Rape in Mauritania, domestic violence in Mexico and Romania, child marriage in Bangladesh, and female genital mutilation/cutting in Kenya are just a few of the abuses visited on women and girls explored in a new United Nations Population Fund report released today in New York.
Unlike other publications that simply chronicle the extent of the problem, Programming to Address Violence Against Women offers 10 case studies that show how carefully targeted and planned interventions can actually reduce gender-based violence.
"What is unusual about this manual is that we have actually demonstrated how entire communities can change their attitudes to violence against women as a result of a few, specifically targeted interventions," says Thoraya Ahmed Obaid, Executive Director of UNFPA, the United Nations Population Fund.
"In many of these cases, the extent of violence against women was so prevalent and so entrenched that it first seemed impossible to budge the prevailing mindset," she says. "What we learned is that persistent advocacy targeting community leaders and the larger public can bring about huge changes in a relatively short time."
"Gender-based violence is not a given in any society," adds Ms. Obaid. "Not even the most traditional ones. We have definitively proven that with these case histories."
As well as working with national and community leaders - including religious authorities, doctors and politicians - UNFPA and its partners assist victims to seek legal redress and, if young, return to school. Because victims of violence face so much stigma, UNFPA and partners also help affected women and girls learn new skills so that they can enjoy economic independence. The organization also backs advocacy efforts to reduce stigma and raise awareness of the prevalence, causes and consequences of gender-based violence.
"Communities can and will change, but the dire consequences associated with gender-based violence constitute a human emergency that requires global and local action," says Ms. Obaid. "We need to treat it as such."
UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.
unfpa
вторник, 5 июня 2012 г.
вторник, 29 мая 2012 г.
Fred Thompson Calls Himself 'Unabashedly Pro-Life,' Defends Lobbying Record
Former Sen. Fred Thompson (Tenn.), who is considering running for the Republican presidential nomination, in an interview on Friday called himself "unabashedly pro-life" and said he has "no apologies to make" about his 20-year lobbying career, the AP/Boston Globe reports (Fournier/Glover, AP/Boston Globe, 8/18).
According to billing records for the law firm Arent Fox, where Thompson worked part time from 1991 to 1994, Thompson charged about $5,000 to the
National Family Planning and Reproductive Health Association, which supports abortion rights, for nearly 20 hours of work in 1991 and 1992. Thompson billed the group for 3.3 hours of lobbying "administration officials," as well as for 22 conversations with then NFPRHA President Judith DeSarno, according to the billing records.
DeSarno has said that in 1991, NFPRHA hired Thompson to urge the George H.W. Bush administration to withdraw or relax a federal policy on funding restrictions for clinics that provided abortion-related counseling. Minutes from a NFPRHA board meeting on Sept. 14, 1991, reportedly state that the group had "hired Fred Thompson Esq. as counsel to aid us in discussions with the administration" on the abortion-counseling policy.
Thompson in a column posted July 11 on the blog Power Line said he does not remember but will not dispute evidence alleging that he lobbied for NFPRHA. In the column, Thompson wrote that if a "client has a legal and ethical right to take a position, then you may appropriately represent him as long as he does not lie or otherwise conduct himself improperly while you are representing him" (Kaiser Daily Women's Health Policy Report, 7/24).
Thompson on Friday said he has an unclear memory of his work for NFPRHA, adding, "I clearly did some work. I proceeded after that to go to the United States Senate and oppose them on every matter that came up." He said there is nothing abnormal or wrong about lawyers representing clients with different views than their own, adding, "It has nothing to do with one's political views" (AP/Boston Globe, 8/18).
According to billing records for the law firm Arent Fox, where Thompson worked part time from 1991 to 1994, Thompson charged about $5,000 to the
National Family Planning and Reproductive Health Association, which supports abortion rights, for nearly 20 hours of work in 1991 and 1992. Thompson billed the group for 3.3 hours of lobbying "administration officials," as well as for 22 conversations with then NFPRHA President Judith DeSarno, according to the billing records.
DeSarno has said that in 1991, NFPRHA hired Thompson to urge the George H.W. Bush administration to withdraw or relax a federal policy on funding restrictions for clinics that provided abortion-related counseling. Minutes from a NFPRHA board meeting on Sept. 14, 1991, reportedly state that the group had "hired Fred Thompson Esq. as counsel to aid us in discussions with the administration" on the abortion-counseling policy.
Thompson in a column posted July 11 on the blog Power Line said he does not remember but will not dispute evidence alleging that he lobbied for NFPRHA. In the column, Thompson wrote that if a "client has a legal and ethical right to take a position, then you may appropriately represent him as long as he does not lie or otherwise conduct himself improperly while you are representing him" (Kaiser Daily Women's Health Policy Report, 7/24).
Thompson on Friday said he has an unclear memory of his work for NFPRHA, adding, "I clearly did some work. I proceeded after that to go to the United States Senate and oppose them on every matter that came up." He said there is nothing abnormal or wrong about lawyers representing clients with different views than their own, adding, "It has nothing to do with one's political views" (AP/Boston Globe, 8/18).
Senate Letters
In related news, Thompson while serving as a senator had two letters to respond to people who wrote to him about abortion -- one labeled "pro abortion" and the other labeled "con abortion," the AP/WKRN reports. The letters, dated 1995 and obtained at the University of Tennessee, both call abortion a "subject on which many people have strong and deeply held personal convictions" and say that Thompson generally believed "government should not interfere with individual convictions and actions in this area."
The letter to abortion-rights opponents contains a statement not in the other letter that Thompson voted for an amendment banning federal funding of abortions except in cases of rape, incest or when a pregnant woman's life is in jeopardy. The letter to abortion-rights supporters says that Thompson did not believe health care workers should have to perform abortions "against their personal convictions" and that he opposed "the use of taxpayer funds to promote or perform abortions" (Mansfield, AP/WKRN, 8/18).
"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.
вторник, 22 мая 2012 г.
Blogs Comment On Global HIV Policy, N.J. Family Planning Bill, Other Topics
The following summarizes selected women's health-related blog entries.
~ "Why Are We Still Funding Abstinence-Only Programming?" Mary Beth Hastings, RH Reality Check: Despite a pledge by the Obama administration that "science will finally trump ideology when it comes to global AIDS prevention," the White House "called for proposals to implement ["Abstain and Be Faithful"]-only programs in Nigeria for youth and couples," Hastings writes. The so-called AB-only programs do not offer information about male and female condoms to young people or couples, instead offering that information to high-risk groups, including commercial sex workers, men who have sex with men, and truck drivers, according to Hastings. "Here's the thing that U.S. decisionmakers still don't seem to get: giving condoms to truck drivers and AB messages to 'regular' couples is not comprehensive prevention," she writes, adding, "Marketing female condoms to sex workers while young people can't get access to them is the same rights-violating, health-endangering idiocy that has been failing for the past decade." During the recently concluded XVIII International AIDS Conference, many advocates were "talking and protesting about funding, demanding world leaders not to let up on funding the global AIDS response," Hastings continues. "We're taking it a step further and asking that world leaders fund programs that work -- because especially in this context, it is criminal for the U.S. to fund anything but the best in HIV prevention," she concludes (Hastings, RH Reality Check, 7/23).
~ "Why is Washington State Flip-Flopping on Pharmacy Refusal?" Amie Newman, RH Reality Check: Women's health and rights advocates in Washington state "are in a state of confused uproar" after the Board of Pharmacy "[s]uddenly and without warning" proposed a change to a 2007 rule that "required pharmacies to fill all prescriptions regardless of a pharmacist's personal objection to a patient or a particular medication," including contraception, Newman writes. The "unexpected switchback" comes as advocates for the original rule were preparing to fight a lawsuit brought by two pharmacist "who claimed the rule infringed on their first amendment rights," she continues, adding that the lawsuit "has been stayed, meaning the proceedings are suspended, much to the dismay of women's rights advocates." The changed rule will "allow pharmacists the right to 'facilitated referral' rather than mandate they fill prescriptions on site," which means that patients "can now be denied their medication at the whim of an individual pharmacists or pharmacy and be forced to go somewhere else," according to Newman. She writes that the issue "sits squarely in the laps of the Board of Pharmacy who has, without rhyme or reason, re-written the rule mid-game." The public should "decide whether a person's right to access their legal medication at any pharmacy is paramount," Newman writes, concluding, "Whether this is the case or not remains to be seen" (Newman, RH Reality Check, 7/23).
~ "New Jersey Gov. Christie Vetoes Funding for Crucial Family Planning Services," Feminists for Choice: New Jersey Gov. Chris Christie's (R) recent veto of a bill (S 2139) that would have restored $7.5 million in state funding for family planning centers was "a result of naive short-term economic thinking," the blog states. Christie explained that his veto was based on "his priority ... to cut spending and decrease the burden on New Jersey taxpayers," the blog adds. However, "the cost of not having comprehensive reproductive health care services significantly increases the financial burden on both the state and the citizens of New Jersey," the blog continues. "To little surprise, Gov. Christie is only thinking about short-term cost without taking into consideration the long-term benefits that family planning services provide the state and local communities." According to the blog, "Despite Gov. Christie's 'assurance' that this veto is based primarily on budgetary concerns, the New Jersey Right to Life, along with several anti-choice Republicans in the Assembly and Senate, are using this veto as momentum to fuel their ideological battle against reproductive health care." The blog's author writes, "If I had it my way, our tax dollars wouldn't be spent on bankrupt anti-choice abstinence only programs ... [or] a variety of other useless right-wing ideological agendas," adding, "Family planning ... has sustainable economic benefits on top of the social advantages provided through reproductive health care services" (Feminists for Choice, 7/24).
~ "An Update on Missouri ... The Good, the Bad, the Ugly," Pamela Merritt, RH Reality Check: "With the 2010 Abortion Restriction Law (SB 793), Missouri adds more restrictions on access to abortion to the more than 30 restrictions already on the books," making abortion "the most regulated medical procedure in Missouri," Merritt writes. The law "forces women to receive state-mandated materials that contain ideological messages aimed at causing emotional distress" and statements that "are not widely agreed-upon by physicians and are not medically accurate," she writes. However, the state Legislature also provided "an example of how state government should work when prevention legislation became law with the passage of HB 1375," which promotes education and treatment of human papillomavirus, she writes. Missouri legislators have shown that they "can do the right thing for Missourians and support legislation that promotes reproductive health care," but the "question remains whether Missouri legislators will do the right thing in 2011" (Merritt, RH Reality Check, 7/27).
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.
вторник, 15 мая 2012 г.
Obama's Economic Stimulus Plan Includes Medicaid Family Planning Provision
As President Obama's $825 billion stimulus package heads to the floor of the House of Representatives this week, some Republican lawmakers are criticizing parts of the plan, the New York Times reports (Otterman, New York Times, 1/26). House Minority Leader John Boehner (R-Ohio) specifically expressed concerns with a provision to allow states to expand Medicaid coverage of family planning services, the San Francisco Chronicle reports.
Immediately following Obama's meeting with Congress, Boehner said, "How can you spend hundreds of millions of dollars on contraceptives? How does that stimulate the economy?" House Speaker Nancy Pelosi (D-Calif.) defended the spending on family planning services, saying that such initiatives would "reduce cost" and that states are "in a terrible fiscal budget crisis right now...and what we do for children's health, education and some of those elements, are to help the states meet their financial needs" (Coile, San Francisco Chronicle, 1/26).
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.
Immediately following Obama's meeting with Congress, Boehner said, "How can you spend hundreds of millions of dollars on contraceptives? How does that stimulate the economy?" House Speaker Nancy Pelosi (D-Calif.) defended the spending on family planning services, saying that such initiatives would "reduce cost" and that states are "in a terrible fiscal budget crisis right now...and what we do for children's health, education and some of those elements, are to help the states meet their financial needs" (Coile, San Francisco Chronicle, 1/26).
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.
вторник, 8 мая 2012 г.
Cognitive Behavioral Therapy For Sexual Dysfunctions In Women
Drs. Moniek ter Kuile, Stephanie Both, and Jacques van Lankveld have authored a superb review of cognitive behavioral therapy for sexual dysfunctions in women that is highly recommended for providers who treat IC/BPS and its often-associated symptoms of sexual dysfunction. The review suggests to me that our literature in this regard is sorely lacking, and that our knowledge of definitions of this problem is every bit as important as definitions of IC/BPS itself if we are to make progress in treatment.
Dyspareunia is defined in DSM-IV-TR as recurrent genital pain associated with sexual intercourse that causes distress and interpersonal problems. There would seem to be a symptom of dyspareunia as well as a disorder. The disorder should not be diagnosed if it is caused exclusively by vaginismus, lack of lubrication, or a medical condition. Dyspareunia is typically described as either superficial or deep. The latter is almost always somatic. Provoked vestibulodynia disorder (PVD) was previously referred to as vulvar vestibulitis syndrome and is the most frequent type of superficial dyspareunia in premenopausal women. It is a burning or pain localized strictly to the vestibule of the vulva and provoked by pressure or friction. The presence or absence of inflammation in the vestibule is debated. Generalized vulvodynia is rare and is diagnosed when the pain is located on the whole vulva. It is a chronic pain problem rather than a sexual problem. There is a wide range of prevalence estimates for dyspareunia going up to one-third of younger women and 45% of older women.
The cognitive behavioral therapy (CBT) model is a circular one. It is assumed that pain during penetration or catastrophic memories of that pain lead to fear of pain and hypervigilance in new sexual situations. Fear of penetration results in decreased sexual arousal as well as vaginal dryness and/or increased pelvic floor muscle tone. A vicious cycle results.
CBT is often delivered in a group format with 8-10 weekly sessions encompassed by education and information about 1)vestibulodynia and dyspareunia, 2) a multifactorial view of pain, and 3) sexual anatomy. Instruction is given in progressive muscle relaxation, abdominal breathing, Kegel exercises, vaginal dilatation, distraction techniques focusing on sexual imagery, rehearsal of coping self-statements, communication skills training, and cognitive restructuring.
EMG and biofeedback training (behavioral modification), CBT, pharmacological therapy, and surgery all have similar efficacy. Effect sizes are modest. The authors conclude noting that painless intercourse may not be a realistic therapeutic goal for many women. Nevertheless, it would seem that these techniques may benefit a subset of IC/BPS women, and referral for sexual therapy is not an unreasonable approach in conjunction with treatment of the primary disorder.
ter Kuile MM, Both S, van Lankveld JJ
Psychiatr Clin North Am. 2010 Sep;33(3):595-610.
doi: 10.1016/j.psc.2010.04.010
UroToday Contributing Editor Philip M. Hanno, MD, MPH
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2010 - UroToday
Dyspareunia is defined in DSM-IV-TR as recurrent genital pain associated with sexual intercourse that causes distress and interpersonal problems. There would seem to be a symptom of dyspareunia as well as a disorder. The disorder should not be diagnosed if it is caused exclusively by vaginismus, lack of lubrication, or a medical condition. Dyspareunia is typically described as either superficial or deep. The latter is almost always somatic. Provoked vestibulodynia disorder (PVD) was previously referred to as vulvar vestibulitis syndrome and is the most frequent type of superficial dyspareunia in premenopausal women. It is a burning or pain localized strictly to the vestibule of the vulva and provoked by pressure or friction. The presence or absence of inflammation in the vestibule is debated. Generalized vulvodynia is rare and is diagnosed when the pain is located on the whole vulva. It is a chronic pain problem rather than a sexual problem. There is a wide range of prevalence estimates for dyspareunia going up to one-third of younger women and 45% of older women.
The cognitive behavioral therapy (CBT) model is a circular one. It is assumed that pain during penetration or catastrophic memories of that pain lead to fear of pain and hypervigilance in new sexual situations. Fear of penetration results in decreased sexual arousal as well as vaginal dryness and/or increased pelvic floor muscle tone. A vicious cycle results.
CBT is often delivered in a group format with 8-10 weekly sessions encompassed by education and information about 1)vestibulodynia and dyspareunia, 2) a multifactorial view of pain, and 3) sexual anatomy. Instruction is given in progressive muscle relaxation, abdominal breathing, Kegel exercises, vaginal dilatation, distraction techniques focusing on sexual imagery, rehearsal of coping self-statements, communication skills training, and cognitive restructuring.
EMG and biofeedback training (behavioral modification), CBT, pharmacological therapy, and surgery all have similar efficacy. Effect sizes are modest. The authors conclude noting that painless intercourse may not be a realistic therapeutic goal for many women. Nevertheless, it would seem that these techniques may benefit a subset of IC/BPS women, and referral for sexual therapy is not an unreasonable approach in conjunction with treatment of the primary disorder.
ter Kuile MM, Both S, van Lankveld JJ
Psychiatr Clin North Am. 2010 Sep;33(3):595-610.
doi: 10.1016/j.psc.2010.04.010
UroToday Contributing Editor Philip M. Hanno, MD, MPH
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2010 - UroToday
вторник, 1 мая 2012 г.
Kansas Judge Dismisses Charges Filed By AG Kline Against Physician Tiller For Allegedly Performing Illegal Late-Term Abortions
Sedgwick County, Kan., District Judge Paul Clark on Wednesday ruled against reinstating criminal charges filed last month by state Attorney General Phill Kline (R) against physician George Tiller for allegedly performing illegal late-term abortions on women, the AP/Washington Post reports. Kline filed 30 misdemeanor charges against Tiller -- who owns the Wichita, Kan.-based abortion clinic Women's Health Care Services -- for allegedly performing 15 illegal late-term abortions in 2003 on patients ages 10 to 22 without properly reporting the details to the state (Hanna, AP/Washington Post, 12/28/06). Kline asked Clark to reconsider his ruling, and, after reviewing the arguments again, the judge announced at a hearing Wednesday that he is upholding his previous decision, the Los Angeles Times reports (Simon, Los Angeles Times, 12/28/06).
Reaction
State Attorney General-elect Paul Morrison (D), who defeated Kline in the November 2006 election, after the hearing Wednesday in a statement said he would review the evidence thoroughly, adding, "Kansans expect more from their attorney general than grandstanding and political stunts." He also said he plans to "refocus the vast resources of the attorney general's office" (Los Angeles Times, 12/28/06). Morrison would not rule out assigning a special prosecutor to the case, but he said that if he did the person "certainly" would not be McKinney, who Kline recently appointed to the case. "He is extraordinarily political and, in my opinion, would absolutely not present any kind of independent perspective," Morrison said (AP/USA Today, 12/28/06). McKinney declined to respond to Morrison's comments but said that the state has enacted laws to "protect babies that are about to be born" and that "those laws need to be enforced and not winked at" (Hanna, AP/International Herald Tribune, 12/28/06). Sedgwick County District Attorney Nola Foulston (D) has asked Kline to give her office his evidence against Tiller so that she can decide whether to file charges, but Kline has said repeatedly that he intends to continue the investigation from the attorney general's office. "The investigation ... is ongoing," Kline said Wednesday (Los Angeles Times, 12/28/06). Meanwhile, Kansas Gov. Kathleen Sebelius (D) on Thursday criticized Kline for his actions against Tiller, the AP/Wichita Eagle reports. "It is not appropriate, to me, to have an attorney general who isn't following Kansas law," Sebelius said (Hanna, AP/Wichita Eagle, 12/29/06).
"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.
вторник, 24 апреля 2012 г.
Actress Gloria Reuben Returns To NBC's 'ER,' Portrays HIV-Positive Woman
Actress Gloria Reuben, who played an HIV-positive woman on NBC's television drama "ER" and left the show in 2000, on Thursday rejoined the cast for a "one-time appearance," the Los Angeles Times reports.
Reuben before leaving the show played a physician's assistant named Jeanie Boulet who contracted HIV from her husband after he had sex with another woman. The character represented the first time a prime-time series showed an HIV-positive woman continuing "with her life and career despite the stigma surrounding the virus," according to the Times (Braxton, Los Angeles Times, 1/2). When Reuben left the show, she and the producers decided to avoid sending a negative message about HIV/AIDS by not having the character die, according to the Pittsburgh Post-Gazette (Owen, Pittsburgh Post-Gazette, 1/3). In Thursday's episode, Boulet is directing two HIV/AIDS clinics and sends her son to the emergency department at the fictional hospital where the show is set after he is injured in a gym class.
According to the Times, since Reuben's departure from the program, she has begun working as an advocate for HIV/AIDS. She has spoken during World AIDS Day and this year produced a program, "Positive Voices: Women and HIV," for Showtime, on which she interviews women living with or affected by the virus. In addition, she has co-starred in an HBO film "Life Support," which featured Queen Latifah as an HIV-positive woman (Los Angeles Times, 1/2). According to the Post-Gazette, Reuben became an HIV/AIDS advocate after reading about high death rates among black women with HIV/AIDS (Pittsburgh Post-Gazette, 1/3).
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.
вторник, 17 апреля 2012 г.
Sexual Violence Aimed At Girls, Women In Swaziland Linked To High HIV/AIDS Risk, Other Health Issues, Report Says
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вторник, 10 апреля 2012 г.
Pelvic Disorders Affect Large Number Of Women
Nearly one-quarter of all women suffer from pelvic-floor disorders, such as incontinence, at some point in their lives, a national study, including researchers from UT Southwestern Medical Center, has found.
The study of nearly 2,000 women in seven U.S. cities found that 23.7 percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.
"This study is the first nationwide study to confirm what we consider a high prevalence of pelvic-floor disorders in the U.S.," said Dr. Joseph Schaffer, professor of obstetrics and gynecology at UT Southwestern and an author of the study, which appears in today's issue of the Journal of the American Medical Association.
"Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent," he said.
The national rate of pelvic-floor disorders has not been well-studied, although several regional studies have found that almost 10 percent of women go through surgery for such conditions at some point in their lives, while one-third of those women have two or more surgeries.
The current study was designed to assess the national rate of such disorders. The participating women were interviewed in 2005 and 2006 at their homes or at a mobile interview center and did not undergo physical examination. The questions were part of the National Health and Nutrition Examination Survey.
For the current study, the researchers focused on three conditions: urinary incontinence, fecal incontinence and symptomatic pelvic organ prolapse, which occurs when women can feel or see an organ dropping or bulging in the vaginal area. This can indicate a dropping of the uterus, bladder or rectum as supporting structures weaken.
The researchers interviewed 1,961 nonpregnant women older than 20. Overall, 15.7 percent of women experienced urinary incontinence; 9 percent experienced fecal incontinence; and 2.9 percent reported symptomatic pelvic organ prolapse. In all, 23.7 percent reported one or more conditions.
The rates of the conditions went up substantially with the number of childbirths and with age. They were also were higher among the poor or less educated. Obesity also increased the risk. Race or ethnicity had no effect on the conditions.
"Physicians with expertise in caring for pelvic-floor disorders offer a variety of nonsurgical and surgical treatments that can significantly improve the quality of life for patients with these problems," Dr. Schaffer said. "Patients with pelvic-floor disorders should be encouraged to seek care from health care providers, particularly those with expertise in pelvic-floor medicine and surgery."
The study was funded by the National Institutes of Health.
The research was conducted by the Pelvic Floor Disorders Network, which, in addition to UT Southwestern, includes study authors from the NIH, University of Utah School of Medicine, Cleveland Clinic, University of Alabama at Birmingham, Loyola University Stritch School of Medicine, University of Michigan School of Public Health, University of North Carolina School of Medicine and Duke University School of Medicine.
Dr. Schaffer has reported receiving research support from Cook Medical Inc. and speaking fees from Astellas/GlaxoSmithKline.
Visit utsouthwestern/obgyn to learn more about UT Southwestern's clinical services in obstetrics and gynocology.
Dr. Joseph Schaffer -- utsouthwestern.edu/findfac/professional/0,2356,22212,00.html
UT Southwestern Medical Center
5323 Harry Hines Blvd.
Dallas, TX 75390-9060
United States
utsouthwestern.edu
The study of nearly 2,000 women in seven U.S. cities found that 23.7 percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.
"This study is the first nationwide study to confirm what we consider a high prevalence of pelvic-floor disorders in the U.S.," said Dr. Joseph Schaffer, professor of obstetrics and gynecology at UT Southwestern and an author of the study, which appears in today's issue of the Journal of the American Medical Association.
"Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent," he said.
The national rate of pelvic-floor disorders has not been well-studied, although several regional studies have found that almost 10 percent of women go through surgery for such conditions at some point in their lives, while one-third of those women have two or more surgeries.
The current study was designed to assess the national rate of such disorders. The participating women were interviewed in 2005 and 2006 at their homes or at a mobile interview center and did not undergo physical examination. The questions were part of the National Health and Nutrition Examination Survey.
For the current study, the researchers focused on three conditions: urinary incontinence, fecal incontinence and symptomatic pelvic organ prolapse, which occurs when women can feel or see an organ dropping or bulging in the vaginal area. This can indicate a dropping of the uterus, bladder or rectum as supporting structures weaken.
The researchers interviewed 1,961 nonpregnant women older than 20. Overall, 15.7 percent of women experienced urinary incontinence; 9 percent experienced fecal incontinence; and 2.9 percent reported symptomatic pelvic organ prolapse. In all, 23.7 percent reported one or more conditions.
The rates of the conditions went up substantially with the number of childbirths and with age. They were also were higher among the poor or less educated. Obesity also increased the risk. Race or ethnicity had no effect on the conditions.
"Physicians with expertise in caring for pelvic-floor disorders offer a variety of nonsurgical and surgical treatments that can significantly improve the quality of life for patients with these problems," Dr. Schaffer said. "Patients with pelvic-floor disorders should be encouraged to seek care from health care providers, particularly those with expertise in pelvic-floor medicine and surgery."
The study was funded by the National Institutes of Health.
The research was conducted by the Pelvic Floor Disorders Network, which, in addition to UT Southwestern, includes study authors from the NIH, University of Utah School of Medicine, Cleveland Clinic, University of Alabama at Birmingham, Loyola University Stritch School of Medicine, University of Michigan School of Public Health, University of North Carolina School of Medicine and Duke University School of Medicine.
Dr. Schaffer has reported receiving research support from Cook Medical Inc. and speaking fees from Astellas/GlaxoSmithKline.
Visit utsouthwestern/obgyn to learn more about UT Southwestern's clinical services in obstetrics and gynocology.
Dr. Joseph Schaffer -- utsouthwestern.edu/findfac/professional/0,2356,22212,00.html
UT Southwestern Medical Center
5323 Harry Hines Blvd.
Dallas, TX 75390-9060
United States
utsouthwestern.edu
вторник, 3 апреля 2012 г.
Having Synchronous Cancers Means Better Survival Outcome
New research published in this month's edition of Obstetrics & Gynecology (Vol. 113, Issue 4), by a team of investigators from The Cancer Institute of New Jersey (CINJ) shows better survival outcomes for women who have cancer of the ovaries and endometrial lining of the uterus at the same time (synchronous) than those who only have one tumor in the ovaries. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.
The study, Synchronous Primary Ovarian and Endometrial Cancers: A Population-Based Assessment of Survival, utilized a massive data set from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program, which collects and compiles information on cancer cases representing about one quarter of the U.S. population. Registries from New Jersey, Connecticut, Los Angeles and other large metropolitan areas were targeted, which yielded data on more than 85,000 women both those who were diagnosed with primary ovarian cancer and those with synchronous primary ovarian and endometrial cancers between 1973 and 2005.
While the definition for synchronous cancer can vary, the CINJ team utilized the SEER definition, which is one being diagnosed with endometrial or ovarian cancer within two months of the other. Researchers note this characterization should not be confused with the metastasis or spread of disease from one tumor site to another.
Once exclusion criteria were applied, results were based on 55,348 single ovarian cases and 1,355 synchronous ovarian and endometrial cancer cases. Among women with synchronous cancers, 70 percent had endometrial tumors diagnosed at a localized stage and 75 percent were in an earlier stage of disease. A previous study has shown that 75 percent of endometrial cancers are detected in earlier, treatable stages. Authors of this study conclude synchronous cases may have a lead-time advantage over single ovarian tumors due to the presence of irregular bleeding, which prompts earlier examination and treatment.
According to the American Cancer Society, 40,000 new cases of endometrial cancer were diagnosed in the United States last year, with 7,400 deaths, while there were more than 22,000 new cases of ovarian cancer and more than 15,000 deaths. Having both cancers diagnosed within a short time of one another is relatively uncommon.
Melony G. Williams, MPH, who is a research training specialist and project coordinator at CINJ and UMDNJ-Robert Wood Johnson Medical School, and a doctoral student at UMDNJ-School of Public Health, is the lead author on the paper. She notes, "While synchronous cancers are rare, their identification and optimal clinical management are key in the battle to reduce ovarian cancer deaths. The development of a national registry to document these cases and the means to collect and review such data would help to achieve this goal."
According to Williams, other factors that may affect survival such as family history, income, education, health insurance, recurrences and co-morbidities were not included, because they were not available in the SEER database, but that future studies should aim to address these issues.
Along with Williams, the author team consists of Elisa V. Bandera, MD, PhD, epidemiologist at CINJ and assistant professor of epidemiology at UMDNJ-Robert Wood Johnson Medical School and the UMDNJ-School of Public Health; Kitaw Demissie, MD, PhD, MPH, co-program leader of CINJ's Population Science Program and associate professor of epidemiology at UMDNJ-School of Public Health; and Lorna Rodriguez, MD, PhD, chief of gynecologic oncology at CINJ and professor of gynecologic oncology at UMDNJ-Robert Wood Johnson Medical School.
About The Cancer Institute of New Jersey
The Cancer Institute of New Jersey (cinj) is the state's first and only National Cancer Institute-designated Comprehensive Cancer Center, and is dedicated to improving the prevention, detection, treatment and care of patients with cancer. CINJ's physician-scientists engage in translational research, transforming their laboratory discoveries into clinical practice, quite literally bringing research to life. The Cancer Institute of New Jersey is a center of excellence of UMDNJ-Robert Wood Johnson Medical School.
The Cancer Institute of New Jersey Network is comprised of hospitals throughout the state and provides a mechanism to rapidly disseminate important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. Major Clinical Research Affiliate Hospitals: Carol G. Simon Cancer Center at Morristown Memorial Hospital, Carol G. Simon Cancer Center at Overlook Hospital, and Jersey Shore University Medical Center. Affiliate Hospitals: Bayshore Community Hospital, CentraState Healthcare System, Cooper University Hospital, JFK Medical Center, Raritan Bay Medical Center, Robert Wood Johnson University Hospital at Hamilton (CINJ at Hamilton), Saint Peter's University Hospital, Somerset Medical Center, Southern Ocean County Hospital, The University Hospital/UMDNJ-New Jersey Medical School, and University Medical Center at Princeton.
Cancer Institute of New Jersey
195 Little Albany St.
New Brunswick
NJ 08903-2681
United States
cinj
The study, Synchronous Primary Ovarian and Endometrial Cancers: A Population-Based Assessment of Survival, utilized a massive data set from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program, which collects and compiles information on cancer cases representing about one quarter of the U.S. population. Registries from New Jersey, Connecticut, Los Angeles and other large metropolitan areas were targeted, which yielded data on more than 85,000 women both those who were diagnosed with primary ovarian cancer and those with synchronous primary ovarian and endometrial cancers between 1973 and 2005.
While the definition for synchronous cancer can vary, the CINJ team utilized the SEER definition, which is one being diagnosed with endometrial or ovarian cancer within two months of the other. Researchers note this characterization should not be confused with the metastasis or spread of disease from one tumor site to another.
Once exclusion criteria were applied, results were based on 55,348 single ovarian cases and 1,355 synchronous ovarian and endometrial cancer cases. Among women with synchronous cancers, 70 percent had endometrial tumors diagnosed at a localized stage and 75 percent were in an earlier stage of disease. A previous study has shown that 75 percent of endometrial cancers are detected in earlier, treatable stages. Authors of this study conclude synchronous cases may have a lead-time advantage over single ovarian tumors due to the presence of irregular bleeding, which prompts earlier examination and treatment.
According to the American Cancer Society, 40,000 new cases of endometrial cancer were diagnosed in the United States last year, with 7,400 deaths, while there were more than 22,000 new cases of ovarian cancer and more than 15,000 deaths. Having both cancers diagnosed within a short time of one another is relatively uncommon.
Melony G. Williams, MPH, who is a research training specialist and project coordinator at CINJ and UMDNJ-Robert Wood Johnson Medical School, and a doctoral student at UMDNJ-School of Public Health, is the lead author on the paper. She notes, "While synchronous cancers are rare, their identification and optimal clinical management are key in the battle to reduce ovarian cancer deaths. The development of a national registry to document these cases and the means to collect and review such data would help to achieve this goal."
According to Williams, other factors that may affect survival such as family history, income, education, health insurance, recurrences and co-morbidities were not included, because they were not available in the SEER database, but that future studies should aim to address these issues.
Along with Williams, the author team consists of Elisa V. Bandera, MD, PhD, epidemiologist at CINJ and assistant professor of epidemiology at UMDNJ-Robert Wood Johnson Medical School and the UMDNJ-School of Public Health; Kitaw Demissie, MD, PhD, MPH, co-program leader of CINJ's Population Science Program and associate professor of epidemiology at UMDNJ-School of Public Health; and Lorna Rodriguez, MD, PhD, chief of gynecologic oncology at CINJ and professor of gynecologic oncology at UMDNJ-Robert Wood Johnson Medical School.
About The Cancer Institute of New Jersey
The Cancer Institute of New Jersey (cinj) is the state's first and only National Cancer Institute-designated Comprehensive Cancer Center, and is dedicated to improving the prevention, detection, treatment and care of patients with cancer. CINJ's physician-scientists engage in translational research, transforming their laboratory discoveries into clinical practice, quite literally bringing research to life. The Cancer Institute of New Jersey is a center of excellence of UMDNJ-Robert Wood Johnson Medical School.
The Cancer Institute of New Jersey Network is comprised of hospitals throughout the state and provides a mechanism to rapidly disseminate important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. Major Clinical Research Affiliate Hospitals: Carol G. Simon Cancer Center at Morristown Memorial Hospital, Carol G. Simon Cancer Center at Overlook Hospital, and Jersey Shore University Medical Center. Affiliate Hospitals: Bayshore Community Hospital, CentraState Healthcare System, Cooper University Hospital, JFK Medical Center, Raritan Bay Medical Center, Robert Wood Johnson University Hospital at Hamilton (CINJ at Hamilton), Saint Peter's University Hospital, Somerset Medical Center, Southern Ocean County Hospital, The University Hospital/UMDNJ-New Jersey Medical School, and University Medical Center at Princeton.
Cancer Institute of New Jersey
195 Little Albany St.
New Brunswick
NJ 08903-2681
United States
cinj
вторник, 27 марта 2012 г.
NASA Funded Study Finds Exercise Could Help Women On Bed Rest
Short but intense
sessions of exercise may help women on bed rest stay strong and recuperate
more quickly, according to a NASA funded study by researchers at Ball State
University, Muncie, Ind. The findings of the first comprehensive bed rest
study focusing exclusively on women will help NASA develop more effective
countermeasures to mitigate strength and muscle loss in female astronauts
on long-duration missions to the International Space Station and, perhaps,
someday to Mars.
It also may have implications for women on Earth confined to bed rest
because of illness, injury or pregnancy.
"With NASA astronaut Peggy Whitson commanding the International Space
Station now and astronaut Pam Melroy commanding the last space shuttle
mission, we're reminded daily that women make up an important segment of
our astronaut corps and are taking on more and more leadership roles," said
Carl Walz, a former long-duration astronaut and head of NASA's advanced
capabilities division in the agency's Exploration Systems Mission
Directorate, Washington. "It's important that we look at how space travel
-- microgravity, radiation, and other factors -- affects women and men
differently."
Ball State's Human Performance Lab has been working with NASA for more
than a decade to examine the impact spaceflight has on humans, according to
Scott Trappe, the lab's director. He co-authored the study with fellow lab
researcher Todd Trappe, his brother.
"Until we completed this study, we had no solid research on how women
would adapt to long durations in space," Trappe said. "This information
should have a dramatic impact for NASA in the coming years."
Conducted in Toulouse, France, the study was sponsored jointly by the
European Space Agency, the Canadian Space Agency, the French space agency
CNES, and NASA. Results were published recently in the Journal of Applied
Physiology and Acta Physiologica.
The study examined 24 female participants to determine whether specific
exercise regimens or nutritional supplements could prevent the loss of
lower body muscle mass and strength.
The women spent 60 days on bed rest. They lay with their heads pointing
downward at a 6-degree angle, which researchers believe most accurately
simulates the weightless conditions of space. One group was put on an
exercise regimen. A second group was put on a high-protein diet rich with
leucine, an amino acid. The control group did not take part in any exercise
or dietary protocols.
"When we looked at these women after two months, the difference in the
physical condition among the three groups was undeniable," Trappe said.
"The women who did not exercise lost nearly half their strength in some
cases. What's more, the group who ate a high-protein diet but did not
exercise lost even more muscle mass than the control group."
The exercise regimen included a 40 to 50 minute aerobic workout two or
three times a week and 20-minute strength training sessions two or three
days a week. While lying on their backs, the women did multiple sets of
thigh and calf exercises using a flywheel device similar to a typical leg
press machine at a gym. They also worked out on a vertical treadmill.
"The message for women and their doctors is that it really took very
little exercise to make an impact," said Trappe. "The total time spent
exercising was less than two percent of the time they spent in bed during
the entire 60-day period. In the end, a little bit of intense exercise goes
a long way."
Using a magnetic resonance imaging device, or MRI, researchers measured
muscle mass in all of the study subjects after the 60-day period. They
found that women in the control group lost 21 percent of the muscle mass in
their quadriceps, and the nutrition group lost more than 24 percent, but
the exercise group lost none. Results were similar for MRI scans of the
calf muscle.
The loss of muscle strength was even more significant. Researchers
tested strength using the flywheel device. Women who did not exercise
during the study lost as much as 33 percent of their strength in squat
exercises and 46 percent in calf press exercises. But the women who
exercised maintained their strength.
NASA's Human Research Program is working to understand the health
effects of spaceflight on astronauts in preparation for long-duration
missions. "It could take six months to reach the surface of Mars, and we
have to make sure our astronauts are healthy when they get there," Walz
said.
NASA
nasa
sessions of exercise may help women on bed rest stay strong and recuperate
more quickly, according to a NASA funded study by researchers at Ball State
University, Muncie, Ind. The findings of the first comprehensive bed rest
study focusing exclusively on women will help NASA develop more effective
countermeasures to mitigate strength and muscle loss in female astronauts
on long-duration missions to the International Space Station and, perhaps,
someday to Mars.
It also may have implications for women on Earth confined to bed rest
because of illness, injury or pregnancy.
"With NASA astronaut Peggy Whitson commanding the International Space
Station now and astronaut Pam Melroy commanding the last space shuttle
mission, we're reminded daily that women make up an important segment of
our astronaut corps and are taking on more and more leadership roles," said
Carl Walz, a former long-duration astronaut and head of NASA's advanced
capabilities division in the agency's Exploration Systems Mission
Directorate, Washington. "It's important that we look at how space travel
-- microgravity, radiation, and other factors -- affects women and men
differently."
Ball State's Human Performance Lab has been working with NASA for more
than a decade to examine the impact spaceflight has on humans, according to
Scott Trappe, the lab's director. He co-authored the study with fellow lab
researcher Todd Trappe, his brother.
"Until we completed this study, we had no solid research on how women
would adapt to long durations in space," Trappe said. "This information
should have a dramatic impact for NASA in the coming years."
Conducted in Toulouse, France, the study was sponsored jointly by the
European Space Agency, the Canadian Space Agency, the French space agency
CNES, and NASA. Results were published recently in the Journal of Applied
Physiology and Acta Physiologica.
The study examined 24 female participants to determine whether specific
exercise regimens or nutritional supplements could prevent the loss of
lower body muscle mass and strength.
The women spent 60 days on bed rest. They lay with their heads pointing
downward at a 6-degree angle, which researchers believe most accurately
simulates the weightless conditions of space. One group was put on an
exercise regimen. A second group was put on a high-protein diet rich with
leucine, an amino acid. The control group did not take part in any exercise
or dietary protocols.
"When we looked at these women after two months, the difference in the
physical condition among the three groups was undeniable," Trappe said.
"The women who did not exercise lost nearly half their strength in some
cases. What's more, the group who ate a high-protein diet but did not
exercise lost even more muscle mass than the control group."
The exercise regimen included a 40 to 50 minute aerobic workout two or
three times a week and 20-minute strength training sessions two or three
days a week. While lying on their backs, the women did multiple sets of
thigh and calf exercises using a flywheel device similar to a typical leg
press machine at a gym. They also worked out on a vertical treadmill.
"The message for women and their doctors is that it really took very
little exercise to make an impact," said Trappe. "The total time spent
exercising was less than two percent of the time they spent in bed during
the entire 60-day period. In the end, a little bit of intense exercise goes
a long way."
Using a magnetic resonance imaging device, or MRI, researchers measured
muscle mass in all of the study subjects after the 60-day period. They
found that women in the control group lost 21 percent of the muscle mass in
their quadriceps, and the nutrition group lost more than 24 percent, but
the exercise group lost none. Results were similar for MRI scans of the
calf muscle.
The loss of muscle strength was even more significant. Researchers
tested strength using the flywheel device. Women who did not exercise
during the study lost as much as 33 percent of their strength in squat
exercises and 46 percent in calf press exercises. But the women who
exercised maintained their strength.
NASA's Human Research Program is working to understand the health
effects of spaceflight on astronauts in preparation for long-duration
missions. "It could take six months to reach the surface of Mars, and we
have to make sure our astronauts are healthy when they get there," Walz
said.
NASA
nasa
вторник, 20 марта 2012 г.
Obesity In Girls Triggered By Stress Hormone, Depression
Depression raises stress hormone levels in adolescent boys and girls but may lead to obesity only in girls, according to researchers. Early treatment of depression could help reduce stress and control obesity - a major health issue.
"This is the first time cortisol reactivity has been identified as a mediator between depressed mood and obesity in girls," said Elizabeth J. Susman, the Jean Phillips Shibley professor of biobehavioral health at Penn State. "We really haven't seen this connection in kids before, but it tells us that there are biological risk factors that are similar for obesity and depression."
Cortisol, a hormone, regulates various metabolic functions in the body and is released as a reaction to stress. Researchers have long known that depression and cortisol are related to obesity, but they had not figured out the exact biological mechanism.
Although it is not clear why high cortisol reactions translate into obesity only for girls, scientists believe it may be due to physiological and behavioral differences -- estrogen release and stress eating in girls -- in the way the two genders cope with anxiety.
"The implications are to start treating depression early because we know that depression, cortisol and obesity are related in adults," said Susman.
If depression were to be treated earlier, she noted, it could help reduce the level of cortisol, and thereby help reduce obesity.
"We know stress is a critical factor in many mental and physical health problems," said Susman. "We are putting together the biology of stress, emotions and a clinical disorder to better understand a major public health problem."
Susman and her colleagues Lorah D. Dorn, professor of pediatrics, Cincinnati Children's Hospital Medical Center, and Samantha Dockray, postdoctoral fellow, University College London, used a child behavior checklist to assess 111 boys and girls ages 8 to 13 for symptoms of depression. Next they measured the children's obesity and the level of cortisol in their saliva before and after various stress tests.
"We had the children tell a story, make up a story, and do a mental arithmetic test," said Susman. "The children were also told that judges would evaluate the test results with those of other children."
Statistical analyses of the data suggest that depression is associated with spikes in cortisol levels for boys and girls after the stress tests, but higher cortisol reactions to stress are associated with obesity only in girls. The team reported its findings in a recent issue of the Journal of Adolescent Health.
"In these children, it was mainly the peak in cortisol that was related to obesity," Susman explained. "It was how they reacted to an immediate stress."
The National Institutes of Health supported this work.
Source:
Amitabh Avasthi
Penn State
"This is the first time cortisol reactivity has been identified as a mediator between depressed mood and obesity in girls," said Elizabeth J. Susman, the Jean Phillips Shibley professor of biobehavioral health at Penn State. "We really haven't seen this connection in kids before, but it tells us that there are biological risk factors that are similar for obesity and depression."
Cortisol, a hormone, regulates various metabolic functions in the body and is released as a reaction to stress. Researchers have long known that depression and cortisol are related to obesity, but they had not figured out the exact biological mechanism.
Although it is not clear why high cortisol reactions translate into obesity only for girls, scientists believe it may be due to physiological and behavioral differences -- estrogen release and stress eating in girls -- in the way the two genders cope with anxiety.
"The implications are to start treating depression early because we know that depression, cortisol and obesity are related in adults," said Susman.
If depression were to be treated earlier, she noted, it could help reduce the level of cortisol, and thereby help reduce obesity.
"We know stress is a critical factor in many mental and physical health problems," said Susman. "We are putting together the biology of stress, emotions and a clinical disorder to better understand a major public health problem."
Susman and her colleagues Lorah D. Dorn, professor of pediatrics, Cincinnati Children's Hospital Medical Center, and Samantha Dockray, postdoctoral fellow, University College London, used a child behavior checklist to assess 111 boys and girls ages 8 to 13 for symptoms of depression. Next they measured the children's obesity and the level of cortisol in their saliva before and after various stress tests.
"We had the children tell a story, make up a story, and do a mental arithmetic test," said Susman. "The children were also told that judges would evaluate the test results with those of other children."
Statistical analyses of the data suggest that depression is associated with spikes in cortisol levels for boys and girls after the stress tests, but higher cortisol reactions to stress are associated with obesity only in girls. The team reported its findings in a recent issue of the Journal of Adolescent Health.
"In these children, it was mainly the peak in cortisol that was related to obesity," Susman explained. "It was how they reacted to an immediate stress."
The National Institutes of Health supported this work.
Source:
Amitabh Avasthi
Penn State
вторник, 13 марта 2012 г.
Managing Early-Onset Menopause
Menopause, which marks the end of a woman's reproductive years, usually occurs around age 50 or 51. But for various reasons, some women experience early menopause. Early menopause can be an emotional blow and can increase the risk of health problems, including osteoporosis and cardiovascular disease.
The February issue of Mayo Clinic Women's HealthSource describes types of early menopause.
Premature menopause: Though there is some debate over the age of onset that defines it, premature menopause is often defined as menopause before age 40. There are no more menstrual periods, no ovarian function, and pregnancy is no longer possible.
Premature ovarian failure: This is similar to premature menopause, but women can have intermittent, unpredictable ovarian function for years, may occasionally release an egg (ovulate) and, rarely, can become pregnant. About 1 percent of American women experience premature ovarian failure; the average age of onset is 27 years.
Treatment-induced menopause: Certain surgical or medical treatments can cause early-onset menopause, including ovary removal, chemotherapy or radiation therapy.
The standard treatment for early-onset menopause is hormone therapy until you reach the average menopausal age. And that raises questions about the risks of hormone therapy. The results of the Women's Health Initiative trial, a study suggesting risks related to hormone therapy, don't apply in the same way to women with premature menopause or premature ovarian failure.
Early menopause, whatever the cause, is quite different from the average menopause experience. And each woman's experience differs. A knowledgeable, experienced doctor with expertise in reproductive hormone disorders is critical to helping you work out the best way to stay healthy during early-onset menopause.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
mayoclinic/
The February issue of Mayo Clinic Women's HealthSource describes types of early menopause.
Premature menopause: Though there is some debate over the age of onset that defines it, premature menopause is often defined as menopause before age 40. There are no more menstrual periods, no ovarian function, and pregnancy is no longer possible.
Premature ovarian failure: This is similar to premature menopause, but women can have intermittent, unpredictable ovarian function for years, may occasionally release an egg (ovulate) and, rarely, can become pregnant. About 1 percent of American women experience premature ovarian failure; the average age of onset is 27 years.
Treatment-induced menopause: Certain surgical or medical treatments can cause early-onset menopause, including ovary removal, chemotherapy or radiation therapy.
The standard treatment for early-onset menopause is hormone therapy until you reach the average menopausal age. And that raises questions about the risks of hormone therapy. The results of the Women's Health Initiative trial, a study suggesting risks related to hormone therapy, don't apply in the same way to women with premature menopause or premature ovarian failure.
Early menopause, whatever the cause, is quite different from the average menopause experience. And each woman's experience differs. A knowledgeable, experienced doctor with expertise in reproductive hormone disorders is critical to helping you work out the best way to stay healthy during early-onset menopause.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
mayoclinic/
вторник, 6 марта 2012 г.
Statement Of Secretary Kathleen Sebelius On Women's Health Week, May 9 - 16, 2010
This is National Women's Health Week, an annual, week-long observance that reminds women to make their personal health a priority. But until this year, millions of women have found it difficult to follow through on that advice, because a broken health insurance system limited their access to medical care.
This past March, when President Obama signed the Patient Protection and Affordable Care Act, we took an historic step to fix our broken health care system, which far too often has charged women more for less than adequate insurance and unstable coverage.
In 45 states across the U.S., when a woman tried to buy health insurance through the individual insurance market, companies could legally charge women higher premiums, exclude benefits like breast cancer treatment, and reject your application if you were a victim of domestic violence. The vast majority of individual policies did not cover maternity care.
Under the Affordable Care Act, all of that will change. The new law will make landmark improvements to women's health security, banning insurance companies from discriminating based on gender, expanding coverage to people with pre-existing conditions, offering free coverage for preventive services, helping pregnant women and new mothers get the care they need, and prohibiting insurers from dropping women's coverage if they get sick.
For too many years, American women have been paying the price for a broken health care system that was not set up to help them. Thanks to the Affordable Care Act, Women's Health Week 2010 can be a true celebration of a healthier future for the women of America, and a new opportunity for all Americans to live longer, happier, and healthier lives.
Source
HHS
This past March, when President Obama signed the Patient Protection and Affordable Care Act, we took an historic step to fix our broken health care system, which far too often has charged women more for less than adequate insurance and unstable coverage.
In 45 states across the U.S., when a woman tried to buy health insurance through the individual insurance market, companies could legally charge women higher premiums, exclude benefits like breast cancer treatment, and reject your application if you were a victim of domestic violence. The vast majority of individual policies did not cover maternity care.
Under the Affordable Care Act, all of that will change. The new law will make landmark improvements to women's health security, banning insurance companies from discriminating based on gender, expanding coverage to people with pre-existing conditions, offering free coverage for preventive services, helping pregnant women and new mothers get the care they need, and prohibiting insurers from dropping women's coverage if they get sick.
For too many years, American women have been paying the price for a broken health care system that was not set up to help them. Thanks to the Affordable Care Act, Women's Health Week 2010 can be a true celebration of a healthier future for the women of America, and a new opportunity for all Americans to live longer, happier, and healthier lives.
Source
HHS
вторник, 28 февраля 2012 г.
Age Is An Independent Risk Factor In Young Women With Breast Cancer
Nice, France, Thursday 23 March 2006 - A 30 year old woman diagnosed with breast cancer has the same chance of survival as a 60 year old woman with breast cancer according to the latest findings presented today at the European Breast Cancer Conference (EBCC-5).
Scientists have known for a while that young women with breast cancer have a poor prognosis. It was thought to be because younger women were diagnosed later, with more advanced disease. The study set out to see if youth on its own was a factor for poor prognosis.
Researchers analysed the American SEER (Surveillance, Epidemiology, and End Results) database of over 45,000 women with breast cancer. All women with early stage breast cancer (stage 1) were included in the study and the various age groups were compared. The results were surprising and indicated that being young was an independent indicator of poor survival - regardless of other factors known to be predictive of outcomes in older women such as tumour size, location, hormone receptor status, race, or treatment.
In fact the odds of dying from breast cancer rather than any other disease increased by 5% for every year that a women was under 45 when diagnosed. For example, a women who was diagnosed with breast cancer at age 35 was 50% more likely to die of the disease. The 10-year overall survival probability of a 30-year old patient (85%) was equal to that of a 60-year old, indicating a considerably reduced life expectancy in young patients.
S. Aebi, leading author of the study comments, "These findings suggest that age in young women, more than any other factor affects the chances of survival. It is very important now to carry on more research and analyse what makes the tumours in young women different - what causes these women to die."
Breast cancer in the under 40's is rare, making up around 5% of all cases. However the impact of the disease can be hard for young women, who often have young children or want to start a family of their own. Improving survival rates would make a big difference to these women.
SOURCE: toniclc
Scientists have known for a while that young women with breast cancer have a poor prognosis. It was thought to be because younger women were diagnosed later, with more advanced disease. The study set out to see if youth on its own was a factor for poor prognosis.
Researchers analysed the American SEER (Surveillance, Epidemiology, and End Results) database of over 45,000 women with breast cancer. All women with early stage breast cancer (stage 1) were included in the study and the various age groups were compared. The results were surprising and indicated that being young was an independent indicator of poor survival - regardless of other factors known to be predictive of outcomes in older women such as tumour size, location, hormone receptor status, race, or treatment.
In fact the odds of dying from breast cancer rather than any other disease increased by 5% for every year that a women was under 45 when diagnosed. For example, a women who was diagnosed with breast cancer at age 35 was 50% more likely to die of the disease. The 10-year overall survival probability of a 30-year old patient (85%) was equal to that of a 60-year old, indicating a considerably reduced life expectancy in young patients.
S. Aebi, leading author of the study comments, "These findings suggest that age in young women, more than any other factor affects the chances of survival. It is very important now to carry on more research and analyse what makes the tumours in young women different - what causes these women to die."
Breast cancer in the under 40's is rare, making up around 5% of all cases. However the impact of the disease can be hard for young women, who often have young children or want to start a family of their own. Improving survival rates would make a big difference to these women.
SOURCE: toniclc
вторник, 21 февраля 2012 г.
Maternal Mortality In Calif. Up Nearly Threefold Over Last Decade, State Data Show
California's maternal mortality rate has nearly tripled during the past decade, according to an unreleased report from the state Department of Public Health, the Sacramento Bee reports. California Watch, a project of the Center for Investigative Reporting, conducted the investigation into the state's pregnancy-related deaths. The report "shows the most significant spike in pregnancy-related deaths since the 1930s," according to the Bee. The Bee notes that pregnancy remains safe for the vast majority of women in California, with 95 deaths in the state out of more than 500,000 live births in 2006. However, if California had met goals set by HHS, the number of deaths would have been around 28.
In 1996, California's pregnancy-related mortality rate was 5.6 maternal deaths per 100,000 live births, slightly more than the national goal of 4.3 per 100,000 live births After the World Health Organization revised its coding system, California's rate increased to 6.7 in 1998 and 7.7 in 1999. According to the Bee, WHO's coding-system change might have contributed to the rise in deaths in the late 1990s.
Reasons for Increase Disputed
California changed its coding system once more in 2003, and the maternal mortality rate rose to 14.6 maternal deaths per 100,000 live births. In 2006, California's rate reached 16.9, compared with the national average of 13.3. Investigators estimate that reporting system changes account for less than 30% of the increase in maternal mortality rates.
California might be mirroring the rest of the country with its rise in pregnancy-related deaths, according to a recent "Sentinel Event Alert" from the Joint Commission, a hospital accreditation organization. On Jan. 26, the commission sent the alert to hospitals to inform them that maternal mortality rates appear to be increasing nationwide. The Joint Commission suggested that diabetes, high blood pressure, hemorrhaging from caesarean sections and obesity could account for some of the increase in maternal mortality rates.
The Centers for Disease Control and Prevention reported a national rise in maternal mortality in 2007. Jeffrey King, head of an inquiry into maternal mortality for the American Congress of Obstetricians and Gynecologists, and some other experts attribute the change to more accurate recordkeeping.
Elliott Main, principal investigator for California's report, said the rise cannot be fully explained by population changes, such as fertility treatments, obesity and older mothers. "What I call the usual suspects are certainly there," Main said, adding, "However, when we looked at those factors and the data analyzed so far, those only account for a modest amount of the increase." Main noted that c-sections also increased by 50% during the same decade that pregnancy-related deaths went up. Currently, c-sections are the most common surgical procedure in the U.S.
In response to the rise in maternal mortality, California officials are starting work on pilot programs designed to improve hospital responses to hemorrhages, reduce the incidence of induced births and strengthen tracking systems for women's medical conditions (Johnson, Sacramento Bee, 2/3).
Broadcast Coverage
On Wednesday, KQED's "The California Report" included a segment on the rise in maternal mortality (Montgomery, "The California Report," KQED, 2/3).
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.
вторник, 14 февраля 2012 г.
New Proteomic Method To Detect Inflammation In Amniotic Fluid
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New proteomic method to detect inflammation in amniotic fluid
A score that measures the proteomic profile of amniotic fluid may predict inflammation before delivery. Researchers from Yale University, led by Catalin Buhimschi, have previously identified a set of four protein markers that were closely associated with inflammation in the amniotic fluid, and developed a score based on these proteins ?the "Mass Restricted" (MR) score. This score has been shown to be able to identify women at risk of preterm delivery. In the current study, the researchers assessed whether MR scores were associated with the outcome of pregnancy; the presence of infection in the placenta, and severe infection in the newborn baby.
169 women recruited into the study had a sample of amniotic fluid taken as part of their routine clinical management from which the protein MR score was calculated, and evidence of bacterial infection was sought. These results were then related to length of time until delivery, presence of placental inflammation after birth, and whether there was evidence of infection in the babies. In line with findings from their previous studies, women with a higher MR score gave birth sooner. There was also agreement between the MR score and evidence of inflammation in the placenta, and mothers with a high MR score were more likely to give birth to babies with suspected or confirmed sepsis.
In this group of women, the MR score seemed to be the most accurate in predicting inflammation when compared with other tests for inflammation such as white cell count, and may therefore provide a useful test for recognizing women at risk of preterm delivery and babies at risk of poor outcome. However, although promising, a further evaluation of the test in different populations will be needed before it could become a standard procedure in the clinic.
Citation: Buhimschi CS, Bhandari V, Hamar BD, Bahtiyar MO, Zhao G, et al. (2007) Proteomic profiling of the amniotic fluid to detect inflammation, infection, and neonatal sepsis. PLoS Med 4(1): e18.
About the PUBLIC LIBRARY OF SCIENCE
PLoS is a nonprofit organization of scientists whose aim is to make the world's scientific and medical research literature a public resource. We are funded by a grant from the Gordon and Betty Moore Foundation to develop a publishing program based on the Open Access business model, whereby the costs of publication are paid upfront so that anyone with an internet connection can have access to the content, in a free and unrestricted manner. Our immediate goal is to launch two top-tier journals - PLoS Biology (in October, 2003) and PLoS Medicine (in 2004).
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New proteomic method to detect inflammation in amniotic fluid
A score that measures the proteomic profile of amniotic fluid may predict inflammation before delivery. Researchers from Yale University, led by Catalin Buhimschi, have previously identified a set of four protein markers that were closely associated with inflammation in the amniotic fluid, and developed a score based on these proteins ?the "Mass Restricted" (MR) score. This score has been shown to be able to identify women at risk of preterm delivery. In the current study, the researchers assessed whether MR scores were associated with the outcome of pregnancy; the presence of infection in the placenta, and severe infection in the newborn baby.
169 women recruited into the study had a sample of amniotic fluid taken as part of their routine clinical management from which the protein MR score was calculated, and evidence of bacterial infection was sought. These results were then related to length of time until delivery, presence of placental inflammation after birth, and whether there was evidence of infection in the babies. In line with findings from their previous studies, women with a higher MR score gave birth sooner. There was also agreement between the MR score and evidence of inflammation in the placenta, and mothers with a high MR score were more likely to give birth to babies with suspected or confirmed sepsis.
In this group of women, the MR score seemed to be the most accurate in predicting inflammation when compared with other tests for inflammation such as white cell count, and may therefore provide a useful test for recognizing women at risk of preterm delivery and babies at risk of poor outcome. However, although promising, a further evaluation of the test in different populations will be needed before it could become a standard procedure in the clinic.
Citation: Buhimschi CS, Bhandari V, Hamar BD, Bahtiyar MO, Zhao G, et al. (2007) Proteomic profiling of the amniotic fluid to detect inflammation, infection, and neonatal sepsis. PLoS Med 4(1): e18.
About the PUBLIC LIBRARY OF SCIENCE
PLoS is a nonprofit organization of scientists whose aim is to make the world's scientific and medical research literature a public resource. We are funded by a grant from the Gordon and Betty Moore Foundation to develop a publishing program based on the Open Access business model, whereby the costs of publication are paid upfront so that anyone with an internet connection can have access to the content, in a free and unrestricted manner. Our immediate goal is to launch two top-tier journals - PLoS Biology (in October, 2003) and PLoS Medicine (in 2004).
PUBLIC LIBRARY OF SCIENCE
European Bioinformatics Institute
Wellcome Trust Genome Campus
CB10 1DS
plos
вторник, 7 февраля 2012 г.
Test To Predict Early Menopause Getting Closer
A test to predict when a woman will enter the menopause has come nearer the grasp of scientists from the University of Exeter Peninsula Medical School, England, and the Institute of Cancer, also in England, according to an article published in the scientific peer-reviewed journal Human Molecular Genetics. Being able to know when her reproductive years will end would have a huge impact on a woman's family planning, the researchers say, especially as the current trend is towards having children later on in life.
This research forms part of the Breakthrough Generations Study, a study involving 100,000 UK females aimed at investigating the causes of breast cancer. Over the coming four decades it hopes to determine what genetic, lifestyle and environmental factors influence breast cancer occurrence.
The scientists tested four genes known to be linked to the menopause. 2,000 females from the Breakthrough Generations Study who had entered menopause early were compared to another 2,000 of the same age and ethnicity who had not experienced early menopause (matched group).
The researchers found that the four genes all affected early menopause in their own ways, and much more so when they were all present. They added that their findings help explain why some females go into menopause early.
Women who enter the menopause early have a higher risk of developing cardiovascular disease, infertility and osteoporosis, and a lower risk of getting breast cancer.
Dr Anna Murray, study leader, said:
It is estimated that a woman's ability to conceive decreases on average ten years before she starts the menopause. Therefore, those who are destined to have an early menopause and delay childbearing until their 30s are more likely to have problems conceiving.
These findings are the first stage in developing an easy and relatively inexpensive genetic test which could help the one in 20 UK women who may be affected by early menopause.
"Breakthrough Generations Study" principal researcher, Prof. Anthony Swerdlow, said:
We have made a valuable step towards helping women across the country identify and predict whether they are at risk of early menopause. This may in turn allow them to make informed decisions about their future fertility.
We could not have made these findings without the 100,000 women who are participating in the Breakthrough Generations Study. We hope that many more medical advances will be made over the next 40 years as a consequence of the study.
The authors concluded:
Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM (early menopause) in an independent cohort from the BGS (Breakthrough Generations Study). The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.
"Breakthrough Generations Study"
"Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study"
Anna Murray, Claire E. Bennett, John R.B. Perry, Michael N. Weedon, Patricia A. Jacobs, Danielle H. Morris, Nicholas Orr, Minouk J. Schoemaker, Michael Jones, Alan Ashworth4 and Anthony J. Swerdlow
Hum. Mol. Genet. (2010) doi: 10.1093/hmg/ddq417 First published online: October 17, 2010
Sources: Institute of Cancer Research, University of Exeter
This research forms part of the Breakthrough Generations Study, a study involving 100,000 UK females aimed at investigating the causes of breast cancer. Over the coming four decades it hopes to determine what genetic, lifestyle and environmental factors influence breast cancer occurrence.
The scientists tested four genes known to be linked to the menopause. 2,000 females from the Breakthrough Generations Study who had entered menopause early were compared to another 2,000 of the same age and ethnicity who had not experienced early menopause (matched group).
The researchers found that the four genes all affected early menopause in their own ways, and much more so when they were all present. They added that their findings help explain why some females go into menopause early.
Women who enter the menopause early have a higher risk of developing cardiovascular disease, infertility and osteoporosis, and a lower risk of getting breast cancer.
Dr Anna Murray, study leader, said:
It is estimated that a woman's ability to conceive decreases on average ten years before she starts the menopause. Therefore, those who are destined to have an early menopause and delay childbearing until their 30s are more likely to have problems conceiving.
These findings are the first stage in developing an easy and relatively inexpensive genetic test which could help the one in 20 UK women who may be affected by early menopause.
"Breakthrough Generations Study" principal researcher, Prof. Anthony Swerdlow, said:
We have made a valuable step towards helping women across the country identify and predict whether they are at risk of early menopause. This may in turn allow them to make informed decisions about their future fertility.
We could not have made these findings without the 100,000 women who are participating in the Breakthrough Generations Study. We hope that many more medical advances will be made over the next 40 years as a consequence of the study.
The authors concluded:
Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM (early menopause) in an independent cohort from the BGS (Breakthrough Generations Study). The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.
"Breakthrough Generations Study"
"Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study"
Anna Murray, Claire E. Bennett, John R.B. Perry, Michael N. Weedon, Patricia A. Jacobs, Danielle H. Morris, Nicholas Orr, Minouk J. Schoemaker, Michael Jones, Alan Ashworth4 and Anthony J. Swerdlow
Hum. Mol. Genet. (2010) doi: 10.1093/hmg/ddq417 First published online: October 17, 2010
Sources: Institute of Cancer Research, University of Exeter
вторник, 31 января 2012 г.
Women And Recovery From Alcoholism
PhD candidate Ms Janice Withnall, from the UWS School of Education, is carrying out the project in a bid to better understand the experiences of women who have successfully stopped drinking.
National statistics show that alcohol-related illness hospitalises 95,000 Australians a year. Of that group, 7 per cent are women who are alcohol dependent.
However, Ms Withnall says the numbers of midlife women aged 35 to 55 years who are living with the painful flow-on effects from their own alcohol misuse - like health problems, damage to self-esteem, and impact on career, business and family - is increasing. The figure may be as high as 13 per cent, according to the 2005 Australian Longitudinal Study of Womens Health and the Australian Bureau of Statistics health data.
"Women progress from alcohol use to alcoholism more rapidly than men in a process of acceleration known as 'telescoping.' Research has shown that alcoholism is becoming the third leading cause of death in women aged 35 to 55," Ms Withnall says.
"There is little research internationally that specifically looks at midlife women and their experiences with alcohol, the negative impact it can have on their lives, families and communities. Likewise, little is understood of midlife women in sober recovery in Australia."
While we don't know all the reasons why these women appear to be more at risk compared to other age groups, there are some clues, according to Ms Withnall.
"This group of women is what we call the 'sandwich generation' - they face different pressures from different directions. These are women who may have childcare responsibilities, or look after elderly parents, on top of also experiencing their own relationship and career pressures," she says.
"We hope to shed more light on the recovery issue, increase our knowledge, and improve care and support for Australian women to achieve long and satisfying lives."
Professionals who focus on alcohol and drug harm and have helped women to maintain sobriety are also being asked to take part in the study, which will be in the form of a survey and interviews.
The study is designed to preserve anonymity and confidentiality, and has been approved by the UWS Ethics Committee.
Contact: Lyn Danninger
Research Australia
National statistics show that alcohol-related illness hospitalises 95,000 Australians a year. Of that group, 7 per cent are women who are alcohol dependent.
However, Ms Withnall says the numbers of midlife women aged 35 to 55 years who are living with the painful flow-on effects from their own alcohol misuse - like health problems, damage to self-esteem, and impact on career, business and family - is increasing. The figure may be as high as 13 per cent, according to the 2005 Australian Longitudinal Study of Womens Health and the Australian Bureau of Statistics health data.
"Women progress from alcohol use to alcoholism more rapidly than men in a process of acceleration known as 'telescoping.' Research has shown that alcoholism is becoming the third leading cause of death in women aged 35 to 55," Ms Withnall says.
"There is little research internationally that specifically looks at midlife women and their experiences with alcohol, the negative impact it can have on their lives, families and communities. Likewise, little is understood of midlife women in sober recovery in Australia."
While we don't know all the reasons why these women appear to be more at risk compared to other age groups, there are some clues, according to Ms Withnall.
"This group of women is what we call the 'sandwich generation' - they face different pressures from different directions. These are women who may have childcare responsibilities, or look after elderly parents, on top of also experiencing their own relationship and career pressures," she says.
"We hope to shed more light on the recovery issue, increase our knowledge, and improve care and support for Australian women to achieve long and satisfying lives."
Professionals who focus on alcohol and drug harm and have helped women to maintain sobriety are also being asked to take part in the study, which will be in the form of a survey and interviews.
The study is designed to preserve anonymity and confidentiality, and has been approved by the UWS Ethics Committee.
Contact: Lyn Danninger
Research Australia
вторник, 24 января 2012 г.
US Commercial Genetic Testing Does Not Detect All Cancer-associated Mutations In Certain Genes
Despite a negative (normal) genetic test for mutations in the BRCA1 and BRCA2 genes, about 12 percent of breast cancer patients from high-risk families carried previously undetected cancer-associated mutations, according to a study in the March 22/29 issue of JAMA, a theme issue on women's health.
Co-author Mary-Claire King, Ph.D., of the University of Washington, Seattle, presented the findings of the study today at a JAMA media briefing on women's health in New York.
Inherited mutations in BRCA1 and BRCA2 predispose to high risks of breast and ovarian cancer. Lifetime risks of breast cancer are as high as 80 percent among U.S. women with mutations in these genes, according to background information in the article. Risks for young women with inherited BRCA1 or BRCA2 mutations are particularly increased. Among white women in the U.S., 5 percent to 10 percent of breast cancer cases are due to inherited mutations in BRCA1 and BRCA2. Inherited mutations in other genes, including CHEK2, TP53 and PTEN, can also influence risk of breast cancer.
Clinical options for women at high genetic risk of breast cancer include screening starting at a young age, the use of highly sensitive detection methods, and prophylactic surgeries of the ovaries or breast. Because prophylactic surgeries, while highly effective in reducing risk, are also highly invasive, it is particularly important to distinguish mutation carriers from noncarriers with similarly severe family histories. Women with BRCA1 or BRCA2 mutations are possible candidates for such surgeries. Genetic testing to identify harmful BRCA1 and BRCA2 mutations in as-yet unaffected women with severe family histories of breast or ovarian cancer has become an integral part of clinical practice in many communities. To provide accurate and complete information to high-risk patients, it is critical to understand the implications of a negative test result.
Dr. King and colleagues conducted a study to determine the frequency and types of undetected cancer-predisposing mutations in BRCA1, BRCA2, CHEK2, TP53, and PTEN among patients with breast cancer from high-risk families (4 or more cases of breast or ovarian cancer) with negative results from commercial genetic testing of BRCA1 and BRCA2. Between 2002-2005, the researchers evaluated DNA and RNA samples from 300 breast cancer probands (initial member of a family to come under study) and used multiple different screening approaches to identify mutations of all genomic classes in BRCA1, BRCA2, CHEK2, TP53, and PTEN.
The researchers found that of the 300 probands, 52 (17 percent) carried previously undetected mutations, including 35 (12 percent) with genomic rearrangements of BRCA1 or BRCA2, 14 (5 percent) with CHEK2 mutations, and 3 (1 percent) with TP53 mutations. No inherited mutations were detected in PTEN. At BRCA1 and BRCA2, 22 different genomic rearrangements were found. Of these, 14 were not previously described and all were individually rare. Inherited rearrangements of BRCA1 were more frequent among probands diagnosed when younger than 40 years (16 percent) than among probands diagnosed when 40 years or older (6.5 percent).
"Women at high risk and their clinicians want accurate assessment of genetic risk prior to embarking on ... invasive and expensive risk management options. Our results suggest that genetic testing, as currently carried out in the United States, does not provide all available information to women at risk. Our data indicate that 12 percent of those from high-risk families with breast cancer and with negative (wild-type) commercial genetic test results for BRCA1 and BRCA2 nonetheless carry cancer-predisposing genomic deletions or duplications in one of these genes," the authors write.
"The clinical dilemma is what to offer to women with a high probability of carrying a mutation in BRCA1 or BRCA2 but with negative commercial test results. Technically, the answer is at hand. The mutations identified in our study that were missed by commercial testing are detectable using other approaches that are currently available," the researchers write. They add that for families testing negative (wild type) for BRCA1 and BRCA2 by conventional sequencing, multiplex ligation-dependent probe amplification (MLPA - a molecular method to detect genetic variation) followed by sequence confirmation of breakpoints in patients' genomic DNA is the current best choice for evaluating the wide range of genomic rearrangements in BRCA1 and BRCA2. Clinical testing using MLPA is currently not available in the U.S.
"As more breast cancer susceptibility genes of different penetrances are identified, clinicians will be increasingly challenged to offer the most appropriate genetic tests, to assist patients in interpreting the results, and to optimize risk reduction strategies," the authors conclude. "Effective methods for identifying these mutations should be made available to women at high risk."
(JAMA. 2006;295:1379-1388. Available pre-embargo to the media at mailto:www.jamamedia)
Editor's Note: For funding/support information, please see the JAMA article.
Contact: Clare Hagerty
JAMA and Archives Journals
Co-author Mary-Claire King, Ph.D., of the University of Washington, Seattle, presented the findings of the study today at a JAMA media briefing on women's health in New York.
Inherited mutations in BRCA1 and BRCA2 predispose to high risks of breast and ovarian cancer. Lifetime risks of breast cancer are as high as 80 percent among U.S. women with mutations in these genes, according to background information in the article. Risks for young women with inherited BRCA1 or BRCA2 mutations are particularly increased. Among white women in the U.S., 5 percent to 10 percent of breast cancer cases are due to inherited mutations in BRCA1 and BRCA2. Inherited mutations in other genes, including CHEK2, TP53 and PTEN, can also influence risk of breast cancer.
Clinical options for women at high genetic risk of breast cancer include screening starting at a young age, the use of highly sensitive detection methods, and prophylactic surgeries of the ovaries or breast. Because prophylactic surgeries, while highly effective in reducing risk, are also highly invasive, it is particularly important to distinguish mutation carriers from noncarriers with similarly severe family histories. Women with BRCA1 or BRCA2 mutations are possible candidates for such surgeries. Genetic testing to identify harmful BRCA1 and BRCA2 mutations in as-yet unaffected women with severe family histories of breast or ovarian cancer has become an integral part of clinical practice in many communities. To provide accurate and complete information to high-risk patients, it is critical to understand the implications of a negative test result.
Dr. King and colleagues conducted a study to determine the frequency and types of undetected cancer-predisposing mutations in BRCA1, BRCA2, CHEK2, TP53, and PTEN among patients with breast cancer from high-risk families (4 or more cases of breast or ovarian cancer) with negative results from commercial genetic testing of BRCA1 and BRCA2. Between 2002-2005, the researchers evaluated DNA and RNA samples from 300 breast cancer probands (initial member of a family to come under study) and used multiple different screening approaches to identify mutations of all genomic classes in BRCA1, BRCA2, CHEK2, TP53, and PTEN.
The researchers found that of the 300 probands, 52 (17 percent) carried previously undetected mutations, including 35 (12 percent) with genomic rearrangements of BRCA1 or BRCA2, 14 (5 percent) with CHEK2 mutations, and 3 (1 percent) with TP53 mutations. No inherited mutations were detected in PTEN. At BRCA1 and BRCA2, 22 different genomic rearrangements were found. Of these, 14 were not previously described and all were individually rare. Inherited rearrangements of BRCA1 were more frequent among probands diagnosed when younger than 40 years (16 percent) than among probands diagnosed when 40 years or older (6.5 percent).
"Women at high risk and their clinicians want accurate assessment of genetic risk prior to embarking on ... invasive and expensive risk management options. Our results suggest that genetic testing, as currently carried out in the United States, does not provide all available information to women at risk. Our data indicate that 12 percent of those from high-risk families with breast cancer and with negative (wild-type) commercial genetic test results for BRCA1 and BRCA2 nonetheless carry cancer-predisposing genomic deletions or duplications in one of these genes," the authors write.
"The clinical dilemma is what to offer to women with a high probability of carrying a mutation in BRCA1 or BRCA2 but with negative commercial test results. Technically, the answer is at hand. The mutations identified in our study that were missed by commercial testing are detectable using other approaches that are currently available," the researchers write. They add that for families testing negative (wild type) for BRCA1 and BRCA2 by conventional sequencing, multiplex ligation-dependent probe amplification (MLPA - a molecular method to detect genetic variation) followed by sequence confirmation of breakpoints in patients' genomic DNA is the current best choice for evaluating the wide range of genomic rearrangements in BRCA1 and BRCA2. Clinical testing using MLPA is currently not available in the U.S.
"As more breast cancer susceptibility genes of different penetrances are identified, clinicians will be increasingly challenged to offer the most appropriate genetic tests, to assist patients in interpreting the results, and to optimize risk reduction strategies," the authors conclude. "Effective methods for identifying these mutations should be made available to women at high risk."
(JAMA. 2006;295:1379-1388. Available pre-embargo to the media at mailto:www.jamamedia)
Editor's Note: For funding/support information, please see the JAMA article.
Contact: Clare Hagerty
JAMA and Archives Journals
вторник, 17 января 2012 г.
Discovery Of Behavorial Link Between Insomnia And Tension-Type Headaches
Using sleep or napping to cope with chronic pain caused by tension-type headaches could lead to chronic insomnia according to a new study by researchers at Rush University Medical Center. The study, published in the February 15 issue of the Journal of Clinical Sleep Medicine, found that napping to relieve headache pain could serve as a behavioral link between headache and sleep disturbance.
The study compared a group of 32 women who were confirmed to have tension-type headaches, as classified by the International Headache Society System, to a control group of 33 women who experience minimal pain.
Eighty-one percent of the women in the headache group reported going to sleep as a way of managing their headaches; this method was also rated as the most effective self-management strategy for pain.
Principal investigator and lead author, Jason C. Ong, PhD, assistant professor of behavioral sciences at Rush University Medical Center, said the extent to which the headache sufferers rated sleep as being an effective method for coping with pain was somewhat surprising.
"Insomnia is a common complaint among headache sufferers. While napping may relieve pain, it may also decrease the brain's need for sleep at night, leading to reduced ability to initiate and maintain sleep at night," said Ong.
The study found 58 percent of those with tension-type headaches reported sleep problems as a trigger of headaches compared to 18 percent of those who only suffer minimal headache pain. Similar studies have found that sleep disturbances, which include difficulty falling asleep or staying asleep, have been identified as a risk factor for developing chronic headaches.
Women in the headache group also reported a significantly higher rating of pain interfering with sleep compared to the control group. No significant differences were found between the groups on use of medication to relieve headaches.
Ong encourages further behavioral treatment studies to examine alternative coping strategies for pain that do not involve sleep. He notes that clinicians should be sensitive to the dilemma of managing pain and sleep disturbances.
In addition, the study concludes that medical experts should assess daytime napping behaviors among individuals who report insomnia and headaches. Such an assessment may be important for developing behavioral sleep interventions.
The study involved 65 women recruited from undergraduate psychology courses at a university located in the southeastern U.S. The average age of members of the headache group was 21.9 years, while the average age of the control group was 18.9 years.
The average time since the first headache of any type was 9.4 years for participants in the headache group, with an average of 8.11 headache days per month. Participants reported an average of 12.2 tension-type headaches over the past year, and 2.1 tension-type headaches in the past month, with a median duration of 2.0 hours. The average tension-type headache intensity rating using a 0-to-10 scale was 5.6. Six participants in the headache group also met criteria for migraine disorder.
Founded in 1978, the Sleep Disorders Center at Rush was the first such center in Illinois and the first in the region to receive accreditation from the American Academy of Sleep Medicine (then the American Sleep Disorders Association). The staff of the Sleep Disorders Service and Research Center has established a national reputation for clinical excellence, for innovation in sleep medicine research and for providing superior training to the next generation of sleep professionals.
RushUniversity Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children's Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,730 students, is home to one of the first medical schools in the Midwest, and one of the nation's top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.
The Journal of Clinical Sleep Medicine (JCSM), is the official publication of the American Academy of Sleep Medicine (AASM). AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kim Waterman
Rush University Medical Center
The study compared a group of 32 women who were confirmed to have tension-type headaches, as classified by the International Headache Society System, to a control group of 33 women who experience minimal pain.
Eighty-one percent of the women in the headache group reported going to sleep as a way of managing their headaches; this method was also rated as the most effective self-management strategy for pain.
Principal investigator and lead author, Jason C. Ong, PhD, assistant professor of behavioral sciences at Rush University Medical Center, said the extent to which the headache sufferers rated sleep as being an effective method for coping with pain was somewhat surprising.
"Insomnia is a common complaint among headache sufferers. While napping may relieve pain, it may also decrease the brain's need for sleep at night, leading to reduced ability to initiate and maintain sleep at night," said Ong.
The study found 58 percent of those with tension-type headaches reported sleep problems as a trigger of headaches compared to 18 percent of those who only suffer minimal headache pain. Similar studies have found that sleep disturbances, which include difficulty falling asleep or staying asleep, have been identified as a risk factor for developing chronic headaches.
Women in the headache group also reported a significantly higher rating of pain interfering with sleep compared to the control group. No significant differences were found between the groups on use of medication to relieve headaches.
Ong encourages further behavioral treatment studies to examine alternative coping strategies for pain that do not involve sleep. He notes that clinicians should be sensitive to the dilemma of managing pain and sleep disturbances.
In addition, the study concludes that medical experts should assess daytime napping behaviors among individuals who report insomnia and headaches. Such an assessment may be important for developing behavioral sleep interventions.
The study involved 65 women recruited from undergraduate psychology courses at a university located in the southeastern U.S. The average age of members of the headache group was 21.9 years, while the average age of the control group was 18.9 years.
The average time since the first headache of any type was 9.4 years for participants in the headache group, with an average of 8.11 headache days per month. Participants reported an average of 12.2 tension-type headaches over the past year, and 2.1 tension-type headaches in the past month, with a median duration of 2.0 hours. The average tension-type headache intensity rating using a 0-to-10 scale was 5.6. Six participants in the headache group also met criteria for migraine disorder.
Founded in 1978, the Sleep Disorders Center at Rush was the first such center in Illinois and the first in the region to receive accreditation from the American Academy of Sleep Medicine (then the American Sleep Disorders Association). The staff of the Sleep Disorders Service and Research Center has established a national reputation for clinical excellence, for innovation in sleep medicine research and for providing superior training to the next generation of sleep professionals.
RushUniversity Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children's Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,730 students, is home to one of the first medical schools in the Midwest, and one of the nation's top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.
The Journal of Clinical Sleep Medicine (JCSM), is the official publication of the American Academy of Sleep Medicine (AASM). AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kim Waterman
Rush University Medical Center
вторник, 10 января 2012 г.
Women's Health Initiative Investigators' Letter To Editor Responds To Wall Street Journal Article On WHI Findings
A recent Wall Street Journal article about the findings of the five-year, $725 million NIH-sponsored Women's Health Initiative on the effects of hormone replacement therapy included some "misperceptions," Jacques Rossouw -- chief of the WHI branch at the National Heart, Lung and Blood Institute -- and Marcia Stefanick -- chair of the WHI executive committee and a professor at Stanford University -- write in a Journal letter to the editor (Rossouw/Stefanick, Wall Street Journal, 7/21).
WHI researchers in July 2002 ended the study on combination HRT three years early because they determined that the treatment might increase the risk for heart disease, invasive breast cancer and other health problems. According to the Journal article, in the five years since the study was released, many in the medical community have said "some aspects" of the initial findings "were either misleading" or "overgeneralized in large part because they excluded many of the study's own investigators and physicians from the first review" (Kaiser Daily Women's Health Policy Report, 7/9).
According to Rossouw and Stefanick, NIH and WHI researchers "are jointly responsible for all scientific articles arising from the study," and both "parties stand by the original findings and conclusions." The most recent analysis of data from the study, conducted earlier this year, "included some data not available" to researchers in 2002, Rossouw and Stefanick write. "The latest analyses add some further reassurance to women wishing to take hormone therapy in the short term for the relief of hot flashes and night sweats," Rossouw and Stefanick write, adding, "They don't provide evidence that even estrogen alone can help prevent heart attacks in the long term." Rossouw and Stefanick conclude that "more effective options" than HRT use are recommended to lower heart disease risk, "including adopting healthy lifestyles and identifying and treating risk factors, such as high blood cholesterol and high blood pressure" (Wall Street Journal, 7/21).
WHI researchers in July 2002 ended the study on combination HRT three years early because they determined that the treatment might increase the risk for heart disease, invasive breast cancer and other health problems. According to the Journal article, in the five years since the study was released, many in the medical community have said "some aspects" of the initial findings "were either misleading" or "overgeneralized in large part because they excluded many of the study's own investigators and physicians from the first review" (Kaiser Daily Women's Health Policy Report, 7/9).
According to Rossouw and Stefanick, NIH and WHI researchers "are jointly responsible for all scientific articles arising from the study," and both "parties stand by the original findings and conclusions." The most recent analysis of data from the study, conducted earlier this year, "included some data not available" to researchers in 2002, Rossouw and Stefanick write. "The latest analyses add some further reassurance to women wishing to take hormone therapy in the short term for the relief of hot flashes and night sweats," Rossouw and Stefanick write, adding, "They don't provide evidence that even estrogen alone can help prevent heart attacks in the long term." Rossouw and Stefanick conclude that "more effective options" than HRT use are recommended to lower heart disease risk, "including adopting healthy lifestyles and identifying and treating risk factors, such as high blood cholesterol and high blood pressure" (Wall Street Journal, 7/21).
Correction
The Journal on Saturday printed a correction that says the article on WHI "incorrectly sa[id] the WHI intended to address only whether the heart protection women get from taking hormones at a younger age continues with long-term use." According to the correction, WHI clinical trials were "designed to answer many questions" (Wall Street Journal, 7/21).
"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.
вторник, 3 января 2012 г.
World First Early Stage Diagnostic Test For Ovarian Cancer
There is new hope for women around the world, with the launch of an early detection test for ovarian cancer. The test, developed in Melbourne by HealthLinx scientists in collaboration with ARL Pathology, is called the OvPlex™ Panel and works by identifying whether five biomarkers (proteins) are present in a blood sample.
Two Victorian women have become the first test recipients.
Chairman of HealthLinx Limited (ASX-HTX), Professor Greg Rice, who helped develop the technology, said: "OvPlex™ is a new type of blood test. The difference between current blood tests and OvPlex™ is that OvPlex™ measures five different substances in blood that are associated with ovarian cancer and builds a diagnostic based on that information rather than relying on a single marker for the disease. This is really what I see as a new generation of diagnostics."
CEO of ARL Pathology, Pam Davey, said: "Women all around the world will benefit from this. This test has not been available. By putting the five biomarkers together, we really increase the chances of detecting ovarian cancer early."
1500 Australian women are diagnosed with ovarian cancer each year; 800 of those women will die.
Around the world, 230,000 new cases are diagnosed each year, with more than 142,000 women dying.
Professor Rice said: "The reason why it is the most lethal of the reproductive tract cancers is that 75 per cent of women with ovarian cancer are not diagnosed until late stage disease. Their chances of surviving five years are probably only 20 per cent. But if the disease is diagnosed at early stage, where it is contained within the ovary, the chance of surviving five years rises to eighty per cent.
"That is why it is so important to try and develop better tests for diagnosing ovarian cancer, particularly early stage disease. That is where we can really make a difference."
HealthLinx scientists stress this is not a general community screening test, rather a diagnostic test.
The test will be available through general practitioners in Melbourne from 29th October, before being rolled out to other states across Australia. It will cost around $200. Results are available within a fortnight.
About HealthLinx Limited (ASX:HTX)
HealthLinx uses biomarkers to develop best practice diagnostics that detect and monitor diseases. First commercial targets are:
- Ovarian cancer diagnostic (OvPlex) targeting US$270m pa market
- Prostate Cancer targeting US$350m pa market
A biomarker is a specific biochemical in the body that measures disease or the effects of treatment. HealthLinx targets important markets with unmet needs and is developing next generation high accuracy diagnostics and will seek to out-license to global partners for worldwide sales.
HealthLinx Limited
Source
Davinia Khong
Monsoon Communications
Level 1 350 Collins Street
Melbourne VIC 3000, Australia
monsoon.au
Two Victorian women have become the first test recipients.
Chairman of HealthLinx Limited (ASX-HTX), Professor Greg Rice, who helped develop the technology, said: "OvPlex™ is a new type of blood test. The difference between current blood tests and OvPlex™ is that OvPlex™ measures five different substances in blood that are associated with ovarian cancer and builds a diagnostic based on that information rather than relying on a single marker for the disease. This is really what I see as a new generation of diagnostics."
CEO of ARL Pathology, Pam Davey, said: "Women all around the world will benefit from this. This test has not been available. By putting the five biomarkers together, we really increase the chances of detecting ovarian cancer early."
1500 Australian women are diagnosed with ovarian cancer each year; 800 of those women will die.
Around the world, 230,000 new cases are diagnosed each year, with more than 142,000 women dying.
Professor Rice said: "The reason why it is the most lethal of the reproductive tract cancers is that 75 per cent of women with ovarian cancer are not diagnosed until late stage disease. Their chances of surviving five years are probably only 20 per cent. But if the disease is diagnosed at early stage, where it is contained within the ovary, the chance of surviving five years rises to eighty per cent.
"That is why it is so important to try and develop better tests for diagnosing ovarian cancer, particularly early stage disease. That is where we can really make a difference."
HealthLinx scientists stress this is not a general community screening test, rather a diagnostic test.
The test will be available through general practitioners in Melbourne from 29th October, before being rolled out to other states across Australia. It will cost around $200. Results are available within a fortnight.
About HealthLinx Limited (ASX:HTX)
HealthLinx uses biomarkers to develop best practice diagnostics that detect and monitor diseases. First commercial targets are:
- Ovarian cancer diagnostic (OvPlex) targeting US$270m pa market
- Prostate Cancer targeting US$350m pa market
A biomarker is a specific biochemical in the body that measures disease or the effects of treatment. HealthLinx targets important markets with unmet needs and is developing next generation high accuracy diagnostics and will seek to out-license to global partners for worldwide sales.
HealthLinx Limited
Source
Davinia Khong
Monsoon Communications
Level 1 350 Collins Street
Melbourne VIC 3000, Australia
monsoon.au
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