Exposure to dioxins during pregnancy harms the cells in rapidly-changing breast tissue, which may explain why some women have trouble breastfeeding or don't produce enough milk, according to a University of Rochester Medical Center study.
Researchers believe their findings, although only demonstrated in mice at this point, begin to address an area of health that impacts millions of women but has received little attention in the laboratory, said corresponding author B. Paige Lawrence, Ph.D., associate professor of Environmental Medicine and of Microbiology and Immunology at URMC.
"Estimates are that three to six million mothers worldwide are either unable to initiate breastfeeding or are unable to produce enough milk to nourish their infants," Lawrence said. "But the cause of this problem is unclear, though it has been suggested that environmental contaminants might play a role. We showed definitively that a known and abundant pollutant has an adverse effect on the way mammary glands develop during pregnancy."
Dioxins are generated mostly by the incineration of municipal and medical waste, especially certain plastics. Most people are exposed through diet. Dioxins get into the food supply when air emissions settle on farm fields and where livestock graze. Fish also ingest dioxins and related pollutants from contaminated waters. When humans take in dioxin - most often through meat, dairy products, fish and shellfish - the toxin settles in fatty tissues; natural elimination takes place very slowly. The typical human exposure is a daily low dose, which has been linked to possible impairment of the immune system and developing organs.
In 2004 Lawrence's laboratory made the novel discovery that dioxin impairs the normal development of mammary glands during pregnancy. However, the underlying mechanisms were unclear, as was the extent of injury and whether exposure during certain stages of pregnancy had more or less of an impact on milk production.
This week, in an online report in Toxicological Sciences, researchers showed that dioxin has a profound effect on breast tissue by causing mammary cells to stop their natural cycle of proliferation as early as six days into pregnancy, and lasting through mid-pregnancy. In tissue samples from mice, exposure to dioxin caused a 50-percent decrease in new epithelial cells. This is important, Lawrence said, because mammary glands have a high rate of cell proliferation, especially during early to mid-pregnancy when the most rapid development of the mammary gland occurs.
Researchers also found that dioxin altered the induction of milk-producing genes, which occurs around the ninth day of pregnancy, and decreased the number of ductal branches and mature lobules in the mammary tissue.
The timing of dioxin exposure also seemed to be significant, the study noted. For example, when exposure occurs very early in pregnancy but not later, lab experiments showed that sometimes the mammary glands can partially recover from the cellular injury. However, although it is important to understand timing of exposure for research purposes, it is irrelevant for humans, who cannot really control their exposure to dioxins, Lawrence said.
"Our goal is not to find a safe window of exposure for humans, but to better understand how dioxins affect our health," she said. "The best thing people who are concerned about this can do is think about what you eat and where your food comes from. We're not suggesting that we all become vegans -- but we hope this study raises awareness about how our food sources can increase the burden of pollutants in the body. Unfortunately, we have very little control over this, except perhaps through the legislative process."
Much of Lawrence's research focuses on a transcription factor known as aryl hydrocarbon receptor, or AhR.When pollutants enter the body they bind to AhR, which then turns on certain genes responsible for detoxification. By using dioxin to activate AhR, researchers have learned that dioxin impairs the ability to fight off infection. The link between dioxin and the immune system is still being studied, but meanwhile researchers looked further at the mammary tissue after observing coincidentally that cells involved in milk production were sustaining so much damage that rodents could not nourish their offspring.
The next step is to understand what controls the differentiation process. An important question to answer, Lawrence said, is whether the toxic harm is occurring directly in the breast, or if it occurs throughout the entire body but has a unique manifestation in the fatty mammary tissue.
The URMC research group is also studying a possible connection between dioxin and breast cancer.Their hypothesis is that dioxin exposure in some people might cancel the general protection that pregnancy has on breast tissue against breast cancer.
The research was supported by grants from the National Institutes of Health and the URMC Environmental Health Sciences Center, as well as the Art BeCAUSE Foundation of Boston, which funds breast-cancer related research.
Source:
Leslie Orr
University of Rochester Medical Center
четверг, 29 декабря 2011 г.
четверг, 22 декабря 2011 г.
What Women Need To Know: Getting The Facts About Women And Heart Disease
Many women don't worry about heart disease, or if they do, they are concerned it's something the men in their lives might develop. But that attitude is a mistake.
While it's true that estrogen gives women some protection against the disease, at least until menopause, heart disease is still the leading killer of American women. Here's what women should watch for.
Keep heart disease at bay. First, because the disease is so prevalent, prevention is the key. Two major risk factors obesity and smoking are in your control. Padma Uppalapati, M.D., a cardiologist on the medical staff at Baylor Medical Center at Irving, says that women sometimes develop a cluster of conditions, including obesity, diabetes, high blood pressure, polycystic ovarian disease and depression that are linked with a high risk of heart disease. And while smoking is a risk factor for both men and women, it seems to affect women differently, she says.
Watch and test. Dr. Uppalapati recommends that all women at high risk for heart disease be tested, even if they don't have any symptoms. That's because symptoms in women can be more subtle than in men. "Women may have shortness of breath, feel tired, and maybe just have neck, jaw or upper back pain," she explains. "It's so common to hear women say, 'I'm just not feeling well,' with no additional symptoms."
Search for signs. In women, a stress test with an EKG has a higher rate of false positives than in men, Dr. Uppalapati says. She recommends combining a stress test with an ultrasound, which can check for other heart problems such as mitral valve prolapse. She notes that with a good image from an ultrasound you shouldn't need a nuclear scan, which sometimes returns a false positive in women due to a breast shadow.
Time to treat. Dr. Uppalapati warns that because women's symptoms can be mild, they often postpone seeking treatment. Women need to get to the hospital early so the blockage can be cleared. "Time is extremely crucial," she says. "It's very important to get in early. Once women have angioplasty or bypass surgery they can do fine."
Here are five ways women can lower their risk of heart disease:
1. Maintain a healthy weight.
2. Eat a balanced diet that helps keep cholesterol levels under control.
3. Exercise.
4. Don't smoke.
5. Talk to your doctor about the pros and cons of hormone replacement therapy.
For more information about Baylor Medical Center at Irving, visit BaylorHealth.
Baylor Health Care System
2001 Bryan St., Ste. 2200
Dallas, TX 75201
United States
BaylorHealth
While it's true that estrogen gives women some protection against the disease, at least until menopause, heart disease is still the leading killer of American women. Here's what women should watch for.
Keep heart disease at bay. First, because the disease is so prevalent, prevention is the key. Two major risk factors obesity and smoking are in your control. Padma Uppalapati, M.D., a cardiologist on the medical staff at Baylor Medical Center at Irving, says that women sometimes develop a cluster of conditions, including obesity, diabetes, high blood pressure, polycystic ovarian disease and depression that are linked with a high risk of heart disease. And while smoking is a risk factor for both men and women, it seems to affect women differently, she says.
Watch and test. Dr. Uppalapati recommends that all women at high risk for heart disease be tested, even if they don't have any symptoms. That's because symptoms in women can be more subtle than in men. "Women may have shortness of breath, feel tired, and maybe just have neck, jaw or upper back pain," she explains. "It's so common to hear women say, 'I'm just not feeling well,' with no additional symptoms."
Search for signs. In women, a stress test with an EKG has a higher rate of false positives than in men, Dr. Uppalapati says. She recommends combining a stress test with an ultrasound, which can check for other heart problems such as mitral valve prolapse. She notes that with a good image from an ultrasound you shouldn't need a nuclear scan, which sometimes returns a false positive in women due to a breast shadow.
Time to treat. Dr. Uppalapati warns that because women's symptoms can be mild, they often postpone seeking treatment. Women need to get to the hospital early so the blockage can be cleared. "Time is extremely crucial," she says. "It's very important to get in early. Once women have angioplasty or bypass surgery they can do fine."
Here are five ways women can lower their risk of heart disease:
1. Maintain a healthy weight.
2. Eat a balanced diet that helps keep cholesterol levels under control.
3. Exercise.
4. Don't smoke.
5. Talk to your doctor about the pros and cons of hormone replacement therapy.
For more information about Baylor Medical Center at Irving, visit BaylorHealth.
Baylor Health Care System
2001 Bryan St., Ste. 2200
Dallas, TX 75201
United States
BaylorHealth
четверг, 15 декабря 2011 г.
Gynecologic Cancer Patients Should Consider Clinical Trials
For the estimated 83,000 women who will be diagnosed with a gynecologic cancer in 2010, participation in clinical trials offers an opportunity both to ensure that future patients benefit from the most up-to-date treatments and increased survival rates and to potentially improve the health of current patients. The American College of Obstetricians and Gynecologists supports the efforts to raise awareness about gynecologic cancers and participation in clinical trials-a main focus of this year's Gynecologic Cancer Awareness Month (GCAM) in September.
Gynecologic cancers originate in the female reproductive organs including the cervix, ovaries, uterus, fallopian tubes, vagina, and vulva. "Raising awareness of gynecologic cancers is extremely important because every woman is at risk," said Richard Waldman, MD, president of The College. "As ob-gyns, we have a responsibility to educate our patients about the very real threat of these cancers, which will kill approximately 28,000 women in the US this year alone."
In addition to raising general awareness of gynecologic cancers, this year's GCAM highlights the critical role of clinical trials in the prevention and treatment of disease. These trials are a key step in the discovery process that leads to the development of new therapies and advances in medicine.
Women who participate in clinical trials make an extremely valuable contribution to scientific knowledge. They also may gain access to new research treatments before they are widely available and can benefit from having their health closely monitored on an ongoing basis. They often have easy access to the clinical trial team, obtain expert medical care at leading health care facilities, and are able to raise questions and concerns during treatment. Some women who participate in a clinical trial report feeling empowered because they are taking an active role in decisions regarding their health. It can also be a way of paying-it-forward and helping those who will struggle with that disease in the future.
Despite the importance of participating in clinical trials, only three percent of adults do so. That rate is even lower among low-income women and minorities, groups that have disproportionately higher rates of cancer-related deaths.
"The thought of trying a novel approach instead of a more tried-and-true therapy may be frightening when you're dealing with an illness," Dr. Waldman notes. "But considering participation in a clinical trial may be wise for cancer patients-it could be a choice that saves your life."
Gynecologic Cancer Foundation (GCF), which sponsors GCAM, urges women diagnosed with a gynecologic cancer to learn more about clinical trials. The GCF's Women's Cancer Network website is a comprehensive and educational resource on gynecologic cancers. Women can find out about clinical trials that are currently enrolling, take a free 15-minute online risk assessment to learn about their personal risk of developing cancer, and more. A tool-kit designed to help community members set up local awareness events is also available.
Source:
American College of Obstetricians and Gynecologists
Gynecologic cancers originate in the female reproductive organs including the cervix, ovaries, uterus, fallopian tubes, vagina, and vulva. "Raising awareness of gynecologic cancers is extremely important because every woman is at risk," said Richard Waldman, MD, president of The College. "As ob-gyns, we have a responsibility to educate our patients about the very real threat of these cancers, which will kill approximately 28,000 women in the US this year alone."
In addition to raising general awareness of gynecologic cancers, this year's GCAM highlights the critical role of clinical trials in the prevention and treatment of disease. These trials are a key step in the discovery process that leads to the development of new therapies and advances in medicine.
Women who participate in clinical trials make an extremely valuable contribution to scientific knowledge. They also may gain access to new research treatments before they are widely available and can benefit from having their health closely monitored on an ongoing basis. They often have easy access to the clinical trial team, obtain expert medical care at leading health care facilities, and are able to raise questions and concerns during treatment. Some women who participate in a clinical trial report feeling empowered because they are taking an active role in decisions regarding their health. It can also be a way of paying-it-forward and helping those who will struggle with that disease in the future.
Despite the importance of participating in clinical trials, only three percent of adults do so. That rate is even lower among low-income women and minorities, groups that have disproportionately higher rates of cancer-related deaths.
"The thought of trying a novel approach instead of a more tried-and-true therapy may be frightening when you're dealing with an illness," Dr. Waldman notes. "But considering participation in a clinical trial may be wise for cancer patients-it could be a choice that saves your life."
Gynecologic Cancer Foundation (GCF), which sponsors GCAM, urges women diagnosed with a gynecologic cancer to learn more about clinical trials. The GCF's Women's Cancer Network website is a comprehensive and educational resource on gynecologic cancers. Women can find out about clinical trials that are currently enrolling, take a free 15-minute online risk assessment to learn about their personal risk of developing cancer, and more. A tool-kit designed to help community members set up local awareness events is also available.
Source:
American College of Obstetricians and Gynecologists
четверг, 8 декабря 2011 г.
Orthopedics Surgeons At Rush University Medical Center Performe Total Knee Replacement Surgery On Live, Online Computer Webcast
Orthopedic surgeons at Rush University Medical Center performed a Total Knee Replacement surgery which could be viewed online.
Orthopedic surgeon Dr. Richard A. Berger performed the surgery which featured the use of the knee replacement shaped to fit a woman's anatomy The webcast was moderated by Dr. Aaron G. Rosenberg, also from Rush. Berger and Rosenberg were two of the 12 surgeons who sought to address shape-related differences of a woman's knee by developing the new prosthesis.
Questions from both surgeons and the general public were sent in via email during the broadcast. The webcast was sponsored by The Zimmer Institute.
The procedure uses a Zimmer Minimally Invasive Solutions ™(MIS) sub-vastus approach and requires an incision of only 9 to 14 cm, compared with 20 to 30 cm used in a standard knee replacement arthroplasty. Among the goals of this minimally invasive technique are shorter hospital stays, lower blood loss, faster rehabilitation and a more cosmetically appealing surgical scar.
Knee replacements have long been available in many sizes, but merely using a different size for women doesn't resolve anatomical differences. Various studies show that women's knees significantly differ in shape from men's knees. Pioneering research conducted for Zimmer precisely maps out those differences and is the foundation for the design and development of the Gender Solutions Knee.
"Knee implants have been functioning very well for men and women, but we want to meet women's unique needs by making knee replacements that feel, fit and function even better," says Rosenberg. "The implant is the best of both worlds. It's based on the current implant we use, a highly successful implant with great mechanics and 10 years of clinical success. Only the shape of this new implant is different, to make it feel more natural."
When placing traditional implants, some surgeons accommodate women's differences by removing more bone or repositioning the implant during surgery, but their ability to make the implant precisely conform to the patient is limited. The Gender Solutions High-Flex Implant was designed so the surgeon can more closely match the female patient's knee anatomy.
"Mounting research indicates that a woman's knee is not simply a smaller version of a man's knee. The differences involve the bones, ligaments and tendons in the joints," says Rosenberg. "Women can wear men's clothing and shoes, but most prefer clothing and shoes made for them. It's the same with knees, and it makes perfect sense to design knee implants with women in mind, particularly considering that women are by far the majority of the knee replacement patient population."
Nearly two-thirds of the more than 400,000 annual knee replacement patients are women, according to the National Center for Health Statistics, and the numbers continue to increase each year. Research shows that while both women and men vastly underuse knee replacement, women are three times less likely than men to undergo the procedure, although they suffer from more knee pain and resulting disability.
The Gender Solutions High-Flex Knee, the first of several gender innovations to come from Zimmer, is based on the company's more than 20 years of clinical success with total knee implants. Further, it can be placed using Zimmer MIS Procedures, which typically offer smaller scars, shorter hospitalization and quicker rehabilitation and recovery; and safely accommodates high flexion (up to 155 degrees), which is necessary for many activities, such as climbing stairs, sitting in a chair, gardening and golfing.
The knee joint is composed of three bones: the end of the femur (thighbone), the top of the tibia (shinbone) and the patella (kneecap), which are all held together by tendons and ligaments and cushioned by cartilage. Knees can become painful, due to arthritis, injury and infection, which cause deterioration of the cartilage. When the cartilage is gone, the bones of the knee grind against each other, wearing away and typically causing severe pain. Total knee replacement involves removing the portion of bone that is damaged and resurfacing the knee with metal and plastic implants.
For more information on orthopedics at Rush
Contact: Mary Ann Schultz
Rush University Medical Center
Orthopedic surgeon Dr. Richard A. Berger performed the surgery which featured the use of the knee replacement shaped to fit a woman's anatomy The webcast was moderated by Dr. Aaron G. Rosenberg, also from Rush. Berger and Rosenberg were two of the 12 surgeons who sought to address shape-related differences of a woman's knee by developing the new prosthesis.
Questions from both surgeons and the general public were sent in via email during the broadcast. The webcast was sponsored by The Zimmer Institute.
The procedure uses a Zimmer Minimally Invasive Solutions ™(MIS) sub-vastus approach and requires an incision of only 9 to 14 cm, compared with 20 to 30 cm used in a standard knee replacement arthroplasty. Among the goals of this minimally invasive technique are shorter hospital stays, lower blood loss, faster rehabilitation and a more cosmetically appealing surgical scar.
Knee replacements have long been available in many sizes, but merely using a different size for women doesn't resolve anatomical differences. Various studies show that women's knees significantly differ in shape from men's knees. Pioneering research conducted for Zimmer precisely maps out those differences and is the foundation for the design and development of the Gender Solutions Knee.
"Knee implants have been functioning very well for men and women, but we want to meet women's unique needs by making knee replacements that feel, fit and function even better," says Rosenberg. "The implant is the best of both worlds. It's based on the current implant we use, a highly successful implant with great mechanics and 10 years of clinical success. Only the shape of this new implant is different, to make it feel more natural."
When placing traditional implants, some surgeons accommodate women's differences by removing more bone or repositioning the implant during surgery, but their ability to make the implant precisely conform to the patient is limited. The Gender Solutions High-Flex Implant was designed so the surgeon can more closely match the female patient's knee anatomy.
"Mounting research indicates that a woman's knee is not simply a smaller version of a man's knee. The differences involve the bones, ligaments and tendons in the joints," says Rosenberg. "Women can wear men's clothing and shoes, but most prefer clothing and shoes made for them. It's the same with knees, and it makes perfect sense to design knee implants with women in mind, particularly considering that women are by far the majority of the knee replacement patient population."
Nearly two-thirds of the more than 400,000 annual knee replacement patients are women, according to the National Center for Health Statistics, and the numbers continue to increase each year. Research shows that while both women and men vastly underuse knee replacement, women are three times less likely than men to undergo the procedure, although they suffer from more knee pain and resulting disability.
The Gender Solutions High-Flex Knee, the first of several gender innovations to come from Zimmer, is based on the company's more than 20 years of clinical success with total knee implants. Further, it can be placed using Zimmer MIS Procedures, which typically offer smaller scars, shorter hospitalization and quicker rehabilitation and recovery; and safely accommodates high flexion (up to 155 degrees), which is necessary for many activities, such as climbing stairs, sitting in a chair, gardening and golfing.
The knee joint is composed of three bones: the end of the femur (thighbone), the top of the tibia (shinbone) and the patella (kneecap), which are all held together by tendons and ligaments and cushioned by cartilage. Knees can become painful, due to arthritis, injury and infection, which cause deterioration of the cartilage. When the cartilage is gone, the bones of the knee grind against each other, wearing away and typically causing severe pain. Total knee replacement involves removing the portion of bone that is damaged and resurfacing the knee with metal and plastic implants.
For more information on orthopedics at Rush
Contact: Mary Ann Schultz
Rush University Medical Center
четверг, 1 декабря 2011 г.
Women Dominate Hospitalizations For Chest Pain With No Known Cause
Women are more likely than men to be hospitalized for chest pain for which doctors cannot find a cause, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. In 2006, there were 477,000 admissions of women to U.S. community hospitals for unspecified chest pain compared with 379,000 admissions for men.
Unspecified chest pain is usually characterized by a feeling of pressure, burning, or numbness. Although it is not clear why women receive this diagnosis more than men, there is some evidence that heart disease develops differently in women than men and that symptoms may be different. Medical experts believe that physicians may not always be aware of this gender difference.
The federal agency also found that men were more likely to be hospitalized for heart disease or heart attacks than were women in 2006.
Specifically:
- Women made up 56 percent of all admissions for unspecified chest pain, but only 38 percent of all admissions for coronary artery disease.
- Roughly 451,000 women, compared with 747,000 men, were hospitalized for coronary artery disease. This disease results in narrowing of the arteries.
- Heart attacks, which are usually caused by heart disease, sent 269,000 women to hospitals, compared with 406,000 men. Women made up 40 percent of all admissions for heart attacks.
- Hospitalizations for congestive heart failure were roughly the same for women (565,000) and men (534,000).
- Hospitalizations for irregular heart beat were also similar for women (379,000) and men (369,000).
This AHRQ News and Numbers summary is based on data in HCUP Facts and Figures, 2006, which provides highlights of the latest data from the 2006 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project. The report provides data on leading reasons for hospitalization, such as arthritis, asthma, childbirth, cancer, diabetes, depression, and heart conditions, on procedures performed on hospital patients, and on related topics.
AHRQ
Unspecified chest pain is usually characterized by a feeling of pressure, burning, or numbness. Although it is not clear why women receive this diagnosis more than men, there is some evidence that heart disease develops differently in women than men and that symptoms may be different. Medical experts believe that physicians may not always be aware of this gender difference.
The federal agency also found that men were more likely to be hospitalized for heart disease or heart attacks than were women in 2006.
Specifically:
- Women made up 56 percent of all admissions for unspecified chest pain, but only 38 percent of all admissions for coronary artery disease.
- Roughly 451,000 women, compared with 747,000 men, were hospitalized for coronary artery disease. This disease results in narrowing of the arteries.
- Heart attacks, which are usually caused by heart disease, sent 269,000 women to hospitals, compared with 406,000 men. Women made up 40 percent of all admissions for heart attacks.
- Hospitalizations for congestive heart failure were roughly the same for women (565,000) and men (534,000).
- Hospitalizations for irregular heart beat were also similar for women (379,000) and men (369,000).
This AHRQ News and Numbers summary is based on data in HCUP Facts and Figures, 2006, which provides highlights of the latest data from the 2006 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project. The report provides data on leading reasons for hospitalization, such as arthritis, asthma, childbirth, cancer, diabetes, depression, and heart conditions, on procedures performed on hospital patients, and on related topics.
AHRQ
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