New Report Focuses on Women and Diabetes
Posted by on February 22, 2011 - 10:39am

A new report Women at High Risk for Diabetes: Access and Quality of Health Care, 2003–2006 was released on February 14, 2011 by the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) . The full report can be downloaded or free print copies ordered HERE .

Using the most scientifically based measures and national data sources available, this collaborative effort compared the quality of preventive health care received by U.S. women at high risk for diabetes with that for U.S. women not at high risk for diabetes. The report presents quality measures across several crucial elements of health care: access to care, general health and wellbeing, and use of preventive care and behaviors.
Among the report’s major findings:
·         Regardless of diabetes risk status, minority women, women with low levels of education, or women who lived in low income families more often reported having fair-to-poor health.
·         Regardless of diabetes risk status, women with a high school education or less were significantly more likely than women with more than a high school education to have been uninsured all year.
·         Women at high risk for diabetes who had a high school education or less were significantly less likely than women at high risk for diabetes who had more than a high school education to have tried to lose weight in the past year.
·         Women at high risk for diabetes were significantly less likely than women not at high risk for diabetes to report that they were physically active 150 minutes per week, the level of moderate physical activity per week recommended as part of a strategy to prevent or delay onset of type 2 diabetes.

Additional resources on diabetes and women can be found HERE.

Understanding the Science of Acupuncture
Posted by on February 21, 2011 - 10:33am

Acupuncture is a traditional medicine that’s been practiced in China and other Asian countries for thousands of years. Its proponents say it can do everything from relieving pain to bringing a general sense of wellness. Others think the only benefits you get from acupuncture are in your head. Recent studies have found that both sides may have a point. Acupuncture can be effective for certain health problems, such as some types of chronic pain. But how it works is something of a mystery.

Acupuncture is the stimulation of specific points on the body. The methods can vary, but the most well known type in the United States is the insertion of thin metal needles through the skin. At least 3 million adults nationwide use acupuncture every year, according to the latest estimates.

Acupuncture is part of a family of procedures that originated in China. According to traditional Chinese medicine, the body contains a delicate balance of 2 opposing and inseparable forces: yin and yang. Yin represents the cold, slow or passive principle. Yang represents the hot, excited or active principle. Health is achieved through balancing the 2. Disease comes from an imbalance that leads to a blockage in the flow of qi—the vital energy or life force thought to regulate your spiritual, emotional, mental and physical health. Acupuncture is intended to remove blockages in the flow of qi and restore and maintain health.

Researchers don’t know how these ideas translate to our Western understanding of medicine, explains Dr. Richard L. Nahin of NIH’s National Center for Complementary and Alternative Medicine. But the fact is that many well-designed studies have found that acupuncture can help with certain conditions, such as back pain, knee pain, headaches and osteoarthritis.

“In many research studies, it’s clear that if you’re comparing acupuncture to usual care, the acupuncture group almost always does better,” Nahin says. The problem, he explains, is that when researchers have compared acupuncture to carefully designed “control” treatments, the picture becomes more complicated.

Well-designed clinical trials need control groups—people who get a sham or simulated treatment called a placebo. Placebos might come in the form of a sugar pill or a saline injection. They give researchers something to compare the real treatment with. But designing a placebo for acupuncture is a challenge.

“I don’t really think you can come up with a great placebo needling,” says Dr. Karen J. Sherman, an NIH-funded acupuncture researcher at Group Health Research Institute in Seattle.

For example, when researchers have compared inserting needles with just pressing a toothpick onto acupuncture points, they’ve often found both treatments to be successful. But Sherman questions whether these are really controls. Many traditional acupuncturists would consider them true treatments, too. The important thing, in their view, is to hit the right spot, not necessarily how deep you go.

Another option for a placebo would be to test a different location. But Sherman says that would be inappropriate for treating pain because acupuncturists traditionally needle tender points. “To me, there’s no place on the back, if you have back pain, where you can say you have a great control,” Sherman says, “so I don’t think that’s a really solid idea.”

Further complicating things is that acupuncture treatments are about more than just needles. “There’ll be needles,” Sherman says, “but there’ll probably be other things they do in the course of the treatment. Acupuncturists will talk to you in a particular way. They might give you dietary advice or exercise advice that stems from a non-Western theoretical construct. They’ll try to engage you in your own healing. They might give you a different model for thinking about your health.”

“It’s hard to design placebo-controlled studies of acupuncture when we don’t understand what the active component of the intervention is,” explains Dr. Richard E. Harris, an NIH-funded researcher at the Chronic Pain and Fatigue Research Center in Ann Arbor, Michigan.

Treatment for pain is the best-studied aspect of acupuncture. Many parts of the brain are connected in the processing of pain, and how much pain you feel partly depends on context. “If a person has an injury in battle, they might not feel it,” Sherman explains, “but if they have a similar injury just walking down the street, they might just think it was dreadful.”

“If you look at some of the data, what you find is that sham acupuncture and true acupuncture both produce some pain relief in whatever condition they’re looking at,” Nahin says. “But while both treatments turn on areas of the brain, they turn on different areas of the brain.”

Harris and his colleagues, in studies of fibromyalgia patients, have found differences at the molecular level as well. “We were able to show that sham acupuncture and real acupuncture both reduced pain in fibromyalgia patients equally,” he says, “but they do it by different mechanisms.”

If acupuncture truly works by a different mechanism than sham acupuncture, Harris says, then they’re not the same thing, even if they both help relieve pain. Harris and others are now trying to get to the bottom of what acupuncture is actually doing. Their ultimate goal is to see if other treatments might pair well with acupuncture to reduce pain better than either alone.

Should you try acupuncture? Studies have found it to be very safe, with few side effects. If you’re thinking about it, talk to your doctor. “We tell people they really need to talk to their primary care provider and discuss whether acupuncture is a viable option for them,” Nahin says. “While you could go to an acupuncturist independent of a medical practitioner, we feel that an integrated approach to care is always the best approach.”

“Find somebody who’s dealt with your problem before,” Sherman advises. “Talk to the practitioner about your specific situation and then see if it’s something you can live with because it might not be the right treatment for you.”

If you do decide to try acupuncture, she adds, “You need to know that you should give it some time. You can’t expect one session will tell you whether it works or not. Be open minded and willing to at least entertain some of the notions that the acupuncturist brings up. Give it a try if you’re open to it.”

If You Want to Try Acupuncture

Talk to your health care provider about it, especially if you’re pregnant or nursing, or are thinking of using acupuncture to treat a child.
Find an acupuncturist who’s experienced working with your problem.
Check credentials. Most states require a license to practice acupuncture.
Don’t use acupuncture as a replacement for conventional care.
Don’t rely on a diagnosis of disease by an acupuncturist who doesn’t have conventional medical training.
To help ensure coordinated and safe care, tell your health care providers about any complementary and alternative practices you use.

Source:  NIH Office of Communications
and Public Liaison

Women Benefit More than Men with New Heart Device
Posted by on February 18, 2011 - 6:58am

Research has shown that women are not treated as aggressively as men after a heart attack or stroke.   A new study has found that women benefit more than men from a device that improves the heart's pumping ability and corrects abnormal heart rhythms.  The new device combines cardiac resynchronization therapy with an implanted defibrillator.  The study published in the Journal of the American College of Cardiology found that the device was linked to a 70% reduction in heart failure in women vs. 35% reduction in men who were in the study.   This study identified three factors to account for the unexpected findings in women:

  • Women are more likely to have non-ischemic cardiomyopathy (heart disease not cause by artery blockage)
  • Women in this study were more likely to have a condition called left bundle branch block, and
  • Women have smaller hearts.

These three factors are shown to respond well to cardiac resynchronization which uses electrical impulses to make the heart pump more efficiently.   Furthermore, an implanted defibrillator monitors the heart and delivers a shock if there is a irregular heart beat.

Further study is needed but this study demonstrates the importance of looking at gender differences when studying heart disease.

Drinking Raw Milk May Not Be a Healthy Idea
Posted by on February 17, 2011 - 4:40pm

As more people turn to organic lifestyles, we thought it would be a good idea to share this post on raw milk.
Posted February 15, 2011     By LCDR Casey Barton Behravesh, DVM, DrPH, US Public Health Service

There are many reasons why some people are thinking about drinking raw milk these days. (Raw milk is milk that has not been pasteurized to kill harmful germs.) Some people want to eat less processed food. Others have heard that raw milk contains more of certain nutrients than pasteurized milk, or that it can prevent or even solve various health problems. Still others think of buying raw milk as one way to support local farmers and sustainable agriculture.

As a public health epidemiologist and veterinarian, I know firsthand how animals and their germs can contaminate all kinds of food, including milk. Also, in my job in the Outbreak Response and Prevention Branch at CDC, I help investigate outbreaks caused by contaminated food and contact with infected animals.

If you’re thinking about adding raw milk to your diet (or your family’s diet), it’s important for you to understand the risks of drinking raw milk.

Why raw milk is dangerous
Raw milk can carry harmful bacteria and other germs that can make you very sick or kill you. Yes, it’s true that it’s possible to get “food poisoning” or foodborne illnesses from many foods, but raw milk is one of the riskiest of all. Raw milk and products made from raw milk (such as cheeses and yogurts) can cause serious infections, such as Salmonella, Listeria, and E. coli.

What happens if you get sick from raw milk
Getting sick from raw milk can mean many days of diarrhea, stomach cramping, and vomiting. Less commonly, it can mean kidney failure, paralysis, chronic disorders, and even death. The seriousness of the illness is determined by many factors, such as the type of germ, the amount of contamination, and the person’s immune defenses.

Speaking of immune defenses… it’s important to remember that some people are at higher risk of getting sick from drinking raw milk. The risk is greater for certain age groups, such as infants, young children, and older adults. It’s also particularly risky for pregnant women (and their unborn babies) and those with weakened immune systems, such as people with cancer, an organ transplant, or HIV/AIDS.

Though some people are at higher risk of getting sick from raw milk, even healthy adults and older children can get seriously ill. Those who recover often suffer from life-long medical consequences. To see how devastating these illnesses can be, check out these real-life stories about the dangers of raw milk.

Even healthy animals may carry germs that contaminate raw milk
Outbreaks of illness related to raw milk have been traced back to both grass-fed and grain-fed animals. Raw milk supplied by “certified,” “organic,” or “local dairies has no guarantee of being safe.

How to stay safe
To keep your family safe, follow these simple tips:

Always drink pasteurized milk. Check the label or package to be sure.
If you prefer organic milk, make sure that it’s pasteurized. Raw, organic milk is not safe.
If you or a member of your family consumes raw milk and then becomes ill, call your health care provider immediately. If it’s an emergency, call 911.
For more information, including questions and answers about raw milk, see Food Safety and Raw Milk (CDC).

3-D Mammography System Approved
Posted by on February 16, 2011 - 10:05am

The U.S. Food and Drug Administration (FDA) has approved the first 3-D mammography imaging system that may boost accuracy in breast cancer detection and diagnosis.

A mammogram is a safe, low-dose X-ray of the breast that is the best tool for early detection of breast cancer. However, with the limitations of conventional two-dimensional (2-D) imaging, about 10 percent of women undergo additional testing after the initial screening exam for abnormalities that are later determined to be noncancerous.

The Selenia Dimensions System, an upgrade to Hologic’s existing FDA-approved 2-D system, can provide 2-D and 3-D X-ray images of the breasts. The 3-D images may help physicians more accurately detect and diagnose breast cancer.

“Physicians can now access this unique and innovative 3-D technology that could significantly enhance existing diagnosis and treatment approaches,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health.

The National Cancer Institute recommends women ages 40 and older have a mammogram every one to two years. Nearly 40 million mammograms are performed each year in the United States.

As part of the approval process, the FDA reviewed results from two studies where board-certified radiologists were asked to review 2-D and 3-D images from more than 300 mammography exams.  In both studies, radiologists viewing both the 2-D and 3-D images obtained a 7 percent improvement in their ability to distinguish between cancerous and non-cancerous cases as compared to viewing 2-D images alone.

While the combination of the Selenia’s 2-D and 3-D images approximately doubled the radiation dose the patient received, it improved the accuracy with which radiologists detected cancers, decreasing the number of women recalled for a diagnostic workup. There is uncertainty for radiation risk estimates; however, the increase in cancer risk from having both a 2-D and 3-D exam is expected to be less than 1.5 percent compared to the natural cancer incidence, and less than 1 percent compared to the risk from conventional 2-D mammography.

The Mammography Quality Standards Act requires that all health care professionals obtain eight hours of training prior to using new mammography technology on patients. The FDA also requires that the manufacturer provide each facility with a manual clearly defining the tests required for initial, periodic, and yearly quality control measures.

According to the NCI, nearly 200,000 women will be diagnosed with breast cancer this year. And 1 in 8 women will be diagnosed with breast cancer during their lifetime. There is a 98 percent survival rate when breast cancer is detected early and still localized to the breast.

Science and the Acai Berry
Posted by on February 14, 2011 - 10:21am

Juice bar in Manaus, Brazil

Acai berry palm tree

During a recent trip to the Amazon region of Brazil I got to see "up close and personal"  the palm trees that produce the acai berry (ah-sigh-EE) which has gained popularity across the U.S. as a "super food".  I also visited a juice bar in Manaus, the biggest city in the Amazon region and enjoyed a smoothie made from acai juice and other tropical fruits.  The acai berry has also been a key component for fad diets and is being added to cosmetics and other beauty products.     So, what is the fact, or fiction, surrounding this humble (but colorful) berry!

I spent an afternoon looking for scientific studies and found very little.   Most of the information available is from the popular press and on websites and blogs promoting and selling acai products (and,  of course,  raving about its health properties).

Acai berries contains anthocyanin and flavonoids, powerful antioxidants that help defend the body against life stressor's.  Antioxidants and other nutrients are  needed by the body to protect against cell damage.   The benefit of dietary antioxidants is that they slow the chemical process of oxidation by neutralizing free radicals that are harmful by-products made by the human body.  This oxidation is what causes narrowing of the arteries and heart-related problems due to cholesterol deposits. Antioxidants also may reduce the risks of certain forms of cancer but this still undergoing further study.

According to researchers at the Texas A & M University, the berry is naturally low in sugar and hints of a mixture of "red wine and chocolate".   These same researchers found that the pulp and juice of the berry is absorbed by the body so it is a good source of antioxidants.   The University of Florida is also doing research on acai.   At this time, there is no evidence that this berry is superior to other sources of antioxidants such as blueberries and strawberries so claims that it is a superfood are premature.

Claims made by makers of supplements that contain acai do raise concerns.   While acai berries by themselves contains beneficial antioxidants,  supplements usually contain other ingredients that may be unhealthy.   Caffeine is a common component of weight loss supplements and is known to cause head and stomach aches and other side effects.   Acai berries also contain some minerals that in large doses may be toxic to certain individuals.   If you have allergies to  pollens and trees, you could be susceptible to an allergen in the acai berry.

The bottom line, it's probably okay to try a smoothie made with acai (you may like it!), be skeptical of fad diets that make claims about huge weight loss due to the acai berry, and continue to watch for new, solid research as we learn more about this purple berry.

Women Veterans Need Our Support!
Posted by on February 11, 2011 - 3:19pm

Fatigues to Fabulous to Aid Women Veterans

The Society for Women's Health Research (SWHR) announced today that Tuesday, February 15th during Mercedes Benz Fashion Week, SWHR and their partner Grace After Fire, a support network for women veterans, will be launching the Fatigues to Fabulous (F2F) campaign – a national program created to honor the service of women veterans and support their transition home. The campaign is working with the fashion industry to help women make the transition to a civilian wardrobe, raise awareness of the challenges women veterans face upon return, and harness resources to support them.

Just as disease affects women differently than men, so too do military women have unique health concerns that differ from their male counterparts. While accidents and injuries are often an uncontrollable reality for those who serve, what we can control is making sure women are appropriately equipped and protected. For those injuries that cannot be prevented, we must have in place care options that are designed for women. Some studies are already reporting important differences in the incidence, severity, and outcomes among male and female veterans in conditions ranging from PTSD to urological conditions and muscle and joint disorders. Finding the best, evidence-based treatments for women and men can only happen with research.

Please  help to get the word out about the campaign. Visit the F2F Facebook Page and become a fan! And please don’t be shy…share the link with your friends, family and professional associations.

http://www.facebook.com/pages/Fatigues-to-Fabulous/151113794941720

High School Girls Focus on Science
Posted by on February 11, 2011 - 10:57am

This weekend, the Oncofertility Consortium, along with the Institute for Women's Health Research, is hosting the fifth annual Oncofertility Saturday Academy (OSA) at the Feinberg School of Medicine at Northwestern University.  OSA is an informal science education program designed to expose high school girls to the wonders of science and medicine through hands-on and experiential activities.  These high school girls come from the Young Women's Leadership Charter School, on the near south side of Chicago.  Through a rigorous application program, 16 juniors and 16 seniors are selected to participate in OSA.  Tomorrow, the juniors will participate in rotations in the Woodruff Lab, learning about cutting-edge fertility preservation techniques.  Additionally, the juniors will be paired with students in the new Physician Assistant Program at Northwestern University, who will lead a workshop on birth control and STD prevention.  The seniors will be paired with medical students for "Doctor for a Day."  Each student will learn how to administer a basic exam and will gain exposure to the medical field.  Both juniors and seniors will conclude the day by hearing the story of a cancer patient survivor's quest to preserve her fertility.

To learn more about this innovative high school program click HERE.  The term "oncofertility" was coined by Dr. Teresa K. Woodruff at Northwestern to describe the merging of two disciplines:   oncology and fertility preservation.  Many cancer treatments result in infertility and her research has focused on ways to preserve fertility in young women with cancer.

Hormone Therapy and Breast Cancer Risk
Posted by on February 10, 2011 - 2:24pm

Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

Women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later. The finding, from the Million Women Study (MWS)—a large observational study in the United Kingdom—adds to a growing body of evidence that the use of combined hormone therapy (estrogen plus progestin) to treat menopausal symptoms increases the risk of breast cancer and deaths from the disease. The results appeared in the Journal of the National Cancer Institute on January 28.

The pattern of increased breast cancer risk “was seen across different types of hormonal therapy, among women [in the MWS] who used hormonal therapy for either short or long durations, and also in lean and in overweight and obese women,” Dr. Valerie Beral of Oxford University and her colleagues wrote. Their findings support results from the Women’s Health Initiative (WHI), a randomized clinical trial that, in 2002, first reported evidence linking combined hormone use to breast cancer.

“The new findings underscore the idea that there’s really no safe window of time for women to take combined hormone therapy,” said Dr. Leslie Ford of NCI’s Division of Cancer Prevention and the Institute’s WHI liaison. After the initial WHI results were announced, she noted, some people had argued that hormones may be safer when started at the time of menopause. “The new findings refute that argument,” she added.

WHI and MWS investigators have both reported that breast cancer incidence rates declined rapidly once women stopped taking combined hormone therapy. “It is important for women to know that if they stop using hormones, the risk of breast cancer very quickly returns to where it was before hormone therapy began,” Dr. Ford said.

There has been a discrepancy between the WHI and MSW results to date as to whether estrogen-only therapy raises breast cancer risk in postmenopausal women. WHI reports have found little risk associated with this treatment, whereas the MWS investigators have observed a statistically significant increased risk.

Additional follow-up from the WHI estrogen-only intervention trial should help clarify this issue in the coming years, noted Drs. Rowan T. Chlebowski of Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and Garnet L. Anderson of the Fred Hutchinson Cancer Research Center in an accompanying editorial.

Drug to Reduce Preterm Birth in At-Risk Pregnant Women Approved
Posted by on February 9, 2011 - 12:29pm

The U.S. Food and Drug Administration on Feb. 4, 2011, approved Makena (hydroxyprogesterone caproate) injection to reduce the risk of preterm delivery before 37 weeks of pregnancy, in pregnant women with a history of at least one spontaneous preterm birth. The drug is not intended for use in women with a multiple pregnancy, such as a twin pregnancy, or other risk factors for preterm birth.

The FDA approved Makena under the agency’s accelerated approval regulations that allow promising drugs to be approved based on a surrogate endpoint benefit (here, reducing the risk of delivery before 37 weeks of pregnancy) that is reasonably likely to predict a clinical benefit.

Under these regulations, the manufacturer must conduct additional studies after the product is approved to demonstrate that the drug does, in fact, have a clinical benefit.  An international trial is ongoing to learn if there is also improvement in the outcome of babies born to women given Makena. Such outcomes include reducing the number of babies who do not survive or who suffer serious health problems shortly after birth.

“Preterm birth is a significant public health issue in the United States,” said Sandra Kweder, M.D., deputy director of the Office of New Drugs in the FDA’s Center for Drug Evaluation and Research. “This is the first drug approved by the FDA that is indicated to specifically reduce this risk.”  A health care provider would give Makena once a week by injection into the hip. Treatment should begin at 16 weeks and no later than 21 weeks of pregnancy.

The FDA reviewed data on the safety and effectiveness of Makena in a multicenter randomized double-blind clinical trial. The study included 463 women 16 to 43 years of age who were pregnant with a single fetus and had a history of a prior spontaneous preterm birth. Among women treated with Makena, 37 percent delivered early (before 37 weeks) as compared with 55 percent of women in the control group.

A separate study evaluated the development of children born to mothers enrolled in the controlled trial. In this study, children ages 2.5 years to 5 years reached similar developmental targets, regardless of the mother’s treatment.  The confirmatory study that is ongoing will be followed by a similar infant follow-up study, to be completed about 2018.  That study is expected to include 580-750 infants, depending on the number of study sites and mothers willing to participate.

The most common side effects reported with Makena included pain, swelling, or itching at the injection site; hives, nausea and diarrhea. Serious adverse reactions were rare; there was a single report each of blood clot in the lungs (pulmonary embolism) and an infection at the injection site.

The FDA originally approved hydroxyprogesterone caproate under the trade name Delalutin in 1956 for use in pregnant women. The approved indications include threatened miscarriage. The original manufacturer requested the withdrawal of Delalutin from the market in 2000 for reasons unrelated to safety.

Consumers and health care professionals are encouraged to report adverse events from medications to the FDA's MedWatch program at 800-FDA-1088 or online at www.fda.gov/medwatch/how.htm1.

Source:  Food and Drug Administration

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