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This Week in JAMA
March 21, 2001

This Week in JAMA

JAMA. 2001;285(11):1399. doi:10.1001/jama.285.11.1399

Women's Health

Edited by Catherine D. DeAngelis, MD, MPH, and Margaret A. Winker, MD

Physical Activity and Coronary Heart Disease in Women

Physically active women have lower rates of coronary heart disease than inactive women. To determine whether this association differs by intensity of activity or for women at high risk of coronary heart disease, Lee and colleagues analyzed data from 39 372 healthy women enrolled in the Women's Health Study and followed up for an average of 5 years. Physical activity, even light to moderate activity, was inversely associated with risk of coronary heart disease, including among women who were overweight, had increased cholesterol levels, or were smokers.

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Homicide as a Cause of Pregnancy-Associated Death

Using a definition of pregnancy-associated death as a death during pregnancy or within 1 year of delivery or pregnancy termination from any cause, including injuries, suicide, or homicide, Horon and ChengArticle used multiple data sources to identify pregnancy-associated deaths in Maryland between 1993 and 1998. The leading cause of pregnancy-associated death was homicide, followed by cardiovascular disorders. In an editorial, FryeArticle urges routine screening of all female patients for domestic violence.

Estrogen After Menopause

The decision to use hormone replacement therapy (HRT) after menopause is complicated by conflicting data on its benefits, such as reducing risk of dementia, and the increase in risk of endometrial and breast cancer, and possibly ovarian cancer. In a prospective study of postmenopausal women followed up for 14 years, Rodriguez and colleaguesArticle found that women who used estrogens at baseline (1982) or within 15 years prior to baseline for 10 or more years had higher death rates from ovarian cancer than never users. Geerlings and colleaguesArticle, using data from a prospective study of postmenopausal women aged 55 or older, found that a longer reproductive period, as an indicator of long-term exposure to endogenous estrogens, was not associated with a decreased risk of dementia. LeBlanc and colleaguesArticle conducted a systematic review and meta-analysis of studies on the relationship between HRT and the risk of cognitive decline and dementia. HRT use was associated with improvement in some cognitive functions among women who had symptoms of menopause, but not among asymptomatic women. Risk of dementia appeared to be reduced among women who used HRT, but most of the studies had methodological limitations.

Mortality Among Women With HIV and Depression

Clinical levels of depression have been reported by 30% to 60% of women infected with HIV. Ickovics and colleagues used data from the prospective HIV Epidemiologic Research Study to determine whether depressive symptoms were associated with HIV-related mortality among women infected with HIV observed for up to 7 years. HIV-seropositive women with chronic depressive symptoms were 2 times more likely to die than those with limited or no depressive symptoms. Chronic depressive symptoms were also associated with significantly greater decline in CD4 cell counts.

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Ipriflavone as Therapy for Postmenopausal Osteoporosis

In preclinical studies, ipriflavone, a synthetic isoflavone derivative available as an over-the-counter preparation, has been shown to inhibit bone resorption and stimulate osteoblast activity. In this randomized trial among postmenopausal women, Alexandersen and colleagues found that during the 3-year treatment period, decreases in bone mineral density were not significantly different between the ipriflavone and placebo groups, and changes in biochemical markers of bone resorption and rates of new vertebral fracture were also similar. Twenty-nine of the 234 women in the ipriflavone group developed subclinical lymphocytopenia during ipriflavone treatment, most of whom recovered spontaneously within 2 years after discontinuation of ipriflavone.

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A Piece of My Mind

"When I was told my diagnosis, my first question was: ‘How will I tell my sisters?'" From "Searching for Margaret."

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Contempo Updates

Available therapies for postmenopausal osteoporosis and the patient subgroups likely to benefit.

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Medical News & Perspectives

Physicians who treat women are putting increased emphasis on encouraging physical exercise to enhance female strength and agility and on effectively treating depression.

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Cervical Cytologic and Histologic Diagnoses

Findings that agreement among well-trained pathologists on the interpretation of cytologic and histologic cervical specimens is only moderate, and not more reproducible for histologic than for cytologic specimens, underscore the need to clarify diagnostic criteria and nomenclature.

JAMA Patient Page

For your patients: Information about the benefits of physical activity and exercise for women's cardiovascular health.

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