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Fanti P, Stephenson TJ, Tsukamoto Y, Nomura M, Morishita T, Kitiyakara C, Custer LJ, Franke AA. Circulating levels of conjugated and unconjugated soy isoflavones in Japanese hemodialysis patients with high soyfood intake. Journal of the American Society of Nephrology. 13: 674A-674A Suppl, 2002. Soy Isoflavones, Soyfood.
Prostate cancer is most commonly diagnosed in older men 50 years of age ; , with the only other well-established risk factors being ethnicity and family history of disease. As such, screening via DRE and the PSA blood test should be offered annually to men of average risk beginning at age 50. In those men at higher risk for developing prostate cancer, such as African Americans and individuals.
9; 290 2 ; : 207-14., Division of General Internal Medicine, Department of Medicine, University of California, San Francisco 94143, USA. -- CONTEXT: Clinical trials demonstrating increased risk of cardiovascular disease and breast cancer among women randomized to hormone replacement therapy have increased interest in other therapies for menopausal symptoms. Dietary supplements containing isoflavones are widely used as alternatives to hormonal therapies for hot flashes, but there is a paucity of data supporting their efficacy. -- OBJECTIVE: To compare the efficacy and safety of 2 dietary supplements derived from red clover with placebo in symptomatic menopausal women. -- DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial of menopausal women, aged 45 to 60 years, who were experiencing at least 35 hot flashes per week. The study was conducted between November 1999 and March 2001 at 3 US medical centers and included women who were recently postmenopausal mean [SD], 3.3 [4.5] years since menopause ; experiencing 8.1 hot flashes per day. Women were excluded if they were vegetarians, consumed soy products more than once per week, or took medications affecting isoflavone absorption. -- INTERVENTION: After a 2-week placebo run-in, 252 participants were randomly assigned to Promensil 82 mg of total isoflavones per day ; , Rimostil 57 mg of total isoflavones per day ; , or an identical placebo, and followed-up for 12 weeks. -- MAIN OUTCOME MEASURE: The primary outcome measure was the change in frequency of hot flashes measured by participant daily diaries. Secondary outcome measures included changes in quality of life and adverse events. -- RESULTS: Of 252 participants, 246 98% ; completed the 12-week protocol. The reductions in mean daily hot flash count at 12 weeks were similar for the Promensil 5.1 ; , Rimostil 5.4 ; , and placebo 5.0 ; groups. In comparison with the placebo group, participants in the Promensil group 41%; 95% confidence interval [CI], 29%-51%; P .03 ; , but not in the Rimostil group 34%; 95% CI, 22%-46%; P .74 ; reduced hot flashes more rapidly. Quality-of-life improvements and adverse events were comparable in the 3 groups. -- CONCLUSION: Although the study provides some evidence for a biological effect of Promensil, neither supplement had a clinically important effect on hot flashes or other symptoms of menopause.
Each system of medicine rests on metaphysical assumptions that, by definition, cannot be empirically demonstrated to be true or false. Therefore, neither system can be shown to be objectively, empirically more valid than the other Basic differences in metaphysical assumptions have resulted in a conceptual gap between Chinese and Western medical theory and practice Therefore, the only claims that can be made about either system of medicine are specific claims of effectiveness of specific treatments with respect to specific symptoms.
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CONTRAINDICATIONS AND WARNINGS: SORIATANE acitretin ; must not be used by females who are pregnant or who may become pregnant during therapy or at any time for at least 3 years after discontinuation of treatment. SORIATANE also must not be used by females of reproductive potential who may not use 2 effective forms of contraception birth control ; simultaneously for at least 1 month before, during and for at least 3 years after treatment. Two effective forms of contraception birth control ; are to be used simultaneously, even when 1 form is a hormonal contraceptive. Patients should not self-medicate with St. John's Wort because of a possible interaction with hormonal contraceptives. Prescribers must obtain negative results for 2 pregnancy tests before initiating treatment with SORIATANE. The first test is a screening test; the second is a confirmation test done during the first 5 days of the menstrual period immediately preceding SORIATANE therapy. For patients with amenorrhea, the second test should be done at least 11 days after the last act of unprotected sexual intercourse. Timing of pregnancy testing throughout the treatment course should be monthly or individualized based on the prescriber's clinical judgment. Females must sign a Patient Information Consent about the risks of birth defects. Acitretin is a metabolite of etretinate and major fetal abnormalities have been reported with both drugs. Acitretin can interact with ethanol to form etretinate. Therefore, females of reproductive potential must not ingest ethanol during treatment and for 2 months after cessation of treatment. Before prescribing, please see complete pregnancy warning in the accompanying complete product information. Females who have undergone treatment with Tegison etretinate ; must continue to follow the contraception requirements for Tegison and vasodilan, for example, isoflavones skin.
FINDING: Isoflavone content should be expressed as the aglycone weight. Isoflavones naturally occur in the soybean in the form of glycosides a glucose attached to the isoflavone molecule. The weight of the sugar is approximately 40 percent of the total weight of the isoflavone glycoside. Of course, the sugar is biologically irrelevant. The situation with isoflavones is analogous to calcium salts such as calcium carbonate. A 500 mg tablet of calcium.
Also, isoflavones positively affect various cardiovascular-related conditions, including heart disease, cholesterol saponins also positively affect cholesterol ; , angiogenesis and other vascular effects and ketorolac.
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Crouse III JR, Morgan T, Terry JG, Ellis J, Vitolins M, Burke GL 1999 A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Arch Intern Med 159: 2070-2076!
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L abuza 2004 ; critical issues in r& d of soy isoflavone-enriched foods and dietary supplements journal of food science 69 3 ; , crh77– crh8 doi: 1 1111 j 65-262 200 tb1334 x prev article next article abstract critical issues in r& d of soy isoflavone-enriched foods and dietary supplements uzzan 1 authors uzzan and labuza are with the dept.
How isoflavones lessen LDL cholesterol production, which is increased by increased intake of saturated fat and cholesterol, should be investigated, including effects on LDL receptor activity. Effects of soy protein on plasma HDL cholesterol concentrations are inconsistent. Anderson et al. 11 ; reported no significant changes in human HDL cholesterol with soy protein consumption. An increase in HDL cholesterol was seen only in female rhesus monkeys fed soy protein 16 ; , similar to the present study in which female hamsters fed ISP - ; had higher HDL cholesterol levels compared with hamsters fed casein or daidzein. The mechanism for the effects on HDL cholesterol and the reasons for the gender difference are unknown. It has been postulated that the effect may be mediated by the interaction between isoflavones and estrogen receptors 34 ; . Our results seem to rule out this hypothesis because there was no effect on HDL cholesterol concentrations when daidzein was added to the casein diet. In the present study, there were no differences in triglyceride levels among treatments in males. However, triglycerides were significantly less in female hamsters fed ISP - ; compared with those fed casein, consistent with another report that soflavone-depleted soy protein isolate significantly lessened serum triglyceride concentrations in both sham-operated and ovariectomized female hamsters compared with casein 13 ; . The cause of the different effects of protein sources on triglycerides in females is unknown and further studies are needed. We detected all 3 isoflavones and equol in plasma samples, ranging from 0.4 to 3.6 M, which were similar to the levels detected in human 35 ; and rat plasmas 36 ; . We found both daidzein and its metabolite, equol, in plasma of daidzein-treated hamsters, which showed that hamsters had the ability to metabolize daidzein to equol. While isoflavones were detected in most of the male hamster plasma samples, only a few females had detectable plasma isoflavone levels. This suggested a gender difference in isoflavone absorption and metabolism in hamsters. However, there are no reports of more rapid glucuronidation seemingly the main metabolic reaction of isoflavones ; by female hamsters, which would increase clearance of plasma isoflavones. This remains to be determined. The plasma cholesterol-lowering activity for the other isoflavones, genistein and glycitein, as well as the combinations of these 3 isoflavones, must be examined. The possible cholesterol-lowering effects of soy isoflavones suggest the potential to use these soy components as dietary cholesterol-lowering agents and lamictal.
In addition, a Medicare Prescription Drug Plan cannot cover a drug that is covered under Medicare Part A or Part B. See "How does your enrollment in this Plan affect coverage for drugs covered under Medicare Part A or Part B?" below. Also, while a Medicare Prescription Drug Plan can cover off-label uses of a prescription drug, we cover the off-label use only in cases where the use is supported by certain reference book citations. Congress specifically listed the reference books that list whether the off-label use would be permitted. 1 If the use is not supported by one of these reference books known as compendia ; , then the drug would be considered a non-Part D drug and could not be covered by our plan, for example, soy isoflavones estrogen.
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Gardner, Jason D., Gregory L. Brower, and Joseph S. Janicki. Effects of dietary phytoestrogens on cardiac remodeling secondary to chronic volume overload in female rats. J Appl Physiol 99: 13781383, 2005. First published June 16, 2005; doi: 10.1152 we demonstrated that intact female rats fed a standard rodent diet containing soybean products exhibit essentially no adverse left ventricular LV ; remodeling in response to aortocaval fistula-induced chronic volume overload. We hypothesized that phytoestrogenic compounds in the diet contributed to the female cardioprotection. To test this hypothesis, four groups of female rats were studied: shamoperated Sham ; and fistula Fist ; rats fed a diet with [P ; ] or without [P ; ] phytoestrogens. Eight weeks postfistula, systolic and diastolic cardiac function was assessed by using a blood-perfused, isolated heart preparation. High-phytoestrogen diet had no effect on body, heart, and lung weights, or cardiac function in Sham rats. Fistula groups developed LV hypertrophy, which was not reduced by dietary phytoestrogens [1, 184 229 mg Fist-P ; and 1, 079 199 mg Fist-P ; vs. 620 47 mg for combined Sham groups, P 0.05]. Unstressed LV volume increased in Fist-P ; rats 428 16 vs. 300 14 l Sham, P 0.0001 ; , but it was not different from Sham for Fist-P ; animals 286 17 l ; . Fist-P ; rats developed increased ventricular compliance 5.3 0.8 vs. 2.3 0.3 l mmHg Sham, P 0.01 ; , whereas Fist-P ; rats had no change in compliance 2.8 0.4 l mmHg ; . Intrinsic ventricular contractility was maintained in the Fist-P ; rats, but it was reduced P 0.001 ; in the Fist-P ; rats [systolic pressure-volume slope: 1.04 0.03, 0.60 and 0.99 0.08 mmHg l, for Fist-P ; , Fist-P ; , and Sham, respectively]. These data indicate that dietary phytoestrogens contribute significantly to female cardioprotection against volume overloadinduced adverse ventricular remodeling and that studies evaluating gender differences in cardiovascular remodeling must consider the influence of dietary phytoestrogens. ventricular function; heart failure; hypertrophy; gender; isoflavones; dilatation.
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Induced prostatic dysplasia in the Noble rat 10 ; . Similarly, TRPM-2 expression was enhanced in the absence of increased apoptotic activity and reduced androgen stimulation in rat prostate cancer and ventral prostate tissues 25 ; . The overexpression of TRPM-2 in LNCaP prostate cancer cells enhances the resistance to apoptosis induced by tumor necrosis factor 14 ; . Collectively, these conflicting data do not clearly define the functional role of TRPM-2 associated with apoptosis induced by various types of stimuli. TRPM-2 mRNA is highly up-regulated in Shionogi tumors after castration and in AI recurrent tumors. These changes in TRPM-2 are similar to previously reported findings in the rat prostate 5 ; and the human prostate cancer xenograft 9 ; . To differentiate between androgen-repressed versus apoptosis-associated up-regulation, CCBs were administered before castration to prevent castration-induced apoptosis because an early event in apoptotic cascade involves increases in the intracellular-free calcium concentration, with subsequent endonuclease activation 26, 27 ; . Castration-induced apoptosis and up-regulation of TRPM-2 was prevented by CCB treatment, thereby supporting TRPM-2 as an apoptosis-related rather than androgen-repressed gene. To determine whether TRPM-2 up-regulation after androgen ablation helps mediate the progression to androgen independence, we generated TRPM-2 overexpressing LNCaP prostate cancer cell lines. Although tumor take rates and growth in intact male mice were similar between parental and overexpressing TRPM-2 tumors, after castration, tumor growth and serum PSA increased severalfold faster in TRPM-2-tranfected tumors. These findings provide the first clear evidence that increased TRPM-2 results in the acquisition of androgen resistance and accelerates time to AI progression. The up-regulation of TRPM-2 in Shionogi tumors after castration and the acquisition of androgen resistance with TRPM-2 overexpression suggests that preventing TRPM-2 up-regulation precipitated by androgen ablation may enhance castration-induced apoptosis and delay the AI progression of prostate cancer. Antisense ODN, a chemically modified stretch of single-stranded DNA that is complementary to mRNA regions of a target gene and thereby effectively inhibits gene expression by forming RNA DNA duplexes 28 ; , offers one strategy to specifically target TRPM-2 gene expression. Phosphorothioate ODNs are water soluble, stable agents manufactured to resist nuclease digestion. After parenteral administration, phosphorothioate ODNs become associated with high capacity, low affinity serum binding proteins 29 ; . In this study, the phosphorothioate antisense TRPM-2 ODN corresponding to the mouse TRPM-2 translation initiation site reduced TRPM-2 expression levels in a sequence-specific and dose-dependent manner. In vivo administration of antisense TRPM-2 ODN accelerated castration-induced tumor regression and delayed the time to AI progression compared to that of mismatch control ODNs. Consistent with the in vitro data, in vivo treatment with the antisense TRPM-2 ODN also reduced TRPM-2 mRNA levels. The earlier detection of PARP cleavage fragments in Shionogi tumors after antisense TRPM-2 ODN treatment suggests that the inhibition of TRPM-2 up-regulation after castration results in an earlier induction of castration-induced apoptosis. Because TRPM-2 plays a critical role in some normal organs, including the brain, kidney, spleen, and prostate 4, 30, 31 ; , the effects of antisense TRPM-2 ODNs on TRPM-2 expression levels in these organs were also examined. Although antisense ODNs significantly reduced TRPM-2 levels in the AD prostate and tumor tissues undergoing castration-induced apoptosis, TRPM-2 expression was not altered by antisense ODNs in the other organs examined. We reported similar differential decreases in Bcl-2 levels after treatment with mouse antisense Bcl-2 ODNs in Shionogi tumors 32 ; . We speculate that tissues undergoing apoptosis may be more sensitive to antisense TRPM-2 ODN treatment relative to intact organs because of the.
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Participate in the administrative and educational activities of the medical staff. In addition, they must have satisfactorily completed the required period on the provisional staff. see below ; Provisional: Midwives who meet the criteria for active staff membership are usually initially granted privileges to the provisional staff category for a minimum of six months. Provisional staff have the same privileges and responsibilities as active staff, except they are not entitled to vote and hold office. A midwife who has a conditional certificate of registration will usually hold provisional staff privileges until she is granted general registration by the College. Associate: Members of the associate staff generally participate in patient care under the direction of the most responsible care giver. They may not admit patients nor write orders for patients in hospital unless those privileges have been specifically granted to them. They may write orders for diagnostic and treatment services for out-patients. They may utilize diagnostic facilities and assist in the delivery room, but cannot perform patient investigational procedures or participate beyond the privileges granted to them. In some hospitals this position is called "clinical trainee" rather than "associate staff". ; A conditional registrant may also be granted associate privileges. However, in order to meet her conditions, a conditional registrant is required to demonstrate that she can work more independently that this category sometimes allows. Provisions will need to be made for conditional registrants to admit patients and write orders if they are privileged in this category. Locum Tenens: Members of the locum tenens staff are appointed to replace a member of the active or provisional staff during an absence. Privileges for locum tenens do not exceed those of the staff member they are replacing. Renewal of locum tenens privileges may be considered upon review. Locum tenens are expected to attend educational activities. A midwife who has a temporary certificate of registration will usually apply for privileges in this category and lithobid.
Prescription Limitations All Medicaid beneficiaries are limited to five 5 ; prescriptions per month with no more than two 2 ; being brand name drugs, including refills, with the exception of long-term care residents. Children under the age of twenty-one 21 ; may receive more than the prescription limit as allowed through expanded EPSDT when medically necessary and the physician receives prior authorization from the Division of Medicaid's Pharmacy Benefits Manager.
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The number of Americans without health insurance continues to climb and will reach upwards of 50 million in the coming decade. Many of these folks use the emergency rooms for their medical problems and many simply have no way to pay for services or prescribed drugs. The costs of insurance are skyrocketing and there is no end in sight. To reduce costs the companies including Medicare continually reduce coverage and reimbursement amounts. Actually, if you join the Army you may be entitled, according to recent news items, to liposuction, a nose job or a breast enlargement. Their docs need the practice? In my opinion it might be better to have no private for-profit health insurance and set up a national coverage plan similar to flood insurance or Medicare. This would certainly bring down costs that began to soar when the insurance industry discovered that their gravy train would begin when they offered health insurance. The record system is broken as well. Every time one sees a new physician a whole new set of records must be filled out with the same stuff that nobody ever seems to read. And who cares that I had my tonsils out in 1934, etc. Considering that you may see a half dozen doctors a years your info is gathering dust among those wall of files one finds in every doctors office. A handful of doctors have streamlined their practices using computers and email. The rest continue to scribble orders and prescriptions that are misread or unread.
3. Clarkson, T. B. 2002 ; Soy, soy phytoestrogens and cardiovascular disease. J. Nutr. 132: 566S569S. 4. Anthony, M. S. 2000 ; Soy and cardiovascular disease: cholesterol lowering and beyond. J. Nutr. 130: 662S 663S. Yamakoshi, J., Piskula, M. K., Izumi, T., Tobe, K., Saito, M., Kataoka, S., Obata, A. & Kikuchi, M. 2000 ; Isoflavone aglycone-rich extract without soy protein attenuates atherosclerosis development in cholesterol-fed rabbits. J. Nutr. 130: 18871893. 6. Iqbal, M. J., Yaegashi, S., Ahsan, R., Lightfoot, D. A. & Banz, W. J. 2002 ; Differentially abundant mRNAs in rat liver in response to diets containing soy protein isolate. Physiol. Genomics 11: 219 226. Nestel, P. 2002 ; Role of soy protein in cholesterol-lowering: how good is it? Arterioscler. Thromb. Vasc. Biol. 22: 17431744. 8. Polkowski, K. & Mazurek, A. P. 2000 ; Biological properties of genistein. A review of in vitro and in vivo data. Acta Pol. Pharm. 57: 135155. 9. Wilson, T., March, H., Banz, W. J., Hou, Y., Adler, S., Meyers, C. Y., Winters, T. A. & Maher, M. A. 2002 ; Antioxidant effects of phyto- and synthetic-estrogens on cupric ion-induced oxidation of human low-density lipoproteins in vitro. Life Sci. 70: 22872297. 10. Anthony, M. S., Clarkson, T. B. & Williams, J. K. 1998 ; Effects of soy isoflavones on atherosclerosis: potential mechanisms. Am. J. Clin. Nutr. 68: 1390S1393S. 11. Crouse, J. R., 3rd, Morgan, T., Terry, J. G., Ellis, J., Vitolins, M. & Burke, G. L. 1999 ; A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Arch. Intern. Med. 159: 2070 2076. Lichtenstein, A. H, Jalbert, S. M., Adlercreutz, H., Goldin, B. R., Rasmussen, H., Schaefer, E. J. & Ausman, L. M. 2002 ; Lipoprotein response to diets high in soy or animal protein with and without isoflavones in moderately hypercholesterolemic subjects. Arterioscler. Thromb. Vasc. Biol. 22: 18521858. 13. Gardner, C. D., Newell, K. A., Cherin, R. & Haskell, W. L. 2001 ; The effect of soy protein with or without isoflavones relative to milk protein on plasma lipids in hypercholesterolemic postmenopausal women. Am. J. Clin. Nutr. 73: 728 735. Simons, L. A., von Konigsmark, M., Simons, J. & Celermajer, D. S. 2000 ; Phytoestrogens do not influence lipoprotein levels or endothelial function in healthy, postmenopausal women. Am. J. Cardiol. 85: 12971301. 15. Sirtori, C. R. 2001 ; Risks and benefits of soy phytoestrogens in cardiovascular diseases, cancer, climacteric symptoms and osteoporosis. Drug Saf. 24: 665 682. Jenkins, D.J.A., Kendall, C.W.C., Jackson, C.-J.C., Connelly, P. W., Parker, T., Faulkner, D., Vidgen, E., Cunnane, S. C., Leiter, L. A. & Josse, R. G. 2002 ; Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women. Am. J. Clin. Nutr. 76: 365372. 17. Jayagopal, V., Albertazzi, P., Kilpatrick, E. S., Howarth, E. M., Jennings, P. E., Hepburn, D. A. & Atkin, S. L. 2002 ; Beneficial effects of soy phytoestrogen intake in postmenopausal women with Type 2 diabetes. Diabetes Care 25: 1709 1714. Bhathena, S. J. & Velasquez, M. T. 2002 ; Beneficial role of dietary phytoestrogens in obesity and diabetes. Am. J. Clin. Nutr. 76: 11911201. 19. Chinetti, G., Fruchart, J. C. & Staels, B. 2000 ; Peroxisome proliferator-activated receptors PPARs ; : nuclear receptors at the crossroads between lipid metabolism and inflammation. Infamm. Res. 49: 497505. 20. Neve, B. P., Fruchart, J. C. & Staels, B. 2000 ; Role of the peroxisome proliferator-activated receptors PPAR ; in atherosclerosis. Biochem. Pharmacol. 60: 12451250. 21. de Villiers, W.J.S. & Smart, E. J. 1999 ; Macrophage scavenger receptors and foam cell formation. J. Leukoc. Biol. 66: 740 746. Napoli, C., de Nigris, F. & Palinski, W. 2001 ; Multiple role of reactive oxygen species in the arterial wall. J. Cell. Biochem. 82: 674 682. Nagy, L., Tontonoz, P., Alvarez, J.G.A., Chen, H. & Evans, R. M. 1998 ; Oxidized LDL regulates macrophage gene expression through ligand activation of PPAR . Cell 93: 229 240. Qi, C., Yijun, Z. & Reddy, J. K. 2000 ; Peroxisome proliferator-activated receptors, coactivators, and downstream targets. Cell. Biochem. Biophys. 32: 187204. 25. Ricote, M. & Glass, C. K. 2001 ; New role for PPARs in cholesterol homeostasis. Trends Pharmacol. Sci. 22: 441 443. Gotto, A. M. 2002 ; Lipid management in diabetic patients: lessons from prevention trials. Am. J. Med. 112 suppl. 8A ; : 19S26S. 27. Picard, F. & Auwerx, J. 2002 ; PPAR and glucose homeostasis. Annu. Rev. Nutr. 22: 167197. 28. Peluso, M. R., Winters, T. A., Shanahan, M. F. & Banz, W. J. 2000 ; A cooperative interaction between soy protein and its isoflavone-enriched fraction lowers hepatic lipids in male obese Zucker rats and reduces blood platelet sensitivity in male Sprague-Dawley rats. J. Nutr. 130: 23332342. 29. O'Connor, T. P., Liesen, D. A., Mann, P. C., Rolando, L. & Banz, W. J. 2002 ; A high isoflavone soy protein diet and intravenous genistein delay rejection of rat cardiac allografts. J. Nutr. 132: 22832287. 30. Reeves, P. G., Nielsen, F. H. & Fahey, G. C., Jr. 1993 ; AIN-93 purified diets for laboratory rodents: final report of the American Institute of Nutrition ad hoc writing committee on the reformulation of the AIN-76A rodent diet. J. Nutr. 123: 1939 1951. Allain, C. C., Poon, L. S., Chan, C.S.G., Richmond, W. & Fu, P. C. 1974 ; Enzymatic determination of total serum cholesterol. Clin. Chem. 20: 470 475 and loxitane.
Prevention delay of type 2 diabetes drug therapy should not be routinely used to prevent diabetes until more information is known about its cost effectiveness.
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A bolded paragraph regarding the association of qt prolongation and torsade de pointes in other drugs is found at the bottom of the page, because isoflavones estrogen.
Forty two postmenopausal women consumed three servings of soy foods over 12 weeks containing 60 milligrams per day of isoflavones and isoniazid.
Please advise your PHC members with Medicare coverage NOT to opt out of the new Medicare prescription drug plan as they will no longer have prescription drug coverage from PHC beginning January 1, 2006. If you have questions about the new Medicare.
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