Re: ACOG Chicago..a sad story-Heart disease in women
From: jay kulkin (jkulkin@hotmail.com)
Thu May 3 08:59:04 2001
Can't speak to the folate but the talk on the Human Genome Project at ACOG
clearly stated we should not expect genetic treatment for diseases for the
next 10-20 years. Will be an incredible story as it unfolds.
Jay
>From: evsono@pipeline.com (art fougner, md)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
>Subject: Re: ACOG Chicago..a sad story-Heart disease in women
>Date: Thu, 3 May 2001 08:11:07 -0500
>
>predisposition to MI's will doubtless be better understood with the
>rapid expansion of knowledge of human genetics. i've oft wondered if
>any of the hormone trials to date really demonstrate anything since we
>know little of the genetics of the populations involved. for example,
>perhaps genetics would explain the disparity in breast cancer risk data?
>jay, i agree, until more is known about true risks, we are groping in
>the dark and informed consent would be the way to go. for these women,
>i wonder if boosting folate supplementation ala periconceptional and
>prenatal dosing for prevention of NTD's might be useful.
>
>art
>
>At Thu, 03 May 2001, jkulkin wrote:
> >
> >Can't extrapolate the PEPI Trial data on micronized progesterone as MI
>was not a measureable endpoint, only lipid changes. The WHI study wil help
>us with that when the data is avaialable in
> >3-4 years. In the interim, I thnk using HRT in these people is as exposes
>the doc should these people have a repeat MI in year one of HRT. Possibly
>informed consent is a good idea?
> >
> >Jay
> >
> >Larry Glazerman wrote:
> >
> >> Yeah, but first of all, there was no data in HERS about progestins
>other
> >> than MPA, in addition, over the 4 years of the study, the incidence of
> >> repeat MI was unchanged.
> >>
> >> At 05:33 PM 5/2/01 -0500, you wrote:
> >> >Went to an interactive session. You know, where you use the "audeince
> >> >participation" device like they do on "who wants to be a
> >> >millionaire". The topic was HRT. The case posed was, "A 54 yo lady
>s/p MI now
> >> >presents with menopausal symptoms i.e., amenorrhea, hot flashes,
>trouble
> >> >sleeping etc. They then listed the options for treatment . As I
>recall
> >> >they were:
> >> >
> >> >HRT
> >> >SERM
> >> >Bisphosphonates
> >> >Belergal
> >> >There was one more but I forget what it was though it was irrelevant.
> >> >
> >> >An incredible 71% responded they would give the patient HRT. Clearly
>they
> >> >were unaware of the HERS data indicating an increased risk of repeat
>MI in
> >> >the first year in this group of women with known heart
> >> >disease. . Pretty troubling to think this is happening.
> >> >
> >> >Jay
> >> >
> >> >"art fougner, md" wrote:
> >> >
> >> > > and that should read "courts, not course." of course ;)
> >> > >
> >> > > art
> >> > >
> >> > > At Fri, 27 Apr 2001, RModugno@aol.com wrote:
> >> > > >
> >> > > > <A
> >> >
>HREF="http://www.ctnow.com/scripts/editorial.dll?fromspage=CG/articles/business.htm&categoryid=&bfromind=377&eeid=4458465&eetype=article&render=y&ck=&ver=2.8&p;eeid=4458465&eetype=article&render=y&ck=&ver=2.8&article&render=y&ck=&ver=2.8&icle&render=y&ck=&ver=2.8>>
> >> > >Robert Modugno MD MBA FACOG
> >> > > >Marietta, GA
> >> > >
> >> > > --
> >> > > art fougner, md
> >> > >
> >> > > A series of 1000 cases begins with but a single anecdote.
> >>
> >> Larry R. Glazerman, MD
> >> Ob-Gyn at Trexlertown
> >> 610-402-0161
> >> l.glazerman@rcn.com
>
>--
>art fougner, md
>
>A series of 1000 cases begins with but a single anecdote.
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