Papers by Carolyn Torkelson
Menopause, Aug 1, 2011
Objective-To assess the efficacy of TU-025, keishibukuryogan, a Japanese prescription herbal medi... more Objective-To assess the efficacy of TU-025, keishibukuryogan, a Japanese prescription herbal medicine used for hot flash management, in American women. Methods-This randomized, double-blind, placebo-controlled, phase II trial enrolled 178 postmenopausal women, aged 45-58 years, with a Mayo hot flash score greater than 28 per week and who met other inclusion criteria. After a one-week placebo run-in period, participants were randomly assigned to either 12 weeks of placebo, 7.5 g/day or 12.5 g/day. Primary and secondary outcomes were measured by the Mayo Clinic Hot Flash Diary, the Greene Climacteric Index and the Pittsburgh Sleep Quality Index. Results-At three months, hot flash scores, climacteric symptoms and sleep quality improved by 34% in the placebo group, 40% in the 7.5 g/day group and 38% in the 12.5 g/day group. (p < 0.001). However, the differences in changes between groups were not statistically significant (p = 0.990). Diarrhea unexpectedly developed in 20% of participants receiving active medication. Conclusions-For American women, unlike the clinical experience for Japanese women, TU-025 did not significantly reduce the frequency and severity of hot flash symptoms, improve climacteric symptoms or benefit sleep quality. This study identified several potentially significant methodological factors to be considered in future scientific assessments of traditional Asian medicines.
Journal of Gerontological Nursing, Dec 1, 2022
Few studies have examined women's perspectives on their health and priorities in older age. I... more Few studies have examined women's perspectives on their health and priorities in older age. In the current study, we administered a cross-sectional survey to women aged ≥60 years, recruited at a large community event in 2019. Participants ( N = 303; mean age = 68 years) reported up to three 12-month life goals in open-text fields ( N = 1,053 goals). Our qualitative analysis identified 25 themes under four domains: Health and Wellness ( n = 339 goals), Work and Leisure ( n = 316 goals), Relationships ( n = 199 goals), and Personal Growth ( n = 170 goals). The most frequent themes pertained to family relationships, travel, staying healthy, and physical activity. Findings did not vary by participants' comorbidity status. Women have diverse aspirations as they age, including nurturing relationships, acquiring novel skills and experiences, and maintaining overall health and wellness. Gerontological nurses can better meet the needs of this population by expanding their awareness of patients' life goals and partnering with women to optimize health to achieve these goals. [ Journal of Gerontological Nursing, 48 (12), 25–33.]
CRC Press eBooks, Aug 17, 2022
PubMed, May 1, 2009
Minnesota has played a leading role in the integrative holistic medicine movement in the United S... more Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.
The Clinical Journal of Pain, May 1, 2019
Objectives: Fibromyalgia syndrome (FMS) is a chronically painful condition whose symptoms are wid... more Objectives: Fibromyalgia syndrome (FMS) is a chronically painful condition whose symptoms are widely reported to be exacerbated by stress. We hypothesized that female patients with FMS differ from healthy female controls in their sympathetic responses, a fact that may unmask important biomarkers and factors that contribute to the etiology of FMS. Methods: In a pilot study, blood pressure (BP), skin temperature, thermogenic activity, circulating glucose, and pain sensitivity of 13 patients and 11 controls at room temperature (24°C) were compared to that after exposure to cold (19°C). Results: When measured at 24°C, BP, skin temperature, blood glucose and brown adipose tissue (BAT) activity, measured using 18 F-fluorodeoxyglucose (FDG) PET/CT, did not differ between controls and patients with FMS. However, after cold exposure (19°C), BP and BAT activity increased in controls but not in FMS patients; skin temperature on the calf and arm decreased in controls more than in FMS patients; and circulating glucose was lower in FMS patients than in controls. Pain sensitivity did not change during the testing interval in response to cold. Discussion: The convergence of the effect of cold on four relatively simple measures of thermogenic, cardiovascular and metabolic activity, each regulated by sympathetic activity, strongly indicate that patients with FMS have impaired sympathetic responses to stress that are observable and highly significant even when measured in extraordinarily small sample
PubMed, Jul 26, 2006
Background: Despite widespread public use of complementary and alternative medicine (CAM) therapi... more Background: Despite widespread public use of complementary and alternative medicine (CAM) therapies, no standardized CAM curriculum is available to medical educators, and evaluation of such curricula is limited. Objectives: (1) To evaluate the impact of a 3-week elective CAM rotation--integrating site-visits, small groups lectures and discussion, reference materials, a research paper--on medical students' confidence in their knowledge about CAM, attitudes toward CAM, and perceived effectiveness of CAM therapies. (2) To generate greater interest in evaluation of CAM curricula in medical school. Methods: Students (N=24) completed a pre- and post-course self-assessment tool designed to assess respondents' confidence in their knowledge about CAM (e.g., CAM principles and philosophy, indications for referral), attitudes toward CAM (e.g., its importance to heath professionals), and perceptions of the effectiveness of 10 CAM therapies. Results: Students' confidence increased substantially in the 4 domains of knowledge assessed. Students' positive pre-course attitudes toward CAM were sustained or improved, and their views on the effectiveness of CAM modalities increased. Conclusion: A course that provides students with the opportunity to delve into the vast area of CAM though site visits, small group discussions, lectures, and independent research projects may be an effective means of providing a CAM curriculum.
Food and Chemical Toxicology, Sep 1, 2015
PubMed, Apr 1, 2010
Objective: To evaluate the effectiveness of vitamin E, evening primrose oil (EPO), and the combin... more Objective: To evaluate the effectiveness of vitamin E, evening primrose oil (EPO), and the combination of vitamin E and EPO for pain control in women with cyclical mastalgia. Procedure: A double-blind, randomized, placebo-controlled trial was conducted at two U.S. academic medical centers. Eighty-five women with premenstrual cyclical breast discomfort were enrolled. Participants were randomly assigned to one of four six-month oral treatments: vitamin E (1,200 IU per day), EPO (3,000 mg per day), vitamin E (1,200 IU per day) plus EPO (3,000 mg per day), or double placebo. The primary outcome measure was change in breast pain, measured by the modified McGill Pain Questionnaire at enrollment and at six months. Results: Forty-one patients completed the study. Intent-to-treat analysis (pretesting and post testing) showed a difference in worst-pain improvement with the treatments EPO (p=0.005), vitamin E (p=0.04), and EPO plus vitamin E (p=0.05), but no difference with placebo (p=0.93). Results from two-sample t-test showed a nonsignificant decrease in cyclical mastalgia individually for the three treatment groups compared with the placebo group (EPO, p=0.18; vitamin E, p=0.10; and EPO plus vitamin E, p=0.16). The data were also analyzed with the separation test by Aickin, which showed a trend toward a reduction of cyclical mastalgia with vitamin E and EPO individually and in combination. Conclusion: Daily doses of 1,200 IU vitamin E, 3,000 mg EPO, or vitamin E and EPO in combination at these same dosages taken for six months may decrease the severity of cyclical mastalgia.
PubMed, Mar 1, 2016
Context • Strontium ranelate is an approved prescription medication for the treatment of osteopor... more Context • Strontium ranelate is an approved prescription medication for the treatment of osteoporosis in Europe. In the United States, the only available forms of strontium are those that are nonprescription, dietary supplements. Some patients with osteoporosis use those products because they prefer an alternate treatment to conventional therapy. Currently, no controlled trials have been conducted on the effectiveness of the supplements for treating osteoporosis. Objective • The study intended to examine how one woman responded to the use of strontium chloride. Design • This was a retrospective case study. Setting • The woman in the case study was a patient in an academic urban women's health clinic in Minneapolis, MN, USA. Participant • The participant was a postmenopausal woman with a history of vertebral fracture. Intervention • The participant took 680 mg daily of strontium chloride for 2.5 y. Outcome Measures • The patient had begun receiving dual-energy X-ray absorptiometry (DXA) scans in 2004 and continued to receive follow-up scans every 2 y. After beginning strontium therapy in December 2011, she received DXA scans in March 2012 and May 2014. Results • During the study, the analysis of the patient's DXA scans showed a positive increase in the bone mineral density (BMD) of her vertebrae and her right hip and maintenance of her BMD in her left hip. Conclusions • Although the current case report does not provide enough evidence to conclude that US dietary supplements of strontium are effective in preventing fractures, it demonstrates a positive experience for one patient.
Liver injury effects of green tea–based products have been reported in sporadic case reports. How... more Liver injury effects of green tea–based products have been reported in sporadic case reports. However, no study has examined systematically such adverse effects in an unbiased manner. We examined the potential effects of a high, sustained oral dose of green tea extract (GTE) on liver injury measures in a randomized, placebo-controlled, double-blinded phase II clinical trial, which enrolled 1,075 women with the original aim to assess the effect of daily GTE consumption for 12 months on biomarkers of breast cancer risk. The current analysis examined the effect of GTE consumption on liver injury in 1,021 participants (513 in GTE and 508 in placebo arm) with normal baseline levels of liver enzymes. Among women in the GTE arm, alanine aminotransferase (ALT) increased by 5.4 U/L [95% confidence interval (CI), 3.6–7.1] and aspartate aminotransferase increased by 3.8 U/L (95% CI, 2.5–5.1), which were significantly higher than those among women in the placebo arm (both P &lt; 0.001). Overall, 26 (5.1%) women in GTE developed moderate or more severe abnormalities in any liver function measure during the intervention period, yielding an OR of 7.0 (95% CI, 2.4–20.3) for developing liver function abnormalities as compared with those in the placebo arm. ALT returned to normal after dechallenge and increased again after one or more rechallenges with GTE. The rise–fall pattern of liver enzyme values following the challenge–dechallenge cycles of GTE consumption strongly implicates the effect of high-dose GTE on liver enzyme elevations. Cancer Prev Res; 10(10); 571–9. ©2017 AACR.
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
CRC Press eBooks, Aug 17, 2022
The FASEB Journal, Apr 1, 2015
ABSTRACT Green tea is thought to provide health benefits, though adverse reactions to green tea e... more ABSTRACT Green tea is thought to provide health benefits, though adverse reactions to green tea extract (GTE) have been reported. We conducted a randomized, double-blind, placebo-controlled study of GTE on breast cancer biomarkers, including mammographic density, in which 1075 postmenopausal women were randomly assigned to consume GTE containing 843 mg (-)-epigallocatechin-3-gallate (EGCG) or placebo daily for one year. There were no significant differences in % of women with adverse events (AEs, 75.6% and 72.8% of the GTE group and placebo group, respectively) or serious AEs (2.2 % and 1.5% of GTE and placebo groups, respectively). Women on GTE reported significantly higher incidence of nausea (P &lt; 0.001) and dermatologic AEs (P = 0.05) and significantly lower diarrhea incidence (P = 0.02). More women in the GTE group experienced an alanine aminotransferase (ALT) elevation compared with placebo group (n=36, (6.7%) vs. n=4, (0.7%); P &lt; 0.001). There were no statistically significant differences between groups in frequencies of other AEs. Overall, AEs were mainly mild and transient, indicating that daily consumption of GTE containing 843 mg EGCG is generally well tolerated by a group of predominantly Caucasian postmenopausal women. However, 6.7% of GTE consumers experienced ALT elevations, with 1.3% experiencing ALT-related serious AEs. Copyright © 2015. Published by Elsevier Ltd.
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Papers by Carolyn Torkelson