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  1. Article ; Online: Women's experiences of trauma, the psychosocial impact and health service needs during the perinatal period.

    Perera, Essence / Chou, Sharon / Cousins, Nicole / Mota, Natalie / Reynolds, Kristin

    BMC pregnancy and childbirth

    2023  Volume 23, Issue 1, Page(s) 197

    Abstract: Background: Traumatic events are associated with psychological and physical health problems for women in the perinatal period (i.e., pregnancy-12-months after childbirth). Despite the negative impact of trauma on perinatal women, the long-term impact of ...

    Abstract Background: Traumatic events are associated with psychological and physical health problems for women in the perinatal period (i.e., pregnancy-12-months after childbirth). Despite the negative impact of trauma on perinatal women, the long-term impact of such diverse trauma and women's experience during the perinatal period remains understudied.
    Methods: This study explored two research questions: 1) What are the psychological experiences of perinatal women who have experienced interpersonal traumatic events? And 2) What are the service needs and gaps expressed by women relating to perinatal medical protocols and psychological services? These questions were addressed via in-depth semi-structured qualitative interviews with nine perinatal women (one pregnant and eight postpartum) residing in central Canada who reported experiencing interpersonal traumatic events occurring from adolescence to the perinatal period. Recruitment and data collection occurred from October 2020 to June 2021. Interviews were audio-recorded, transcribed, and analyzed according to constructivist grounded theory.
    Results: The emergent grounded theory model revealed the central theme of the role of prior trauma in shaping women's perinatal experiences, with four related main themes including perinatal experiences during the COVID-19 pandemic, the role of social support in women's perinatal experiences, the barriers that women experienced while seeking psychological and medical services prior to the perinatal period and during the perinatal period, and the specific needs of perinatal women with a history of interpersonal trauma.
    Conclusions: Findings of this research highlight the negative and long-lasting impact of traumatic events experienced on women's psychological health and psychosocial functioning during the perinatal period, as well as perinatal women's unmet psychological and medical service needs. A call to action for perinatal researchers and clinicians is imperative in furthering this important area of research and practicing person-centered and trauma-informed care with this population.
    MeSH term(s) Pregnancy ; Adolescent ; Female ; Humans ; Pandemics ; COVID-19 ; Parturition/psychology ; Postpartum Period/psychology ; Maternal Health Services ; Qualitative Research
    Language English
    Publishing date 2023-03-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059869-5
    ISSN 1471-2393 ; 1471-2393
    ISSN (online) 1471-2393
    ISSN 1471-2393
    DOI 10.1186/s12884-023-05509-5
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  2. Article ; Online: Vitamin D and Incident Fractures. Reply.

    LeBoff, Meryl S / Chou, Sharon H / Manson, JoAnn E

    The New England journal of medicine

    2022  Volume 387, Issue 17, Page(s) 1626–1627

    MeSH term(s) Humans ; Aged ; Vitamin D ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Vitamins
    Chemical Substances Vitamin D (1406-16-2) ; Vitamins
    Language English
    Publishing date 2022-10-27
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2211434
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Bone metabolism in anorexia nervosa and hypothalamic amenorrhea.

    Chou, Sharon H / Mantzoros, Christos

    Metabolism: clinical and experimental

    2017  Volume 80, Page(s) 91–104

    Abstract: Anorexia nervosa (AN) and hypothalamic amenorrhea (HA) are states of chronic energy deprivation associated with severely compromised bone health. Poor bone accrual during adolescence followed by increased bone loss results in lifelong low bone density, ... ...

    Abstract Anorexia nervosa (AN) and hypothalamic amenorrhea (HA) are states of chronic energy deprivation associated with severely compromised bone health. Poor bone accrual during adolescence followed by increased bone loss results in lifelong low bone density, degraded bone architecture, and higher risk of fractures, despite recovery from AN/HA. Amenorrhea is only one of several compensatory responses to the negative energy balance. Other hypothalamic-pituitary hormones are affected and contribute to bone deficits, including activation of hypothalamic-pituitary-adrenal axis and growth hormone resistance. Adipokines, particularly leptin, provide information on fat/energy stores, and gut hormones play a role in the regulation of appetite and food intake. Alterations in all these hormones influence bone metabolism. Restricted in scope, current pharmacologic approaches to improve bone health have had overall limited success.
    MeSH term(s) Amenorrhea/drug therapy ; Amenorrhea/genetics ; Amenorrhea/pathology ; Anorexia Nervosa/drug therapy ; Anorexia Nervosa/metabolism ; Anorexia Nervosa/pathology ; Bone and Bones/metabolism ; Bone and Bones/pathology ; Female ; Humans ; Hypothalamic Diseases/drug therapy ; Hypothalamic Diseases/metabolism ; Male
    Language English
    Publishing date 2017-10-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80230-x
    ISSN 1532-8600 ; 0026-0495
    ISSN (online) 1532-8600
    ISSN 0026-0495
    DOI 10.1016/j.metabol.2017.10.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Relative Energy Deficiency in sport (REDs): Endocrine manifestations, pathophysiology and treatments.

    Angelidi, Angeliki M / Stefanakis, Konstantinos / Chou, Sharon H / Valenzuela-Vallejo, Laura / Dipla, Konstantina / Boutari, Chrysoula / Ntoskas, Konstantinos / Tokmakidis, Panagiotis / Kokkinos, Alexander / Goulis, Dimitrios G / Papadaki, Helen A / Mantzoros, Christos S

    Endocrine reviews

    2024  

    Abstract: Research on lean, energy-deficient athletic and military cohorts has broadened the concept of the Female Athlete Triad into the Relative Energy Deficiency in Sport (REDs) syndrome. REDs represents a spectrum of abnormalities induced by low energy ... ...

    Abstract Research on lean, energy-deficient athletic and military cohorts has broadened the concept of the Female Athlete Triad into the Relative Energy Deficiency in Sport (REDs) syndrome. REDs represents a spectrum of abnormalities induced by low energy availability (LEA), which serves as the underlying cause of all symptoms described within the REDs concept, affecting exercising populations of either biological sex. Both short- and long-term LEA, in conjunction with other moderating factors, may produce a multitude of maladaptive changes that impair various physiological systems and adversely affect health, well-being, and sport performance. Consequently, the comprehensive definition of REDs encompasses a broad spectrum of physiological sequelae and adverse clinical outcomes related to LEA, such as neuroendocrine, bone, immune, and hematological effects, ultimately resulting in compromised health and performance. In this review, we discuss the pathophysiology of REDs and associated disorders. We briefly examine current treatment recommendations for REDs, primarily focusing on non-pharmacological, behavioral, and lifestyle modifications that target its underlying cause - energy deficit. We also discuss treatment approaches aimed at managing symptoms, such as menstrual dysfunction and bone stress injuries, and explore potential novel treatments that target the underlying physiology, emphasizing the roles of leptin and the activin-follistatin-inhibin axis, the roles of which remain to be fully elucidated, in the pathophysiology and management of REDs. In the near future, novel therapies leveraging our emerging understanding of molecules and physiological axes underlying energy availability or lack thereof may restore LEA-related abnormalities, thus preventing and/or treating REDs-related health complications, such as stress fractures, and improving performance.
    Language English
    Publishing date 2024-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603096-8
    ISSN 1945-7189 ; 0163-769X
    ISSN (online) 1945-7189
    ISSN 0163-769X
    DOI 10.1210/endrev/bnae011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Effects of Supplemental Vitamin D3, Omega-3 Fatty Acids on Physical Performance Measures in VITamin D and OmegA-3 TriaL.

    Chou, Sharon H / Cook, Nancy R / Kotler, Gregory / Kim, Eunjung / Copeland, Trisha / Lee, I-Min / Cawthon, Peggy M / Buring, Julie E / Manson, JoAnn E / LeBoff, Meryl S

    The Journal of clinical endocrinology and metabolism

    2024  

    Abstract: Context: Declining muscle strength and performance in older adults are associated with falls, fractures, and premature death.: Objective: To determine whether supplementation with vitamin D3 or omega-3 fatty acids vs. placebo for 2 years improves ... ...

    Abstract Context: Declining muscle strength and performance in older adults are associated with falls, fractures, and premature death.
    Objective: To determine whether supplementation with vitamin D3 or omega-3 fatty acids vs. placebo for 2 years improves physical performance measures.
    Design: VITamin D and OmegA-3 TriaL (VITAL) was a double-blinded, placebo-controlled randomized trial of supplemental vitamin D3 and/or omega-3 fatty acids vs. placebo in the prevention of cancer and cardiovascular disease in 25,871 U.S. adults. This ancillary study was completed in a New England sub-cohort that had in-person evaluations at baseline and 2-year follow-up.
    Setting: Center for Clinical Investigations in Boston.
    Participants: 1,054 participants (men ≥50 and women ≥55 years).
    Interventions: 2x2 factorial design of supplemental vitamin D3 (cholecalciferol, 2000 IU/day) and/or marine omega-3 fatty acids (1 g/day).
    Main outcome measures: 2-year changes in physical performance measures of grip strength, walking speed, standing balance, repeated chair stands, and Timed-up and Go (TUG).
    Results: At 2 years, all randomized groups showed worsening walking speeds and TUG. There were no differences in changes in grip strength, walking speeds, Short Physical Performance Battery (composite of walking speed, balance, and chair stands), and TUG between the vitamin D3-treated and the placebo-treated groups and between the omega-3-treated and the placebo-treated groups. Effects overall did not vary by sex, age, body mass index, or baseline measures of total or free 25-hydroxyvitamin D (25[OH]D) or plasma n-3 index; TUG slightly worsened with vitamin D supplementation, compared to placebo, in participants with baseline total 25(OH)D levels above the median (p=0.01, p for interaction=0.04).
    Conclusions: Neither supplemental vitamin D3 nor marine omega-3 fatty acids for 2 years improved physical performance in this generally healthy adult population.
    Language English
    Publishing date 2024-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/clinem/dgae150
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  6. Article: Vertebral Morphometry.

    Chou, Sharon H / Vokes, Tamara

    Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry

    2016  Volume 19, Issue 1, Page(s) 48–53

    Abstract: There is as yet no agreement about the criteria by which to arrive at an imaging diagnosis of a vertebral fracture. Because high-grade fractures result in alterations in vertebral shape, 1 possible avenue of diagnosis has been to quantitate changes in ... ...

    Abstract There is as yet no agreement about the criteria by which to arrive at an imaging diagnosis of a vertebral fracture. Because high-grade fractures result in alterations in vertebral shape, 1 possible avenue of diagnosis has been to quantitate changes in vertebral shape. The result has been a variety of methods for the relative and absolute measurements of vertebral dimensions. Such measurements have also lent themselves to automated computed analysis. The number of techniques reflects the absence of any consensus about the best. The semiquantitative technique proposed by Genant has become the most widely used and has served the field well for comparative purposes. Its use in higher grade fractures has been widely endorsed, if some concepts (e.g., short vertebral height-vertebrae) are at variance with lower grades of fracturing. Vertebral morphometry may be the only recourse in high volume epidemiological and interventional studies.
    MeSH term(s) Female ; Humans ; Osteoporotic Fractures/diagnostic imaging ; Radiography ; Spinal Fractures/diagnostic imaging ; Spine/anatomy & histology ; Spine/diagnostic imaging
    Language English
    Publishing date 2016-01
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2040951-5
    ISSN 1094-6950
    ISSN 1094-6950
    DOI 10.1016/j.jocd.2015.08.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Accounting for Surgical Confounding Factors Affecting Dual-Energy X-ray Absorptiometry in a Large Clinical Trial.

    Donlon, Catherine M / Chou, Sharon H / Yu, Cindy Y / LeBoff, Meryl S

    Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry

    2021  Volume 25, Issue 2, Page(s) 127–132

    Abstract: Joint replacements are among the most common orthopedic procedures performed in the U.S. and will continue to increase with the aging population. It is therefore necessary to account for these and other confounding factors, such as breast implants, when ... ...

    Abstract Joint replacements are among the most common orthopedic procedures performed in the U.S. and will continue to increase with the aging population. It is therefore necessary to account for these and other confounding factors, such as breast implants, when performing dual-energy X-ray absorptiometry (DXA) measurements. Whole-body DXA scans were performed in 771 participants (men ≥50 yr and women ≥55 yr) to assess bone mineral density (BMD) and body composition (fat and lean mass). In the DXA scan analyses of participants with internal metal, these affected regions of interest were replaced with measures from the unaffected, contralateral side, consistent with recommendations of the International Society for Clinical Densitometry. T-scores and Z-scores were recalculated using default sex and ethnicity-matched databases. We also explored effects of breast implants on bone density and body composition analyses. Approximately 13.1% of participants had internal metal artifacts at baseline. Replacing metal artifacts with the unaffected, contralateral side decreased the whole-body BMD by an average of 8.1% (SEM 0.84%; n = 67). In participants with unilateral hip (n = 17) and knee replacements (n = 20), BMD was decreased by an average of 14.1% (SEM 1.7%) and 11.2% (SEM 1.1%), respectively. Fat and lean mass were not significantly affected by metal artifacts, as differences between values with and without metal were within 1%. Two participants had bilateral breast implants, and in a separate trial, one participant had a unilateral breast implant. Bone mineral content (BMC) in the region with the breast implant was 5.8 times higher than the contralateral side, and whole-body BMC was increased by 4.7%. Metal artifacts and breast implants can confound DXA whole-body bone but not fat and lean results. It is therefore important in clinical studies to account for these factors to detect physiologically relevant differences in bone measures.
    MeSH term(s) Absorptiometry, Photon/methods ; Body Composition ; Bone Density ; Bone and Bones ; Clinical Trials as Topic ; Female ; Humans ; Male ; Middle Aged ; Whole Body Imaging
    Language English
    Publishing date 2021-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2040951-5
    ISSN 1094-6950
    ISSN 1094-6950
    DOI 10.1016/j.jocd.2021.06.002
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  8. Article ; Online: Effects of Vitamin D 3 Supplementation on Incident Fractures by eGFR in VITAL.

    Hsu, Simon / Zelnick, Leila R / Buring, Julie E / Chou, Sharon H / Cook, Nancy R / D'Agostino, Denise / Hoofnagle, Andrew N / LeBoff, Meryl S / Lee, I-Min / Limonte, Christine P / Sesso, Howard D / Manson, JoAnn E / de Boer, Ian H

    Clinical journal of the American Society of Nephrology : CJASN

    2024  Volume 19, Issue 5, Page(s) 638–640

    MeSH term(s) Humans ; Cholecalciferol/therapeutic use ; Dietary Supplements/adverse effects ; Male ; Female ; Aged ; Fractures, Bone/prevention & control ; Fractures, Bone/etiology ; Glomerular Filtration Rate/drug effects ; Middle Aged ; Incidence
    Chemical Substances Cholecalciferol (1C6V77QF41)
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.0000000000000434
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  9. Article ; Online: 20 years of leptin: role of leptin in human reproductive disorders.

    Chou, Sharon H / Mantzoros, Christos

    The Journal of endocrinology

    2014  Volume 223, Issue 1, Page(s) T49–62

    Abstract: Leptin, as a key hormone in energy homeostasis, regulates neuroendocrine function, including reproduction. It has a permissive role in the initiation of puberty and maintenance of the hypothalamic-pituitary-gonadal axis. This is notable in patients with ... ...

    Abstract Leptin, as a key hormone in energy homeostasis, regulates neuroendocrine function, including reproduction. It has a permissive role in the initiation of puberty and maintenance of the hypothalamic-pituitary-gonadal axis. This is notable in patients with either congenital or acquired leptin deficiency from a state of chronic energy insufficiency. Hypothalamic amenorrhea is the best-studied, with clinical trials confirming a causative role of leptin in hypogonadotropic hypogonadism. Implications of leptin deficiency have also emerged in the pathophysiology of hypogonadism in type 1 diabetes. At the other end of the spectrum, hyperleptinemia may play a role in hypogonadism associated with obesity, polycystic ovarian syndrome, and type 2 diabetes. In these conditions of energy excess, mechanisms of reproductive dysfunction include central leptin resistance as well as direct effects at the gonadal level. Thus, reproductive dysfunction due to energy imbalance at both ends can be linked to leptin.
    MeSH term(s) Amenorrhea/drug therapy ; Amenorrhea/metabolism ; Amenorrhea/physiopathology ; Energy Metabolism/drug effects ; Energy Metabolism/physiology ; Female ; Humans ; Hypogonadism/drug therapy ; Hypogonadism/metabolism ; Hypogonadism/physiopathology ; Hypothalamic Diseases/drug therapy ; Hypothalamic Diseases/metabolism ; Hypothalamic Diseases/physiopathology ; Leptin/metabolism ; Leptin/physiology ; Leptin/therapeutic use ; Obesity/drug therapy ; Obesity/metabolism ; Obesity/physiopathology ; Reproduction/drug effects ; Reproduction/physiology
    Chemical Substances Leptin
    Language English
    Publishing date 2014-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 3028-4
    ISSN 1479-6805 ; 0022-0795
    ISSN (online) 1479-6805
    ISSN 0022-0795
    DOI 10.1530/JOE-14-0245
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  10. Article ; Online: Vertebral Imaging in the Diagnosis of Osteoporosis: a Clinician's Perspective.

    Chou, Sharon H / LeBoff, Meryl S

    Current osteoporosis reports

    2017  Volume 15, Issue 6, Page(s) 509–520

    Abstract: Purpose of review: Vertebral fractures are the most common osteoporotic fracture and result in functional decline and excess mortality. Dual-energy x-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis to identify patients at ...

    Abstract Purpose of review: Vertebral fractures are the most common osteoporotic fracture and result in functional decline and excess mortality. Dual-energy x-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis to identify patients at risk for fragility fractures; however, advances in imaging have expanded the role of computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating bone health.
    Recent findings: The utility of CT and MRI in the assessment of bone density is starting to gain traction, particularly when used opportunistically. DXA, conventional radiography, CT, and MRI can all be used to assess for vertebral fractures, and MRI can determine the acuity of fractures. Finally, advances in imaging allow for non-invasive assessment of measures of bone quality, including microarchitecture, bone strength, and bone turnover, to help identify and treat at-risk patients prior to sustaining a vertebral fracture. CT and MRI techniques remain primarily research tools to assess metabolic bone dysfunction, while use of DXA can be clinically expanded beyond measurement of bone density to assess for vertebral fractures and bone architecture to improve fracture risk assessment and guide treatment.
    MeSH term(s) Absorptiometry, Photon ; Bone Density ; Bone Remodeling ; Humans ; Magnetic Resonance Imaging ; Osteoporosis/diagnostic imaging ; Osteoporotic Fractures/diagnostic imaging ; Radiography ; Spinal Fractures/diagnostic imaging ; Spine/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2017-09-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2186581-4
    ISSN 1544-2241 ; 1544-1873
    ISSN (online) 1544-2241
    ISSN 1544-1873
    DOI 10.1007/s11914-017-0404-x
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