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Biomedical subjects

S Penckofer

Publications and source records attributed to S Penckofer.

16 recordsLinked to original sources
PubMed2001

Hormone replacement therapy: primary and secondary prevention.

Researchers are far from understanding the mechanism(s) of action of hormone replacement therapy (HRT) on the cardiovascular system. Moreover, the results of clinical trials that can clarify these dilemmas will not be available for several years. As clients seek guidance in making the pivotal decision about taking HRT, it is important that practitioners understand what the current research reveals about its risks and benefits. This article addresses the role of HRT in primary and secondary prevention and includes observational research, clinical trials (completed and in progress), benefits and risks, and implications for clinical practice in counseling patients.

Adult↗
PubMed2000

Improved iron status parameters may be a benefit of hormone replacement therapy.

One of the benefits of hormone replacement therapy (HRT) is to decrease cardiovascular disease. A mechanism whereby HRT may play a role in reducing cardiovascular risk is through improved iron status parameters. High serum ferritin has been related to increased risk of coronary heart disease, whereas low iron-binding capacity has been identified as an important risk factor for myocardial infarction. This study examined iron status parameters in a group of postmenopausal women taking oral HRT (n = 27) and those not taking oral HRT (n = 27) at two times 1 year apart. Women were compared on the following serum measures: estradiol, lipids, iron, total iron-binding capacity, and ferritin. Women taking HRT had higher levels of estradiol (p < 0.001) and improved lipid profiles (p < 0.001) (lower total and low-density lipoprotein [LDL] cholesterol and higher levels of high-density lipoprotein [HDL] cholesterol). In addition, women on HRT had better iron status parameters than those not on HRT (p = 0.002). Total iron-binding capacity was greater for women on HRT compared with women not on HRT, and serum ferritin levels were lower in women on HRT than those not on HRT. The groups were comparable in age, body mass index, and physical activity. Our results confirm previous findings and indicate that women taking HRT have higher serum levels of estradiol and improved lipid profiles compared with those not taking HRT. In addition, we have found that iron status parameters are better in women taking HRT, suggesting the need to further examine this effect as it relates to decreased cardiovascular risk in postmenopausal women.

Diet↗
PubMed1993

Measurement of functional ability in patients with coronary artery disease.

The purpose of this study was to examine measures of functional ability in a group (n = 60) of cardiac patients undergoing treadmill exercise tests. Functional ability was defined as the degree to which the individual is able to perform physical activity in the absence of symptoms. Instruments used were the Modified Harvard Alumni Scale (MHAS), the Symptom Scale (SS) comprised of the following subscales: angina (AS), shortness of breath (SOBS), and fatigue (FS); the overall Health Rating Index (OHRI); and the Goldman Specific Activity Scale (SAS). Concurrent validity was supported by the fact that the instruments were correlated with metabolic equivalents achieved on the treadmill. Correlations were: MHAS (r = .34, P < .01), SS (r = .67, p < .01), AS (r = .54, p < .01), SOBS (r = -.41, p < .05), FS (r = -.56, P < .001) and the OHRI (r = .45, p < .001). Reliability was determined using Cronbachs, alpha and were: SS = .92, AS = .87, SOBS = .86, FS = .85 and OHRI = .88. Findings support the need for testing and evaluation of instruments measuring functional ability in diverse cardiovascular populations.

Activities of Daily Living↗
PubMed1993

Coronary artery disease in women: assessment, diagnosis, intervention, and strategies for life style change.

Coronary heart disease is reaching epidemic proportions in women. With increased longevity, more women are living many years beyond menopause, the time when heart disease peaks in women. For midlife women, it is important to determine a personal profile of unmodifiable (family history, age, and race) and modifiable risk factors. The goal for every woman must be to control coronary risk factors such as smoking, hyperlipidemia, diabetes, sedentary life style/weight control and stress, which have been proven to be amenable to modification strategies. Many women also may consider hormonal replacement but must be counseled to make informed choices concerning the benefits and risks. Finally, as nurses and as leaders in the health care of women, we must model heart healthy behaviors to encourage each other and to increase our effectiveness with the clients we serve.

Coronary Disease↗
PubMed1989

Adherence to risk-factor instructions one year following coronary artery bypass surgery.

A convenience sample (n = 60) of two comparable groups of cardiac bypass patients was studied to assess the effectiveness of a structured teaching guide used by nurses in educating patients and families about normal postoperative recovery and risk-factor modification. One group was educated by an unstructured method, and the other group received structured teaching with the use of a written guide developed by nurses experienced in open-heart recovery. Both groups had higher total knowledge scores postoperatively than preoperatively. To assess whether the type of teaching had affected changes in behavior, a six-week postoperative health interview was conducted, and a follow-up questionnaire was mailed at one year.

Adult↗
PubMed1988

Quality of life following cerebral bypass surgery.

Information available for nurses on counseling cerebral bypass patients regarding the outcomes of surgery is limited. In order to assess the impact of surgery on the patient's quality of life, a questionnaire was mailed to a sample of cerebral bypass patients who were at least three months postoperative and had suffered an ischemic event prior to surgery. Objective and subjective indicators were used to assess quality of life. Objective measures included type and frequency of symptoms most often associated with ischemic events, as well as return to work status. Subjective aspects included an overall assessment of life satisfaction as measured by the Cantril Self Anchoring Scale and satisfaction with these related domains of life: family, social, sex and occupation. Perceptions of body image were also examined. One hundred and two questionnaires were analyzed. Results indicated that for patients who were working before surgery, return to work was significant (p less than .0001). The signs and symptoms most often associated with an ischemic event were identified and overall, the number of reported symptoms was significantly decreased (p less than .0001) after surgery. In addition, an analysis of variance (ANOVA) with repeated measures indicated that patients viewed present and future life as better than life prior to surgery. Patients also reported greater satisfaction with family life (p less than .0001) and body image (p less than .01) following surgery. This information will be useful to nurses in diagnosing and counseling patients with stroke symptoms as well as in developing a comprehensive plan of care for patients who may undergo cerebral bypass surgery.

Activities of Daily Living↗
PubMed1986

Structured postoperative teaching and knowledge and compliance of patients who had coronary artery bypass surgery.

A convenience sample of two comparable groups of patients who had coronary artery bypass surgery was studied to assess the effectiveness of a structured teaching guide used by nurses in educating the patient and his family about normal postoperative recovery. Preoperative health assessments were performed on 64 patients, and risk factors for heart disease were identified for each individual. One group was educated by an unstructured method; the other group received structured teaching with the use of a guide developed by nurses experienced in recovery after open heart surgery. Knowledge was assessed before instituting teaching and on discharge from the hospital. All patients were again assessed 6 weeks after discharge for postoperative health and compliance with their health risk factors identified earlier. An analysis of variance with repeated measures revealed that both groups had higher total knowledge scores after surgery. Most postoperative health behaviors (angina, smoking, hypertension, and diet) were comparable between groups. However, those patients who had structured postoperative teaching walked more blocks after surgery (mean = 15.61) than those patients who received routine teaching (mean = 7.00) (p less than 0.005), although these two groups were not equivalent before surgery. In addition, the patients who had structured teaching had higher total compliance scores (mean = 86.8) than those who had unstructured teaching (mean = 79.5) (p less than 0.05). Therefore although structured teaching may not have initially affected patient's knowledge, it may have had an impact on their compliance with postoperative health behaviors.

Aged↗
PubMedDate not supplied

Sex differences and the effects of sex hormones on hemostasis and vascular reactivity.

Thrombus formation and vasospasm are involved in the initiation of acute ischemic events in the heart. Gender differences in persons with coronary artery disease and the incidence of myocardial ischemia have been clearly documented. In addition, it is well established that sex hormones influence the risk of developing coronary artery disease. Epidemiologic studies suggest that estrogen may exert a protective effect, yet the results of recently completed and ongoing prospective trials of estrogen and hormone (estrogen + progesterone) replacement suggest that these hormones can increase thrombotic events in postmenopausal women. This review focuses on sex (gender) differences in hemostasis and vascular reactivity and on the influence that sex hormones have on these physiologic systems. This review takes the novel approach of focusing on sex differences in hemostasis and vascular reactivity in healthy premenopausal women and men of a similar age. By comparing men and women in this age group, the confounding issues of age, pathology, or decline in sex hormone levels are avoided. Animal and in vitro investigations pertinent to examining potential cellular mechanism(s) of sex hormones in mediating these sex differences are discussed. We assume there is a relationship between the normal physiologic and pathologic effects of sex hormones; elucidating sex differences in normal cardiovascular function will help clarify the basis for sex differences in the incidence and manifestations of coronary heart disease and will aid in the future development of gender-specific therapies for cardiovascular disease.

Adult↗
PubMedDate not supplied

Perimenopause: the transition into menopause.

With an ever-accumulating body of knowledge about menopause has come the realization that the transition into menopause, specifically the perimenopausal period, is a process occurring over a period of years. We now know that the majority of women do not move from a time of regular menses to an abrupt cessation of menses. Rather, they experience perimenopause, a time of menstrual irregularity defined by changes in the length of the menstrual cycle and/or changes in level of discomfort associated with menses. We also know now that hormonal levels during the perimenopausal period may fluctuate more intensely, precipitating vasomotor and other symptoms. There is a tremendous need to educate women and their health care providers about the stages of the menopausal process. Such education will foster understanding of when women can expect the onset of perimenopausal symptoms. Health care providers should assist women with their questions and concerns as they move through this time of transition.

Adult↗
PubMedDate not supplied

The relationship between physical activity and perimenopause.

Our purpose in conducting this study was to examine the relationship between physical activity and symptoms associated with perimenopause. A group of 214 perimenopausal women aged 40-55 years (mean = 47 years) completed the Women's Health Assessment Scale (assesses symptoms associated with perimenopause: vasomotor, psychosomatic, menstrual, and sexual symptoms) and the physical activity questionnaire. These women were categorized into three groups based on their levels of physical activity: inactive, relatively active, and active. Analyses of covariance (ANCOVA) revealed significant differences between groups in frequency and distress of overall symptoms associated with perimenopause (F = 8.86, p = .00, F = 6.25, p = .00, respectively). Further analyses indicated that relatively active and active women had significantly fewer and less distressful psychosomatic symptoms (F = 8.05, p = .00, F = 5.80, p = .00, respectively), such as irritability, forgetfulness, and headache as well as fewer and less distressful sexual symptoms (F = 3.42, p = .03, F = 3.73, p = .03, respectively), such as vaginal dryness and decreased sexual desire than inactive women. No significant differences were found among groups on vasomotor and menstrual symptoms. In conclusion, physical activity may be an important alternative/adjunct to hormone therapy particularly for psychosomatic and sexual symptom management at perimenopause.

Adaptation, Psychological↗
PubMedDate not supplied

Coronary heart disease: requisite knowledge for developing prevention strategies for the aging adult.

More people than ever before are reaching old age, with the latest statistics indicating that life expectancy for a man of 45 years has increased from 70.4 to 77.3 years and from 77.0 to 82.8 years for a woman. One of the primary factors associated with this increase in longevity is the decrease in mortality from cardiovascular disease. Since the mid 1960's, there has been a decline in cardiovascular mortality of about three percent per year. Recent technological advances and healthier lifestyles are among the reasons contributing to this trend, supporting the notion that the decrease in cardiovascular mortality and morbidity is due to more than just aging and genetic predisposition. Our challenge as health care professionals, is to be aware not only of the cardiovascular changes that occur as a result of aging, but to identify when and how much intervention is appropriate (i.e. risk factor modification) for selected age groups, particularly the older adult.

Age Factors↗