Syfte: Syftet var att beskriva hur sjukvårdspersonal kan hjälpa vuxna patienter att sluta röka, en kortare eller längre tid, inför en elektiv operation.Metod: Studien genomfördes som en litteraturöversikt. Genom sökning i databaserna Pubmed och Cinahl erhölls 10 vetenskapliga artiklar. Sökningar genomfördes med både MeSH-termer och fritextsökning. Artiklarna kvalitetsgranskades, analyserades och samanställdes. Resultat: Metoder som kan användas för att hjälpa patienter att sluta röka är olika former av rådgivning och utbildning: hälsoutbildning, program för livsstilsförändringar, sluta-röka-linje. Att erbjuda rådgivning och stöd i kombination nikotinersättningspreparat är fungerande metoder: motiverande samtal och nikotinersättning, regelbunden rådgivning och nikotinersättning, rökavvänjning med hjälp av interaktivt dataprogram, information och hjälp med planering, nikotinersättning och uppmuntrande telefonsamtal. Effekten av nikotinplåster, läkemedel och akupunktstimulering som ensamma metoder var begränsad. Slutsatser: Olika former av rådgivning eller utbildning kan användas när patienter behöver sluta röka inför en elektiv operation. Metoder som kombinerar nikotinersättning och rådgivning eller stöd var mest effektiva. Använder sig sjukvårdspersonal av detta kan lidande minskas, undvika förlängd vårdtid och pengar sparas.

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 117-132).

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 103-131).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 93-113).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 54-58).

The purpose of this study was to determine the factors that influence women's decisions to use hormone replacement therapy (HRT) during menopause. Using the Theory of Planned Behavior and constructs of risk perception, this study was able to explore the beliefs and attitudes of women about HRT use during menopause. The study was also able to explore how risk perception of HRT and the conditions that affect women during midlife impact their decision to use HRT during that time. Focus groups were conducted to develop the questionnaire used in the larger study. A community-based sample of women from Houston area churches participated in the study. The major theme that emerged from the focus groups was the weighing of cancer risks and the protection benefits of HRT. The most interesting factor that emerged as a barrier to HRT use was "negative publicity" and myths toward taking HRT. Results from the larger study demonstrated that the construct of attitude was the predominate predictor of intention when direct measures were used in a model to predict intention. Meaning that women's attitudes towards HRT use during menopause (whether they are safe, wise to use, good or bad, beneficial, risky, pleasant, or valuable) played a significant role in their intention. In contrast when the belief-based measures were used in the model, subjective norm and perceived behavioral control were significant predictors of intention. Meaning that the intention to use HRT was based more on the influence of their husbands, physicians, and families. This also meant that the dosage form, cost, negative publicity, family history of cancer, personal fear of developing cancer, and education about HRT would affect their intention to use HRT during menopause more than the advantages and disadvantages of using HRT (advantages such as protection from osteoporosis, relief from hot flashes; or, disadvantages such as risk of breast cancer). Finally, women's perception of risk with regards to HRT was highest for breast cancer followed by heart disease, endometrial cancer, and osteoporosis. This study found that there are many factors that may affect the decision to use HRT during menopause and that overall these factors affect women’s attitudes towards HRT and their intention to use it. / text

No description available.

This dissertation investigated the role of two therapeutic interventions (exercise training and hormone replacement therapy) on two different states of endothelial dysfunction, chronic coronary occlusion and aging. Despite remarkable evidence for the therapeutic benefits of physical activity, the mechanisms by which regular exercise improves vascular function in the setting of coronary artery disease are not fully understood. Similarly, the effects of aging and hormone replacement therapy on vascular function are often paradoxical and poorly understood. Thus, the first project utilized a model of chronic coronary artery occlusion to evaluate the effects of exercise training on cellular and molecular adaptations of collateral-dependent coronary vasculature compared to the nonoccluded control. This study provided new evidence that exercise training concomitantly enhanced the contributions of multiple vasodilator mechanisms, including nitric oxide, prostacyclin and BKCa channels to vascular function in the ischemic heart. Increased contribution of multiple vasodilator signaling pathways after exercise training appears to promote compensation or redundancy to ensure adequate vasodilation and coronary vascular blood flow. The second project utilized a model of aging to evaluate the interactive effects of age and hormone replacement therapy on the cellular and molecular mechanisms underlying the regulation of cerebrovascular function. Although the mechanisms underlying the beneficial effects of estrogen on cerebrovascular function have been studied at length, the mechanisms responsible for age-dependent deleterious effects of estrogen are largely unknown. The results of this study revealed that estrogen exerts divergent effects on the cerebrovasculature with advancing age. In younger females, estrogen replacement treatment is beneficial, attenuating vasoconstriction primarily by the COX-1 dependent prostanoid pathway and increased PGI2 production. In contrast, in older reproductively senescent females, estrogen augmented vasoconstriction via the COX-2 dependent prostanoid pathway and increased TXA2 production. A better understanding the mechanisms by which estrogen exerts beneficial versus detrimental effects on the cerebrovasculature may lead to new gender-specific therapeutic agents designed specifically to target the cerebrovascular system and other estrogen-responsive tissues.

Background: During the past 5 decades, hormone replacement therapy (HRT) has been used, and appreciated for its beneficial effects, by millions of women in their menopause. As treatment for climacteric symptoms, estrogen is outstanding, and effects on hot flushes, vaginal dryness, and insomnia have been widely documented. The increased risks of venous thrombosis and breast cancer, however, restrict the use of estrogen. Estrogen treatment in women with a remaining uterus includes a progestin, added to protect the endometrium from hyperplasia and malignancies. The long-standing clinical impression, that progestin addition negatively influences mood, has been discussed in previous studies. Mood deterioration is, however, not mortal, although mood is important to the wellbeing and daily functioning of women treated with hormones. Studies of the mental side effects of HRT add to our understanding of steroid effects in the brain. Aims and methods: In our studies, we aimed to establish to what extent negative side effects cause women to discontinue HRT, and find out which drug compounds lead to mood deterioration. The questions asked were whether the type and dose of progestin and the estrogen dose during the progestin addition influence the mood and physical symptoms during sequential HRT. Compliance with HRT and reasons for discontinuing the therapy were evaluated in a retrospective longitudinal follow-up study. Treatment effects were studied in three randomized, double-blind, cross-over trials. During continuous estrogen treatment, effects of sequential addition of a progestin were studied by comparing two different progestins, medroxyprogesterone acetate (MPA) andnorethisterone acetate (NETA), comparing different doses of the same progestin, MPA, and comparing two doses of estrogen during addition of the same dose of MPA. The main outcome measure was the daily rating on mood and physical symptoms kept by the participants throughout the studies. The clinical trials were carried out at three gynecological centers in northern Sweden. Results and conclusions: Besides fear of cancer and a wish to determine whether climacteric symptoms had meanwhile disappeared, negative side effects was the most common reason or discontinuing HRT. Tension in the breasts, weight gain, a depressed mood, abdominal bloating, and irritability were the most important side effects seen both in women who continued HRT and in women who had discontinued the therapy. In our clinical trials, we showed that addition of a progestin to estrogen treatment induces cyclic mood swings characterized by tension, irritability, and depression, as well as increased breast tension, bloatedness, and hot flushes. Women with a history of premenstrual syndrome (PMS) appeared to be more sensitive to the progestin addition and responded with lower mood scores compared with women without previous PMS. In our studies, MPA provoked depressed mood to a lesser extent than did NETA. Surprisingly, the higher dose of MPA (20 mg) enhanced the mood, compared with 10 mg, when added to estrogen treatment. In women continuously treated with 3 mg estradiol, mood and physical symptoms worsened during the progestin addition, as compared with treatment with 2 mg estradiol. The negative side effects seen during sequential HRT have much in common with symptoms seen in the premenstrual dysphoric disorder (PMDD), which is a psychoneuroendocrine disorder with psychiatric expression. Explanations for treatment effects on mood are likely to be found in drug interactions with neurotransmitter systems of the brain. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 2003</p> / digitalisering@umu

Tikslas: įvertinti fizinių pratimų poveikį, vyrams sergantiems hipogonadizmu, kuriems taikoma pakaitinė testosterono terapija. Uždaviniai: 1. Nustatyti vyrų sergančių hipogonadizmu kūno masės komponentų pokyčius atsiradusius dėl 6 mėnesių trukmės kineziterapijos programos taikymo. 2. Palyginti kūno masės komponentus vyrų sergančių hipogonadizmu ir sveikų vyrų prieš ir po kinezirerapijos taikymo. 3. Nustatyti vyrų sergančių hipogonadizmu fizinių ypatybių (šuolio metu išvystomų rodiklių: jėgos, galingumo, greičio, aukščio, santykinio galingumo bei kūno slėgio centro svyravimų elipsės ploto) pokyčius atsiradusius dėl 6 mėnesių kineziterapijos programos taikymo 4. Palyginti fizinių ypatybių pokyčius (šuolio metu išvystomų rodiklių: jėgos, galingumo, greičio, aukščio, santykinio galingumo bei kūno slėgio centro svyravimų elipsės ploto) vyrų sergančių hipogonadizmu ir sveikų vyrų prieš ir po kineziterapijos taikymo. Tiriamieji: 38 vyrai: 18 – sergantys hipogonadizmu ir 20 sveikų vyrų. Tyrimo organizavimas: vyrai sergantys hipogonadizmu padalinti į du pogrupius: 8 vyrams 6 mėn. buvo taikyta pakaitinė testosterono terapija ir kineziterapija (2 k/sav. po 60 min), 10 vyrų taikyta tik pakaitinė testosterono terapija 3 k/6 mėn. kas 8 savaitės buvo švirkščiama Nebido 1000 mg/4 ml injekcinis tirpalas. Tyrimo metodai: 1. Tiriamųjų fizinis aktyvumas, naudojant Tarptautinį fizinio aktyvumo klausimyną (IPAQ). 2. Kūno sudėties analizė X – SCAN įranga – ūgį, kūno svorį, kūno masės indeksą... [toliau žr. visą tekstą] / The aim of the research is to assess the effect of exercise therapy on males with hypogonadism treated with testosterone replacement therapy. Objectives: 1. To determine changes in body weight components resulting from a six-month programme of exercise therapy. 2. To compare the body weight components in males with hypogonadism and healthy males before and after exercise therapy. 3. To determine changes in physical parameters (parameters achieved during jumping tasks: strength, power, speed, altitude, relative power, and the ellipse area of body centre pressure) in males with hypogonadism resulting from a six-month programme of exercise therapy programme. 4. To compare the changes in physical parameters (indicators achieved during jumping tasks: strength, power, speed, altitude, relative power, and the ellipse area of body centre pressure) in males with hypogonadism and healthy males before and after exercise therapy. Subjects: 38 males including 18 males with hypogonadism and 20 healthy males. Research design: males with hypogonadism were arranged into two subgroups: 8 men were treated with testosterone replacement therapy combined with exercise therapy for 6 months (2/60-minute sessions per week), 10 men were given testosterone replacement therapy only: 3 times per 6 months, i.e. every 8 weeks they received Nebido 1000 mg/4 ml injections. Research methods: 1. International Physical Activity Questionnaire to obtain estimates of physical activity. 2. X – SCAN for body... [to full text]