scholarly journals Health consequences of short- and long-term postmenopausal hormone therapy

1996 ◽  
Vol 42 (8) ◽  
pp. 1342-1344 ◽  
Author(s):  
N S Weiss
Keyword(s):  
Breast Cancer ◽  
Myocardial Infarction ◽  
Extended Period ◽  
Postmenopausal Hormone Therapy ◽  
Short Term ◽  
Increased Risk ◽  
Short And Long Term ◽  
Hormone Use ◽  
Risk Of Cancer

Abstract Some women take an estrogen preparation for as long as several years to ease symptoms of the menopause. Such women appear to have little or no alteration in their risk of endometrial cancer, especially if they are also taking a progestogen, and no alteration in their risk of breast cancer. Similarly, the incidence of fractures is unaffected by relatively short-term hormone use. The risk of ischemic heart disease also is reduced among women who currently take estrogens (with or without a progestogen), but the influence of duration of use on this association is uncertain. Postmenopausal women who take estrogens for an extended period of time (e.g., a decade or more) incur a sharply increased risk of cancer of the endometrium. This is largely abated by use of a progestogen for at least 10 days per month. Such long-term estrogen use, whether accompanied by a progestogen or not, may increase the risk of breast cancer slightly, but this is an area of great controversy, at present unresolved. The incidence of both myocardial infarction and fracture is substantially reduced in long-term users of menopausal hormones.

scholarly journals Short- and Long-Term Impact of Receiving Genetic Mutation Results in Women at Increased Risk for Hereditary Breast Cancer

2004 ◽  
Vol 13 (2) ◽  
pp. 115-133 ◽  
Author(s):  
Jacqueline Lim ◽  
Mariette Macluran ◽  
Melanie Price ◽  
Barbara Bennett ◽  
Phyllis Butow ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hereditary Breast Cancer ◽  
Genetic Mutation ◽  
Increased Risk ◽  
Short And Long Term ◽  
Long Term Impact

Low High-Density Lipoprotein Cholesterol to Monitor Long-Term Average Increased Triglycerides

2019 ◽  
Vol 105 (4) ◽  
pp. e1657-e1666 ◽  
Author(s):  
Anne Langsted ◽  
Anne Marie Reimer Jensen ◽  
Anette Varbo ◽  
Børge G Nordestgaard
Keyword(s):  
Myocardial Infarction ◽  
High Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Short Term ◽  
Glucose Levels ◽  
Increased Risk ◽  
Remnant Cholesterol ◽  
Low Hdl

Abstract Context Increased triglyceride-rich remnants represent a causal risk factor for ischemic cardiovascular disease. Objective We tested the hypothesis that low high-density lipoprotein (HDL) cholesterol can be used to monitor long-term high triglycerides/remnant cholesterol, just as high hemoglobin A1c (HbA1c) can be used to monitor long-term high glucose levels. Design, Setting, Participants, and Interventions We studied cross-sectionally 108 731 individuals, dynamically 1313 individuals with lipid measurement at 10 repeated visits, short-term 305 individuals during a fat load, and long-term 10 479 individuals with 2 lipid measurements 10 years apart. Main Outcome Measures Levels of HDL cholesterol and triglycerides. Results Cross-sectionally, HDL cholesterol was inversely associated with triglycerides (R2 = 0.26) and remnant cholesterol (R2 = 0.26). Dynamically, major changes in triglyceride levels from measurement to measurement were mimicked by corresponding modest changes in HDL cholesterol. In the short-term after a fat load, median triglycerides increased 96% while HDL cholesterol decreased only 1%. Long-term, in individuals with measurements 10 years apart, those who initially had the highest triglycerides and corresponding lowest HDL cholesterol, still had highest triglycerides and lowest HDL cholesterol 10 years later. Prospectively, individuals with increased triglycerides/remnant cholesterol had increased risk of myocardial infarction; however, when the HDL cholesterol monitoring was removed, increased triglycerides/remnant cholesterol were largely no longer associated with increased risk of myocardial infarction. Conclusions Low HDL cholesterol is a stable marker of average high triglycerides/remnant cholesterol. This suggests that low HDL cholesterol can be used to monitor long-term average high triglycerides and remnant cholesterol, analogous to high HbA1c as a long-term monitor of average high glucose levels.

scholarly journals Matched-Pair Long-Term Survival Analysis of Male and Female Patients with Breast Cancer: A Population-Based Study

2021 ◽  
Author(s):  
Xiaoshuang Feng ◽  
Miao Mo ◽  
Chunxiao Wu ◽  
Yangming Gong ◽  
Changming Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Rates ◽  
Matched Pair ◽  
Term Survival ◽  
Male And Female ◽  
Long Term Survival ◽  
Female Patients ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Purpose: To examine the differences in long-term survival between male and matched female breast cancer cases based on data from the Shanghai Cancer Registry (SCR).Methods: Every male breast cancer case was matched with four female cases according to the year of diagnosis, age, tumor stage, and histological subtype. Cumulative observed overall survival (OS) and cancer-specific survival (CSS) rates were calculated using Kaplan-Meier survival estimates, and log-rank tests were applied to compare the survival rates of male and female cases. Cox proportional-hazards regression models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for the association between sex and the risk of death.Results: 50,958 patients with breast cancer (0.85% male) were registered in the SCR between 2002 and 2013. After matching, 434 male and 1736 female patients were included in the study. With a median follow-up time of 10 years, men with breast cancer showed significantly worse OS (P < 0.0001) and CSS (P < 0.0001) than women. The 5- and 10-year OS rates for male and female patients were 67.27% and 77.75%, and 45.95% and 62.60%, respectively; the 5- and 10-year CSS rates for male and female patients were 70.19% and 79.79%, and 50.57% and 67.20%, respectively. Compared with women, men had 65% increased risk of overall death (95% CI: 1.42-1.92) and 70% increased risk of cancer-specific death (95% CI: 1.44-2.00).Conclusion: The study provided evidence at the population level that male patients with breast cancer had lower survival rates than women in China.

scholarly journals Comparison of Technical and Fundamental Analysis Trading Disciplines on Portfoilo Performance: Short and Long Term Backtest Analysis on Borsa İstanbul National Stock Indices

2021 ◽  
Vol 3 (3) ◽  
pp. 128-143
Author(s):  
Mustafa ÖZYEŞİL
Keyword(s):  
Abnormal Returns ◽  
Fundamental Analysis ◽  
Short Term ◽  
Risk And Return ◽  
Stock Indices ◽  
Technical And Fundamental Analysis ◽  
Increased Risk ◽  
Short And Long Term

The aim of this study is to comparatively analyze the backtest performances of trading disciplines applied in various portfolio baskets (Bist 30, 50 and 100) for different investment periods (short term – ytd and long term). According to the results of the analysis, it has been determined that in all trading disciplines, the investor has a higher return than the benchmark indicator in a 5-year term, that is, they can earn abnormal returns. Also, the return in the 5-year term is much higher than the 1-year and YTD returns. In the P / E & MA model, the Bist - 50 index in the 5-year period and the Bist - 100 index in the 1-year period provide the maximum return, while according to the P / E model, the Bist-30 and Bist -50 indices provide optimum returns in all maturity options. Based on these findings, it can be expected that if the trading disciplines used in this study are applied in a long term such as 5 years and on the portfolio basket consisting of Bist-30 and Bist-50 industrial stocks, it will maximize returns. In terms of risk and return, in YTD period, the sharpe and treynor ratios of the model portfolio formed in all trading disciplines except M /B trading discipline were lower than in 1 year in the 5-year investment period. This situation arose due to the increased risk of the portfolio as a result of the extended maturity and is in line with our expectations.

Does Long-Term Exposure to Gel-Filled Silicone Implants Increase the Risk of Relapse after Breast Cancer?

1998 ◽  
Vol 84 (5) ◽  
pp. 525-528 ◽  
Author(s):  
Jean-Yves Petit ◽  
Monique Lê ◽  
Mario Rietjens ◽  
Geneviève Contesso ◽  
Andrée Lehmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Proportional Hazards Model ◽  
Silicone Implants ◽  
Control Group ◽  
Second Primary ◽  
Increased Risk ◽  
Risk Of Cancer

Background An increased risk of cancer and autoimmune diseases associated with gel-filled silicone implants, debated by FDA experts since 1991, has given rise to a profusion of literature on the subject. However, such effects have not been adequately investigated in patients with breast cancer. In a previous report we compared 146 breast cancer patients with gel-filled silicone implants for breast reconstruction to 146 control patients in whom no reconstruction had been performed. The observed results were reassuring, as the evolution of the disease after 10 years was better in the reconstruction group than in the control group. We now report the end results of this study with a median follow-up of 13 years after the breast reconstruction (range, 10-20 years). Method The relative risks of detrimental events were estimated with Cox's Proportional Hazards Model, with stratification according to age at diagnosis. Results The risks of locoregional recurrences and distant metastasis were significantly lower in the BR group than in the control group. The risks of death, of a second breast cancer and of a second primary cancer at a site other than the breast were not significantly different between the two groups of patients. Conclusion Long-term follow-up of patients exposed to gel-filled silicone implants confirms the absence of detrimental effects after breast cancer. The power of our study is, however, below that required to detect a very slight increase in the risks studied.

scholarly journals Association Between Out-of-Hour Admission and Short- and Long-Term Mortality in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Yan Yu ◽  
Bo-Wen Zhao ◽  
Lan Ma ◽  
Xiao-Ce Dai
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Publication Bias ◽  
Meta Analysis ◽  
Short Term ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
Long Term Mortality

Objectives: Out-of-hour admission (on weekends, holidays, and weekday nights) has been associated with higher mortality in patients with acute myocardial infarction (AMI). We conducted a meta-analysis to verify the association between out-of-hour admission and mortality (both short- and long-term) in AMI patients.Design: This Systematic review and meta-analysis of cohort studies.Data Sources: PubMed and EMBASE were searched from inception to 27 May 2021.Eligibility Criteria for Selected Studies: Studies of any design examined the potential association between out-of-hour admission and mortality in AMI.Data Extraction and Synthesis: In total, 2 investigators extracted the data and evaluated the risk of bias. Analysis was conducted using a random-effects model. The results are shown as odds ratios [ORs] with 95% confidence intervals (CIs). I2 value was used to estimate heterogeneity. Grading of Recommendations Assessment, Development, and Evaluation was used to assess the certainty of the evidence.Results: The final analysis included 45 articles and 15,346,544 patients. Short-term mortality (defined as either in-hospital or 30-day mortality) was reported in 42 articles (15,340,220 patients). Out-of-hour admission was associated with higher short-term mortality (OR 1.04; 95%CI 1.02–1.05; I2 = 69.2%) but there was a significant statistical indication for publication bias (modified Macaskill's test P &lt; 0.001). One-year mortality was reported in 10 articles (1,386,837 patients). Out-of-hour admission was also associated with significantly increased long-term mortality (OR 1.03; 95%CI 1.01–1.04; I2 = 66.6%), with no statistical indication of publication bias (p = 0.207). In the exploratory subgroup analysis, the intervention effect for short-term mortality was pronounced among patients in different regions (p = 0.04 for interaction) and socio-economic levels (p = 0.007 for interaction) and long-term mortality was pronounced among patients with different type of AMI (p = 0.0008 for interaction) or on different types of out-to-hour admission (p = 0.006 for interaction).Conclusion: Out-of-hour admission may be associated with an increased risk of both short- and long-term mortality in AMI patients.Trial Registration: PROSPERO (CRD42020182364).

Cancer occurrence in Turner syndrome and the effect of sex hormone substitution therapy

2021 ◽  
Vol 184 (1) ◽  
pp. 79-88
Author(s):  
Mette Hansen Viuff ◽  
Kirstine Stochholm ◽  
Angela Lin ◽  
Agnethe Berglund ◽  
Svend Juul ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Skin Cancer ◽  
General Population ◽  
Turner Syndrome ◽  
Skin Neoplasms ◽  
Cancer Occurrence ◽  
Increased Risk ◽  
Rectal Cancers ◽  
Risk Of Cancer

Objective Although the overall risk of cancer is not increased in Turner syndrome, the pattern of cancer occurrence differs from the general population. We aim to describe the cancer morbidity pattern in Turner syndrome and evaluate the effect of long-term hormone replacement therapy (HRT). Design Nationwide epidemiological study. Methods 1156 females with Turner syndrome diagnosed during 1960–2014, were linked with data from the Danish National Patient Registry. Statistics Denmark randomly identified 115 578 female controls. Stratified Cox regression was used to analyze cancer morbidity, mortality and effect of HRT. Results Overall risk of cancer was not elevated (hazard ratio 1.04 (95% CI: 0.80–1.36)). The risk of skin cancer and benign skin neoplasms was two-fold increased, while the risk of breast cancer was decreased (hazard ratio 0.4 (0.2–0.9)). Turner syndrome (45,X) had a two- to five-fold increased risk of benign CNS tumors, colon and rectal cancers, benign skin neoplasms and skin cancer. Turner syndrome women with a 45,X/46,XX karyotype had an increased risk of tongue cancer. HRT had no impact on the risk of any cancer investigated in this study. Conclusions The lack of one X chromosome might play a role in skin neoplasms, CNS tumors, colon and rectal cancers. The risk of breast cancer is lower than in the general population. Long-term HRT during the premenopausal age range seems not to exert a cancerous effect in Turner syndrome. Increased vigilance concerning specific types of cancer in Tuner syndrome harboring a 45,X karyotype is needed.

Abstract 1513: Short And Long-term Mortalitty In Chest-Pain Patients Ruling-in For Myocardial InfarctionI: STEMI Versus Non-STEMI In The Era Of A Troponin-based Definition For MI

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michael C Kontos ◽  
Thomas T Noel ◽  
Charlotte S Roberts ◽  
F Philip Anderson ◽  
James L Tatum ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Short Term ◽  
Serial Sampling ◽  
Increased Risk ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
St Elevation ◽  
Pain Patients ◽  
Long Term Mortality

Background: Several randomized clinical trials have demonstrated that patients (pts) with ST Elevation myocardial infarction (STEMI) have a higher short-term mortality than those with non-STEMI, but that long-term mortality is similar. More recent studies suggest that pts who are troponin positive (TnI+), but not meeting the older CKMB criteria for MI may also be at increased risk. However, there is little data examining outcomes differentiating these 3 MI populations using the current ACC/ESC definition for MI selected from a heterogeneous cohort of pts admitted from the emergency department. Methods: Consecutive pts admitted for exclusion of myocardial ischemia underwent serial sampling of CK, CKMB, and TnI. MI was defined using ACC/ESC criteria. Pts were separated into 3 groups: STEMI (n=363; 22%), non-STEMI pts who met the prior CKMB criteria for MI (n=743; 46%), and non-STEMI pts who had MI based on TnI (+) alone (n=512; 32%) without meeting CKMB MI criteria. Demographic and clinical variables were compared among the three cohorts of patients, and 30 day and 1 year mortality were assessed. Results : Over a 6 year period, 1,618 pts were diagnosed with MI. Co-morbidities and outcomes are shown below in the table . Variables associated with worse outcomes were significantly more common in both groups of non-STEMI pts, particularly in the TnI (+) only pts. Thirty day mortality was similar and not significantly different among the 3 cohorts. However, at 1 year, mortality was a significant 68% higher in the 2 non-STEMI groups, despite having significantly lower peak CK (median 123 U/L for TnI (+) pts and 414 U/L for CKMB MI pts vs 1400 U/L for STEMI pts) and CKMB values (median 4 ng/ml for TnI (+) pts and 29 ng/ml for CKMB MI pts vs 140 ng/ml for STEMI pts) compared to STEMI pts. Conclusions : All MI pts had similar 30 day mortality; however, at 1 yr pts with non-STEMI had a substantially increased mortality compared to STEMI pts.

Perioperative atrial fibrillation and risk of stroke after cardiac surgery: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.K Wang ◽  
P Chen ◽  
P Meyre ◽  
M.Z Ali ◽  
R Heo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Short Term ◽  
Increased Risk ◽  
Short And Long Term ◽  
New Onset

Abstract Background Perioperative atrial fibrillation (POAF) after cardiac surgery has been associated with an increased risk of stroke. However, many previous studies have not systematically excluded patients with pre-existing AF. As such, the association between new-onset POAF and stroke risk has not been well established. Purpose To perform a systematic review and meta-analysis on the short and long-term risks of stroke in patients experiencing new-onset POAF after cardiac surgery. Methods We searched MEDLINE, EMBASE, and the Cochrane Library databases for studies comparing the risk of stroke in patients with versus without new-onset POAF after cardiac surgery. Studies were included in our review if they enrolled ≥100 patients and defined POAF as new-onset AF in patients with no history of preoperative AF. Data were independently extracted in duplicate. The quality of studies was assessed using the Newcastle Ottawa Scale. Random-effects meta-analysis was used to calculate summary risk ratios. Short-term stroke risk was calculated using events occurring either in-hospital or ≤30 days after surgery, and long-term risk was calculated using events occurring &gt;30 days after surgery. Results After reviewing 11,791 citations, 46 studies met the inclusion criteria. These studies included 364,822 patients, of which 76,388 (20.9%) developed new-onset POAF. The incidence of stroke was higher among patients with POAF versus no POAF (n=44 studies; incidence 2.76% vs. 1.53%; relative risk (RR) 1.91, 95% CI 1.65–2.23; I2 = 78%). A sensitivity analysis of high-quality studies alone yielded similar results (n=9 studies; RR 1.74, 95% CI 1.31–2.30; I2 = 88%). Patients with POAF had a higher incidence of stroke both in the short-term (n=35 studies; 2.71% vs. 1.36%; RR 2.13, 95% CI 1.81–2.51; I2 = 69%) and long-term (n=20 studies; 1.6 vs. 1.0 per 100 patient-years; RR 1.39, 95% CI 1.24–1.57; I2 = 27%). The risk of stroke was increased in POAF patients across all types of cardiac surgery performed, including isolated CABG (n=19 studies; RR 1.93, 95% CI 1.60–2.32; I2 = 62%), isolated transcatheter aortic valve implantation (n=7 studies; RR 1.86, 95% CI 1.32–2.63; I2 = 0%), and studies including multiple procedure types (n=16 studies; RR 1.90, 95% CI 1.44–2.51; I2 = 89%). Conclusion New-onset POAF after cardiac surgery is associated with an increased risk of stroke, both in the short and long term. The absolute risk difference is small, and randomized trials are needed to assess the efficacy and safety of treatment interventions in this patient population. Funding Acknowledgement Type of funding source: None

scholarly journals 523Use of beta blockers and death from breast cancer in New Zealand breast cancer patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Oliver Scott ◽  
Sandar TinTin ◽  
Alana Cavadino ◽  
Mark Elwood
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Beta Blockers ◽  
Cancer Registries ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Short Term ◽  
Breast Cancer Death ◽  
Increased Risk

Abstract Background Beta blockers (BB), used for a range of cardiovascular indications, have been associated with improved, worsened, and unchanged breast cancer outcomes in previous studies. This study examines the association between the use of BBs and death from breast cancer in a large, representative sample of New Zealand women. Methods Women diagnosed with a first primary breast cancer between 2007 and 2016 were identified from four population-based regional NZ breast cancer registries and linked to pharmaceutical data, hospital discharges, and death records. The median follow up time was 4.51 years. Cox proportional hazard models were used to assess the hazard of breast cancer specific death (BCD) associated with post-diagnostic BB use. Results Of the 14,976 women included in analysis, 21% used a BB after diagnosis. Although not significant, beta blocker use increased the risk of BCD (adjusted hazard ratio: 1.08; 95% CI: 0.93-1.26). The increased risk was seen only in those with at least one cardiac condition, and was also reduced by lagging the exposure, suggesting effects of BB use close to the end of life. The increased risk was also confined to short term use (0-3 months). BB use for more than 1 year was associated with a decreased risk of BCD, and the risk steadily decreased to HR 0.53 (95% CI: 0.33-0.85) for use for 3+ years. Conclusions Any increased risk associated with BB use is likely to be due to a combination of confounding by indication and short-term use. Long-term BB use may confer some protection for BCD. Key messages The effect of beta blockers is difficult to separate from the indications for the drug. While there was no significant overall effect, there was a suggestion that beta blockers may be protective for breast cancer death with long-term exposure.

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