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To determine if differing degrees of levothyroxine (LT4) suppression therapy for benign and malignant thyroid disease are associated with proportionately increased rates of bone loss, this longitudinal assessment of bone densitometry changes (single-photon and dual-photon absorptiometry) was conducted in three groups of subjects: 24 thyroid cancer patients who were treated with near-total thyroidectomy, radioiodine ablation, and aggressive LT4-suppression; 44 patients who were treated with more conservative LT4-suppression for benign thyroid disorders; and 24 normal controls. Bone densitometry values were adjusted for age, weight, height, and menopausal status. The rates of bone loss in benign LT4-suppressed patients were greater than those in controls at the midradius, distal radius, lumbar spine, and femoral neck. The rates of loss in the thyroid cancer patients were also greater than those in the controls at all four sites and greater than in the benign LT4-suppressed patients at the midradius, distal radius, and femoral neck but not in the lumbar spine. Rates of bone loss were not significantly correlated with LT4 dose or with the serum level of T4 or TSH. LT4-suppression therapy for benign thyroid disease is associated with accelerated bone loss. More aggressive LT4-suppression for thyroid cancer is associated with even greater bone loss, particularly in cortical bone regions. These risks must be weighed against the benefits of LT4 therapy in individual patients. [ABSTRACT FROM AUTHOR]

Coronary arteriovenous fistula are uncommon if not rare, but represent the most prevalent hemodynamically significant congenital malformations of the coronary arterial circulation. The goal of this report is to evaluate the use of 3D volume rendering from transaxial breathhold coronary MR angiograms to visualize coronary arteriovenous fistulas. Coronary MR angiography offers a new non-invasive technique that accurately defines the anatomy of these malformations, setting the stage for surgical intervention. [ABSTRACT FROM AUTHOR]

Using data from a case-control study of family homelessness in Worcester, Massachusetts, this analysis compares the economic, psychosocial and health characteristics of 159 Puerto Rican and 170 Non-Hispanic White poor, single mothers. When compared to Non-Hispanic Whites, the Puerto Rican mothers had more children, less education, fewer work experiences, fewer social supports, and more English language problems. Although the absolute rates were high in both groups, Puerto Rican mothers had experienced less violence and suffered fewer mental health problems, with the exception of major depression, than Non-Hispanic Whites. In addition, Puerto Rican mothers were less likely to use traditional health services. These findings suggest that to escape poverty, Puerto Rican mothers need a unique combination of educational opportunities (including English as a Second Language), job training, and child care. [ABSTRACT FROM AUTHOR]

To examine the extent to which congenital heart disease (CHD) influences ovarian function, 98 women (mean age 32.7 years) were asked to complete a mailed questionnaire regarding their menstrual patterns. Patients were divided into acyanotic (60%) and cyanotic (38.8%) groups. Cycle lengths, duration of menstrual cycle, regularity of menses, amount of flow, and breakthrough bleeding were compared in these two groups and against agematched controls. The mean age of menarche for the sample (13.4 years) was significantly different ( p<0.004) when compared to their controls (12.5 years). With the exception of breakthrough bleeding, statistical differences were not found between the study population and the controls. When the menstrual histories of cyanotic women were compared with those of acyanotic women, differences were found for all categories of menstrual patterns with the exception of the amount of menstrual flow. Menstrual patterns of cyanotic women compared to controls were found to be significantly different for all categories with the exception of amount of flow. In general, women with CHD have menstrual patterns similar to those in the general population. [ABSTRACT FROM AUTHOR]

Objective: To compare the health characteristics and service utilization patterns of homeless women and low-income housed women who are heads of household.Design: Case-control study.Setting: Community of Worcester, Massachusetts.Participants: A sample of 220 homeless mothers and 216 low-income housed mothers receiving welfare.Measurements and Main Results: Outcome measures included health status, chronic conditions, adverse lifestyle practices, outpatient and emergency department use and hospitalization rates, and use of preventive screening measures. Both homeless mothers and housed mothers demonstrated low levels of physical and role functioning and high levels of bodily pain. Prevalence rates of asthma, anemia, and ulcer disease were high in both groups. More than half of both groups were current smokers. Compared with the housed mothers, homeless mothers reported more HIV risk behaviors. Although 90% of the homeless mothers had been screened for cervical cancer, almost one third had not been screened for tuberculosis. After controlling for potential confounding factors, the homeless mothers, compared with the housed mothers, had more frequent emergency department visits in the past year (adjusted mean, homeless vs housed, 1.41 vs .95, p = .10) and were significantly more likely to be hospitalized in the past year (adjusted odds ratio 2.22; 95% confidence interval 1.13, 4.38).Conclusions: Both homeless mothers and low-income housed mothers had lower health status, more chronic health problems, and higher smoking rates than the general population. High rates of hospitalization, emergency department visits, and more risk behaviors among homeless mothers suggest that they are at even greater risk of adverse health outcomes. Efforts to address gaps in access to primary care and to integrate psychosocial supports with health care delivery may improve health outcomes for homeless mothers and reduce use of costly medical care services. [ABSTRACT FROM AUTHOR]