Journal of Women's Health

: To characterize reports of adverse events occurring during mammography to women with breast implants submitted to the Food and Drug Administration (FDA).

: We searched the adverse events database for any report on silicone gel breast implants or saline breast implants that included the word "mammography" or "mammogram" in the text. We also searched adverse event reports for mammographic equipment that included the term "breast implant" in the text.

: We retrieved 714 adverse event reports using this strategy. Sixty-six of these reports detailed an adverse event that occurred during mammography or described breast implant interference with mammography. The majority of these reports, 41 of 66 (62.1%), described breast implant rupture during mammography. Other adverse events reported included mammographic compression crushing implants, pain during mammography attributed to implants, inability to perform mammography because of capsular contracture or fear of implant rupture, and delayed detection of cancer attributed to implants.

: It is important that women considering breast implants be informed of these potential risks and that clinicians, radiologists, and mammographic technicians keep them in mind when imaging women with implants.

: Vascular calcification holds promise as a useful cardiovascular risk maker. Our objective was to examine the association between breast vascular calcification and risk of cardiovascular disease (CVD) outcomes.

: A cohort study was performed among 12,761 women, 40-79 years of age at baseline (1968-1973), who attended multiphasic health checkups that included mammography. The outcome measures included coronary heart disease (CHD), ischemic stroke, transient ischemic attack (TIA), hemorrhagic stroke, and heart failure, ascertained using discharge diagnosis codes and death records through December 31, 2000 (median follow-up, 24.8 years).

: Breast vascular calcification was present in 424 (3%) women. It was independently and positively associated with age, high parity, and diabetes and inversely associated with education level and current cigarette smoking. After adjustment for age, education level, race, cigarette smoking, alcohol use, body mass index (BMI), serum total cholesterol, hypertension, diabetes, parental history of myocardial infarction (MI), parity, and hormone replacement therapy (HRT), breast vascular calcification was associated with a 1.32-fold increased risk of CHD (95% confidence interval [CI] 1.08-1.60), a 1.41-fold increased risk of ischemic stroke (95% CI 1.11-1.78), and a 1.52-fold increased risk of heart failure (95% CI 1.18-1.98).

: Breast vascular calcification detected as part of a screening mammogram was an independent risk factor for multiple cardiovascular outcomes among women. The value of mammography in cardiovascular risk stratification deserves further investigation.

: In light of substantial sex differences in health outcomes, researchers need to focus on disentangling the underlying biological and social determinants. The objective of this study is to determine whether two populations that differ in many cultural and social dimensions - Taiwan and the United States - also vary with regard to sex differentials in biological markers of chronic disease.

: The analysis is based on three population-based surveys that include interviews, urine and blood specimens, and physical examinations: the Social Environment and Biomarkers of Aging Study(SEBAS) in Taiwan, the Wisconsin Longitudinal Survey (WLS), and the MacArthur studies of successful aging. The outcomes comprise six indicators of cardiovascular risk (total/high-density lipoprotein [HDL] cholesterol, HDL cholesterol, systolic and diastolic blood pressure, glycosylated hemoglobin, and waist/hip ratio) and four markers of sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal(HPA) axis functioning (epinephrine, norepinephrine, cortisol, and dehydroepiandrosterone sulfate [DHEA-S]).

: U.S. males have significantly higher risk than females for all indicators of cardiovascular risk except glycosylated hemoglobin (p < 0.05). Sex differences are less consistent and smaller in Taiwan. Indicators of SNS and HPA axis functioning reveal a significant female disadvantage in both countries.

: The analysis identifies important sex differences between Taiwan and the United States in biomarkers of cardiovascular risk that are consistent with cause of death data and may emanate from cultural and social differences between the two societies. The similarity of sex differences in SNS and HPA axis functioning across studies may reflect either stable sex differences in biological aging of these axes or commonalities in the social construction of gender-based responses to life experiences.

: Raloxifene (RX), a selective estrogen receptor modulator (SERM), has demonstrated hypolipidemic and in vitro antioxidant properties. In the pathogenesis of atherosclerosis, the oxidative modification of low-density lipoprotein (LDL) is implicated to play a crucial role.

: In this study, we investigated the antioxidant properties of RX during in vitro LDL and high-density lipoprotein (HDL) oxidation. The concentrations of RX, chosen ranged from 5.1 to 5100 nM. Isolated lipoproteins were supplemented with RX, and copper-mediated oxidation was monitored via the formation of conjugated dienes (CD), and oxidation resistance (lag time) was calculated. The formation of thiobarbituric acid-reactive substances (TBARS) was measured after 90, 120, 210, and 300 minutes of oxidation.

: We found a dose-dependent inhibition of LDL and HDL oxidation in terms of both increased lag time and decreased formation of TBARS. Differences in lag time became significant at 51 nM RX added to LDL and HDL, respectively. TBARS formation in LDL was significantly reduced after 120 minutes incubation with 510 and 5100 nM RX and also after 300 minutes with 51 nM RX added. In HDL, significant reduction in TBARS formation was observed after 90 minutes by the addition of 51, 510, and 5100 nM RX.

: These results confirm data from previous studies concerning inhibition of in vitro oxidation of LDL by RX and additionally show that RX efficiently inhibits in vitro oxidation of HDL in a broad concentration range.

: The impact of a 6-month lifestyle change intervention on cardiovascular risk factors in obese, sedentary, postmenopausal women was examined. A secondary aim of this investigation was to determine whether the addition of self-control skills training to an empirically supported lifestyle change intervention would result in greater cardiovascular risk reduction.

: Forty-four women were randomly assigned to receive either a lifestyle change or a lifestyle change with self-control skills intervention. Pretreatment and posttreatment weight loss, body composition, physical activity, cardiorespiratory fitness, diet, blood pressure (BP), blood lipids, and psychosocial functioning were assessed. Also, at 1-year posttreatment, weight loss, body composition, self-reported physical activity, and psychosocial functioning were assessed.

: The women significantly increased their physical activity (+39.6%) and cardiorespiratory fitness (+13.5%) and reduced their body weight (-6.5%), fat mass (-7.4%), body fat (-2.4%), BP (SBP -6.2%, DBP -9.2%), total cholesterol (-7.4%), triglycerides (-16.5%), and low-density lipoprotein (LDL) cholesterol (9.1%) and improved their diet (p < 0.05). At the 1-year follow-up, women had regained approximately 63% of their posttreatment weight loss (p < 0.05), but had maintained their previous increases in physical activity. Additionally, there were no significant changes in fat free mass, body fat, anxiety, or depression between the end of treatment and 1-year posttreatment. The addition of self-control skills training did not significantly improve cardiovascular risk reduction.

: Lifestyle change interventions may be an effective means for reducing cardiovascular risk in obese, sedentary, postmenopausal women. However, greater attention should be devoted to the maintenance of these positive lifestyle changes.

: To determine whether ArginMax® (The Daily Wellness Co., Sunnyvale, CA) or the Panax ginseng extract it contains has any estrogenic activity. ArginMax for Women, a nutritional supplement for optimization of sexual health, contains L-arginine, ginseng, ginkgo, damiana, multivitamins, and minerals.

: A human endometrial adenocarcinoma cell line, Ishikawa, which contains an alkaline phosphatase (AP) enzyme sensitive to estrogen stimulation, was used in a bioassay to determine whether Panax ginseng or ArginMax contained estrogenic components.

: Neither ArginMax nor Panax ginseng stimulated AP at any of the concentrations tested.

: No estrogenic activity was evident in the sample of Panax ginseng extract tested or in a sample of ArginMax containing this extract in combination with other ingredients.

: To gather information about women's responses to the publication of the Women's Health Initiative (WHI) and to determine what proportion of women stopped hormone replacement therapy (HRT) and whether the technique of discontinuation affected the recurrence of menopausal symptoms.

: 73 subjects were identified through VA pharmacy records and were mailed a letter detailing the results of the WHI. A follow-up questionnaire was mailed several months later to the same population.

: 48 subjects responded and were eligible for inclusion in the study. Mean age was 62 years; 37(77%) stopped taking HRT, and 11(23%) continued. Twenty patients stopped abruptly, and 17 tapered off HRT. Eight (40%) of the group who stopped abruptly experienced recurrent menopausal symptoms, compared with 12(71%) of the group who tapered HRT.

: In a population of women veterans, 77% stopped HRT after publication of the WHI. Tapering HRT, rather than stopping abruptly, did not reduce the recurrence of menopausal symptoms in our patient population.