Although the U.S.' "national investment" in abstinence-only sex education "may not be a scam on the scale of Bernie Madoff, ... this industry has had standards for truth as loose as some mortgage lenders," syndicated columnist Ellen Goodman writes in a Pittsburgh Post-Gazette opinion piece. Goodman writes that a recent Johns Hopkins study about teenagers and virginity pledges found "absolutely no difference" in the sexual behavior of those who took pledges and those who did not. She writes, "In fact, the only difference" was that teens who took pledges were "significantly less likely to use birth control, especially condoms." She adds that the "lesson many students seemed to retain from their abstinence-only program was a negative and inaccurate view of contraception." The study is "not just a primer on the capacity for teenage denial or the inner workings of adolescent neurobiology," Goodman writes. She adds, "What makes this study important is simply this: 'virginity pledges' are one of the ways that the government measures whether abstinence-only education is 'working.' They count the pledges as proof that teens will abstain," which is "like counting New Year's resolutions as proof that you lost 10 pounds."
Goodman continues, "Over the last eight years, a cottage industry of 'abstinence-only-until-marriage' purveyors became a McMansion industry." According to Goodman, annual funding for abstinence-only programs increased from $73 million in 2001 to $204 million in 2008, for "a grand total of $1.5 billion in federal money for an ideology in search of a methodology." Goodman writes that, "By now, there's an archive of research showing that the binge was a bust," and that "abstinence-only programs have been given failing grades for truth and effectiveness."
The "sorry part is that sex education got caught in the culture wars," continues Goodman. She writes that Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy said sex education has been framed "as a battle between 'those who wanted virginity pledges and those who wanted to hand out condoms to 14-year-olds.'" According to Goodman, "Meanwhile, six in 10 teens have sex before they leave high school and 730,000 teenage girls will get pregnant this year ... What the overwhelming majority of protective parents actually want is not a political battle. They want teens to delay sex and to have honest information about sexuality, including contraception." Goodman says that the "programs that work best combine those lessons." She concludes that teenagers "are not the only masters of denial. But we are finally stepping back from the culture wars. We are, with luck, returning to something that used to be redundant -- evidence-based science. That's a pledge worth signing ... and remembering" (Goodman, Pittsburgh Post-Gazette, 1/2).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2008 The Advisory Board Company. All rights reserved.
суббота, 30 июля 2011 г.
суббота, 23 июля 2011 г.
Obstetric Fistula In Tanzania Fueled By Poverty, Inadequate Health Services, Lack Of Knowledge, Report Says
Poverty, inadequate health care services, lack of knowledge about maternal health and pregnancy-related emergencies are fueling the problem of obstetric fistula in Tanzania, according to a report released last week by the nongovernmental organization EngenderHealth and the Tanzania Women's Dignity Project, IRIN News reports (IRIN News, 6/14).
Obstetric fistula develops when a fetus becomes lodged during labor in the narrow birth canal of a girl or young woman, causing pressure that blocks the flow of blood to vital tissues and tearing holes in the bowel, urethra or both, causing incontinence. Physicians can repair a small fistula surgically in less than two hours, but repairing a larger fistula and restoring a woman's continence sometimes requires more than one surgery (Kaiser Daily Women's Health Policy Report, 6/14). According to the report, titled "Risk and Resilience: Obstetric Fistula in Tanzania," the fetus dies in nearly all fistula cases.
For the report, researchers in 2006 conducted case studies of 61 girls and women living with fistula in the Singida Rural, Songea Rural and Ukerewe districts of Tanzania. The report also included studies of the women's families, health care providers and community members. According to the report, lack of preparation for childbirth, including basic information, increases women's risk of fistula. In addition, although prenatal care is widely available in Tanzania, it is inconsistent and inadequate, the report found.
Barriers to "facility-based delivery" -- including lack of money, distance to a hospital and transportation are the "critical reasons why women ... do not get the care they need," according to the report. The report also found that surgery to repair fistula is expensive and inaccessible for many women in the country and urged that fistula repair services be available at no cost or at reduced prices. The report also found that women living with fistula and their families had substantial emotional and economic effects because of stigma and the cost of care, IRIN News reports (IRIN News, 6/14).
The report is available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Obstetric fistula develops when a fetus becomes lodged during labor in the narrow birth canal of a girl or young woman, causing pressure that blocks the flow of blood to vital tissues and tearing holes in the bowel, urethra or both, causing incontinence. Physicians can repair a small fistula surgically in less than two hours, but repairing a larger fistula and restoring a woman's continence sometimes requires more than one surgery (Kaiser Daily Women's Health Policy Report, 6/14). According to the report, titled "Risk and Resilience: Obstetric Fistula in Tanzania," the fetus dies in nearly all fistula cases.
For the report, researchers in 2006 conducted case studies of 61 girls and women living with fistula in the Singida Rural, Songea Rural and Ukerewe districts of Tanzania. The report also included studies of the women's families, health care providers and community members. According to the report, lack of preparation for childbirth, including basic information, increases women's risk of fistula. In addition, although prenatal care is widely available in Tanzania, it is inconsistent and inadequate, the report found.
Barriers to "facility-based delivery" -- including lack of money, distance to a hospital and transportation are the "critical reasons why women ... do not get the care they need," according to the report. The report also found that surgery to repair fistula is expensive and inaccessible for many women in the country and urged that fistula repair services be available at no cost or at reduced prices. The report also found that women living with fistula and their families had substantial emotional and economic effects because of stigma and the cost of care, IRIN News reports (IRIN News, 6/14).
The report is available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
суббота, 16 июля 2011 г.
Percentage Of U.S. Women Breast-Feeding Their Infants Reaches Highest Level On Record, Report Says
The percentage of women in the U.S. who breast-feed their infants has reached the highest level on record amid growing evidence that the practice provides many health benefits to infants and women, according to a study published in the Aug. 3 issue of CDC's Morbidity and Mortality Weekly Report, Reuters reports.
According to CDC, breast-feeding has been associated with a decreased risk of many diseases and conditions -- including ear infections, respiratory tract infections, obesity, eczema, sudden infant death syndrome and diarrhea -- among infants. It also is associated with benefits for women, including a reduced risk of the most common form of diabetes, and breast and ovarian cancer, the agency said (Dunham, Reuters, 8/3).
The report, based on a survey of about 17,000 respondents, found that the percentage of women who started breast-feeding increased from 71% to 74% between 2000 to 2004. However, the report found that the rate of exclusive breast-feeding during the first three and six months after birth was 31% and 11%, respectively (Stobbe, AP/Forbes, 8/2). The goal of the federal government's Healthy People 2010 campaign is to have 50% or more of women breast-feeding at six months and 25% at one year (Kaiser Daily Women's Health Policy Report, 2/2).
According to the study, rates of exclusive breast-feeding were lowest among black women and women who are low-income, unmarried, live in rural areas, have a high school diploma or less education and are younger than age 20 (AP/Forbes, 8/2).
"We've made quite a bit of progress," CDC epidemiologist and lead author of the report Celeste Philip said. She added that she hopes the new statistics will prompt physicians to renew efforts to promote breast-feeding among women. CDC is working with hospitals to encourage support of breast-feeding in the days after birth, Philip said (Reuters, 8/2).
The report is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
According to CDC, breast-feeding has been associated with a decreased risk of many diseases and conditions -- including ear infections, respiratory tract infections, obesity, eczema, sudden infant death syndrome and diarrhea -- among infants. It also is associated with benefits for women, including a reduced risk of the most common form of diabetes, and breast and ovarian cancer, the agency said (Dunham, Reuters, 8/3).
The report, based on a survey of about 17,000 respondents, found that the percentage of women who started breast-feeding increased from 71% to 74% between 2000 to 2004. However, the report found that the rate of exclusive breast-feeding during the first three and six months after birth was 31% and 11%, respectively (Stobbe, AP/Forbes, 8/2). The goal of the federal government's Healthy People 2010 campaign is to have 50% or more of women breast-feeding at six months and 25% at one year (Kaiser Daily Women's Health Policy Report, 2/2).
According to the study, rates of exclusive breast-feeding were lowest among black women and women who are low-income, unmarried, live in rural areas, have a high school diploma or less education and are younger than age 20 (AP/Forbes, 8/2).
"We've made quite a bit of progress," CDC epidemiologist and lead author of the report Celeste Philip said. She added that she hopes the new statistics will prompt physicians to renew efforts to promote breast-feeding among women. CDC is working with hospitals to encourage support of breast-feeding in the days after birth, Philip said (Reuters, 8/2).
The report is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
суббота, 9 июля 2011 г.
Asthmatic Girls And Children Exposed To Tobacco Smoke Benefit More From Montelukast (Singulair)
Girls and children exposed to tobacco smoke respond particularly well to montelukast (Singulair) according to researchers at National Jewish Medical and Research Center. Associate Professor of Pediatrics Nathan Rabinovitch, MD, and his colleagues also identified two biomarkers that may help physicians predict even more precisely which patients will benefit from montelukast.
"These findings will help doctors know in advance which patients are most likely to benefit from montelukast and to tailor an effective treatment regimen for specifically them," said Dr. Rabinovitch.
The study was recently published online and will appear in the June issue of the Journal of Allergy and Clinical Immunology.
Inhaled corticosteroids are considered the first-line treatment for cases of persistent asthma. However, steroids alone do not effectively control asthma in 30 percent to 40 percent of patients and they may have some side effects, especially in children. In those cases, a secondary medication is often used. Montelukast is one such medication.
Montelukast, one of the most widely prescribed medications for asthma and allergies, blocks the action of chemicals called leukotrienes, which contribute to inflammation. However, physicians have found that montelukast is quite variable in its effectiveness, helping some patients but not others. Dr. Rabinovitch and his colleagues set out to better understand its variable effectiveness.
They followed the 27 asthmatic students from the Kunsberg School on the National Jewish campus for five months. The children received daily montelukast or a placebo without any change in their other asthma medications. The primary measure of asthma control was how often children needed to use their short-acting rescue medication albuterol.
Before the children began taking montelukast, researchers found that when leukotriene levels in their urine rose, the children used 20 to 25% more albuterol two days later. Once they began taking montelukast, however, children did not need to take albuterol as often when their leukotriene levels rose. Two groups of children responded particularly well to montelukast: girls and children with high levels of cotinine in their urine, which indicated exposure to secondhand tobacco smoke. Both had statistically significant reduced sensitivity to leukotrienes once they began taking montelukast.
"When looking at a general population of patients, montelukast does not appear to be very effective," said Dr. Rabinovitch. "However, in certain patients, the choice of motelukast may be warranted, particularly in school-age girls and children exposed to tobacco smoke."
Dr. Rabinovitch and his colleagues also found that measuring exhaled nitric oxide, a measure of inflammation in patients' breath, and leukotrienes in their urine, could also help them predict which patients would respond well to montelukast-- those with a high leukotriene/nitric oxide ratio.
"Increasingly we have come to understand that asthma is not just one disease; it is more likely several diseases that present with similar symptoms. Thus different medications are likely to work for different patients," said Dr. Rabinovitch. "It is important that we be more selective and tailor our medication regimen so that each child receives the most safe and effective treatment for their type of asthma."
Source: William Allstetter
National Jewish Medical and Research Center
View drug information on Singulair.
"These findings will help doctors know in advance which patients are most likely to benefit from montelukast and to tailor an effective treatment regimen for specifically them," said Dr. Rabinovitch.
The study was recently published online and will appear in the June issue of the Journal of Allergy and Clinical Immunology.
Inhaled corticosteroids are considered the first-line treatment for cases of persistent asthma. However, steroids alone do not effectively control asthma in 30 percent to 40 percent of patients and they may have some side effects, especially in children. In those cases, a secondary medication is often used. Montelukast is one such medication.
Montelukast, one of the most widely prescribed medications for asthma and allergies, blocks the action of chemicals called leukotrienes, which contribute to inflammation. However, physicians have found that montelukast is quite variable in its effectiveness, helping some patients but not others. Dr. Rabinovitch and his colleagues set out to better understand its variable effectiveness.
They followed the 27 asthmatic students from the Kunsberg School on the National Jewish campus for five months. The children received daily montelukast or a placebo without any change in their other asthma medications. The primary measure of asthma control was how often children needed to use their short-acting rescue medication albuterol.
Before the children began taking montelukast, researchers found that when leukotriene levels in their urine rose, the children used 20 to 25% more albuterol two days later. Once they began taking montelukast, however, children did not need to take albuterol as often when their leukotriene levels rose. Two groups of children responded particularly well to montelukast: girls and children with high levels of cotinine in their urine, which indicated exposure to secondhand tobacco smoke. Both had statistically significant reduced sensitivity to leukotrienes once they began taking montelukast.
"When looking at a general population of patients, montelukast does not appear to be very effective," said Dr. Rabinovitch. "However, in certain patients, the choice of motelukast may be warranted, particularly in school-age girls and children exposed to tobacco smoke."
Dr. Rabinovitch and his colleagues also found that measuring exhaled nitric oxide, a measure of inflammation in patients' breath, and leukotrienes in their urine, could also help them predict which patients would respond well to montelukast-- those with a high leukotriene/nitric oxide ratio.
"Increasingly we have come to understand that asthma is not just one disease; it is more likely several diseases that present with similar symptoms. Thus different medications are likely to work for different patients," said Dr. Rabinovitch. "It is important that we be more selective and tailor our medication regimen so that each child receives the most safe and effective treatment for their type of asthma."
Source: William Allstetter
National Jewish Medical and Research Center
View drug information on Singulair.
суббота, 2 июля 2011 г.
A Woman's Age At First Menstruation Influences Risk Of Obesity For Her Children
A new study published in PLoS Medicine suggests that the age when a woman's periods start may affect her children's growth rate during childhood,
final height and risk of obesity in later life. Researchers from the Medical Research Council and University of Cambridge, led by Dr Ken Ong, studied
the association between mother's age at first menstruation, mother's adult body size and obesity risk, and children's growth and obesity risk in 6,009
children from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) in Bristol.
In mothers, earlier age of periods was associated with shorter adult height, increased weight, and body mass index compared with women whose periods
started later. The children of women whose periods started earlier had a faster growth tempo, characterised by rapid weight gain and growth,
particularly during infancy, which led to taller childhood stature. However this pattern of childhood growth is likely to result in earlier maturation
and therefore shorter adult stature. This growth pattern is known to confer an increased risk of childhood and adult obesity.
The researchers conclude that "earlier age at menarche may indicate a transgenerational influence toward a faster tempo of childhood growth, which
is transmitted from the mother to her offspring" and that "understanding the genetic, epigenetic, or behavioural factors that underlie this
process will identify processes that regulate both the timing of puberty and the risk of childhood-onset obesity."
-- Citation: Ong KK, Northstone K, Wells JC, Rubin C, Ness AR (2007)
Earlier mother's age at menarche predicts rapid infancy growth and childhood obesity.
PLoS Med 4(4): e132.
Click here to see article online
PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit www.plosmedicine
About the Public Library of Science
The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit www.plos
final height and risk of obesity in later life. Researchers from the Medical Research Council and University of Cambridge, led by Dr Ken Ong, studied
the association between mother's age at first menstruation, mother's adult body size and obesity risk, and children's growth and obesity risk in 6,009
children from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) in Bristol.
In mothers, earlier age of periods was associated with shorter adult height, increased weight, and body mass index compared with women whose periods
started later. The children of women whose periods started earlier had a faster growth tempo, characterised by rapid weight gain and growth,
particularly during infancy, which led to taller childhood stature. However this pattern of childhood growth is likely to result in earlier maturation
and therefore shorter adult stature. This growth pattern is known to confer an increased risk of childhood and adult obesity.
The researchers conclude that "earlier age at menarche may indicate a transgenerational influence toward a faster tempo of childhood growth, which
is transmitted from the mother to her offspring" and that "understanding the genetic, epigenetic, or behavioural factors that underlie this
process will identify processes that regulate both the timing of puberty and the risk of childhood-onset obesity."
-- Citation: Ong KK, Northstone K, Wells JC, Rubin C, Ness AR (2007)
Earlier mother's age at menarche predicts rapid infancy growth and childhood obesity.
PLoS Med 4(4): e132.
Click here to see article online
PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit www.plosmedicine
About the Public Library of Science
The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit www.plos
пятница, 1 июля 2011 г.
BJOG Release: Further Risks Highlighted For Obese Pregnant Women, UK
New research published in BJOG: An International Journal of Obstetrics and Gynaecology has reported obesity, and having previously given birth, as the two largest risk factors for blood clots in the lungs during pregnancy (antenatal pulmonary embolism).
Blood clotting in the lungs is the most important cause of death directly related to pregnancy in women in the UK today, and obese women were found to have an increased risk of 165% compared with non-obese women.
The study was conducted by the National Perinatal Epidemiology Unit (NPEU), in collaboration with doctors and midwives throughout the UK, using information collected from the UK Obstetric Surveillance System (UKOSS). The study addressed management, outcomes and the extent to which preventive and management guidelines are followed in the United Kingdom. All 229 consultant-led maternity units throughout the UK took part over a 19 month period from February 2005 until August 2006.
During this time there were a total of 143 antenatal pulmonary embolisms in an estimated 1 132 964 maternities, giving an incidence rate of 1.3 per 10 000 maternities or 1 per 7700 maternities. Of these cases, there were five maternal deaths.
The study suggested that 62% of pulmonary embolism cases could be attributed to a number of births of one or more, and 21% to obesity (a BMI of 30kg/m2 or greater).
However, while 70% of women had a documented "classical" risk factor (as listed in current UK guidelines), such as a history of blood clots, age of 35 or older, recent bedrest, five or more previous births, obesity (BMI ?? 30 kg/m2), recent long haul travel, surgery during pregnancy, or known thrombophilia (abnormal blood clotting) worryingly, nearly one-third of women had no classical risk factors at all, and only 18% had more than one. This meant that only nine women with classical risk factors were eligible for preventive treatment under current guidelines. Preventive treatment (usually subcutaneous injections of low molecular weight heparin) has been shown in large studies to be remarkably safe, and so in the light of these results, there may be scope to revisit national guidelines, in particular whether the threshold for preventive treatment should be lower.
The study also found a need for further work on guideline implementation. Only two of the nine women with an antenatal pulmonary embolism received the appropriate dose of preventive medication as recommended in the guidelines. Half the women who received antenatal treatment were given lower than the recommended dosage.
Dr Marian Knight, Senior Clinical Research Fellow and Honorary Consultant in Public Health at the National Perinatal Epidemiology Unit, University of Oxford, said "Pulmonary embolism remains an important cause of death in pregnant women in the UK.
"This national study shows that for every woman who dies, more than thirty have a blood clot but survive. Overweight and obese pregnant women were at particular risk, with a more than two and a half times increased risk compared with women of normal weight. This is an especially important observation given the increasing prevalence of obesity in our population.
"Both women and their doctors and midwives should be aware of the risk factors for blood clotting in order that preventive measures can be undertaken where appropriate."
Professor Philip Steer, BJOG editor in chief, said "Antenatal pulmonary embolism is a rare but very serious pregnancy complication and this study has produced some striking results. One of the most interesting is the relatively weak association between pulmonary embolism and many of the classical risk factors for the condition, alerting clinicians to remain ever vigilant when assessing the women in their care.
"Because of the rarity of the condition and thus fairly small numbers of women affected, further multi-national studies are required to ascertain the need for guidelines to be updated regarding diagnosis and treatment."
Notes
- BJOG: An International Journal of Obstetrics and Gynaecologyis owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ' BJOG' or ' BJOG: An International Journal of Obstetrics and Gynaecology ' when referring to the journal.
- The National Perinatal Epidemiology Unit (NPEU) is a research unit at Oxford University established in 1978 by the Department of Health. The unit has expanded considerably in recent years and now has well over 40 staff including epidemiologists, obstetricians, midwives, nurses, paediatricians, social scientists, and information specialists. The NPEU is funded by the Department of Health in England. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Department of Health.
- UKOSS is a joint research initiative between the NPEU and the Royal College of Obstetricians and Gynaecologists, in collaboration with the Royal College of Midwives, the Obstetric Anaesthetists Association, the National Childbirth Trust, the Faculty of Public Health of the Royal College of Physicians, and the Confidential Enquiry into Maternal and Child Health, and is supported by the Department of Health.
- UKOSS is a UK-wide obstetric surveillance system to describe the epidemiology of a variety of uncommon disorders of pregnancy. The aim is to use this system to lessen the burden on reporting clinicians of multiple requests for information from different sources.
- The recent report "Saving Mothers Lives: Reviewing maternal deaths to make motherhood safer - 2003-2005" from the Confidential Enquiry into Maternal and Child Health showed that 27% of women who died from causes directly or indirectly related to pregnancy were obese.
Reference
Antenatal pulmonary embolism: risk factors, management and outcomes.
Knight M on behalf of UKOSS.
BJOG 2008; DOI: 10.1111/j.1471-0528.2007.01622.x.
Please click here to view article online
Royal College of Obstetricians and Gynaecologists
Blood clotting in the lungs is the most important cause of death directly related to pregnancy in women in the UK today, and obese women were found to have an increased risk of 165% compared with non-obese women.
The study was conducted by the National Perinatal Epidemiology Unit (NPEU), in collaboration with doctors and midwives throughout the UK, using information collected from the UK Obstetric Surveillance System (UKOSS). The study addressed management, outcomes and the extent to which preventive and management guidelines are followed in the United Kingdom. All 229 consultant-led maternity units throughout the UK took part over a 19 month period from February 2005 until August 2006.
During this time there were a total of 143 antenatal pulmonary embolisms in an estimated 1 132 964 maternities, giving an incidence rate of 1.3 per 10 000 maternities or 1 per 7700 maternities. Of these cases, there were five maternal deaths.
The study suggested that 62% of pulmonary embolism cases could be attributed to a number of births of one or more, and 21% to obesity (a BMI of 30kg/m2 or greater).
However, while 70% of women had a documented "classical" risk factor (as listed in current UK guidelines), such as a history of blood clots, age of 35 or older, recent bedrest, five or more previous births, obesity (BMI ?? 30 kg/m2), recent long haul travel, surgery during pregnancy, or known thrombophilia (abnormal blood clotting) worryingly, nearly one-third of women had no classical risk factors at all, and only 18% had more than one. This meant that only nine women with classical risk factors were eligible for preventive treatment under current guidelines. Preventive treatment (usually subcutaneous injections of low molecular weight heparin) has been shown in large studies to be remarkably safe, and so in the light of these results, there may be scope to revisit national guidelines, in particular whether the threshold for preventive treatment should be lower.
The study also found a need for further work on guideline implementation. Only two of the nine women with an antenatal pulmonary embolism received the appropriate dose of preventive medication as recommended in the guidelines. Half the women who received antenatal treatment were given lower than the recommended dosage.
Dr Marian Knight, Senior Clinical Research Fellow and Honorary Consultant in Public Health at the National Perinatal Epidemiology Unit, University of Oxford, said "Pulmonary embolism remains an important cause of death in pregnant women in the UK.
"This national study shows that for every woman who dies, more than thirty have a blood clot but survive. Overweight and obese pregnant women were at particular risk, with a more than two and a half times increased risk compared with women of normal weight. This is an especially important observation given the increasing prevalence of obesity in our population.
"Both women and their doctors and midwives should be aware of the risk factors for blood clotting in order that preventive measures can be undertaken where appropriate."
Professor Philip Steer, BJOG editor in chief, said "Antenatal pulmonary embolism is a rare but very serious pregnancy complication and this study has produced some striking results. One of the most interesting is the relatively weak association between pulmonary embolism and many of the classical risk factors for the condition, alerting clinicians to remain ever vigilant when assessing the women in their care.
"Because of the rarity of the condition and thus fairly small numbers of women affected, further multi-national studies are required to ascertain the need for guidelines to be updated regarding diagnosis and treatment."
Notes
- BJOG: An International Journal of Obstetrics and Gynaecologyis owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ' BJOG' or ' BJOG: An International Journal of Obstetrics and Gynaecology ' when referring to the journal.
- The National Perinatal Epidemiology Unit (NPEU) is a research unit at Oxford University established in 1978 by the Department of Health. The unit has expanded considerably in recent years and now has well over 40 staff including epidemiologists, obstetricians, midwives, nurses, paediatricians, social scientists, and information specialists. The NPEU is funded by the Department of Health in England. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Department of Health.
- UKOSS is a joint research initiative between the NPEU and the Royal College of Obstetricians and Gynaecologists, in collaboration with the Royal College of Midwives, the Obstetric Anaesthetists Association, the National Childbirth Trust, the Faculty of Public Health of the Royal College of Physicians, and the Confidential Enquiry into Maternal and Child Health, and is supported by the Department of Health.
- UKOSS is a UK-wide obstetric surveillance system to describe the epidemiology of a variety of uncommon disorders of pregnancy. The aim is to use this system to lessen the burden on reporting clinicians of multiple requests for information from different sources.
- The recent report "Saving Mothers Lives: Reviewing maternal deaths to make motherhood safer - 2003-2005" from the Confidential Enquiry into Maternal and Child Health showed that 27% of women who died from causes directly or indirectly related to pregnancy were obese.
Reference
Antenatal pulmonary embolism: risk factors, management and outcomes.
Knight M on behalf of UKOSS.
BJOG 2008; DOI: 10.1111/j.1471-0528.2007.01622.x.
Please click here to view article online
Royal College of Obstetricians and Gynaecologists
Health Care for Muslim Women in the USA, Post Conference News Brief
A conference titled, "Patient-centered Health Care for Muslim Women in the United States," the first of its kind in North
America, was held on March 4 and 5, 2005 at the University of Illinois at Chicago. This event was the first in a series of
activities designed to identify and overcome patient, provider and health services related factors that are barriers to the
provision of high quality, culturally appropriate, patient-centered care for Muslim women. Participation was not limited to
any professional, racial or ethnic group. More than 200 participants from across the country attended the conference.
The conference was sponsored by the Department of Family Medicine of the UIC College of Medicine and funded by the Agency for
Healthcare Research and Quality, United States Department of Health and Human Services. This collaborative project was
supported by several UIC Colleges and Centers including the National Center of Excellence in Women's Health; Center for
Research on Women and Gender; School of Public Health; College of Nursing; and, the Great Cities Institute. The project also
was supported by the Illinois Department of Public Health and the Society for Teachers of Family Medicine.
Proceedings began with a welcome address by Dr. Patrick Tranmer, Professor of Clinical Family Medicine and Head, Department
of Family Medicine, College of Medicine, University of Illinois at Chicago. He stressed the importance of addressing health
care needs of diverse populations as a core principle for all health providers and particularly family physicians.
Dr. Memoona Hasnain, Director of Research, Department of Family Medicine, College of Medicine, University of Illinois at
Chicago, principal investigator and conference chair, presented the conference overview, describing the background and
rationale for the project. She touched upon the concepts of patient-centered care and cultural competence. Dr. Hasnain
stated that the religious and cultural beliefs of Muslim women impact their health care needs and they face major barriers
while seeking health care that the rest of the population, particularly health care providers, often are unaware of. The
paucity of research on issues related to health care for Muslim women in the US demands further research in this area. She
also emphasized the importance of keeping in mind that Muslims in America are a diverse group and said that in addition to
the African Americans who are indigenous to this country, immigrant Muslims come from over 150 countries and it would be a
fallacy to lump them all together in one group.
In addition to presentations by national experts, conference highlights included the opportunity for participants to work in
small groups to discuss barriers to culturally appropriate patient-centered health care for Muslim women and develop a
research, action and best practice agenda for future work; as well as to interact with a panel of Muslim women clients who
discussed their health experiences and concerns. Throughout the conference, participants actively engaged in discussions and
voiced strong support for additional conferences on this topic on an ongoing basis.
Plenary presentations included a variety of topics:
Dr. Asma Barlas, Professor, Department of Politics at Ithaca College, New York, and author of "Believing Women" In Islam:
Unreading Patriarchal Interpretations of the Qur'an (University of Texas Press, 2002) gave the keynote address, "Women in
Islam: Facts and Perceptions." She focused her talk on health care needs of Muslim women within the context of Islamic
tenets; dispelling misconceptions about gender preferences, the young age of marriage for girls, views of the wife as her
husband's sexual property, and polygamy, stating that of these issues raise practical problems for Muslim women and are
bogged down in misleading stereotypes.
Dr. Rosaly Correa-de-Araujo, Senior Advisor on women's health at the Agency for Healthcare Research and Quality, presented an
interactive lecture on "Patient Centered Care: Relevance to Women's Health." Dr. Correa contextualized Muslim women's health
care within the broader realm of patient-centered care and provided an overview of key research findings from national
studies on minority and underserved women's health.
Dr. Fauzia W. Lodhi, Director, Palliative Care and Hospice Program, Rush University Medical Center and member of the Board of
Directors of the Muslim Community Center in Chicago, gave a presentation on "Culturally Appropriate Health Care for Muslim
Women." Dr. Lodhi's talk emphasized the need for health care providers to respect the customs and beliefs of patients from
every religions and culture.
Dr. Nawal M. Nour, Assistant Professor, Harvard Medical School and Director, African Women's Health Center, Brigham and
Women's Hospital, presented "Clinical Perspective: Female Genital Cutting," a topic of great interest to clinicians. Dr.
Nour emphasized that this tradition transcends all religions and geographical locations. People continue the practice of FGC
due to a multitude of complex beliefs, fears and societal pressures that we may never completely comprehend. She explained
that by not circumcising their daughters, parents who, believe in female genital cutting, feel they have done them a great
disservice. She also stressed that providers need to continue to help victims of female genital cutting in a manner that
does not make the patient feel guilty.
The presentation "Patient-Physician Communication: the Case of the Muslim Woman Patient," by Dr. Elizabeth A. Burns,
Professor and Chair, Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences,
provided an example of a US physician who has worked successfully with Muslim women patients by closely understanding and
accommodating their religious and cultural needs.
The conference concluded with a wrap-up by Dr. Memoona Hasnain who thanked all the participants for their input and
reemphasized that the purpose of this line of work is to understand, and raise awareness about the health care issues faced
by Muslim women in this country and design interventions to educate both providers and clients to improve outcomes.
Additional information about the conference is available at: uic.edu/depts/ci/mwhconf
UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25,000
students, 12,000 faculty and staff, 15 colleges and the state's major public medical center. A hallmark of the campus is the
Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and
government partners in hundreds of programs to improve the quality of life in metropolitan areas around the world. For more
information about UIC, please visit uic.edu
America, was held on March 4 and 5, 2005 at the University of Illinois at Chicago. This event was the first in a series of
activities designed to identify and overcome patient, provider and health services related factors that are barriers to the
provision of high quality, culturally appropriate, patient-centered care for Muslim women. Participation was not limited to
any professional, racial or ethnic group. More than 200 participants from across the country attended the conference.
The conference was sponsored by the Department of Family Medicine of the UIC College of Medicine and funded by the Agency for
Healthcare Research and Quality, United States Department of Health and Human Services. This collaborative project was
supported by several UIC Colleges and Centers including the National Center of Excellence in Women's Health; Center for
Research on Women and Gender; School of Public Health; College of Nursing; and, the Great Cities Institute. The project also
was supported by the Illinois Department of Public Health and the Society for Teachers of Family Medicine.
Proceedings began with a welcome address by Dr. Patrick Tranmer, Professor of Clinical Family Medicine and Head, Department
of Family Medicine, College of Medicine, University of Illinois at Chicago. He stressed the importance of addressing health
care needs of diverse populations as a core principle for all health providers and particularly family physicians.
Dr. Memoona Hasnain, Director of Research, Department of Family Medicine, College of Medicine, University of Illinois at
Chicago, principal investigator and conference chair, presented the conference overview, describing the background and
rationale for the project. She touched upon the concepts of patient-centered care and cultural competence. Dr. Hasnain
stated that the religious and cultural beliefs of Muslim women impact their health care needs and they face major barriers
while seeking health care that the rest of the population, particularly health care providers, often are unaware of. The
paucity of research on issues related to health care for Muslim women in the US demands further research in this area. She
also emphasized the importance of keeping in mind that Muslims in America are a diverse group and said that in addition to
the African Americans who are indigenous to this country, immigrant Muslims come from over 150 countries and it would be a
fallacy to lump them all together in one group.
In addition to presentations by national experts, conference highlights included the opportunity for participants to work in
small groups to discuss barriers to culturally appropriate patient-centered health care for Muslim women and develop a
research, action and best practice agenda for future work; as well as to interact with a panel of Muslim women clients who
discussed their health experiences and concerns. Throughout the conference, participants actively engaged in discussions and
voiced strong support for additional conferences on this topic on an ongoing basis.
Plenary presentations included a variety of topics:
Dr. Asma Barlas, Professor, Department of Politics at Ithaca College, New York, and author of "Believing Women" In Islam:
Unreading Patriarchal Interpretations of the Qur'an (University of Texas Press, 2002) gave the keynote address, "Women in
Islam: Facts and Perceptions." She focused her talk on health care needs of Muslim women within the context of Islamic
tenets; dispelling misconceptions about gender preferences, the young age of marriage for girls, views of the wife as her
husband's sexual property, and polygamy, stating that of these issues raise practical problems for Muslim women and are
bogged down in misleading stereotypes.
Dr. Rosaly Correa-de-Araujo, Senior Advisor on women's health at the Agency for Healthcare Research and Quality, presented an
interactive lecture on "Patient Centered Care: Relevance to Women's Health." Dr. Correa contextualized Muslim women's health
care within the broader realm of patient-centered care and provided an overview of key research findings from national
studies on minority and underserved women's health.
Dr. Fauzia W. Lodhi, Director, Palliative Care and Hospice Program, Rush University Medical Center and member of the Board of
Directors of the Muslim Community Center in Chicago, gave a presentation on "Culturally Appropriate Health Care for Muslim
Women." Dr. Lodhi's talk emphasized the need for health care providers to respect the customs and beliefs of patients from
every religions and culture.
Dr. Nawal M. Nour, Assistant Professor, Harvard Medical School and Director, African Women's Health Center, Brigham and
Women's Hospital, presented "Clinical Perspective: Female Genital Cutting," a topic of great interest to clinicians. Dr.
Nour emphasized that this tradition transcends all religions and geographical locations. People continue the practice of FGC
due to a multitude of complex beliefs, fears and societal pressures that we may never completely comprehend. She explained
that by not circumcising their daughters, parents who, believe in female genital cutting, feel they have done them a great
disservice. She also stressed that providers need to continue to help victims of female genital cutting in a manner that
does not make the patient feel guilty.
The presentation "Patient-Physician Communication: the Case of the Muslim Woman Patient," by Dr. Elizabeth A. Burns,
Professor and Chair, Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences,
provided an example of a US physician who has worked successfully with Muslim women patients by closely understanding and
accommodating their religious and cultural needs.
The conference concluded with a wrap-up by Dr. Memoona Hasnain who thanked all the participants for their input and
reemphasized that the purpose of this line of work is to understand, and raise awareness about the health care issues faced
by Muslim women in this country and design interventions to educate both providers and clients to improve outcomes.
Additional information about the conference is available at: uic.edu/depts/ci/mwhconf
UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25,000
students, 12,000 faculty and staff, 15 colleges and the state's major public medical center. A hallmark of the campus is the
Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and
government partners in hundreds of programs to improve the quality of life in metropolitan areas around the world. For more
information about UIC, please visit uic.edu
Colorado Antiabortion-Rights Advocates Begin Campaign For New 'Personhood' Amendment
This week, abortion-rights opponents in Colorado began collecting signatures in an attempt to place a "personhood" amendment before voters that would give human embryos legal protection as people under the state constitution, the AP/CBS4 reports. The advocates are trying to collect enough signatures to place the proposed amendment on the state's 2010 ballot. Voters in 2008 voted three to one against a similar measure that would have granted rights to fertilized eggs. The latest version of the amendment replaces "fertilized" with the phrase "the beginning of the biological development." Supporters claim that voters in the 2008 election might have been confused by the wording and visualized chicken eggs. The Colorado Title Board approved the new wording of the amendment earlier this month, a necessary step before advocates could begin gathering signatures (AP/CBS4, 8/25).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Experts Say Single Abortion Not A Risk To Women's Mental Health
A task force of the American Psychological Association has concluded there is no significant evidence that a single elective abortion increases
the risk of mental health problems for adult women.
The draft Report of the APA Task Force on Mental Health and Abortion is dated 13 August 2008 and was published online on the APA website on
18th August. It was presented to the APA's governing Council of Representatives at the association's Annual Convention in Boston which finished on
Sunday.
Chair of the Task Force, Dr Brenda Major, said they found that the best scientific evidence suggests that among adult women who have an unplanned
pregnancy:
"The relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy."
"The evidence regarding the relative mental health risks associated with multiple abortions is more uncertain," she added.
The Task Force, which started in 2006, reviewed all the empirical studies available in English and published in peer-reviewed journals since 1989 that
either compared the mental health of women who elected to have an abortion with counterparts that did not, or investigated predictors of mental
health for US women who elected to have an abortion.
They found that many of the studies had serious methodological problems, varied in quality, and failed to control for potentially confounding factors,
so they focused only on those whose methods were the best.
While there is some evidence that women experience feelings of loss, sadness and grief after an abortion, and some have "clinically significant
disorders, including depression and anxiety", the task force found there was "no evidence sufficient to support the claim that an observed association
between abortion history and mental health was caused by the abortion per se, as opposed to other factors."
The task force said there was evidence that other factors came into play, regardless of the outcome of a pregnancy, and that failure to take these into
account led to misleading links between abortion history and mental health problems. These other co-occurring risk factors were things like being
exposed to violence, a history of drug or alcohol use, poverty, a history of emotional problems, and previous unwanted births. These predisposed
women to have both unwanted pregnancies, or mental health problems after a pregnancy, said the the task
They said "global statements about the psychological impact of abortion can be misleading", because women have abortions for lots of different
reasons under different personal, social, cultural and economic circumstances, all of which affect a woman's mental state after an abortion.
The task force said they did find evidence that the women who were most likely to experience negative psychological reactions after an abortion were
women who terminated a wanted pregnancy, or who felt under pressure from others to have a termination, or who felt they had to keep their abortion
secret from their family and friends for fear of stigma.
The report pointed out that few studies included comparison groups to address the important issue of understanding the mental health implications of
abortion compared to other alternatives such as having and keeping the baby or adoption.
The task force said better and more rigourously designed studies were needed, particularly in respect of two things: (1) separating out the effects of
confounding factors and, (2) establishing relative risks of having an abortion compared to the alternatives.
The conclusions are similar to a literature review published by the APA in 1990.
"Report of the APA Task Force on Mental Health and Abortion"
Brenda Major, Mark Appelbaum, Linda Beckman, Mary Ann Dutton, Nancy Felipe Russo, and Carolyn West.
American Psychological Association, Report dated 13 Aug 2008, published online 18 Aug 2008.
Click here to view full report (PDF).
Source: APA.
: Catharine Paddock, PhD
the risk of mental health problems for adult women.
The draft Report of the APA Task Force on Mental Health and Abortion is dated 13 August 2008 and was published online on the APA website on
18th August. It was presented to the APA's governing Council of Representatives at the association's Annual Convention in Boston which finished on
Sunday.
Chair of the Task Force, Dr Brenda Major, said they found that the best scientific evidence suggests that among adult women who have an unplanned
pregnancy:
"The relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy."
"The evidence regarding the relative mental health risks associated with multiple abortions is more uncertain," she added.
The Task Force, which started in 2006, reviewed all the empirical studies available in English and published in peer-reviewed journals since 1989 that
either compared the mental health of women who elected to have an abortion with counterparts that did not, or investigated predictors of mental
health for US women who elected to have an abortion.
They found that many of the studies had serious methodological problems, varied in quality, and failed to control for potentially confounding factors,
so they focused only on those whose methods were the best.
While there is some evidence that women experience feelings of loss, sadness and grief after an abortion, and some have "clinically significant
disorders, including depression and anxiety", the task force found there was "no evidence sufficient to support the claim that an observed association
between abortion history and mental health was caused by the abortion per se, as opposed to other factors."
The task force said there was evidence that other factors came into play, regardless of the outcome of a pregnancy, and that failure to take these into
account led to misleading links between abortion history and mental health problems. These other co-occurring risk factors were things like being
exposed to violence, a history of drug or alcohol use, poverty, a history of emotional problems, and previous unwanted births. These predisposed
women to have both unwanted pregnancies, or mental health problems after a pregnancy, said the the task
They said "global statements about the psychological impact of abortion can be misleading", because women have abortions for lots of different
reasons under different personal, social, cultural and economic circumstances, all of which affect a woman's mental state after an abortion.
The task force said they did find evidence that the women who were most likely to experience negative psychological reactions after an abortion were
women who terminated a wanted pregnancy, or who felt under pressure from others to have a termination, or who felt they had to keep their abortion
secret from their family and friends for fear of stigma.
The report pointed out that few studies included comparison groups to address the important issue of understanding the mental health implications of
abortion compared to other alternatives such as having and keeping the baby or adoption.
The task force said better and more rigourously designed studies were needed, particularly in respect of two things: (1) separating out the effects of
confounding factors and, (2) establishing relative risks of having an abortion compared to the alternatives.
The conclusions are similar to a literature review published by the APA in 1990.
"Report of the APA Task Force on Mental Health and Abortion"
Brenda Major, Mark Appelbaum, Linda Beckman, Mary Ann Dutton, Nancy Felipe Russo, and Carolyn West.
American Psychological Association, Report dated 13 Aug 2008, published online 18 Aug 2008.
Click here to view full report (PDF).
Source: APA.
: Catharine Paddock, PhD
Editorials, Opinion Pieces Respond To Senate Approval Of Stem Cell Research Enhancement Act, HOPE Act
Several newspapers this week published editorials related to the Senate votes on Wednesday to pass two stem cell research-related bills. Federal funding for human embryonic stem cell research is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by President Bush on that date. The Senate voted 63-34 to pass a bill (S 5) that would expand federal funding for embryonic stem cell research. The bill, called the Stem Cell Research Enhancement Act of 2007, would allow federal funding for research using stem cells derived from human embryos originally created for fertility treatments and willingly donated by patients. The Senate measure differs from a House-approved bill (HR 3) of the same name because it includes language that would require NIH to research and fund methods of creating embryonic stem cell lines without destroying embryos. Bush has threatened to veto the bill. The Senate also voted 70-28 to pass a bill (S 30) that would allow federal funding for stem cell research using embryos with no chance of survival. The legislation, known as the HOPE Act, would fund research on stem cells taken from "dead" human embryos or extracted from living embryos without destroying them. In addition, it would allow federal funding for research on stem cell lines derived from embryos that are not likely to survive during the freezing process or in the womb. According to Sen. Johnny Isakson (R-Ga.), the measure also would promote research using stem cells derived from other sources, such as amniotic fluid (Kaiser Daily Women's Health Policy Report, 4/12). Summaries appear below.
Editorials
Boston Globe: President Bush should "think twice" before vetoing the Stem Cell Research Enhancement Act, a Globe editorial says. "For basic research in an area as innovative as embryonic stem cells, generous government funding is crucial," the editorial says, concluding, "Republicans who understand the effect this issue had on the 2006 election should talk sense to him and persuade him that the health of millions, and of his own party, would benefit if he reverses his position" (Boston Globe, 4/15).
Los Angeles Times: Bush's "compromise" on embryonic stem cell research "was bad science and bad policy on the day it was announced, and it hasn't improved with time," a Times editorial says. Although Bush "isn't known for re-examining previous positions," he should "make amends" for his veto last year of a measure similar to the Stem Cell Research Enhancement Act and sign the new bill, according to the editorial (Los Angeles Times, 4/12).
New York Times: "Concerned voters will need to ratchet up the pressure on recalcitrant Republicans to help stop" Bush "from killing the second enlightened stem cell bill in less than a year," according to a Times editorial. Bush and social conservatives are "trying to impose their moral code on the rest of the nation and stand in the way of scientific progress," the editorial says, adding that the HOPE Act is a "poorly considered proposal that can only be deemed a diversion from the main business at hand -- the need to free American science from the chains imposed by the president" (New York Times, 4/13).
Washington Post: It is "disappointing" that the Stem Cell Research Enhancement Act "will almost certainly not become law," and Senate debate on the measure also was "frustrating," a Post editorial says. Many of the bill's supporters during the Senate debate "rightly pointed to the scientific consensus on the potential of embryonic stem cell research to lead to medical breakthroughs," but their accounts of "ill relatives or constituents ... verge on overselling," according to the Post. "Worse were the rhetorical manipulations by the bill's opponents," including Sen. Sam Brownback (R-Kan.), who implied that funding embryonic stem cell research "would steal money from the most promising stem cell research," according to the editorial. Federal funding should be "open to supporting as many avenues of stem cell research as a considered look at the morality of the issue allows," the editorial concludes (Washington Post, 4/13).
Opinion Pieces
John Gill/Rep. Pete Sessions (R-Texas), Wall Street Journal: Nonviable embryos originally created for in vitro fertilization that are not "suitable" for implantation or freezing might become the "middle ground" that would give researchers "the stem cells they need to realize medical discoveries, while still recognizing and preserving the sanctity of life," Gill, chair of the Texas Healthcare Task Force, and Sessions write in a Journal opinion piece. According to Gill and Sessions, the cells of "defective, nonviable embryos could be donated" for stem cell research with ethical safeguards in place. The approach "merits further discussion," the authors write, adding that "with appropriate safeguards," it "could satisfy the demands of all concerned parties" (Gill/Sessions, Wall Street Journal, 4/14).
Carrie Gordon Earll, Los Angeles Times: "[T]he public has a right to know we can pursue ethical treatments without sacrificing young humans on the altar of science," Gordon Earll, senior bioethics analyst for Focus on the Family Action, writes in a Times letter to the editor. According to Gordon Earll, the country should fund adult stem cell research, which has "already proven effective" (Gordon Earll, Los Angeles Times, 4/15).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Epidurals in labor and delivery reduce pain but can increase the risk of needing forceps
Pain relief is an important issue for women in labour and epidurals are increasingly used. They reduce pain, but increase the likelihood of an instrumental delivery. Currently there is a lack of evidence that epidurals increase the risk of having a caesarean delivery, but women who use epidural have a longer second stage of labour compared to those who use other forms of pain relief.
Epidurals, first introduced in 1946, are now used by about one-fifth of women in the UK and one-half of women in the USA during labour. In an epidural, anaesthetic agents are injected into the lower region of the spine. This blocks the activity of the nerves that transmit painful stimuli from the birth canal to the brain, which results in pain relief.
A systematic review of literature included 21 studies of epidural pain-relief in labour, involving 6664 women. The Cochrane Review Authors drew several conclusions from these data.
When compared to women using other forms of pain relief in labor, women who use epidurals have better pain relief, longer second stage of labor, increased likelihood of having an instrumental delivery, and increased likelihood of having fever during labor.
There was a lack of evidence that epidurals affect the new-born, increase the likelihood of caesarean delivery, increase the likelihood of long term backache, and affect maternal satisfaction.
"The evidence in this review needs to be made available to women considering pain relief in labour," says lead author Millicent Anim-Somuah, an honorary Research Fellow at the School of Reproductive and Developmental Medicine, at Liverpool Women's Hospital NHS Trust, Liverpool, UK.
Review title: Anim-Somuah M et al. Epidural versus non-epidural ornoanalgesia in labour. The Cochrane Database of Systematic Reviews 2005, Issue 4.
John Wiley & Sons, Inc.
interscience.wiley
The Cochrane Library newsletter, 2005, Issue 4
Epidurals, first introduced in 1946, are now used by about one-fifth of women in the UK and one-half of women in the USA during labour. In an epidural, anaesthetic agents are injected into the lower region of the spine. This blocks the activity of the nerves that transmit painful stimuli from the birth canal to the brain, which results in pain relief.
A systematic review of literature included 21 studies of epidural pain-relief in labour, involving 6664 women. The Cochrane Review Authors drew several conclusions from these data.
When compared to women using other forms of pain relief in labor, women who use epidurals have better pain relief, longer second stage of labor, increased likelihood of having an instrumental delivery, and increased likelihood of having fever during labor.
There was a lack of evidence that epidurals affect the new-born, increase the likelihood of caesarean delivery, increase the likelihood of long term backache, and affect maternal satisfaction.
"The evidence in this review needs to be made available to women considering pain relief in labour," says lead author Millicent Anim-Somuah, an honorary Research Fellow at the School of Reproductive and Developmental Medicine, at Liverpool Women's Hospital NHS Trust, Liverpool, UK.
Review title: Anim-Somuah M et al. Epidural versus non-epidural ornoanalgesia in labour. The Cochrane Database of Systematic Reviews 2005, Issue 4.
John Wiley & Sons, Inc.
interscience.wiley
The Cochrane Library newsletter, 2005, Issue 4
16th International Conference Of The Nursing Network On Violence Against Women
The University of Miami School of Nursing and Health Studies hosts the 16th International Conference of the Nursing Network on Violence Against Women International (NNVAWI). This year's conference theme, "Trajectories for Change: Creating Culturally Meaningful Interventions to Prevent and Reduce Violence," underscores the fact that violence against women is a pressing health issue worldwide. Collaboration among health and human service professionals, violence advocates, policy makers and communities is needed if these women and children are to live safer, healthier lives.
WHEN/WHERE: Thursday, October 1 through Saturday, October 3, at the Westin Colonnade Hotel, 180 Aragon Avenue, Coral Gables, Fl.
EVENTS:
Educational opportunities-all day on Thursday and Friday
Poster Session-3:30-5:00 pm. on Thursday, October 1
Special Complimentary Seminar "Health Disparities: Women Experiencing Violence" -8:00 am.-3:30 pm., Saturday, October 3, sponsored by the Center of Excellence for Hispanic Health Disparities Research: El Centro.
Saturday October 3, 2009- complimentary registration at: www6.miami.edu/sonhs/announ/anoun16.html
WHY: The Nursing Network on Violence Against Women (NNVAW) was formed to encourage the development of nursing practice that focuses on preventing violence and the health issues relating to the effects of violence on women's lives.
Source:
Marie Guma-Diaz
University of Miami
WHEN/WHERE: Thursday, October 1 through Saturday, October 3, at the Westin Colonnade Hotel, 180 Aragon Avenue, Coral Gables, Fl.
EVENTS:
Educational opportunities-all day on Thursday and Friday
Poster Session-3:30-5:00 pm. on Thursday, October 1
Special Complimentary Seminar "Health Disparities: Women Experiencing Violence" -8:00 am.-3:30 pm., Saturday, October 3, sponsored by the Center of Excellence for Hispanic Health Disparities Research: El Centro.
Saturday October 3, 2009- complimentary registration at: www6.miami.edu/sonhs/announ/anoun16.html
WHY: The Nursing Network on Violence Against Women (NNVAW) was formed to encourage the development of nursing practice that focuses on preventing violence and the health issues relating to the effects of violence on women's lives.
Source:
Marie Guma-Diaz
University of Miami
Muscle Power In Adolescent Girls And Vitamin D
Vitamin D is significantly associated with muscle power and force in adolescent girls, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Although vitamin D is naturally produced in the body through exposure to direct sunlight, vitamin D deficiency has become widely common in the United States. Vitamin D deficiency has been shown to have a significant negative impact on muscle and bone health, and can lead to conditions including osteoporosis and rickets.
"We know vitamin D deficiency can weaken the muscular and skeletal systems, but until now, little was known about the relationship of vitamin D with muscle power and force," said Dr. Kate Ward, Ph.D., of the University of Manchester in the U.K., and lead author of the study. "Our study found that vitamin D is positively related to muscle power, force, velocity and jump height in adolescent girls."
For this study, researchers followed 99 adolescent girls between the ages of 12 and 14 years. Dr. Ward and her colleagues took blood samples to measure the girls' serum levels of vitamin D. Many of these girls were found to have low levels of vitamin D despite not presenting any symptoms.
Researchers used a novel outcome measure called jumping mechanography to measure muscle power and force. Jumping mechanography derives power and force measurements from a subject's performance in a series of jumping activities. Dr. Ward says this method of testing is ideal as the muscles required to jump are those most often affected in subjects with vitamin D deficiency. Girls without vitamin D deficiency performed significantly better in these tests.
"Vitamin D affects the various ways muscles work and we've seen from this study that there may be no visible symptoms of vitamin D deficiency," said Dr. Ward. "Further studies are needed to address this problem and determine the necessary levels of vitamin D for a healthy muscle system."
Other researchers working on the study include Geeta Das of the Longsight Health Centre in Manchester, U.K.; Jacqueline Berry, Stephen Roberts, and Judith Adams of the University of Manchester in the U.K.; Rainer Rawer of Novotec Medical GmBH in Pforzheim, Germany; and Zulf Mughal of Saint Mary's Hospital for Women & Children in Manchester, U.K.
The article "Vitamin D Status and Muscle Function in Post-Menarchal Adolescent Girls," will appear in the February 2009 issue of JCEM.
Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 100 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at endo-society/.
Source: Aaron Lohr
The Endocrine Society
Although vitamin D is naturally produced in the body through exposure to direct sunlight, vitamin D deficiency has become widely common in the United States. Vitamin D deficiency has been shown to have a significant negative impact on muscle and bone health, and can lead to conditions including osteoporosis and rickets.
"We know vitamin D deficiency can weaken the muscular and skeletal systems, but until now, little was known about the relationship of vitamin D with muscle power and force," said Dr. Kate Ward, Ph.D., of the University of Manchester in the U.K., and lead author of the study. "Our study found that vitamin D is positively related to muscle power, force, velocity and jump height in adolescent girls."
For this study, researchers followed 99 adolescent girls between the ages of 12 and 14 years. Dr. Ward and her colleagues took blood samples to measure the girls' serum levels of vitamin D. Many of these girls were found to have low levels of vitamin D despite not presenting any symptoms.
Researchers used a novel outcome measure called jumping mechanography to measure muscle power and force. Jumping mechanography derives power and force measurements from a subject's performance in a series of jumping activities. Dr. Ward says this method of testing is ideal as the muscles required to jump are those most often affected in subjects with vitamin D deficiency. Girls without vitamin D deficiency performed significantly better in these tests.
"Vitamin D affects the various ways muscles work and we've seen from this study that there may be no visible symptoms of vitamin D deficiency," said Dr. Ward. "Further studies are needed to address this problem and determine the necessary levels of vitamin D for a healthy muscle system."
Other researchers working on the study include Geeta Das of the Longsight Health Centre in Manchester, U.K.; Jacqueline Berry, Stephen Roberts, and Judith Adams of the University of Manchester in the U.K.; Rainer Rawer of Novotec Medical GmBH in Pforzheim, Germany; and Zulf Mughal of Saint Mary's Hospital for Women & Children in Manchester, U.K.
The article "Vitamin D Status and Muscle Function in Post-Menarchal Adolescent Girls," will appear in the February 2009 issue of JCEM.
Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 100 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at endo-society/.
Source: Aaron Lohr
The Endocrine Society
Strong Link Found Between Muscle Damage In Childbirth, Fallen Bladder
An increase among women electing to have caesarean sections in recent years has been due in large part to a concern that giving birth vaginally will lead to a fallen bladder and uterus in later life, and the issue has been hotly debated in the medical community.
New research from the University of Michigan Health System establishes one of the strongest connections yet discovered between muscle damage that can occur during vaginal deliveries and pelvic organ prolapse, a condition that causes the uterus, bladder or bowel to fall down later in a woman's life. This is a very common problem and requires surgery in more than 200,000 women each year. Rates were particularly high when forceps had been used to assist the delivery.
Even so, the researchers caution against using these findings as support for more elective C-sections because that would result in numerous women having an operation they do not need. Rather, they say, the study results should be used to help determine how to prevent these injuries in the first place.
The study appearing in the February issue of the journal Obstetrics & Gynecology found major defects of the levator ani, an important muscle that supports the bladder and uterus, among 55 percent of women with prolapse and just 16 percent of women who don't have prolapse.
"Our findings are an important step forward in the search to identify what causes pelvic organ prolapse and subsequent difficulties with other problems, such as incontinence," says lead author John O. L. DeLancey, M.D., the Norman F. Miller Professor of Obstetrics and Gynecology at the U-M Medical School and director of pelvic floor research.
"The next step is for researchers to look at ways of preventing and treating these injuries of the levator ani muscle in order to reduce the rate of pelvic organ prolapse later in life," he says.
Pelvic organ prolapse can mean the falling of the bladder, uterus, vagina or lower bowel. One of the most common effects of the condition is urinary incontinence that is, the inability to control the release of urine. Many women with prolapse experience a protrusion or bulging in the vaginal area. The condition is common; one of nine women has surgery to correct prolapse and other pelvic floor disorders in her lifetime.
The U-M researchers studied 151 women with prolapse and compared them with 135 women who do not have prolapse. Magnetic resonance imaging was used to determine the extent of damage to the levator ani muscles. The women's vaginal closure force at rest and while contracting her pelvic muscle also was measured.
Women with prolapse were found to have a much higher rate of major levator ani damage than women without prolapse (55 percent compared with 16 percent). When they asked women to contract their muscles, the muscles were 40 percent weaker in women with prolapse.
In addition, about 52 percent of the women in the study with prolapse recalled having forceps used during childbirth, nearly twice the amount (about 27 percent) of women in the study who do not have prolapse who remembered that forceps were used. Thirty-one percent of women with prolapse reported a family history of the condition, compared with 13 percent of the women without prolapse.
The researchers from the Department of Obstetrics and Gynecology have joined forces with a colleague in the U-M College of Engineering, James A. Ashton-Miller, Ph.D., who has helped to create the intricate computer simulations necessary for understanding how the levator ani muscles are damaged. The computer modeling is a vital part of this line of research, DeLancey notes.
The senior author of the paper is Ashton-Miller, Ph.D., director of the Biomechanics Research Laboratories, research professor and distinguished research scientist, Mechanical Engineering Department, U-M College of Engineering, and senior research scientist, U-M Institute of Gerontology; and Daniel M. Morgan, M.D., Dee E. Fenner, M.D., Rohna Kearney, M.D., Kenneth Guire, M.S., Janis M. Miller, R.N., A.N.P., Ph.D., Hero Hussain, M.D., Wolfgang Umek, M.D., and Yvonne Hsu, M.D. All are from the pelvic floor research group at U-M. Kearney also has an appointment with University College Hospital, London, and Umek has an appointment at Medical University, Vienna, Austria.
Funding was provided by the National Institute of Child Health & Human Development, part of the National Institutes of Health.
Reference: Obstetrics & Gynecology, "Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse," Feb 1, 2007, 109 (2).
For more information, visit these Web sites:
Understanding pelvic floor disorders, information from the University of Michigan Health System: med.umich.edu/obgyn/pelvicfloor/understanding.htm
Pelvic floor disorders, information from the NICHD: nichd.nih/health/topics/Pelvic_Floor_Disorders.cfm
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu/
New research from the University of Michigan Health System establishes one of the strongest connections yet discovered between muscle damage that can occur during vaginal deliveries and pelvic organ prolapse, a condition that causes the uterus, bladder or bowel to fall down later in a woman's life. This is a very common problem and requires surgery in more than 200,000 women each year. Rates were particularly high when forceps had been used to assist the delivery.
Even so, the researchers caution against using these findings as support for more elective C-sections because that would result in numerous women having an operation they do not need. Rather, they say, the study results should be used to help determine how to prevent these injuries in the first place.
The study appearing in the February issue of the journal Obstetrics & Gynecology found major defects of the levator ani, an important muscle that supports the bladder and uterus, among 55 percent of women with prolapse and just 16 percent of women who don't have prolapse.
"Our findings are an important step forward in the search to identify what causes pelvic organ prolapse and subsequent difficulties with other problems, such as incontinence," says lead author John O. L. DeLancey, M.D., the Norman F. Miller Professor of Obstetrics and Gynecology at the U-M Medical School and director of pelvic floor research.
"The next step is for researchers to look at ways of preventing and treating these injuries of the levator ani muscle in order to reduce the rate of pelvic organ prolapse later in life," he says.
Pelvic organ prolapse can mean the falling of the bladder, uterus, vagina or lower bowel. One of the most common effects of the condition is urinary incontinence that is, the inability to control the release of urine. Many women with prolapse experience a protrusion or bulging in the vaginal area. The condition is common; one of nine women has surgery to correct prolapse and other pelvic floor disorders in her lifetime.
The U-M researchers studied 151 women with prolapse and compared them with 135 women who do not have prolapse. Magnetic resonance imaging was used to determine the extent of damage to the levator ani muscles. The women's vaginal closure force at rest and while contracting her pelvic muscle also was measured.
Women with prolapse were found to have a much higher rate of major levator ani damage than women without prolapse (55 percent compared with 16 percent). When they asked women to contract their muscles, the muscles were 40 percent weaker in women with prolapse.
In addition, about 52 percent of the women in the study with prolapse recalled having forceps used during childbirth, nearly twice the amount (about 27 percent) of women in the study who do not have prolapse who remembered that forceps were used. Thirty-one percent of women with prolapse reported a family history of the condition, compared with 13 percent of the women without prolapse.
The researchers from the Department of Obstetrics and Gynecology have joined forces with a colleague in the U-M College of Engineering, James A. Ashton-Miller, Ph.D., who has helped to create the intricate computer simulations necessary for understanding how the levator ani muscles are damaged. The computer modeling is a vital part of this line of research, DeLancey notes.
The senior author of the paper is Ashton-Miller, Ph.D., director of the Biomechanics Research Laboratories, research professor and distinguished research scientist, Mechanical Engineering Department, U-M College of Engineering, and senior research scientist, U-M Institute of Gerontology; and Daniel M. Morgan, M.D., Dee E. Fenner, M.D., Rohna Kearney, M.D., Kenneth Guire, M.S., Janis M. Miller, R.N., A.N.P., Ph.D., Hero Hussain, M.D., Wolfgang Umek, M.D., and Yvonne Hsu, M.D. All are from the pelvic floor research group at U-M. Kearney also has an appointment with University College Hospital, London, and Umek has an appointment at Medical University, Vienna, Austria.
Funding was provided by the National Institute of Child Health & Human Development, part of the National Institutes of Health.
Reference: Obstetrics & Gynecology, "Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse," Feb 1, 2007, 109 (2).
For more information, visit these Web sites:
Understanding pelvic floor disorders, information from the University of Michigan Health System: med.umich.edu/obgyn/pelvicfloor/understanding.htm
Pelvic floor disorders, information from the NICHD: nichd.nih/health/topics/Pelvic_Floor_Disorders.cfm
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu/
Women With Hormone Disorder May Benefit From Acupuncture
Getting pregnant with her first child was difficult, but when Rebecca Killmeyer of Charlottesville, Va. experienced a miscarriage during her second pregnancy, she wasn't sure if she would ever have another baby. When she decided to enter a study testing the impact of acupuncture on women with polycystic ovary syndrome (PCOS) at the University of Virginia Health System, she came out with a miracle.
"To our great surprise we were blessed with a third pregnancy during the PCOS study," said Killmeyer. "I'm absolutely certain the acupuncture treatments helped me ovulate regularly, which allowed me to become pregnant."
Lisa Pastore, assistant professor of obstetrics and gynecology at UVA Health System and principle researcher of the study, was hoping for results like this. Her goal has been to help women with PCOS have regular menstrual cycles. PCOS causes a hormonal imbalance, interfering with ovulation and ultimately, fertility. With several women in the study reporting pregnancies, Pastore believes that acupuncture could be an important alternative, non-drug therapy for women with this disorder.
"Over the last year we have seen women who never had a regular menstrual cycle start having regular periods. We can also boast several pregnancies since the study began," said Pastore. "Now we would like to recruit more people to the study in order to complete the study. It is important for research to have enough participants to ensure that the results are scientifically credible and not due to chance."
Scared and skeptical was how Killmeyer described her initial feelings towards the experimental treatment, but soon her worries gave way to relaxation.
"When I saw those tiny little needles coming at me I thought to myself, 'I didn't sign up for this!' but I tried it and after a few minutes I was asleep on the table," Killmeyer said. "The sessions were completely refreshing after awhile."
Killmeyer learned of her PCOS in 2005. Over the past five years she did not have regular, monthly periods. One month after she started acupuncture treatments she got a period and for the next three months, they continued.
"I had finished all my acupuncture treatments and was in the end stages of the study when I became pregnant," Killmeyer said. "We had already scheduled our follow-up appt with our fertility doctors when we found out we were pregnant."
Five percent of reproductive age women are affected by PCOS. Symptoms of PCOS can include small cysts on their ovaries, infrequent or irregular vaginal bleeding, male-pattern hair growth, and acne. Insulin resistance and pre-diabetes also can develop.
While there are many traditional drugs and therapies that manage this syndrome, this research is assessing whether acupuncture can be successful in regulating hormones and curing the symptoms of PCOS.
Source: Abena Foreman-Trice
University of Virginia Health System
"To our great surprise we were blessed with a third pregnancy during the PCOS study," said Killmeyer. "I'm absolutely certain the acupuncture treatments helped me ovulate regularly, which allowed me to become pregnant."
Lisa Pastore, assistant professor of obstetrics and gynecology at UVA Health System and principle researcher of the study, was hoping for results like this. Her goal has been to help women with PCOS have regular menstrual cycles. PCOS causes a hormonal imbalance, interfering with ovulation and ultimately, fertility. With several women in the study reporting pregnancies, Pastore believes that acupuncture could be an important alternative, non-drug therapy for women with this disorder.
"Over the last year we have seen women who never had a regular menstrual cycle start having regular periods. We can also boast several pregnancies since the study began," said Pastore. "Now we would like to recruit more people to the study in order to complete the study. It is important for research to have enough participants to ensure that the results are scientifically credible and not due to chance."
Scared and skeptical was how Killmeyer described her initial feelings towards the experimental treatment, but soon her worries gave way to relaxation.
"When I saw those tiny little needles coming at me I thought to myself, 'I didn't sign up for this!' but I tried it and after a few minutes I was asleep on the table," Killmeyer said. "The sessions were completely refreshing after awhile."
Killmeyer learned of her PCOS in 2005. Over the past five years she did not have regular, monthly periods. One month after she started acupuncture treatments she got a period and for the next three months, they continued.
"I had finished all my acupuncture treatments and was in the end stages of the study when I became pregnant," Killmeyer said. "We had already scheduled our follow-up appt with our fertility doctors when we found out we were pregnant."
Five percent of reproductive age women are affected by PCOS. Symptoms of PCOS can include small cysts on their ovaries, infrequent or irregular vaginal bleeding, male-pattern hair growth, and acne. Insulin resistance and pre-diabetes also can develop.
While there are many traditional drugs and therapies that manage this syndrome, this research is assessing whether acupuncture can be successful in regulating hormones and curing the symptoms of PCOS.
Source: Abena Foreman-Trice
University of Virginia Health System
Angiogenesis Linked To Poor Survival In Patients With Rare Type Of Ovarian Cancer
Researchers from The University of Texas M. D. Anderson Cancer Center have found that increased angiogenesis, or blood vessel formation, and vascular endothelial growth factor expression are associated with poor survival in women with sex cord-stromal ovarian tumors. This data was presented in a poster session today at the Society of Gynecologic Oncologists' 40th Annual Meeting on Women's Cancer.
Sex cord-stromal ovarian tumors are rare, accounting for five to seven percent of all ovarian cancer diagnosed, and there is little data available on how they advance, or metastasize, in patients. These findings provide doctors greater understanding into how they may be able to successfully treat patients with this type of tumor by inhibiting angiogenesis according to the study's authors.
"These tumors tend to metastasize very differently from other, more common types of ovarian tumors," said Jubilee Brown, M.D., assistant professor in the Department of Gynecologic Oncology and lead author on the study. "For instance, sex cord-stromal tumor cells rarely break away and invade the lymph nodes, but we still see evidence of their spread to distant locations in the body such as the abdomen and liver. This unusual progression hinted that a different pattern of metastasis in which tumor cells break off and invade the blood system, may be at play."
The American Cancer Society estimates approximately 21,650 new cases of ovarian cancer were diagnosed in the United States in 2008. There are more than 30 different types of ovarian cancer, categorized by the type of cell where the malignancy begins. Sex cord-stromal ovarian tumors, which develop in the connective tissue that holds the ovary together, are typically diagnosed at an earlier stage.
Researchers looked at 54 sex cord-stromal ovarian tumor samples, 28 from women with primary occurrences and 26 from women with recurrences. The samples were evaluated for two common indicators of angiogenesis: expression of the vascular endothelial growth factor (VEGF) protein and high microvessel density (MVD), or a large number of blood vessels associated with the tumor. Of those tumors studied, VEGF overexpression was noted in 52 percent and a high MVD was present in 32 percent. Both high MVD and VEGF were linked to significantly poorer survival (130 months versus 415 months in those with high MVD and 154 months versus 394 months in those with VEGF overexpression). Researchers noted that high MVD was also associated with recurrence and metastasis to other locations such as the abdomen, liver, lung and bone.
"Unlike most ovarian tumors which metastasize to nearby tissues or invade the lymphatic system, we suspect that the biological qualities of sex cord-stromal tumors, especially their ability to spread to and survive in distant sites of the body, explain why this type of ovarian cancer behaves so differently in patients," said Anil Sood, M.D., professor in the Departments of Gynecologic Oncology and Cancer Biology at M. D. Anderson and senior author on the study. "By honing in on how sex cord-stromal tumors utilize the blood vessels to become deadly, we can begin to test targeted anti-angiogenic therapies as possible means to control their growth."
Anti-angiogenic agents have been used in other cancers including colorectal, breast, lung and kidney cancers to slow tumor growth. Brown is currently the principal investigator on a Gynecologic Oncology Group Phase II clinical trial at M. D. Anderson to test the efficacy of bevacizumab (Avastin), a drug that blocks angiogenesis through antibodies against VEGF, in patients with sex cord-stromal tumors.
In addition to Brown and Sood, M. D. Anderson researchers contributing to this study include Alpa Nick, M.D., Ljiljana Milojevic, D.D.S. and David M. Gershenson, M.D, all from the Department of Gynecologic Oncology, and Michael Deavers, M.D., from the Department of Pathology.
About M. D. Anderson
The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 41 Comprehensive Cancer Centers designated by the National Cancer Institute. For four of the past six years, M. D. Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.
University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd., Box 229
Houston
TX 77030
United States
mdanderson
View drug information on Avastin.
Sex cord-stromal ovarian tumors are rare, accounting for five to seven percent of all ovarian cancer diagnosed, and there is little data available on how they advance, or metastasize, in patients. These findings provide doctors greater understanding into how they may be able to successfully treat patients with this type of tumor by inhibiting angiogenesis according to the study's authors.
"These tumors tend to metastasize very differently from other, more common types of ovarian tumors," said Jubilee Brown, M.D., assistant professor in the Department of Gynecologic Oncology and lead author on the study. "For instance, sex cord-stromal tumor cells rarely break away and invade the lymph nodes, but we still see evidence of their spread to distant locations in the body such as the abdomen and liver. This unusual progression hinted that a different pattern of metastasis in which tumor cells break off and invade the blood system, may be at play."
The American Cancer Society estimates approximately 21,650 new cases of ovarian cancer were diagnosed in the United States in 2008. There are more than 30 different types of ovarian cancer, categorized by the type of cell where the malignancy begins. Sex cord-stromal ovarian tumors, which develop in the connective tissue that holds the ovary together, are typically diagnosed at an earlier stage.
Researchers looked at 54 sex cord-stromal ovarian tumor samples, 28 from women with primary occurrences and 26 from women with recurrences. The samples were evaluated for two common indicators of angiogenesis: expression of the vascular endothelial growth factor (VEGF) protein and high microvessel density (MVD), or a large number of blood vessels associated with the tumor. Of those tumors studied, VEGF overexpression was noted in 52 percent and a high MVD was present in 32 percent. Both high MVD and VEGF were linked to significantly poorer survival (130 months versus 415 months in those with high MVD and 154 months versus 394 months in those with VEGF overexpression). Researchers noted that high MVD was also associated with recurrence and metastasis to other locations such as the abdomen, liver, lung and bone.
"Unlike most ovarian tumors which metastasize to nearby tissues or invade the lymphatic system, we suspect that the biological qualities of sex cord-stromal tumors, especially their ability to spread to and survive in distant sites of the body, explain why this type of ovarian cancer behaves so differently in patients," said Anil Sood, M.D., professor in the Departments of Gynecologic Oncology and Cancer Biology at M. D. Anderson and senior author on the study. "By honing in on how sex cord-stromal tumors utilize the blood vessels to become deadly, we can begin to test targeted anti-angiogenic therapies as possible means to control their growth."
Anti-angiogenic agents have been used in other cancers including colorectal, breast, lung and kidney cancers to slow tumor growth. Brown is currently the principal investigator on a Gynecologic Oncology Group Phase II clinical trial at M. D. Anderson to test the efficacy of bevacizumab (Avastin), a drug that blocks angiogenesis through antibodies against VEGF, in patients with sex cord-stromal tumors.
In addition to Brown and Sood, M. D. Anderson researchers contributing to this study include Alpa Nick, M.D., Ljiljana Milojevic, D.D.S. and David M. Gershenson, M.D, all from the Department of Gynecologic Oncology, and Michael Deavers, M.D., from the Department of Pathology.
About M. D. Anderson
The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 41 Comprehensive Cancer Centers designated by the National Cancer Institute. For four of the past six years, M. D. Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.
University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd., Box 229
Houston
TX 77030
United States
mdanderson
View drug information on Avastin.
South Africa In Grip Of Strangulation Spate
Murder of women by strangulation is a serious problem in South Africa. Researchers writing in the open access journal BMC Public Health compared four South African cities for the period 2001 to 2005, and report information about the prevalence and timing of attacks, and give details about the victims.
Most cases of strangulation are committed by men against women, as it requires a large disparity in strength between attacker and victim. According to the authors of the study, Shahnaaz Suffla, Ashley van Niekerk and Najuwa Arendse of the South African Medical Research Council and University of South Africa, "Gender-based violence persists as a global problem. In the year 2000, there were an estimated 119,000 female homicides worldwide and South Africa is estimated to have the highest rate of intimate female homicide in the world, despite its democratic transformation, strong emerging economy and widespread structural and social improvements".
The authors found that most cases of strangulation occurred early in the morning and that, while most victims had drunk no alcohol, drinking more than the legal limit was associated with a higher occurrence than drinking in moderation. In all of the cities studied, most strangulations occurred in the home. The authors said, "The strangulation rates we found are likely to be high relative to those of other African countries, where the overall homicide rate is up to 30% lower than in South Africa".
While strangulation rates declined over the five years studied in Pretoria, Johannesburg and Durban, they increased in Cape Town. The Western Cape Province, of which Cape Town is the capital and largest metropolitan centre, also reported the highest number of reported cases of rape during this period. According to Suffla and her co-authors, "This supports the proposed link between sexual violence and female strangulation".
Notes:
1. Female homicidal strangulation in urban South Africa
Shahnaaz Suffla, Ashley Van Niekerk and Najuwa Arendse
BMC Public Health (in press)
Article available at journal website: biomedcentral/bmcpublichealth/
All articles are available free of charge, according to BioMed Central's open access policy.
2. BMC Public Health is an open access journal publishing original peer-reviewed research articles in all aspects of epidemiology and public health medicine. BMC Public Health (ISSN 1471-2458) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, Thomson Scientific (ISI) and Google Scholar.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Graeme Baldwin
BioMed Central
Most cases of strangulation are committed by men against women, as it requires a large disparity in strength between attacker and victim. According to the authors of the study, Shahnaaz Suffla, Ashley van Niekerk and Najuwa Arendse of the South African Medical Research Council and University of South Africa, "Gender-based violence persists as a global problem. In the year 2000, there were an estimated 119,000 female homicides worldwide and South Africa is estimated to have the highest rate of intimate female homicide in the world, despite its democratic transformation, strong emerging economy and widespread structural and social improvements".
The authors found that most cases of strangulation occurred early in the morning and that, while most victims had drunk no alcohol, drinking more than the legal limit was associated with a higher occurrence than drinking in moderation. In all of the cities studied, most strangulations occurred in the home. The authors said, "The strangulation rates we found are likely to be high relative to those of other African countries, where the overall homicide rate is up to 30% lower than in South Africa".
While strangulation rates declined over the five years studied in Pretoria, Johannesburg and Durban, they increased in Cape Town. The Western Cape Province, of which Cape Town is the capital and largest metropolitan centre, also reported the highest number of reported cases of rape during this period. According to Suffla and her co-authors, "This supports the proposed link between sexual violence and female strangulation".
Notes:
1. Female homicidal strangulation in urban South Africa
Shahnaaz Suffla, Ashley Van Niekerk and Najuwa Arendse
BMC Public Health (in press)
Article available at journal website: biomedcentral/bmcpublichealth/
All articles are available free of charge, according to BioMed Central's open access policy.
2. BMC Public Health is an open access journal publishing original peer-reviewed research articles in all aspects of epidemiology and public health medicine. BMC Public Health (ISSN 1471-2458) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, Thomson Scientific (ISI) and Google Scholar.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Graeme Baldwin
BioMed Central
HPV Testing A Cost-effective Strategy For Women With Equivocal Cervical Screening Results
A new study has found that using human papillomavirus (HPV) DNA testing to determine who should receive a cervical examination called colposcopy is a cost-effective management strategy for women with equivocal Pap test results known as ASCUS (atypical squamous cells of undetermined significance). The study appears in the January 18 issue of the Journal of the National Cancer Institute.
About 5% of all Pap tests result in a diagnosis of ASCUS; however, only about 10% of women with this abnormality actually have precancer or cancer. The ASCUS and low-grade squamous intraepithelial lesions (LSIL) triage study (ALTS) was launched in the late 1990s to determine the best management strategy for women with these Pap test abnormalities that would both maximize the detection of clinically significant disease and reduce the need for unnecessary office visits and procedures. Results from ALTS, published in 2003, found that referring only those women with a positive HPV test to colposcopy was as effective at detecting cervical precancer or cancer as referring all women to colposcopy.
Shalini L. Kulasingam, Ph.D., of the Duke Center for Clinical Health Policy Research, and colleagues used data from 3488 women with ASCUS enrolled in ALTS to study the cost-effectiveness of three management strategies studied in ALTS--immediate colposcopy, HPV DNA testing, or conservative management with repeat Pap tests at 6-month intervals.
They found that the cost associated with HPV DNA testing was acceptable given the number of precancers and cancers found by this strategy. HPV DNA testing was less costly and detected more cases of precancer than immediately sending all women to receive colposcopy. The least costly strategy was a single repeat Pap test with referral to colposcopy for only those women with a high grade Pap test result; however, this option detected the fewest cases of precancer. The researchers conclude that HPV DNA testing for women with ASCUS is cost-effective and therefore, economically viable.
In an accompanying editorial, Joy Melnikow, M.D., of the University of California-Davis in Sacramento, and Stephen Birch, D.Phil, of McMaster University in Ontario, write that despite the analysis by Kulasingam, et al., HPV DNA testing for the 3 million women a year diagnosed as ASCUS would require an overall total of $250 million dollars a year. Such money, in addition to money saved by reducing overscreening for cervical cancer, could instead be used to screen for cervical cancer and precancer in underscreened populations, particularly women who have little access to health care. The authors write, "Decision makers will need to consider the value of HPV triage in relation to the expected benefits, in terms of the quality and quantity of life-years produced, and weigh these potential benefits against he substantial extra resource requirements (i.e., where will these resources be found? What are the potential benefits of using these resources for other programs?)."
Citations:
-- Article: Kulasingam SL, Kim JJ, Lawrence WF, Mandelblatt JS, Myers ER, Schiffman M, et al. Cost-effectiveness Analysis Based on the ASCUS and LSIL Triage Study (ALTS). J Natl Cancer Inst 2006;98:92-100.
-- Editorial: Melnikow J, Birch S. Human Papillomavirus Triage of Atypical Squamous Cells of Undetermined Significance: Cost Effective, But At What Cost? J Natl Cancer Inst 2006;98:82-83
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jncicancerspectrum.oxfordjournals.
Ariel Whitworth
jncimediaoxfordjournals
Journal of the National Cancer Institute
jncicancerspectrum.oupjournals
About 5% of all Pap tests result in a diagnosis of ASCUS; however, only about 10% of women with this abnormality actually have precancer or cancer. The ASCUS and low-grade squamous intraepithelial lesions (LSIL) triage study (ALTS) was launched in the late 1990s to determine the best management strategy for women with these Pap test abnormalities that would both maximize the detection of clinically significant disease and reduce the need for unnecessary office visits and procedures. Results from ALTS, published in 2003, found that referring only those women with a positive HPV test to colposcopy was as effective at detecting cervical precancer or cancer as referring all women to colposcopy.
Shalini L. Kulasingam, Ph.D., of the Duke Center for Clinical Health Policy Research, and colleagues used data from 3488 women with ASCUS enrolled in ALTS to study the cost-effectiveness of three management strategies studied in ALTS--immediate colposcopy, HPV DNA testing, or conservative management with repeat Pap tests at 6-month intervals.
They found that the cost associated with HPV DNA testing was acceptable given the number of precancers and cancers found by this strategy. HPV DNA testing was less costly and detected more cases of precancer than immediately sending all women to receive colposcopy. The least costly strategy was a single repeat Pap test with referral to colposcopy for only those women with a high grade Pap test result; however, this option detected the fewest cases of precancer. The researchers conclude that HPV DNA testing for women with ASCUS is cost-effective and therefore, economically viable.
In an accompanying editorial, Joy Melnikow, M.D., of the University of California-Davis in Sacramento, and Stephen Birch, D.Phil, of McMaster University in Ontario, write that despite the analysis by Kulasingam, et al., HPV DNA testing for the 3 million women a year diagnosed as ASCUS would require an overall total of $250 million dollars a year. Such money, in addition to money saved by reducing overscreening for cervical cancer, could instead be used to screen for cervical cancer and precancer in underscreened populations, particularly women who have little access to health care. The authors write, "Decision makers will need to consider the value of HPV triage in relation to the expected benefits, in terms of the quality and quantity of life-years produced, and weigh these potential benefits against he substantial extra resource requirements (i.e., where will these resources be found? What are the potential benefits of using these resources for other programs?)."
Citations:
-- Article: Kulasingam SL, Kim JJ, Lawrence WF, Mandelblatt JS, Myers ER, Schiffman M, et al. Cost-effectiveness Analysis Based on the ASCUS and LSIL Triage Study (ALTS). J Natl Cancer Inst 2006;98:92-100.
-- Editorial: Melnikow J, Birch S. Human Papillomavirus Triage of Atypical Squamous Cells of Undetermined Significance: Cost Effective, But At What Cost? J Natl Cancer Inst 2006;98:82-83
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jncicancerspectrum.oxfordjournals.
Ariel Whitworth
jncimediaoxfordjournals
Journal of the National Cancer Institute
jncicancerspectrum.oupjournals
Gender Differences In Thrill-Seeking And Addiction Discovered In Rat Model
It seems that women become addicted to cocaine more easily than men and find it harder to give up. New research published in BioMed Central's open access journal Biology of Sex Differences reinforces this position by showing that the motivation of female rats to work for cocaine is much higher than males.
Researchers from the Molecular and Behavioral Neuroscience Institute, University of Michigan, found that rats bred to have an elevated stress response and increased impulsiveness are more easily trained to reward themselves with cocaine. They are also more determined, than similar rats with low impulsivity and lower stress responses, in pursuit of their next fix.
While cocaine dependency has something to do with thrill seeking and impulsivity, it is also affected by the differences between males and females. At a low dose, for both sets of rats, it was the females who were quickest to learn self-administration and were the most willing to work harder for their next fix. At higher doses, the differences in behaviour between the male and female rats were less apparent.
Whilst certain personality types are perhaps predisposed towards drug addiction Dr Jennifer Cummings explained, "An individual's sex continues to increase the likelihood of drug abuse."
Notes:
Effects of a selectively bred novelty-seeking phenotype on the motivation to take cocaine in male and female rats
Jennifer A Cummings, Brooke A Gowl, Christel Westenbroek, Sarah M Clinton, Huda Akiland and Jill B Becker
Biology of Sex Differences (in press)
Source:
Dr. Hilary Glover
BioMed Central
Researchers from the Molecular and Behavioral Neuroscience Institute, University of Michigan, found that rats bred to have an elevated stress response and increased impulsiveness are more easily trained to reward themselves with cocaine. They are also more determined, than similar rats with low impulsivity and lower stress responses, in pursuit of their next fix.
While cocaine dependency has something to do with thrill seeking and impulsivity, it is also affected by the differences between males and females. At a low dose, for both sets of rats, it was the females who were quickest to learn self-administration and were the most willing to work harder for their next fix. At higher doses, the differences in behaviour between the male and female rats were less apparent.
Whilst certain personality types are perhaps predisposed towards drug addiction Dr Jennifer Cummings explained, "An individual's sex continues to increase the likelihood of drug abuse."
Notes:
Effects of a selectively bred novelty-seeking phenotype on the motivation to take cocaine in male and female rats
Jennifer A Cummings, Brooke A Gowl, Christel Westenbroek, Sarah M Clinton, Huda Akiland and Jill B Becker
Biology of Sex Differences (in press)
Source:
Dr. Hilary Glover
BioMed Central
American Academy Of Pediatrics Calls Ritual 'Nick' Option 'Last Resort' To Prevent Female Genital Mutilation
The American Academy of Pediatrics' committee on bioethics released a policy statement last week noting that some U.S. physicians who work closely with immigrant populations in which female genital mutilation is endemic have cited concerns with the adverse effects of criminalization of FGM and advocate for performing a ceremonial "nick" or pinprick procedure on girls from African or Asian cultures to prevent their families from sending the girls overseas for female genital cutting, the New York Times reports. The statement terms a ritual nick a "last resort" in such cases and mentions that current U.S. law criminalizes "any nonmedical procedure performed on the genitals" of a girl.
Lainie Friedman Ross, associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago and a member of the AAP bioethics committee, said the panel's members "oppose all types of female genital cutting that impose risks or physical or psychological harm" on girls and that their intent was to issue a "statement on safety in a culturally sensitive context." The panel felt that a "just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good," she added, noting that procedures performed in foreign countries might be performed "without anesthesia, with unsterilized knives or even glass." She said the nick is "supposed to be as benign as getting a girl's ears pierced. It's taking a pin and creating a drop of blood."
Some advocates against female genital mutilation criticized the policy statement. Rep. Joseph Crowley (D-N.Y.) said, "I am sure the academy had only good intentions, but what their recommendation has done is only create confusion about whether [female genital mutilation] is acceptable in any form, and it is the wrong step forward on how best to protect young women and girls." Crowley recently introduced legislation (HR 5137) to strengthen federal law by making it a crime to bring a girl overseas for circumcision. The AAP statement acknowledges that opponents, "including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure."
More than 130 million women and girls around the world have undergone female genital cutting, according to the American Congress of Obstetricians and Gynecologists. The procedure is most common on girls younger than age 15 in Ethiopia, Somalia and Sudan (Belluck, New York Times, 5/6).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Novel Egg Freezing Technique Opens The Door
Vitrification is a novel technique for
freezing human eggs (also referred to as oocytes), which is opening the
door to long-term human egg storage. Traditional methods of human egg
cryopreservation have met with limited success. The scientific team at
Georgia Reproductive Specialists (GRS), who were responsible for the first
frozen human egg births in North America in 1997, have successfully
implemented the new technique of vitrification and celebrate the birth this
month of the newest baby born as a result of this technique.
It is GRS' intention to be able to offer egg freezing (oocyte
cryopreservation) as a viable solution for women desiring to preserve their
eggs for future use. Some of the potential applications of egg freezing are
as follows:
- Egg banking for women wishing to preserve their fertility
following cancer therapy
- Egg banking for women delaying pregnancy
- Establishment of a donor egg bank
- Rescue of excess eggs from an unexpectedly strong stimulation of the
ovaries during an Artificial Insemination (Intrauterine Insemination -
IUI) treatment cycle
Currently GRS has research programs in the last two areas; and the
latest "frozen egg baby" arrived as a result of the rescue of excess eggs,
which would have otherwise been discarded in an IUI cycle. Had these eggs
been allowed to remain in the ovaries during the IUI cycle, the woman would
have run an extremely high risk of conceiving with a multiple pregnancy
potentially endangering both her and her babies.
Ovarian hyperstimulation syndrome, painful ovarian enlargement, is
another potential complication that may result from an overly vigorous
response to ovulation medications. While traditionally this leads to
canceling the treatment cycle or converting to standard IVF, GRS' approach
allows both a safe attempt at pregnancy within the IUI cycle and, if the
pregnancy does not occur, then the woman is able to use her "rescued"
frozen eggs to attempt pregnancy with routine in vitro fertilization.
On June 5th, the first such reported use of this exciting technology
established a clear approach for the use of egg freezing to reduce the
costs and risks involved in modern reproductive medicine.
Georgia Reproductive Specialists (GRS) applies medical science's most
advanced fertility technologies to provide the highest standards of
patient- centered, reproductive healthcare. The staff at GRS, including
infertility laboratory pioneer Michael Tucker, Ph.D., is focused on
providing individualized, innovative solutions for reproductive challenges
and infertility, specializing in in vitro fertilization, intracytoplasmic
sperm injection and other assisted reproductive technologies.
Fellowship-trained reproductive endocrinologists Dr. Susan C. Conway, Dr.
Carolyn Kaplan and Dr. Mark Perloe are experts in female and male disorders
including polycystic ovary syndrome (PCOS), repeated pregnancy loss,
menstrual disorders and azoospermia. GRS has three offices, Atlanta,
Alpharetta and Decatur, to conveniently serve patients across Metro
Atlanta. For more information about Georgia Reproductive Specialists, visit
ivf.
Georgia Reproductive Specialists
ivf
freezing human eggs (also referred to as oocytes), which is opening the
door to long-term human egg storage. Traditional methods of human egg
cryopreservation have met with limited success. The scientific team at
Georgia Reproductive Specialists (GRS), who were responsible for the first
frozen human egg births in North America in 1997, have successfully
implemented the new technique of vitrification and celebrate the birth this
month of the newest baby born as a result of this technique.
It is GRS' intention to be able to offer egg freezing (oocyte
cryopreservation) as a viable solution for women desiring to preserve their
eggs for future use. Some of the potential applications of egg freezing are
as follows:
- Egg banking for women wishing to preserve their fertility
following cancer therapy
- Egg banking for women delaying pregnancy
- Establishment of a donor egg bank
- Rescue of excess eggs from an unexpectedly strong stimulation of the
ovaries during an Artificial Insemination (Intrauterine Insemination -
IUI) treatment cycle
Currently GRS has research programs in the last two areas; and the
latest "frozen egg baby" arrived as a result of the rescue of excess eggs,
which would have otherwise been discarded in an IUI cycle. Had these eggs
been allowed to remain in the ovaries during the IUI cycle, the woman would
have run an extremely high risk of conceiving with a multiple pregnancy
potentially endangering both her and her babies.
Ovarian hyperstimulation syndrome, painful ovarian enlargement, is
another potential complication that may result from an overly vigorous
response to ovulation medications. While traditionally this leads to
canceling the treatment cycle or converting to standard IVF, GRS' approach
allows both a safe attempt at pregnancy within the IUI cycle and, if the
pregnancy does not occur, then the woman is able to use her "rescued"
frozen eggs to attempt pregnancy with routine in vitro fertilization.
On June 5th, the first such reported use of this exciting technology
established a clear approach for the use of egg freezing to reduce the
costs and risks involved in modern reproductive medicine.
Georgia Reproductive Specialists (GRS) applies medical science's most
advanced fertility technologies to provide the highest standards of
patient- centered, reproductive healthcare. The staff at GRS, including
infertility laboratory pioneer Michael Tucker, Ph.D., is focused on
providing individualized, innovative solutions for reproductive challenges
and infertility, specializing in in vitro fertilization, intracytoplasmic
sperm injection and other assisted reproductive technologies.
Fellowship-trained reproductive endocrinologists Dr. Susan C. Conway, Dr.
Carolyn Kaplan and Dr. Mark Perloe are experts in female and male disorders
including polycystic ovary syndrome (PCOS), repeated pregnancy loss,
menstrual disorders and azoospermia. GRS has three offices, Atlanta,
Alpharetta and Decatur, to conveniently serve patients across Metro
Atlanta. For more information about Georgia Reproductive Specialists, visit
ivf.
Georgia Reproductive Specialists
ivf
Abnormal Blood Vessel Function Found In Women With Broken Heart Syndrome
A team of Mayo Clinic researchers has found that patients with broken heart syndrome, also known as apical ballooning syndrome (ABS), have blood vessels that don't react normally to stress. These results offer clues to the cause of this rare syndrome and may help with efforts to identify patients who are more vulnerable to mental stress so that appropriate therapies can be developed. The study is published online in the Journal of the American College of Cardiology.
Apical ballooning syndrome affects mainly postmenopausal women, and a few men. The symptoms mimic those of a heart attack, but unlike heart attack patients, ABS patients' heart arteries show no blockages and there is no permanent damage to the heart. Their hearts show the hallmark of ABS - a ballooning and weakening of the tip of the left ventricle, the heart's main pumping chamber.
"This is usually associated with severe mental or emotional stress in the patient," says Amir Lerman, M.D., a Mayo Clinic cardiologist. "Fortunately, for most of these patients, their heart function returns to normal in several weeks, although ABS recurs in about 11 percent of cases."
Besides stress, estrogen levels and functioning of the blood vessels are other suspected causes of ABS. For the study, Dr. Lerman and his research team compared blood vessel responses to mental stress in 12 women who had been diagnosed with ABS in the last six months, 12 postmenopausal women control subjects, and four women who had experienced typical heart attacks.
Although the original stressors in the ABS patients included the death of a husband or family member, divorces, claustrophobia and church fundraising, no such extreme measures were employed for the study. Instead, to elicit mental stress, the women were given number and letter memory tests of increasing length and complexity along with subtraction tasks and Stroop word-color conflict tests. Blood samples were taken before and after the stress tests, and blood vessel function was measured with noninvasive devices such as blood pressure arm and finger cuffs.
In the ABS women, researchers found increased vascular reactivity and decreased endothelial function in response to acute mental stress compared to other postmenopausal women and the women who had regular heart attacks.
"In the ABS patients, rather than the blood vessel getting bigger to provide more blood during mental stress, the blood vessel gets smaller and prevents the blood from going where it's needed," explained Dr. Lerman. "This study tells us there is a group of women patients who are more sensitive to mental stress, which is a unique risk factor for them to have an ABS-type heart attack. The body's response to mental stress plays a significant role in ABS syndrome."
Dr. Lerman and his team are working to develop treatment options for ABS patients. "It's possible that we could identify these stress-sensitive patients with a mental stress test," Dr. Lerman says. "If we discover that some patients are more sensitive to mental stress in this way, we could design specific therapies to aid them if they have an ABS attack or to prevent its recurrence."
This study was funded by grants from the Department of Defense and the National Institutes of Health. Other members of the Mayo Clinic research team are Abhiram Prasad, M.D.; Charanjit Rihal, M.D.; and Lilach Lerman, M.D.; and Elizabeth Martin, Ph.D., who now works at Cedars-Sinai Medical Center, Los Angeles.
Source: Mayo Clinic
Apical ballooning syndrome affects mainly postmenopausal women, and a few men. The symptoms mimic those of a heart attack, but unlike heart attack patients, ABS patients' heart arteries show no blockages and there is no permanent damage to the heart. Their hearts show the hallmark of ABS - a ballooning and weakening of the tip of the left ventricle, the heart's main pumping chamber.
"This is usually associated with severe mental or emotional stress in the patient," says Amir Lerman, M.D., a Mayo Clinic cardiologist. "Fortunately, for most of these patients, their heart function returns to normal in several weeks, although ABS recurs in about 11 percent of cases."
Besides stress, estrogen levels and functioning of the blood vessels are other suspected causes of ABS. For the study, Dr. Lerman and his research team compared blood vessel responses to mental stress in 12 women who had been diagnosed with ABS in the last six months, 12 postmenopausal women control subjects, and four women who had experienced typical heart attacks.
Although the original stressors in the ABS patients included the death of a husband or family member, divorces, claustrophobia and church fundraising, no such extreme measures were employed for the study. Instead, to elicit mental stress, the women were given number and letter memory tests of increasing length and complexity along with subtraction tasks and Stroop word-color conflict tests. Blood samples were taken before and after the stress tests, and blood vessel function was measured with noninvasive devices such as blood pressure arm and finger cuffs.
In the ABS women, researchers found increased vascular reactivity and decreased endothelial function in response to acute mental stress compared to other postmenopausal women and the women who had regular heart attacks.
"In the ABS patients, rather than the blood vessel getting bigger to provide more blood during mental stress, the blood vessel gets smaller and prevents the blood from going where it's needed," explained Dr. Lerman. "This study tells us there is a group of women patients who are more sensitive to mental stress, which is a unique risk factor for them to have an ABS-type heart attack. The body's response to mental stress plays a significant role in ABS syndrome."
Dr. Lerman and his team are working to develop treatment options for ABS patients. "It's possible that we could identify these stress-sensitive patients with a mental stress test," Dr. Lerman says. "If we discover that some patients are more sensitive to mental stress in this way, we could design specific therapies to aid them if they have an ABS attack or to prevent its recurrence."
This study was funded by grants from the Department of Defense and the National Institutes of Health. Other members of the Mayo Clinic research team are Abhiram Prasad, M.D.; Charanjit Rihal, M.D.; and Lilach Lerman, M.D.; and Elizabeth Martin, Ph.D., who now works at Cedars-Sinai Medical Center, Los Angeles.
Source: Mayo Clinic
Breast Cancer Survival Rates Improved By Novel Drug Sequence, Say Researchers
Changing the way women are treated for breast cancer could improve their overall chance of survival, according to research published today in the Lancet. The new paper shows that switching to a drug called exemestane, two to three years after commencing standard therapy with the drug tamoxifen, can cut the risk of death for certain women by a further 17% compared with using tamoxifen alone.
Postmenopausal women with early-stage hormone-sensitive primary breast cancer are usually treated with tamoxifen for five years, once they are free of disease, to reduce the risk of their cancer recurring. This therapy was once viewed as the 'gold-standard' treatment and it has been shown to cut the risk of death by 34%.
Over recent years, increasing numbers of these women have been receiving treatment with tamoxifen followed by Aromatase Inhibitors such as exemestane.
The Intergroup Exemestane Study (IES), which involved women from 37 different countries, has been examining the benefits of taking tamoxifen for two to three years and then switching to exemestane for the remainder of the five-year period. This new research is the first to show that early benefits of the tamoxifen and exemestane treatment sequence are maintained after treatment has stopped. The study, which was led by researchers from Imperial College London and The Institute of Cancer Research, was funded by Cancer Research UK and Pfizer.
The majority of breast cancer cases are hormone-sensitive, meaning that the cancer cells respond to oestrogen and die when they are deprived of the hormone. Tamoxifen works by preventing oestrogen from acting on cancer cells, whereas exemestane is an Aromatase Inhibitor, which works by stopping the body's production of oestrogen.
The researchers believe that during treatment with tamoxifen, some cancer cells can become resistant to the effects of the drug. Exemestane is subsequently able to kill these resistant cells by withdrawing the oestrogen from circulation.
The researchers examined 2,352 postmenopausal women with early-stage breast cancer who switched to exemestane, compared with another group of 2,372 women who were treated with tamoxifen alone. The women were halfway through their five-year tamoxifen treatment when they joined the study and they were followed up for a median of 56 months after this point.
The study found that the women taking exemestane had a 15% lower risk of dying than those taking only tamoxifen. When women whose tumours were found not to be hormone sensitive were excluded (8% of the total), the improvement increased to 17%.
The results of the study also suggest that sequential use of tamoxifen and exemestane is safe and well tolerated.
Professor Charles Coombes, lead author of the paper from the Cancer Research UK Department of Cancer Medicine at Imperial College London, and based at Hammersmith Hospital, said: "This study shows that, in order to get best results, patients need to be treated with a sequence of anti-hormonal treatments. Just giving one or other drug, such as has been done in some other studies, has not been shown to give added benefit in terms of improved survival. The task now is to determine what other drugs should be given in sequence to prevent cancer cells that have become resistant to exemestane from growing."
Professor Judith Bliss, Director of The Cancer Research UK Clinical Trials and Statistics Unit at The Institute of Cancer Research said: "This trial is an excellent example of how international collaborations between researchers and clinicians can be quickly translated into a cost effective treatment strategy providing patient benefit. To the many postmenopausal breast cancer patients around the world this new research offers the hope of improved treatment options."
Current practice is to give patients treatment for a period of time after surgery and then stop. Following this, doctors wait for a recurrence of the cancer, at which point it is often impossible to cure the disease.
Professor Coombes added: "The other challenge is to find a way of monitoring breast cancer to find a blood test that can tell us when some cancer cells are once more growing. This will allow us to time the sequence of treatment more accurately. A test for early resistance would give us a chance of curing the disease whilst it is still at an early stage."
IMPERIAL COLLEGE UNIVERSITY OF LONDON
Exhibition Road
London
SW7 2AZ
ic.ac
Postmenopausal women with early-stage hormone-sensitive primary breast cancer are usually treated with tamoxifen for five years, once they are free of disease, to reduce the risk of their cancer recurring. This therapy was once viewed as the 'gold-standard' treatment and it has been shown to cut the risk of death by 34%.
Over recent years, increasing numbers of these women have been receiving treatment with tamoxifen followed by Aromatase Inhibitors such as exemestane.
The Intergroup Exemestane Study (IES), which involved women from 37 different countries, has been examining the benefits of taking tamoxifen for two to three years and then switching to exemestane for the remainder of the five-year period. This new research is the first to show that early benefits of the tamoxifen and exemestane treatment sequence are maintained after treatment has stopped. The study, which was led by researchers from Imperial College London and The Institute of Cancer Research, was funded by Cancer Research UK and Pfizer.
The majority of breast cancer cases are hormone-sensitive, meaning that the cancer cells respond to oestrogen and die when they are deprived of the hormone. Tamoxifen works by preventing oestrogen from acting on cancer cells, whereas exemestane is an Aromatase Inhibitor, which works by stopping the body's production of oestrogen.
The researchers believe that during treatment with tamoxifen, some cancer cells can become resistant to the effects of the drug. Exemestane is subsequently able to kill these resistant cells by withdrawing the oestrogen from circulation.
The researchers examined 2,352 postmenopausal women with early-stage breast cancer who switched to exemestane, compared with another group of 2,372 women who were treated with tamoxifen alone. The women were halfway through their five-year tamoxifen treatment when they joined the study and they were followed up for a median of 56 months after this point.
The study found that the women taking exemestane had a 15% lower risk of dying than those taking only tamoxifen. When women whose tumours were found not to be hormone sensitive were excluded (8% of the total), the improvement increased to 17%.
The results of the study also suggest that sequential use of tamoxifen and exemestane is safe and well tolerated.
Professor Charles Coombes, lead author of the paper from the Cancer Research UK Department of Cancer Medicine at Imperial College London, and based at Hammersmith Hospital, said: "This study shows that, in order to get best results, patients need to be treated with a sequence of anti-hormonal treatments. Just giving one or other drug, such as has been done in some other studies, has not been shown to give added benefit in terms of improved survival. The task now is to determine what other drugs should be given in sequence to prevent cancer cells that have become resistant to exemestane from growing."
Professor Judith Bliss, Director of The Cancer Research UK Clinical Trials and Statistics Unit at The Institute of Cancer Research said: "This trial is an excellent example of how international collaborations between researchers and clinicians can be quickly translated into a cost effective treatment strategy providing patient benefit. To the many postmenopausal breast cancer patients around the world this new research offers the hope of improved treatment options."
Current practice is to give patients treatment for a period of time after surgery and then stop. Following this, doctors wait for a recurrence of the cancer, at which point it is often impossible to cure the disease.
Professor Coombes added: "The other challenge is to find a way of monitoring breast cancer to find a blood test that can tell us when some cancer cells are once more growing. This will allow us to time the sequence of treatment more accurately. A test for early resistance would give us a chance of curing the disease whilst it is still at an early stage."
IMPERIAL COLLEGE UNIVERSITY OF LONDON
Exhibition Road
London
SW7 2AZ
ic.ac
Teva Announces Approval Of Generic Sarafem(R) Pulvules(R)
Teva Pharmaceutical Industries Ltd. (Nasdaq: TEVA) announced that the U.S. Food and Drug Administration has granted final approval for the Company's Abbreviated New Drug Application (ANDA) for Fluoxetine Capsules USP, 10 mg and 20 mg. Shipment of the product will begin immediately. As the first company to file an ANDA containing a paragraph IV certification for this product, Teva has been awarded a 180-day period of marketing exclusivity.
Teva's Fluoxetine Capsules are the AB-rated generic equivalent of Eli Lilly's Sarafem® Pulvules®, and are indicated for the treatment of premenstrual dysphoric disorder (PMDD).
The brand product had annual sales of approximately $39 million in the United States for the twelve months that ended March 31, 2008, based on IMS sales data.
About Teva
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies in the world and is the world's leading generic pharmaceutical company. The Company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients, as well as animal health pharmaceutical products. Over 80 percent of Teva's sales are in North America and Europe.
Safe Harbor Statement under the U. S. Private Securities Litigation Reform Act of 1995
This release contains forward-looking statements, which express the current beliefs and expectations of management. Such statements are based on management's current beliefs and expectations and involve a number of known and unknown risks and uncertainties that could cause Teva's future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to: Teva's ability to accurately predict future market conditions, potential liability for sales of generic products prior to a final resolution of outstanding patent litigation, including that relating to the generic versions of Allegra®, Neurontin®, Lotrel®, Famvir® and Protonix®, Teva's ability to successfully develop and commercialize additional pharmaceutical products, the introduction of competing generic equivalents, the extent to which Teva may obtain U.S. market exclusivity for certain of its new generic products and regulatory changes that may prevent Teva from utilizing exclusivity periods, competition from brand-name companies that are under increased pressure to counter generic products, or competitors that seek to delay the introduction of generic products, the impact of consolidation of our distributors and customers, the effects of competition on our innovative products, especially Copaxone® sales, the impact of pharmaceutical industry regulation and pending legislation that could affect the pharmaceutical industry, the difficulty of predicting U.S. Food and Drug Administration, European Medicines Agency and other regulatory authority approvals, the regulatory environment and changes in the health policies and structures of various countries, our ability to achieve expected results though our innovative R&D efforts, Teva's ability to successfully identify, consummate and integrate acquisitions (including the pending acquisition of Bentley Pharmaceuticals, Inc.), potential exposure to product liability claims to the extent not covered by insurance, dependence on the effectiveness of our patents and other protections for innovative products, significant operations worldwide that may be adversely affected by terrorism, political or economical instability or major hostilities, supply interruptions or delays that could result from the complex manufacturing of our products and our global supply chain, environmental risks, fluctuations in currency, exchange and interest rates, and other factors that are discussed in Teva's Annual Report on Form 20-F and its other filings with the U.S. Securities and Exchange Commission. Forward-looking statements speak only as of the date on which they are made and the Company undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise.
Teva Pharmaceutical Industries
View drug information on Allegra; Copaxone; Famvir.
Teva's Fluoxetine Capsules are the AB-rated generic equivalent of Eli Lilly's Sarafem® Pulvules®, and are indicated for the treatment of premenstrual dysphoric disorder (PMDD).
The brand product had annual sales of approximately $39 million in the United States for the twelve months that ended March 31, 2008, based on IMS sales data.
About Teva
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies in the world and is the world's leading generic pharmaceutical company. The Company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients, as well as animal health pharmaceutical products. Over 80 percent of Teva's sales are in North America and Europe.
Safe Harbor Statement under the U. S. Private Securities Litigation Reform Act of 1995
This release contains forward-looking statements, which express the current beliefs and expectations of management. Such statements are based on management's current beliefs and expectations and involve a number of known and unknown risks and uncertainties that could cause Teva's future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to: Teva's ability to accurately predict future market conditions, potential liability for sales of generic products prior to a final resolution of outstanding patent litigation, including that relating to the generic versions of Allegra®, Neurontin®, Lotrel®, Famvir® and Protonix®, Teva's ability to successfully develop and commercialize additional pharmaceutical products, the introduction of competing generic equivalents, the extent to which Teva may obtain U.S. market exclusivity for certain of its new generic products and regulatory changes that may prevent Teva from utilizing exclusivity periods, competition from brand-name companies that are under increased pressure to counter generic products, or competitors that seek to delay the introduction of generic products, the impact of consolidation of our distributors and customers, the effects of competition on our innovative products, especially Copaxone® sales, the impact of pharmaceutical industry regulation and pending legislation that could affect the pharmaceutical industry, the difficulty of predicting U.S. Food and Drug Administration, European Medicines Agency and other regulatory authority approvals, the regulatory environment and changes in the health policies and structures of various countries, our ability to achieve expected results though our innovative R&D efforts, Teva's ability to successfully identify, consummate and integrate acquisitions (including the pending acquisition of Bentley Pharmaceuticals, Inc.), potential exposure to product liability claims to the extent not covered by insurance, dependence on the effectiveness of our patents and other protections for innovative products, significant operations worldwide that may be adversely affected by terrorism, political or economical instability or major hostilities, supply interruptions or delays that could result from the complex manufacturing of our products and our global supply chain, environmental risks, fluctuations in currency, exchange and interest rates, and other factors that are discussed in Teva's Annual Report on Form 20-F and its other filings with the U.S. Securities and Exchange Commission. Forward-looking statements speak only as of the date on which they are made and the Company undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise.
Teva Pharmaceutical Industries
View drug information on Allegra; Copaxone; Famvir.
Some Women Suffering From Moderate-To-Severe PMS May Benefit From Low Doses Of Anti-Depressant
Some women who experience moderate-to-severe premenstrual syndrome may benefit from treatment with low doses of anti-depressant medication, according to a new study led by a Virginia Commonwealth University researcher.
In the October issue of the Journal of Clinical Psychiatry, researchers reported that low doses of sertraline taken for two weeks before the onset of the menstrual period may be an effective and well-tolerated treatment for some women who experience moderate-to-severe premenstrual syndrome, or PMS.
The researchers also tested and found two other anti-depressant dosing strategies to be effective. One of those dosing strategies was taking medication daily throughout the menstrual cycle. The other was waiting until PMS symptoms begin to start medication each cycle, which is known as 'symptom-onset' dosing. Sertraline is a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of depression and anxiety, as well as for premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome.
"Our study is the first to evaluate the use of low-dose antidepressant medication for women who have moderate-to-severe PMS, and the first placebo-controlled study to include the novel dosing strategy of 'symptom-onset dosing,'" said Susan G. Kornstein, M.D., a professor of psychiatry and obstetrics and gynecology in VCU's School of Medicine and lead author on the study.
"Our findings suggest that women with less severe forms of PMS than PMDD may also benefit from treatment with antidepressant medication, and they may be able to take medication only on the days that they are symptomatic," she said.
Up to 60 percent of women suffer from PMS, while only about 5 percent of women suffer from PMDD. PMS symptoms may include irritability, depressed mood, anxiety and mood swings, in addition to physical symptoms such as bloating and breast tenderness. PMDD is characterized by severe mood symptoms that interfere with functioning.
Previous research studies have focused on the use of anti-depressants for PMDD. According to Kornstein, women with less severe symptoms have not received as much attention in treatment studies, although calcium supplementation has been shown to be helpful.
Kornstein and her colleagues evaluated approximately 300 women with PMS from 22 sites throughout the United States. The participants were randomly assigned to fixed-dose treatment with 25 or 50 mg of sertraline or given a placebo for four menstrual cycles.
This work was funded by Pfizer, Inc.
Kornstein, is executive director of VCU's Institute for Women's Health, designated a National Center of Excellence by the U.S. Department of Health and Human Services, and director of the VCU Mood Disorders Institute. She collaborated with Teri B. Pearlstein, M.D., from Brown University School of Medicine; and Rana Fayyad, Ph.D., Gail M. Farfel, Ph.D., and John A. Gillespie, Ph.D., who are researchers with Pfizer, Inc.
A copy of the study is available via fax from the Journal of Clinical Psychiatry by contacting Judy Beach.
About VCU and the VCU Medical Center: Located on two downtown campuses in Richmond, Va., Virginia Commonwealth University ranks among the top 100 universities in the country in sponsored research and enrolls 30,000 students in more than 180 certificate, undergraduate, graduate, professional and doctoral programs in the arts, sciences and humanities in 15 schools and one college. Sixty of the university's programs are unique in Virginia, and 20 graduate and professional programs have been ranked by U.S. News & World Report as among the best of their kind. MCV Hospitals, clinics and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the leading academic medical centers in the country. For more, see vcu.edu/.
Contact: Sathya Achia-Abraham
Virginia Commonwealth University
In the October issue of the Journal of Clinical Psychiatry, researchers reported that low doses of sertraline taken for two weeks before the onset of the menstrual period may be an effective and well-tolerated treatment for some women who experience moderate-to-severe premenstrual syndrome, or PMS.
The researchers also tested and found two other anti-depressant dosing strategies to be effective. One of those dosing strategies was taking medication daily throughout the menstrual cycle. The other was waiting until PMS symptoms begin to start medication each cycle, which is known as 'symptom-onset' dosing. Sertraline is a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of depression and anxiety, as well as for premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome.
"Our study is the first to evaluate the use of low-dose antidepressant medication for women who have moderate-to-severe PMS, and the first placebo-controlled study to include the novel dosing strategy of 'symptom-onset dosing,'" said Susan G. Kornstein, M.D., a professor of psychiatry and obstetrics and gynecology in VCU's School of Medicine and lead author on the study.
"Our findings suggest that women with less severe forms of PMS than PMDD may also benefit from treatment with antidepressant medication, and they may be able to take medication only on the days that they are symptomatic," she said.
Up to 60 percent of women suffer from PMS, while only about 5 percent of women suffer from PMDD. PMS symptoms may include irritability, depressed mood, anxiety and mood swings, in addition to physical symptoms such as bloating and breast tenderness. PMDD is characterized by severe mood symptoms that interfere with functioning.
Previous research studies have focused on the use of anti-depressants for PMDD. According to Kornstein, women with less severe symptoms have not received as much attention in treatment studies, although calcium supplementation has been shown to be helpful.
Kornstein and her colleagues evaluated approximately 300 women with PMS from 22 sites throughout the United States. The participants were randomly assigned to fixed-dose treatment with 25 or 50 mg of sertraline or given a placebo for four menstrual cycles.
This work was funded by Pfizer, Inc.
Kornstein, is executive director of VCU's Institute for Women's Health, designated a National Center of Excellence by the U.S. Department of Health and Human Services, and director of the VCU Mood Disorders Institute. She collaborated with Teri B. Pearlstein, M.D., from Brown University School of Medicine; and Rana Fayyad, Ph.D., Gail M. Farfel, Ph.D., and John A. Gillespie, Ph.D., who are researchers with Pfizer, Inc.
A copy of the study is available via fax from the Journal of Clinical Psychiatry by contacting Judy Beach.
About VCU and the VCU Medical Center: Located on two downtown campuses in Richmond, Va., Virginia Commonwealth University ranks among the top 100 universities in the country in sponsored research and enrolls 30,000 students in more than 180 certificate, undergraduate, graduate, professional and doctoral programs in the arts, sciences and humanities in 15 schools and one college. Sixty of the university's programs are unique in Virginia, and 20 graduate and professional programs have been ranked by U.S. News & World Report as among the best of their kind. MCV Hospitals, clinics and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the leading academic medical centers in the country. For more, see vcu.edu/.
Contact: Sathya Achia-Abraham
Virginia Commonwealth University
Blogs Comment On Women Deliver Conference, Birth Control Coverage, Other Topics
The following summarizes selected women's health-related blog entries.
~ "Filling the Unmet Need for Contraception: Can We Deliver for Young Women?" Carmen Barroso, RH Reality Check: Unintended pregnancy and abortion are reason enough for advocates to pay more attention to the unmet need for contraception among adolescents and young adults, but there are "three other reasons that are as or more compelling," according to the International Planned Parenthood Federation/Western Hemisphere Region's Carmen Barroso, who will be presenting on the topic at the Women Deliver conference this week. The first reason "is purely demographic," Barroso writes, adding that "early childbearing contributes to population momentum, the neglected component of population growth." According to Barroso, a slower population growth rate can be achieved by "fulfilling young women's right to information, to health services and to autonomy regarding the decision on whether and when to have children and how many children to bear." Second, meeting the needs of younger women "has proved more difficult than is the case with older women," likely because of varying social conditions in different countries, Barroso writes. "A third and pervading factor that affects both wanted and unwanted pregnancies of adolescents in most societies is the basic question of young people's sexual rights," she continues, noting that "[i]n most societies there is a deep resistance to recognize young people as subject of rights, and an equally strong denial of the recognition of them as sexual beings." To meet young women's unmet needs for contraception, Barroso suggests that advocates endorse the Millennium Development Goal 5B, lobby for services and education funding, and support policies aimed at empowering young women economically. "But above all," she recommends "promot[ing] the sexual rights of young women, their full recognition as rights bearers, according to their evolving capacity" (Barroso, RH Reality Check, 6/7).
~ "For Women, the Ultimate in Preventive Health Care: Birth Control," Cecile Richards, Huffington Post blogs: "Despite the approval of the [birth control] pill 50 years ago, and the subsequent development of new and superior forms of contraception like the ring or the patch, half of all pregnancies in the U.S. are unplanned," Planned Parenthood Federation of America President Richards writes. She adds that "millions of American women ... need birth control, but for too many women, it is not easily accessible or affordable." Noting that contraception is "a critical topic of debate in the U.S. as the newly signed health care law (PL 111-148) begins to go into effect," Richards says that a "key question is what type of health care services for women will be considered essential preventive care -- and therefore made more affordable?" Because of the pill, "[m]aternal and infant health improved dramatically; the infant death rate plummeted; and women were able to fulfill increasingly diverse educational, political, professional, and social aspirations," according to Richards. She asks, "So -- for women -- what could be more basic preventive care than birth control?" Richards continues, "It is time to finally make birth control not just a medical reality," but "a practical reality for all women." She concludes, "Only then will we achieve our shared goal of reducing unintended pregnancies and giving women the ability to raise happy and healthy families" (Richards, Huffington Post blogs, 6/4).
~ "Sex Shaming and the Rhythm Method," Amanda Marcotte, RH Reality Check: Advocates of abstinence-only sex education "can count one success in altering teenage sexual behavior," Marcotte writes, noting that the Centers for Disease Control and Prevention recently reported that the "percentage of teenage girls who use the rhythm method as birth control (at least some of the time) jumped from 11% in 2002 to 17% in 2008." She adds that it is "high enough of a jump that it might explain why the teenage pregnancy rate is still as high as it is." Marcotte says that abstinence-only advocates can be "blame[d]" for the increase because the rhythm method is "associated with the prudish stand of Christian moralizing that also drives the abstinence-only movement," adding that "the more popular that kind of thinking, the more likely the rhythm method will be seen as a legitimate practice by teenagers." While it is possible that "a few" teenage girls using the rhythm method are "experts in their own fertility," Marcotte notes that to "use the method effectively requires more than counting the days in your cycle," and that "merely counting days is ineffective in women who have regular periods. For teenage girls, who often have irregular periods, it’s basically a waste of time. In addition, the rhythm method offers no protection against STDs." The impact of abstinence-only programs "is softened every time right-thinking politicians strike a blow against it," Marcotte writes, concluding, "Hopefully the next time the CDC takes this study, there will be more comprehensive sex education, and we'll see improvements in contraceptive use amongst teenagers" (Marcotte, RH Reality Check, 6/8).
~ "Reproductive Crisis? Do Not Proceed to a Catholic Hospital," Angela Bonavoglia, Huffington Post blogs: "So many things are galling" about the excommunication of a Phoenix-based nun who helped approve an abortion at a Catholic hospital "that it's hard to know where to begin," Bonavoglia writes. The nun, Sister Margaret McBride, was excommunicated by Bishop Thomas Olmstead for participating in the decision to authorize an abortion to save the life of a woman who was 11 weeks' pregnant and experiencing pulmonary hypertension. Bonavoglia writes that "surely one of the most urgent issues this case raises is the danger faced by any woman who sets foot in a Catholic hospital in the midst of a reproductive crisis." It is unknown "how often such decisions come up in Catholic hospitals" or "if any go the other way -- that is, the beliefs of ... the Church prevail and discharge is followed by a funeral," she continues. "What we do know is that Catholic hospitals, charged with abiding by the Ethical and Religious Directives for Catholic Health Care Services, pose a real danger to women's health and lives," she states. Bonavoglia writes that "more research into how often and in what ways physicians compromise patient care as a result of the Catholic Directives" is needed, adding, "But for now, the experience of the nameless, faceless, pregnant woman who Bishop Olmstead would have sentenced to death ... is a cautionary tale." She continues, "Unless you are a deeply devoted Catholic and want your local bishop to make your most intimate medical decisions, when the ambulance pulls up, be ready" with "your own ethical and moral directive saying: Do Not Take Me to a Catholic Hospital," because "there may not be a Sister Margaret in the house" (Bonavoglia, Huffington Post blogs, 6/7).
~ "Anti-Choice Activity in the States Implores You To Act," Grace Lesser, National Women's Law Center's "Womenstake": The "flurry of anti-choice activity in the states" that has resulted from the passage of the national health reform law (PL 111-148) constitutes an "emboldened attack on women's reproductive health," according to Lesser, a program assistant at NWLC. "Health reform energized the far right," she writes, adding, "State laws making abortion services less affordable, less accessible and less respectful are being pushed across the country." Lesser notes that a "particularly dangerous form of recent anti-choice activity has come in the form of insurance restrictions on the state level." She adds, "How ironic that a national bill that was designed and crafted to increase access to non-discriminatory, fair, equitable and quality health care has energized anti-choice forces to push for just the opposite on the state level." She concludes that "those of us who care about women's autonomy and choice must organize and push back" and "fight to restore access, funding and ownership over our reproductive health freedoms in every state across the nation" (Lesser, "Womenstake," National Women's Law Center, 6/4).
~ "Women Deliver Promises Hope Around the World," Tamar Abrams, Huffington Post blogs: Abrams writes about the ongoing Women Deliver conference in Washington, D.C., which has drawn thousands of participants who "gathered to celebrate the role of women in the well-being of families, communities and nations." Abrams says it is "galling that American antiabortion advocates are excoriating Women Deliver," with some describing the conference as "anti-women." Antiabortion-rights activists also "claim that the conference is a cover for some sort of worldwide conspiracy to force abortion on women everywhere," she adds. "Reproductive health is not [just] abortion, and mentioning the word does not subsume every other part of reproductive health," Abrams writes, noting that topics discussed at the conference included how to ensure better newborn health rates and how to collaborate to lower maternal mortality. She concludes, "Perhaps someday 'women deliver' will be not only a clever turn of phrase but also a promise of prosperity, good health and hope no matter where you are born on this planet" (Abrams, Huffington Post blogs, 6/7).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.
© 2010 National Partnership for Women & Families. All rights reserved.
Подписаться на:
Комментарии (Atom)