Biomedical subjects

M H Milner

Publications and source records attributed to M H Milner.

3 recordsLinked to original sources

PubMed1996

A 2-year study of lipid and lipoprotein changes in postmenopausal women with tibolone and estrogen-progestin.

OBJECTIVE: To assess changes in lipid-lipoprotein profile in postmenopausal women taking tibolone and estrogen-progestin, compared with untreated controls. METHODS: Sixty-three women were randomized to take a combined estrogen-progestin preparation (n = 31) or tibolone (n = 32), and 50 other women acted as controls. Fasting lipid-lipoprotein levels were measured over 96 weeks. RESULTS: The controls, who were older and postmenopausal longer than the therapy subjects, exhibited significant decreases in total (P < .05) and low-density lipoprotein (LDL) (P < .001) cholesterol and increases in triglyceride (P < .05) and lipoprotein (a) (P < .001) over the 96-week period of study. Lipoprotein (a) also decreased significantly in both treated groups (P < .001). Total and LDL cholesterol decreased and triglyceride increased in the estrogen-progestin group, but, compared with controls, these changes were not significant. Total cholesterol decreased in the tibolone group, although decreases in low- and particularly high-density lipoprotein (HDL) (P < .001) cholesterol and parallel decreases in apolipoprotein A1 (P < .001) and B (p < .01) were also observed. There was evidence of a reversion phenomenon in apolipoproteins A1 and B in all groups, and in lipoprotein (a) with tibolone. CONCLUSION: Some changes accompanying tibolone may be favorable and may counter its adverse effect on HDL cholesterol. Lowering of lipoprotein (a) was the only significant change found with estrogen-progestin.

Animals↗

PubMed1994

Pain and increased mammographic density in women receiving hormone replacement therapy: a prospective study.

OBJECTIVE: A prospective study was designed to evaluate the effects of hormone replacement therapy on mammographic density in postmenopausal women. The possible association of breast pain with increased mammographic density was evaluated. SUBJECTS AND METHODS: Thirty-three postmenopausal women undergoing hormone replacement therapy for a mean of 11 months had mammography before and after commencing treatment. As a control, 31 postmenopausal women who never had hormone therapy also had baseline and follow-up mammograms after a mean of 13 months. Subjects were asked whether breast pain, which they graded as mild, moderate, or severe, had developed since their entry into the study. Baseline and follow-up mammograms were assessed objectively and subjectively for interval changes in density. The presence of breast pain was correlated with changes in density on the mammograms. RESULTS: A subjective increase in mammographic density was seen in nine (27%) of the women taking hormones and in none of the control subjects (p = .002). Changes were focal in four, multifocal in four, and diffuse in one. An increase in density was seen with all types of treatment used, and was noted as early as 4 months after the start of treatment. Seven (78%) of nine patients with mammographic changes had breast pain, which they classed as moderate or severe, that had developed since the start of treatment. In five patients with mild or moderate breast pain, an increase in density was not shown on mammograms. Of the 21 women taking hormones who did not have breast pain, increased density on follow-up mammograms was shown in only two (p = .004). None of the patients in the control group had breast pain. CONCLUSION: Focal, multifocal, or diffuse mammographic increases in density occur in a significant percentage of women undergoing hormone replacement therapy. A large proportion of these women have breast pain. Increased mammographic density appears to be associated with breast pain in women receiving hormones. This has implications for mammography in women receiving hormone replacement therapy.

Breast↗

PubMedDate not supplied

Orion--shaping a new accreditation process.

In January, the Joint Commission on Accreditation of Healthcare Organizations announced an Action Plan in response to criticisms leveled by the American Hospital Association. A key element of the plan is the Orion Project. Already in the planning stages, it was designed to test various accreditation process improvements. Here, two of JCAHO's leaders describe what Orion is and how it will work.

Accreditation↗