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Biomedical subjects

M Notelovitz

Publications and source records attributed to M Notelovitz.

At least 19 recordsLinked to original sources
PubMed1992

Changes in coagulation and anticoagulation in women taking low-dose triphasic oral contraceptives: a controlled comparative 12-month clinical trial.

OBJECTIVE: The effects of two triphasic oral contraceptives on coagulation and anticoagulation factors were compared in a 12-month open-label study. STUDY DESIGN: Fifty-two women (mean age 26 years) were enrolled in and completed the study; 20 had been randomly assigned to receive levonorgestrel plus ethinyl estradiol, 24 had been randomly assigned to receive norethindrone plus ethinyl estradiol, and eight surgically sterile women acted as untreated controls. Coagulation and anticoagulation factors were measured at baseline and during the sixth and twelfth months. RESULTS: Both oral contraceptives produced significant decreases from baseline in prothrombin time and partial thromboplastin time; there were also significant changes in laboratory control times. Factor XII was significantly increased in both oral contraceptive groups after 6 and 12 months. Fibrinogen antigen was significantly increased for norethindrone plus ethinyl estradiol after 6 and 12 months and for levonorgestrel plus ethinyl estradiol after 12 months. Platelet counts were unchanged. There was a significant increase in antithrombin III activity with norethindrone plus ethinyl estradiol at 12 months. Antithrombin III antigen was unchanged with the oral contraceptives; however, significant increases existed for alpha 1-antitrypsin antigen and plasminogen antigen and activity after 6 and 12 months and for alpha 2-macroglobulin antigen after 12 months for both oral contraceptives. alpha 2-Antiplasmin antigen was significantly increased for norethindrone plus ethinyl estradiol at the 12-month evaluation. There were no significant differences between the oral contraceptives for any coagulation or anticoagulation factor, and mean values generally remained within reference ranges. CONCLUSIONS: Levonorgestrel plus ethinyl estradiol and norethindrone plus ethinyl estradiol had equivalent, minimal effects on hemostasis, and changes in coagulation factors appeared to be balanced by changes in anticoagulation factors.

Adult↗
PubMed1992

Axial and peripheral bone density and nutrient intakes of postmenopausal vegetarian and omnivorous women.

The study investigated whether differences exist between postmenopausal Caucasian vegetarian and omnivorous women regarding trabecular and cortical bone density measured with single- and dual-photon absorptiometry. Anthropometric measurements, blood and urine samples, and food intakes of the twenty-eight matched pairs were also compared. The Wilcoxon signed-rank test indicated no significant differences in bone measurements between vegetarians and omnivores at any sites except the skull. The vegetarians' serum globulin and total protein measured higher. Urine calcium and creatinine were similar between the groups. The vegetarians consumed greater quantities of carbohydrate, fiber, magnesium, ascorbic acid, copper, and energy as percent carbohydrate, and lower quantities of protein, niacin, alcohol, vitamin B-12, cholesterol, and energy as percent protein. Despite several differences in dietary intakes, the results indicate that neither cortical nor trabecular bone density in these postmenopausal women was affected by a lactoovovegetarian diet.

Aged↗
PubMed1992

Lp(a) lipoprotein: relationship to cardiovascular disease risk factors, exercise, and estrogen.

OBJECTIVE: Lp(a) lipoprotein is a distinct lipoprotein particle that recently has been found to be associated with cardiovascular disease. A study was conducted to assess the influence of cardiovascular disease risk factors on levels of Lp(a) and to evaluate the effects of age, exercise, and estrogen on these levels. STUDY DESIGN: Two studies, a cross-sectional study of older men (n = 105) and women (n = 75) (mean age 76 years) and a prospective study of younger postmenopausal women (mean age 48 years), were carried out. Lp(a) and other lipoproteins were measured in the two studies and differences were sought by statistical analysis. RESULTS: In the cross-sectional study, serum Lp(a) was similar in men and women and was not influenced by age. Lp(a) levels in men and women were higher when there was more than one cardiovascular disease risk factor present (p less than 0.028). We could not demonstrate such a relationship with other lipid and lipoprotein measurements. In the prospective study exercise alone had no influence on Lp(a) levels. Oral estrogen decreased Lp(a) levels marginally (p = 0.08). The decrease in Lp(a) with oral estrogen was associated with increases in triglycerides (p less than 0.01) and very-low-density lipoprotein (p less than 0.06). CONCLUSIONS: These data confirm that elevated Lp(a) levels are an independent risk factor for cardiovascular disease. Lp(a) levels are primarily influenced by genetic factors and it appears estrogen may have a minor influence on its hepatic synthesis.

Aging↗
PubMed1991

Estrogen therapy and variable-resistance weight training increase bone mineral in surgically menopausal women.

This study was undertaken to examine the effect of estrogen replacement therapy alone and estrogen replacement therapy plus variable-resistance weight training on the bone mineral content of surgically menopausal women. A total of 20 surgically menopausal women were randomized and treated with either 0.625 mg conjugated estrogen daily or the same dose of estrogen plus a closely monitored exercise program involving the use of Nautilus muscle strengthening/endurance equipment. After 1 year's observation, the bone mineral density (BMD) of the spine determined by dual-photon absorptiometry increased in the exercising subjects by 8.3 +/- 5.3% (p = 0.004), 95% confidence limits (CL) 3.9-12.8%; the group with estrogen replacement therapy alone maintained their BMD: 1.5 +/- 12.4% (p = 0.36; 95% CL = -6.9-9.8%). The total body BMD of the exercising group increased by 2.1 +/- 1.5% (p = 0.003; 95% CL = 0.8-3.3%); the nonexercising women had a nonsignificant 0.6 +/- 2.9% change (p = 0.30; 95% CL = -1.4-2.5%). A significant increase of 4.1 +/- 4.3% (p = 0.01; 95% CL = 0.8-7.4%) in the radial midshaft BMD of the exercising group was found; the estrogen alone group recorded a nonsignificant change of -0.3 +/- 3.1% (p = 0.33; 95% CL = -1.7-2.4%). The results of this study suggest that variable-resistance training in estrogen-replete women adds bone to both the axial and appendicular skeleton.

Absorptiometry, Photon↗
PubMed1991

The effect of low-dose oral contraceptives on lipids and lipoproteins in two at-risk populations: young female smokers and older premenopausal women.

Young women who smoke and women over age 35 are considered to be at high risk for cardiovascular complications associated with oral contraceptive use. This study evaluated the effects of low-dose oral contraceptives on lipid and lipoprotein concentrations in 45 high-risk patients before, during, and after 6 months of treatment. Neither group showed a significant change from baseline in cholesterol, HDL cholesterol, LDL cholesterol or cholesterol ratios. Triglycerides increased and HDL2a levels decreased significantly in both groups but returned to baseline after treatment was discontinued, with the largest changes in both triglycerides and HDL2a levels occurring at 1 month. The change in triglyceride and HDL2a blood levels were within the laboratories' reference range. The lipid profile of these patients, therefore, was not worsened significantly through 6 months of oral contraceptive use. The young women who smoked did have consistently lowered levels of HDL cholesterol and its HDL2a subfraction when compared to their elder non-smoking cohort.

Adult↗
PubMed1991

The effect of moderate aerobic exercise on physical fitness among women 70 years and older.

This study investigated benefits of 26 weeks of moderate aerobic exercise for women 70 years or older. Sixteen healthy women with a mean age of 72.0 years were randomized into exercise (n = 10) and control groups (n = 6). The exercise group walked on a treadmill 3 times per week for 20 min, at 70% of maximum heart rate. Oxygen uptake VO2max expressed in l/min and ml.kg-1.min-1, total exercise time on the treadmill (TET), maximum heart rate (HRmax) and body mass index (BMI) were measured at baseline and 6 months. Two-way repeated measures analysis of variance (ANOVA) determined the effect of exercise intervention. Both measures of VO2max in addition to TET were significantly improved by the moderate training program, compared to the control group. VO2max in the exercise group increased by +/- 6.6% (S.E. 2.9) measured in l/min and 8.4% (S.E. 3.2) measured in ml.kg-1.min-1. TET increased by 25.4% (S.E. 4.9) in the exercise group. The ANOVA was unable to detect significance between the exercise and control groups for HRmax or BMI. All exercising subjects finished the program, apparently tolerating the intervention. The results indicate that healthy women over the age of 70 years can increase fitness measures with a moderate training program.

Age Factors↗
PubMed1991

Effect of long-term triphasic oral contraceptive use on glucose tolerance and insulin secretion.

This study was designed to compare the effects of two low-dose triphasic oral contraceptives (OCs) on glucose tolerance and insulin secretion. Fifty-seven women were randomized to receive OCs containing ethinyl estradiol and either levonorgestrel or norethindrone. Ten subjects using nonhormonal contraception served as controls. Glucose tolerance and insulin secretion were measured at baseline and at 6 and 12 months after an oral glucose stimulus. Both preparations produced a relative hyperglycemia at 6 and 12 months compared with baseline, but within the norms for glucose tolerance. The insulin response, measured in 48 treated and eight control subjects, also increased over 12 months in both treated groups, but the total insulin area was within the range of the reference laboratory. Such minor changes have not been associated with cardiovascular diseases and support the safety of low-dose triphasic preparations.

Adult↗
PubMed1990

Effect of cyclic estrone sulfate treatment on lipid profiles of postmenopausal women with elevated cholesterol levels.

The effects of two doses of cyclic unopposed estrone sulfate therapy on the lipid profiles of 153 healthy postmenopausal women with baseline total cholesterol levels above 219 mg/dL were compared in a multicenter, double-blind, placebo-controlled study. Patients were assigned randomly to one of three treatment groups: estrone sulfate 0.625 mg (N = 59) or 1.25 mg (N = 43), or placebo (N = 51). The median baseline total cholesterol levels of the three treatment groups were 262, 269, and 262 mg/dL, respectively. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and the HDL/LDL ratio were assessed after 6, 9, and 12 months of treatment. There was a significant monotonic dose-response relationship of estrone sulfate in raising HDL levels, lowering LDL levels, and raising the HDL/LDL ratio at all intervals measured. These results indicate that estrone sulfate is effective in creating a beneficial change in the lipid profile of postmenopausal women with elevated baseline total cholesterol.

Cholesterol, HDL↗
PubMed1989

Predicting maximal oxygen uptake from treadmill testing in trained and untrained women.

This study was conducted to develop an equation to predict maximal oxygen uptake from exercise time during a standardized treadmill test in women aged 29 to 75 years before and after aerobic training. Treadmill tests were administered to 181 women with measurement of maximal oxygen uptake, and an equation predicting maximal oxygen uptake was derived: maximal oxygen uptake (ml.kg-1.min-1) = 10.34 + 1.29 (exercise time), r = 0.88, standard error of the estimate = 2.1, p less than 0.0001. Thirty-three women were retested after 6 and 12 months of aerobic exercise training. Maximal oxygen uptake was predicted from the equation developed and compared with the measured values at 6 and 12 months. The predicted and measured maximal oxygen uptake values after training were not significantly different. These results indicate that it is possible to predict maximal oxygen uptake for clinical purposes with a single equation from exercise time in untrained and trained women across a wide range of ages.

Adult↗
PubMed1989

Monitoring skeletal response to estrogen.

Estrogen replacement therapy at accepted doses is not fully effective in preventing bone loss and fractures in postmenopausal women. Bone densitometry is useful for monitoring estrogen replacement therapy to assess dose, foster compliance, and check for secondary bone loss. The most appropriate site for bone loss monitoring is probably the spine because it shows larger decreases at the menopause than appendicular sites, it shows larger increases with therapy, and it has clinical import in terms of fracture. Both dual-photon absorptiometry (or dual-energy x-ray absorptiometry) and computed tomography are the preferred monitoring methods. The precision of these densitometry methods is generally adequate to permit interim decisions with regard to continuing therapy, as well as conclusive decisions on therapeutic efficacy after 1 to 2 years of monitoring. Judicious use of densitometry in combination with biochemical determinations can enhance therapeutic control and provide both patient and physician confidence in long-term estrogen replacement therapy.

Absorptiometry, Photon↗
PubMed1989

Estrogen replacement therapy: indications, contraindications, and agent selection.

Three groups of indications exist for postmenopausal estrogen use: relief of symptoms related to estrogen deficiency, osteoporosis prophylaxis and treatment, and cardioprotection. Estrogen replacement therapy enhances a woman's sense of well-being and reduces the morbidity, mortality, and health care costs associated with osteoporosis and atherosclerotic heart disease. There are a few absolute contraindications to estrogen replacement therapy. Many estrogen preparations are currently available in the United States. Establishing equivalencies among the different preparations is complicated by the many physiologic and pharmacologic effects of estrogens and the variety of treatment end points used. Most estrogens have the same biologic effect provided equivalent blood levels are achieved. Estrogen replacement therapy has proved beneficial to selected postmenopausal women.

Blood Coagulation↗
PubMed1989

Lipid and lipoprotein changes in women taking low-dose, triphasic oral contraceptives: a controlled, comparative, 12-month clinical trial.

Effects on lipid/lipoprotein metabolism of two triphasic oral contraceptives, Triphasil (ethinyl estradiol/levonorgestrel) and Ortho-Novum 7/7/7 (ethinyl estradiol/norethindrone) were compared in a 12-month controlled, prospective clinical trial. The data indicate that use of both estrogen-progestin preparations were accompanied by increases in cholesterol, low-density lipoprotein and high-density lipoprotein3 cholesterol, apolipoproteins A1 and B, and triglycerides. Also observed were a decline in high-density lipoprotein cholesterol and greater decreases in high-density lipoprotein2 cholesterol levels; the latter were below the lower limits of laboratory's reference range. All other changes remained within clinically acceptable limits. There were no statistically significant differences between the test preparations, suggesting that the impact on lipid metabolism of the triphasic preparations Triphasil and Ortho-Novum 7/7/7 are similar and, given the dynamic balance between the various fractions, are unlikely to impart an adverse cardiovascular risk.

Adult↗
PubMed1988

Effect of exercise on glucose metabolism in postmenopausal women.

A cross-sectional study was conducted to examine the effect of treadmill and muscle resistance training on glucose tolerance and insulin levels in a group of 25 normal-weight, naturally menopausal women. Subjects trained 20 minutes three times per week for at least 6 months to 70% to 85% of maximum heart rate on a treadmill, or to maximum effort for all major muscle groups on Nautilus equipment. A nonexercising age-height-weight--matched group was monitored as a control. All three groups were of above-average fitness for age as measured by aerobic capacity during initial testing. The treadmill group significantly increased its maximal oxygen uptake over the training period. Glucose tolerance and insulin response, measured as areas under the curve after a 75 gm oral glucose load, were improved in both exercise groups compared with controls, with more marked improvement in the treadmill group. The only difference achieving statistical significance was the insulin levels 30 minutes or less after glucose ingestion, representing the first phase of insulin release. Long-term exercise training that increases aerobic power thus maintains normoglycemia with lower insulin values than in otherwise physically fit postmenopausal women.

Aged↗
PubMed1988

The use of oral contraceptives past the age of 35: bridging the gap.

With women deciding to delay pregnancy, there is an increasing need for safe contraception to bridge the gap until the onset of the menopause. Alternatives to guide the physician and the patient are summarized, and the safety and noncontraceptive benefit of low-dose oral contraceptives for women over the age of 35 is reviewed.

Adult↗