Researchers have pinpointed why mutations that cause Rett Syndrome (RTT)--among the leading causes of mental retardation in females--specifically target the brain rather than other body tissues. They said their findings yield important insight into the origin and course of the disease.
RTT has been especially puzzling because girls with the disorder develop normally through the first 6 to 18 months of life. But then they lose motor skills and speech, their heads cease normal growth, and they begin to show irregular breathing, obsessive hand-wringing, and autistic behaviors.
Researchers had traced the RTT's cause to mutations in the gene for methyl-CpG-binding protein 2 (MeCP2)--a protein found in tissues throughout the body that regulates many target genes by repressing their activity. The gene for MeCP2 is found on the X chromosome, which is why females, with two X chromosomes, are far more likely to suffer from RTT than are males.
In their new studies, reported in the October 19, 2006, issue of the journal Neuron, published by Cell Press, Michael Greenberg and colleagues tackled a central mystery of the disorder: why mutations in the MeCP2 gene specifically produce neural pathology. They also sought to understand why the pathology of RTT does not appear until well into infant development.
In experiments with rats and mice, the researchers identified a particular site, called S421, on the MeCP2 protein that is the trigger site for activating MeCP2 during its normal function. MeCP2 is activated by a process called phosphorylation, in response to neuronal activity, as when the brain receives sensory experience, they found. Without such activation, as occurs when MeCP2 is "crippled" by a mutation affecting S421, the protein does not function properly.
Particularly significant was the researchers' finding that MeCP2 is selectively phosphorylated at the S421 site only in the brain. This specificity explains why mutations affecting that site target brain development, they said.
The researchers' experiments showed that mutating the MeCP2 gene specifically at the S421 site disrupts normal growth of interconnections, called dendrites, among neurons. Such growth is necessary for the brain to wire itself normally in response to experience. Dendrites are the structures that form one side of the contacts, called synapses, among neurons.
"In this study, we identify an important missing link in the synaptic hypothesis of RTT by identifying S421 as a major site of activity-dependent modification on MeCP2 that is required for the maturation of neuronal connectivity, thereby providing a potential mechanism by which experience-dependent stimuli might regulate MeCP2 function," concluded the researchers.
They wrote that "These findings suggest a key role for the activity-dependent regulation of MeCP2 in the maturation of neuronal connectivity and provide a new framework for understanding how mutations in MeCP2 lead to the deregulation of these processes in RTT."
The researchers include Zhaolan Zhou, Elizabeth J. Hong, Sonia Cohen, Hsin-yi Henry Ho, Wen G. Chen, Yingxi Lin, Eric C. Griffith, and Michael E. Greenberg of Children's Hospital Boston and Harvard Medical School in Boston, Massachusetts; Wen-ning Zhao and Charles J. Weitz of Harvard Medical School in Boston, Massachusetts; Lauren Schmidt, Erin Savner, Linda Hu, and Judith A.J. Steen of Children's Hospital Boston in Boston, Massachusetts.
This work was supported by the Rett Syndrome Research Foundation (M.E.G.), National Institutes of Health grants (NS048276,M.E.G.; NS43491, C.J.W.), the NIH Medical Scientist Training Program (S.C.), the Damon Runyon Cancer Research Foundation (H.-y.H.H), the Fannie and John Hertz Foundation (E.J.H.), and the Helen Hay Whitney Foundation (E.C.G., Z.Z.).
Zhou et al.: "Brain-Specific Phosphorylation of MeCP2 Regulates Activity-Dependent Bdnf Transcription, Dendritic Growth, and Spine Maturation." Publishing in Neuron 52, 255??"269, October 19, 2006. DOI 10.1016/j.neuron.2006.09.037 neuron/
Contact: Heidi Hardman
Cell Press
четверг, 29 декабря 2011 г.
четверг, 22 декабря 2011 г.
Kaiser Daily Women's Health Policy Report Highlights Women's Health Policy Issues Related To 2006 Elections
The following highlights recent election-related news on women's health issues.
Connecticut: Although Gov. M. Jodi Rell (R) supports abortion rights, NARAL Pro-Choice Connecticut recently chose not to endorse her bid for re-election in part because of her lack of support for legislation that would require hospitals to provide rape survivors access to emergency contraception and because of the voting record of her running mate, the AP/Stamford Advocate reports. According to gubernatorial candidate John DeStefano's (D) campaign, Rell's running mate, former state Rep. Michael Fedele (R), in 1998 voted for a failed amendment to a measure that would have classified performing a late-term abortion as a class D felony, punishable by up to five years in prison. NARAL Pro-Choice Connecticut Executive Director Carolyn Treiss said that Fedele did not return the group's candidate questionnaire for the November election, adding in a statement, "It concerns us Gov. Rell did not take the issue of women's reproductive freedom into account when selecting a running mate." Rell said that Fedele supports abortion rights, adding, "A lot of people feel very strongly on the 'partial-birth' abortion, but Mike has always been pro-choice." Rell also said she is proud of her record on women's issues, including supporting legislation allowing women to stay in the hospital longer after a mastectomy and increasing access to mammograms (Haigh, AP/Stamford Advocate, 10/3).
Iowa: Gubernatorial candidates Jim Nussle (R) and Chet Culver (D) on Monday during their first televised debate discussed abortion rights and human embryonic stem cell research issues, the Des Moines Register reports (Beaumont, Des Moines Register, 10/3). Nussle, a U.S. representative, last year voted against a bill (HR 810) that would have expanded federal funding for embryonic stem cell research and in July voted to sustain President Bush's veto of the measure, saying he opposes giving federal funding to research using human embryos. Culver, Iowa's secretary of state, has said if elected, he would call for the repeal of a 2002 state law that bans multiple forms of stem cell research and would call for the allocation of $10 million to create an Iowa Center for Regenerative Medicine at the University of Iowa Hospital and Clinics (Kaiser Daily Women's Health Policy Report, 7/25). Culver also has said he supports abortion rights and would veto any legislation seeking to place limitations on the procedure. Campaign staff for Nussle has said he would sign a bill banning abortion in the second and third trimesters of pregnancy if elected (Kaiser Daily Women's Health Policy Report, 9/8). Nussle on Monday also said Iowa should approve a law requiring minors seeking abortion to obtain consent from their parents (Glover, AP/Charles City Press, 10/3). Culver said that his position on abortion rights is with the "mainstream in the state" and that Nussle's is an "extreme position." Nussle said, "I do not have an extreme position unless you believe that it's extreme to protect unborn life" (Gearino, Sioux City Journal, 10/5).
Ohio: Secretary of State and gubernatorial candidate J. Kenneth Blackwell (R) in a meeting before the Columbus Dispatch editorial board said medical science has advanced to the point at which choosing to save the life of a pregnant woman or aborting the fetus is "no longer the dilemma the medial profession had to deal with," the Dispatch reports. U.S. Rep. Ted Strickland, the Democratic gubernatorial candidate, who supports abortion rights and also attended the meeting, said "every physician I've talked with" has said that Blackwell's statement "is flat out wrong," adding that Blackwell has "nuanced" his position from opposing all abortions during the Republican primary to now allowing it to save the life of the pregnant woman. Blackwell said that he has not changed his position. He also said that if his daughter were raped, the "more traumatic choice for that young woman, in this case my daughter," would be to undergo an abortion rather than to carry the pregnancy to term. Strickland said, "It ought to be her choice" (Hallett/Niquette, Columbus Dispatch, 10/3).
"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.
четверг, 15 декабря 2011 г.
West Australian Women: Drinking Before, And During, Pregnancy
* In a survey of non-indigenous West Australian women, 79.8 percent reported drinking alcohol in the three months before becoming pregnant.
* Nearly half of the women (46.7%) surveyed reported that their pregnancy was unplanned.
* More than half (58.7%) drank alcohol during pregnancy despite recommendations of abstinence.
Complications due to drinking during pregnancy can range from the very serious Fetal Alcohol Syndrome to the less severe and possibly greater-occurring Fetal Alcohol Spectrum Disorders. The timing of alcohol consumption, its frequency, the beverage size and type, all appear to be crucial elements of identifying risk. A new survey has found that nearly 80 percent of non-Indigenous West Australian women consumed alcohol during the three months before pregnancy; nearly half had not planned their pregnancies; and more than half drank alcohol during pregnancy despite recommendations of abstinence.
Results are published in the February issue of Alcoholism: Clinical & Experimental Research.
"There is a lack of information as it relates to the measurement of alcohol consumption during the periconceptional period of pregnancy," said Lyn Colvin, a researcher at the Telethon Institute for Child Health Research at The University of Western Australia and corresponding author for the study. "In particular, information on specific alcoholic beverage consumed, frequency, timing during pregnancy, and volume in standard drinks are rare."
Colleen O'Leary, a research associate at the Telethon Institute for Child Health Research, concurs. "The most vulnerable period for the fetus is during the first trimester," she said, "although there is potential risk to the baby from drinking throughout pregnancy. It is important to know how much alcohol women are drinking both during the periconceptional period and throughout pregnancy, as well as more about the relationship between alcohol consumption during the periconceptional period and unplanned pregnancy. This information is important for women and men, policy makers and researchers."
Researchers analyzed data from a survey of 4,839 women 12 weeks after delivery. The women had agreed to participate in the 1995 - 1997 West Australian Pregnancy and Infancy Survey, created from a 10-percent random sample of all non-Indigenous women giving birth in Western Australia. Each participant was asked questions about alcohol consumption during four time periods: the periconceptional period, and each trimester of pregnancy. Questions were designed to measure the volume and type of alcoholic beverage consumed, as well as frequency of consumption.
* Nearly 80 percent reported drinking alcohol in the three months before becoming pregnant.
"Of those 3,860 women consuming alcohol in the three months before pregnancy," said Colvin, "the majority (55.6%) drank more than one type of alcoholic beverage. Once pregnant, the majority (65.5%) drank only one type of alcoholic beverage."
* Nearly half of the women (46.7%) surveyed had not planned their pregnancy.
"These data are in agreement with other Australian studies, and studies from the United States and Britain," said O'Leary. "It is concerning, however, that with the range of contraceptive options available to women that such a high proportion of pregnancies are unplanned." Furthermore, she added, the women who had planned their pregnancies were significantly less likely to drink alcohol during the first trimester than women who did not plan their pregnancy. "This would indicate that many pregnancies may be exposed to high levels of alcohol during the periconceptional period, prior to pregnancy awareness."
* More than half of the women (58.7%) drank alcohol during pregnancy despite the recommendation at the time of the study (1995-1997) of abstinence.
"It is interesting to note that the number of women who consumed alcohol during the 2nd trimester (42.4%) was similar to the number during the 1st trimester (42.1%)," said Colvin. "This probably indicates that the pregnant women were unaware of the recommendation of abstinence."
"Until 2001," added O'Leary, "the Australian guideline for alcohol consumption during pregnancy was abstinence. However, to my knowledge, there was no health promotion campaign in WA to educate women of this policy during or prior to the period these data were collected. Furthermore, a survey of health professionals conducted in WA during 2002 - 2003 found that fewer than half of health professionals surveyed routinely provided information to pregnant women about alcohol consumption during pregnancy."
'Despite what initially appears alarming, said Colvin, "it is actually encouraging that many women who drank alcohol reduced their consumption in the first trimester of pregnancy. With appropriate information, they and others may be able to further reduce or abstain from consuming alcohol when they are pregnant or might soon become pregnant. The challenge is to develop effective health promotion messages to reach women of child-bearing age before they consider pregnancy so they can make informed decisions." She added that involving health-promotion practitioners, medical practitioners and obstetricians would be key.
Both Colvin and O'Leary were concerned about "binge" drinking among women of childbearing age. "The findings that 14.2 percent of women surveyed consumed five or more standard drinks per occasion during the three months prior to pregnancy, and that almost half of the pregnancies were unplanned pregnancies, indicate that many women may have exposed their babies to high levels of alcohol before they were aware of their pregnancy," said O'Leary. In addition, she observed, "the percentage of Australian teenagers who binge drink has increased over the past decade since these data were collected. We need to find ways to reduce the very culture of binge drinking which is particularly concerning in young people as this is when drinking patterns are established."
O'Leary spoke of the need to educate both men and women. "We need to be careful how we frame our health-promotion messages since many women may have consumed alcohol prior to pregnancy awareness and unintentionally exposed their baby to alcohol," she said. "It is important not to generate undue fear and/or guilt. In addition, it is important not to place all the responsibility onto women alone: both women and men need to know about the risks to the baby from the consumption of alcohol during pregnancy; and many women and men need to take better precautions to prevent unplanned pregnancies."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Alcohol Consumption During Pregnancy in Non-Indigenous West Australian Women," were: Jan Payne, Deborah E. Parsons, and Carol Bower of the Telethon Institute for Child Health Research at The University of Western Australia; and Jennifer J. Kurinczuk of the National Perinatal Epidemiology Unit at the University of Oxford. The study was funded by the Health Promotion Foundation of Western Australia.
Contact:
Lyn Colvin, M.P.H.
Colleen O'Leary, M.P.H.
Telethon Institute for Child Health Research
Alcoholism: Clinical & Experimental Research
* Nearly half of the women (46.7%) surveyed reported that their pregnancy was unplanned.
* More than half (58.7%) drank alcohol during pregnancy despite recommendations of abstinence.
Complications due to drinking during pregnancy can range from the very serious Fetal Alcohol Syndrome to the less severe and possibly greater-occurring Fetal Alcohol Spectrum Disorders. The timing of alcohol consumption, its frequency, the beverage size and type, all appear to be crucial elements of identifying risk. A new survey has found that nearly 80 percent of non-Indigenous West Australian women consumed alcohol during the three months before pregnancy; nearly half had not planned their pregnancies; and more than half drank alcohol during pregnancy despite recommendations of abstinence.
Results are published in the February issue of Alcoholism: Clinical & Experimental Research.
"There is a lack of information as it relates to the measurement of alcohol consumption during the periconceptional period of pregnancy," said Lyn Colvin, a researcher at the Telethon Institute for Child Health Research at The University of Western Australia and corresponding author for the study. "In particular, information on specific alcoholic beverage consumed, frequency, timing during pregnancy, and volume in standard drinks are rare."
Colleen O'Leary, a research associate at the Telethon Institute for Child Health Research, concurs. "The most vulnerable period for the fetus is during the first trimester," she said, "although there is potential risk to the baby from drinking throughout pregnancy. It is important to know how much alcohol women are drinking both during the periconceptional period and throughout pregnancy, as well as more about the relationship between alcohol consumption during the periconceptional period and unplanned pregnancy. This information is important for women and men, policy makers and researchers."
Researchers analyzed data from a survey of 4,839 women 12 weeks after delivery. The women had agreed to participate in the 1995 - 1997 West Australian Pregnancy and Infancy Survey, created from a 10-percent random sample of all non-Indigenous women giving birth in Western Australia. Each participant was asked questions about alcohol consumption during four time periods: the periconceptional period, and each trimester of pregnancy. Questions were designed to measure the volume and type of alcoholic beverage consumed, as well as frequency of consumption.
* Nearly 80 percent reported drinking alcohol in the three months before becoming pregnant.
"Of those 3,860 women consuming alcohol in the three months before pregnancy," said Colvin, "the majority (55.6%) drank more than one type of alcoholic beverage. Once pregnant, the majority (65.5%) drank only one type of alcoholic beverage."
* Nearly half of the women (46.7%) surveyed had not planned their pregnancy.
"These data are in agreement with other Australian studies, and studies from the United States and Britain," said O'Leary. "It is concerning, however, that with the range of contraceptive options available to women that such a high proportion of pregnancies are unplanned." Furthermore, she added, the women who had planned their pregnancies were significantly less likely to drink alcohol during the first trimester than women who did not plan their pregnancy. "This would indicate that many pregnancies may be exposed to high levels of alcohol during the periconceptional period, prior to pregnancy awareness."
* More than half of the women (58.7%) drank alcohol during pregnancy despite the recommendation at the time of the study (1995-1997) of abstinence.
"It is interesting to note that the number of women who consumed alcohol during the 2nd trimester (42.4%) was similar to the number during the 1st trimester (42.1%)," said Colvin. "This probably indicates that the pregnant women were unaware of the recommendation of abstinence."
"Until 2001," added O'Leary, "the Australian guideline for alcohol consumption during pregnancy was abstinence. However, to my knowledge, there was no health promotion campaign in WA to educate women of this policy during or prior to the period these data were collected. Furthermore, a survey of health professionals conducted in WA during 2002 - 2003 found that fewer than half of health professionals surveyed routinely provided information to pregnant women about alcohol consumption during pregnancy."
'Despite what initially appears alarming, said Colvin, "it is actually encouraging that many women who drank alcohol reduced their consumption in the first trimester of pregnancy. With appropriate information, they and others may be able to further reduce or abstain from consuming alcohol when they are pregnant or might soon become pregnant. The challenge is to develop effective health promotion messages to reach women of child-bearing age before they consider pregnancy so they can make informed decisions." She added that involving health-promotion practitioners, medical practitioners and obstetricians would be key.
Both Colvin and O'Leary were concerned about "binge" drinking among women of childbearing age. "The findings that 14.2 percent of women surveyed consumed five or more standard drinks per occasion during the three months prior to pregnancy, and that almost half of the pregnancies were unplanned pregnancies, indicate that many women may have exposed their babies to high levels of alcohol before they were aware of their pregnancy," said O'Leary. In addition, she observed, "the percentage of Australian teenagers who binge drink has increased over the past decade since these data were collected. We need to find ways to reduce the very culture of binge drinking which is particularly concerning in young people as this is when drinking patterns are established."
O'Leary spoke of the need to educate both men and women. "We need to be careful how we frame our health-promotion messages since many women may have consumed alcohol prior to pregnancy awareness and unintentionally exposed their baby to alcohol," she said. "It is important not to generate undue fear and/or guilt. In addition, it is important not to place all the responsibility onto women alone: both women and men need to know about the risks to the baby from the consumption of alcohol during pregnancy; and many women and men need to take better precautions to prevent unplanned pregnancies."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Alcohol Consumption During Pregnancy in Non-Indigenous West Australian Women," were: Jan Payne, Deborah E. Parsons, and Carol Bower of the Telethon Institute for Child Health Research at The University of Western Australia; and Jennifer J. Kurinczuk of the National Perinatal Epidemiology Unit at the University of Oxford. The study was funded by the Health Promotion Foundation of Western Australia.
Contact:
Lyn Colvin, M.P.H.
Colleen O'Leary, M.P.H.
Telethon Institute for Child Health Research
Alcoholism: Clinical & Experimental Research
четверг, 8 декабря 2011 г.
Ovarian Cancer Screening Does Not Appear To Reduce Risk Of Ovarian Cancer Death
In a clinical trial that included nearly 80,000 women, those who received ovarian cancer screening did not have a reduced risk of death from ovarian cancer compared to women who received usual care, but did have an increase in invasive medical procedures and associated harms as a result of being screened, according to a study in the June 8 issue of JAMA, a theme issue on cancer. The study is being published early online to coincide with its presentation at the American Society of Clinical Oncology 2011 Annual Meeting.
In the United States, ovarian cancer is among the 5 leading causes of cancer death in women. Most women with ovarian cancer are diagnosed with advanced stage disease, which has a 5-year survival of only 30 percent. The recognition that early detection of ovarian cancer may have the potential to improve prognosis prompted the development of randomized controlled trials to evaluate the efficacy of transvaginal ultrasound and serum cancer antigen 125 (CA-125) as screening tools to reduce ovarian cancer mortality, according to background information in the article.
Saundra S. Buys, M.D., of the University of Utah Health Sciences Center, Salt Lake City, and colleagues examined the ovarian cancer-specific mortality results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial to evaluate the effect of screening for ovarian cancer. The randomized controlled trial included 78,216 women, ages 55 to 74 years, assigned to undergo either annual screening (n = 39,105) or usual care (n = 39,111) at 10 screening centers across the United States between November 1993 and July 2001. The intervention group was offered annual screening with CA-125 for 6 years and transvaginal ultrasound for 4 years. Participants and their health care practitioners received the screening test results and managed evaluation of abnormal results. The usual care group was not offered annual screening with CA-125 for 6 years or transvaginal ultrasound but received their usual medical care. Participants were followed up for a maximum of 13 years for cancer diagnoses and death until February 28, 2010.
Through the follow-up period, 212 ovarian cancer cases were diagnosed in the intervention group and 176 cases in the usual care group. There were 118 deaths caused by ovarian cancer in the intervention group and 100 deaths in the usual care group. Analysis of data indicated that the difference in survival between the intervention and usual care groups was not statistically significant.
"All-cause mortality (excluding deaths from ovarian, colorectal, and lung cancer) was similar in the 2 study groups; there were 2,924 deaths in the intervention group and 2,914 deaths in the usual care group. Mortality rates for the major causes of death were generally similar between the 2 study groups," the authors write.
Of 3,285 women with false-positive results, 1,080 underwent surgery (32.9 percent for oophorectomy [surgical removal of one or both ovaries]) as part of the diagnostic workup. Of these 1,080 women, 163 (15 percent) experienced a total of 222 distinct major complications, which yielded a rate of 20.6 complications per 100 surgical procedures. A total of 1,771 women in the intervention group (7.7 percent) and 1,304 in the usual care group (5.8 percent) reported oophorectomy, with women in the intervention group having a higher rate of oophorectomy than women in the usual care group.
Regarding the outcomes of this trial, the researchers suggest that although the screening tests as used in this study did not reduce mortality, it is possible if used differently that CA-125 and transvaginal ultrasound may have the potential to be beneficial. For example, assessing the changes in CA-125 over time rather than a single CA-125 value as used in this study may allow detection of cancers at an earlier stage when cure is possible. However, there is no evidence from other clinical trials to support this approach at this time. The authors also suggest that even an optimized program of annual screening may be insufficient to detect cancers early enough to reduce mortality. "Evidence from modeling suggests that aggressive cancers progress rapidly through the early stages, limiting the ability to detect these cancers with yearly screening. In contrast, more ovarian cancers were diagnosed in the screened group than in the usual care group (212 vs. 176), suggesting that some of the additional cancers detected by screenings were not clinically important and, if left undetected, may never have caused any symptoms or affected the women during their life-limes (i.e., overdiagnosis)."
"We conclude that annual screening for ovarian cancer as performed in the PLCO trial with simultaneous CA-125 and transvaginal ultrasound does not reduce disease-specific mortality in women at average risk for ovarian cancer but does increase invasive medical procedures and associated harms," the authors write.
JAMA. 2011;305[22]2295-2303.
In the United States, ovarian cancer is among the 5 leading causes of cancer death in women. Most women with ovarian cancer are diagnosed with advanced stage disease, which has a 5-year survival of only 30 percent. The recognition that early detection of ovarian cancer may have the potential to improve prognosis prompted the development of randomized controlled trials to evaluate the efficacy of transvaginal ultrasound and serum cancer antigen 125 (CA-125) as screening tools to reduce ovarian cancer mortality, according to background information in the article.
Saundra S. Buys, M.D., of the University of Utah Health Sciences Center, Salt Lake City, and colleagues examined the ovarian cancer-specific mortality results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial to evaluate the effect of screening for ovarian cancer. The randomized controlled trial included 78,216 women, ages 55 to 74 years, assigned to undergo either annual screening (n = 39,105) or usual care (n = 39,111) at 10 screening centers across the United States between November 1993 and July 2001. The intervention group was offered annual screening with CA-125 for 6 years and transvaginal ultrasound for 4 years. Participants and their health care practitioners received the screening test results and managed evaluation of abnormal results. The usual care group was not offered annual screening with CA-125 for 6 years or transvaginal ultrasound but received their usual medical care. Participants were followed up for a maximum of 13 years for cancer diagnoses and death until February 28, 2010.
Through the follow-up period, 212 ovarian cancer cases were diagnosed in the intervention group and 176 cases in the usual care group. There were 118 deaths caused by ovarian cancer in the intervention group and 100 deaths in the usual care group. Analysis of data indicated that the difference in survival between the intervention and usual care groups was not statistically significant.
"All-cause mortality (excluding deaths from ovarian, colorectal, and lung cancer) was similar in the 2 study groups; there were 2,924 deaths in the intervention group and 2,914 deaths in the usual care group. Mortality rates for the major causes of death were generally similar between the 2 study groups," the authors write.
Of 3,285 women with false-positive results, 1,080 underwent surgery (32.9 percent for oophorectomy [surgical removal of one or both ovaries]) as part of the diagnostic workup. Of these 1,080 women, 163 (15 percent) experienced a total of 222 distinct major complications, which yielded a rate of 20.6 complications per 100 surgical procedures. A total of 1,771 women in the intervention group (7.7 percent) and 1,304 in the usual care group (5.8 percent) reported oophorectomy, with women in the intervention group having a higher rate of oophorectomy than women in the usual care group.
Regarding the outcomes of this trial, the researchers suggest that although the screening tests as used in this study did not reduce mortality, it is possible if used differently that CA-125 and transvaginal ultrasound may have the potential to be beneficial. For example, assessing the changes in CA-125 over time rather than a single CA-125 value as used in this study may allow detection of cancers at an earlier stage when cure is possible. However, there is no evidence from other clinical trials to support this approach at this time. The authors also suggest that even an optimized program of annual screening may be insufficient to detect cancers early enough to reduce mortality. "Evidence from modeling suggests that aggressive cancers progress rapidly through the early stages, limiting the ability to detect these cancers with yearly screening. In contrast, more ovarian cancers were diagnosed in the screened group than in the usual care group (212 vs. 176), suggesting that some of the additional cancers detected by screenings were not clinically important and, if left undetected, may never have caused any symptoms or affected the women during their life-limes (i.e., overdiagnosis)."
"We conclude that annual screening for ovarian cancer as performed in the PLCO trial with simultaneous CA-125 and transvaginal ultrasound does not reduce disease-specific mortality in women at average risk for ovarian cancer but does increase invasive medical procedures and associated harms," the authors write.
JAMA. 2011;305[22]2295-2303.
четверг, 1 декабря 2011 г.
Low Complication Profile For Pelvic Floor Repair - New Restorelle™ Series Demonstrates Near Zero Mesh Erosion Rate
Mpathy Medical, a rapidly growing medical device company which specializes in restoring pelvic health to women, today announced the findings of a retrospective cohort study carried out by Red Alinsod, MD, FACOG, FACS, ACGE, Laguna Beach, CA. This study demonstrates a low complication profile for Restorelle™, the company's pelvic floor restoration product line, which is constructed with its ultra lightweight Smartmesh™.
In a series of 201 patients and 360 total mesh implantsi, carried out from November 2005 to October 2008, the results report that the use of Restorelle™ is associated with a 0.28% erosion rate and a 99.5% cure rate based on POP-Q assessment of the enrolled patients. The follow up time for this series ranged from 36 months to 2 months, resulting in a mean follow up of 22 months. Important factors regarding patient quality of life were measured and included:
-- No new occurrence of dyspareunia (painful intercourse) attributable to prolapse repair.
-- Non-palpability of the mesh throughout - neither the patient nor partner could feel the implant postoperatively in uncomplicated repairs.
-- 93% patients reporting that their quality of life was "good" or "very good" postoperatively compared to "poor" or "fair" preoperatively.
"The results from this substantial series clearly demonstrate the low complication profile associated with Mpathy Medical's ultra lightweight mesh material when used to surgically manage pelvic organ prolapse," stated Dr. Red Alinsod, South Coast Urogynecology, Laguna Beach, CA. "I have been extremely pleased with the fully functional and restored anatomy which Restorelle™ products help me to deliver to my patients. I have consistently been able to achieve these positive results without my patients or their partners experiencing dyspareunia, which was often present after using previous surgical solutions."
The Food and Drug Administration recently issued a public health notification which reported serious complications associated with transvaginal placement of mesh in the repair of urinary stress incontinence (USI) and pelvic organ prolapse (POP). This announcement came following over 1,000 reports of adverse events associated with mesh from nine manufacturers. These complications ranged from issues that negatively affect the patient's quality of life, such as dispareunia or narrowing of the vaginal wall, to more serious problems that can include chronic pain and require additional surgery to correct.
"We are pleased to share the results from Dr. Alinsod's study," stated Ian Stevens, Chief Executive Officer, Mpathy Medical. "We believe that the recent FDA announcement raises important issues relating to the use of mesh for this type of surgery. We are very confident that Smartmesh™ is the right solution for women and their surgeons, since it is the only product which has been designed specifically with the female anatomy and physiology in mind."
To review the abstract from Dr. Alinsod's series, click here.
Facts on Pelvic Health Conditions:
-- The prevalence of USI and POP increases with ageii.
-- USI affects approximately 1 in 4 women while POP affects up to half of all women over the age of 50.
-- Approximately 20% of women who have symptoms of POP also experience USI.
-- Approximately 200,000 procedures are performed each year to correct USI and POPiii.
-- Women who are obese have a 40-75% increased risk of POPiv.
-- Many women who suffer from USI or POP are unaware of the procedures that are available to correct these problems. A recent study indicated 2/3 of women were not aware of sling procedures to treat USIv.
-- Depression is a common resulting factor of pelvic health conditions. The risk of depression is 40% higher for incontinent women. Women with severe incontinence are 80% more likely to experience depressionvi.
About Mpathy Medical
Mpathy Medical is a rapidly growing medical device company which has developed and brought to market a range of surgical solutions used to restore pelvic health to women. Mpathy Medical's core product lines - Minitape® and Restorelle™ - are used by surgeons specializing in urogynecology, gynecology, and urology to treat female urinary stress incontinence and pelvic organ prolapse. Founded in 2003 by a surgeon, Dr. James Browning, Mpathy Medical supplies the only mesh solutions designed specifically for the female anatomy and physiology. The mesh - branded Smartmesh™ - is a physiologically compatible, ultra lightweight polypropylene mesh which encourages superior collagen growth and works in concert with the patient's own natural tissue for optimum safety and results. The company is headquartered in Glasgow, Scotland with US operations in Raynham, MA and has received 510(k) clearance to market by the FDA in the US and CE marking in the UK for all its medical devices. To learn more about Mpathy Medical, visit www.mpathymedical.
i Many patients received a multi-compartment vaginal repair; therefore, requiring more than one piece of Restorelle™ mesh.
ii Nygaard, I. et al (2008). Prevelance of Symptomatic Pelvic Floor Disorders in US Women. Journal of American Medical Association; 300, 1311-1316.
iii American Urogynecologic Society.
iv American Urogynecologic Society.
v American Academy of Gynecologic Laparoscopists.
vi Nygaard, I. et al (2003). Urinary Stress Incontinence and Depression in Middle-Aged United States Women. The American College of Obstetricians and Gynecologists; 101,149-156.
In a series of 201 patients and 360 total mesh implantsi, carried out from November 2005 to October 2008, the results report that the use of Restorelle™ is associated with a 0.28% erosion rate and a 99.5% cure rate based on POP-Q assessment of the enrolled patients. The follow up time for this series ranged from 36 months to 2 months, resulting in a mean follow up of 22 months. Important factors regarding patient quality of life were measured and included:
-- No new occurrence of dyspareunia (painful intercourse) attributable to prolapse repair.
-- Non-palpability of the mesh throughout - neither the patient nor partner could feel the implant postoperatively in uncomplicated repairs.
-- 93% patients reporting that their quality of life was "good" or "very good" postoperatively compared to "poor" or "fair" preoperatively.
"The results from this substantial series clearly demonstrate the low complication profile associated with Mpathy Medical's ultra lightweight mesh material when used to surgically manage pelvic organ prolapse," stated Dr. Red Alinsod, South Coast Urogynecology, Laguna Beach, CA. "I have been extremely pleased with the fully functional and restored anatomy which Restorelle™ products help me to deliver to my patients. I have consistently been able to achieve these positive results without my patients or their partners experiencing dyspareunia, which was often present after using previous surgical solutions."
The Food and Drug Administration recently issued a public health notification which reported serious complications associated with transvaginal placement of mesh in the repair of urinary stress incontinence (USI) and pelvic organ prolapse (POP). This announcement came following over 1,000 reports of adverse events associated with mesh from nine manufacturers. These complications ranged from issues that negatively affect the patient's quality of life, such as dispareunia or narrowing of the vaginal wall, to more serious problems that can include chronic pain and require additional surgery to correct.
"We are pleased to share the results from Dr. Alinsod's study," stated Ian Stevens, Chief Executive Officer, Mpathy Medical. "We believe that the recent FDA announcement raises important issues relating to the use of mesh for this type of surgery. We are very confident that Smartmesh™ is the right solution for women and their surgeons, since it is the only product which has been designed specifically with the female anatomy and physiology in mind."
To review the abstract from Dr. Alinsod's series, click here.
Facts on Pelvic Health Conditions:
-- The prevalence of USI and POP increases with ageii.
-- USI affects approximately 1 in 4 women while POP affects up to half of all women over the age of 50.
-- Approximately 20% of women who have symptoms of POP also experience USI.
-- Approximately 200,000 procedures are performed each year to correct USI and POPiii.
-- Women who are obese have a 40-75% increased risk of POPiv.
-- Many women who suffer from USI or POP are unaware of the procedures that are available to correct these problems. A recent study indicated 2/3 of women were not aware of sling procedures to treat USIv.
-- Depression is a common resulting factor of pelvic health conditions. The risk of depression is 40% higher for incontinent women. Women with severe incontinence are 80% more likely to experience depressionvi.
About Mpathy Medical
Mpathy Medical is a rapidly growing medical device company which has developed and brought to market a range of surgical solutions used to restore pelvic health to women. Mpathy Medical's core product lines - Minitape® and Restorelle™ - are used by surgeons specializing in urogynecology, gynecology, and urology to treat female urinary stress incontinence and pelvic organ prolapse. Founded in 2003 by a surgeon, Dr. James Browning, Mpathy Medical supplies the only mesh solutions designed specifically for the female anatomy and physiology. The mesh - branded Smartmesh™ - is a physiologically compatible, ultra lightweight polypropylene mesh which encourages superior collagen growth and works in concert with the patient's own natural tissue for optimum safety and results. The company is headquartered in Glasgow, Scotland with US operations in Raynham, MA and has received 510(k) clearance to market by the FDA in the US and CE marking in the UK for all its medical devices. To learn more about Mpathy Medical, visit www.mpathymedical.
i Many patients received a multi-compartment vaginal repair; therefore, requiring more than one piece of Restorelle™ mesh.
ii Nygaard, I. et al (2008). Prevelance of Symptomatic Pelvic Floor Disorders in US Women. Journal of American Medical Association; 300, 1311-1316.
iii American Urogynecologic Society.
iv American Urogynecologic Society.
v American Academy of Gynecologic Laparoscopists.
vi Nygaard, I. et al (2003). Urinary Stress Incontinence and Depression in Middle-Aged United States Women. The American College of Obstetricians and Gynecologists; 101,149-156.
четверг, 24 ноября 2011 г.
Sen. Menendez Introduces Bill That Would Increase Postpartum Depression Research
Sen. Robert Menendez (D-N.J.) on Friday said he would introduce a bill (S 1375) that would increase postpartum depression research at NIH and would provide grants to state and local health care workers to increase screening and treatment of the condition, CQ HealthBeat reports (Webber, CQ HealthBeat, 5/11).
The House Energy and Commerce Health Subcommittee earlier this month debated similar legislation (HR 20), sponsored by Rep. Bobby Rush (D-Ill.), that would "expand and intensify" research at the National Institute of Mental Health and other agencies on postpartum depression and postpartum psychosis. The bill also would provide grants through HHS for the "establishment, operation and coordination of effective and cost-efficient systems for the delivery of essential services" for women with the conditions and their families. Some Republicans on the House panel indicated that the measure should be amended to include language on "postabortion depression" (Kaiser Daily Women's Health Policy Report, 5/2).
Menendez's bill includes a provision from Rush's bill requiring NIMH to increase research on postpartum depression and postpartum psychosis. The measure, which is supported by several psychiatric and women's health organizations, does not specify funding amounts for grants or research, but it would authorize "such sums as may be appropriated," Menendez said.
Menendez said the legislation is modeled after a 2006 New Jersey law that provides $4.5 million annually for postpartum depression education and screening and requires health care workers to inform pregnant women about postpartum depression. According to CQ HealthBeat, versions of Rush's and Menendez's measures have been introduced for several years but have never seen action. About 10% to 20% of women experience postpartum depression after giving birth to their first infant, according to NIH estimates (CQ HealthBeat, 5/11).
"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.
The House Energy and Commerce Health Subcommittee earlier this month debated similar legislation (HR 20), sponsored by Rep. Bobby Rush (D-Ill.), that would "expand and intensify" research at the National Institute of Mental Health and other agencies on postpartum depression and postpartum psychosis. The bill also would provide grants through HHS for the "establishment, operation and coordination of effective and cost-efficient systems for the delivery of essential services" for women with the conditions and their families. Some Republicans on the House panel indicated that the measure should be amended to include language on "postabortion depression" (Kaiser Daily Women's Health Policy Report, 5/2).
Menendez's bill includes a provision from Rush's bill requiring NIMH to increase research on postpartum depression and postpartum psychosis. The measure, which is supported by several psychiatric and women's health organizations, does not specify funding amounts for grants or research, but it would authorize "such sums as may be appropriated," Menendez said.
Menendez said the legislation is modeled after a 2006 New Jersey law that provides $4.5 million annually for postpartum depression education and screening and requires health care workers to inform pregnant women about postpartum depression. According to CQ HealthBeat, versions of Rush's and Menendez's measures have been introduced for several years but have never seen action. About 10% to 20% of women experience postpartum depression after giving birth to their first infant, according to NIH estimates (CQ HealthBeat, 5/11).
"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.
четверг, 17 ноября 2011 г.
China To Augment Fines For Couples Who Violate One-Child Policy According To Income Level
The Chinese government recently ordered local authorities to check incomes and financial statements before issuing fines for couples who violate the national one-child-per-family policy, the South China Morning Post reports (Pinghui, South China Morning Post, 9/15). China's one-child-per-family policy seeks to keep the country's population, now 1.3 billion, at about 1.7 billion by 2050. Methods of enforcing the policy, such as fines and work demotions, vary among Chinese provinces and cities (Kaiser Daily Women's Health Policy Report, 8/27).
According to the Morning Post, the National Population and Family Planning Commission and 10 other ministries and bureaus in a joint statement released on NPFPC's Web site said that fines will be adjusted according to income level. The policy was approved five years ago, but local authorities have not enforced it effectively, the Morning Post reports. The statement said that people who violate the policy will be recorded in the People's Bank of China's credit system, but it did not say how the information would be used, the Morning Post reports.
The statement said influential people and public figures should "set a good example" by following the law. The "relevant authorities must make obeying the family planning regulation a basic requirement of hiring or promoting a cadre," the statement said, adding, "It should be a key factor in deciding whether a person is qualified to be a delegate to the party congress at all levels or as a deputy to the National People's Congress and the Chinese People's Political Consultative Conference." According to the statement, "Any public figure who deliberately violates the policy will be publicly denounced and severely punished according to the law."
According to Reuters, government media recently has released an increasing number of reports about officials, entertainers and business executives having more than one child, and some provinces have scaled up enforcement of the one-child policy (Reuters, 9/15).
According to the Morning Post, the National Population and Family Planning Commission and 10 other ministries and bureaus in a joint statement released on NPFPC's Web site said that fines will be adjusted according to income level. The policy was approved five years ago, but local authorities have not enforced it effectively, the Morning Post reports. The statement said that people who violate the policy will be recorded in the People's Bank of China's credit system, but it did not say how the information would be used, the Morning Post reports.
The statement said influential people and public figures should "set a good example" by following the law. The "relevant authorities must make obeying the family planning regulation a basic requirement of hiring or promoting a cadre," the statement said, adding, "It should be a key factor in deciding whether a person is qualified to be a delegate to the party congress at all levels or as a deputy to the National People's Congress and the Chinese People's Political Consultative Conference." According to the statement, "Any public figure who deliberately violates the policy will be publicly denounced and severely punished according to the law."
According to Reuters, government media recently has released an increasing number of reports about officials, entertainers and business executives having more than one child, and some provinces have scaled up enforcement of the one-child policy (Reuters, 9/15).
Opinion Piece
To enhance China's "long-term economic outlook," the country must recognize that its one-child policy "has been a tragic and historic mistake" and must "abandon it, immediately," Nicholas Eberstadt, resident scholar at the American Enterprise Institute, writes in a related Wall Street Journal opinion piece. According to Eberstadt, the "superficial success" of the policy to reduce the country's fertility rate "comes with immense inadvertent costs and unintended consequences," including China's "incipient aging crisis, its looming family-structure problems and its worrisome gender imbalances."
Some Chinese officials might "worry that the end of the one-child policy might mean the return to the five-child family -- but in reality, modern China is most unlikely to return to preindustrial fertility norms," Eberstadt writes. He concludes, "Trusting China's people to act in their own self-interest ... may very well prove to be the key to whether China ultimately succeeds in abolishing poverty and attaining mass affluence in the decades and generations ahead." According to the Journal, Eberstadt's opinion piece is an excerpt he delivered at a World Economic Forum conference in Dalian, China, earlier this month (Eberstadt, Wall Street Journal, 9/17).
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.
четверг, 10 ноября 2011 г.
Morpace Inc. Reports: Hispanic American Women Unaware Of Heart Disease Threat
In a national survey
of adults, 60 percent of Hispanic American adult females indicated a lack
of awareness that heart disease is the #1 fatal disease among women.
Further, nearly half are unaware that Hispanic women's risk of heart
disease is greater than that of Caucasian women. Dania Rich-Spencer, Vice
President of Morpace's Health Care practice, said, "Programs such as the Go
Red For Women, founded by the American Heart Association (AHA), have made
great strides in raising awareness of heart disease's impact on women, but
the message apparently has not made its way into Hispanic communities." She
added, "Our research suggests that there is a real opportunity to target
this key ethnic group with educational efforts that raise awareness and
promote prevention strategies."
Rich-Spencer said that the heart disease awareness data comes from the
quarterly Morpace Omnibus Survey, conducted on the Internet in July, 2008,
on a variety of current topics.
About Morpace Inc.
Morpace is a full-service survey research and consulting organization
specializing in automotive, financial services, health care, retail and
technology. Morpace has global expertise in providing innovative
proprietary solutions to clients in four core areas: market definition and
segmentation; product development and pricing; brand and image positioning;
and customer satisfaction and loyalty.
Established in 1941, Morpace Inc., an ISO 9001:2000 certified
organization, is one of the largest privately held marketing research firms
in the United States. Headquartered in Farmington Hills, Michigan the
company has offices in Irvine, California; New York City; and London,
England.
Visit morpace for more information.
Morpace Inc.
morpace
of adults, 60 percent of Hispanic American adult females indicated a lack
of awareness that heart disease is the #1 fatal disease among women.
Further, nearly half are unaware that Hispanic women's risk of heart
disease is greater than that of Caucasian women. Dania Rich-Spencer, Vice
President of Morpace's Health Care practice, said, "Programs such as the Go
Red For Women, founded by the American Heart Association (AHA), have made
great strides in raising awareness of heart disease's impact on women, but
the message apparently has not made its way into Hispanic communities." She
added, "Our research suggests that there is a real opportunity to target
this key ethnic group with educational efforts that raise awareness and
promote prevention strategies."
Rich-Spencer said that the heart disease awareness data comes from the
quarterly Morpace Omnibus Survey, conducted on the Internet in July, 2008,
on a variety of current topics.
About Morpace Inc.
Morpace is a full-service survey research and consulting organization
specializing in automotive, financial services, health care, retail and
technology. Morpace has global expertise in providing innovative
proprietary solutions to clients in four core areas: market definition and
segmentation; product development and pricing; brand and image positioning;
and customer satisfaction and loyalty.
Established in 1941, Morpace Inc., an ISO 9001:2000 certified
organization, is one of the largest privately held marketing research firms
in the United States. Headquartered in Farmington Hills, Michigan the
company has offices in Irvine, California; New York City; and London,
England.
Visit morpace for more information.
Morpace Inc.
morpace
четверг, 3 ноября 2011 г.
'New And Improved Antiabortion Movement' Still Ignores Needs Of Women, Salon Opinion Piece States
A "new set of antiabortion actors" who are "anti-war, anti-capital punishment, pro-environment 'pro-lifers'" have "emerged as the face of a new and improved antiabortion movement," Salon columnist Frances Kissling writes. Although these advocates supported President Obama in the 2008 election, they "suffer from the same lack of understanding of women's nature and identity as do old-line anti-abortionists," Kissling writes. She notes that this group has "already decided that a political effort to make abortion illegal is hopeless, which helps the pro-choice cause." According to Kissling, "Taking legality off the table" increases the prospects for "rational public discourse about all the factors at play in women's decisions not to continue pregnancy and not to become mothers," but "[w]e are ... far from common ground between the new anti-abortionists and the pro-choice advocates."
Members of this new group believe that data suggesting that many women decide to have abortions for financial reasons prove that "better economic support" for pregnant women "will result in more continued pregnancies and more women embracing motherhood," Kissling writes. In addition, they "assert that if adoption policies were friendlier," more women would choose adoption over abortion, according to Kissling. "But facts have little place in their strategy," as the policies they support "are already in place in much of Europe," and "few women who face unintended pregnancies in those countries opt out of abortion," Kissling writes. She adds, "Something much deeper influences a woman's decision about what to do when she is pregnant and does not want to become a mother -- and the new anti-choicers don't seem to have a clue about what this might be." For this group, "the outcome [of pregnancy] -- the new person -- is obviously so much more valuable than whatever short-term loss or pain the women might experience," Kissling writes. Therefore, they believe it is "not asking much of a woman who faces an unwanted, difficult or unintended pregnancy to shift the plan she had for this time in her life and continue the pregnancy," according to Kissling.
Kissling lists four "positions taken by the new antiabortionists [that] illuminate this flawed thinking." The first is "[d]enying the 'need' for abortion," she writes. Secondly, their "same sense of pregnancy as no big deal influences the new antiabortionists' unwillingness to embrace contraception," Kissling says. She adds that "[i]f we really understood what it meant for women to consent to becoming mothers, we would want them to be able to meet their moral obligation to their own identity by avoiding becoming pregnant." The third position is an attempt to make "sex sacred," Kissling writes, adding that if "creating new life is sacred, then we want men and women to have the tools necessary to fulfill the obligation to create life responsibly and not create it when they cannot -- or choose not to -- bring it to fruition." The fourth position is "[r]edefining adoption," Kissling continues. She asks whether adoption is "now a process of finding children for needy parents," adding, "Might it not be more generous of us as a society to work harder to make it possible for women to keep their children if they so wish?"
Kissling writes that the "challenge to the new antiabortionists" is whether "women's perspectives on the meaning of pregnancy and motherhood will be considered in their project" or if "their ethical frame will remain focused on the fetus." She asks, "How many of these women's decisions will the new antiabortionists be able to say 'yes' to?" Kissling concludes, "So far it seems that it is far more than abortion that is a stumbling block to common ground" (Kissling, Salon, 7/20).
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.
Members of this new group believe that data suggesting that many women decide to have abortions for financial reasons prove that "better economic support" for pregnant women "will result in more continued pregnancies and more women embracing motherhood," Kissling writes. In addition, they "assert that if adoption policies were friendlier," more women would choose adoption over abortion, according to Kissling. "But facts have little place in their strategy," as the policies they support "are already in place in much of Europe," and "few women who face unintended pregnancies in those countries opt out of abortion," Kissling writes. She adds, "Something much deeper influences a woman's decision about what to do when she is pregnant and does not want to become a mother -- and the new anti-choicers don't seem to have a clue about what this might be." For this group, "the outcome [of pregnancy] -- the new person -- is obviously so much more valuable than whatever short-term loss or pain the women might experience," Kissling writes. Therefore, they believe it is "not asking much of a woman who faces an unwanted, difficult or unintended pregnancy to shift the plan she had for this time in her life and continue the pregnancy," according to Kissling.
Kissling lists four "positions taken by the new antiabortionists [that] illuminate this flawed thinking." The first is "[d]enying the 'need' for abortion," she writes. Secondly, their "same sense of pregnancy as no big deal influences the new antiabortionists' unwillingness to embrace contraception," Kissling says. She adds that "[i]f we really understood what it meant for women to consent to becoming mothers, we would want them to be able to meet their moral obligation to their own identity by avoiding becoming pregnant." The third position is an attempt to make "sex sacred," Kissling writes, adding that if "creating new life is sacred, then we want men and women to have the tools necessary to fulfill the obligation to create life responsibly and not create it when they cannot -- or choose not to -- bring it to fruition." The fourth position is "[r]edefining adoption," Kissling continues. She asks whether adoption is "now a process of finding children for needy parents," adding, "Might it not be more generous of us as a society to work harder to make it possible for women to keep their children if they so wish?"
Kissling writes that the "challenge to the new antiabortionists" is whether "women's perspectives on the meaning of pregnancy and motherhood will be considered in their project" or if "their ethical frame will remain focused on the fetus." She asks, "How many of these women's decisions will the new antiabortionists be able to say 'yes' to?" Kissling concludes, "So far it seems that it is far more than abortion that is a stumbling block to common ground" (Kissling, Salon, 7/20).
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.
четверг, 27 октября 2011 г.
C-Section Most Common Medical Procedure in U.S. Hospitals; 1.2M Performed Annually, Government Report Says
The caesarean section is the most common medical procedure performed in US hospitals, with 1.2 million performed annually, according to a report released on Tuesday by the... Agency for Healthcare Research and Quality Healthcare Cost & Utilization Project, USA Today reports (Healy, USA Today, 8/3). The report, which is based on data from 38 states representing 90% of all hospital stays, found that at least 20% of the four million infants born annually are delivered by c-sections, according to Anne Elixhauser, an analyst who helped compile the report. "Nearly a quarter of all (U.S.) hospital stays are related to pregnancy and childbirth," Elixhauser said, adding, "Most people don't realize what a big chunk of hospital care that is." C-sections cost about $14.6 billion in total hospital charges in 2003, according to the report. The next most common hospital procedure is upper gastrointestinal endoscopy, which was performed about 712,000 times in U.S. hospitals in 2003 (Reuters, 8/2).
"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.
четверг, 20 октября 2011 г.
Women Previously Diagnosed With Cervical Intraepithelial Neoplasia At Higher Risk For Recurrence And Invasive Cancer
Long-term risks of invasive cancer and recurrence of severe cervical intraepithelial neoplasia (CIN) are higher among women previously treated for CIN, compared with those with no CIN diagnosis, according to data from a large, retrospective cohort study published in the May 12 online issue of the Journal of the National Cancer Institute.
The study was undertaken because information on the long-term risks of subsequent CIN or invasive cancer among women previously treated for the disease is limited. More information on long-term risks is needed to help guide long-term follow-up of these patients.
To determine such risks, Joy Melnikow, M.D., of the Center for Healthcare Policy and Research at the University of California, Davis, and colleagues retrospectively identified a CIN cohort of 37,142 women who were treated for CIN 1, 2, or 3 from January 1, 1986, through December 31, 2000, and compared them with a cohort of 71,213 women with no previous CIN diagnosis. Both groups were under active surveillance through 2004.
The researchers found that risk for subsequent CIN or cervical cancer was associated with initial CIN grade, treatment type, and age. The risk of invasive cervical cancer and CIN 2/3 recurrence was highest for women who were older than 40 years, previously treated for CIN 3, or treated with cryotherapy. According to the study, the highest rates of CIN recurrence were observed in the first 6 years after treatment in the CIN cohort, with a majority of those identified in the first 2 years. Recurrence rates for CIN 2 or 3 during this 6 year period ranged from 2.3 % in the lowest risk group to 35% in the highest risk group. Overall incidence of cervical cancer in the CIN group was 37 cervical cancers per 100,000 woman-years compared with six cervical cancers per 100,000 woman-years among women who had not been previously diagnosed.
"This large, population-based cohort study with more than 300,000 women-years of observation in the CIN cohort provided important information that could contribute to evidence-based guidelines for follow-up of women treated for CIN," the authors write. "Future randomized trials will need longer term follow-up to define the impact of treatment choice on subsequent CIN and invasive cancer."
In an accompanying editorial, Edward J. Wilkinson, M.D., of the University of Florida College of Medicine in Gainesville, Fla., points out that these results support evidence that active surveillance has value in identifying most incidences of CIN 2/3 recurrence and early stages of cervical cancer. He also notes that the majority of women who were later diagnosed with CIN had their CIN 2/3 diagnosed a relatively short time later (2 years). This short interval suggests that the subsequent CIN lesion was probably persistent CIN 2/3 rather than a new lesion.
"[T]his work provides evidence that women with CIN who have undergone treatment need long-term surveillance after their therapy and remain at some risk for CIN as well as for cervical carcinoma for 20 years or more," he concludes.
Citations:
Article:
"Cervical Intraepithelial Neoplasia Outcomes After Treatment: Long-Term Follow-up From the British Columbia Cohort Study."
Melnikow et al.
J Natl Cancer Inst 2009, 101: 721-728.
Editorial:
"Women with Cervical Intraepithelial Neoplasia: Requirement for Active Long-Term Surveillance After Therapy"
Wilkinson E.
J Natl Cancer Inst 2009, 101: 696-697.
Source
Journal of the National Cancer Institute
The study was undertaken because information on the long-term risks of subsequent CIN or invasive cancer among women previously treated for the disease is limited. More information on long-term risks is needed to help guide long-term follow-up of these patients.
To determine such risks, Joy Melnikow, M.D., of the Center for Healthcare Policy and Research at the University of California, Davis, and colleagues retrospectively identified a CIN cohort of 37,142 women who were treated for CIN 1, 2, or 3 from January 1, 1986, through December 31, 2000, and compared them with a cohort of 71,213 women with no previous CIN diagnosis. Both groups were under active surveillance through 2004.
The researchers found that risk for subsequent CIN or cervical cancer was associated with initial CIN grade, treatment type, and age. The risk of invasive cervical cancer and CIN 2/3 recurrence was highest for women who were older than 40 years, previously treated for CIN 3, or treated with cryotherapy. According to the study, the highest rates of CIN recurrence were observed in the first 6 years after treatment in the CIN cohort, with a majority of those identified in the first 2 years. Recurrence rates for CIN 2 or 3 during this 6 year period ranged from 2.3 % in the lowest risk group to 35% in the highest risk group. Overall incidence of cervical cancer in the CIN group was 37 cervical cancers per 100,000 woman-years compared with six cervical cancers per 100,000 woman-years among women who had not been previously diagnosed.
"This large, population-based cohort study with more than 300,000 women-years of observation in the CIN cohort provided important information that could contribute to evidence-based guidelines for follow-up of women treated for CIN," the authors write. "Future randomized trials will need longer term follow-up to define the impact of treatment choice on subsequent CIN and invasive cancer."
In an accompanying editorial, Edward J. Wilkinson, M.D., of the University of Florida College of Medicine in Gainesville, Fla., points out that these results support evidence that active surveillance has value in identifying most incidences of CIN 2/3 recurrence and early stages of cervical cancer. He also notes that the majority of women who were later diagnosed with CIN had their CIN 2/3 diagnosed a relatively short time later (2 years). This short interval suggests that the subsequent CIN lesion was probably persistent CIN 2/3 rather than a new lesion.
"[T]his work provides evidence that women with CIN who have undergone treatment need long-term surveillance after their therapy and remain at some risk for CIN as well as for cervical carcinoma for 20 years or more," he concludes.
Citations:
Article:
"Cervical Intraepithelial Neoplasia Outcomes After Treatment: Long-Term Follow-up From the British Columbia Cohort Study."
Melnikow et al.
J Natl Cancer Inst 2009, 101: 721-728.
Editorial:
"Women with Cervical Intraepithelial Neoplasia: Requirement for Active Long-Term Surveillance After Therapy"
Wilkinson E.
J Natl Cancer Inst 2009, 101: 696-697.
Source
Journal of the National Cancer Institute
четверг, 13 октября 2011 г.
Federal Judge Rules That Attorneys For Abortion Provider Tiller Cannot Prevent Grand Jury From Being Formed To Investigate Tiller
U.S. District Judge J. Thomas Marten on Tuesday ruled against a motion to prevent a grand jury from convening in Sedgwick County, Kan., to investigate abortion provider George Tiller, the Wichita Eagle reports (Lefler, Wichita Eagle, 9/12). The antiabortion group Kansans for Life last week delivered a petition that contained 7,857 signatures asking the Sedgwick County District Court to convene a grand jury and appoint an independent prosecutor to investigate Tiller. Petitioners want the grand jury to examine late-term abortions that Tiller performed during the past five years and the reasons cited for the abortions (Kaiser Daily Women's Health Policy Report, 9/7).
Sedgwick County Election Commissioner Bill Gale on Tuesday certified the petition and sent it to Sedgwick County Administrative Judge Michael Corrigan. Gale said the petitioners submitted 6,683 valid signatures, more than the 2,449 needed to convene a grand jury.
Sedgwick County Election Commissioner Bill Gale on Tuesday certified the petition and sent it to Sedgwick County Administrative Judge Michael Corrigan. Gale said the petitioners submitted 6,683 valid signatures, more than the 2,449 needed to convene a grand jury.
Tiller Motion, Reaction
Tiller's attorneys filed a motion requesting that the grand jury not be convened, claiming that Tiller has been investigated several times in the past year and that another grand jury investigation would be "unfair, harassing and bad faith." According to the Eagle, if the grand jury is seated, it will conduct at least the fifth investigation of Tiller since 2006, including a pending case in which state Attorney General Paul Morrison (D) has charged Tiller with 19 misdemeanors for allegedly violating a state law that requires an independent, consulting physician to approve some late-term abortions.
Tiller's attorneys in the motion said the petition to convene a grand jury is "part of a repeated, persistent and harassing effort to induce criminal prosecution" of Tiller "by those who oppose lawful abortion." Marten said that Tiller's lawyers made a strong case, but added, "Frankly, I'm reluctant to jump into the middle of something that is essentially a state matter." Marten suggested that Tiller's attorneys re-file the motion in state court, and Tiller's attorneys said they plan to do so (Wichita Eagle, 9/12).
Kansans for Life leaders said they were unaware that Tiller's attorneys had sought to prevent state courts from convening a grand jury. David Gittrich, development director of Kansans for Life, said that if the motion had been granted, it would have been an insult to those who signed the petition and to state lawmakers seeking to change abortion policy. He added that the group hopes the grand jury will file charges against Tiller similar to those filed by former Attorney General Phill Kline (R) (Wichita Eagle, 9/12).
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.
четверг, 6 октября 2011 г.
Symptoms Of Toxicity Are Markers Of Breast Cancer Treatment Success
An article published early online and in the December edition of The Lancet
Oncology reports that if breast cancer patients who receive endocrine treatment
develop hot flushes, vasomotor symptoms (such as cold and night sweats), and
joint symptoms, then they have a lower likelihood of cancer recurrence. That
is, the toxicity of the treatment is acting as an indicator of treatment
success.
Professor Jack Cuzick (Cancer Research UK and Queen Mary School of Medicine and
Dentistry, London, UK) and colleagues say that the above
symptoms during endocrine treatment are related to estrogen depletion or
estrogen blockage.
Their analysis used data on women who participated in the Arimidex,
Tamoxifen, Alone or in Combination (ATAC) trial, a study designed to assess
tamoxifen or anastrozole for adjuvant therapy of post-menopausal breast cancer.
To test for a relationship between the toxicity symptoms and cancer recurrence,
the researchers compared two groups of women with hormone-receptor-positive
tumors: one group reported symptoms at their first follow-up visit in the ATAC
trial, and the second group did not report symptoms.
After three months of treatment, 37.5% of eligible women reported new vasomotor
symptoms. These women had a 9-year cancer recurrence rate of 23%, while women
without new vasomotor symptoms had a recurrence rate of 18%. The 31.4% of women
who reported new joint symptoms after three months of treatment had a 9-year
cancer recurrence rate of 14%, while those without joint symptoms had a 23%
recurrence rate. Women who received both tamoxifen and anastrozole exhibited
these rate differences, and anastrozole was linked to lower recurrence rates
than tamoxifen independent of the presence of symptoms.
"The appearance of new vasomotor symptoms or joint symptoms within the
first 3 months is a useful biomarker, suggesting a greater response to
endocrine treatment compared with women without these symptoms. Awareness of
the relation between early treatment-emergent symptoms and beneficial response
to therapy might be useful when reassuring patients who present with them, and
might help to improve long-term treatment adherence when symptoms cannot be
alleviated," conclude the authors.
Treatment-emergent endocrine symptoms and the risk of breast cancer recurrence:
a retrospective analysis of the ATAC trial
Jack Cuzick, Ivana Sestak, David Cella, Lesley Fallowfield, on behalf of
the ATAC Trialists' Group
The Lancet Oncology (2008).
DOI:10.1016/S1470-2045(08)70259-6
Click Here to View Journal Website
: Peter M Crosta
View drug information on Arimidex.
Oncology reports that if breast cancer patients who receive endocrine treatment
develop hot flushes, vasomotor symptoms (such as cold and night sweats), and
joint symptoms, then they have a lower likelihood of cancer recurrence. That
is, the toxicity of the treatment is acting as an indicator of treatment
success.
Professor Jack Cuzick (Cancer Research UK and Queen Mary School of Medicine and
Dentistry, London, UK) and colleagues say that the above
symptoms during endocrine treatment are related to estrogen depletion or
estrogen blockage.
Their analysis used data on women who participated in the Arimidex,
Tamoxifen, Alone or in Combination (ATAC) trial, a study designed to assess
tamoxifen or anastrozole for adjuvant therapy of post-menopausal breast cancer.
To test for a relationship between the toxicity symptoms and cancer recurrence,
the researchers compared two groups of women with hormone-receptor-positive
tumors: one group reported symptoms at their first follow-up visit in the ATAC
trial, and the second group did not report symptoms.
After three months of treatment, 37.5% of eligible women reported new vasomotor
symptoms. These women had a 9-year cancer recurrence rate of 23%, while women
without new vasomotor symptoms had a recurrence rate of 18%. The 31.4% of women
who reported new joint symptoms after three months of treatment had a 9-year
cancer recurrence rate of 14%, while those without joint symptoms had a 23%
recurrence rate. Women who received both tamoxifen and anastrozole exhibited
these rate differences, and anastrozole was linked to lower recurrence rates
than tamoxifen independent of the presence of symptoms.
"The appearance of new vasomotor symptoms or joint symptoms within the
first 3 months is a useful biomarker, suggesting a greater response to
endocrine treatment compared with women without these symptoms. Awareness of
the relation between early treatment-emergent symptoms and beneficial response
to therapy might be useful when reassuring patients who present with them, and
might help to improve long-term treatment adherence when symptoms cannot be
alleviated," conclude the authors.
Treatment-emergent endocrine symptoms and the risk of breast cancer recurrence:
a retrospective analysis of the ATAC trial
Jack Cuzick, Ivana Sestak, David Cella, Lesley Fallowfield, on behalf of
the ATAC Trialists' Group
The Lancet Oncology (2008).
DOI:10.1016/S1470-2045(08)70259-6
Click Here to View Journal Website
: Peter M Crosta
View drug information on Arimidex.
четверг, 29 сентября 2011 г.
Mental Health Woes Remain One Of The Top Reasons For Doctor Visits
Depression and other mental health problems prompted 156 million visits to doctors' offices, clinics, and hospital outpatient departments in 2005, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.
Problems with mental health were one of the top three reasons for Americans to seek treatment. Also, the number of mental health visits has increased 30 percent since 1996.
AHRQ's analysis also ranked the other top reasons for getting non emergency ambulatory care in 2005:
-- Back problems prompted 139 million visits and cost $17.6 billion.
-- Trauma- related disorders, such as fractures, prompted 133 million visits that cost $27 billion.
-- Chronic obstructive pulmonary disease and asthma, grouped together, resulted in 93 million visits that cost $12 billion.
-- High blood pressure resulted in 79 million visits and cost $10 billion.
AHRQ, which is part of the U.S. Department of Health and Human Services, works to enhance the quality, safety, efficiency, and effectiveness of health care in the United States. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey (MEPS), a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid.
Agency for Healthcare Research and Quality (AHRQ)
540 Gaither Rd.
Rockville, MD 20850
United States
ahrq
Problems with mental health were one of the top three reasons for Americans to seek treatment. Also, the number of mental health visits has increased 30 percent since 1996.
AHRQ's analysis also ranked the other top reasons for getting non emergency ambulatory care in 2005:
-- Back problems prompted 139 million visits and cost $17.6 billion.
-- Trauma- related disorders, such as fractures, prompted 133 million visits that cost $27 billion.
-- Chronic obstructive pulmonary disease and asthma, grouped together, resulted in 93 million visits that cost $12 billion.
-- High blood pressure resulted in 79 million visits and cost $10 billion.
AHRQ, which is part of the U.S. Department of Health and Human Services, works to enhance the quality, safety, efficiency, and effectiveness of health care in the United States. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey (MEPS), a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid.
Agency for Healthcare Research and Quality (AHRQ)
540 Gaither Rd.
Rockville, MD 20850
United States
ahrq
четверг, 22 сентября 2011 г.
Resolving Confusion About The Recent FDA Press Release On Bioidentical Hormones, Women To Women Responds With Clarifying Stance On BHRT
"I'm concerned that the recent FDA press release on bioidentical hormones is misleading women," says Marcelle Pick, founder of the renowned Women to Women clinic in Yarmouth, Maine. "The press coverage implies that the FDA is saying bioidentical compounded hormones are unsafe. But they're quite safe, provided they are prescribed by an experienced healthcare professional and are made by a reputable compounding pharmacy. We've prescribed them for over 15 years for thousands of women."
On January 9, 2008, the FDA issued a press release entitled "FDA Takes Action Against Compounded Menopause Hormone Therapy Drugs." At the same time, they issued a number of warning letters to compounding pharmacies taking issue with the use of the word "bio-identical" as a marketing term implying a benefit, where they state "there is no medical or scientific basis."
"First," says Pick, "it is important that women understand the message: the FDA has not outlawed the use of bio-identical HRT."
"Second, it's the job of a reputable compounding lab to prepare a product that has the same molecular structure as the hormones your body produces naturally --- the word 'bio-identical' in this sense means 'identical to life.' If a woman is lacking the hormones she needs to feel balanced, bHRT, as compared to synthetics, allows the body to metabolize the hormones in much the same way as it was designed to do naturally. This is the key to minimizing side effects."
Dixie Mills, MD, renowned breast care specialist and partner in Women to Women's Personal Program, says, "It comes as no surprise to me that a big pharmaceutical company like Wyeth was a part of this press release. Pharmaceutical companies also sell bioidentical hormone products, but with unique delivery methods for bHRT that are patentable, such as special skin patches or vaginal rings."
Pick explains, "Because the hormones created by compounding pharmacies are chemically identical to those found naturally, they cannot be patented --- drug companies can't patent things that occur naturally in the human body."
She continues to say, "At Women to Women, we have found that about 85% of women can find relief through an approach that combines medical-grade nutritional supplements, gentle phytotherapy to normalize the endocrine system, and dietary and lifestyle changes. If prescription-strength relief is necessary due to advanced symptoms of menopause, we always recommend that women consider beginning with bHRT. It is our clinical experience that with the right protocol (including diagnostic blood tests, controlled dosage and duration, and regularly scheduled follow-up blood tests), bHRT can help to alleviate the symptoms of menopause without the negative side effects that may be experienced from the body not being able to process synthetic HRT as well."
"I urge women to consider all their choices," concludes Mills, "and to discuss bHRT with their healthcare practitioners before narrowing their choices based on the titles of FDA press releases."
About Women to Women
Women to Women is America's leading medical practice devoted to health care for women, by women. Founded over 21 years ago, it has always advocated an approach to women's health that combines the best of alternative and conventional medicine. Through its practice, website, and publications, Women to Women supports over a million women a year in their efforts to create health and well-being in their lives.
Women to Women
On January 9, 2008, the FDA issued a press release entitled "FDA Takes Action Against Compounded Menopause Hormone Therapy Drugs." At the same time, they issued a number of warning letters to compounding pharmacies taking issue with the use of the word "bio-identical" as a marketing term implying a benefit, where they state "there is no medical or scientific basis."
"First," says Pick, "it is important that women understand the message: the FDA has not outlawed the use of bio-identical HRT."
"Second, it's the job of a reputable compounding lab to prepare a product that has the same molecular structure as the hormones your body produces naturally --- the word 'bio-identical' in this sense means 'identical to life.' If a woman is lacking the hormones she needs to feel balanced, bHRT, as compared to synthetics, allows the body to metabolize the hormones in much the same way as it was designed to do naturally. This is the key to minimizing side effects."
Dixie Mills, MD, renowned breast care specialist and partner in Women to Women's Personal Program, says, "It comes as no surprise to me that a big pharmaceutical company like Wyeth was a part of this press release. Pharmaceutical companies also sell bioidentical hormone products, but with unique delivery methods for bHRT that are patentable, such as special skin patches or vaginal rings."
Pick explains, "Because the hormones created by compounding pharmacies are chemically identical to those found naturally, they cannot be patented --- drug companies can't patent things that occur naturally in the human body."
She continues to say, "At Women to Women, we have found that about 85% of women can find relief through an approach that combines medical-grade nutritional supplements, gentle phytotherapy to normalize the endocrine system, and dietary and lifestyle changes. If prescription-strength relief is necessary due to advanced symptoms of menopause, we always recommend that women consider beginning with bHRT. It is our clinical experience that with the right protocol (including diagnostic blood tests, controlled dosage and duration, and regularly scheduled follow-up blood tests), bHRT can help to alleviate the symptoms of menopause without the negative side effects that may be experienced from the body not being able to process synthetic HRT as well."
"I urge women to consider all their choices," concludes Mills, "and to discuss bHRT with their healthcare practitioners before narrowing their choices based on the titles of FDA press releases."
About Women to Women
Women to Women is America's leading medical practice devoted to health care for women, by women. Founded over 21 years ago, it has always advocated an approach to women's health that combines the best of alternative and conventional medicine. Through its practice, website, and publications, Women to Women supports over a million women a year in their efforts to create health and well-being in their lives.
Women to Women
четверг, 15 сентября 2011 г.
Fewer Women Entering Heroin Addiction Treatment - More Successfully Completing Treatment, England
Far fewer women are entering treatment for heroin addiction and more women are successfully completing treatment for drug dependency than ever before. A detailed study of statistics about women in treatment in England shows a 19 per cent fall in the number of adult females under 30 entering heroin programmes over the last five years - 1,000 fewer female addicts than in 2005.
The fall is even sharper - 26 per cent - for the 18-25 age-group, providing further evidence that the heroin epidemic of previous decades may have peaked.
Although part of the trend was offset by rising numbers of cocaine and crack addicts seeking treatment over the same period, the numbers of women entering treatment in the under 30 age group fell by nearly nine per cent in four years.
The study also showed that at the same time the numbers of women problem drug users successfully leaving treatment having overcome their addiction almost doubled. In addition, the number of women dropping out of treatment has fallen by well over a third in four years.
The study by the National Treatment Agency for Substance Misuse (NTA) also highlights:
- While women start using drugs at a younger age than men, they are more adept at seeking help for themselves and tend to come into treatment earlier
- Cocaine is the fastest growing treatment need among women drug users, accounting for a 55 per cent increase in new entrants since 2005
- The number of women entering treatment for crack dependency has increased by 14 per cent since 2005
- Almost two-thirds of women entering treatment are mothers, nearly half of whom have a child living with them. The data indicates that treatment outcomes for mothers are stronger than those who were not parents.
"These findings demonstrate how thousands of women have successfully obtained drug treatment and recovered through it," said Rosanna O'Connor, NTA director of delivery. "Treatment is the first step on the road to recovery, so it is encouraging that women tend to seek help of their own volition, enter treatment earlier before their drug misuse has become entrenched and frequently achieve better outcomes sooner. Treatment provides the opportunity for individuals to get better, for families to stabilise, and for children to be looked-after at home."
The bulletin Women in drug treatment: what the latest figures reveal is available to download from nta.nhs
Around 57,000 women were recorded in drug treatment in England in 2008/09, compared to around 153,000 men; a gender breakdown of 1:3.
The NTA was set up by Government in 2001 to improve the availability, capacity and effectiveness of treatment for drug misuse in England.
Source
National Treatment Agency for Substance Misuse
The fall is even sharper - 26 per cent - for the 18-25 age-group, providing further evidence that the heroin epidemic of previous decades may have peaked.
Although part of the trend was offset by rising numbers of cocaine and crack addicts seeking treatment over the same period, the numbers of women entering treatment in the under 30 age group fell by nearly nine per cent in four years.
The study also showed that at the same time the numbers of women problem drug users successfully leaving treatment having overcome their addiction almost doubled. In addition, the number of women dropping out of treatment has fallen by well over a third in four years.
The study by the National Treatment Agency for Substance Misuse (NTA) also highlights:
- While women start using drugs at a younger age than men, they are more adept at seeking help for themselves and tend to come into treatment earlier
- Cocaine is the fastest growing treatment need among women drug users, accounting for a 55 per cent increase in new entrants since 2005
- The number of women entering treatment for crack dependency has increased by 14 per cent since 2005
- Almost two-thirds of women entering treatment are mothers, nearly half of whom have a child living with them. The data indicates that treatment outcomes for mothers are stronger than those who were not parents.
"These findings demonstrate how thousands of women have successfully obtained drug treatment and recovered through it," said Rosanna O'Connor, NTA director of delivery. "Treatment is the first step on the road to recovery, so it is encouraging that women tend to seek help of their own volition, enter treatment earlier before their drug misuse has become entrenched and frequently achieve better outcomes sooner. Treatment provides the opportunity for individuals to get better, for families to stabilise, and for children to be looked-after at home."
The bulletin Women in drug treatment: what the latest figures reveal is available to download from nta.nhs
Around 57,000 women were recorded in drug treatment in England in 2008/09, compared to around 153,000 men; a gender breakdown of 1:3.
The NTA was set up by Government in 2001 to improve the availability, capacity and effectiveness of treatment for drug misuse in England.
Source
National Treatment Agency for Substance Misuse
четверг, 8 сентября 2011 г.
Men, Women Should Share Responsibility For HIV/AIDS Prevention, Treatment, Malaysian Official Says
Men and women should share equal responsibility for preventing HIV/AIDS and providing treatment to people living with the diseases, Ng Yen Yen -- Malaysian minister for women, family and community development -- said last week at the 53rd Session of the U.N. Commission on the Status of Women, Bernama Daily Malaysian News reports. According to Ng, the percentage of new HIV/AIDS cases in Malaysia that occur among women has increased from 1.2% in 1990 to 16.4% in 2007. In addition, most HIV-positive women in the country contract the virus from their husbands, Ng said.
According to Ng, it is "important that both men and women take equal responsibility in preventing the spread of HIV among women." She added that "it is crucial that in the intersection of care-giving and HIV/AIDS, women are given the utmost support" because the "role of care-giving in many societies often falls upon women." Ng said that it is important to increase HIV/AIDS awareness among men in Malaysia so that they can become "involved in shouldering their responsibility in care-giving" for people living with HIV (Bernama Daily Malaysian News, 3/5). In addition, men and women should share equal responsibility for promoting safer sex, she said.
According to Ng, gender stereotypes pose significant challenges to equal responsibility and the advancement of women. She added that policymakers often encounter difficulty discussing stereotypes and implementing initiatives to address the issue. Ng said that "chipping away long-held biases and ways of thinking require strenuous efforts. But the outcome is worthwhile and the international community should not shirk from this" (Malaysia National News/Bernama, 3/4). Ng added that gender equality also can contribute to Malaysia's development at both the family level and the wider community and political levels. According to Ng, the Malaysian government "places the utmost importance on gender equality and Malaysian women have made significant progress in various fields, such as in the education, health and economic sectors" (Bernama Daily Malaysian News, 3/5).
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.
According to Ng, it is "important that both men and women take equal responsibility in preventing the spread of HIV among women." She added that "it is crucial that in the intersection of care-giving and HIV/AIDS, women are given the utmost support" because the "role of care-giving in many societies often falls upon women." Ng said that it is important to increase HIV/AIDS awareness among men in Malaysia so that they can become "involved in shouldering their responsibility in care-giving" for people living with HIV (Bernama Daily Malaysian News, 3/5). In addition, men and women should share equal responsibility for promoting safer sex, she said.
According to Ng, gender stereotypes pose significant challenges to equal responsibility and the advancement of women. She added that policymakers often encounter difficulty discussing stereotypes and implementing initiatives to address the issue. Ng said that "chipping away long-held biases and ways of thinking require strenuous efforts. But the outcome is worthwhile and the international community should not shirk from this" (Malaysia National News/Bernama, 3/4). Ng added that gender equality also can contribute to Malaysia's development at both the family level and the wider community and political levels. According to Ng, the Malaysian government "places the utmost importance on gender equality and Malaysian women have made significant progress in various fields, such as in the education, health and economic sectors" (Bernama Daily Malaysian News, 3/5).
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.
четверг, 1 сентября 2011 г.
Issues Like Abortion Rights Highlight Ongoing Debates Over Judicial Activism, Restraint, Opinion Piece Says
Although it is necessary to give some thought to what should be decided by judges and what should be determined by legislators, the "current fashion of framing substantive issues," such as abortion rights, "in terms of activism or restraint can only take you so far," Ann Althouse, law professor at the University of Wisconsin, writes in a Wall Street Journal opinion piece. According to Althouse, there was a time when people "openly praised the activist judge," but now "we all seem to love to wrap ourselves in the mantle of the new fashion" that "comes at the price of candor." Although the Supreme Court at one time "wrongly" believed that "enshrining abortion rights in the Constitution would spare us a torturous political fight," the court's decision in Roe v. Wade -- the 1973 Supreme Court decision that effectively outlawed state abortion bans -- "laid the groundwork for decades of controversial cases and contentious confirmation battles," according to Althouse. However, it also is a "delusion to think that matters would improve if the court rescinded" its decision in Roe because "[n]ew political fights would spring up and produce a new set of cases that would plunge the courts into even more troublesome legal disputes," Althouse writes. Although this situation "easily translates into the conclusion" that Roe "should not be overturned," such a conclusion is an "oblique argument that avoids speaking directly about the importance or reality of the rights in question," according to Althouse. The argument against overturning Roe "appeals to our preferences and aversions about judicial behavior," Althouse writes, adding that it also "assumes that these days we like our judges restrained. With this assumption, we're reconfiguring arguments into plans for, or limitations about, minimizing judicial activism" (Althouse, Wall Street Journal, 10/21).
"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.
"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.
четверг, 25 августа 2011 г.
Protection Against Cancer May Begin During Pregnancy
There may be another reason for pregnant and nursing women to eat a nutritious diet that includes generous amounts of cruciferous vegetables like broccoli and cabbage - it could help protect their children from cancer, both as infants and later in life.
A new study by scientists from the Linus Pauling Institute at Oregon State University, done with laboratory mice, found that supplements of a key phytochemical found in certain vegetables provided a very high level of protection against leukemia and lymphoma in young animals, and also significantly protected against lung cancer during the rodent's equivalent of middle age.
The research, published in the journal Carcinogenesis, is one of the first of its type to demonstrate that diet may play a protective role in a fight against cancer that may begin - and could be won or lost - well before a person is ever born. And some of the protective benefits may last into adulthood.
"Research of this type is still in its infancy, but it's pretty exciting," said David Williams, an LPI researcher and director of the Marine and Freshwater Biomedical Sciences Center at OSU.
"There's strong epidemiologic evidence that infant cancers can be caused by exposure of the fetus to carcinogens, either during pregnancy or by nursing," Williams said. "Among all childhood deaths in the U.S., cancer is second only to accidents as the leading cause, and the fetus and neonate are sensitive targets for toxic carcinogens. It would be important if we could affect this through maternal diet."
There are particular concerns about common environmental pollutants called polycyclic aromatic hydrocarbons, or PAHs, which can be produced by cigarette smoking or the combustion of organic materials such as wood, coal, cooking oil or diesel fuel. Exposure of a fetus to PAHs has been shown to cause DNA damage in newborns and is also associated with increased levels of childhood leukemia. It has also been shown that a significant portion of the total lifetime exposure to PAHs and other toxins, including PCBs and dioxins, is transmitted to the fetus across the placental barrier and during nursing.
In laboratory studies, researchers exposed pregnant mice to a single high dose of one PAH called dibenzopyrene, a potent carcinogen, and about 80 percent of their 100 offspring died early in life from an aggressive T-cell lymphoma. Of those that survived to the mouse-equivalent of middle age, 100 percent had lung tumors.
By comparison, in a group of pregnant mice given the same carcinogen but who also received the chemoprotective supplement Indole-3-carbinol, or I3C, deaths from lymphoma were cut in half, and the number of lung tumors later in life was significantly reduced.
"It's clear that in mice this supplement provided significant protection against lymphoma and, later on, lung cancer," Williams said. "It's also worth noting that none of the infant mice received the protective supplement later in their life, at any stage beyond breast feeding. The protective effect of the compound came solely from maternal intake during pregnancy and nursing, but lasted into the animal's middle age. This is somewhat remarkable."
Although lung cancer is the leading cause of cancer death in both men and women, it's also true that only about one smoker in 10 gets lung cancer. It's possible, researchers say, that dietary and other factors in addition to smoking may predispose some smokers to get cancer while others don't. That this process may begin with carcinogens crossing the placental boundary - and might be affected by diet - is an area that has not been adequately studied, Williams said. In this study, both the exposure to carcinogens and the levels of Indole-3-carbinol given to pregnant mice through supplements were higher than those that would ordinarily be found in the environment or a normal diet, researchers said.
The scientists do not recommend that pregnant women take supplements of this compound, which is available in health food stores, because there have been questions about its possible role in causing birth defects when ingested at high levels in the first trimester of pregnancy. That topic needs further study, they said.
However, the amounts of this and other valuable phytochemicals that could be obtained in any normal diet rich in cruciferous vegetables should be safe and useful, they said. These vegetables include broccoli, cabbage, cauliflower, kale, radishes, turnips and other types of greens and cabbages.
Indole-3-carbinol is also being studied by scientists in other U.S. research programs for chemoprotection of women against breast cancer.
Cancer chemoprotection is one of the main research areas at the Linus Pauling Institute, a world leader in the study of vitamins, phytochemicals and other nutrients that may help prevent disease or provide optimum health.
By David Stauth
This research was funded by the National Institutes of Health.
Contact: David Williams
Oregon State University
A new study by scientists from the Linus Pauling Institute at Oregon State University, done with laboratory mice, found that supplements of a key phytochemical found in certain vegetables provided a very high level of protection against leukemia and lymphoma in young animals, and also significantly protected against lung cancer during the rodent's equivalent of middle age.
The research, published in the journal Carcinogenesis, is one of the first of its type to demonstrate that diet may play a protective role in a fight against cancer that may begin - and could be won or lost - well before a person is ever born. And some of the protective benefits may last into adulthood.
"Research of this type is still in its infancy, but it's pretty exciting," said David Williams, an LPI researcher and director of the Marine and Freshwater Biomedical Sciences Center at OSU.
"There's strong epidemiologic evidence that infant cancers can be caused by exposure of the fetus to carcinogens, either during pregnancy or by nursing," Williams said. "Among all childhood deaths in the U.S., cancer is second only to accidents as the leading cause, and the fetus and neonate are sensitive targets for toxic carcinogens. It would be important if we could affect this through maternal diet."
There are particular concerns about common environmental pollutants called polycyclic aromatic hydrocarbons, or PAHs, which can be produced by cigarette smoking or the combustion of organic materials such as wood, coal, cooking oil or diesel fuel. Exposure of a fetus to PAHs has been shown to cause DNA damage in newborns and is also associated with increased levels of childhood leukemia. It has also been shown that a significant portion of the total lifetime exposure to PAHs and other toxins, including PCBs and dioxins, is transmitted to the fetus across the placental barrier and during nursing.
In laboratory studies, researchers exposed pregnant mice to a single high dose of one PAH called dibenzopyrene, a potent carcinogen, and about 80 percent of their 100 offspring died early in life from an aggressive T-cell lymphoma. Of those that survived to the mouse-equivalent of middle age, 100 percent had lung tumors.
By comparison, in a group of pregnant mice given the same carcinogen but who also received the chemoprotective supplement Indole-3-carbinol, or I3C, deaths from lymphoma were cut in half, and the number of lung tumors later in life was significantly reduced.
"It's clear that in mice this supplement provided significant protection against lymphoma and, later on, lung cancer," Williams said. "It's also worth noting that none of the infant mice received the protective supplement later in their life, at any stage beyond breast feeding. The protective effect of the compound came solely from maternal intake during pregnancy and nursing, but lasted into the animal's middle age. This is somewhat remarkable."
Although lung cancer is the leading cause of cancer death in both men and women, it's also true that only about one smoker in 10 gets lung cancer. It's possible, researchers say, that dietary and other factors in addition to smoking may predispose some smokers to get cancer while others don't. That this process may begin with carcinogens crossing the placental boundary - and might be affected by diet - is an area that has not been adequately studied, Williams said. In this study, both the exposure to carcinogens and the levels of Indole-3-carbinol given to pregnant mice through supplements were higher than those that would ordinarily be found in the environment or a normal diet, researchers said.
The scientists do not recommend that pregnant women take supplements of this compound, which is available in health food stores, because there have been questions about its possible role in causing birth defects when ingested at high levels in the first trimester of pregnancy. That topic needs further study, they said.
However, the amounts of this and other valuable phytochemicals that could be obtained in any normal diet rich in cruciferous vegetables should be safe and useful, they said. These vegetables include broccoli, cabbage, cauliflower, kale, radishes, turnips and other types of greens and cabbages.
Indole-3-carbinol is also being studied by scientists in other U.S. research programs for chemoprotection of women against breast cancer.
Cancer chemoprotection is one of the main research areas at the Linus Pauling Institute, a world leader in the study of vitamins, phytochemicals and other nutrients that may help prevent disease or provide optimum health.
By David Stauth
This research was funded by the National Institutes of Health.
Contact: David Williams
Oregon State University
четверг, 18 августа 2011 г.
African-American Women Who Have Received HIV Treatment Are Sought To Participate In GRACE Study
The GRACE study (Gender, Race
And Clinical Experience) is now recruiting participants for the largest
clinical study to date in treatment-experienced adult women with HIV to
evaluate gender and race differences in response to an HIV medication. On
the occasion of the seventh annual National Black HIV/AIDS Awareness Day on
February 7, the study's sponsor, Tibotec Therapeutics Clinical Affairs, a
division of Ortho Biotech Clinical Affairs, LLC, is seeking to raise
awareness among African-American women of the trial and its importance to
the treatment of HIV.
Today, women account for nearly one-third of new HIV diagnoses in the
U.S., and rates of HIV infection are particularly high among women of
color. African-American women, who represent only 13% of the U.S. female
population, account for 64% of female AIDS cases.
"We expect GRACE will be an historic study because HIV treatment trials
in treatment-experienced populations have traditionally included small
numbers of women and people of color, especially in the earliest studies of
new antiretroviral agents. We know that there are gender- and race-specific
complications associated with HIV disease. However, we do not know a great
deal about how gender and race impact the efficacy and side effects of HIV
medications," said Debbie Hagins, M.D., Clinical Director of Outpatient
Services, a Ryan White funded clinic in Savannah, GA, and an investigator
in the GRACE study.
GRACE, a multi-center, open-label Phase IIIb trial, will compare gender
differences in the efficacy, safety and tolerability of PREZISTA
(darunavir) tablets administered with ritonavir and other antiretroviral
agents over a 48-week treatment period. The study also will explore racial
differences in treatment outcomes. Eligibility is open to men and women of
all races.
PREZISTA, co-administered with 100 mg ritonavir (PREZISTA/r) and with
other antiretroviral agents, is indicated for the treatment of human
immunodeficiency virus (HIV) infection in antiretroviral
treatment-experienced adult patients, such as those with HIV-1 strains
resistant to more than one protease inhibitor. PREZISTA received
accelerated approval based on the 24- week analysis of HIV viral load and
CD4+ cell counts from the pooled analysis of the TMC114-C213 (POWER 1) and
TMC114-C202 (POWER 2) studies. Longer-term data will be required before the
FDA can consider traditional approval for PREZISTA (see the full indication
and important safety information below).
"As an African-American woman living with HIV for more than 20 years, I
am encouraged to see studies like GRACE that are designed to learn more
about HIV treatment in treatment-experienced African-Americans and women in
the U.S." said Rae Lewis-Thornton, a renowned AIDS activist and Emmy
Award-winning journalist. "GRACE is an example of the steps that need to be
taken to address the evolving HIV epidemic in the African-American
community, and those who participate in GRACE will play a very important
role in advancing the understanding of HIV treatment in women and people of
color."
The GRACE study will include approximately 50 sites in the United
States, Mexico and Canada, and will seek to enroll approximately 420
participants, 70 percent of whom will be women. Participants must be of 18
years or older, have a viral load of 1000 copies/mL or greater and have
previous intolerance or failure to prior therapy consisting of a protease
inhibitor and/or non- nucleoside reverse transcriptase inhibitor-based
highly active antiretroviral treatment regimen of at least 12 weeks. All
participants will receive PREZISTA/r (600/100mg twice a day) with an
optimized background regimen chosen by the investigator and based on
resistance testing and prior treatment history.
Indication
PREZISTA, co-administered with 100 mg ritonavir (PREZISTA/r) and with
other antiretroviral agents, is indicated for the treatment of human
immunodeficiency virus (HIV) infection in antiretroviral
treatment-experienced adult patients, such as those with HIV-1 strains
resistant to more than one protease inhibitor.
This indication is based on Week 24 analyses of plasma HIV RNA levels
and CD4+ cell counts from two controlled trials of PREZISTA/rtv in
combination with other antiretroviral drugs. Both studies were conducted in
clinically advanced, treatment-experienced (NRTIs, NNRTIs, and PIs) adult
patients with evidence of HIV-1 replication despite ongoing antiretroviral
therapy.
The following points should be considered when initiating therapy with
PREZISTA/rtv:
-- Treatment history and, when available, genotypic or phenotypic testing
should guide the use of PREZISTA/rtv.
-- The use of other active agents with PREZISTA/rtv is associated with a
greater likelihood of treatment response.
-- The risks and benefits of PREZISTA/rtv have not been established in
treatment-na??ve adult patients or pediatric patients.
Important Safety Information
PREZISTA does not cure HIV infection or AIDS, and does not prevent
passing HIV to others.
PREZISTA is contraindicated in patients with known hypersensitivity to
any of its ingredients.
Coadministration of PREZISTA/r is contraindicated with drugs that are
highly dependent on CYP3A for clearance and have a narrow therapeutic index
(e.g., astemizole, terfenadine, dihydroergotamine, ergonovine, ergotamine,
methylergonovine, cisapride, pimozide, midazolam, or triazolam) and for
which elevated plasma concentrations are associated with serious and/or
life- threatening events. Coadministration is not recommended with
carbamazepine, phenobarbital, phenytoin, rifampin, lopinavir/ritonavir,
saquinavir, lovastatin, pravastatin, simvastatin, or products containing
St. John's wort (Hypericum perforatum).
Caution should be used when prescribing agents such as sildenafil,
vardenafil, tadalafil, or other substrates, inhibitors, or inducers of
CYP3A in patients receiving PREZISTA/rtv. This list of potential drug
interactions is not complete.
PREZISTA must be co-administered with 100 mg ritonavir and food to
exert its therapeutic effect. Failure to correctly administer PREZISTA with
ritonavir and food will result in reduced plasma concentration of darunavir
that will be insufficient to achieve the desired antiviral effect. Please
refer to ritonavir prescribing information for additional information on
precautionary measures.
Severe skin rash, including erythema multiforme and Stevens-Johnson
Syndrome, has been reported in subjects receiving PREZISTA during the
clinical development program. In some cases, fever and elevations of
transaminases have also been reported. In clinical trials (n=924), rash
(all grades, regardless of causality) occurred in seven percent of subjects
treated with PREZISTA; discontinuation due to rash was 0.3 percent. Rashes
were generally mild-to-moderate, self-limiting and maculopapular. PREZISTA
should be discontinued if severe rash develops.
PREZISTA should be used with caution in patients with known sulfonamide
allergy.
New-onset or exacerbations of pre-existing diabetes mellitus and
hyperglycemia, and increased bleeding in hemophiliacs have been reported in
patients receiving protease inhibitors. A causal relationship between
protease inhibitors and these events has not been established.
PREZISTA should be used with caution in patients with hepatic
impairment. There are no data regarding the use of PREZISTA in patients
with varying degrees of hepatic impairment; therefore, specific dosage
recommendations cannot be made.
Redistribution and/or accumulation of body fat have been observed in
patients receiving ARV therapy. The causal relationship, mechanism, and
long- term consequences of these events have not been established.
Immune reconstitution syndrome has been reported in patients treated
with ARV therapy.
The potential for HIV-cross-resistance among protease inhibitors has
not been fully explored in PREZISTA/rtv treated patients.
PREZISTA should be used during pregnancy only if the potential benefit
justifies the potential risk. There are no adequate and well-controlled
studies in pregnant women. The effects of PREZISTA on pregnant women or
their unborn babies are not known.
In the pooled analysis of POWER 1 and 2 studies, the most frequently
reported drug-related adverse events of at least moderate to severe
intensity in patients receiving PREZISTA/rtv-containing regimen were
headache (3.8 percent), diarrhea (2.3 percent), abdominal pain (2.3
percent), constipation (2.3 percent), and vomiting (1.5 percent).
Please see full Prescribing Information for more details.
About PREZISTA
PREZISTA was developed by Tibotec Pharmaceuticals Ltd. and is marketed
in the U.S. by Tibotec Therapeutics, a division of Ortho Biotech Products,
L.P.
About Tibotec Therapeutics
Tibotec Therapeutics, a division of Ortho Biotech Products, L.P.,
headquartered in Bridgewater, N.J., is dedicated to delivering innovative
virology therapeutics that help healthcare professionals address serious
unmet needs in people living with HIV.
About Tibotec Pharmaceuticals Ltd.
Tibotec Pharmaceuticals Ltd., based in Cork, Ireland, is a
pharmaceutical research and development company. The Company's main
research and development facilities are in Mechelen, Belgium with offices
in Yardley, PA. Tibotec is dedicated to the discovery and development of
innovative HIV/AIDS drugs and anti-infectives for diseases of high unmet
medical need.
Tibotec Pharmaceuticals is developing a Global Access Program to
facilitate access to its antiretrovirals for patients living with HIV/AIDS
in developing countries. The Global Access Program includes access pricing,
registration, medical education for appropriate use and voluntary
licensing.
Tibotec Therapeutics
tibotectherapeutics
View drug information on Prezista.
And Clinical Experience) is now recruiting participants for the largest
clinical study to date in treatment-experienced adult women with HIV to
evaluate gender and race differences in response to an HIV medication. On
the occasion of the seventh annual National Black HIV/AIDS Awareness Day on
February 7, the study's sponsor, Tibotec Therapeutics Clinical Affairs, a
division of Ortho Biotech Clinical Affairs, LLC, is seeking to raise
awareness among African-American women of the trial and its importance to
the treatment of HIV.
Today, women account for nearly one-third of new HIV diagnoses in the
U.S., and rates of HIV infection are particularly high among women of
color. African-American women, who represent only 13% of the U.S. female
population, account for 64% of female AIDS cases.
"We expect GRACE will be an historic study because HIV treatment trials
in treatment-experienced populations have traditionally included small
numbers of women and people of color, especially in the earliest studies of
new antiretroviral agents. We know that there are gender- and race-specific
complications associated with HIV disease. However, we do not know a great
deal about how gender and race impact the efficacy and side effects of HIV
medications," said Debbie Hagins, M.D., Clinical Director of Outpatient
Services, a Ryan White funded clinic in Savannah, GA, and an investigator
in the GRACE study.
GRACE, a multi-center, open-label Phase IIIb trial, will compare gender
differences in the efficacy, safety and tolerability of PREZISTA
(darunavir) tablets administered with ritonavir and other antiretroviral
agents over a 48-week treatment period. The study also will explore racial
differences in treatment outcomes. Eligibility is open to men and women of
all races.
PREZISTA, co-administered with 100 mg ritonavir (PREZISTA/r) and with
other antiretroviral agents, is indicated for the treatment of human
immunodeficiency virus (HIV) infection in antiretroviral
treatment-experienced adult patients, such as those with HIV-1 strains
resistant to more than one protease inhibitor. PREZISTA received
accelerated approval based on the 24- week analysis of HIV viral load and
CD4+ cell counts from the pooled analysis of the TMC114-C213 (POWER 1) and
TMC114-C202 (POWER 2) studies. Longer-term data will be required before the
FDA can consider traditional approval for PREZISTA (see the full indication
and important safety information below).
"As an African-American woman living with HIV for more than 20 years, I
am encouraged to see studies like GRACE that are designed to learn more
about HIV treatment in treatment-experienced African-Americans and women in
the U.S." said Rae Lewis-Thornton, a renowned AIDS activist and Emmy
Award-winning journalist. "GRACE is an example of the steps that need to be
taken to address the evolving HIV epidemic in the African-American
community, and those who participate in GRACE will play a very important
role in advancing the understanding of HIV treatment in women and people of
color."
The GRACE study will include approximately 50 sites in the United
States, Mexico and Canada, and will seek to enroll approximately 420
participants, 70 percent of whom will be women. Participants must be of 18
years or older, have a viral load of 1000 copies/mL or greater and have
previous intolerance or failure to prior therapy consisting of a protease
inhibitor and/or non- nucleoside reverse transcriptase inhibitor-based
highly active antiretroviral treatment regimen of at least 12 weeks. All
participants will receive PREZISTA/r (600/100mg twice a day) with an
optimized background regimen chosen by the investigator and based on
resistance testing and prior treatment history.
Indication
PREZISTA, co-administered with 100 mg ritonavir (PREZISTA/r) and with
other antiretroviral agents, is indicated for the treatment of human
immunodeficiency virus (HIV) infection in antiretroviral
treatment-experienced adult patients, such as those with HIV-1 strains
resistant to more than one protease inhibitor.
This indication is based on Week 24 analyses of plasma HIV RNA levels
and CD4+ cell counts from two controlled trials of PREZISTA/rtv in
combination with other antiretroviral drugs. Both studies were conducted in
clinically advanced, treatment-experienced (NRTIs, NNRTIs, and PIs) adult
patients with evidence of HIV-1 replication despite ongoing antiretroviral
therapy.
The following points should be considered when initiating therapy with
PREZISTA/rtv:
-- Treatment history and, when available, genotypic or phenotypic testing
should guide the use of PREZISTA/rtv.
-- The use of other active agents with PREZISTA/rtv is associated with a
greater likelihood of treatment response.
-- The risks and benefits of PREZISTA/rtv have not been established in
treatment-na??ve adult patients or pediatric patients.
Important Safety Information
PREZISTA does not cure HIV infection or AIDS, and does not prevent
passing HIV to others.
PREZISTA is contraindicated in patients with known hypersensitivity to
any of its ingredients.
Coadministration of PREZISTA/r is contraindicated with drugs that are
highly dependent on CYP3A for clearance and have a narrow therapeutic index
(e.g., astemizole, terfenadine, dihydroergotamine, ergonovine, ergotamine,
methylergonovine, cisapride, pimozide, midazolam, or triazolam) and for
which elevated plasma concentrations are associated with serious and/or
life- threatening events. Coadministration is not recommended with
carbamazepine, phenobarbital, phenytoin, rifampin, lopinavir/ritonavir,
saquinavir, lovastatin, pravastatin, simvastatin, or products containing
St. John's wort (Hypericum perforatum).
Caution should be used when prescribing agents such as sildenafil,
vardenafil, tadalafil, or other substrates, inhibitors, or inducers of
CYP3A in patients receiving PREZISTA/rtv. This list of potential drug
interactions is not complete.
PREZISTA must be co-administered with 100 mg ritonavir and food to
exert its therapeutic effect. Failure to correctly administer PREZISTA with
ritonavir and food will result in reduced plasma concentration of darunavir
that will be insufficient to achieve the desired antiviral effect. Please
refer to ritonavir prescribing information for additional information on
precautionary measures.
Severe skin rash, including erythema multiforme and Stevens-Johnson
Syndrome, has been reported in subjects receiving PREZISTA during the
clinical development program. In some cases, fever and elevations of
transaminases have also been reported. In clinical trials (n=924), rash
(all grades, regardless of causality) occurred in seven percent of subjects
treated with PREZISTA; discontinuation due to rash was 0.3 percent. Rashes
were generally mild-to-moderate, self-limiting and maculopapular. PREZISTA
should be discontinued if severe rash develops.
PREZISTA should be used with caution in patients with known sulfonamide
allergy.
New-onset or exacerbations of pre-existing diabetes mellitus and
hyperglycemia, and increased bleeding in hemophiliacs have been reported in
patients receiving protease inhibitors. A causal relationship between
protease inhibitors and these events has not been established.
PREZISTA should be used with caution in patients with hepatic
impairment. There are no data regarding the use of PREZISTA in patients
with varying degrees of hepatic impairment; therefore, specific dosage
recommendations cannot be made.
Redistribution and/or accumulation of body fat have been observed in
patients receiving ARV therapy. The causal relationship, mechanism, and
long- term consequences of these events have not been established.
Immune reconstitution syndrome has been reported in patients treated
with ARV therapy.
The potential for HIV-cross-resistance among protease inhibitors has
not been fully explored in PREZISTA/rtv treated patients.
PREZISTA should be used during pregnancy only if the potential benefit
justifies the potential risk. There are no adequate and well-controlled
studies in pregnant women. The effects of PREZISTA on pregnant women or
their unborn babies are not known.
In the pooled analysis of POWER 1 and 2 studies, the most frequently
reported drug-related adverse events of at least moderate to severe
intensity in patients receiving PREZISTA/rtv-containing regimen were
headache (3.8 percent), diarrhea (2.3 percent), abdominal pain (2.3
percent), constipation (2.3 percent), and vomiting (1.5 percent).
Please see full Prescribing Information for more details.
About PREZISTA
PREZISTA was developed by Tibotec Pharmaceuticals Ltd. and is marketed
in the U.S. by Tibotec Therapeutics, a division of Ortho Biotech Products,
L.P.
About Tibotec Therapeutics
Tibotec Therapeutics, a division of Ortho Biotech Products, L.P.,
headquartered in Bridgewater, N.J., is dedicated to delivering innovative
virology therapeutics that help healthcare professionals address serious
unmet needs in people living with HIV.
About Tibotec Pharmaceuticals Ltd.
Tibotec Pharmaceuticals Ltd., based in Cork, Ireland, is a
pharmaceutical research and development company. The Company's main
research and development facilities are in Mechelen, Belgium with offices
in Yardley, PA. Tibotec is dedicated to the discovery and development of
innovative HIV/AIDS drugs and anti-infectives for diseases of high unmet
medical need.
Tibotec Pharmaceuticals is developing a Global Access Program to
facilitate access to its antiretrovirals for patients living with HIV/AIDS
in developing countries. The Global Access Program includes access pricing,
registration, medical education for appropriate use and voluntary
licensing.
Tibotec Therapeutics
tibotectherapeutics
View drug information on Prezista.
четверг, 11 августа 2011 г.
Delegates Agree To Focus On HIV/AIDS, Other Issues Hindering African Development At Close Of Tokyo Conference
Delegates at the close of the fourth Tokyo International Conference on African Development in Yokohama, Japan, on Friday agreed to focus on health issues, including HIV/AIDS, on the continent, the Kyodo News/TMCnet reports. In the Yokohama declaration, delegates also pledged to pay "special attention" to issues -- such as health, poverty and food insecurity -- that are hindering African development.
Conference participants discussed strategies to help African nations meet the United Nations Millennium Development Goals and agreed it would be a "difficult task" for the continent to achieve the goals by 2015 in part because of the spread of HIV/AIDS and other diseases. The delegates also reaffirmed commitments to increase efforts to fight HIV/AIDS, malnutrition, and infant and maternal mortality on the continent. In addition, the delegates called on the Group of Eight industrialized nations to honor their commitments to provide development aid to Africa.
Africa's progress toward meeting the MDGs will be monitored by a three-tier follow-up plan developed at the conference. Under the plan, participants will produce an annual progress report. A list of proposed strategies to help Africa meet the goals, as well as possible contributions from stakeholders, also are included in the plan.
Africa "made its case during this meeting," Tanzanian President Jakaya Mrisho Kikwete said, adding that delegates "heard very strong voices at this meeting championing not just for increased aid but also for increased trade and investment and for more private-sector participation" in helping African nations address HIV/AIDS and other issues that are hindering development. U.N. Deputy Secretary-General Asha-Rose Migiro added that the delegates established "a way forward" to help Africa meet the MDGs and "have charted" out how the continent can achieve the goals.
During the conference, the Japanese government pledged 43 billion yen, or about $409 million, to be used for health programs in Africa over the next five years. Japan also pledged to provide assistance for education, infrastructure, water, sanitation and agriculture (Kyodo News/TMCnet, 5/30). In addition, Japan will train 100,000 health care workers over the next five years to help address Africa's shortage of health care workers.
The conference was co-organized by the Japanese government, the U.N. Office of the Special Adviser on Africa, the U.N. Development Program and the World Bank (Kaiser Daily HIV/AIDS Report, 5/29). More than 2,500 delegates attended the conference, the largest since the first TICAD in 1993. The next conference will be held in 2013, the Kyodo News/TMCnet reports (Kyodo News/TMCnet, 5/30).
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.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Conference participants discussed strategies to help African nations meet the United Nations Millennium Development Goals and agreed it would be a "difficult task" for the continent to achieve the goals by 2015 in part because of the spread of HIV/AIDS and other diseases. The delegates also reaffirmed commitments to increase efforts to fight HIV/AIDS, malnutrition, and infant and maternal mortality on the continent. In addition, the delegates called on the Group of Eight industrialized nations to honor their commitments to provide development aid to Africa.
Africa's progress toward meeting the MDGs will be monitored by a three-tier follow-up plan developed at the conference. Under the plan, participants will produce an annual progress report. A list of proposed strategies to help Africa meet the goals, as well as possible contributions from stakeholders, also are included in the plan.
Africa "made its case during this meeting," Tanzanian President Jakaya Mrisho Kikwete said, adding that delegates "heard very strong voices at this meeting championing not just for increased aid but also for increased trade and investment and for more private-sector participation" in helping African nations address HIV/AIDS and other issues that are hindering development. U.N. Deputy Secretary-General Asha-Rose Migiro added that the delegates established "a way forward" to help Africa meet the MDGs and "have charted" out how the continent can achieve the goals.
During the conference, the Japanese government pledged 43 billion yen, or about $409 million, to be used for health programs in Africa over the next five years. Japan also pledged to provide assistance for education, infrastructure, water, sanitation and agriculture (Kyodo News/TMCnet, 5/30). In addition, Japan will train 100,000 health care workers over the next five years to help address Africa's shortage of health care workers.
The conference was co-organized by the Japanese government, the U.N. Office of the Special Adviser on Africa, the U.N. Development Program and the World Bank (Kaiser Daily HIV/AIDS Report, 5/29). More than 2,500 delegates attended the conference, the largest since the first TICAD in 1993. The next conference will be held in 2013, the Kyodo News/TMCnet reports (Kyodo News/TMCnet, 5/30).
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.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 4 августа 2011 г.
Kaiser Daily Women's Health Policy Report Highlights Recently Released Journal Articles
The following highlights recently released journal articles on women's health issues.
Public Health
"Efficacy of Naltrexone in Smoking Cessation: A Preliminary Study and an Examination of Sex Differences," Nicotine and Tobacco Research: Andrea King of the Department of Psychiatry at the University of Chicago and colleagues examined 110 adults who smoked 15 to 40 cigarettes daily and had tried to quit several times, the Chicago Sun-Times reports. All participants underwent six sessions of behavioral counseling and wore a nicotine patch for one month. Half of the participants took a naltrexone pill daily, and half took a placebo. According to the study, 58% of the women who took naltrexone after two months had quit successfully, compared with 39% in the placebo group. The results were not statistically significant among men. In addition, about one-third of all participants continued not to smoke after six months (Ritter, Chicago Sun-Times, 10/9). "The results suggest continued examination of naltrexone as an adjunct in smoking cessation, particularly in female smokers, who have historically shown worse outcomes with traditional treatment methods," researchers concluded (King et al., Nicotine and Tobacco Research, October 2006). King is conducting a follow-up study that will monitor 324 smokers for one year (Chicago Sun-Times, 10/9).
"Occupation and Breast Cancer: A Canadian Case-Control Study," Annals of the New York Academy of Sciences: James Brophy -- executive director of the Occupational Health Clinic for Ontario Workers in Sarnia, Canada -- and colleagues compared the work histories of 564 women diagnosed with breast cancer at the Windsor Regional Cancer Centre from 2000 through 2002. Of the 564 women, 154 had worked on farms, the study finds. The women who had worked on farms were compared to an equal number of women living in the same area who did not have breast cancer, Toronto's Globe and Mail reports. The study finds that women with farming experience were 2.8 times more likely to develop breast cancer compared with nonfarmers. In addition, the study finds that women who had worked on farms and then worked in the automotive industry were four times more likely to develop the disease than those who had worked in neither industry (Mittelstaedt, Globe and Mail, 10/12). According to Brophy, environmental contaminants such as antibiotics, growth hormones and diesel fumes are common in agricultural settings and could be a factor in the higher breast cancer rates, but the study could not determine if one type of farming is more dangerous than another. The study is not a "smoking gun," Brophy said, adding that it "shows the importance of looking at occupation as a potential risk factor [for developing breast cancer] and that something is going on ... within the rural population." Ann Chambers, a professor of oncology at the University of Western Ontario's Schulich School of Medicine and Dentistry, said that it was a "good study" but that it is important to understand that the association between cancer and farming that is drawn from the study does not prove there is a causal relationship between the two. Brophy currently is expanding his sample size to 1,000 women to see if the link between breast cancer and farming is seen outside the Windsor area, the Toronto Star reports (Hall, Toronto Star, 10/12).
"Truncating Mutations in the Fanconi Anemia J Gene BRIP1 Are Low-Penetrance Breast Cancer Susceptibility Alleles," Nature Genetics: Nazneen Rahman of the Institute of Cancer Research in the United Kingdom and colleagues screened women for genes that interact with BRCA1 and BRCA2 -- mutations of which have been found to increase the risk of developing breast cancer -- Reuters UK reports. The researchers conducted the study among 1,212 women with breast cancer who did not have mutations in BRCA1 and BRCA2 and more than 2,000 women without breast cancer. The researchers found that nine of the women with breast cancer had mutations in a gene called BRIP1 -- which helps to repair damaged DNA -- while two of the women without cancer had the mutation. According to the researchers, certain mutations in BRIP1 -- which also is called BACH1 -- might cause the blood disorder Fanconi anemia (Reuters UK, 10/9).
"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 Naltrexone Hydrochloride Tablets.
четверг, 28 июля 2011 г.
Kansas Supreme Court Declines Abortion Clinics' Request To Appoint Special Prosecutor, Seize Records Given To AG Kline
The Kansas Supreme Court on Thursday declined a request by two abortion clinics in the state to seize from state Attorney General Phill Kline (R) the medical records of 90 women and girls who underwent late-term abortions and appoint a special prosecutor to investigate whether Kline released the records to Bill O'Reilly of Fox News, the AP/Kansas City Star reports (Hanna, AP/Kansas City Star, 11/30). Kline in 2004 subpoenaed the records of the women and girls who in 2003 received late-term abortions at Comprehensive Health, which is operated by Planned Parenthood of Kansas and Mid-Missouri in Overland Park, Kan., and Women's Health Care Services in Wichita, Kan., saying there is probable cause that each record contains evidence of a felony. The original subpoena asked that the records include each patient's name, medical history, birth control practices, psychological profile and sexual history and asked for the records of all women and girls who sought abortions at or after 22 weeks' gestation. The clinics in March 2005 filed a brief with the state Supreme Court requesting that the court block Kline's subpoena, and the court in February ruled that Kline can seek access to the records but that he must return to Shawnee County, Kan., District Court Judge Richard Anderson and present his reasons for seeking the subpoenas. Anderson turned over the records to Kline's office last month after removing information that would identify individuals. O'Reilly on Nov. 3 on his show, "The O'Reilly Factor," said he had obtained information from a source that physician George Tiller, who owns Women's Health Care Services, had performed late-term abortions on women because they were depressed (Kaiser Daily Women's Health Policy Report, 11/30).
Ruling, Reaction
According to the AP/Star, the court gave no reason for its ruling in a one-sentence order signed by Chief Justice Kay McFarland. "There could be various reasons the court decided not to hear the case at this point," Peter Brownlie, president and CEO of PPKM, said, adding, "We will be continuing our efforts to protect patients' privacy and their rights." Kline and Fox News both said they were happy with the ruling. "These motions were without legal basis and the decision is appropriate," Kline said (AP/Kansas City Star, 11/30).
"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.
четверг, 21 июля 2011 г.
Discovery Of Genetic Links To Age Of First Menstrual Period And Menopause
Newly identified gene variants associated with the age at which females experience their first menstrual period and the onset of menopause may help shed light on the prevention of breast and endometrial cancer, osteoporosis, and cardiovascular disease.
In a new study, researchers from Harvard School of Public Health (HSPH), Brigham and Women's Hospital (BWH), National Cancer Institute (NCI), and the Broad Institute of Harvard and MIT report that they have identified 10 genetic variants in two chromosomal regions associated with age at menarche (the first menstrual period), and 13 genetic variants in four chromosomal regions associated with age at natural menopause. The paper, "Genome-wide association studies identify loci associated with age at menarche and at natural menopause," was published online in Nature Genetics on May 17, 2009 (nature/ng/journal/vaop/ncurrent/index.html ).
Menarche and natural menopause are two important physiological events in a woman's life. An early onset of menarche and later menopause are well-established risk factors for the development of breast cancer and endometrial cancer, the researchers explain. On the other hand, early menopause increases risk of osteoporosis and cardiovascular disease.
Previous studies have suggested both menarche and menopause may be partially under genetic control. To identify common genetic variants influencing these states, the researchers analyzed more than 317,000 gene variants in a total of 17,438 women from the Nurses' Health Study (NHS) and the Women's Genome Health Study (WGHS) based at BWH.
"At these newly identified loci, fine mapping or sequencing might lead to identification of the causal variants, and thus expand our knowledge of the underlying physiology and biological regulation of these traits," said lead author Chunyan He, who was a doctoral student in the HSPH Department of Epidemiology while conducting the research. "Insights into the genetic factors in?¬‚uencing the timing of menarche and natural menopause might shed light on normal reproductive function and the prevention of the diseases associated with these two traits."
Daniel Chasman, Director of Computational Biology in the Center for Cardiovascular Disease Prevention at BWH, said: "The collaboration of the WGHS and the NHS represents a great example of how large cohorts with genome-wide data can complement each other. While only one locus reached near genome-wide significance in the NHS alone, the meta-analysis of combined data had much more statistical power and revealed a total of two loci for timing of menarche and four for timing of menopause." Chasman, also an assistant professor at Harvard Medical School, added, "Of the loci for timing of menopause, three were already strong but not proven candidates in the NHS; these loci reached genome-wide significance in the WGHS alone, supplementing the meta-analysis by a second mode of validation through replication. The remaining locus, for timing of menopause, would not have been identified, even as a candidate, without the joint power of these two cohorts working together. Future collaborations will hopefully continue to leverage the combined power of the two cohorts for association studies directed at other clinical characteristics."
The NHS was begun in 1976 to investigate the potential long term consequences of the use of oral contraceptives. The studies were soon expanded to include diet and nutrition, in recognition of their roles in the development of chronic diseases. The research continues today with more than 116,000 women enrolled in the study.
The WGHS was announced in 2006 as a survey of genetic differences among 28,000 initially healthy American women who had already been tracked for over a decade for the development of heart disease, stroke, diabetes, and other common health disorders. Stored genetic samples from each participant undergo a fully confidential "genome-wide scan" evaluating more than 317,000 potential genetic differences.
"Genome-wide association studies identify loci associated with age at menarche and at natural menopause," Chunyan He, Peter Kraft, Constance Chen, Julie Buring, Guillaume Pare??, Susan Hankinson, Stephen Chanock, Paul Ridker, David Hunter, and Daniel Chasman, Nature Genetics, online May 17, 2009.
The Women's Genome Health Study (WGHS) is supported by the National Heart, Lung, and Blood Institute, National Cancer Institute, Donald W. Reynolds Foundation and the Fondation Leducq, with collaborative scientific support and funding for genotyping provided by Amgen. The Nurses' Health Study (NHS) is supported by the National Cancer Institute (NCI). The NHS genome-wide association study was performed as part of the Cancer Genetic Markers of Susceptibility initiative of the NCI.
Source:
Christina Roache
Harvard School of Public Health
In a new study, researchers from Harvard School of Public Health (HSPH), Brigham and Women's Hospital (BWH), National Cancer Institute (NCI), and the Broad Institute of Harvard and MIT report that they have identified 10 genetic variants in two chromosomal regions associated with age at menarche (the first menstrual period), and 13 genetic variants in four chromosomal regions associated with age at natural menopause. The paper, "Genome-wide association studies identify loci associated with age at menarche and at natural menopause," was published online in Nature Genetics on May 17, 2009 (nature/ng/journal/vaop/ncurrent/index.html ).
Menarche and natural menopause are two important physiological events in a woman's life. An early onset of menarche and later menopause are well-established risk factors for the development of breast cancer and endometrial cancer, the researchers explain. On the other hand, early menopause increases risk of osteoporosis and cardiovascular disease.
Previous studies have suggested both menarche and menopause may be partially under genetic control. To identify common genetic variants influencing these states, the researchers analyzed more than 317,000 gene variants in a total of 17,438 women from the Nurses' Health Study (NHS) and the Women's Genome Health Study (WGHS) based at BWH.
"At these newly identified loci, fine mapping or sequencing might lead to identification of the causal variants, and thus expand our knowledge of the underlying physiology and biological regulation of these traits," said lead author Chunyan He, who was a doctoral student in the HSPH Department of Epidemiology while conducting the research. "Insights into the genetic factors in?¬‚uencing the timing of menarche and natural menopause might shed light on normal reproductive function and the prevention of the diseases associated with these two traits."
Daniel Chasman, Director of Computational Biology in the Center for Cardiovascular Disease Prevention at BWH, said: "The collaboration of the WGHS and the NHS represents a great example of how large cohorts with genome-wide data can complement each other. While only one locus reached near genome-wide significance in the NHS alone, the meta-analysis of combined data had much more statistical power and revealed a total of two loci for timing of menarche and four for timing of menopause." Chasman, also an assistant professor at Harvard Medical School, added, "Of the loci for timing of menopause, three were already strong but not proven candidates in the NHS; these loci reached genome-wide significance in the WGHS alone, supplementing the meta-analysis by a second mode of validation through replication. The remaining locus, for timing of menopause, would not have been identified, even as a candidate, without the joint power of these two cohorts working together. Future collaborations will hopefully continue to leverage the combined power of the two cohorts for association studies directed at other clinical characteristics."
The NHS was begun in 1976 to investigate the potential long term consequences of the use of oral contraceptives. The studies were soon expanded to include diet and nutrition, in recognition of their roles in the development of chronic diseases. The research continues today with more than 116,000 women enrolled in the study.
The WGHS was announced in 2006 as a survey of genetic differences among 28,000 initially healthy American women who had already been tracked for over a decade for the development of heart disease, stroke, diabetes, and other common health disorders. Stored genetic samples from each participant undergo a fully confidential "genome-wide scan" evaluating more than 317,000 potential genetic differences.
"Genome-wide association studies identify loci associated with age at menarche and at natural menopause," Chunyan He, Peter Kraft, Constance Chen, Julie Buring, Guillaume Pare??, Susan Hankinson, Stephen Chanock, Paul Ridker, David Hunter, and Daniel Chasman, Nature Genetics, online May 17, 2009.
The Women's Genome Health Study (WGHS) is supported by the National Heart, Lung, and Blood Institute, National Cancer Institute, Donald W. Reynolds Foundation and the Fondation Leducq, with collaborative scientific support and funding for genotyping provided by Amgen. The Nurses' Health Study (NHS) is supported by the National Cancer Institute (NCI). The NHS genome-wide association study was performed as part of the Cancer Genetic Markers of Susceptibility initiative of the NCI.
Source:
Christina Roache
Harvard School of Public Health
четверг, 14 июля 2011 г.
Arizona Senate Approves Bill To Permit Pharmacists To Refuse To Dispense Contraceptives for Moral, Religious Reasons
The Arizona Senate on Wednesday approved 17-11 a bill... (SB 1485) that would allow pharmacists, health professionals and anyone employed by a health professional to decline to dispense prescription contraceptives, including emergency contraception, or drugs prescribed for sterilization or abortion if they oppose their use for moral or religious reasons, the AP/Arizona Republic reports (AP/Arizona Republic, 4/6). Under the measure, which is sponsored by state Sen. Dean Martin (R), health professionals would have to state their moral objections in writing and would be exempt from any disciplinary action as a result of their refusal to provide certain services or medications. Current state law exempts health professionals from participating in abortion procedures if they are morally opposed, but the law does not explicitly apply to pharmacists (Kaiser Daily Reproductive Health Report, 2/16). The state House voted 35-24 to approve the measure in February. The bill now goes to Arizona Gov. Janet Napolitano (D), who supports abortion rights and believes the bill is a "way to deny legal drugs to consumers," according to the AP/Republic. "You can safely say I view a refusal-to-sell bill with great skepticism," Napolitano said (AP/Arizona Republic, 4/6).
"Reprinted with permission from kaisernetwork kaisernetwork. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork/dailyreports/repro The Kaiser Daily Reproductive Health 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 kaisernetwork. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork/dailyreports/repro The Kaiser Daily Reproductive Health 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.
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