A minimally invasive procedure
called endometrial ablation is as effective as hysterectomy in solving a
common female complaint called "dysfunctional uterine bleeding" or DUB,
according to a new federally-funded study published in the Journal of
Obstetrics and Gynecology.
DUB (dysfunctional uterine bleeding) can be described as abnormal
bleeding which cannot be attributed to abnormalities of the female
reproductive system, pharmacological interaction, intrauterine
contraception, or bleeding disorders. It is also referred to
menometrorrhagia.
The condition affects up to a third of all women at some point during
their reproductive years, usually women over age 30. It is characterized by
extremely heavy, erratic menstrual bleeding and is often accompanied by
fatigue, pelvic pain and decreased quality of life. The excessive blood
loss in DUB can provoke iron deficiency anemia.
"This is a very important study, proving that a minimally invasive
procedure -- endometrial ablation -- can solve the problem of excessive
bleeding as well as hysterectomy," commented Franklin D. Loffer, M.D.,
Executive Vice President/Medical Director of AAGL, the professional
organization dedicated to the advancement of minimally-invasive gynecologic
surgery. "Women should always be offered the least invasive, effective
approach to solving her medical problems."
While hysterectomy (the removal of the uterus and in some cases the
ovaries and cervix) has a long history of use to cure DUB, newer, less
invasive procedures have become available in recent years. These have
stirred controversy over whether hysterectomy is overused, particularly for
conditions such as DUB for which more conservative approaches may be just
as effective and cause fewer complications.
The new study, bearing the acronym of StopDUB for "Surgical Treatments
Outcomes Project for Dysfunctional Uterine Bleeding," was a multi-center,
randomized, controlled trial in the U.S. and Canada involving 237 women at
25 treatment centers. The primary complaint causing women to seek surgery
was excessive bleeding that had not been mitigated by medical therapy.
These women were randomly assigned to receive either hysterectomy or
endometrial ablation, a minimally invasive technique that removes only the
lining of the uterus (the lining cells are responsible for the bleeding),
not the entire organ.
The primary measure of success in the study was women's satisfaction
with their treatment, rather than just a clinical endpoint. After three
years of follow-up, the vast majority of patients in both groups (93-95%)
reported that their problem was solved. The secondary endpoints of pain and
fatigue were also similar between the hysterectomy group and the
endometrial ablation group.
"Using women's satisfaction as the study goal, rather than clinical
endpoints alone, was very astute from our perspective, because the most
important outcome is the woman's opinion, not the doctor's," said Dr.
Loffer. "Our view at AAGL is always patient-focused: how much pain will
there be, how much trauma, how much time lost, what impact on the quality
of life? These are the measures that count."
Advantages of the less invasive procedure include shorter hospital
stays (hours instead of days), less blood loss, fewer complications and
quicker recovery. In many cases endometrial ablation causes menstrual
periods to become much lighter and more regular, rather than eliminating
them altogether. Many women consider this to be a satisfactory outcome and
would prefer to have normal periods rather than lose their uterus.
"Both endometrial ablation and hysterectomy are effective treatments in
women with dysfunctional uterine bleeding. However, hysterectomy was
associated with about four times more adverse events and six times as many
postoperative infections," said Malcolm Munro, MD, an investigator in the
StopDUB Research Group at the David Geffen School of Medicine, University
of California Los Angeles. Dr. Munro is also an advisor to the AAGL.
The American College of Obstetricians and Gynecologists (ACOG)
recommends that treatment for menorrhagia begin with the least invasive
therapy. But, for some women, endometrial ablation may not solve their
problem.
"In this study about two thirds of women were able to avoid
hysterectomy by having an endometrial ablation procedure while about a
third of the patients who had received endometrial ablation ended up having
a hysterectomy several years later. This rate is comparable to that seen in
other studies," said Munro.
About 600,000 hysterectomies are performed annually in the U.S., making
it the second most common major surgery performed on women of reproductive
age. There is controversy about how many of these hysterectomies are really
necessary. Clearly, 120,000 hysterectomies performed each year for DUB
(without uterine pathology) are amenable to endometrial ablation. Moreover,
many patients with uterine fibroids and abnormal bleeding can be treated
via endometrial ablation. Fibroids account for 40% of hysterectomies each
year.
While some doctors may look for anemia as a diagnostic indicator for
DUB, in the StopDUB study women's perception of their problem was the main
criterion, supported by clinical measures of excess duration, amount, or
unpredictability of flow. "We felt that women should not have to be anemic
in order to seek help and have their problem taken seriously," said Munro.
"Based on our results, it is reasonable to recommend that women should
select the type of surgery they want for DUB, based on their preferences
and situations," concluded Munro.
About AAGL
The AAGL is the first and largest organization in the world dedicated
to gynecologic endoscopic surgery. Founded in 1971, AAGL works to advance
the safest and most efficacious diagnostic and therapeutic techniques that
afford less invasive treatments for gynecologic conditions through the
integration of clinical practice, research, innovation, and dialogue. For
the past 36 years, the organization has educated the world's finest
surgeons while improving the lives of women everywhere. This global
commitment to women's health care is embodied in their continuing medical
education of physicians and professionals to further promote the
well-documented high standards of minimally invasive gynecologic surgery.
For more information visit aagl.
AAGL
aagl
четверг, 30 июня 2011 г.
среда, 29 июня 2011 г.
Blogs Comment On Plan B Court Decision, Mexican Abortion Law, Teen Pregnancy, Other Topics
The following summarizes selected women's health-related blog entries.
~ "Do the Right Thing: Make Emergency Contraception Accessible and Affordable," Sondra Goldschein/Vania Leveille, The Hill's Congress Blog: Although a federal judge this week ordered FDA to "do the right thing and revisit its politically motivated decision to unnecessarily restrict access to the emergency contraceptive Plan B," the ruling is "only the first step," Goldschein, director of state advocacy for the American Civil Liberties Union's Reproductive Freedom Project and Leveille, a legislative counsel for ACLU, write. "More work is needed to make sure that all women have true access to emergency contraception," they continue, noting that they "remain concerned about the high cost" of nonprescription EC. "Most state Medicaid plans ... currently don't cover Plan B, meaning that many low-income women who rely on Medicaid for their health care needs currently can't afford access," Goldschein and Leveille write, adding that "with the mounting cost of health care in general, coupled with our tough economic times, more and more women -- many of whom don't qualify for Medicaid -- will find it difficult if not impossible to cover the costs of Plan B when they need it." They conclude that the "court decision has given us the opportunity not only to put science and health care back into the FDA decision-making process, but to simultaneously reconsider ways to make Plan B accessible and affordable for all women who need it" (Goldschein/Leveille, The Hill's Congress Blog, 3/24).
~ "Ignoring Evidence, Mexican States Move to Increase Abortion Restrictions," Sharon Camp/Fatima Juarez, AlterNet: In Mexico, a "new spate of state-level laws further restrict[s] Mexican women's already limited access to legal abortion," Camp and Juarez of the Guttmacher Institute write in a blog entry. They continue, "Worse, there is evidence that women are being denied abortion care even when they meet the strict criteria for a legal procedure." The "trend" among Mexican states to "reinforce what are already strict restrictions on abortion access comes in reaction" to a 2007 policy legalizing the procedure during the first 12 weeks of pregnancy, which was recently upheld by Mexico's Supreme Court, Camp and Juarez write. The new policies "not only demonstrate a shocking lack of compassion, they also directly contradict strong evidence from Mexico and other parts of the world that restricting abortion access does not make abortion less common -- it just results in more women dying or being injured by clandestine and unsafe practices," Camp and Juarez continue. They add, "If Mexican policymakers are concerned about reducing the need for abortion and safeguarding women's health, they should heed the strong evidence and focus on policies that promote prevention" (Camp/Juarez, AlterNet, 3/24).
~ "Why Canada's on Top in Teen Pregnancy," Vanessa Richmond, Huffington Post blogs: Canada's policies regarding sex education and access to pregnancy prevention methods "might actually be beacons of sustainable light, not dull lead weights," Richmond writes. The U.S.' teen birth rate rose for the second year in a row from 41.9 births per 1,000 in 2006 to 42.5 in 2007, which is "not a huge jump, but it's still significant because until two years ago, it had declined every year for 14 years," Richmond writes. The U.S. has the highest observed juvenile birth rates among industrialized countries, almost twice the rate in Canada and 10 times higher than Japan and the Netherlands, according to a comparative study from Statistics Canada. Richmond writes that the "main reason" for this is that "Canada's teens of all social classes get comprehensive information about contraception and about how to avoid unwanted pregnancies." Teens in Canada "get more sex-ed in school, and can access high-school-based family planning counseling through the nurse," she continues, adding they can "also always access universally free medical services, including visiting a family doctor and special health clinics." In addition, "at all levels, there's a more positive attitude towards the pill, and either cheaper or free prescriptions for it," Richmond writes. In the U.S., the "role institutions can play is one of providing information about the pill and condoms, rather than telling kids they shouldn't have sex," Richmond writes, concluding, "When adults treat teens as intelligent beings capable of making informed decisions when armed with good information, then they do. That's backed not just by belief, but by actual numbers and science" (Richmond, Huffington Post blogs, 3/26).
~ "The Down and Dirty Politics of Sex," Lon Newman, Below the Waist: The Obama administration "will need to sideline a few of the professional wrestlers and sports announcers in the abortion-rights contest" to achieve a "solid" reproductive health care policy as part of larger health care reform efforts, Newman writes. The "ongoing face-off" over issues like abortion rights, access to contraception and sex education "provides a dramatized competition that does not reflect the real lives of Americans," Newman says. He continues, "In their personal choices, citizens have accepted and embraced the right to informed consent on reproductive health issues," and, "[i]n this case, public policy should reflect private behavior." Although Obama has "reached out to listen to fundamentalist members of Congress and to interest groups who disagree, most of the time he has tried to set policy based on practical scientific decision-making instead of partisan crowd noise," Newman writes. The administration and Congress "must continue on this course of providing leadership on the principle that reproductive health care policy will be based on two foundations of American democracy -- reason and science," he continues, concluding, "We must not be distracted from that principle by battles over who holds higher moral ground. Instead, we must keep our attention on developing reproductive health care policy that is down to earth" (Newman, Below the Waist, 3/24).
~ "Colorado House Passes Birth Control Bill," Wendy Norris, RH Reality Check: Norris reports that the Colorado House this week passed the Birth Control Protection Act (S.B. 225) "on a largely party-line roll call vote of 39 to 25," after efforts to block the measure "shriveled" and supporters squelched an attempt to "add a poison pill amendment to insert the religious definition of pregnancy as at the moment of conception." According to Norris, the Birth Control Protection Act "codifies 'contraception or a contraceptive device as a medically acceptable drug, device or procedure used to prevent pregnancy.'" The measure is an attempt by two Democratic state representatives to "thwart future legal or constitutional challenges similar to Amendment 48," a failed November 2008 ballot measure that "sought to grant constitutional rights to fertilized eggs," she says. "The lawmakers reasoned that having a clear-cut definition that complements state law defining pregnancy will eliminate a debate over whether contraception includes abortions," Norris explains. She writes that the bill was amended to exclude mifespristone "and other federally approved pharmaceuticals that induce abortion, from the proposed legal definition of contraception," which will likely result in Gov. Bill Ritter's (D) approval of the bill (Norris, RH Reality Check, 3/25).
~ "Pope Condom Quote Undermines Credibility," Wayne Besen, Huffington Post blogs: Besen, founder of Truth Wins Out, responds to Pope Benedict XVI's recent comments that the distribution of condoms will not help curb the spread of HIV in Africa. Besen asks, "How many people is this man willing to see die to defend his outdated dogma? How high must the body count be before the Pope is no longer considered pro-life?" He continues, "How ironic that a pope fixated on staunching the decline of the Catholic Church in Western Europe would declare something so out of touch with the modern world," adding, "His unconscionable cruelty has transformed him into a crusty relic on the verge of irrelevance." Besen writes that it is "such wanton disregard for reality and wearing of rose-colored shades to blind oneself from avoidable carnage that define fanaticism." He continues, "There is something pathological and perverse in the psyche of people willing to do enormous wrong in order to prove their doctrine right." Besen says Benedict will continue to "dupe the developing world," particularly countries "where people aren't as attuned to the ethical depravity of his unscientific proclamations." He continues, "Far from infallibility, this pope has failed on so many levels that he has virtually no credibility on matters of morality," concluding that "sadly, compassion is out of fashion at the Vatican these days" (Besen, Huffington Post blogs, 3/25).
~ "Do the Right Thing: Make Emergency Contraception Accessible and Affordable," Sondra Goldschein/Vania Leveille, The Hill's Congress Blog: Although a federal judge this week ordered FDA to "do the right thing and revisit its politically motivated decision to unnecessarily restrict access to the emergency contraceptive Plan B," the ruling is "only the first step," Goldschein, director of state advocacy for the American Civil Liberties Union's Reproductive Freedom Project and Leveille, a legislative counsel for ACLU, write. "More work is needed to make sure that all women have true access to emergency contraception," they continue, noting that they "remain concerned about the high cost" of nonprescription EC. "Most state Medicaid plans ... currently don't cover Plan B, meaning that many low-income women who rely on Medicaid for their health care needs currently can't afford access," Goldschein and Leveille write, adding that "with the mounting cost of health care in general, coupled with our tough economic times, more and more women -- many of whom don't qualify for Medicaid -- will find it difficult if not impossible to cover the costs of Plan B when they need it." They conclude that the "court decision has given us the opportunity not only to put science and health care back into the FDA decision-making process, but to simultaneously reconsider ways to make Plan B accessible and affordable for all women who need it" (Goldschein/Leveille, The Hill's Congress Blog, 3/24).
~ "Ignoring Evidence, Mexican States Move to Increase Abortion Restrictions," Sharon Camp/Fatima Juarez, AlterNet: In Mexico, a "new spate of state-level laws further restrict[s] Mexican women's already limited access to legal abortion," Camp and Juarez of the Guttmacher Institute write in a blog entry. They continue, "Worse, there is evidence that women are being denied abortion care even when they meet the strict criteria for a legal procedure." The "trend" among Mexican states to "reinforce what are already strict restrictions on abortion access comes in reaction" to a 2007 policy legalizing the procedure during the first 12 weeks of pregnancy, which was recently upheld by Mexico's Supreme Court, Camp and Juarez write. The new policies "not only demonstrate a shocking lack of compassion, they also directly contradict strong evidence from Mexico and other parts of the world that restricting abortion access does not make abortion less common -- it just results in more women dying or being injured by clandestine and unsafe practices," Camp and Juarez continue. They add, "If Mexican policymakers are concerned about reducing the need for abortion and safeguarding women's health, they should heed the strong evidence and focus on policies that promote prevention" (Camp/Juarez, AlterNet, 3/24).
~ "Why Canada's on Top in Teen Pregnancy," Vanessa Richmond, Huffington Post blogs: Canada's policies regarding sex education and access to pregnancy prevention methods "might actually be beacons of sustainable light, not dull lead weights," Richmond writes. The U.S.' teen birth rate rose for the second year in a row from 41.9 births per 1,000 in 2006 to 42.5 in 2007, which is "not a huge jump, but it's still significant because until two years ago, it had declined every year for 14 years," Richmond writes. The U.S. has the highest observed juvenile birth rates among industrialized countries, almost twice the rate in Canada and 10 times higher than Japan and the Netherlands, according to a comparative study from Statistics Canada. Richmond writes that the "main reason" for this is that "Canada's teens of all social classes get comprehensive information about contraception and about how to avoid unwanted pregnancies." Teens in Canada "get more sex-ed in school, and can access high-school-based family planning counseling through the nurse," she continues, adding they can "also always access universally free medical services, including visiting a family doctor and special health clinics." In addition, "at all levels, there's a more positive attitude towards the pill, and either cheaper or free prescriptions for it," Richmond writes. In the U.S., the "role institutions can play is one of providing information about the pill and condoms, rather than telling kids they shouldn't have sex," Richmond writes, concluding, "When adults treat teens as intelligent beings capable of making informed decisions when armed with good information, then they do. That's backed not just by belief, but by actual numbers and science" (Richmond, Huffington Post blogs, 3/26).
~ "The Down and Dirty Politics of Sex," Lon Newman, Below the Waist: The Obama administration "will need to sideline a few of the professional wrestlers and sports announcers in the abortion-rights contest" to achieve a "solid" reproductive health care policy as part of larger health care reform efforts, Newman writes. The "ongoing face-off" over issues like abortion rights, access to contraception and sex education "provides a dramatized competition that does not reflect the real lives of Americans," Newman says. He continues, "In their personal choices, citizens have accepted and embraced the right to informed consent on reproductive health issues," and, "[i]n this case, public policy should reflect private behavior." Although Obama has "reached out to listen to fundamentalist members of Congress and to interest groups who disagree, most of the time he has tried to set policy based on practical scientific decision-making instead of partisan crowd noise," Newman writes. The administration and Congress "must continue on this course of providing leadership on the principle that reproductive health care policy will be based on two foundations of American democracy -- reason and science," he continues, concluding, "We must not be distracted from that principle by battles over who holds higher moral ground. Instead, we must keep our attention on developing reproductive health care policy that is down to earth" (Newman, Below the Waist, 3/24).
~ "Colorado House Passes Birth Control Bill," Wendy Norris, RH Reality Check: Norris reports that the Colorado House this week passed the Birth Control Protection Act (S.B. 225) "on a largely party-line roll call vote of 39 to 25," after efforts to block the measure "shriveled" and supporters squelched an attempt to "add a poison pill amendment to insert the religious definition of pregnancy as at the moment of conception." According to Norris, the Birth Control Protection Act "codifies 'contraception or a contraceptive device as a medically acceptable drug, device or procedure used to prevent pregnancy.'" The measure is an attempt by two Democratic state representatives to "thwart future legal or constitutional challenges similar to Amendment 48," a failed November 2008 ballot measure that "sought to grant constitutional rights to fertilized eggs," she says. "The lawmakers reasoned that having a clear-cut definition that complements state law defining pregnancy will eliminate a debate over whether contraception includes abortions," Norris explains. She writes that the bill was amended to exclude mifespristone "and other federally approved pharmaceuticals that induce abortion, from the proposed legal definition of contraception," which will likely result in Gov. Bill Ritter's (D) approval of the bill (Norris, RH Reality Check, 3/25).
~ "Pope Condom Quote Undermines Credibility," Wayne Besen, Huffington Post blogs: Besen, founder of Truth Wins Out, responds to Pope Benedict XVI's recent comments that the distribution of condoms will not help curb the spread of HIV in Africa. Besen asks, "How many people is this man willing to see die to defend his outdated dogma? How high must the body count be before the Pope is no longer considered pro-life?" He continues, "How ironic that a pope fixated on staunching the decline of the Catholic Church in Western Europe would declare something so out of touch with the modern world," adding, "His unconscionable cruelty has transformed him into a crusty relic on the verge of irrelevance." Besen writes that it is "such wanton disregard for reality and wearing of rose-colored shades to blind oneself from avoidable carnage that define fanaticism." He continues, "There is something pathological and perverse in the psyche of people willing to do enormous wrong in order to prove their doctrine right." Besen says Benedict will continue to "dupe the developing world," particularly countries "where people aren't as attuned to the ethical depravity of his unscientific proclamations." He continues, "Far from infallibility, this pope has failed on so many levels that he has virtually no credibility on matters of morality," concluding that "sadly, compassion is out of fashion at the Vatican these days" (Besen, Huffington Post blogs, 3/25).
вторник, 28 июня 2011 г.
Merck Pledges To Stop Lobbying States To Pass Laws Requiring Girls To Receive Its HPV Vaccine Gardasil
Merck has decided to suspend its campaign to lobby for state proposals that would mandate girls receive its human papillomavirus vaccine Gardasil in light of opposition from some parents, patient advocacy groups and public health officials, the Wall Street Journal reports (Carreyrou/Rubenstein, Wall Street Journal, 2/21). Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. Merck last year began lobbying state legislatures to pass laws mandating that middle school age girls receive Gardasil. Merck also supports requiring private insurers to cover Gardasil, which costs $360 and is administered in three injections given over six months, as well as funding for programs that help defray vaccine costs for low-income and uninsured children (Kaiser Daily Women's Health Policy Report, 2/8). Texas Gov. Rick Perry (R) on Feb. 2 signed an executive order mandating HPV vaccination for girls entering the sixth grade beginning in September 2008, and at least 20 states are considering proposals that would mandate HPV vaccination for young girls. Some public health experts recently have expressed concern that proponents of HPV vaccination proposals, including Merck, have acted far too fast and are potentially undermining eventual prospects for the broadest possible immunization (Kaiser Daily Women's Health Policy Report, 2/20). According to the Journal, opposition to proposals has grown in recent weeks among parents who are concerned about the mandates and the potential side effects of vaccination (Wall Street Journal, 2/21).
Merck Comments, Reaction
"Our goal is preventing women from getting HPV and cervical cancer," Richard Haupt, executive director of medical affairs for Merck's vaccines division, said, adding, "What's unfortunate is that our role appears to be a distraction to that goal" (Gardner, Washington Post, 2/21). Haupt said the company would continue distributing information about the Gardasil if requested by government officials, the AP/Long Island Newsday reports. Anne Francis, chair of an American Academy of Pediatrics committee that advocates for better insurer reimbursement for vaccines, said Merck's decision to stop lobbying is "a good move for the public," adding that the initiation of the campaign was "a little bit premature ... so soon after (Gardasil's) release, before we have a picture of whether there are going to be any untoward side effects" (Johnson, AP/Long Island Newsday, 2/21). Joseph Bocchini, chair of the American Academy of Pediatrics' Committee on Infectious Diseases, lauded Merck's move. "At this point, we really don't know whether we even need to consider a mandate," Bocchini said, adding, "We need to get some data over time" (Rubin, USA Today, 2/21). After Merck's announcement, Perry spokesperson Krista Moody said, "Gov. Perry's executive order was not about a company. It's about saving lives and preventing women from contracting cancer" (Hoppe, Dallas Morning News, 2/20).
Washington Times Examines Age Group Targeted for Gardasil
The Washington Times on Wednesday examined whether lawmakers are targeting the "wrong age group" in their efforts to require girls ages 11 to 13 to receive Gardasil. According to the Times, Gardasil has proven effectiveness for only five years (Lopes/Dolan, Washington Times, 2/21).
"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.
View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.
Women Given More Options In Breast Cancer Treatment Procedure
A new minimally invasive approach to partial breast irradiation provides another treatment option for women with breast cancer. The researchers presented their findings at the annual meeting of the Radiological Society of North America.
"Women with breast cancer have many serious decisions to make in a short amount of time, including decisions regarding radiation therapy," said Lora D. Barke, D.O., assistant professor at Feinberg School of Medicine, Northwestern University and Northwestern Memorial Hospital in Chicago. "This procedure, which uses ultrasound to precisely guide balloon catheter placement to the lumpectomy site for partial breast irradiation treatment, removes one weighty decision women must make before surgery."
This is the first study to assess the use of ultrasound to guide the placement of the balloon catheter before partial breast irradiation therapy with brachytherapy.
In treatment with breast brachytherapy, the cancerous breast lump is surgically excised, and radiation is directed only to the portion of the breast surrounding the lumpectomy site. This approach maintains the likelihood of destroying the tumor but reduces the risk of damaging healthy tissue far from the tumor site. Since the target is smaller, brachytherapy allows for a shorter treatment regime - averaging five to seven days, compared to conventional whole-breast, external beam radiation, which may take six to seven weeks.
Balloon catheters used to deliver radiation to the affected area with brachytherapy are sometimes placed during surgery, or a surgical incision is reopened to insert the catheter. Often the catheter is placed unnecessarily, because later findings reveal that localized radiation is not appropriate or the breast tissue overlying the balloon is too thin.
"Our research shows that immediate placement of the balloon catheter is unnecessary and may add to cost. Radiologists can wait until receiving the final pathology, and then safely and efficiently insert the catheter with ultrasound guidance immediately before the patient begins brachytherapy," Dr. Barke explained. "This allows time to determine if brachytherapy is appropriate for the patient and allows the patient and physician to consider and weigh the benefits of various treatment options," she said.
The researchers studied ultrasound guidance of balloon catheter placement into the lumpectomy cavities of 75 new patients with early-stage breast cancer seven to 47 days after their lumpectomies. Patients were initially screened to assure an adequate surgical cavity size and skin thickness over the balloon. After successful insertion of the catheter, patients received twice-a-day brachytherapy treatments for one week.
The investigators concluded that ultrasound-guided placement of partial breast irradiation balloon catheters is safe, efficient and minimally invasive. No immediate complications occurred at insertion. One balloon ruptured and had to be replaced. Insertion of the catheter with local anesthesia took less than five minutes. The total procedure, including preparation time, averaged 25 minutes.
Co-authors are Ellen B. Mendelson, M.D., Krystyna D. Kiel, M.D., and Judith A. Wolfman, M.D.
RSNA is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.
The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting.
Contact: Maureen Morley
Radiological Society of North America
"Women with breast cancer have many serious decisions to make in a short amount of time, including decisions regarding radiation therapy," said Lora D. Barke, D.O., assistant professor at Feinberg School of Medicine, Northwestern University and Northwestern Memorial Hospital in Chicago. "This procedure, which uses ultrasound to precisely guide balloon catheter placement to the lumpectomy site for partial breast irradiation treatment, removes one weighty decision women must make before surgery."
This is the first study to assess the use of ultrasound to guide the placement of the balloon catheter before partial breast irradiation therapy with brachytherapy.
In treatment with breast brachytherapy, the cancerous breast lump is surgically excised, and radiation is directed only to the portion of the breast surrounding the lumpectomy site. This approach maintains the likelihood of destroying the tumor but reduces the risk of damaging healthy tissue far from the tumor site. Since the target is smaller, brachytherapy allows for a shorter treatment regime - averaging five to seven days, compared to conventional whole-breast, external beam radiation, which may take six to seven weeks.
Balloon catheters used to deliver radiation to the affected area with brachytherapy are sometimes placed during surgery, or a surgical incision is reopened to insert the catheter. Often the catheter is placed unnecessarily, because later findings reveal that localized radiation is not appropriate or the breast tissue overlying the balloon is too thin.
"Our research shows that immediate placement of the balloon catheter is unnecessary and may add to cost. Radiologists can wait until receiving the final pathology, and then safely and efficiently insert the catheter with ultrasound guidance immediately before the patient begins brachytherapy," Dr. Barke explained. "This allows time to determine if brachytherapy is appropriate for the patient and allows the patient and physician to consider and weigh the benefits of various treatment options," she said.
The researchers studied ultrasound guidance of balloon catheter placement into the lumpectomy cavities of 75 new patients with early-stage breast cancer seven to 47 days after their lumpectomies. Patients were initially screened to assure an adequate surgical cavity size and skin thickness over the balloon. After successful insertion of the catheter, patients received twice-a-day brachytherapy treatments for one week.
The investigators concluded that ultrasound-guided placement of partial breast irradiation balloon catheters is safe, efficient and minimally invasive. No immediate complications occurred at insertion. One balloon ruptured and had to be replaced. Insertion of the catheter with local anesthesia took less than five minutes. The total procedure, including preparation time, averaged 25 minutes.
Co-authors are Ellen B. Mendelson, M.D., Krystyna D. Kiel, M.D., and Judith A. Wolfman, M.D.
RSNA is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.
The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting.
Contact: Maureen Morley
Radiological Society of North America
Northwestern University Awarded $21M Grant To Develop Methods Aimed At Protecting Fertility Of Women Undergoing Radiation, Chemotherapy
Northwestern University's Feinberg School of Medicine has been awarded a $21 million grant from NIH for an initiative that aims to protect the fertility of women who are undergoing radiation or chemotherapy, the Chicago Tribune reports.
The initiative, called the Oncofertility Consortium, aims to change the way physicians approach women undergoing such treatment by placing a greater emphasis on their reproductive health, the Tribune reports. A person called a patient navigator will help answer questions and explore options for newly diagnosed women and teenagers, according to the Tribune. The patient navigator will act as a liaison between the patients and specialists to ensure that fertility considerations are reflected in future treatment plans.
When a woman is diagnosed with cancer, the first priority is to save her life, Teresa Woodruff, chief of the Feinberg School's new fertility preservation division, said. She added that although most women will survive, the treatments that attack malignant tumors and cells also can destroy the ability to conceive. "The fertility docs are not used to treating sick people; the oncologists are not focused on anything beyond survival ... so this is about breaking down those barriers," Woodruff said, adding, "On the day of diagnosis every cancer patient can be treated as a survivor, advised of her reproductive options from the very beginning."
NIH Deputy Director Alan Krensky said, "This really is a new discipline ... an unprecedented group coming together to address problems that are affecting an increasing number of Americans and people around the world." According to the Tribune, the program will be funded under NIH's Roadmap for Medical Research program, which is designed to accelerate the research process. Northwestern University is among nine grant recipients nationwide, the Tribune reports (Miller Rubin, Chicago Tribune, 9/6).
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.
The initiative, called the Oncofertility Consortium, aims to change the way physicians approach women undergoing such treatment by placing a greater emphasis on their reproductive health, the Tribune reports. A person called a patient navigator will help answer questions and explore options for newly diagnosed women and teenagers, according to the Tribune. The patient navigator will act as a liaison between the patients and specialists to ensure that fertility considerations are reflected in future treatment plans.
When a woman is diagnosed with cancer, the first priority is to save her life, Teresa Woodruff, chief of the Feinberg School's new fertility preservation division, said. She added that although most women will survive, the treatments that attack malignant tumors and cells also can destroy the ability to conceive. "The fertility docs are not used to treating sick people; the oncologists are not focused on anything beyond survival ... so this is about breaking down those barriers," Woodruff said, adding, "On the day of diagnosis every cancer patient can be treated as a survivor, advised of her reproductive options from the very beginning."
NIH Deputy Director Alan Krensky said, "This really is a new discipline ... an unprecedented group coming together to address problems that are affecting an increasing number of Americans and people around the world." According to the Tribune, the program will be funded under NIH's Roadmap for Medical Research program, which is designed to accelerate the research process. Northwestern University is among nine grant recipients nationwide, the Tribune reports (Miller Rubin, Chicago Tribune, 9/6).
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.
Radio Discussion Examines Birth Control Pills Forty Years After U.S. Approval
NPR's "All Things Considered" on Thursday included a discussion with Cynthia Pearson, director of the National Women's Health Network, and Carolyn Westhoff, medical director of the Family Planning Center at Columbia University, about the history, popularity and effectiveness of oral contraceptives, which were first approved in the U.S. 40 years ago.
Pearson discussed attitudes toward family planning when birth control pills were first introduced, marketing of the pills and their health risks. Pearson said that birth control pills have some "serious and rare risks," including blood clots, but added that the most recent and largest studies seem to indicate that the pills do not increase the risk of breast cancer in young women. She also discussed insurance coverage for contraceptives and FDA's approval last month of Wyeth's oral contraceptive Lybrel, which is designed to eliminate monthly menstrual periods.
Westhoff said men and women also are turning to other forms of contraception, including sterilization, which is the most popular choice after birth control pills for individuals ages 30 to 49. Westhoff said IUDs, which are the most popular contraception method worldwide, are safe and effective but not as widely used in the U.S. as in other countries, possibly because of misconceptions about safety. She also discussed variations of hormonal methods and experimental male birth control pills (Norris, "All Things Considered," NPR, 5/31). Audio and a partial transcript of the segment are available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Pearson discussed attitudes toward family planning when birth control pills were first introduced, marketing of the pills and their health risks. Pearson said that birth control pills have some "serious and rare risks," including blood clots, but added that the most recent and largest studies seem to indicate that the pills do not increase the risk of breast cancer in young women. She also discussed insurance coverage for contraceptives and FDA's approval last month of Wyeth's oral contraceptive Lybrel, which is designed to eliminate monthly menstrual periods.
Westhoff said men and women also are turning to other forms of contraception, including sterilization, which is the most popular choice after birth control pills for individuals ages 30 to 49. Westhoff said IUDs, which are the most popular contraception method worldwide, are safe and effective but not as widely used in the U.S. as in other countries, possibly because of misconceptions about safety. She also discussed variations of hormonal methods and experimental male birth control pills (Norris, "All Things Considered," NPR, 5/31). Audio and a partial transcript of the segment are available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Beneficial Eveidence Lacking For Pre-Implantation Genetic Screening In Older Women
Preimplantation genetic screening (PGS), often considered to hold out the best chance for older women undergoing IVF to have a pregnancy and birth, does not increase on-going pregnancy or live birth rates, an embryologist told the 23rd annual conference of the European Society of Human Reproduction and Embryology. The research is published simultaneously in the New England Journal of Medicine*. Sebastiaan Mastenbroek, M.Sc, from the Centre for Reproductive Medicine of the Academic Medical Centre of the University of Amsterdam, The Netherlands, said that the results of his team's research suggested that PGS should not be carried out routinely in women of advanced maternal age.
In a randomised double-blind trial, the team compared three cycles of IVF with and without PGS in women from35 to 41 years of age. Of the 408 women, 206 of whom were given PGS and 202 were not, the ongoing pregnancy rate was considerably lower in the PGS group than in those who did not have PGS. "We found that, at 12 weeks, 52 or 25% of the women in the PGS group were pregnant, whereas 74 or 37% of the control group had an ongoing pregnancy", said Mr. Mastenbroek. "And the women in the PGS group also had a significantly lower live birth rate - 49 or 24% as opposed to 71 or 35% of the controls."
The investigators believe that there may be a number of explanations for the failure of PGS to improve IVF outcomes in older women. "It is possible that the biopsy of a cell from an early embryo on day 3 after conception hampers the potential of an embryo to successfully implant", said Mr. Mastenbroek, "though the effect of biopsy alone on pregnancy rates has not been studied."
Furthermore, say the investigators, the limitation on the number of chromosomes that can be analysed could lead to the transfer of embryos that appear normal but are in fact abnormal for one or more chromosomes not tested. Finally, many embryos resulting from IVF may be mosaic, where a single cell does not properly reflect the chromosomal composition of the whole, so that chromosomal analysis may not be representative of the entire embryo.
PGS is a relatively new technique that is in increasing use in IVF centres around the world. In 2003, more than 1700 IVF cycles with PGS for various indications were reported to the ESHRE preimplantation genetic diagnosis (ESHRE-PGD) consortium. This figure under-estimates the total number of IVF/PGD cycles, since only 50 centres worldwide reported their data to the consortium. "In a recent survey of 415 assisted reproductive technology clinics in the US, 186 respondents (45%) reported that they had performed a total of 2197 cycles of PGS in 2005", said Mr. Mastenbroek.
The investigators are currently following up their work by investigating why PGS does not work. Even though evidence underpinning the effectiveness of PGS was lacking until now, patients as well as doctors were attracted to this technique. The idea of screening embryos for chromosomal abnormalities to increase live birth rates in IVF is very plausible, and women of advanced maternal age are willing to undergo any technique that may provide them with a baby", said Mr. Mastenbroek.
"Our study was limited to older women undergoing PGS. We believe that our findings imply that the efficacy of the technique also needs to be investigated in other groups of women who are offered PGS, such as those who suffer recurrent miscarriage or repeated failure of IVF, since evidence for a benefit of PGS in these groups of women is currently still lacking", he said.
*ref: Mastenbroek S, Twisk M, van Echten-Arends J, et al. In Vitro Fertilization with Preimplantation Genetic Screening. N Engl J Med 2007;357:9-17.
Source: Mary Rice
European Society for Human Reproduction and Embryology
In a randomised double-blind trial, the team compared three cycles of IVF with and without PGS in women from35 to 41 years of age. Of the 408 women, 206 of whom were given PGS and 202 were not, the ongoing pregnancy rate was considerably lower in the PGS group than in those who did not have PGS. "We found that, at 12 weeks, 52 or 25% of the women in the PGS group were pregnant, whereas 74 or 37% of the control group had an ongoing pregnancy", said Mr. Mastenbroek. "And the women in the PGS group also had a significantly lower live birth rate - 49 or 24% as opposed to 71 or 35% of the controls."
The investigators believe that there may be a number of explanations for the failure of PGS to improve IVF outcomes in older women. "It is possible that the biopsy of a cell from an early embryo on day 3 after conception hampers the potential of an embryo to successfully implant", said Mr. Mastenbroek, "though the effect of biopsy alone on pregnancy rates has not been studied."
Furthermore, say the investigators, the limitation on the number of chromosomes that can be analysed could lead to the transfer of embryos that appear normal but are in fact abnormal for one or more chromosomes not tested. Finally, many embryos resulting from IVF may be mosaic, where a single cell does not properly reflect the chromosomal composition of the whole, so that chromosomal analysis may not be representative of the entire embryo.
PGS is a relatively new technique that is in increasing use in IVF centres around the world. In 2003, more than 1700 IVF cycles with PGS for various indications were reported to the ESHRE preimplantation genetic diagnosis (ESHRE-PGD) consortium. This figure under-estimates the total number of IVF/PGD cycles, since only 50 centres worldwide reported their data to the consortium. "In a recent survey of 415 assisted reproductive technology clinics in the US, 186 respondents (45%) reported that they had performed a total of 2197 cycles of PGS in 2005", said Mr. Mastenbroek.
The investigators are currently following up their work by investigating why PGS does not work. Even though evidence underpinning the effectiveness of PGS was lacking until now, patients as well as doctors were attracted to this technique. The idea of screening embryos for chromosomal abnormalities to increase live birth rates in IVF is very plausible, and women of advanced maternal age are willing to undergo any technique that may provide them with a baby", said Mr. Mastenbroek.
"Our study was limited to older women undergoing PGS. We believe that our findings imply that the efficacy of the technique also needs to be investigated in other groups of women who are offered PGS, such as those who suffer recurrent miscarriage or repeated failure of IVF, since evidence for a benefit of PGS in these groups of women is currently still lacking", he said.
*ref: Mastenbroek S, Twisk M, van Echten-Arends J, et al. In Vitro Fertilization with Preimplantation Genetic Screening. N Engl J Med 2007;357:9-17.
Source: Mary Rice
European Society for Human Reproduction and Embryology
Super Micro-Surgery Offers New Hope For Breast Cancer Patients With Lymphedema
Breast cancer patients with lymphedema in their upper arm experienced reduced fluid in the swollen arm by up to 39 percent after undergoing a super-microsurgical technique known as lymphaticovenular bypass, report researchers at The University of Texas M. D. Anderson Cancer Center.
The results from the prospective analysis, presented at the 88th Annual Meeting of the American Association of Plastic Surgeons, suggest another option for breast cancer patients considering ways to manage lymphedema, a common and debilitating condition following surgery and/or radiation therapy for breast cancer.
Lymphedema results when the lymph nodes are removed or blocked due to treatment and lymph fluid accumulates causing chronic swelling in the upper arm. Currently, there is no cure or preventive measure for lymphedema and it is difficult to manage; the use of compression bandages, massage and other forms of lymphatic therapy are commonly recommended options for patients. According to the National Cancer Institute, 25 to 30 percent of women who have breast cancer surgery with lymph node removal and radiation therapy develop lymphedema.
Researchers evaluated 20 breast cancer patients with stage II and III treatment-related lymphedema of the upper arm who underwent a lymphaticovenular bypass at M. D. Anderson from December 2005 to September 2008. Due to lymphedema, the patients' affected arm was an average of 34 percent larger compared to the unaffected arm prior to the surgery. Of these 20 patients, 19 reported initial significant clinical improvement following the procedure. In those patients with postoperative volumetric analysis measurements, total mean reduction in the volume differential at one month was 29 percent, at three months 33 percent, at six months 39 percent and 25 percent at one year.
"Patients often resort to lymphatic therapy because other options brought forward to reduce lymphedema haven't proved effective," said lead author on the study David W. Chang, M.D., professor in the Department of Plastic Surgery and Director of the Plastic Surgery Clinic at M. D. Anderson. "Surgical techniques, in particular, have been limited and therefore have been met with skepticism by surgeons, making it extremely important to determine which new techniques promise to bring real benefits to patients."
In lymphaticovenular bypass surgery, surgeons use tiny microsurgical tools to make two to three small incisions measuring an inch or less in the patient's arm. Lymphatic fluid is then redirected to microscopic vessels - approximately 0.3 - 0.8 millimeters in diameter - to promote drainage and alleviate lymphedema. The procedure is minimally invasive and is generally completed in less than four hours under general anesthesia, allowing patients to return home from the hospital within 24 hours. M. D. Anderson is among a few institutions in the United States to offer this technically complex surgery.
"Lymphedema is like a massive traffic jam with no exit," Chang said. "This procedure does a lot to help relieve lymphedema by giving the fluid a way out. While it does not totally eliminate the condition, there is very little downside for the patient and we may see significant improvement in its severity."
Chang notes that while most effective when completed in earlier stages before the affected arm is fibrotic, almost any breast cancer patient suffering from lymphedema stage I, II or III is a candidate. Though breast cancer was the focus of this study, the surgery can also be performed on patients who have lymphedema in the leg resulting from cancers involving pelvic regions.
Cancer treatment is not the only cause of lymphedema. Primary lymphedema can develop from developmental causes at birth, the onset of puberty or in adulthood. Secondary lymphedema can develop as a result of surgery, radiation, infection or trauma. In developing countries, a form of lymphedema caused by a parasite called Filariasis affects as many as 200 million people worldwide. "As we begin to refine our technique and learn more about the efficacy of this surgery, we have the potential to impact a large number of people," Chang said.
Long-term follow-up with patients who have received lymphaticovenular bypass surgery is necessary to determine if the procedure continues to promote drainage after one year. Chang and his team of surgeons at M. D. Anderson believe that the fluid volume will keep decreasing over time and suggest that the surgery could possibly be used as a preventive measure for lymphedema in the future. "Working toward a definitive technique to cure this encumbering side effect of cancer and improve a patient's quality of life as a cancer survivor is a priority for those of us in this field."
About M. D. Anderson
The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 41Comprehensive Cancer Centers designated by the National Cancer Institute. For four of the past six years, M. D. Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.
University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd., Box 229
Houston
TX 77030
United States
mdanderson
The results from the prospective analysis, presented at the 88th Annual Meeting of the American Association of Plastic Surgeons, suggest another option for breast cancer patients considering ways to manage lymphedema, a common and debilitating condition following surgery and/or radiation therapy for breast cancer.
Lymphedema results when the lymph nodes are removed or blocked due to treatment and lymph fluid accumulates causing chronic swelling in the upper arm. Currently, there is no cure or preventive measure for lymphedema and it is difficult to manage; the use of compression bandages, massage and other forms of lymphatic therapy are commonly recommended options for patients. According to the National Cancer Institute, 25 to 30 percent of women who have breast cancer surgery with lymph node removal and radiation therapy develop lymphedema.
Researchers evaluated 20 breast cancer patients with stage II and III treatment-related lymphedema of the upper arm who underwent a lymphaticovenular bypass at M. D. Anderson from December 2005 to September 2008. Due to lymphedema, the patients' affected arm was an average of 34 percent larger compared to the unaffected arm prior to the surgery. Of these 20 patients, 19 reported initial significant clinical improvement following the procedure. In those patients with postoperative volumetric analysis measurements, total mean reduction in the volume differential at one month was 29 percent, at three months 33 percent, at six months 39 percent and 25 percent at one year.
"Patients often resort to lymphatic therapy because other options brought forward to reduce lymphedema haven't proved effective," said lead author on the study David W. Chang, M.D., professor in the Department of Plastic Surgery and Director of the Plastic Surgery Clinic at M. D. Anderson. "Surgical techniques, in particular, have been limited and therefore have been met with skepticism by surgeons, making it extremely important to determine which new techniques promise to bring real benefits to patients."
In lymphaticovenular bypass surgery, surgeons use tiny microsurgical tools to make two to three small incisions measuring an inch or less in the patient's arm. Lymphatic fluid is then redirected to microscopic vessels - approximately 0.3 - 0.8 millimeters in diameter - to promote drainage and alleviate lymphedema. The procedure is minimally invasive and is generally completed in less than four hours under general anesthesia, allowing patients to return home from the hospital within 24 hours. M. D. Anderson is among a few institutions in the United States to offer this technically complex surgery.
"Lymphedema is like a massive traffic jam with no exit," Chang said. "This procedure does a lot to help relieve lymphedema by giving the fluid a way out. While it does not totally eliminate the condition, there is very little downside for the patient and we may see significant improvement in its severity."
Chang notes that while most effective when completed in earlier stages before the affected arm is fibrotic, almost any breast cancer patient suffering from lymphedema stage I, II or III is a candidate. Though breast cancer was the focus of this study, the surgery can also be performed on patients who have lymphedema in the leg resulting from cancers involving pelvic regions.
Cancer treatment is not the only cause of lymphedema. Primary lymphedema can develop from developmental causes at birth, the onset of puberty or in adulthood. Secondary lymphedema can develop as a result of surgery, radiation, infection or trauma. In developing countries, a form of lymphedema caused by a parasite called Filariasis affects as many as 200 million people worldwide. "As we begin to refine our technique and learn more about the efficacy of this surgery, we have the potential to impact a large number of people," Chang said.
Long-term follow-up with patients who have received lymphaticovenular bypass surgery is necessary to determine if the procedure continues to promote drainage after one year. Chang and his team of surgeons at M. D. Anderson believe that the fluid volume will keep decreasing over time and suggest that the surgery could possibly be used as a preventive measure for lymphedema in the future. "Working toward a definitive technique to cure this encumbering side effect of cancer and improve a patient's quality of life as a cancer survivor is a priority for those of us in this field."
About M. D. Anderson
The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 41Comprehensive Cancer Centers designated by the National Cancer Institute. For four of the past six years, M. D. Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.
University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd., Box 229
Houston
TX 77030
United States
mdanderson
Senate Judiciary Committee Scheduled To Consider Johnsen Nomination For DOJ Office Of Legal Counsel
Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) has placed the nomination of Dawn Johnsen for assistant attorney general at the Department of Justice's Office of Legal Counsel on the panel's agenda for a Jan. 28 markup, going against Republican requests for a second confirmation hearing, CQ Today reports. The committee approved the nomination on a party-line vote in March 2009, but President Obama was forced to resubmit Johnsen after the full Senate failed to take up the nomination by the end of last year.
In a Jan. 13 letter to Leahy, the seven Republicans on the committee requested a second confirmation hearing, arguing that they "believe many unanswered questions remain" regarding Johnsen's ability to lead OLC, which provides legal advice to the executive branch. In a letter to committee ranking Republican Jeff Sessions (Ala.), Leahy said that he supports Johnsen and that "if there are senators who disagree, they can vote against her nomination and should make clear their reasons." Johnsen has the support of Republican Sen. Richard Lugar, who represents her home state of Indiana (Perine, CQ Today, 1/25). Senate Judiciary Committee member Arlen Specter (D-Pa.) announced in a Jan. 12 statement that he would back her after the two held a "second extensive meeting" (Women's Health Policy Report, 1/25).
Leahy also wrote that he believes another hearing is unnecessary, although he stopped short of rejecting the idea. According to CQ Today, this "leaves room for the two sides to strike a deal," such as allowing a second confirmation hearing in exchange for a Republican guarantee to allow a Senate floor vote on Johnsen's nomination. Such a deal appears unlikely, however, and Republicans are expected to use the committee's rules to delay a panel vote on the nomination for a week (CQ Today, 1/25).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Women Often Misdiagnose And Self-Treat Yeast Infection
Most women who think they have a vaginal yeast infection are wrong and may be doing more harm than good in treating their problem, says a Saint Louis University researcher who presented her findings recently.
"Everything that itches isn't a yeast infection," said Susan Hoffstetter, Ph.D., assistant professor of obstetrics, gynecology and women's health at Saint Louis University School of Medicine and a SLUCare women's health nurse practitioner.
"People keep treating themselves. They buy over-the-counter medicines for yeast infections or they call the doctor to get a prescription for medicine over and over again."
Nearly three times out of four, they're treating themselves or calling a doctor for a medicine to treat a problem they don't have, said Hoffstetter, who co-directs the SLUCare Vulvar and Vaginal Disease Clinic, which specializes in treating women who have chronic pain, unhealthy discharges or skin problems in their vaginal area.
"If you treat yourself and it never goes away, you shouldn't continue to treat yourself," Hoffstetter said. "You're making a situation worse and you can get into cyclic episodes where you think you have a yeast infection all of the time."
Vaginal yeast infections are common; three out of four women have had one at some point during their lives. Symptoms include pain or discomfort during sex; burning, redness and swelling of the vaginal area; a thick, white cottage cheese-like discharge that doesn't smell bad; and pain during urination.
Hoffstetter analyzed the records of more than 150 new patients of the SLUCare Vulvar and Vaginal Disease Clinic, a specialty practice that sees women with recurrent vaginitis problems. These women thought they had yeast infections, however only 26 percent actually did.
"Their symptoms didn't correlate with the clinical evidence of a yeast infection," she said.
The women reported itching and a vaginal discharge, which also could indicate an inflammation, dry skin tissues or a sexually transmitted infection. These problems require a different treatment than the anti-fungal medicine given for a yeast infection.
Her advice to women who think they have a yeast infection is to call their doctor or women's health nurse practitioner for an appointment. The physician or nurse practitioner will do a pelvic exam to detect swelling and unhealthy discharge. The health professional also may take a swab to get a specimen for a lab test or to be examined under the microscope to see if yeast is the true culprit.
"Women shouldn't just run to the drugstore if they think they have a yeast infection. The optimal thing would be to be evaluated," Hoffstetter says.
Hoffstetter discussed her findings recently at an education session presented by the International Society for the Study of Vulvovaginal Disease. She was inducted as a Fellow in that prestigious gynecological society.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.
Source: Nancy Solomon
Saint Louis University
"Everything that itches isn't a yeast infection," said Susan Hoffstetter, Ph.D., assistant professor of obstetrics, gynecology and women's health at Saint Louis University School of Medicine and a SLUCare women's health nurse practitioner.
"People keep treating themselves. They buy over-the-counter medicines for yeast infections or they call the doctor to get a prescription for medicine over and over again."
Nearly three times out of four, they're treating themselves or calling a doctor for a medicine to treat a problem they don't have, said Hoffstetter, who co-directs the SLUCare Vulvar and Vaginal Disease Clinic, which specializes in treating women who have chronic pain, unhealthy discharges or skin problems in their vaginal area.
"If you treat yourself and it never goes away, you shouldn't continue to treat yourself," Hoffstetter said. "You're making a situation worse and you can get into cyclic episodes where you think you have a yeast infection all of the time."
Vaginal yeast infections are common; three out of four women have had one at some point during their lives. Symptoms include pain or discomfort during sex; burning, redness and swelling of the vaginal area; a thick, white cottage cheese-like discharge that doesn't smell bad; and pain during urination.
Hoffstetter analyzed the records of more than 150 new patients of the SLUCare Vulvar and Vaginal Disease Clinic, a specialty practice that sees women with recurrent vaginitis problems. These women thought they had yeast infections, however only 26 percent actually did.
"Their symptoms didn't correlate with the clinical evidence of a yeast infection," she said.
The women reported itching and a vaginal discharge, which also could indicate an inflammation, dry skin tissues or a sexually transmitted infection. These problems require a different treatment than the anti-fungal medicine given for a yeast infection.
Her advice to women who think they have a yeast infection is to call their doctor or women's health nurse practitioner for an appointment. The physician or nurse practitioner will do a pelvic exam to detect swelling and unhealthy discharge. The health professional also may take a swab to get a specimen for a lab test or to be examined under the microscope to see if yeast is the true culprit.
"Women shouldn't just run to the drugstore if they think they have a yeast infection. The optimal thing would be to be evaluated," Hoffstetter says.
Hoffstetter discussed her findings recently at an education session presented by the International Society for the Study of Vulvovaginal Disease. She was inducted as a Fellow in that prestigious gynecological society.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.
Source: Nancy Solomon
Saint Louis University
Age at first period has little or no influence on adult weight
Although overweight girls are more likely to start their periods earlier than their peers who are at or below normal weight, early menstruation is not by itself a risk factor for later obesity, according to a long-term study released today. In fact, it's more likely that excess body fat jump-starts puberty than the other way around. Additionally, girls who are overweight before their first periods are almost eight times more likely than their slimmer peers to be overweight as adults.
"It has been long known that if you are overweight as you grow up, you are more likely to begin puberty early," said Aviva Must, Ph.D., associate professor of Public Health and Family Medicine at Tufts University School of Medicine in Boston and lead author of the study, published in the September issue of the journal Pediatrics. "Girls who are overweight are more likely to have early menarche, or start their period, before age 12. I have been concerned that a widespread belief was forming that the timing of menarche was itself linked to later weight status."
This belief, which may have led physicians to focus on changing the timing of puberty as a way to combat adult obesity, was discounted by Dr. Must's findings. "These findings are significant because they show us where our efforts should focus: childhood obesity," said Dr. Must, who is also a scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts. She spoke today in New York City at the American Medical Association and National PTA media briefing, Back to School: Child and Adolescent Health.
The new paper used data from the Newton Girls Study, which followed a group of about 700 girls from a small city near Boston. The girls were recruited in 1965 and studied from before their first period through their 20th period. The girls or their mothers provided monthly reports, allowing researchers to accurately pinpoint their age at menarche. Most studies rely on subjects recalling the age at which they got their first period, which may be remembered with error, Dr. Must said.
Dr. Must and her coauthors contacted the original participants of the Newton Girls Study 30 years later. About 450 of the women, with an average age of 42, participated in the follow-up. The women provided their current weight and height and researchers computed their body mass index (BMI), a weight measure that is adjusted for height and can be used to determine whether a person is overweight or obese. About 28 percent of the women were overweight and 9 percent were obese. In addition, 153 of the women came to the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts for a laboratory analysis of their body fat percentage.
The women whose BMIs indicated they were overweight before their first periods were 7.7 times more likely to be overweight as adults than those who were at or below normal weight at the beginning of the original study. This effect was even more pronounced when level of fat was evaluated for those women who came into the lab for more accurate body fat measurements. Neither the girls' age at menarche nor the interaction between their weight and the age at menarche accurately predicted whether or not they would have more fat as adults.
Parents can learn something from this study whether their daughters are overweight or not, said Dr. Must. "The parents of an overweight child may expect that their child is going to mature earlier," she said. "She may be taller than her classmates before menarche, and she may have her first menstrual period and start developing breasts before her leaner girlfriends. That is not a cause for concern; it is part of normal growth and development for an overweight child. For the parents of a girl who is not overweight and who gets her first period early, it doesn't mean she's at increased risk for being overweight as an adult."
Editor's Note: Dr. Must has received grant support from the National Institutes of Health and the Centers for Disease Control and Prevention. She has received honoraria from and/or serves on speakers bureaus for Dairy Management, Inc. Dr. Must has received an honorarium from the American Medical Association to speak at today's briefing.
Siobhan Gallagher
617-636-6586
American Medical Association
ama-assn
"It has been long known that if you are overweight as you grow up, you are more likely to begin puberty early," said Aviva Must, Ph.D., associate professor of Public Health and Family Medicine at Tufts University School of Medicine in Boston and lead author of the study, published in the September issue of the journal Pediatrics. "Girls who are overweight are more likely to have early menarche, or start their period, before age 12. I have been concerned that a widespread belief was forming that the timing of menarche was itself linked to later weight status."
This belief, which may have led physicians to focus on changing the timing of puberty as a way to combat adult obesity, was discounted by Dr. Must's findings. "These findings are significant because they show us where our efforts should focus: childhood obesity," said Dr. Must, who is also a scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts. She spoke today in New York City at the American Medical Association and National PTA media briefing, Back to School: Child and Adolescent Health.
The new paper used data from the Newton Girls Study, which followed a group of about 700 girls from a small city near Boston. The girls were recruited in 1965 and studied from before their first period through their 20th period. The girls or their mothers provided monthly reports, allowing researchers to accurately pinpoint their age at menarche. Most studies rely on subjects recalling the age at which they got their first period, which may be remembered with error, Dr. Must said.
Dr. Must and her coauthors contacted the original participants of the Newton Girls Study 30 years later. About 450 of the women, with an average age of 42, participated in the follow-up. The women provided their current weight and height and researchers computed their body mass index (BMI), a weight measure that is adjusted for height and can be used to determine whether a person is overweight or obese. About 28 percent of the women were overweight and 9 percent were obese. In addition, 153 of the women came to the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts for a laboratory analysis of their body fat percentage.
The women whose BMIs indicated they were overweight before their first periods were 7.7 times more likely to be overweight as adults than those who were at or below normal weight at the beginning of the original study. This effect was even more pronounced when level of fat was evaluated for those women who came into the lab for more accurate body fat measurements. Neither the girls' age at menarche nor the interaction between their weight and the age at menarche accurately predicted whether or not they would have more fat as adults.
Parents can learn something from this study whether their daughters are overweight or not, said Dr. Must. "The parents of an overweight child may expect that their child is going to mature earlier," she said. "She may be taller than her classmates before menarche, and she may have her first menstrual period and start developing breasts before her leaner girlfriends. That is not a cause for concern; it is part of normal growth and development for an overweight child. For the parents of a girl who is not overweight and who gets her first period early, it doesn't mean she's at increased risk for being overweight as an adult."
Editor's Note: Dr. Must has received grant support from the National Institutes of Health and the Centers for Disease Control and Prevention. She has received honoraria from and/or serves on speakers bureaus for Dairy Management, Inc. Dr. Must has received an honorarium from the American Medical Association to speak at today's briefing.
Siobhan Gallagher
617-636-6586
American Medical Association
ama-assn
Philadelphia Inquirer Examines HPV Vaccine Development, Marketing Competition Between Merck, GSK
The Philadelphia Inquirer on Sunday examined the competition between Merck and GlaxoSmithKline on the development and marketing of human papillomavirus vaccines (Stark, Philadelphia Inquirer, 7/8).
Merck's HPV vaccine Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with HPV strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these strains. FDA in June 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine, which is given in a three-shot series (Kaiser Daily Women's Health Policy Report, 6/26).
Cervarix also has shown to be 100% effective in preventing infection with HPV strains 16 and 18. According to preliminary data from a Phase III clinical trial, published last month in the journal Lancet, Cervarix also provided significant protection against HPV strains 31, 45 and 52, which together account for about 12% of cervical cancer cases. The Australian Therapeutic Goods Administration last month granted the first major market license for Cervarix, approving the vaccine for girls and women ages 10 to 45. The European Medicines Agency could recommend the vaccine this month. FDA has granted a standard 10-month review of Cervarix and will most likely take action on GSK's application in January 2008, according to analysts at Evolution Securities (Kaiser Daily Women's Health Policy Report, 6/28).
Gardasil might have a "potential advantage" over Cervarix because it protects against strains 6 and 11, the Inquirer reports. GSK officials say that the narrower focus of Cervarix makes it better in preventing cervical cancer.
According to the Inquirer, some experts have said that they have not found an advantage for Cervarix and that Gardasil's genital wart coverage might give it a temporary edge. Hildegund Ertl, founding director of the Wistar Institute Vaccine Center, said if given a choice, she would choose Gardasil "because of the extra protection." John Schiller, a senior investigator at the National Cancer Institute, said, "There's going to be a bit of an arms race between Merck and GSK," adding, "I wouldn't be surprised if GSK adds the wart types."
According to the Inquirer, Gardasil is expected to reach at least $1 billion in sales after one year on the U.S. market. In an attempt to "leapfrog its competition," GSK is funding a clinical trial to determine whether Cervarix is more effective than Gardasil, with results expected early next year, the Inquirer reports. Merck is developing another HPV vaccine, currently being tested in Phase II clinical trials, that aims to block eight HPV types.
Enrique Hernandez, chair of obstetrics and gynecology at Temple University Hospital who has served on advisory boards at both GSK and Merck, said the choice will come down to the price. "Whoever comes out with a cheaper product wins," he said, adding that he does not "think there's a significant difference" between the two vaccines (Philadelphia Inquirer, 7/8).
"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.
View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.
Merck's HPV vaccine Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with HPV strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these strains. FDA in June 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine, which is given in a three-shot series (Kaiser Daily Women's Health Policy Report, 6/26).
Cervarix also has shown to be 100% effective in preventing infection with HPV strains 16 and 18. According to preliminary data from a Phase III clinical trial, published last month in the journal Lancet, Cervarix also provided significant protection against HPV strains 31, 45 and 52, which together account for about 12% of cervical cancer cases. The Australian Therapeutic Goods Administration last month granted the first major market license for Cervarix, approving the vaccine for girls and women ages 10 to 45. The European Medicines Agency could recommend the vaccine this month. FDA has granted a standard 10-month review of Cervarix and will most likely take action on GSK's application in January 2008, according to analysts at Evolution Securities (Kaiser Daily Women's Health Policy Report, 6/28).
Gardasil might have a "potential advantage" over Cervarix because it protects against strains 6 and 11, the Inquirer reports. GSK officials say that the narrower focus of Cervarix makes it better in preventing cervical cancer.
According to the Inquirer, some experts have said that they have not found an advantage for Cervarix and that Gardasil's genital wart coverage might give it a temporary edge. Hildegund Ertl, founding director of the Wistar Institute Vaccine Center, said if given a choice, she would choose Gardasil "because of the extra protection." John Schiller, a senior investigator at the National Cancer Institute, said, "There's going to be a bit of an arms race between Merck and GSK," adding, "I wouldn't be surprised if GSK adds the wart types."
According to the Inquirer, Gardasil is expected to reach at least $1 billion in sales after one year on the U.S. market. In an attempt to "leapfrog its competition," GSK is funding a clinical trial to determine whether Cervarix is more effective than Gardasil, with results expected early next year, the Inquirer reports. Merck is developing another HPV vaccine, currently being tested in Phase II clinical trials, that aims to block eight HPV types.
Enrique Hernandez, chair of obstetrics and gynecology at Temple University Hospital who has served on advisory boards at both GSK and Merck, said the choice will come down to the price. "Whoever comes out with a cheaper product wins," he said, adding that he does not "think there's a significant difference" between the two vaccines (Philadelphia Inquirer, 7/8).
"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.
View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.
Blogs Comment On Abstinence, Cost Of Contraception, Dickey Amendment, Other Topics
The following summarizes selected women's health-related blog entries.
~ "Anti-Abortion or Anti-Sex?" Cindy Handler, Huffington Post blogs: Recent news reports indicate that Alaska Gov. Sarah Palin's (R) 18-year-old daughter Bristol, who gave birth in December 2008 after an unintended pregnancy, does not plan to marry Levi Johnson, the teenage father of her child; however, there has been no "conservative outrage directed at this very public unwed mother who chose to bring a child into the world without the benefit of heterosexual marriage," Handler writes in a blog entry. She continues that conservatives have not spoken out about Bristol Palin "because to the base of her mother's party, it's not important whether she gets married or not." Handler writes, "To the far right, the error she made was not that she had unprotected sex, but that she was unmarried and had sex at all." Handler writes that "observers on the left, who have long labored to find middle ground with adamant pro-lifers," have difficulty understanding these points of view. She continues, "Progressives look at a teenage girl who gets knocked up by her teenage boyfriend and think, 'This is sad, as well as further proof that, as the girl admitted herself, abstinence alone isn't realistic.'" In addition, liberals might suggest that teenage mothers and their children face considerable challenges, Handler writes. She adds, "To people who focus on the quality of an individual's life, it makes sense to focus on prevention." According to Handler, several recent studies have demonstrated that abstinence-only education "doesn't decrease the likelihood that teens will have sex before marriage." However, "to right wing ideologues, the debate begins and ends with the sinful act of sex outside of marriage, which can only lead to one outcome: punishment," Handler writes. She continues that for people with this view, "the whole concept of prevention is irrelevant. You play, you pay." Handler writes that "it's important for progressives to keep their eyes and minds open when they argue with their ideological opponents." She continues that if abortion-rights opponents "won't even consider the option of educating kids on how to avoid pregnancy, it's possible that they're just paying lip service to wanting to stop 'the life of an innocent baby (from) being taken.'" Handler concludes that what conservatives "really want is to return to the lily-white, less-complicated 'Leave it to Beaver' world they feel our culture left behind -- a world that, just like the promise of a long, happy future for the Palin-Johnson family, never really existed in the first place" (Handler, Huffington Post blogs, 3/16).
~ "Inconvenient Contraception," Beth Schwartzapfel, American Prospect blogs: Even when birth control becomes less expensive, it will "continue to be two things: inconvenient and thoroughly tied up with the medical system," Schwartzapfel writes in a blog entry. She adds, "A trip to the doctor. Time off from work. A waiting room. A pap smear. A co-pay (assuming you're insured, of course.) A trip to the pharmacy. Another co-pay. Then, finally, your birth control;" however, "[i]t may not have to be this way." She notes an announcement by England's National Health Service that it plans to launch a pilot program that will allow young women in London to obtain birth control over the counter after consulting with a pharmacist. Schwartzapfel explains that a "working group" of doctors, pharmacists and researchers funded by a Hewlett Foundation grant plans to study the "feasibility of making oral contraceptives available over the counter: as easy to purchase as aspirin." She notes that some have raised safety as a concern while others worry about access for low-income women. Schwartzapfel quotes Sharon Camp, a member of the working group and president and CEO of the Guttmacher Institute: "'For most of the people in the reproductive health field, the issue of safety is probably not the biggest one. It really is: Will an over-the-counter product be affordable for women who now get low-cost or reimbursed drugs?" She notes that some have raised safety as a concern while others worry about access for low-income women. Schwartzapfel quotes Sharon Camp, a member of the working group and president and CEO of the Guttmacher Institute: "For most of the people in the reproductive health field, the issue of safety is probably not the biggest one. It really is: Will an over-the-counter product be affordable for women who now get low-cost or reimbursed drugs?" Schwartzapfel writes that the "Obama administration's proposed overhaul of the health care system might make for an entirely new playing field," concluding, "Perhaps, in 10 years, poor women will have affordable and accessible access to health care, leaving working group members and other reproductive health advocates to weigh the proposal on its merits alone" (Schwartzapfel, American Prospect blogs, 3/17).
~ "End Abstinence-Only-Until-Marriage Funding," Vania Leveille, American Civil Liberties Union blog: Leveille writes that $99 million in funding for the Community Based Abstinence Education program is "[b]uried" in the 2009 omnibus spending bill that President Obama recently signed into law, as well as the "media blizzard about earmarks." She continues that "it absolutely boggles the mind that this program still receives any funding at all," adding that "$162 million remains in the budget for abstinence-only-until-marriage funding" and that Congress has allotted "more than a billion taxpayer dollars on abstinence-only-until-marriage programs despite busloads of evidence that they don't work and pleas from the scientific and public health community to stop, stop, stop!" According to Leveille, "We know that abstinence-only-until-marriage programs censor information that can help young people make responsible, healthy and safe decisions about relationships and sexual activity;" however, "the money keeps flowing." She continues, "It's time to put scientific integrity and the real needs of teenagers ahead of narrow, ideological agendas," and a "big leap" will be made if Obama gives "zero dollars for abstinence-only programs in his 2010 fiscal year budget recommendation to Congress," as ACLU has requested. "We may lose tremendous momentum in the fight against abstinence-only programs if President Obama's 2010 fiscal year budget includes funds for these programs," Leveille writes. She concludes, "We need to let President Obama know that it's enough already" (Leveille, ACLU blog, 3/13).
~ "A Radical Vision for the Council on Girls and Women," Courtney Martin, American Prospect blogs: "Sometimes you fight so long and hard for something that it's hard to believe you've actually won," Martin writes in a blog entry, adding, "There was a bit of that sentiment among the feminist community following President Obama's announcement last week that he would create a White House Council on Women and Girls." Although some people were "quick to insert cynicism into the celebration before it had even begun," Martin writes that she "imagine[s] the truth is somewhere in between. Obama is a savvy politician who understands the importance of attracting and sustaining support from female voters (and often-overlooked male voters who care about injustices facing women and girls)." Martin writes, "We need to shift our priorities, and the White House Council on Women and Girls can be the catalyst," adding, "There are some long-neglected issues that I'd like to challenge the council to take on, namely domestic sex trafficking, the HIV/AIDS infection rate among black women, and a federally funded, comprehensive sexual-education policy." According to Martin, what will "make this proposed White House Council truly radical is if it doesn't just serve the self-interest of the women with a seat at the table but the young women and struggling mothers who have been given the scraps of governmental goodwill for far too long." She adds, "With these women as a top priority rather than an afterthought, this council could demonstrate effective cooperation among departments and agencies, acknowledge that you can't look at gender without also considering class and race (and vice versa) and connect with grassroots groups doing work on the ground, within their own communities. In short, it could be that transformative" (Martin, American Prospect blogs, 3/16).
Antiabortion Blog
~ What Is the Dickey Amendment and Why Should I Care?" ProLifeBlogs: There is "a lot of work to do getting the word out about" the Dickey Amendment, which "prohibits federal funds to be used to create or destroy human embryos for research purposes," according to the blog entry. It adds that Obama's executive order overturning some restrictions on federal funding for stem cell research and the Stem Cell Research Enhancement Act of 2009 still do not allow federal funding for "research that creates or destroys human embryos thanks to the Dickey Amendment." Therefore, it is "important to understand that this fight to protect human embryos is far from over," the blog says, adding that those opposed to stem cell research should contact their "representatives in Congress and President Obama and ask them to uphold the Dickey Amendment. Tell them you do not want your money to fund the creation and destruction of nascent human life" (ProLifeBlogs, 3/13).
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.
~ "Anti-Abortion or Anti-Sex?" Cindy Handler, Huffington Post blogs: Recent news reports indicate that Alaska Gov. Sarah Palin's (R) 18-year-old daughter Bristol, who gave birth in December 2008 after an unintended pregnancy, does not plan to marry Levi Johnson, the teenage father of her child; however, there has been no "conservative outrage directed at this very public unwed mother who chose to bring a child into the world without the benefit of heterosexual marriage," Handler writes in a blog entry. She continues that conservatives have not spoken out about Bristol Palin "because to the base of her mother's party, it's not important whether she gets married or not." Handler writes, "To the far right, the error she made was not that she had unprotected sex, but that she was unmarried and had sex at all." Handler writes that "observers on the left, who have long labored to find middle ground with adamant pro-lifers," have difficulty understanding these points of view. She continues, "Progressives look at a teenage girl who gets knocked up by her teenage boyfriend and think, 'This is sad, as well as further proof that, as the girl admitted herself, abstinence alone isn't realistic.'" In addition, liberals might suggest that teenage mothers and their children face considerable challenges, Handler writes. She adds, "To people who focus on the quality of an individual's life, it makes sense to focus on prevention." According to Handler, several recent studies have demonstrated that abstinence-only education "doesn't decrease the likelihood that teens will have sex before marriage." However, "to right wing ideologues, the debate begins and ends with the sinful act of sex outside of marriage, which can only lead to one outcome: punishment," Handler writes. She continues that for people with this view, "the whole concept of prevention is irrelevant. You play, you pay." Handler writes that "it's important for progressives to keep their eyes and minds open when they argue with their ideological opponents." She continues that if abortion-rights opponents "won't even consider the option of educating kids on how to avoid pregnancy, it's possible that they're just paying lip service to wanting to stop 'the life of an innocent baby (from) being taken.'" Handler concludes that what conservatives "really want is to return to the lily-white, less-complicated 'Leave it to Beaver' world they feel our culture left behind -- a world that, just like the promise of a long, happy future for the Palin-Johnson family, never really existed in the first place" (Handler, Huffington Post blogs, 3/16).
~ "Inconvenient Contraception," Beth Schwartzapfel, American Prospect blogs: Even when birth control becomes less expensive, it will "continue to be two things: inconvenient and thoroughly tied up with the medical system," Schwartzapfel writes in a blog entry. She adds, "A trip to the doctor. Time off from work. A waiting room. A pap smear. A co-pay (assuming you're insured, of course.) A trip to the pharmacy. Another co-pay. Then, finally, your birth control;" however, "[i]t may not have to be this way." She notes an announcement by England's National Health Service that it plans to launch a pilot program that will allow young women in London to obtain birth control over the counter after consulting with a pharmacist. Schwartzapfel explains that a "working group" of doctors, pharmacists and researchers funded by a Hewlett Foundation grant plans to study the "feasibility of making oral contraceptives available over the counter: as easy to purchase as aspirin." She notes that some have raised safety as a concern while others worry about access for low-income women. Schwartzapfel quotes Sharon Camp, a member of the working group and president and CEO of the Guttmacher Institute: "'For most of the people in the reproductive health field, the issue of safety is probably not the biggest one. It really is: Will an over-the-counter product be affordable for women who now get low-cost or reimbursed drugs?" She notes that some have raised safety as a concern while others worry about access for low-income women. Schwartzapfel quotes Sharon Camp, a member of the working group and president and CEO of the Guttmacher Institute: "For most of the people in the reproductive health field, the issue of safety is probably not the biggest one. It really is: Will an over-the-counter product be affordable for women who now get low-cost or reimbursed drugs?" Schwartzapfel writes that the "Obama administration's proposed overhaul of the health care system might make for an entirely new playing field," concluding, "Perhaps, in 10 years, poor women will have affordable and accessible access to health care, leaving working group members and other reproductive health advocates to weigh the proposal on its merits alone" (Schwartzapfel, American Prospect blogs, 3/17).
~ "End Abstinence-Only-Until-Marriage Funding," Vania Leveille, American Civil Liberties Union blog: Leveille writes that $99 million in funding for the Community Based Abstinence Education program is "[b]uried" in the 2009 omnibus spending bill that President Obama recently signed into law, as well as the "media blizzard about earmarks." She continues that "it absolutely boggles the mind that this program still receives any funding at all," adding that "$162 million remains in the budget for abstinence-only-until-marriage funding" and that Congress has allotted "more than a billion taxpayer dollars on abstinence-only-until-marriage programs despite busloads of evidence that they don't work and pleas from the scientific and public health community to stop, stop, stop!" According to Leveille, "We know that abstinence-only-until-marriage programs censor information that can help young people make responsible, healthy and safe decisions about relationships and sexual activity;" however, "the money keeps flowing." She continues, "It's time to put scientific integrity and the real needs of teenagers ahead of narrow, ideological agendas," and a "big leap" will be made if Obama gives "zero dollars for abstinence-only programs in his 2010 fiscal year budget recommendation to Congress," as ACLU has requested. "We may lose tremendous momentum in the fight against abstinence-only programs if President Obama's 2010 fiscal year budget includes funds for these programs," Leveille writes. She concludes, "We need to let President Obama know that it's enough already" (Leveille, ACLU blog, 3/13).
~ "A Radical Vision for the Council on Girls and Women," Courtney Martin, American Prospect blogs: "Sometimes you fight so long and hard for something that it's hard to believe you've actually won," Martin writes in a blog entry, adding, "There was a bit of that sentiment among the feminist community following President Obama's announcement last week that he would create a White House Council on Women and Girls." Although some people were "quick to insert cynicism into the celebration before it had even begun," Martin writes that she "imagine[s] the truth is somewhere in between. Obama is a savvy politician who understands the importance of attracting and sustaining support from female voters (and often-overlooked male voters who care about injustices facing women and girls)." Martin writes, "We need to shift our priorities, and the White House Council on Women and Girls can be the catalyst," adding, "There are some long-neglected issues that I'd like to challenge the council to take on, namely domestic sex trafficking, the HIV/AIDS infection rate among black women, and a federally funded, comprehensive sexual-education policy." According to Martin, what will "make this proposed White House Council truly radical is if it doesn't just serve the self-interest of the women with a seat at the table but the young women and struggling mothers who have been given the scraps of governmental goodwill for far too long." She adds, "With these women as a top priority rather than an afterthought, this council could demonstrate effective cooperation among departments and agencies, acknowledge that you can't look at gender without also considering class and race (and vice versa) and connect with grassroots groups doing work on the ground, within their own communities. In short, it could be that transformative" (Martin, American Prospect blogs, 3/16).
Antiabortion Blog
~ What Is the Dickey Amendment and Why Should I Care?" ProLifeBlogs: There is "a lot of work to do getting the word out about" the Dickey Amendment, which "prohibits federal funds to be used to create or destroy human embryos for research purposes," according to the blog entry. It adds that Obama's executive order overturning some restrictions on federal funding for stem cell research and the Stem Cell Research Enhancement Act of 2009 still do not allow federal funding for "research that creates or destroys human embryos thanks to the Dickey Amendment." Therefore, it is "important to understand that this fight to protect human embryos is far from over," the blog says, adding that those opposed to stem cell research should contact their "representatives in Congress and President Obama and ask them to uphold the Dickey Amendment. Tell them you do not want your money to fund the creation and destruction of nascent human life" (ProLifeBlogs, 3/13).
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.
Columbia Laboratories And Watson Announce Publication Of Positive Phase III PROCHIEVE® Vaginal Progesterone Gel Study Results
Columbia Laboratories, Inc. (Nasdaq: CBRX), and Watson Pharmaceuticals, Inc. (NYSE: WPI), announced the publication of Phase III PROCHIEVE® (progesterone gel) data in today's online version of Ultrasound in Obstetrics & Gynecology, the leading peer-reviewed journal of the International Society of Ultrasound in Obstetrics & Gynecology.
The published results indicate that administration of vaginal progesterone from the midtrimester of pregnancy until term in women with a premature cervical shortening as confirmed by transvaginal ultrasound significantly reduced the rate of preterm birth before 33 weeks gestation (p=0.020). Use of PROCHIEVE was associated with a 45% reduction in the incidence of preterm birth before 33 weeks gestation. Further, improvement in infant outcome was noted with PROCHIEVE. Data published in the study also demonstrated that self-administered PROCHIEVE progesterone gel was associated with a significant reduction in the risk of preterm birth before 28 and before 35 weeks of gestation. Adverse events were comparable between women who received PROCHIEVE and those who received placebo.
"The prevention of preterm birth is a major healthcare priority, and there are currently limited interventions available," said Roberto Romero, MD, Chief of the Perinatology Research Branch of NICHD/NIH and the Principal Investigator of the study. "Our data are the first to demonstrate that an intervention can dramatically reduce the rate of early preterm birth (
The published results indicate that administration of vaginal progesterone from the midtrimester of pregnancy until term in women with a premature cervical shortening as confirmed by transvaginal ultrasound significantly reduced the rate of preterm birth before 33 weeks gestation (p=0.020). Use of PROCHIEVE was associated with a 45% reduction in the incidence of preterm birth before 33 weeks gestation. Further, improvement in infant outcome was noted with PROCHIEVE. Data published in the study also demonstrated that self-administered PROCHIEVE progesterone gel was associated with a significant reduction in the risk of preterm birth before 28 and before 35 weeks of gestation. Adverse events were comparable between women who received PROCHIEVE and those who received placebo.
"The prevention of preterm birth is a major healthcare priority, and there are currently limited interventions available," said Roberto Romero, MD, Chief of the Perinatology Research Branch of NICHD/NIH and the Principal Investigator of the study. "Our data are the first to demonstrate that an intervention can dramatically reduce the rate of early preterm birth (
Blogs Comment On Gender Gap In China, Afghan 'Rape Law,' Other Topics
The following summarizes selected women's health-related blog entries.
~ "China's Guy Problems Only Getting Worse," Tracy Clark-Flory, Salon's "Broadsheet": Imagining that men make up the total population of California provides a "solid image" of about "how many more millions of males than females there are in China," Clark-Flory writes. "The gender gap is largely attributed to sex-selective abortion, a result of China's one-child policy and a cultural preference for boys," she continues, adding that a report released Friday found that 1.1 million more boys than girls were born in 2005. The report also says that there is nothing to be done "to prevent this imminent generation of excess men." Clark-Flory says that "experts warn that the inevitable overabundance of lonely bachelors will lead to total chaos." She writes that Therese Hesketh of the Centre for International Health and Development at University College London said that the multitude of "highly sexed young men" may get together and "go out and commit crimes." Clark-Flory adds that "the suggestion seems" that the crimes will be sexually based. She concludes that although she "has held on to an irrational hope that a dearth of girls might actually improve women's status in China," the story in South Korea, "which is also coping with an astronomical gender imbalance," indicates that "[m]en simply outsource, importing brides from other countries" (Clark-Flory, "Broadsheet," Salon, 4/11).
~ "The Afghan 'Rape Law': A View from Kandahar," Vanessa Gezari, "The XX Factor," Slate: It is "curious that the so-called Afghan 'rape law' has drawn such fury in the U.S. and Europe," because "being bound by written law to have sex with your husband on a regular basis is no better or worse than the de facto law under which a great majority of Afghan women already live," Gezari writes. She continues, "The more interesting question is why this is being treated like a new outrage when it really is an enduring one," adding that "an Afghan man -- like a man in many other parts of the world -- can have sex with his wife anytime he wants, whether she wants it or not." This "shouldn't surprise us" when the U.S. has statutes, such as one in Ohio, that legalize spousal rape in some cases, according to Gezari. Gezari notes that the "grave concern" over the law from the Western world "devalues the everyday struggles faced by all Afghan women, as opposed to the 10% to 20% who, as Shias, would be governed by the proposed law." She continues, "The conversation about where Afghan women stand, where they should stand, and what changes are needed in both law and practice to bring them there must be undertaken by Afghans in the context of their own culture, or risk sparking a xenophobic backlash that could ultimately be more damaging to women's interests," Gezari writes, adding that the "encouraging" signatures of more than 100 Afghan officials on a petition opposing the law "carry far more weight, in this instance, than the words of a U.S. president" (Gezari, "The XX Factor," Slate, 4/13).
~ "We're Back! U.S. Reclaims Leadership Role in International Reproductive Health," Sharon Camp, RH Reality Check: "[F]or the first time in eight years, the United States was front and center in advocating an increased global commitment to reproductive health and rights" during this month's annual meeting of the United Nations Commission on Population and Development, Camp writes. According to Camp, the U.S.' new position on reproductive health, renewed support for the United Nations Population Fund, the recent reversal of the "global gag rule" and Secretary of State Hillary Rodham Clinton's statement that women's rights are human rights make it "safe to say: The U.S. is back! Or, more precisely, back on track." However, the "policies of the past eight years have left a lot of catching up to do," Camp writes, adding that the current $545 million allocated for international family planning assistance still "falls far short of the $1 billion that represents the minimum U.S. share of the global commitment." In addition, although the U.S. "contributes more funds than any other country toward voluntary family planning services worldwide, European nations far outspend the United States in terms of the proportion of the gross domestic product allocated to foreign assistance," Camp writes. She continues that meeting international development goals will "require strong commitment and increased cooperation," concluding, "For this to work, the United States must maintain a clear leadership role and European donors cannot back away now just because the United States has returned to the scene" (Camp, RH Reality Check, 4/14).
~ "Stem Cells Proffer New Hope for Infertility," Deborah Kotz, U.S. News and World Report's "On Women": A recently published study suggesting that ovaries "may indeed be able to churn out new eggs could provide hope for those women who find they don't have enough healthy eggs left when they're ready to have a baby," Kotz writes. However, "[a]s exciting as this study is, its results are a far cry from demonstrating that such a technique can work in women," she continues, adding, "If it does though, it could solve a lot of fertility problems." Kotz writes, "If and when [several] hurdles are overcome, we then have to worry that the technique could be misused in older women well beyond menopause." She concludes, "Like other fertility treatments, this one, if it's shown to work, has the potential for widespread abuse" (Kotz, "On Women," U.S. News and World Report, 4/13).
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.
~ "China's Guy Problems Only Getting Worse," Tracy Clark-Flory, Salon's "Broadsheet": Imagining that men make up the total population of California provides a "solid image" of about "how many more millions of males than females there are in China," Clark-Flory writes. "The gender gap is largely attributed to sex-selective abortion, a result of China's one-child policy and a cultural preference for boys," she continues, adding that a report released Friday found that 1.1 million more boys than girls were born in 2005. The report also says that there is nothing to be done "to prevent this imminent generation of excess men." Clark-Flory says that "experts warn that the inevitable overabundance of lonely bachelors will lead to total chaos." She writes that Therese Hesketh of the Centre for International Health and Development at University College London said that the multitude of "highly sexed young men" may get together and "go out and commit crimes." Clark-Flory adds that "the suggestion seems" that the crimes will be sexually based. She concludes that although she "has held on to an irrational hope that a dearth of girls might actually improve women's status in China," the story in South Korea, "which is also coping with an astronomical gender imbalance," indicates that "[m]en simply outsource, importing brides from other countries" (Clark-Flory, "Broadsheet," Salon, 4/11).
~ "The Afghan 'Rape Law': A View from Kandahar," Vanessa Gezari, "The XX Factor," Slate: It is "curious that the so-called Afghan 'rape law' has drawn such fury in the U.S. and Europe," because "being bound by written law to have sex with your husband on a regular basis is no better or worse than the de facto law under which a great majority of Afghan women already live," Gezari writes. She continues, "The more interesting question is why this is being treated like a new outrage when it really is an enduring one," adding that "an Afghan man -- like a man in many other parts of the world -- can have sex with his wife anytime he wants, whether she wants it or not." This "shouldn't surprise us" when the U.S. has statutes, such as one in Ohio, that legalize spousal rape in some cases, according to Gezari. Gezari notes that the "grave concern" over the law from the Western world "devalues the everyday struggles faced by all Afghan women, as opposed to the 10% to 20% who, as Shias, would be governed by the proposed law." She continues, "The conversation about where Afghan women stand, where they should stand, and what changes are needed in both law and practice to bring them there must be undertaken by Afghans in the context of their own culture, or risk sparking a xenophobic backlash that could ultimately be more damaging to women's interests," Gezari writes, adding that the "encouraging" signatures of more than 100 Afghan officials on a petition opposing the law "carry far more weight, in this instance, than the words of a U.S. president" (Gezari, "The XX Factor," Slate, 4/13).
~ "We're Back! U.S. Reclaims Leadership Role in International Reproductive Health," Sharon Camp, RH Reality Check: "[F]or the first time in eight years, the United States was front and center in advocating an increased global commitment to reproductive health and rights" during this month's annual meeting of the United Nations Commission on Population and Development, Camp writes. According to Camp, the U.S.' new position on reproductive health, renewed support for the United Nations Population Fund, the recent reversal of the "global gag rule" and Secretary of State Hillary Rodham Clinton's statement that women's rights are human rights make it "safe to say: The U.S. is back! Or, more precisely, back on track." However, the "policies of the past eight years have left a lot of catching up to do," Camp writes, adding that the current $545 million allocated for international family planning assistance still "falls far short of the $1 billion that represents the minimum U.S. share of the global commitment." In addition, although the U.S. "contributes more funds than any other country toward voluntary family planning services worldwide, European nations far outspend the United States in terms of the proportion of the gross domestic product allocated to foreign assistance," Camp writes. She continues that meeting international development goals will "require strong commitment and increased cooperation," concluding, "For this to work, the United States must maintain a clear leadership role and European donors cannot back away now just because the United States has returned to the scene" (Camp, RH Reality Check, 4/14).
~ "Stem Cells Proffer New Hope for Infertility," Deborah Kotz, U.S. News and World Report's "On Women": A recently published study suggesting that ovaries "may indeed be able to churn out new eggs could provide hope for those women who find they don't have enough healthy eggs left when they're ready to have a baby," Kotz writes. However, "[a]s exciting as this study is, its results are a far cry from demonstrating that such a technique can work in women," she continues, adding, "If it does though, it could solve a lot of fertility problems." Kotz writes, "If and when [several] hurdles are overcome, we then have to worry that the technique could be misused in older women well beyond menopause." She concludes, "Like other fertility treatments, this one, if it's shown to work, has the potential for widespread abuse" (Kotz, "On Women," U.S. News and World Report, 4/13).
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.
New Technology Promises To Have A Major Impact On Supply Of Malaria Treatment Across The Developing World
Canada is delivering on its commitment to help the world's most vulnerable, thanks to new developments which will provide an affordable, reliable, and stable treatment for malaria that will save millions of lives, especially those of women and children in Africa. The Honourable Gary Goodyear, Minister of State for Science and Technology, along with Mr. Brad Trost, Member of Parliament for Saskatoon-Humboldt, announced the breakthrough and highlighted the Government's research support.
"Our government is committed to improving the health of women and children in developing countries," said Minister Goodyear. "This new development in the production of a malaria treatment represents a major development in the fight against the disease. It will strengthen Canada's position as a world leader in health research and provide a reliable and affordable solution."
This announcement is a result of The Artemisinin Project, a public-private partnership led by OneWorld Health in collaboration with sanofi-aventis, Amyris, the University of California at Berkeley, and the National Research Council of Canada. Artemisinin is a natural compound found in a traditional Chinese medicinal plant grown mainly in Africa and Asia to treat malaria. The Government of Canada's investment of approximately $869,000 in this research has led to technology that can produce a stable and affordable supply of artemisinin for the developing world on a not-for-profit basis.
"Collaboration on the development of this new technology promises to have a major impact on supply of malaria treatment across the developing world, which will be an important contribution towards the global effort to combat malaria," said Dr. Richard Chin, Chief Executive Officer of OneWorld Health.
According to the World Health Organization, malaria causes approximately 250 million illnesses and more than one million deaths each year, of which 90 percent occur in Africa, mostly in pregnant women and in children. The disease is endemic in nearly 100 countries, including 28 on the African continent. This project is expected to help treat 200 million cases and prevent over one million deaths annually.
Source:
Media Relations
National Research Council of Canada
"Our government is committed to improving the health of women and children in developing countries," said Minister Goodyear. "This new development in the production of a malaria treatment represents a major development in the fight against the disease. It will strengthen Canada's position as a world leader in health research and provide a reliable and affordable solution."
This announcement is a result of The Artemisinin Project, a public-private partnership led by OneWorld Health in collaboration with sanofi-aventis, Amyris, the University of California at Berkeley, and the National Research Council of Canada. Artemisinin is a natural compound found in a traditional Chinese medicinal plant grown mainly in Africa and Asia to treat malaria. The Government of Canada's investment of approximately $869,000 in this research has led to technology that can produce a stable and affordable supply of artemisinin for the developing world on a not-for-profit basis.
"Collaboration on the development of this new technology promises to have a major impact on supply of malaria treatment across the developing world, which will be an important contribution towards the global effort to combat malaria," said Dr. Richard Chin, Chief Executive Officer of OneWorld Health.
According to the World Health Organization, malaria causes approximately 250 million illnesses and more than one million deaths each year, of which 90 percent occur in Africa, mostly in pregnant women and in children. The disease is endemic in nearly 100 countries, including 28 on the African continent. This project is expected to help treat 200 million cases and prevent over one million deaths annually.
Source:
Media Relations
National Research Council of Canada
Fla. AG Crist Asks Court To Review Ballot Proposal That Would Require $20M In Annual Appropriations To Embryonic Stem Cell Research
Florida Attorney General and Gov.-elect Charlie Crist (R) on Tuesday asked the state Supreme Court to review a proposed constitutional amendment that would require the state to appropriate $20 million annually for 10 years to human embryonic stem cell research projects, the AP/Bradenton Herald reports. Florida Secretary of State Sue Cobb recently confirmed that the group sponsoring the proposal -- Floridians for Stem Cell Research and Cures-- had gathered 10% of the more than 600,000 signatures required to place the proposed initiative on the 2008 ballot. According to the AP/Herald, the state Supreme Court will determine if the initiative meets a requirement that ballot measures cover only one subject. Justices also will decide if the ballot summary for the proposal is accurate and clear. The court has not scheduled a date for oral arguments (AP/Bradenton Herald, 11/7).
"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.
"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.
Institute For Progressive Medicine Announces A Natural Approach To Improving Fertility
The Institute for Progressive Medicine (IPM), a medical clinic that focuses on safe, natural and alternative therapies in combination with traditional medical treatments, announced today the clinic's Preconception Care Program. Preconception health care is for both parents and improves the likelihood of a healthy conception, pregnancy and birth for those who are having trouble conceiving or for parent's-to-be who are looking for ways to have healthier babies. The program also includes alternative methods for pain relief.
Lead by Dr. Julie Kahn, IPM's Preconception Care includes acupuncture, detoxification, herbal medicine, cycle charting, dietary and lifestyle plans and a program of natural medicines to combat the adverse affects of 20th Century lifestyle and living conditions. Environmental pollution, poor nutrient levels in soils and foods, toxic farming methods, chemical radiation and heavy metal exposure, weight problems, overuse of sugar, caffeine, alcohol and the stress of modern living all contribute to poorer general health, and consequently, poorer reproductive health. IPM's program improves sperm count and quality in addition to optimizing egg development and is effective against infertility by itself, or as a supplement to fertility treatments under a reproductive endocrinologist.
"The program is great to use in conjunction with a fertility MD," said Dr. Julie M. Kahn, N.D., L.Ac, expert in Naturopathic medicine and a licensed acupuncturist. "If a patient is spending thousands of dollars on fertility enhancing treatments, IPM's Preconception Care program adds extra insurance. It is also good for people who just want to have a healthy experience, or who are not ready to go the traditional medical route of drugs or surgical procedures to increase fertility."
Research on this type of program has shown a decreased miscarriage rate, no low birth-weight babies, little to no ear infections, and children have less allergies. In addition, the program has proven to decrease labor pains, assist in lowering high blood pressure, decrease nausea, anemia, heartburn and headaches during pregnancy.
"Preconception Care has proven to be very effective in improving the chances of fertility in women," added Kahn. "There has been an overwhelming success rate with unexplained infertility that comes from practicing Preconception Care."
Preconception Care at IPM offers support for couples with fertility problems and also for couples who simply want their child to have the healthiest start to life. It is not only used to achieve a conception, but also to improve the chances for a very natural and healthy pregnancy, birth and baby.
About Preconception Care
The program is modeled after the work done by the Natural Fertility Management program. Natural Fertility Management (NFM) program was first pioneered in Australia in 1975 by Francesca Naish, a naturopath who has dedicated her career to developing a comprehensive and holistic approach to fertility. For more information about their programs, please at fertility.au.
About Institute for Progressive Medicine
The Institute for Progressive Medicine is a revolutionary medical clinic that leans towards a natural and alternative medical routine. Started by Allan E. Sosin, M.D., a renowned physician who is board certified in Internal Medicine and Nephrology, IPM supports the patient's physical, mental and spiritual well-being using the most natural, safe and effective methods available. IPM's mission is to respect patient's rights and look for the most natural and preventive path towards overall health. Dr. Sosin earned the title, Physician of the Year Award in 2000 from the National Health Federation.
Institute for Progressive Medicine
Lead by Dr. Julie Kahn, IPM's Preconception Care includes acupuncture, detoxification, herbal medicine, cycle charting, dietary and lifestyle plans and a program of natural medicines to combat the adverse affects of 20th Century lifestyle and living conditions. Environmental pollution, poor nutrient levels in soils and foods, toxic farming methods, chemical radiation and heavy metal exposure, weight problems, overuse of sugar, caffeine, alcohol and the stress of modern living all contribute to poorer general health, and consequently, poorer reproductive health. IPM's program improves sperm count and quality in addition to optimizing egg development and is effective against infertility by itself, or as a supplement to fertility treatments under a reproductive endocrinologist.
"The program is great to use in conjunction with a fertility MD," said Dr. Julie M. Kahn, N.D., L.Ac, expert in Naturopathic medicine and a licensed acupuncturist. "If a patient is spending thousands of dollars on fertility enhancing treatments, IPM's Preconception Care program adds extra insurance. It is also good for people who just want to have a healthy experience, or who are not ready to go the traditional medical route of drugs or surgical procedures to increase fertility."
Research on this type of program has shown a decreased miscarriage rate, no low birth-weight babies, little to no ear infections, and children have less allergies. In addition, the program has proven to decrease labor pains, assist in lowering high blood pressure, decrease nausea, anemia, heartburn and headaches during pregnancy.
"Preconception Care has proven to be very effective in improving the chances of fertility in women," added Kahn. "There has been an overwhelming success rate with unexplained infertility that comes from practicing Preconception Care."
Preconception Care at IPM offers support for couples with fertility problems and also for couples who simply want their child to have the healthiest start to life. It is not only used to achieve a conception, but also to improve the chances for a very natural and healthy pregnancy, birth and baby.
About Preconception Care
The program is modeled after the work done by the Natural Fertility Management program. Natural Fertility Management (NFM) program was first pioneered in Australia in 1975 by Francesca Naish, a naturopath who has dedicated her career to developing a comprehensive and holistic approach to fertility. For more information about their programs, please at fertility.au.
About Institute for Progressive Medicine
The Institute for Progressive Medicine is a revolutionary medical clinic that leans towards a natural and alternative medical routine. Started by Allan E. Sosin, M.D., a renowned physician who is board certified in Internal Medicine and Nephrology, IPM supports the patient's physical, mental and spiritual well-being using the most natural, safe and effective methods available. IPM's mission is to respect patient's rights and look for the most natural and preventive path towards overall health. Dr. Sosin earned the title, Physician of the Year Award in 2000 from the National Health Federation.
Institute for Progressive Medicine
Fatty Fish Consumption Reduces Kidney Cancer Risk By 44%
If you eat fatty fish, such as salmon or sardines, more than once a week, your chances of developing kidney cancer are 44% less than a person who does not eat fatty fish, according to researchers at the Karolinska Institutet, Stockholm, Sweden.
You can read about this study in the Journal of the American Medical Association, September 20th issue.
The 15-year study of 61,433 women compared lean fish to fatty fish consumption, and the link to renal (kidney) cancer. The women answered a questionnaire about their eating habits in 1987 and then again in 1997. They were followed up in 2004.
The following were classed as fatty fish:
-- Salmon
-- Herring
-- Mackerel
-- Lake trout
-- Sardines
-- Albacore tuna
-- Seafood (shrimps/prawns, lobster, crayfish)
The following are classed as lean fish:
Cod
Haddock
Hake
Pollock
Plaice
Lemon sole
Brill
Turbot
Black sole
Ray
Dogfish
Shark
150 women developed kidney cancer during that 15-year period (1987-2005). Women who had consumed fatty fish at least once a week were significantly less likely to develop kidney cancer than those who never ate fatty fish, said the researchers. Those who consumed lean fish at least once a week were no better off.
The researchers wrote "In this large population-based cohort with data on long-term diet, we found that women who consumed one or more servings of fatty fish per week had a statistically significant 44% decreased risk of RCC (renal cell carcinoma) compared with women who did not consume any fish. Women who reported consistent long-term consumption of fatty fish at baseline and 10 years later had a statistically significant 74 percent lower risk."
The researchers concluded that frequent consumption of fatty fish may lower renal cell cancer risk as a result of a higher intake of eicosapentaenoic acid and docosahexaeneoic acid as well as vitamin D (all found in abundance in fish oils).
Fatty fish have much higher levels of omega-3 fatty acids and vitamin D than lean fish, said the scientists.
It is estimated that there will be about 208,500 cases of kidney cancer worldwide this year, and 101,900 kidney cancer deaths. In the USA there are estimated to be 39,000 new cases this year, and 10,700 deaths (International Agency for Research on Cancer and the American Cancer Society).
Long-term Fatty Fish Consumption and Renal Cell Carcinoma Incidence in Women
Alicja Wolk, DMSc; Susanna C. Larsson, MSc; Jan-Erik Johansson, MD, PhD; Peter Ekman, MD, PhD
JAMA. 2006;296:1371-1376.
Click Here To View Abstract Online
You can read about this study in the Journal of the American Medical Association, September 20th issue.
The 15-year study of 61,433 women compared lean fish to fatty fish consumption, and the link to renal (kidney) cancer. The women answered a questionnaire about their eating habits in 1987 and then again in 1997. They were followed up in 2004.
The following were classed as fatty fish:
-- Salmon
-- Herring
-- Mackerel
-- Lake trout
-- Sardines
-- Albacore tuna
-- Seafood (shrimps/prawns, lobster, crayfish)
The following are classed as lean fish:
Cod
Haddock
Hake
Pollock
Plaice
Lemon sole
Brill
Turbot
Black sole
Ray
Dogfish
Shark
150 women developed kidney cancer during that 15-year period (1987-2005). Women who had consumed fatty fish at least once a week were significantly less likely to develop kidney cancer than those who never ate fatty fish, said the researchers. Those who consumed lean fish at least once a week were no better off.
The researchers wrote "In this large population-based cohort with data on long-term diet, we found that women who consumed one or more servings of fatty fish per week had a statistically significant 44% decreased risk of RCC (renal cell carcinoma) compared with women who did not consume any fish. Women who reported consistent long-term consumption of fatty fish at baseline and 10 years later had a statistically significant 74 percent lower risk."
The researchers concluded that frequent consumption of fatty fish may lower renal cell cancer risk as a result of a higher intake of eicosapentaenoic acid and docosahexaeneoic acid as well as vitamin D (all found in abundance in fish oils).
Fatty fish have much higher levels of omega-3 fatty acids and vitamin D than lean fish, said the scientists.
It is estimated that there will be about 208,500 cases of kidney cancer worldwide this year, and 101,900 kidney cancer deaths. In the USA there are estimated to be 39,000 new cases this year, and 10,700 deaths (International Agency for Research on Cancer and the American Cancer Society).
Long-term Fatty Fish Consumption and Renal Cell Carcinoma Incidence in Women
Alicja Wolk, DMSc; Susanna C. Larsson, MSc; Jan-Erik Johansson, MD, PhD; Peter Ekman, MD, PhD
JAMA. 2006;296:1371-1376.
Click Here To View Abstract Online
Community Factors Predict Reconstruction After Mastectomy
According to new research published in the November issue of Archives
of Surgery, women who live in wealthier communities with
lower population densities and a larger proportion of college-educated
individuals are more likely to have immediate breast reconstruction
after mastectomy.
Every year in the Unites States, breast cancer affects 134 of every
100,000 women. Surgical removal of the breast - or mastectomy - is a
treatment that many women choose, and it can be followed by
reconstructive breast surgery either immediately or after a
delay. "Immediate reconstruction has been shown to be superior
to delayed reconstruction for overall aesthetics, psychosocial
well-being and cost-effectiveness," write author Gedge D. Rosson, M.D.
(Johns Hopkins University School of Medicine, Baltimore) and
colleagues. "With these established benefits of immediate breast
reconstruction, we hypothesized that we could use immediate
reconstruction as a surrogate for optimal therapy and access to care
for patients undergoing mastectomy."
Rosson and colleagues studied 18,690 patients (about 60.1 years old) in
Maryland who underwent mastectomy between 1995 and 2004. The
researchers collected demographic information on the patients'
communities from a software program that is commercially available.
Focusing on the 17,925 patients who were white or African-American, the
researchers found that 27.9% of these (4,994 of 17,925) received
mastectomy and breast reconstruction during the same hospitalization.
The authors write: "We found that increasing income and increasing
population density of the city in which the patient lives had
statistically significant positive associations with the likelihood of
immediate breast reconstruction." They add that, "African American
race/ethnicity, older age, increasing percentage of the patient's
neighborhood with a high school education or less and increasing
African American composition of the patient's neighborhood had
statistically significant negative associations."
Specifically, compared to white women, African-Americans were 47% less
likely to undergo reconstruction during the mastectomy procedure. The
likelihood of joint procedures also decreased as age increased.
Community factors associated with access to immediate reconstruction
maintained their significance even when patient characteristics were
taken into account.
"In clinical medicine, we normally treat individuals, but this
multilevel database analysis points to the need also to evaluate the
community in which the patient lives," conclude Rosson and
colleagues. "The racial/ethnic mix, mean [average] income and
education level of the neighborhood and community are associated with
breast cancer management outcomes. Prospective public health measures,
including educational and informative programs, can be developed and
implemented in the community to address these inequalities
(particularly racial/ethnic disparities based on neighborhood) and to
increase the likelihood that patients with breast cancer and mastectomy
obtain immediate reconstruction."
Multilevel
Analysis of the Impact of Community vs Patient Factors on Access to
Immediate Breast Reconstruction Following Mastectomy in Maryland
Gedge D. Rosson, MD; Navin K. Singh, MD, MSc, MBA; Nita Ahuja, MD; Lisa
K. Jacobs, MD; David C. Chang, PhD, MPH, MBA
Archives of Surgery (2008). 143[11]:
pp. 1076 - 1081.
Click
Here to View Abstract
: Peter M Crosta
of Surgery, women who live in wealthier communities with
lower population densities and a larger proportion of college-educated
individuals are more likely to have immediate breast reconstruction
after mastectomy.
Every year in the Unites States, breast cancer affects 134 of every
100,000 women. Surgical removal of the breast - or mastectomy - is a
treatment that many women choose, and it can be followed by
reconstructive breast surgery either immediately or after a
delay. "Immediate reconstruction has been shown to be superior
to delayed reconstruction for overall aesthetics, psychosocial
well-being and cost-effectiveness," write author Gedge D. Rosson, M.D.
(Johns Hopkins University School of Medicine, Baltimore) and
colleagues. "With these established benefits of immediate breast
reconstruction, we hypothesized that we could use immediate
reconstruction as a surrogate for optimal therapy and access to care
for patients undergoing mastectomy."
Rosson and colleagues studied 18,690 patients (about 60.1 years old) in
Maryland who underwent mastectomy between 1995 and 2004. The
researchers collected demographic information on the patients'
communities from a software program that is commercially available.
Focusing on the 17,925 patients who were white or African-American, the
researchers found that 27.9% of these (4,994 of 17,925) received
mastectomy and breast reconstruction during the same hospitalization.
The authors write: "We found that increasing income and increasing
population density of the city in which the patient lives had
statistically significant positive associations with the likelihood of
immediate breast reconstruction." They add that, "African American
race/ethnicity, older age, increasing percentage of the patient's
neighborhood with a high school education or less and increasing
African American composition of the patient's neighborhood had
statistically significant negative associations."
Specifically, compared to white women, African-Americans were 47% less
likely to undergo reconstruction during the mastectomy procedure. The
likelihood of joint procedures also decreased as age increased.
Community factors associated with access to immediate reconstruction
maintained their significance even when patient characteristics were
taken into account.
"In clinical medicine, we normally treat individuals, but this
multilevel database analysis points to the need also to evaluate the
community in which the patient lives," conclude Rosson and
colleagues. "The racial/ethnic mix, mean [average] income and
education level of the neighborhood and community are associated with
breast cancer management outcomes. Prospective public health measures,
including educational and informative programs, can be developed and
implemented in the community to address these inequalities
(particularly racial/ethnic disparities based on neighborhood) and to
increase the likelihood that patients with breast cancer and mastectomy
obtain immediate reconstruction."
Multilevel
Analysis of the Impact of Community vs Patient Factors on Access to
Immediate Breast Reconstruction Following Mastectomy in Maryland
Gedge D. Rosson, MD; Navin K. Singh, MD, MSc, MBA; Nita Ahuja, MD; Lisa
K. Jacobs, MD; David C. Chang, PhD, MPH, MBA
Archives of Surgery (2008). 143[11]:
pp. 1076 - 1081.
Click
Here to View Abstract
: Peter M Crosta
Useful Source On Human Papillomavirus (HPV), The Main Cause Of Cervical Cancer
For those of you seeking information on the human papillomavirus (HPV), the primary cause of cervical cancer, there is a web site dedicated to this theme. TheHPVtest has recently been updated and has excellent navigation.
As well as comprehensive content, there are new tools to help people learn about HPV and educate family and friends about the virus and causes of cervical cancer.
Some of the features include:
-- Information on the new HPV vaccine
-- A new community section
-- Survivor stories
-- How to talk to your mother
-- What men need to know about HPV
-- HPV news
TheHPVtest was created by the Digene Corporation, the developer of the first HPV test approved by the U.S. FDA.
As well as comprehensive content, there are new tools to help people learn about HPV and educate family and friends about the virus and causes of cervical cancer.
Some of the features include:
-- Information on the new HPV vaccine
-- A new community section
-- Survivor stories
-- How to talk to your mother
-- What men need to know about HPV
-- HPV news
TheHPVtest was created by the Digene Corporation, the developer of the first HPV test approved by the U.S. FDA.
Follow-Up Study Finds Female Genital Mutilation Among Israel's Negev Bedouins Has Virtually Disappeared
A follow-up study by researchers at Ben-Gurion University of the Negev (BGU) in Beer-Sheva has determined that the once prevalent custom of female genital mutilation (FGM) among Israel's Bedouin population in the Negev has virtually disappeared. The findings were reported in the Journal of Sexual Medicine 2009; 6:70-73.
FGM, also known as "female circumcision" or "female cutting," is still practiced in many cultures around the world. "It is of great interest to define processes or situations that can lead to a reduction in the incidence of this phenomenon in cultures where it is practiced," explains BGU Professor of Psychiatry Robert H. Belmaker. "FGM is a culturally entrenched procedure and unless a prohibition of the practice is accompanied by educational efforts, the effectiveness of legal action is low."
In 1995, Prof. Belmaker studied the Bedouin of Southern Israel, a heterogeneous group of tribes for which FGM was a common practice. At the time, a large number of women said that they planned to continue this custom, which involved a ritual incision but no tissue removal, and would perform it on their daughters. This led the researchers to believe at the time that the process was already undergoing modification.
BGU researchers decided to re-survey the Bedouin population nearly 15 years later, and again focused on women in the tribes previously reported to have performed this practice. In the new study, 132 women under 30 were given a gynecological examination and oral questionnaire. They found that none had scarring from the type reported in 1995.
Bedouins have become more westernized since Israel's independence in 1948. Israel's Bedouin demographic data shows that health care, school attendance, school years completed, and literacy have continued to improve over the last 15 years and may be associated with the long-term decrease in FGM since 1995. Today, approximately 180,000 Bedouin live in Southern Israel.
The World Health Organization has made the eradication of female genital mutilation a major goal in Africa, Asia and Australia. Prof. Belmaker says, "Direct eradication by making the custom illegal has had limited success. As in several other areas, such as childhood immunization and literacy, in the elimination of female genital surgery Israel's Arab population is among the leading populations in the Middle East."
Reference
Halila, Suhil, R.H. Belmaker, Yunis Abu Rabia, Miron Froimovici, and Julia Applebaum. "Disappearance of Female Genital Mutilation from the Bedouin Population of Southern Israel." Journal of Sexual Medicine Vol. 6, Issue 1 (January 2009): 70-73.
About Ben-Gurion University of the Negev and American Associates
Ben-Gurion University of the Negev is a world-renowned institute of research and higher learning with 18,000 students on its campuses in Beer-Sheva, Sede Boqer and Eilat in Israel's southern desert. It is a university with a conscience, where the highest academic standards are integrated with community involvement, committed to sustainable development of the Negev. Founded in 1972, American Associates, Ben-Gurion University of the Negev plays a vital role in helping the University fulfill its unique responsibility to develop the Negev, reach out to its local community and its Arab neighbors, and share its expertise with the world. For more information, please visit aabgu/.
Contact: Andrew Lavin
American Associates, Ben-Gurion University of the Negev
FGM, also known as "female circumcision" or "female cutting," is still practiced in many cultures around the world. "It is of great interest to define processes or situations that can lead to a reduction in the incidence of this phenomenon in cultures where it is practiced," explains BGU Professor of Psychiatry Robert H. Belmaker. "FGM is a culturally entrenched procedure and unless a prohibition of the practice is accompanied by educational efforts, the effectiveness of legal action is low."
In 1995, Prof. Belmaker studied the Bedouin of Southern Israel, a heterogeneous group of tribes for which FGM was a common practice. At the time, a large number of women said that they planned to continue this custom, which involved a ritual incision but no tissue removal, and would perform it on their daughters. This led the researchers to believe at the time that the process was already undergoing modification.
BGU researchers decided to re-survey the Bedouin population nearly 15 years later, and again focused on women in the tribes previously reported to have performed this practice. In the new study, 132 women under 30 were given a gynecological examination and oral questionnaire. They found that none had scarring from the type reported in 1995.
Bedouins have become more westernized since Israel's independence in 1948. Israel's Bedouin demographic data shows that health care, school attendance, school years completed, and literacy have continued to improve over the last 15 years and may be associated with the long-term decrease in FGM since 1995. Today, approximately 180,000 Bedouin live in Southern Israel.
The World Health Organization has made the eradication of female genital mutilation a major goal in Africa, Asia and Australia. Prof. Belmaker says, "Direct eradication by making the custom illegal has had limited success. As in several other areas, such as childhood immunization and literacy, in the elimination of female genital surgery Israel's Arab population is among the leading populations in the Middle East."
Reference
Halila, Suhil, R.H. Belmaker, Yunis Abu Rabia, Miron Froimovici, and Julia Applebaum. "Disappearance of Female Genital Mutilation from the Bedouin Population of Southern Israel." Journal of Sexual Medicine Vol. 6, Issue 1 (January 2009): 70-73.
About Ben-Gurion University of the Negev and American Associates
Ben-Gurion University of the Negev is a world-renowned institute of research and higher learning with 18,000 students on its campuses in Beer-Sheva, Sede Boqer and Eilat in Israel's southern desert. It is a university with a conscience, where the highest academic standards are integrated with community involvement, committed to sustainable development of the Negev. Founded in 1972, American Associates, Ben-Gurion University of the Negev plays a vital role in helping the University fulfill its unique responsibility to develop the Negev, reach out to its local community and its Arab neighbors, and share its expertise with the world. For more information, please visit aabgu/.
Contact: Andrew Lavin
American Associates, Ben-Gurion University of the Negev
Neither Abortion Nor Miscarriage Associated With Breast Cancer Risk
Neither induced abortion nor spontaneous abortion (miscarriage) appears to be associated with breast cancer risk in premenopausal women, according to a report in Archives of Internal Medicine, one of the JAMA/Archives journals.
Women younger than age 35 who carry a pregnancy to term appear to have a reduced lifetime risk of breast cancer, according to background information in the article. Pregnancy may accelerate breast cell differentiation, the process by which cells take on specialized roles. "An incomplete pregnancy may not result in sufficient differentiation to counter the high levels of pregnancy hormones that may foster proliferation," the rapid growth and division typical of cancer cells, the authors write. "However, these biological mechanisms are uncertain, and a prematurely terminated pregnancy may not affect breast cancer risk at all."
Karin B. Michels, Sc.D., Ph.D., and colleagues at Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, examined the association between abortion and breast cancer in 105,716 women who were part of the Nurses' Health Study II (NHSII). The women were between age 29 and 46 at the beginning of the study in 1993. At that time, and again every two years through 2003, they answered questions about whether and at what age they had had miscarriages or induced abortions and provided information about breast cancer risk factors and diagnoses.
A total of 16,118 participants (15 percent) reported having a history of induced abortion and 21,753 (21 percent) had a history of spontaneous abortion. Between 1993 and 2003, 1,458 new cases of breast cancer occurred among the women. "In this cohort study of young women, we found no association between induced abortion and breast cancer incidence and a suggestion of an inverse association between spontaneous abortion and breast cancer incidence during 10 years of follow-up," the authors write.
"We observed associations in two subgroups, an association between induced abortion and progesterone receptor-negative breast cancer [cancer that does not respond to the hormone progesterone] and an inverse association between spontaneous abortion before the age of 20 years and breast cancer incidence," they continue. However, they caution that these secondary analyses are based on small numbers of women. "No obvious mechanisms can be provided for these subgroup findings; thus, chance has to be considered as a possible explanation."
A 2003 international expert panel convened by the National Cancer Institute reviewed and assessed research regarding reproductive events and the risk of breast cancer, and concluded that based on existing evidence, induced abortion is not associated with an increased risk of breast cancer. "The data from the NHSII provide further evidence of a lack of an important overall association between induced or spontaneous abortions and risk of breast cancer," the authors conclude. "Among this predominantly pre-menopausal population, neither induced nor spontaneous abortion was associated with the incidence of breast cancer."
(Arch Intern Med. 2007;167:814-820.)
The NHSII is supported by a Public Health Service grant from the National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Leah Gourley
JAMA and Archives Journals
Women younger than age 35 who carry a pregnancy to term appear to have a reduced lifetime risk of breast cancer, according to background information in the article. Pregnancy may accelerate breast cell differentiation, the process by which cells take on specialized roles. "An incomplete pregnancy may not result in sufficient differentiation to counter the high levels of pregnancy hormones that may foster proliferation," the rapid growth and division typical of cancer cells, the authors write. "However, these biological mechanisms are uncertain, and a prematurely terminated pregnancy may not affect breast cancer risk at all."
Karin B. Michels, Sc.D., Ph.D., and colleagues at Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, examined the association between abortion and breast cancer in 105,716 women who were part of the Nurses' Health Study II (NHSII). The women were between age 29 and 46 at the beginning of the study in 1993. At that time, and again every two years through 2003, they answered questions about whether and at what age they had had miscarriages or induced abortions and provided information about breast cancer risk factors and diagnoses.
A total of 16,118 participants (15 percent) reported having a history of induced abortion and 21,753 (21 percent) had a history of spontaneous abortion. Between 1993 and 2003, 1,458 new cases of breast cancer occurred among the women. "In this cohort study of young women, we found no association between induced abortion and breast cancer incidence and a suggestion of an inverse association between spontaneous abortion and breast cancer incidence during 10 years of follow-up," the authors write.
"We observed associations in two subgroups, an association between induced abortion and progesterone receptor-negative breast cancer [cancer that does not respond to the hormone progesterone] and an inverse association between spontaneous abortion before the age of 20 years and breast cancer incidence," they continue. However, they caution that these secondary analyses are based on small numbers of women. "No obvious mechanisms can be provided for these subgroup findings; thus, chance has to be considered as a possible explanation."
A 2003 international expert panel convened by the National Cancer Institute reviewed and assessed research regarding reproductive events and the risk of breast cancer, and concluded that based on existing evidence, induced abortion is not associated with an increased risk of breast cancer. "The data from the NHSII provide further evidence of a lack of an important overall association between induced or spontaneous abortions and risk of breast cancer," the authors conclude. "Among this predominantly pre-menopausal population, neither induced nor spontaneous abortion was associated with the incidence of breast cancer."
(Arch Intern Med. 2007;167:814-820.)
The NHSII is supported by a Public Health Service grant from the National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Leah Gourley
JAMA and Archives Journals
How Maternal Nutrition Affects Fetus
Timeframe before conception may be linked to disease later in life
Mothers' health in the days and weeks prior to becoming pregnant may determine the health of offspring much later in life, according to results of studies reported at the annual meeting of the Society for the Study of Reproduction, which is taking place July 18 to 22 at the David L. Lawrence Convention Center in Pittsburgh. These studies demonstrate that maternal nutrition, protein intake and level of fat in the diet may cause epigenetic changes in the developing fetus that can have long-term health consequences.
Summaries of their findings are as follows:
Too Much of a Sweet Thing? Maternal Diabetes and Embryo Development
The time between ovulation and conception may be a critical one for maternal and fetal health, according to Kelle Moley, M.D., Washington University School of Medicine. In mouse studies, she found that subtle differences in maternal metabolism had long-lasting effects. Indeed, when Dr. Moley transferred embryos from a diabetic mouse into a non-diabetic mouse shortly after egg implantation, she noted neural tube defects, heart defects, limb deformities and growth defects in offspring. These findings indicate that we may need to re-direct our ideas about maternal health to the time prior to pregnancy, she says.
Take Your Vitamins Before Becoming Pregnant
Are we encouraging pregnant women to take vitamins when it may be too late to impact the health of a growing fetus? According to Kevin Sinclair, Ph.D., University of Nottingham, maternal nutrition even at the time of conception can alter fetal development. In studies with sheep and rodents, he found that offspring of mothers with vitamin B12 and folic acid deficiencies were fatter, became insulin resistant and had higher blood pressure by the time they reached middle-age, demonstrating that early molecular changes may not manifest themselves for many years.
Low Protein Diet May Lead to "Jumpy" Offspring
Low protein levels in female mice during the first few moments of conception, when the egg is still dividing, caused abnormal growth, cardiovascular disease, high blood pressure and jumpy behavior in their offspring. According to Tom Fleming, Ph.D., University of Southampton, mice born to mothers with low protein grew bigger - extracting as much nutrients as they could to compensate for poor nutrition while in the womb.
Beyond Genetics: How Dormant Memories Can Impact Later-Life Events
According to epigenetic theory, changes in the genome can happen at any time through the impact of environmental factors on the expression of genes over time. One of the most critical periods is early life when epigenetic memories are created that may impact a person's susceptibility to disease later in life, says Shuk-mei Ho, Ph.D., University of Cincinnati Medical Center. According to her research, these "memories" may remain dormant until an environmental trigger brings them to the surface, modifying risk for disease.
Source:
Clare Collins
University of Pittsburgh Schools of the Health Sciences
Mothers' health in the days and weeks prior to becoming pregnant may determine the health of offspring much later in life, according to results of studies reported at the annual meeting of the Society for the Study of Reproduction, which is taking place July 18 to 22 at the David L. Lawrence Convention Center in Pittsburgh. These studies demonstrate that maternal nutrition, protein intake and level of fat in the diet may cause epigenetic changes in the developing fetus that can have long-term health consequences.
Summaries of their findings are as follows:
Too Much of a Sweet Thing? Maternal Diabetes and Embryo Development
The time between ovulation and conception may be a critical one for maternal and fetal health, according to Kelle Moley, M.D., Washington University School of Medicine. In mouse studies, she found that subtle differences in maternal metabolism had long-lasting effects. Indeed, when Dr. Moley transferred embryos from a diabetic mouse into a non-diabetic mouse shortly after egg implantation, she noted neural tube defects, heart defects, limb deformities and growth defects in offspring. These findings indicate that we may need to re-direct our ideas about maternal health to the time prior to pregnancy, she says.
Take Your Vitamins Before Becoming Pregnant
Are we encouraging pregnant women to take vitamins when it may be too late to impact the health of a growing fetus? According to Kevin Sinclair, Ph.D., University of Nottingham, maternal nutrition even at the time of conception can alter fetal development. In studies with sheep and rodents, he found that offspring of mothers with vitamin B12 and folic acid deficiencies were fatter, became insulin resistant and had higher blood pressure by the time they reached middle-age, demonstrating that early molecular changes may not manifest themselves for many years.
Low Protein Diet May Lead to "Jumpy" Offspring
Low protein levels in female mice during the first few moments of conception, when the egg is still dividing, caused abnormal growth, cardiovascular disease, high blood pressure and jumpy behavior in their offspring. According to Tom Fleming, Ph.D., University of Southampton, mice born to mothers with low protein grew bigger - extracting as much nutrients as they could to compensate for poor nutrition while in the womb.
Beyond Genetics: How Dormant Memories Can Impact Later-Life Events
According to epigenetic theory, changes in the genome can happen at any time through the impact of environmental factors on the expression of genes over time. One of the most critical periods is early life when epigenetic memories are created that may impact a person's susceptibility to disease later in life, says Shuk-mei Ho, Ph.D., University of Cincinnati Medical Center. According to her research, these "memories" may remain dormant until an environmental trigger brings them to the surface, modifying risk for disease.
Source:
Clare Collins
University of Pittsburgh Schools of the Health Sciences
Journal Publishes NAFC Research On The Frustration Of Overactive Bladder In Women
Research by the National Association For Continence (NAFC) about the frustration endured by middle-aged women, who have overactive bladder (OAB) symptoms, will be published in the inaugural issue of Annals of Urology from San Lucas Medical. The purpose of the research was to learn more about what causes women to seek treatment for OAB, how committed women are to their current treatment for OAB and what influences them to change treatment. The study was funded by a research grant provided by Medtronic Inc., a leading medical device company.
On behalf of NAFC, Kelton Research, a California based consumer research and marketing services firm, conducted an online survey from March 18 to March 31, 2009. The survey was completed by 1,111 American women ages 40 to 65, 611 of whom self-reported symptoms of OAB. These 611 women were compared to the remaining 500 non-OAB sufferers in the sample for a baseline view of American women's beliefs about the role of health for achieving a sense of balance in life. Respondents with OAB were further sub-divided into three categories for analytical purposes: women who have never been treated, women who were currently undergoing treatment and women who stopped their treatment.
Based on this survey, NAFC found that middle-aged women are more likely to express annoyance and frustration about their OAB symptoms than embarrassment or stigmatization. In addition, findings suggest that frustration abounds among middle-aged women in treatment for OAB. More research is needed to support the suggestion that female baby boomers are not necessarily obstructed by embarrassment or stigma associated with bladder control in seeking solutions to conditions such as OAB. As a result of the findings, practitioners are encouraged by NAFC to be more interactive and instructional with patients by offering a combination therapy approach to managing symptoms. Moreover, NAFC is calling for greater public health education to make more people aware of their treatment options.
Source:
National Association For Continence (NAFC)
On behalf of NAFC, Kelton Research, a California based consumer research and marketing services firm, conducted an online survey from March 18 to March 31, 2009. The survey was completed by 1,111 American women ages 40 to 65, 611 of whom self-reported symptoms of OAB. These 611 women were compared to the remaining 500 non-OAB sufferers in the sample for a baseline view of American women's beliefs about the role of health for achieving a sense of balance in life. Respondents with OAB were further sub-divided into three categories for analytical purposes: women who have never been treated, women who were currently undergoing treatment and women who stopped their treatment.
Based on this survey, NAFC found that middle-aged women are more likely to express annoyance and frustration about their OAB symptoms than embarrassment or stigmatization. In addition, findings suggest that frustration abounds among middle-aged women in treatment for OAB. More research is needed to support the suggestion that female baby boomers are not necessarily obstructed by embarrassment or stigma associated with bladder control in seeking solutions to conditions such as OAB. As a result of the findings, practitioners are encouraged by NAFC to be more interactive and instructional with patients by offering a combination therapy approach to managing symptoms. Moreover, NAFC is calling for greater public health education to make more people aware of their treatment options.
Source:
National Association For Continence (NAFC)
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