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Index Medicus

ct:o,$

u11l.t1

u i 6t tdt v I a - &uilnqdoil'let:glutruuhtrirfluuvrfiotjofruao'r6,rf,unoulun1:flnuri6'uloga:rj deul#I_r--. / q r U r r & 6 o uo'lutt'l t0.t'lurIay tilnnilau tilofi1 [onrrrutirnu

Problem/background : fl rgrar/ n rqfl aro{nr:vt"rifi'u

Research question/objective : rilrrruru/n'lotuil :s rn rl:r yr u 1 ur a / n Afi n

Case report, retrospective, prospective, randomized trialv 4 9ltt .@ d

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fraotir'runf,odofirnrudfiuoriuLimpaphayom K, Taechakraichana N. Poshyachinda M, Jaisamran U. Effect of hormonalreplacement therapy on bone changes in Thai menopausal women : a preliminary reports.Chula Med J 1ee4 Nov ; 88 (11) : 6ze-82.

Objective

Setting

Design

Subjects

Method

Results

Setting

Research design

Patients/material

Methods (intervention/

measurement/ statistics)

Results

Conclusion

Key words

ffaodrsnrafisuumffodorurn:gruuuulnri (structured abstract)

To study the effect of hormonal replacement therapy on bone changes.

Menopause clinic Deparftnent of obstetrics and Gynecology, Faculty of Medicine,

Chulalongkorn University.

Prospective, randomized study

one hundred and thirty seven premenopausal and postmenopausal women withage range of +o-az (mean + sD = 48,67 ! 7.65) years were recruited into thestudy. women in the study group (zz/tsz) used esffogen replacement therapyeither with or without progestogen. The control group (oo/rsz) did not usehormonal regimens.

Bone mass density was measured at both lumbar spines and hips in each clientswith Dual Energy X-ray AbsorptiomebT/ (DEXA) at o and o months.There were no significant difference in bone changes between the study group(Lumbar spines:0.48 J o.7oo/o; Hips: o.b6 t 1.76%)and the control group(Lumbar spines : z.s? + 7.29o/o ; Hips : l.Bz + L.$%) in the first six-month ofbone monitoring. Nevertheless, when considered into the surgical menopausalwomen, it showed that there was tendency of greater bone loss in the non-hormonalgroup (Lumbar spines: 0.48 + o.T0o/o; Hips: 0.b6 t t.z6o/o) than in the hormonalfeated gncup (Lumbar : -1.20 t o.T8%; Hips i -2.48 t o.b6o/o)t though there was

no statistically significant difference.

Conclusion

Key words

The preliminary results showed some beneficial effects of hormonal replacement

therapy (rRT) in slowing bone loss especially in the group of surgical menopausal,

any further long term effect of HRT in other group of menopausal women willbe followed.

Hormonal replacement therapy, Bone changes.

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z. Parkin DM, Clayton D, Black RI, Masuyer E, Friedl HP, lvanov E, et al. Chidhood leukaemia

in Europe after Chernobyl : b year follow-up. Br J Cancer 1990 ; z3 : 1006-12.ld9^e1.2 o{nflfllluBtullufi

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z. Enzensberger W, Fischer PA. Metonome in Pmkinson' s disease Qeter). l,ancet 1996 ; 34? : 1337.

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'lmuiflury{rfiu ; zrsr.

z. Ringsven MI! Bond D. Gerontology and leadership skills for nurses. 2nd ed. Albany (NY) :

Delmar Fublishers ; 1996.d4 d q

- fiuitdotJlJt:6u1fifl11

r. irrrx imorfiu, il:vnor ?morfru, u::illGnr:. rru:Jfrri61u{{J:u6or#orood. firLr(nYrfi r.

fl:{ryr?rrJld'run: : ryaurloR ; 2535.

2. Norman U, Redfern SJ, editors. Mental health care for elderly people. New York: Churchill

Livingstone ; 1996.

z.z umnd{lunri.rtiom6ooir:ri^qTOU::OI1fiR't:, Utlonfinu.

nr?r (mfiru:n-nfir gofiru).

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z. Phillips SJ. Whisnant JP. Hypertension and stroks. In : Laragh JH, Brenner BM, editors.

Hypertension : pathophysiology, diagnosis, and management. 2nd ed. New York : Raven

Press ; Logb. p. 46b*78.

3. t'lr,{1un1:rj:yrrJ fiuilul.-iC to

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of the roth International Congress of EMG and Clinical Neurophysiology ; 1s9b Oct 1b-19 ;Kyoto, Japan. Amsterdam : Elsevier ; 1996.

Bengsson S, Solheim BG. Enforcement of data protection, privacy and security in medical

informatics. In : Luh KC. Degoulet P, Piemme TE, Rienhoff O, editors, MEDINFO 92.

Proceedings of the ?th World Congress on Medical Informatics ; 1992 Sep o-ro I Geneva,

Switzerland. Amsterdam : North-Holland ; 1992. p 1b61-b.

3.

1.

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olr{nr:outriul art i zbuo.

2. Smith P, Golladay K, Payment for durable medical equipment billed during skilled nursing

facility stays. Final report. Dallas (TX) : Dept. of Health and Human Services (US), Office

of Evaluation and Inspections ; 1994. Report No. HHSIGOEI69200860.

^al5. ?Itt lUT{Ufi

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Riltvrilu?rlun: : 1w1a{R:0lrJfi1?Yru1au ; 2530.

Kaplan SJ. Post-hospital home health care : the elderly, s access utilization (dissartation).

St. Louis (MO) : Washington Univ. ; 1ee5.l^ aCil.tTItJ?IOl{cl

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1. tr{a{il:na. fiilo. nri.:flofiru#lmuig iufi eo ?{ilrnu 2bss i za (no6'rri r).2. LeeG. Hospitalizations tied to orlr" pollution : study estimates Sorooo ad.missions annually.

The Washington Post leeo Jun zr I Sect.A : s (col.r).

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, j jtriruii roo, erouii lze.(a.riufi rr ?rrrnru zblz),

2. Preventive Health Amendments of 1998, Pub L No. tog-teg, 10? Stat. zzz6.(Dec 14, 1994).

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z. Stedman's medical 2oth ed. Baltimore: Williams & Wikins ; 19sb. Apraxia; p. 1s9-20.Add d7. ?Oflfll{" - j j i -adu d. 4 j o r a -l ^aloilIl. Tolto{ (?o1tfl1{).tilo{1r9{afl : ttfio{Han ; ilflflan.

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1. Morse SS. Factors in the emergence of infectious diseses. Emerg Infect Dis (Serial online)

1995 Jan-Mar (cited 19e6 Jun r) ; t (t) : (za screens). Available from : URL : http//www.cdc. gov/ ncidod/ElD /eid.htm

8.2 :'rr,{1uaffslu:rjuuu6rdnyr:ofindll

1. CDI, clinical dennatology illustrated (monograph on CD-ROM). Reeves JRT, Maibach H.

CMEA Multimedia Group, producers. znd ed. Version 2.0 San Diego : CMEA ; 199b.grtlY^d

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Orlando (FL) : Computerized Educational Systems ; 1993.

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