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Biomarkers of Stroke in Postmenopausal Women

Among postmenopausal women, baseline triglycerides, very low-density lipoprotein size, and intermediate-density lipoprotein particle number appear to be significantly associated with incident ischemic stroke, according to findings from a prospective study. The authors noted, however, that no significant baseline differences were observed for total cholesterol, LDL cholesterol, and lipoprotein(a). Abstract: Stroke, February 2, 2012...

Screening Recommendations for Osteoporosis

Over half of all postmenopausal women will develop a fracture related to osteoporosis during their lifetime, including 15% who will suffer hip fractures. Although fewer men than women develop osteoporosis, more than one-third of men who sustain a hip fracture die within 1 year. A new statement issued by the United States Preventive Services Task Force (USPSTF) aims to provide clinicians with current, evidence-based recommendations for osteoporosis screening. These recommendations, published in the January 2011Annals of Internal Medicine, are designed to assist clinicians on the appropriate time to initiate osteoporosis screening based on patient characteristics and clinical data. Major Modifications to Osteoporosis Recommendations In 2002, the USPSTF recommended to routinely screen women aged 65 and older for osteoporosis and screen women between the ages of 60 and 64 with an increased risk for osteoporotic fractures. Since 2002, a wealth of data has emerged on risk among younger women. Accordingly, the new recommendation extended screening for osteoporosis to women aged 65 or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old Caucasian woman who has no additional risk factors. The current guidelines contain no recommendation for or against osteoporosis screening in younger women. “Validation studies on tools to predict osteoporosis risk have been completed, and these investigations have revealed that risk assessment tools can accurately identify potential osteoporosis risk.” In 2002, a single osteoporosis screening tool was not recommended for universal use. Since that time, validation studies on tools to predict osteoporosis risk have been completed, and these investigations have revealed that risk assessment tools can accurately identify potential osteoporosis risk. The World...

An Update on Adjuvant Endocrine Therapy for Breast Cancer

It is estimated that more than 100,000 American women are diagnosed with estrogen receptor (ER)–positive, postmenopausal breast cancer each year, accounting for about half of all women with breast cancer in the United States. “ER–positive breast cancer is the single most common breast cancer diagnosis in the country,” says Harold J. Burstein, MD, PhD. “One of the most important treatments for women with postmenopausal breast cancer is anti-estrogen therapy.” Filling in Knowledge Gaps Tamoxifen and aromatase inhibitors (AIs) are treatments that can be used as adjuvant therapy after initial surgery, chemotherapy, and/or radiation in an effort to prevent breast cancer recurrences. In 2010, the American Society of Clinical Oncology (ASCO) issued a guideline update on the use of adjuvant hormone therapy for women with hormone receptor-positive breast cancer, revising previous guidelines from 2004. For the most recent update, ASCO’s Endocrine Therapy for Breast Cancer Update Committee conducted a systematic review of the available medical literature to develop the recommendations. “We reviewed the wealth of research that has emerged in the past several years on anti-estrogen drugs,” explains Dr. Burstein, who co-chaired the Update Committee. “Our missions were to fill in gaps in our understanding of how best to use these newer treatments and to gain better clarity on the trade-offs and side effects of these therapies.” ASCO’s updated guideline reviews recent research on both AIs and tamoxifen. Tamoxifen is a selective ER modulator, which blocks estrogen’s ability to reach the ER and stimulate residual cancer growth. AIs work differently in that they deplete the production of estrogen in postmenopausal women. “Tamoxifen and AIs work by different mechanisms and have...
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