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.

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

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.

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.



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

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

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