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Meester JAN, Hebert A, Bastiaansen M, Rabaut L, Bastianen J, Boeckx N, Ashcroft K, Atwal PS, Benichou A, Billon C, Blankensteijn JD, Brennan P, Bucks SA, Campbell IM, Conrad S, Curtis SL, Dasouki M, Dent CL, Eden J, Goel H, Hartill V, Houweling AC, Isidor B, Jackson N, Koopman P, Korpioja A, Kraatari-Tiri M, Kuulavainen L, Lee K, Low KJ, Lu AC, McManus ML, Oakley SP, Oliver J, Organ NM, Overwater E, Revencu N, Trainer AH, Trivedi B, Turner CLS, Whittington R, Zankl A, Zentner D, Van Laer L, Verstraeten A, Loeys BL. Expanding the clinical spectrum of biglycan-related Meester-Loeys syndrome. NPJ Genom Med 2024; 9:22. [PMID: 38531898 PMCID: PMC10966070 DOI: 10.1038/s41525-024-00413-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
Pathogenic loss-of-function variants in BGN, an X-linked gene encoding biglycan, are associated with Meester-Loeys syndrome (MRLS), a thoracic aortic aneurysm/dissection syndrome. Since the initial publication of five probands in 2017, we have considerably expanded our MRLS cohort to a total of 18 probands (16 males and 2 females). Segregation analyses identified 36 additional BGN variant-harboring family members (9 males and 27 females). The identified BGN variants were shown to lead to loss-of-function by cDNA and Western Blot analyses of skin fibroblasts or were strongly predicted to lead to loss-of-function based on the nature of the variant. No (likely) pathogenic missense variants without additional (predicted) splice effects were identified. Interestingly, a male proband with a deletion spanning the coding sequence of BGN and the 5' untranslated region of the downstream gene (ATP2B3) presented with a more severe skeletal phenotype. This may possibly be explained by expressional activation of the downstream ATPase ATP2B3 (normally repressed in skin fibroblasts) driven by the remnant BGN promotor. This study highlights that aneurysms and dissections in MRLS extend beyond the thoracic aorta, affecting the entire arterial tree, and cardiovascular symptoms may coincide with non-specific connective tissue features. Furthermore, the clinical presentation is more severe and penetrant in males compared to females. Extensive analysis at RNA, cDNA, and/or protein level is recommended to prove a loss-of-function effect before determining the pathogenicity of identified BGN missense and non-canonical splice variants. In conclusion, distinct mechanisms may underlie the wide phenotypic spectrum of MRLS patients carrying loss-of-function variants in BGN.
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Affiliation(s)
- Josephina A N Meester
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Anne Hebert
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Maaike Bastiaansen
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Laura Rabaut
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jarl Bastianen
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Nele Boeckx
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Kathryn Ashcroft
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds Teaching Hospitals, NHS Foundation Trust, Leeds, UK
| | - Paldeep S Atwal
- Genomic and Personalized Medicine, Atwal Clinic, Palm Beach, FL, USA
| | - Antoine Benichou
- Department of Internal and Vascular Medicine, CHU Nantes, Nantes Université, Nantes, France
| | - Clarisse Billon
- Service de Médecine Génomique des Maladies Rares, Groupe Hospitalier Universitaire Centre, Paris, Assistance Publique Hôpitaux de Paris, Paris, France
- Université de Paris Cité, Inserm, PARCC, Paris, France
| | - Jan D Blankensteijn
- Department of Vascular Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Paul Brennan
- Northern Genetics Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Ian M Campbell
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Solène Conrad
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - Stephanie L Curtis
- Bristol Heart Institute, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Majed Dasouki
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Carolyn L Dent
- South West Genomic Laboratory Hub, Bristol Genetics Laboratory, Bristol, UK
| | - James Eden
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | | | - Verity Hartill
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds Teaching Hospitals, NHS Foundation Trust, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Arjan C Houweling
- Department of Human Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Nicola Jackson
- Clinical Genetics Service, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Pieter Koopman
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Anita Korpioja
- Department of Clinical Genetics, Research Unit of Clinical Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Minna Kraatari-Tiri
- Department of Clinical Genetics, Research Unit of Clinical Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Liina Kuulavainen
- Department of Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kelvin Lee
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Karen J Low
- Clinical Genetics Department, University Hospitals Bristol and Weston NHS Foundation Trust St Michael's Hospital, Bristol, UK
- University of Bristol, Canynge Hall, Bristol, UK
| | - Alan C Lu
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Morgan L McManus
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stephen P Oakley
- John Hunter Hospital, New Lambton Heights, NSW, Australia
- College of Health, Medicine and Wellbeing, School of Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - James Oliver
- Genomic Diagnostics Laboratory, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Nicole M Organ
- John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Eline Overwater
- Department of Human Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicole Revencu
- Center for Human Genetics, Cliniques Universitaires Saint-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Alison H Trainer
- Department of Genomic Medicine, The Royal Melbourne Hospital and University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Bhavya Trivedi
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Claire L S Turner
- Department of Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Andreas Zankl
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Clinical Genetics, Children's Hospital at Westmead, Sydney, NSW, Australia
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Dominica Zentner
- Department of Genomic Medicine, The Royal Melbourne Hospital and University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Lut Van Laer
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Aline Verstraeten
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Bart L Loeys
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
- Department of Clinical Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
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Eden J, Dutkowski P. Prolonging Preservation or Assessment of Organ Quality-What is Key? Transpl Int 2023; 36:12174. [PMID: 38020743 PMCID: PMC10663298 DOI: 10.3389/ti.2023.12174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023]
Affiliation(s)
- J. Eden
- Section of HPB Surgery and Liver Transplantation, Department of Surgery, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - P. Dutkowski
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
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Eden J, Salas J, Santos Rutschman A, Prener CG, Niemotka SL, Wiemken TL. Associations of presidential voting preference and gubernatorial control with county-level COVID-19 case and death rates in the continental United States. Public Health 2021; 198:161-163. [PMID: 34461448 PMCID: PMC8463076 DOI: 10.1016/j.puhe.2021.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate the associations of state gubernatorial party control and 2016 county-level presidential election preference on COVID-19 case and death rates in the United States. STUDY DESIGN This was a secondary analysis of publicly available data. METHODS Data including county-level COVID-19 case and death counts through February 9, 2021, 2020 gubernatorial data, and county-level US Census Bureau data, Broadstreet area deprivation index, and 2016 presidential voting tallies were included. Negative binomial regression estimated the adjusted impact of each variable on COVID-19 case and death rates. RESULTS A total of 3102 counties in the 48 continental United States plus Washington DC were included. County-level case and death rates were higher (12% and 22%, respectively) in Republican vs Democrat controlled states. Case and death rates were higher in counties voting Republican vs Democrat in 2016 and were modified by counties with median ages ≥ 50 years (54% increase in case rate and 91% increase in death rate). CONCLUSIONS These data further support the need for prevention efforts to focus on public health while extricating guidance and prevention from political agendas.
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Affiliation(s)
- J Eden
- Saint Louis University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Allergy, and Immunology, USA
| | - J Salas
- Saint Louis University School of Medicine, Department of Family and Community Medicine, USA; Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, USA
| | - A Santos Rutschman
- Saint Louis University School of Law, Center for Health Law Studies, USA; Saint Louis University Institute for Vaccine Science and Policy, Data Science and Epidemiology, USA
| | - C G Prener
- Saint Louis University School of Arts and Sciences, Department of Sociology and Anthropology, USA
| | - S L Niemotka
- Saint Louis University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Allergy, and Immunology, USA; Saint Louis University Institute for Vaccine Science and Policy, Data Science and Epidemiology, USA
| | - T L Wiemken
- Saint Louis University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Allergy, and Immunology, USA; Saint Louis University Institute for Vaccine Science and Policy, Data Science and Epidemiology, USA.
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Abstract
The successful completion of complex tasks like hanging a picture or laparoscopic surgery requires coordinated motion of more than two limbs. User-controlled supernumerary robotic limbs (SL) have been proposed to bypass the need for coordination with a partner in such tasks. However, neither the capability to control multiple limbs alone relative to collaborative control with partners, nor how that capability varies across different tasks, is well understood. In this work, we present an investigation of tasks requiring three-hands where the foot was used as an additional source of motor commands. We considered: (1) how does simultaneous control of three hands compare to a cooperating dyad; (2) how this relative performance was altered by the existence of constraints emanating from real or virtual physical connections (mechanical constraints) or from cognitive limits (cognitive constraints). It was found that a cooperating dyad outperformed a single user in all scenarios in terms of task score, path efficiency and motion smoothness. However, while the participants were able to reach more targets with increasing mechanical constraints/decreasing number of simultaneous goals, the relative difference in performance between a dyad and a participant performing trimanual activities decreased, suggesting further potential for SLs in this class of scenario.
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Affiliation(s)
- A Noccaro
- NEXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - J Eden
- Department of Bioengineering, Imperial College of Science Technology and Medicine, London, UK
| | - G Di Pino
- NEXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - D Formica
- NEXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - E Burdet
- Department of Bioengineering, Imperial College of Science Technology and Medicine, London, UK
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Olubando D, Hopton C, Eden J, Caswell R, Lowri Thomas N, Roberts SA, Morris-Rosendahl D, Venetucci L, Newman WG. Classification and correlation of RYR2 missense variants in individuals with catecholaminergic polymorphic ventricular tachycardia reveals phenotypic relationships. J Hum Genet 2020; 65:531-539. [PMID: 32152366 DOI: 10.1038/s10038-020-0738-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 11/09/2022]
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is predominantly caused by heterozygous missense variants in the cardiac ryanodine receptor, RYR2. However, many RYR2 missense variants are classified as variants of uncertain significance (VUS). We systematically re-evaluated all RYR2 variants in healthy individuals and those with CPVT or arrhythmia using the 2015 American College of Medical Genomics guidelines. RYR2 variants were identified by the NW Genomic Laboratory Hub, from the published literature and databases of sequence variants. Each variant was assessed based on minor allele frequencies, in silico prediction tools and appraisal of functional studies and classified according to the ACMG-AMP guidelines. Phenotype data was collated where available. Of the 326 identified RYR2 missense variants, 55 (16.9%), previously disease-associated variants were reclassified as benign. Application of the gnomAD database of >140,000 controls allowed reclassification of 11 variants more than the ExAC database. CPVT-associated RYR2 variants clustered predominantly between amino acid positions 3949-4332 and 4867-4967 as well as the RyR and IP3R homology-associated and ion transport domains (p < 0.005). CPVT-associated RYR2 variants occurred at more conserved amino acid positions compared with controls, and variants associated with sudden death had higher conservation scores (p < 0.005). There were five potentially pathogenic RYR2 variants associated with sudden death during sleep which were located almost exclusively in the C-terminus of the protein. In conclusion, control sequence databases facilitate reclassification of RYR2 variants but the majority remain as VUS. Notably, pathogenic variants in RYR2 are associated with death in sleep.
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Affiliation(s)
- Damilola Olubando
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, M13 9WL, UK.,Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, UK
| | - Claire Hopton
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, M13 9WL, UK.,Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, UK
| | - James Eden
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, M13 9WL, UK
| | - Richard Caswell
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - N Lowri Thomas
- School of Pharmacy and Pharmaceutical Sciences, Redwood Building, University of Cardiff, Cardiff, CF10 3NB, UK
| | - Stephen A Roberts
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Deborah Morris-Rosendahl
- Clinical Genetics and Genomics, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Luigi Venetucci
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK.,Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, UK
| | - William G Newman
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, M13 9WL, UK. .,Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, UK. .,Peking University Health Sciences Center, Beijing, PR China.
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Rae D, Eden J, Miedzybrodzka Z. L04 Shaping The Huntington's Disease Journey: A Managed Care Pathway For Scotland. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Walker I, MacDonald F, Stuart H, Butler R, Ellwood-Thompson R, Brown C, Eden J, Gonzalez de Castro D, Thompson L, Lillis S, Mair D, Cloke V, Rehal P, Bell J, Smith M, O'Sullivan B, Taniere P, Griffiths M, Johnson PWM. Utilizing a collaborative working model to optimize molecular analysis of solid tumors in the Cancer Research UK's Stratified Medicine Programme. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.11094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11094 Background: The Stratified Medicine Programme is demonstrating large scale molecular testing of solid tumours in the UK using a range of technologies. The collaborative model has allowed three laboratories to share and compare data on mutation frequencies including mutation exclusivity, test turnaround times and failure rates, to inform a future routine service for clinical care. Methods: Phase One is a two-year pilot study of molecular analysis of surplus diagnostic FFPE tumour tissue obtained from patients with cancer of the breast, colorectum, lung, ovary, prostate or malignant melanoma. Samples are tested for specified genes of clinical and research interest (for example KRAS, BRAF, NRAS, PIK3CA, TP53, PTEN, TMPRSS2-ERG, EGFR, EML4-ALK and KIT). The labs have developed and validated protocols with comparable sensitivity for the simultaneous molecular analysis of multiple genes. Results: By 31 December 2012, 4,734 sets of molecular results were completed with 60% of tumour-site specific reports issued within the target 15 days (from sample receipt). Failure rates vary with both sample quality and the type of analysis performed. The Table illustrates the link between turnaround times and failure rates, showing that repeat testing for specimens which initially fail may reduce overall failure rates but consequently increase average turnaround times. Conclusions: We will report comparative data across the three testing labs and identify multiple factors that affect mutation detection rates, failure rates, turnaround times and reporting procedures. The Stratified Medicine Programme acknowledges funding from Cancer Research UK, AstraZeneca, and Pfizer. [Table: see text]
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Affiliation(s)
- Ian Walker
- Cancer Research UK Institute for Cancer Studies, London, United Kingdom
| | - Fiona MacDonald
- Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Helen Stuart
- All Wales Genetics Laboratory, Cardiff, United Kingdom
| | | | | | - Celia Brown
- All Wales Medical Genetics Service, Cardiff, United Kingdom
| | - James Eden
- All Wales Medical Genetics Service, Cardiff, United Kingdom
| | - David Gonzalez de Castro
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lisa Thompson
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sue Lillis
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Debbie Mair
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Vicky Cloke
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pauline Rehal
- Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Jenny Bell
- Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Matthew Smith
- Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - Michael Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
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Keenan KF, Miedzybrodzka Z, Eden J. N05 Fostering, adoption and Huntington's disease: improving clients' experience. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Schusser S, Smrekar U, Eden J, Beck T, Ellemunter H, Mitmannsgruber H. 361 The influence of experiential avoidance on depression, anxiety and life quality in adult cystic fibrosis (CF) patients. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60373-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Panay N, Al-Azzawi F, Bouchard C, Davis SR, Eden J, Lodhi I, Rees M, Rodenberg CA, Rymer J, Schwenkhagen A, Sturdee DW. Testosterone treatment of HSDD in naturally menopausal women: the ADORE study. Climacteric 2010; 13:121-31. [DOI: 10.3109/13697131003675922] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
AIM To investigate the menopausal experience of Arabic women living in Sydney and to explore the relationship between the psychosomatic symptoms and various sociodemographic factors. METHOD A cross-sectional survey was conducted among 197 Arabic women aged 45-65 years. The Menopause-specific Quality of Life (MENQOL) questionnaire was used to collect information on sociodemographic characteristics and menopausal symptoms. RESULTS The median age at menopause in the present study was 49 years (mean+/-standard deviation, 47.9+/-5.0 years). Out of 29 symptoms, the most frequent symptom reported was 'feeling tired or worn out' (86%), followed by 'aching in muscles and joints' (85%). Sixty-three percent of the subjects reported 'hot flushes' and 54% reported 'vaginal dryness during intercourse'. The least prevalent symptom was 'increased facial hair' (35%). Postmenopausal women suffered more vasomotor and sexual symptoms than pre- and perimenopausal women (p<0.05). Women from the sample who were better educated and had a lower body mass index reported fewer and less severe symptoms. CONCLUSION Menopause-related symptoms among these Arabic women in Sydney were more prevalent and severe than those reported in many other countries and their quality of life was negatively affected by these symptoms.
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Affiliation(s)
- J Lu
- School of Public Health and Community Medicine, Faculty of Medicine, the University of New South Wales, Australia
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Peeyananjarassri K, Cheewadhanaraks S, Hubbard M, Zoa Manga R, Manocha R, Eden J. Menopausal symptoms in a hospital-based sample of women in southern Thailand. Climacteric 2009; 9:23-9. [PMID: 16428122 DOI: 10.1080/13697130500487422] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate menopausal symptoms and quality of life in middle-aged women. STUDY DESIGN Hospital-based, cross-sectional study. METHODS A survey was conducted among 270 women aged 45-65 years who attended the gynecological and menopause clinic, Songklanagarind Hospital. We used the MENQOL questionnaire as the instrument. RESULTS The average age at menopause of the postmenopausal women was 48.7 years (range 40-57 years). The prevalences of the classical menopausal symptoms--hot flushes, night sweats, and vaginal dryness--in the women aged 45-65 years were 36.8%, 20.8 and 55.3%, respectively. The three most prevalent symptoms in perimenopause were aching in muscles and joints, experiencing poor memory, and change in sexual desire. Within the four domains (vasomotor, psychological, physical, and sexual symptoms), more suffering was reported in the perimenopausal and postmenopausal subjects than in the premenopausal subjects (p < 0.001). CONCLUSIONS Peri- and postmenopausal women had a significant decrease in quality of life compared to premenopausal women.
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Affiliation(s)
- K Peeyananjarassri
- Department of Obstetrics & Gynecology, Faculty of Medicine, Songklanagarind Hospital, Hat-Yai, Songkhla, Thailand
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O'Neill SM, Eden J, Baber R, Ekangaki A, Stocks JM, Wolthers T, Davis SR. Transition to raloxifene with and without low-dose estrogen therapy in postmenopausal women: effects on serum lipids and fibrinogen - a pilot study. Climacteric 2009. [DOI: 10.1080/cmt.6.4.347.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Panay N, Al-Azzawi F, Bouchard C, Davis S, Eden J, Lodhi I, Rees M, Rodenberg C, Rymer J, Schwenkhagen A, Sturdee D. TESTOSTERONE FOR TREATMENT OF HSDD IN NATURALLY MENOPAUSAL WOMEN: THE ADORE STUDY. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Griffin HR, Hall DH, Topf A, Eden J, Stuart AG, Parsons J, Peart I, Deanfield JE, O'Sullivan J, Babu-Narayan SV, Gatzoulis MA, Bu'Lock FA, Bhattacharya S, Bentham J, Farrall M, Granados Riveron J, Brook JD, Burn J, Cordell HJ, Goodship JA, Keavney B. Genetic variation in VEGF does not contribute significantly to the risk of congenital cardiovascular malformation. PLoS One 2009; 4:e4978. [PMID: 19308252 PMCID: PMC2654913 DOI: 10.1371/journal.pone.0004978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 01/19/2009] [Indexed: 11/18/2022] Open
Abstract
Several previous studies have investigated the role of common promoter variants in the vascular endothelial growth factor (VEGF) gene in causing congenital cardiovascular malformation (CVM). However, results have been discrepant between studies and no study to date has comprehensively characterised variation throughout the gene. We genotyped 771 CVM cases, of whom 595 had the outflow tract malformation Tetralogy of Fallot (TOF), and carried out TDT and case-control analyses using haplotype-tagging SNPs in VEGF. We carried out a meta-analysis of previous case-control or family-based studies that had typed VEGF promoter SNPs, which included an additional 570 CVM cases. To identify rare variants potentially causative of CVM, we carried out mutation screening in all VEGF exons and splice sites in 93 TOF cases. There was no significant effect of any VEGF haplotype-tagging SNP on the risk of CVM in our analyses of 771 probands. When the results of this and all previous studies were combined, there was no significant effect of the VEGF promoter SNPs rs699947 (OR 1.05 [95% CI 0.95–1.17]); rs1570360 (OR 1.17 [95% CI 0.99–1.26]); and rs2010963 (OR 1.04 [95% CI 0.93–1.16]) on the risk of CVM in 1341 cases. Mutation screening of 93 TOF cases revealed no VEGF coding sequence variants and no changes at splice consensus sequences. Genetic variation in VEGF appears to play a small role, if any, in outflow tract CVM susceptibility.
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Affiliation(s)
- Helen R. Griffin
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Darroch H. Hall
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ana Topf
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - James Eden
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - A. Graham Stuart
- Congenital Heart Centre, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Jonathan Parsons
- Paediatric Cardiology Unit, Leeds General Infirmary, Leeds, United Kingdom
| | - Ian Peart
- Department of Paediatric Cardiology, Alder Hey Royal Children's Hospital, Liverpool, United Kingdom
| | - John E. Deanfield
- Cardiothoracic Unit, Great Ormond Street Hospital, London, United Kingdom
| | - John O'Sullivan
- Congenital Heart Unit, Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Sonya V. Babu-Narayan
- Royal Brompton Hospital and National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - Michael A. Gatzoulis
- Royal Brompton Hospital and National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - Frances A. Bu'Lock
- Congenital and Paediatric Cardiology Service, Glenfield Hospital, Leicester, United Kingdom
| | - Shoumo Bhattacharya
- Department of Cardiovascular Medicine, University of Oxford, Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Jamie Bentham
- Department of Cardiovascular Medicine, University of Oxford, Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Martin Farrall
- Department of Cardiovascular Medicine, University of Oxford, Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Javier Granados Riveron
- Institute of Genetics, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - J. David Brook
- Institute of Genetics, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - John Burn
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Heather J. Cordell
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Judith A. Goodship
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Bernard Keavney
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Chirgwin JH, Lewis J, Woodfield R, Davis SR, Eden J, deBoer R. Menopause surveillance recommendations for patients with endocrine responsive breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #1148
Background: Women aged under 55 receiving breast cancer treatment frequently experience temporary or permanent menopause as a result. Although defining menopause status in these patients is problematic it fundamentally influences subsequent medical management. No definitive data or consensus exists to guide what surveillance is required in these women, particularly with respect to treatment with aromatase inhibitors (AIs) and/or ovarian suppression and for contraceptive advice.The ENHANCE Group, first convened in Australia in 2006, consists of 19 members, comprising Medical Oncologists, Breast Surgeons, Endocrinologists, Gynaecologists and a Consumer Representative. The aim of the Group is to develop practical advice on the management of QoL and adverse event issues associated with hormonal therapy of breast cancer in areas where high-level evidence is insufficient to inform practice. The Group produces recommendations for healthcare professionals and information leaflets for patients. All recommendations are supported with the maximum evidence available together with broad expert opinion.
 Methods:A review of the literature identified information regarding the definition of menopause, tests of menopause status and likelihood of menopause following different adjuvant chemotherapy regimens. Data on the likelihood of return of ovarian function was also identified. In addition, the use and benefit of ovarian function suppression and AIs for treatment of different subpopulations of breast cancer patients was reviewed. Using this review and expert opinion provided by members of the Group, an algorithm for determination of menopausal category was developed. Management recommendations, according to menopausal category were then determined.
 Results:Five distinct menopause categories were identified: Premenopausal, Postmenopausal, Very Low, Low, and Moderate potential for ovarian function recovery. Menopausal status prior to adjuvant chemotherapy, type of adjuvant treatment, age, duration of amenorrhoea, oestradiol and FSH levels and use of tamoxifen determined placement into the categories. The algorithm includes suggested monitoring practice, both clinical and biochemical, for each of the menopause categories and guidance for patients who have had a hysterectomy. The recommendations indicate: (i)contraceptive advice according to age and menopause category; (ii)appropriate use of AIs with suggested monitoring practices; (iii)monitoring suggestions for patients where ovarian function suppression may be appropriate (iv)advice to be provided to patients to assist in monitoring menopausal status. A separate information sheet was developed to inform patients about menopause monitoring.
 Conclusions:Ovarian function can return after a considerable period of amenorrhoea in patients undergoing systemic treatment for breast cancer. Return of ovarian function influences endocrine treatment of breast cancer, but it is often difficult to monitor accurately, and an appropriate schedule has not been investigated. Our work provides evidence-based recommendations (including expert opinion) for best practice in this area.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1148.
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Affiliation(s)
- JH Chirgwin
- 1 Enhance Consultative Group, Melbourne, Australia
| | - J Lewis
- 1 Enhance Consultative Group, Melbourne, Australia
| | - R Woodfield
- 1 Enhance Consultative Group, Melbourne, Australia
| | - SR Davis
- 1 Enhance Consultative Group, Melbourne, Australia
| | - J Eden
- 1 Enhance Consultative Group, Melbourne, Australia
| | - R deBoer
- 1 Enhance Consultative Group, Melbourne, Australia
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Abstract
BACKGROUND Vasomotor symptoms, such as hot flushes and night sweats, are very common during the menopausal transition. Hormone replacement therapy has traditionally been used as a very effective treatment but concerns over increased risks of some chronic diseases have markedly increased the interest of women in alternatives. Some of the most popular of these are treatments based on foods or supplements enriched with phytoestrogens, plant-derived chemicals that have oestrogenic action. OBJECTIVES To assess the efficacy, safety and acceptability of foods and supplements based on high levels of phytoestrogens for reducing hot flushes and night sweats in postmenopausal women. SEARCH STRATEGY Searches were undertaken of the following electronic databases: the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of randomised trials, Cochrane Register of Controlled Trials (CENTRAL) (March 2007), MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007), AMED (1985 to March 2007), PsycINFO (1986 to March 2007) and CINAHL (1982 to March 2007). Attempts were made to access grey literature by letters to pharmaceutical companies and searches of ongoing trial registers. Reference lists of included trials were also searched. SELECTION CRITERIA Studies were included if they were randomised, had peri- or postmenopausal participants with vasomotor symptoms, a duration of at least 12 weeks and where the intervention was a food or supplement with high levels of phytoestrogens (and not combined with other herbal treatments). Trials of women who had breast cancer or a history of breast cancer were excluded. DATA COLLECTION AND ANALYSIS Selection of trials, data extraction and quality assessment were undertaken by at least two authors. Most of the trials were too dissimilar to combine in meta-analysis and their results are provided in table format. Studies were grouped into broad categories: dietary soy, soy extracts, red clover extracts and other types of phytoestrogen. Five trials used Promensil, a red clover extract; these trials were combined in a meta-analysis and summary effect measures were calculated. MAIN RESULTS Thirty trials comparing phytoestrogens with control met the inclusion criteria. Very few trials had data suitable for combining in meta-analysis. Of the five trials with data suitable for pooling that assessed daily frequency of hot flushes, there was no significant difference overall in the frequency of hot flushes between Promensil (a red clover extract) and placebo (WMD=-0.6, 95% CI -1.8 to 0.6). There was no evidence of a difference in percentage reduction in hot flushes in two trials between Promensil and placebo (WMD=20.2, 95% CI -12.1 to 52.4). Individual results from the remaining trials were compared. Some of the trials found that phytoestrogen treatments alleviated the frequency and severity of hot flushes and night sweats when compared to placebo but many of the trials were of low quality and were underpowered. There was a strong placebo effect in most trials with a reduction in frequency ranging from 1% to 59% with placebo. There was no indication that the discrepant results were due to the amount of isoflavone in the active treatment arm, the severity of vasomotor symptoms or trial quality factors. There was also no evidence that the treatments caused oestrogenic stimulation of the endometrium (an adverse effect) when used for up to two years. AUTHORS' CONCLUSIONS There is no evidence of effectiveness in the alleviation of menopausal symptoms with the use of phytoestrogen treatments.
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Affiliation(s)
- A E Lethaby
- University of Auckland, O&G FMHS, Grafton Rd, Private Bag 92019, Auckland, New Zealand, 1142.
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Costello M, Shrestha B, Eden J, Sjoblom P, Johnson N. Insulin-sensitising drugs versus the combined oral contraceptive pill for hirsutism, acne and risk of diabetes, cardiovascular disease, and endometrial cancer in polycystic ovary syndrome. Cochrane Database Syst Rev 2007:CD005552. [PMID: 17253562 DOI: 10.1002/14651858.cd005552.pub2] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Insulin-sensitizing drugs (ISDs) have recently been advocated as possibly a safer and more effective long-term treatment than the oral contraceptive pill (OCP) in women with polycystic ovary syndrome (PCOS). It is important to directly compare the efficacy and safety of ISDs versus OCPs in the long-term treatment of women with PCOS. OBJECTIVES To assess the effectiveness and safety of ISDs versus the OCP (alone or in combination) in improving clinical, hormonal, and metabolic features of PCOS. SEARCH STRATEGY We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (September 2005), Cochrane Central Register of Controlled Trials (CENTRAL (Ovid), third quarter 2005), MEDLINE (1966 to September 2005), CINAHL (1982 to September 2005), and EMBASE (1988 to September 2005). References of the identified articles were handsearched, and pharmaceutical companies and experts in the field were also contacted for additional relevant studies. SELECTION CRITERIA Randomised controlled trials which compared ISDs versus the OCP (alone or in combination). DATA COLLECTION AND ANALYSIS Performed independently by two review authors. MAIN RESULTS Six trials were included for analysis, four of which compared metformin versus OCP (104 participants) and two of which compared OCP combined with metformin versus OCP alone (70 participants). Limited data demonstrated no evidence of difference in effect between metformin and the OCP on hirsutism and acne. There was either insufficient or no data on the relative efficacy of metformin or the OCP (alone or in combination) for preventing the development of diabetes, cardiovascular disease, or endometrial cancer. Metformin was less effective than the OCP in improving menstrual pattern (Peto odds ratio (OR) 0.08, 95% CI 0.01 to 0.45). Metformin resulted in a higher incidence of gastrointestinal (Peto OR 7.75, 95% CI 1.32 to 45.71), and a lower incidence of non-gastrointestinal (Peto OR 0.11, 95% CI 0.03 to 0.39), severe adverse effects requiring stopping of medication. Metformin was less effective in reducing serum androgen levels (total testosterone: weighted mean difference (WMD) 0.54, 95% CI 0.22 to 0.86; free androgen index: WMD 3.69, 95% CI 2.56 to 4.83). Metformin was more effective than the OCP in reducing fasting insulin (WMD -3.46, 95% CI -5.39 to -1.52) and not increasing triglyceride (WMD -0.48, 95% -0.86 to -0.09) levels, but there was insufficient evidence regarding comparative effects on reducing fasting glucose or cholesterol levels. AUTHORS' CONCLUSIONS Up to 12-months treatment with the OCP is associated with an improvement in menstrual pattern and serum androgen levels compared with metformin; but metformin treatment results in a reduction in fasting insulin and lower triglyceride levels than with the OCP. Side-effect profiles differ between the two drugs. There is either extremely limited or no data on important clinical outcomes such as the development of diabetes, cardiovascular disease, or endometrial cancer. There are no data comparing ISDs other than metformin (that is rosiglitazone, pioglitazone, and D-chiro-inositol) versus OCPs (alone or in combination).
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Affiliation(s)
- M Costello
- School of Women's & Children's Health, Royal Hospital for Women, Division of Obstetrics & Gynaecology, Barker Street, Randwick, Sydney, Australia, NSW 2031.
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O'Neill SM, Eden J, Baber R, Ekangaki A, Stocks JM, Wolthers T, Davis SR. Transition to raloxifene with and without low-dose estrogen therapy in postmenopausal women: effects on serum lipids and fibrinogen - a pilot study. Climacteric 2003; 6:347-53. [PMID: 15006256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To compare the effects of transferring from low-dose transdermal estrogen to raloxifene (RLX), with a phase of alternate-day RLX therapy with or without low-dose transdermal estrogen, on serum lipids and fibrinogen in postmenopausal women previously administered estrogen plus progestogen therapy. METHODS Sixty postmenopausal women (mean age 55 years) were randomized to one of two treatment groups: RLX + low-dose transdermal estrogen (RLX + E) or RLX + placebo. The study consisted of four 8-week phases: phase I (all subjects low-dose transdermal estrogen 25 microg/day), phase II (double-blind RLX 60 mg every 2nd day in combination with either low-dose transdermal estrogen or placebo), phase III (all subjects RLX 60 mg every 2nd day + placebo) and phase IV (all subjects RLX 60 mg/day + placebo). RESULTS No significant differences existed between groups for baseline measurements prior to phase I. In phase I, for all subjects combined, total cholesterol and low-density lipoprotein cholesterol both showed a significant increase (median increase of 0.2 mmol/l, p = 0.008 and 0.4 mmol/l, p< 0.001, respectively), while triglycerides decreased significantly (median decrease of 0.2 mmol/l, p< 0.001). For the primary analysis (phase II to phase IV), the mean change from baseline observations showed no significant differences between the therapy groups for serum lipids, fibrinogen, vital signs or weight. In the comparison phase (phase II), changes in serum lipids, fibrinogen, vital signs and weight were not significantly different between groups. CONCLUSION Gradual conversion to RLX from low-dose transdermal estrogen, with a phase of alternate-day RLX therapy with or without low-dose transdermal estrogen, does not have any effect on the serum lipid profile or fibrinogen level.
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Affiliation(s)
- S M O'Neill
- Betty Byrne Henderson Centre, Brisbane, Australia
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Abstract
Community health centers (CHCs) are in a strong position to meaningfully contribute to health promotion, early detection, and improvement in health care outcomes for some of the most vulnerable person in the nation, since almost one in three users of federally funded CHCs was uninsured in 1994. The purpose of this article is to compare uninsured CHC users with uninsured people nationwide. Data for the analysis came primarily from two population-based surveys: the 1994 National Health Interview Survey (NHIS) and the 1995 Community Health Center (CHC) User Survey.
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Affiliation(s)
- B L Carlson
- Mathematica Policy Research, Princeton, New Jersey, USA
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21
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Eden J. [Wellness and fitness in old age homes: enhancing independence and quality of life for seniors]. Pflege Z 2000; 53:529-32. [PMID: 11013559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Abstract
Phytoestrogens are defined as naturally occurring plant compounds that are structurally and functionally similar to 17 beta-estradiol or that produce estrogenic effects. The commonest sources are cereals, legumes and grasses. Isoflavones are the most highly investigated subgroup of phytoestrogens. They are attenuated estrogens and behave both in vivo and in vitro as agonists and antagonists. The highest concentrations are found in soy beans and legumes. The relative potencies of isoflavones as compared to estradiol are small but they can exhibit bioactivity when tested in high concentrations. A high dietary intake of phytoestrogens was first noted to be associated with a decreased incidence of certain diseases. This epidemiological information was obtained primarily from studying Asian populations. Soy consumption is highest in Japan, where urinary levels of phytoestrogen metabolites are extremely high, and where there are lower rates of so-called 'Western' diseases, namely breast, endometrial, colon and prostatic cancers as well as atherosclerotic disease. These observations have prompted extensive research, which has demonstrated the varying degrees of estrogenicity of these phytoestrogen compounds. This article provides an epidemiological background to phytoestrogens, a brief description of their composition and biochemistry, and an overview of the literature to date on phytoestrogens with an emphasis on relief of menopausal symptoms.
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Affiliation(s)
- R Mackey
- School of Obstetrics and Gynaecology, Royal Hospital for Women, Locked Bag 2000, Randwick, NSW, Australia 2031
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25
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Abstract
For most women, the menopause presents two sets of problems. First, most notice unpleasant symptoms such as hot flushes and vaginal dryness, but second, there are long-term sequelae arising from oestrogen deficiency. The main long-term problems are an increased risk of bone loss and cardiovascular disease. This chapter will focus on the role of phytoestrogens in alleviating menopausal symptoms. Studies to date would suggest that phytoestrogenic products may help around two-thirds of women to cope with menopausal symptoms such as hot flushes, but there is little evidence that these products will help with vaginal dryness. It seems probable that these products lower cholesterol and therefore cardiovascular risk; however, it is important that women who use such products to alleviate menopausal symptoms have a bone density performed every 2 or 3 years to assess their risk of osteoporosis.
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Affiliation(s)
- J Eden
- School of Obstetrics and Gynaecology, Royal Hospital for Women, Randwick, New South Wales, Australia
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Eden J. Facing cancer. Nurs Times 1998; 94:32-3. [PMID: 9923374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- J Eden
- Myton Hamlet Hospice, Warwick
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Eden J. Measuring access to care through population-based surveys: where are we now? Health Serv Res 1998; 33:685-707; discussion 709-13. [PMID: 9685112 PMCID: PMC1975652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- J Eden
- Mathematica Policy Research, Inc., Washington, DC 20024, USA
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Dew J, Eden J, Beller E, Magarey C, Schwartz P, Crea P, Wren B. A cohort study of hormone replacement therapy given to women previously treated for breast cancer. Climacteric 1998; 1:137-42. [PMID: 11907916 DOI: 10.3109/13697139809085529] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Women who have been previously treated for breast cancer are usually advised to avoid hormone therapy for fear of increasing their risk of tumor recurrence. However, for some women, menopausal symptoms are so severe that their quality of life is poor. Because ethic committees are reticent to permit a double-blind randomized trial, we performed a cohort study of hormone therapy after breast cancer. METHODS The study group comprised 1472 women with breast cancer. A total of 167 subjects had used an oral or transdermal estrogen after their treatment for breast cancer. Amongst these estrogen users, 152 (91%) had also used a progestin. In total, 106 other women had used a progestin alone as a treatment for menopausal flushes and not as a treatment for breast cancer. Cox regression analysis was performed using estrogen as a time-dependent covariate with disease-free interval as the outcome. RESULTS The uncorrected hazard ratio for the estrogen-progestin users was 0.67 (95% confidence interval (CI) 0.38-1.16) and for the progestin alone users was 0.85 (95% CI 0.44-1.65). CONCLUSIONS This study was unable to demonstrate a significant increase in risk of breast cancer recurrence for women who used HRT and suggests that the time is now appropriate for a randomized prospective trial of hormone therapy after breast cancer.
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Affiliation(s)
- J Dew
- Women's Health Institute, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia
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Abstract
OBJECTIVES To determine if there are specific patterns of illness behaviour in patients with arthritis, and if abnormal patterns of illness behaviour are associated with withdrawal from trials of anti-inflammatory drugs, and to examine which aspects of illness behaviour are perceived by rheumatologist to be related to the disease process. METHODS The illness behaviour questionnaire (IBQ) was administered to 211 patients with rheumatoid arthritis (RA) and 107 patients with osteoarthritis (OA) participating in five drug trials of NSAIDs at the beginning of the studies, and was commented upon by 17 clinical rheumatologists. RESULTS Factor analysis of 211 patients with RA produced a unique factor solution. RA patients were more preoccupied with their illness and its effects and worried more about their health than patients with OA. Patients who withdrew from drug trials showed behaviour patterns similar to those of chronic pain patients, and different from those of patients who completed the studies. When asked to account for a rheumatoid patient's response to the IBQ, rheumatologists focused on physical symptoms and did not recognise some of the psychological issues which patients saw as being relevant. CONCLUSIONS We have demonstrated differences in illness behaviour between patients with OA and with RA. Patients withdrawing from drug trials of NSAIDs showed differences in illness behaviour compared with those successfully completing the trials. Rheumatologists underestimated the impact of the disease on their RA patients' psychological well being.
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Affiliation(s)
- M J Ahern
- Department of Rheumatology, School of Medicine, Flinders University of South Australia, Adelaide
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Affiliation(s)
- J Eden
- OTA Health Program, Washington, DC 20510
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Abstract
Despite the proven efficacy of Electroconvulsive Therapy [ECT], negative attitudes occur in some patients towards its use. However, research into attitudes of patients and public towards ECT, and the influence of the media on these attitudes, is limited and often contradictory. The aims of this study were: to develop a self-administered questionnaire to assess attitudes; to assess the effect of an educational video on attitudes; and to assess the effect of the media on attitudes. The questionnaire was administered to psychiatric and non-psychiatric patients of a Veterans' hospital and to a group of general hospital patients. A video was shown to a randomly assigned group of the Veteran hospital psychiatric patients. Their attitudes were assessed before and after the video. An overall positive attitude towards ECT was demonstrated in all three groups. Showing a video to the Veteran psychiatric patients produced an improvement in some attitudes, but no reduction in fear. For the psychiatric patients, the effect of the media was negative.
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Affiliation(s)
- M Battersby
- Flinders Medical Centre, Bedford Park, South Australia
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Wren BG, Webster M, Eden J. Management of hyperlipidaemia: a consensus statement. Med J Aust 1992; 156:510. [PMID: 1556985 DOI: 10.5694/j.1326-5377.1992.tb126498.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Yellowlees P, Vizard T, Eden J. Australian medical students' attitudes towards specialties and specialists. Med J Aust 1990; 152:587-8, 591-2. [PMID: 2348784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Two hundred and thirteen medical students in their first five years of study at the Flinders University of South Australia completed a 50-item questionnaire studying their beliefs and attitudes towards the specialties and the specialists involved in hospital medicine, surgery, paediatrics, obstetrics and gynaecology, and psychiatry. Four factors were identified that appeared to be of particular importance to the students. These were labelled, "scientific/treatment effective", "patient relationships", "usefulness of specialty" and "intellectual/status". Psychiatry consistently stood out from the other four specialties on all four factors, although the Australian students in this study generally appeared more positive towards all five specialties than did their British counterparts whose attitudes have been described elsewhere. Students' beliefs about medical stereotypes appeared relatively constant throughout their first five years of medical training.
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Eden J. Too much of a good thing? Two cases of oestrogen overdosage associated with oestradiol implants. Med J Aust 1990; 152:558. [PMID: 2338934 DOI: 10.5694/j.1326-5377.1990.tb125373.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Eden J. From the Congressional Office of Technology Assessment. JAMA 1989; 262:3392. [PMID: 2585683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Eden J. Can the fetus cause placental separation? Aust N Z J Obstet Gynaecol 1988; 28:119-20. [PMID: 3228406 DOI: 10.1111/j.1479-828x.1988.tb01638.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Two cases of painless antepartum haemorrhage are presented, in which it would seem the likely explanation was fetal trauma to the placental edge. The value of an immediate ultrasound scan is emphasized.
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Affiliation(s)
- J Eden
- Charing Cross Hospital, London
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Kramer HJ, Düsing R, Stinnesbeck B, Prior W, Bäcker A, Eden J, Kipnowski J, Glänzer K, Krück F. Interaction of conventional and antikaliuretic diuretics with the renal prostaglandin system. Clin Sci (Lond) 1980; 59:67-70. [PMID: 7471645 DOI: 10.1042/cs0590067] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
1. The effects of frusemide, hydrochlorothiazide and spironolactone on the renal prostaglandin system, and the interference with their diuretic and natriuretic effects by inhibition of prostaglandin synthase, were investigated in healthy human subjects.
2. Urinary excretion of prostaglandin E2 was increased by the administration of frusemide (P < 0.05), hydrochlorothiazide and particularly by spironolactone, the least potent natriuretic agent (P < 0.05). A qualitatively similar but statistically insignificant rise in excretion of prostaglandin F2α was observed with hydrochlorothiazide.
3. The rise in urinary excretion of sodium after frusemide and hydrochlorothiazide was significantly reduced by indomethacin, which also abolished the potassium-sparing effect of spironolactone and partially suppressed the diuretic-induced rise in plasma renin activity.
4. Indomethacin had no significant effect on urinary osmolality or free water absorption in the presence of frusemide or hydrochlorothiazide, but markedly enhanced urinary osmolality (P < 0.05) and free water absorption (P < 0.05) in the presence of spironolactone.
5. Increased renal prostaglandin activity after frusemide, hydrochlorothiazide and spironolactone may contribute to their natriuretic action which, in addition to the antikaliuretic effect of spironolactone, may be partially abolished by the presence of non-steroidal antiphlogistic agents.
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Eden J, Applegarth D. A template for the conversion of enzyme reaction rates tointernational units of enzyme activity. Clin Biochem 1967. [DOI: 10.1016/s0009-9120(67)80031-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Eden J, Black I. A Clinical Comparison Between the Friedman Test and an in Vitro Test for Pregnancy. Can Med Assoc J 1963; 88:1174. [PMID: 20327574 PMCID: PMC1921540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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43
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Palmer RA, Maybee TK, Henry EW, Eden J. Peritoneal Dialysis in Acute and Chronic Renal Failure. Can Med Assoc J 1963; 88:920-927. [PMID: 20327512 PMCID: PMC1921256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Clinical experience with peritoneal dialysis in eight cases of acute and four cases of chronic renal failure is presented. Seven of the acute cases survived but in some of these hemodialysis was also employed. The relatively simple technique of peritoneal dialysis was found to be effective, although slower than hemodialysis. In three of the cases it was selected in preference to hemodialysis. Its main advantages are that it does not require elaborate arrangements, or the use of blood or anticoagulants. The authors conclude that when the peritoneum is intact the method can be employed whenever the use of a temporary kidney substitute is indicated.
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Eden J, Black I. A Clinical Comparison Between the Friedman Test and an in Vitro Test for Pregnancy. Can Med Assoc J 1963; 88:792-796. [PMID: 20327485 PMCID: PMC1921329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Latex pregnancy tests were performed on 737 urine samples submitted to a hospital laboratory for Friedman tests. Clinical confirmation of the diagnoses was obtained in 666. Nine Friedman and 31 latex tests were falsely positive in 199 samples having specific gravities over 1.015. Each test gave four false-positive results in 65 samples with specific gravities under 1.015. Between six and 13 weeks of gestation, nine Friedman and 45 latex tests were negative in 176 samples with specific gravities above 1.015; below 1.015, five Friedman and 15 latex tests were false in 42 samples. At other stages of pregnancy, seven Friedman and 18 latex tests were negative in 56 samples with specific gravities over 1.015 and, under 1.015, nine samples had four negative latex tests.The latex test requires careful control and is less reliable than the Friedman test.
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