Oct
01
2008

Lifestyle Can Be A Killer For Middle Age Women

By | Cancer, Fitness, Heart Disease, Nutrition, Vitamins and supplements, Weight loss, Women’s Diseases

Generally it is assumed that persons in their thirties and forties should be in their prime, and health concerns are cropping up in the higher middle age or only in old age.
Also, women were thought to generally enjoy better health and life expectancy, but the large Nurses’ Health Study on 77,782 women in the age group of 34 to 59 years shows other aspects.
Even in females who had no heart problems and no cancer at the onset of the study, lifestyle choices can make it or break it. At the end of the study that spanned 24 years, it became obvious that a total of 28% of all the mortalities could be attributed to smoking. If risky lifestyle choices were combined in the form of smoking, being overweight, having a lack of physical activity and a qualitatively poor diet, this number jumped to 55%. Alcohol intake did not change this estimate significantly.

Lifestyle Can Be A Killer For Middle Age Women

Lifestyle Can Be A Killer For Middle Age Women

It is obvious that for the benefit of better health and less mortality in middle age women, diet, exercise, a healthy body weight and eradicating smoking are key factors.

Reference: BMJ 2008;337:a1440

Comment on Nov. 18, 2012: So how many years longer will a woman live, if she quits at age 30? The Million Women Study found out that she will live 10 years longer than the control group of smoking women (see link). Nothing has changed since 2008. Lifestyle issues remain at the forefront.

Last edited December 3, 2012

Oct
01
2008

Overuse Of Tanning Can Point to Addiction

By | Skin Disorders, Substance abuse, Women’s Diseases

The use of indoor tanning facilities and tanning beds has become popular over the years. Many individuals use tanning in preparation for a vacation in sunny climates, but an overwhelming number flocks to tanning booths in order to preserve this summer tan. Despite all cautioning from dermatologists, tanning salons have their steady clientele. While the occasional use may be no reason for alarm, steady usage sheds a different light on the”artifical sun”.
Tanning dependence has been found to be common in young adults, as a survey of 400 college student revealed. The behavior can be predicted by certain demographic and behavioral variables. Initially the motivation for tanning is the enhancement of appearance, but often those who use tanning facilities frequently report that it contributes to enhance their mood and help with relaxation and socializing. There was also a disregard for warnings about health risks of the practice. Dr. Carolyn Heckman, PhD of Fox Chase Cancer Center in Cheltenham,Pa. and her colleagues reported that these behaviors are commonly reported by individuals with other types of dependencies. In this respect excessive use of tanning has similarities to other behavioral disorders such as obsessive compulsive behavior and eating disorders, which has given it the nickname “tanorexia”.

Overuse Of Tanning Can Point to Addiction

Overuse Of Tanning Can Point to Addiction

The population profile showed that most of the tanning dependent individuals were female, and the highest group was white with a medium skin type, as opposed to fair and darker skinned individuals. Those who were doing the most sunbathing in summer and had the highest rates of sunburn also were the most tanning dependent. They were also the ones who used the least amount of sun protection. Smokers had the highest level of tanning dependence, whereas obese individuals had the lowest one. The highest proportion showed up in the female population. Males did not seem to be that interested in tanning.
The research is relevant for health professionals when it comes to teaching patients about skin cancer prevention and education about sun protection. It also points to possible relationships to other addictive disorders.

More information about skin cancer: http://nethealthbook.com/cancer-overview/skin-cancer/

References: 1. http://www.skincancer.org/content/view/317/78/ 2. Am. J. Health Behav. 2008;32:451-64

Last edited November 5, 2014

Mar
01
2008

Early Breast Cancer Diagnosis With PET/CT Scan Combination

By | Cancer, Women’s Diseases

Breast cancer remains a disease that can strike women in any age group. Despite the immense amount of ongoing research and new treatment modalities, the disease presents puzzles to researchers and treating physicians and enormous challenges to patients. Early diagnosis, accurate staging of the disease and prompt treatment remain the most important points. Breast self examinations on a regular basis are just one aspect. Mammography screening can pick up the disease earlier, and a biopsy of any suspicious area can tell more about the type of cells that cause it. A particularly aggressive type is inflammatory breast cancer. It is not characterized by a suspicious lump. The only symptom is diffuse redness and swelling in the breast of the patient.

This type of cancer can metastasize within six months. It accounts for 1 to 5% of all breast cancers in North America and has a five year survival rate of 25 to 50% of the patients. A team of researchers from the University of Texas M.D.Anderson Cancer Center in Houston led by Dr. Selin Carkaci examined a combination approach of high tech tests for early diagnosis and treatment. Dr. Carkaci pointed out that breast cancer is not a localized disease, but one that is systemic involving the entire body. Based on this knowledge 41 patients with the highly aggressive form of inflammatory breast cancer were examined with a combination PET/CT whole body scan. It was possible to identify cancer in patients’ lymph nodes with 98% accuracy. Early metastasis could be found in 49 % of patients.

Early Breast Cancer Diagnosis With PET, CT Scan Combination

Nodule in lung. A: PET scan . B : CT scan. C : PET, CT scan combo.

PET/CT scan combinations detect cancer in its earliest stages, when changes are happening at the cellular level. Other tests like mammograms, ultrasound and MRI scans can only identify disease when there is destruction of the normal anatomy. The accurate depiction of the cancer within the body is important for an effective treatment plan. PET/CT combination scans are used in cancer diagnosis for a variety of tumors where distant metastases are expected (the image above shows a nodule in one of the lungs). It is especially significant for inflammatory breast cancer patients, where it offers a promise for earlier diagnosis resulting in more effective treatment plans.

More information about diagnosis of breast cancer: http://nethealthbook.com/cancer-overview/breast-cancer/breast-cancer-diagnosis/

Reference: The Medical Post, December 18, 2007, page 15

Last edited November 3, 2014

Mar
01
2008

The Culprits For Periodontal Disease

By | Dentistry, Heart Disease, Men's Health, Substance abuse, Women’s Diseases

When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years.

The Culprits For Periodontal Disease

The Culprits For Periodontal Disease

In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health. This is particularly important as heart disease, which is also an inflammatory condition is closely linked to inflammatory disease of the gums and you likely have heard that heart attacks can be prevented by brushing and flossing teeth.

More information about periodontal disease: http://nethealthbook.com/dentistry/periodontitis/

Reference: Journal of American Medical Association 2008; 299(5): pages 574-575

Last edited November 3, 2014

Apr
01
2007

MRI Scan Finds Hidden Cancer in Opposite Breast

By | Cancer, Prevention, Women’s Diseases

Approximately 1000 women from 25 cancer centers throughout the US who were recently diagnosed with breast cancer in one breast were all examined, radio graphed with conventional mammograms. They also received an MRI scan study of the opposite breast to make sure no hidden cancer would be overlooked. To the surprise of the investigators 1 in 10 women were found to have cancer in the opposite breast that would have conventionally passed as “normal”. More than 90% of these women were picked up with an MRI scan of the opposite breast that up to now would not have been part of the routine work-up. Dr. Elias A. Zerhouni from the National Institutes of Health (NIH) said that it would be a great break through to have a new technique of diagnosing these women with early cancer in the opposite breast. By diagnosing this condition early, the cancer treatment can be customized to the exact breast cancer stage improving survival significantly for these women.Dr. Constance Lehman, the principal investigator of this ACRIN Breast MRI Trial who is also professor of radiology as well as the director of breast imaging at the University of Washington and Seattle Cancer Care Alliance, pointed out that unnecessary bilateral mastectomies (= surgical breast removal) can be avoided in the 90% women whose opposite breasts were normal. At the same time the 10% of women who were accurately diagnosed with early breast cancer can be treated early and effectively.

MRI Scan Finds Hidden Cancer in Opposite Breast

MRI Scan Finds Hidden Cancer in Opposite Breast

This trial has been started in April of 2003 and follow-up examinations were done at 12-18 and 24-30 months. This already shows that the group of 30 patients diagnosed with breast cancer in the opposite breast has a much better survival than patients would have had in the past. However, the final figures will only be available several years into the future.

The cancer specialists in the US have estimated that in 2007 there will be approximately 178,480 women who will be diagnosed with breast cancer and about 40,460 will likely die from the disease.

Reference: The New England Journal of Medicine (NEJM), Vol. 356, No.13, March 29, 2007

Last edited December 5, 2012

Apr
01
2007

Nitroglycerin Patch Helps Premature Babies

By | obstetrics, Women’s Diseases

Nitroglycerine has been a tried and tested drug for patients who suffer from angina, but the chemical has other benefits: the drug can retard labor and delivery, if a woman is having premature labor. This result comes from research at Queen’s University Perinatal Research Unit at Kingston General Hospital, Canada. Other tocolytics, which is the term for labor delaying drugs, are also on the market showing comparable results, but the nitro patch had an advantage, as it significantly reduced morbidity during the neonatal period.

The researchers worked with 158 women who went into premature labor between 24 and 32 weeks of pregnancy. In a randomized trial they either received a transdermal patch of nitroglycerine or placebo. If contractions continued an hour after the patch was put on the skin, another one was added. The following day treatment was repeated. Delivery was delayed 10 days for all, and a very significant 23 days for those in labor before 28 weeks. Any prolongation of pregnancy closer to a term delivery is helpful, but the greatest significance applies to those, where labor starts before 28 weeks. This is the group of babies that are most at risk, says lead author Dr. Graeme Smith of Kingston General.

There may be two reasons for the overall benefits of nitroglycerin treatment. On the one hand nitroglycerine protects pregnancy in the most vulnerable group, where the mothers enter labor before 28 weeks. The other aspect may be that the nitro patch may be having effects beyond the labor-delaying properties such as better blood flow in the placenta, as there is enough of the medication that reaches the placenta.

Nitroglycerin Patch Helps Premature Babies

Nitroglycerin Patch Helps Premature Babies

Dr. Smith reports that at this point there is no “gold standard” tocolytic in Canada. Tocolytics have shown little improvement and frequent side effects. Compared to other tocolytic medications the main side effect of the nitro patch has been a mild headache. In most cases it was not necessary to remove the patch. It is estimated that nitroglycerin is now used in about a third of Canadian centers.

Reference: National Review Of Medicine, February 28, 2007, page 5

Last edited December 5, 2012

Jan
01
2007

Less Invasive Surgery Through Body Orifices

By | Gastrointestinal Disease, Men's Health, Orthopedics, Women’s Diseases

Natural orifice transluminal endoscopic surgery (NOTES) has become increasingly popular during the last few years. This is not surprising, as a surgical procedure which does not need an incision is less threatening for the patient. Unsightly skin scars are not a concern and recovery is usually less complicated. Procedures have become more varied. Transvaginal procedures have been performed for a number of years, such as vaginal hysterectomies.
In 2004 Anthony Kalloo, a gastroenterologist from John Hopkins University reported on the feasability and safety of gastrointestinal surgery and research has proceeded at a stunning rate. The idea behind NOTES is to use a body orifice (the oral cavity in the case of gastro-intestinal surgery) as an entry point to the surgical area. An incision into the abdominal wall is avoided.

The concept of minimally invasive surgery is not new, as laparoscopic procedures for gallbladder surgery and hernia repair are currently in use. Joint surgery through arthroscopic surgery is common and surgery to the pineal gland in the brain has been performed by using the nostrils as an entry to the area.

Experience in gastrointestinal surgery through natural orifice transluminal endoscopic surgery at this point is limited. Seven transgastric appendectomies have been performed by the surgeons Dr. N.Reddy and Dr.V.G Rao in Hyderabad, India.

Less Invasive Surgery Through Body Orifices

Removal of gallbladder through colorectal approach

The research group from John Hopkins is aware that this new technique will revolutionize surgeries, but there is the sentiment that things should not be rushed. The procedures need to be thoroughly researched to ensure that they are safe and beneficial to surgical patients. To this effect the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) has been formed in the US, which promotes research and monitors safety of these new approaches of less invasive surgeries.

Reference: MD Consult news, January 3, 2007: “New procedure aims to avoid surgery”

Last edited December 5, 2012

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Dec
01
2006

Cinnamon And Multivitamins May Boost Fertility

By | Health, Nutrition, obstetrics, Vitamins and supplements, Women’s Diseases

Prenatal vitamin supplements are the norm, as folic acid has been known to play a role in the prevention of neural tube defect. Generally they are taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard School of Public Health in Boston pointed out, that multivitamin supplementation has its place earlier than just after the pregnancy test has become positive. In one of the largest studies involving 18,000 married pre-menopausal women, regular use of multivitamin supplements were associated with a decrease of infertility. The key is in the regular use. Women who took two multivitamin tablets per week had similar infertility rates as women who did not take supplements at all. Those who took 6 or more multivitamins had a 40% lower risk of anovultation, a condition where no eggs are released by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront in reproductive medicine. One condition known as polycystic ovary syndrome (PCOS) is often a reason for infertility. It is one of the red flags that point to the condition of insulin resistance, and it manifests itself in menstrual irregularity and higher levels of androgens, often showing as increased facial hair. As the metabolism is headed for trouble, diabetes, high blood pressure, high cholesterol and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot study to see if insulin sensitivity in women with PCOS could be improved. Cinnamon, a well-known spice, has been known to have a favorable effect on the insulin response of the body. Researchers found that eight weeks of treatment with cinnamon extract significantly decreased fasting glucose and insulin resistance in women with polycystic ovary syndrome.

Cinnamon And Multivitamins May Boost Fertility

Cinnamon And Multivitamins May Boost Fertility

Dr. Jeff Wang who conducted the study reported that no side effects or adverse reactions were reported throughout the study period. If large-scale prospective studies confirm these findings, then recommending cinnamon as a dietary factor may be a simple, inexpensive lifestyle change that can be easily followed. Reducing insulin resistance is a key to improve the overall health status in patients with PCOS, and it ties in with reproductive health benefits as well.

More information about infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: The Medical Post, November 14, 2006, page 32

Last edited November 2, 2014

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Sep
01
2006

Moral Preaching Is Not Enough In AIDS Intervention

By | Infectious Disease, Men's Health, Prevention, Women’s Diseases

At a recent conference of the International AIDS Society in Toronto the full spectrum of the disease was covered: science, community, activism, and people with AIDS.
News Canada data released before the conference suggests that HIV infection remains a serious problem. There were somewhere between 2,300 and 4,500 new cases of HIV in Canada. The numbers are up from the estimated 2,100-4,000 cases that came up in 2002.
There is one statistic that can be a source of hope: the number of deaths from the infection has shown a steep decline in the mid-90’s. This effect is largely due to the discovery and application of three-drug antiretroviral therapy. The widespread use of this therapy has also reduced the viral load, and as a result infectiousness may be reduced.
UBC epidemiologist Dr. Evan Wood sees the encouraging development, but he emphatically spoke of the horrendous effect of AIDS. He stated, ” HIV remains the biggest threat to humanity globally.” He feels that the threat of terrorism pales in comparison to the carnage HIV results in every day. In this light it is short sighted and non-supportive of Canada’s PM, not to appear at this conference, as he had other commitments.
This year also marks the 25th anniversary of AIDS’ discovery, but it is known that the disease was ravaging Africa at least 25 years before it first appeared in the West.
The diagnosis of HIV infection does no longer sound like a death sentence. Things have been improving, but not fast enough, says Dr. Wood. Also one of the speakers, Bill Gates, spoke against naïve insistence on abstinence as a primary weapon in the battle against AIDS.

 

Moral Preaching Is Not Enough In AIDS Intervention

Moral Preaching Is Not Enough In AIDS Intervention

Dr. Wood shared this sentiment. He stated that while the whole idea is well intended, sexuality is part of normal human behavior, and everybody knows that abstinence cannot exist forever.

More information about AIDS: http://nethealthbook.com/infectious-disease/sexually-transmitted-disease/aids-introduction/

Reference: National Review of Medicine, August 30,2006, page 14

Last edited November 1, 2014

Aug
01
2006

Non-Hormone Alternative Against Hot Flashes

By | Hormones, Women’s Diseases

Hormone replacement therapy has its positive and negative effects, and the proven risk of breast cancer has stopped many women from choosing hormone replacement for menopausal problems. Yet menopausal problems can be a source of suffering and frustration for those women who are affected. Menopausal hot flashes can be bothersome, and if they are severe, frequent and go on for years, women find it difficult to cope with this condition. Even if hormone replacement is not an option because of the risk factors, relief of those symptoms is very much needed. Herbal remedies are often not sufficient. As a result the day to day functioning of the patient is affected and even a restful night is interrupted by sweating.
Dr. Sireesha Reddy from the department of obstetrics and gynecology at the University of Rochester’s school of medicine and dentistry has led a study of 60 postmenopausal women. A medication called gabapentin was used in a randomized study. Three equal groups were observed: the first received gabapentin titrated to 2,400 mg per day. The second group received 0.625 mg per day of estrogen, and the third group was given a placebo. The gabapentin group and the estrogen group achieved similar results, namely a 71% reduction, versus 72% in the estrogen group. The placebo group reported a 54 % reduction of hot flashes.
Dr. Reddy states that gabapentin against hot flashes is a good alternative. It works for patients who only have these particular problems, as it does not address other indications where estrogen is prescribed.

Non-Hormone Alternative Against Hot Flashes

Non-Hormone Alternative Against Hot Flashes

Dr. Reddy also added that it might not be necessary to titrate to 2,400 mg gabapentin per day, because some women metabolize it at a higher rate than others.
Specific side effects such as headaches and dizziness occurred more frequently in the gabapentin group, but they were not statistically significant.

Reference: The Medical Post, July 18, 2006, page 4

Comment on Nov. 13, 2012: This is an example of symptomatic therapy for one symptom, in this case hot flashes, but the trade-off are side effects like headaches and dizziness, which were discussed away because they were “statistically not significant”. Women in menopause have a lack of estrogen and progesterone, which is sensed by the receptors for both of these hormones throughout the woman’s body. The solution is bio-identical hormone replacement with specific hormone measurements as discussed under this link.

Last edited December 6, 2012