Hormone replacement therapy (HRT) has
been used to relieve menopausal symptoms—using prescription hormones
to compensate for those natural hormones being lost to menopause.
However, HRT is not without its risks and side effects—both of which
are copiously discussed in our Special Topics list of the top 20
papers on HRT research published in the last decade as well as in the
20 most-cited HRT papers published in the past two years. The two
primary concerns involving HRT, according to our lists, are the
effects on cardiovascular function and the risk of breast
cancer. Cardiovascular effects examined in the top papers include
the risk of venous thromboembolism,
fibrinolysis, and plasma C-reactive protein levels, among other
concerns. On the cancer side of the debate, many studies have shown an
increase in the risk of breast cancer, endometrial cancer, and ovarian
cancer. Other positive effects examined include the potential
reduction in colorectal cancer risk and the prevention of osteoporotic
fractures; whereas other negative effects studied include stroke,
cholecystitis, and an increase in mammographic density. The effects of
estrogen alone versus estrogen plus progesterone combination therapy,
as well as the duration of therapy, are also debated. Through all
these clinical trials, meta-analyses, epidemiologic studies, and
literature reviews, one thing is clear: the decision to use HRT lies
in the balance between relief of menopausal symptoms and the risk of
cancer or other serious side effects.
Methodology
To construct this database,
papers were extracted based on title word supplied keywords for
Hormone Replacement Therapy. The keywords used were as follows:
Hormone Replace*
The baseline time span for this database
is 1993-2003 (sixth bimonthly). The resulting database contained 3,870
(10 years) and 1,066 (2 years) papers; 9,545 authors; 65 countries;
622 journals; and 2,259 institutions.
Rankings
Once the database was in place,
it was used to generate the lists of top 20 papers (two, and ten years
periods), authors, journals,
institutions, and nations, covering a time span of 1993-2003 (sixth
bimonthly).
The top 20 papers are ranked
according to total cites. Rankings for author, journal, institution,
and country are listed in three ways: according to total cites, total
papers, and total cites/paper. The paper thresholds used to determine
scientist, institution, country, and journal rankings according to
total cites/paper were as follows: 12, 27, 26, and 12, respectively. These
thresholds correspond to the top 1% of authors,
1% of institutions, 50% of countries and 5% of journals by total papers.
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