Effects of thirty elements on bone metabolism.

The human skeleton, made of 206 bones, plays vital roles including supporting the body, protecting organs, enabling movement, and storing minerals. Bones are made of organic structures, intimately connected with an inorganic matrix produced by bone cells. Many elements are ubiquitous in our environment, and many impact bone metabolism.

Treatment of climacteric symptoms in breast cancer patients: a retrospective study from a medication databank.

Introduction: Women affected by breast cancer (BC) will often go through menopause at an earlier age and display more frequent and severe symptoms than women who have a natural menopause. The safety of hormone replacement therapy (HRT) and vaginal estrogens for BC survivors has been debated over time and remains unclear. Non hormonal therapies such as antidepressants, gabapentine and clonidine may be useful for those patients but there are few data about their safety.

Update of the evolution of breast cancer incidence in relation to hormone replacement therapy use in Belgium.

Background: Several studies reported a decrease in breast cancer (BC) incidence, subsequent to the decrease in hormone replacement therapy (HRT) use.

Aim: Although Belgium has one of the highest incidences of BC in Europe and one of the highest rates of HRT use, we were unable, in a previous study, to observe a significant association between BC incidence and HRT changes. In this updated report we added the BC data from incidence years 2007 and 2008.

Evolution of breast cancer incidence in relation to hormone replacement therapy use in Belgium.

Background: Recent randomized studies concluded that an increased risk of breast cancer is associated with hormone replacement therapy (HRT). Since then, HRT use has decreased in many countries. Several studies have reported a subsequent decrease in breast cancer incidence.

A survey among breast cancer survivors: treatment of the climacteric after breast cancer.

Aim: To evaluate the prevalence and type of menopausal treatments used by breast cancer survivors. To assess factors that impaired the quality of life of these patients.

Material And Methods: A questionnaire assessing quality of life was sent to 325 breast cancer patients.

Domestic violence during pregnancy: survey of patients and healthcare providers.

Background: Domestic violence is a major public health problem; surveys report that 3%-17% of pregnant women suffer from it during their pregnancy, endangering fetal and maternal health. First, we aim (1) to estimate the prevalence of domestic violence in women who had been admitted to the maternity department of a public hospital that provides healthcare to a multicultural population, (2) to identify risk factors for domestic violence, and (3) to evaluate obstetrical complications. Second, we aim (4) to evaluate the attitude of healthcare providers toward screening for domestic violence.

Treatment of premature menopause in breast cancer patients.

Premature menopause occurs frequently in breast cancer patients (BC), but there are no specific data about its management. Although hormone therapy (HT) is very efficient in relieving menopausal symptoms, the prescription of this type of drug is still not indicated for BC patients, since in one randomized study (of two existing) an increased rate of new breast cancer (BC) occurrence in HT users was reported. The efficacy of other medications, such as serotonin re-uptake inhibitors, clonidine, veralipride, gabapentin, is much lower than that of HT.

Safety of alternative treatments for menopausal symptoms after breast cancer: a qualitative systematic review.

Aim: This qualitative review analyzes systematically the safety of drugs used to alleviate menopausal symptoms, other than hormone replacement therapy, in breast cancer patients.

Methods: We searched systematically studies using tibolone, serotonin reuptake inhibitors, clonidine, veralipride, gabapentin, black cohosh and phytoestrogens in breast cancer patients. We selected five studies for which we evaluated the methodology, characteristics of the studied populations, outcomes in terms of mortality and recurrence rates.

Impact of the fetal pulse oximetry on the obstetrical decision in the theoretical setting.

Objective: to assess whether fetal oxymetry reduces the intervention rate in a "theoretical setting".

Study Design: Data bank including 93 cases where a fetal oxymetry had been used for suspicion of fetal distress. Subjects-Two sets of labor charts were constructed for each case.

Safety of hormone therapy after breast cancer: a qualitative systematic review.

Background: This qualitative review systematically analyses the safety of hormone therapy (HT) in breast cancer (BC) patients.

Methods: We systematically searched studies reporting the use of HT in BC patients. We selected 20 studies in which we evaluated the methodology, characteristics of the studied populations and outcomes in terms of mortality and recurrence rates (RRs).

Estrogen therapy in older patients with recurrent urinary tract infections: a review.

Although urogenital complaints, such as recurrent lower urinary tract infections (UTI), and dysuria, are commonly encountered in elderly women, few women have participated in randomized studies of estrogen therapy for this condition. This is a paradox in view of the often cited beneficial effect of estrogen in reducing the incidence of UTI. Present evidence documents that in postmenopausal women, hormone replacement therapy using topical estrogen normalizes the vaginal flora and greatly reduces the risk of vaginal atrophy.

Cesarean section scar evaluation by saline contrast sonohysterography.

Objective: To investigate the frequency of images suggesting the existence of a dehiscence at the site of the uterine scar after Cesarean section.

Methods: Thirty-three women with a past history of Cesarean section who were planning a further pregnancy were involved in the study. Saline contrast sonohysterography (SCSH) was performed a minimum of 3 months following Cesarean section.

Influence of HRT on prognostic factors for breast cancer: a systematic review after the Women's Health Initiative trial.

Introduction: Mortality due to breast cancer has been reported to be the same or even lower in HRT users than in non-users. This has been attributed to earlier diagnosis and to better prognosis. Nevertheless, more advanced disease in HRT users was reported recently by the Women's Health Initiative (WHI) study.

Opinion survey towards hormone replacement therapy in the prevention of coronary heart disease.

Background: Observational and experimental data underscore the cardioprotective effects of hormone replacement therapy (HRT). On the other hand, the randomised trial available, the 'Heart and Estrogen/Progestin Replacement Study (HERS)', showed no reduced risk of coronary heart disease (CHD), using HRT.

Aim: Opinion survey on the effect of HRT on CHD risk.

"Fellow gynaecologists, help your patients stop smoking!".

Background: Age-adjusted mortality from lung cancer in American women has increased dramatically and has even exceeded breast cancer mortality. Gynaecologists, are often involved as primary actors in prevention strategies but may not be aware of this epidemic. This is especially true in Europe where, lung cancer mortality for women is three times lower than in the US.

Estrogen replacement therapy in patients with endometrial cancer: prescription attitude of Belgian gynecologists.

Background: Endometrial cancer is estrogen dependent and has been considered as a contraindication for HRT. Some uncontrolled studies reported no increase in recurrence in women who received ERT after they had suffered early stage endometrium cancer and many opinion leaders have mandated that early uterus cancer should not be considered as an absolute contraindication to HRT.

Aim: We conducted a survey evaluating the prescription attitude of Belgian gynecologists (n=1363) towards a case describing a patient who presents indication for ERT (climacteric symptoms and osteoporosis) and a past history of early stage endometrium cancer.

Inter-observer reproducibility of relative 99Tcm-DMSA uptake.

99Tcm-DMSA planar images of 49 randomly selected patients (10 adults, 39 children) were sent to 15 physicians at various centres in Belgium. They were asked to calculate, using their own routine program, the relative uptake (expressed as a percentage) of each kidney. The data were sent on disks formatted so that they could be read by all participants, using their own computer systems.

Osteoporosis management.

About 40% of women who reach the age of 50 are expected to suffer from osteoporosis during their remaining life. The morbidity associated with hip, spinal and wrist fractures, resulting from osteoporosis, and the mortality resulting from hip fractures justify the development of prevention strategies. Optimal management of osteoporosis consists of maximizing peak bone mass in early adulthood and preventing the rapid bone loss that occurs soon after the menopause.

Prescription attitudes among gynecologists towards two particular risk factors of osteoporosis: the patient's age and her bone mineral density.

Objective: The present report assesses, among Belgian gynecologists, the effect of age and bone mineral density on osteoporosis prescription strategy in postmenopausal women.

Methods: Charts of postmenopausal women were summarized. We constructed cases by modifying some parameters.

Managing the climacteric.

HRT taken for a sufficient duration may reduce the occurrence of osteoporosis and of cardiovascular disease by up to 50% and possibly also reduce incidence and lessen severity of Alzheimer's disease. Nevertheless, it is often only prescribed when women request it to relieve climacteric symptoms. Furthermore, many physicians prescribe it for only limited periods of time and few are willing to prescribe it to women in their sixties.

Educating patients about the benefits and drawbacks of hormone replacement therapy.

Hormone replacement therapy (HRT) influences many aspects of health: climacteric symptoms, osteoporosis, cardiovascular disease, breast and endometrial cancer, thrombosis and emboli, and Alzheimer's disease. A decision to use HRT may depend on a woman's individual views of the menopausal transition, the postmenopause and its consequences. It is therefore useful that the health provider inquiries about and discusses these issues in a cultural and family context.

Overall accuracy of technetium-99m-MAG3 clearance measurements obtained with a gamma camera heart curve.

Unlabelled: The aim of the present study was to evaluate the accuracy of 99mTc-MAG3 clearance measurements using a precordial gamma camera curve calibrated by a single plasma sample.

Methods: Technetium-99m-MAG3 was administered to ten young normal volunteers. A 60-min gamma camera acquisition was performed.

Effect of bone density evaluation on hormone replacement therapy prescription.

Objectives: This study evaluates whether Bone Mineral Density (BMD) results influence HRT prescription.

Methods: Successive charts of 29 postmenopausal women were summarised. For each chart, 3 'simulated cases' were created by modifying the BMD result (based on the Z-score) in order to have 4 groups with the same clinical story but a wide range of BMD values (Group I = Z-score > 0, Group II = Z-score between 0 and -1, Group III = Z-score between -1 and -2 and Group IV = Z-score < -2).