with timolol have important implications in the clinical management of glaucoma patients. Shortterm "escape" and longterm "drift" are clinical terms which describe the reduction of timolol's efficacy over a few days and over months and years, respectively. Recent physiological studies suggest a cellular explanation for these readjustments in tissue responsiveness to continued administration of timolol. While the precise location of the physiologically responding cells and the interactions of the various adrenergic responsive elements remain unclear, subsensitivity and supersensitivity may prove to be the most accurate designations for alterations in tissue responsiveness to adrenergic stimulation following "down regulation" or "up regulation" of beta receptor density on cell membranes.

Adrenergic beta-Antagonists↗
PubMed1990

Injectable contraceptives and risk of invasive cervical cancer: evidence of an association.

In a case-control study conducted in Latin America, the relationship of injectable contraceptive (IC) use to risk of invasive cervical cancer was analyzed while controlling for a variety of other risk factors, including female and spouse sexual behavior and infection with human papillomaviruses (HPV). Thirty-two cases and 82 controls reported ever having used IC. Women reporting use of IC for less than 5 years had an adjusted RR of 0.5 (95% Cl = 0.3-0.9), but users for 5 or more years had an RR of 2.4 (95% Cl = 1.0-5.7). The effect of prolonged IC use was stronger for women reporting first use 10 or more years before interview (adjusted RR = 3.4, 95% Cl = 1.1-24.9) and more than 5 years since last use (adjusted RR = 5.3, 95% Cl = 1.1-10.0). Cervical cancer risk associated with prolonged IC use was particularly high among women who reported never having had a Pap smear or having had one 2 or more years before interview (adjusted RR = 6.3, 95% Cl = 2.1-18.7). The reduced cervical cancer risk associated with short-term use of IC may reflect intensive Pap smear screening as the method is initiated. Although hampered by small numbers, these results suggest an adverse effect of prolonged IC use on cervical cancer risk, particularly among women who cease participation in screening programs after terminating usage, and indicate that long-term IC users should be monitored for cervical disease until more conclusive results are available.

Case-Control Studies↗
PubMed1981

Comparison of the metabolic effects of two hormonal contraceptive methods: an oral formulation and a vaginal ring. II. Serum lipoproteins and apolipoproteins.

In a long-term, prospective study the effects on lipoprotein lipids and apolipoproteins (apo) of a combined oral contraceptive (OC) (30 micro gram ethinylestradiol and 150 micro gram levonorgestrel) and a contraceptive vaginal ring (CVR) releasing estradiol (about 180 micro gram per day) and levonorgestrel (about 290 micro gram per day) were compared. The two treatments induced significantly different effects. In the OC group the lipoprotein-lipid concentrations showed only minor changes, but apolipoproteins (apo) B and A-I increased by about 15%. In contrast, during treatment with the CVR there was a 25% decrement of cholesterol in high density lipoprotein (HDL) and at most 10% in low density lipoprotein (LDL) cholesterol, with only minor effects on apo B and A-I. The ratio of LDL and HDL cholesterol increased in the CVR group but not in the OC group. The results also indicate a change in the composition of the LDL and HDL particles, with an altered lipid/protein ratio, during both contraceptive treatments. Despite the impressive relative increase in LDL:HDL ratio in the contraceptive ring group, the average absolute value of this ratio did not reach the mena for healthy men.

Adolescent↗
PubMed1998

Bone density among long-term users of medroxyprogesterone acetate as a contraceptive.

The bone density (BD) of 72 women using depot-medroxyprogesterone acetate (DMPA) for at least 1 year was compared with that of 64 women who were not users of hormonal contraceptives. The BD of lumbar spine, femoral neck, Ward's triangle, and trochanter was measured by dual energy X-ray absorptiometry (DEXA-LUNAR DPX). Estradiol (E2) concentrations were measured by radioimmunoassay (RIA). The mean age of DMPA users and nonusers was 31.8 and 31.1 years, respectively. Mean E, was 55.7 pg/mL for users and 149.9 pg/mL for controls (p < 0.001). The BD was significantly lower for DMPA users than for controls in all sites (p < 0.01). In addition, young adult T-scores in the lumbar spine were significantly lower among DMPA users than in controls (p < 0.01). Differences were maintained in a subsample of 47 women per group paired by age and body mass index (BMI). Multiple regression analysis showed that older age, lower BMI, and longer amenorrhea were associated with lower BD in the femoral neck, whereas lower BMI and use of DMPA were associated with lower BD in the lumbar spine.

Absorptiometry, Photon↗
PubMed1982

Plasma high-density-lipoprotein cholesterol levels during long-term use of an oral contraceptive in Nigerian women.

Total and high-density lipoprotein (HDL) cholesterol were estimated in 131 blood samples obtained from women who had been taking the oral contraceptive Noriday 1 + 50Fe (one packet contains 21 tablets of 1 mg of norethindrone + 0.05 mg of mestranol, and 7 of 75 mg of ferrous fumarate) for 1-60 months. Thirty five women who had never used oral contraception (OC) formed the control group. There was a significantly higher mean HDL cholesterol level, and HDL cholesterol/total cholesterol ratio but not total cholesterol level in the women who had been using OC for 19-60 months. The values in women who had been using OC for 1-18 months were not significantly different from those in the control group. The increase in the HDL cholesterol level may not depend on the oestrogen content of the oral contraceptive but on the duration of its intake.

Adult↗
PubMed1989

[Enalapril versus digoxin in chronic congestive cardiac failure. Study of variation of the left ventricular ejection fraction determined by radio-isotopic angioscintigraphy at rest and during exertion].

The effects of enalapril were evaluated in a double-blind, controlled study during 8 weeks, in patients with stable, congestive chronic cardiac insufficiency (functional classification II and III of the NYHA), in sinus rhythm, treated with digitalis and diuretics. 20 patients were randomly divided in two groups: one group continuing the digoxin (group A: 10 patients) and one group where enalapril was substituted for digoxin (group B: 10 patients). Patients from group B presented less clinical aggravation during the study. The left ventricular stroke volume (SV) is significantly decreased in group B at rest (0.21 +/- 0.06 at 50; 0.18 +/- 0.04 at 54; p less than 0.05), while it remained stable during stress. No variations of the SVs were noted at rest and during stress in group A. Considering its favorable clinical effects and after evaluation of its longterm side effects, enalapril may be an acceptable alternative to digitalis in cardiac insufficiency with sinus rhythm, except in patients for whom a drop in the systemic blood pressure or an increased kaliemia or creatininemia, could be potentially harmful.

Digoxin↗