суббота, 14 января 2012 г.
Antidepressant Use May Boost Fracture Risk, From Harvard Women's Health Watch
depression is a risk factor for osteoporosis, reports the June 2007 issue
of Harvard Women's Health Watch. A recent study found that people ages 50
and over who regularly took antidepressants called selective serotonin
reuptake inhibitors (SSRIs) had double the rate of fractures as people not
using such medications. Other research points to depression itself as a
source of endocrine changes that can damage bone.
Whether the danger comes from depression, the drugs used to treat it,
or something else, doctors are paying more attention to this association.
During the 1990s, depression began to emerge as a possible cause of bone
loss, rather than a result. Scientists studied women who didn't have
osteoporosis symptoms or even know they had the condition. They found lower
bone mineral density in those who were depressed. Moreover, the link was
found in both younger women and women past menopause. Other studies have
found a similar relationship, so investigators have been looking at
hormones and brain chemicals potentially involved in both depression and
bone loss.
Researchers working with an animal model found that depression triggers
the release of noradrenaline, which interferes with bone-building cells.
Moreover, they found that imipramine-a member of an older class of drugs
called tricyclic antidepressants-reversed both depression and depression-
induced bone loss.
It may be a long time before the depression-osteoporosis connection is
fully clarified. In the meantime, Harvard Women's Health Watch suggests
that you continue taking an antidepressant if you already use one;
depression is a serious illness that can have profound consequences. You
may also want to talk to your doctor about getting a bone density test, and
make sure you get adequate calcium.
Harvard Health Publications
health.harvard.edu/women
суббота, 7 января 2012 г.
Videos Discuss Antiabortion Threats, Benefits Of Health Reform For Women
Maddow Examines Violent Threats: On Tuesday, MSNBC host Rachel Maddow discussed a potential connection between violent anti-government threats and antiabortion-rights activism. Maddow reports that a Washington man was arrested after leaving anti-health-reform messages that called Sen. Patty Murray (D-Wash.) a "baby killer," while a Texas man was charged for threatening to use physical force to stop a Dallas clinic from performing abortions. The segment also includes an interview with Zachary Roth of Talking Points Memo, who noted that many abortion-rights groups reported an "uptick in this kind of violent language and rhetoric" after the murder of abortion provider George Tiller last year. However, it is not entirely clear if the two men who were arrested can be linked with the antiabortion-rights movement, he added (Maddow, "The Rachel Maddow Show," MSNBC, 4/8).
Richards Discusses Health Reform: In an interview on MSNBC's "The Daily Rundown," Planned Parenthood Action Fund President Cecile Richards said that although abortion-rights groups "didn't like" the abortion restrictions in the health reform law, the "important thing is this is going to expand health care coverage for millions of women and their families." She added that the health reform debate helped remind abortion-rights supporters that "we don't have a pro-choice Congress" (Todd/Guthrie, "The Daily Rundown," MSNBC, 4/1).
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.
суббота, 31 декабря 2011 г.
UCSF Research Shows Private Umbilical Cord Banking Is Not Cost-Effective
The researchers used a technique called decision analysis that tracks hypothetical groups of people and allows comparison of expected costs and health benefits of two alternative strategies (in this case, private cord blood banking versus no cord blood banking). Results of the study appear in the October 2009 issue of the journal Obstetrics & Gynecology.
Cord blood is collected from the umbilical cord shortly after a baby's birth and has the potential to treat a variety of medical conditions ranging from leukemia to metabolic disorders to cerebral palsy. Public cord blood banks store cord blood at no cost and make the blood available to anyone needing treatment, or for research purposes.
Private cord banks charge a fee to store a baby's cord blood for his/her own possible future use or for a family member's possible future use.
"While there are plausible medical advantages of umbilical cord blood stem cells, many of these benefits are primarily theoretical at this point," said Aaron Caughey, MD, PhD, co-author of the paper, a UCSF associate professor of obstetrics, gynecology and reproductive sciences, and director of the UCSF Center for Clinical and Policy Perinatal Research. "Expectant parents need to understand the true likelihood of their family benefitting from private cord blood banking in order to make an informed decision about this expensive process."
Private umbilical cord blood banking companies in the United States market directly to consumers, at times describing cord blood as a "biologic insurance" for their unborn child, the researchers note. However, a survey of private cord blood banks by the American Society for Blood and Marrow Transplantation found that of the approximately 460,000 cord blood units banked, only 99 were confirmed as being shipped for use in treatment.
The decision-analytic model used by the research team included four baseline assumptions: a cost of $3,620, the lowest price quoted from major blood banking company web sites, for umbilical cord blood banking and storage for 20 years; a .04 percent chance of requiring an autologous (self) or stem cell transplant; a .07 percent chance of a sibling requiring an allogenic (from another person) stem cell transplant; and a 50 percent reduction in risk of graft-versus-host disease if a sibling receives a transplant of banked umbilical cord blood cells.
The UCSF team concluded that if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than one out of 110, then private umbilical cord blood banking becomes cost-effective.
The American Academy of Pediatrics (AAP) encourages cord blood donation when the cord blood is stored in a bank for public use and discourages storing cord blood as "biological insurance" because there currently are no scientific data to support autologous transplantation. The AAP does encourage private cord blood banking when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) who potentially could benefit from cord blood transplantation.
"The discrepancy between the benefits of private cord blood banking perceived by families and the lack of benefit seen in this analysis, and in the opinions of professional societies, has important implications for how doctors counsel patients," said Anjali Kaimal, MD, MAS, lead author of the study and a recent graduate of the UCSF Maternal-Fetal Medicine fellowship which is directed by Caughey. Kaimal's work on the study was done while at UCSF; she currently is a physician at Massachusetts General Hospital.
Co-authors of the study are Catherine Smith, MD; Russell K. Laros, Jr, MD; and Yvonne W. Cheng, MD, MPH, all from UCSF.
Caughey's work is supported in part by a grant from the Robert Wood Johnson Foundation Physician Faculty Scholars Program.
Source:
Karin Rush-Monroe
University of California - San Francisco
суббота, 24 декабря 2011 г.
HIV Transmission May Be Slowed Following Study Of 'Good Bacteria' In Women
The findings come from physicians and scientists at the University of Washington and the University of Rochester Medical Center, who worked together in an effort to learn more about how HIV survives and spreads from person to person. The study involving 57 women was done in Seattle and Rochester through the Women's HIV Interdisciplinary Network (WHIN), which is based at the University of Washington.
The team studied the vaginal environment, examining the mix of bacteria that reside there and taking into account several other factors. Physicians tracked the level of HIV virus in the vagina as well as infection by common sexually transmitted diseases like trichomoniasis, gonorrhea and chlamydia, and other more common types of vaginal infections.
Physicians also monitored the levels of beneficial bacteria known as Lactobacillus in the vagina, as well as hydrogen peroxide, which is produced by the bacteria and hinders the virus. They also measured the level of HIV in the women's blood and the rate of progression of the disease overall.
The team found that women with hydrogen-peroxide-producing Lactobacillus in the vagina had lower levels of HIV virus in genital secretions - what physicians call the genital viral load. Physicians know that the lower the level of HIV in the sexual tract, the less likely that the virus will be spread from person to person through sexual contact.
Scientists have previously recognized from laboratory studies that Lactobacillus might give women some natural protection against HIV. The bacteria, commonly found in most women, bind to the virus and secrete hydrogen peroxide. The bacteria are a close cousin of the Lactobacillus bacteria found in the small intestine, a type of "good" bacteria widely found in yogurt.
While previous work in the laboratory has indicated that Lactobacillus might help prevent HIV infection in women, the current study actually links, in women, decreased levels of the virus in the vagina with the presence of Lactobacillus that produce hydrogen peroxide there.
The team also found that the amount of the virus in the vagina varied in step with the presence of Lactobacillus: Women who did not have the bacteria at first but who had acquired it by a subsequent visit had their vaginal HIV levels drop, while vaginal HIV levels increased in women in whom the good bacteria had disappeared between visits.
The research was presented this week at the Conference on Retroviruses and Opportunistic Infections in Boston by Jane Hitti, M.D., associate professor in the Department of Obstetrics & Gynecology at the University of Washington School of Medicine. Hitti has been working closely with Robert Coombs, M.D., Ph.D., the principal investigator for the WHIN study and professor of Laboratory Medicine and of Medicine at the University of Washington. Amneris Luque, M.D., associate professor of Medicine and medical director of the AIDS Center at Strong Memorial Hospital, and Susan Cohn, M.D., associate professor of Medicine at the University of Rochester School of Medicine and Dentistry, also took part in the study.
"These findings underscore the importance of maintaining a healthy, Lactobacillus-dominant vaginal flora for HIV-positive women," said Hitti. "I hope that we can explore Lactobacillus replacement in the future for women who do not have this bacteria, as a strategy to decrease the amount of HIV in the vagina."
"The research opens up some doors," said Luque. "Sexual activity is the most common mode of transmission of HIV. Perhaps we can make it less likely to spread by somehow taking advantage of good bacteria as a natural way to stop HIV and prevent transmission. These findings are striking, though preliminary, and should be looked at further."
Luque and Cohn both care for patients at Strong's AIDS clinic, which provides ongoing care for approximately 900 patients with HIV. The center is part of a broader AIDS treatment and research effort at the University of Rochester Medical Center. The University is the only institution in the nation to be part, since inception, of two major national AIDS research efforts - the search for a vaccine, and the testing of new treatments. More than 3,000 Rochester-area residents have taken part in treatment and vaccine studies at the University's HIV/AIDS Clinical Trials Unit, funded by the National Institute of Allergy and Infectious Diseases.
Cohn stresses the importance of HIV-positive women participating in clinical research. "These women made a large contribution to knowledge about HIV and reproductive health by participating in this study. Advances in the care of HIV-positive women really depend on the dedication of study subjects."
Source: Tom Rickey
University of Rochester Medical Center
суббота, 17 декабря 2011 г.
63% Of Women Report Sexual Problems With Orgasm Proving Biggest Issue In Teens And 20s
Dysfunction rose with age in all categories except orgasm, with more than half of women aged from 18 to 30 reporting orgasm problems, significantly higher than women aged 31 to 54.
Researchers asked 587 women aged from 18 to 95, who attended a urology clinic in New Jersey, about six key areas of female sexual dysfunction (FSD): lack of desire, arousal issues, lack of lubrication, problems achieving orgasm, lack of satisfaction and pain during intercourse.
"We found that 63% of the women suffered from FSD and that there were significant links between FSD and age, menopausal status and use of selective antidepressants" says co-author Dr Debra Fromer, head of the Center for Bladder, Prostate and Pelvic Floor Health at Hackensack University Medical Center, New Jersey.
Twelve per cent of the women who took part in the study were aged 18-30, 27% were 31-45, 25% were 46-54, 24% were 55-70 and 12% were 70 plus.
They attended a typical American metropolitan urology practice caring for conditions such as urinary incontinence, urinary tract infections, pelvic floor problems and kidney stones.
Key findings of the survey included:
-- The most sexually active age groups were 31-45 year-olds (87%), 18-30 year-olds (85%) and 46-54 year-olds (74%). It then fell sharply in 55-70 year-olds (45%) and in women who were over 70 (15%).
-- The top overall problem was lack of desire (47%), followed by orgasm problems (45%), arousal issues (40%), lack of satisfaction (39%), lack of lubrication (37%) and pain (36%).
-- Five of the six categories increased as the women got older: desire from 36 to 96%, arousal from 27 to 54%, lubrication from 26 to 45%, satisfaction from 28 to 88% and pain from 10 to 56%.
-- The only category that bucked the trend was orgasm, with problems higher in the 18-30 age group (54%) than in the 31-45 (43%) and 46-54 (48%) age groups. It then rose to 66% at 55-70 and 87% when women were over 70.
The top three problems by age group were:
-- 18-30: orgasm (54%), desire (36%) and satisfaction (28%)
-- 31-45: desire (48%), orgasm (43%) and satisfaction (40%)
-- 46-54: desire (65%), satisfaction (53%) and orgasm (48%)
-- 55-70: desire (77%), orgasm (66%), satisfaction (65%)
-- Over 70: desire (96%), satisfaction (88%) and orgasm (87%).
"FSD can have a major effect on women's quality of life" says Dr Fromer. "Self-esteem, sense of wholeness and relationships can be seriously and adversely affected, exacting a heavy emotional toll.
"Researchers have found significant associations between major categories of sexual dysfunction, reduced physical and emotional satisfaction and general well-being.
"That is why it is so important to ensure that problems are identified and tackled wherever possible. For example a number of hormone and other drug treatments have been shown to benefit women with FSD."
Known risk factors for FSD include age, a history of sexual abuse or sexually transmitted infections, depression, lower socioeconomic status, lifestyle, overall physical health and sexual experience.
"Interestingly, our study found very similar levels of dysfunction to an age-matched Turkish study" adds Dr Fromer. "This suggests a biological cause for FSD rather than societal or cultural factors, although they make some contribution to certain psychological aspects of the disorder."
Source: Wiley - Blackwell
суббота, 10 декабря 2011 г.
New York Health Commission Recommends Closure Of Hospital That Specializes In Childbirth
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
суббота, 3 декабря 2011 г.
Vaginal Ring Could Protect Against HIV, Researcher Says
According to Saxena, the ring releases antiretroviral drugs over a period of 28 days. He noted that the device potentially could serve as an alternative method to prevent other sexually transmitted infections. Jeffrey Laurence, co-author of the study and a physician at New York Presbyterian Hospital-Weill Cornell Medical Center, said, "No one has ever conquered a viral epidemic with treatment, so prevention is the most effective option." He added, "Ideally, an HIV vaccine is the most desirable method, but that is not foreseeable in the near future. The next best thing would be something that would prevent infection and put the power in the susceptible female partner's control. That's the potential a device such as this can offer" (ANI/Times of India, 5/20).
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.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.