Strong Bones with Calcium and Hormones
Posted by on August 13, 2013 - 8:50pm

After the age of 30, the creation of new bone cannot keep up with the rate of bone loss in your body. The estrogen depletion that comes with menopause results in an increased risk for low bone mineral density, osteopenia and osteoporosis. For 5-10 years after menopause, this bone density loss accelerates into a gradual weakening of your bones and can lead to an increase in the risk for fractures and other injuries.

Physicians and organizations left and right have tried to specify a regimen to  help slow down the weakening of bones in postmenopausal women. The National Osteoporosis Foundation states that both types of hormone therapy, Estrogen therapy and combined Estrogen and Progesterone therapy, reduce the risk of osteoporosis. But what about supplements?

This past February, the US Preventive Services Tasks Force (USPSTF) stated there was insufficient evidence regarding calcium and vitamin D supplementation for bone fracture prevention in postmenopausal women. Now, a new analysis shows the evidence that may very well alter this recommendation.

The North American Menopause Society conducted a trial with 27,347 postmenopausal women, of which 8,000 took supplemental calcium (1,000 mg) and vitamin D (400 mg) daily, and 8,000 took look-alike placebos. These women came from all the hormone groups in the study: on HRT combinations, those on HRT estrogen alone, and the rest on hormone look-alike placebos.

Researchers then studied the hip fracture incidents among women who took hormones and supplements, women who took hormones alone, and women who took neither one. Of the women on both hormones and supplements, there were 11 hip fractures per 10,000 women per year. Of the women solely on hormones, there were 18 hip fractures per 10,000 women per year. And of the women who took neither, there were 22 hip fractures per 10,000 women per year.

Although the researchers could not specify how much of calcium and vitamin D should be taken, they concluded that postmenopausal women taking hormone therapy should also take supplemental calcium and vitamin D to reduce the rate of bone loss. The benefits of calcium and vitamin D seem to increase with increasing total intake, but also depend on the side effects of too much calcium, such as constipation.

So consider taking calcium and vitamin D supplements in combination with your hormone therapy, but don't stop drinking your milk! Continue trying to meet your daily calcium needs with your diet. Furthermore, did you know that weight bearing exercise can also improve your bone health? To learn more about how you can manage your bone health and overall health in menopause, visit http://menopausenu.org/

 

Anesthesia On the Brain
Posted by on August 13, 2013 - 10:33am

New research is surfacing that links anesthesia to inhibited cognitive developments in children under four. Significant brain development occurs in young children at this time, and ketamine—a common anesthetic—has been shown to affect the brain’s learning ability. Studies began back in 2003 when Merle Paule, Ph.D., director of the Division of Neurotoxicology at the FDA’s National Center for Toxicological Research, began observing the effects of ketamine on young rhesus monkeys, since this species closely resembles humans in physiology and behavior. While the ketamine-exposed monkeys performed cognitive experiments less accurately than the control group, the affect of ketamine on human children requires further research.

Interest in this area grew so much that, in 2010, the FDA and the International Anesthesia Research Society founded an initiative called Strategies for Mitigating Anesthesia-Related neuroToxicity in Tots, or “SmartTots” for short.  Director of Anesthesia, Analgesia and Addiction Products at FDA, Bob Rappaport, M.D. said, “Our hope is that research funded through SmartTots will help us design the safest anesthetic regimens possible.” SmartTots continues to advocate for research that can protect the millions of children who receive anesthesia each year.

Supplemental studies are necessary to understand whether all forms of anesthetics elicit similar deficits as ketamine, and, if so, how long these deficits last. Columbia University and the University of Iowa are currently exploring the effects of anesthesia on infant brain development and cognitive and language ability, thanks to the funding from SmartTots.  Until more conclusive data is published, parents are urged to work closely with their child’s clinicians in weighing all options and risks before exposing young children to anesthesia.

Click here to read more on this issue.

 

Menopause and Memory: Women Know What They Do Not Know
Posted by on August 8, 2013 - 3:24pm

The need for health care varies greatly over a lifespan, with older adults having significantly more health-related needs and costs than younger individuals. Women, in particular, often face a myriad of health problems as they transition through menopause.  Sadly, despite the fact that every woman will go through menopause, very little is understood about the physical and mental changes that occur during this period of life.  In addition, women may struggle to find pharmaceutical solutions, which can safely provide proven relief without the worry that those available will increase their likelihood of other health and mental complications.

Much is misunderstood about menopause and the changes that are associated with the hormonal fluctuations. This is largely due to the fact this inevitable transition is rarely apart of the conversation, particularly in the context of health care. Further, menopause is expected to be merely “bothersome”; not something one could attribute real health problems to. Although maternity care and issues related to younger women are required in the Affordable Care Act as essential health benefits, nothing of legislative note will improve the knowledge and acceptance of this natural life progression.

Most insurance companies do not even cover basic medications associated with menopausal symptoms, and conflicting research has women scared about the potential long-term effects associated with hormone replacement therapy. Negative press, little medical literature and low financial assistance often leaves women to suffer through menopause silently, many of whom worry constantly about memory deficits they experience and potential long term changes.

A recent study focused on the memory complaints of midlife women has been receiving a lot of attention. The study, conducted at the University of Illinois- at Chicago (UIC), attempted to determine if women who are experiencing hot flushes during menopause were able to accurately predict their own memory performance.

According to the principal author, Lauren Drogos, “We found that a one-item question: ‘How would you rate your memory in terms of the kinds of problems that you have?’ was the best predictor of verbal memory performance on a list-learning task.  We also found that many complaints were related to mood symptoms.”

In the US, the average woman becomes postmenopausal around the age of 51.  Common symptoms that occur include hot flushes, sleep disturbances, mood changes and memory problems. However, until recently it was believed that women were unable to accurately describe the current state of their memory and the changes they experience as they progress through menopause.

Despite the difficulty in being taken seriously about the physical and mental challenges that menopause presents, this recent study from Drogos, along with other research, shows that woman are able to accurately describe their current memory abilities. Specifically, a group of sixty-eight women performed a series of memory tests and were then asked, to detail the types of memory problems they were experiencing. The study concluded that women were able to accurately rank themselves on a scale from no memory problems to severe problems.

Using recall of a short story, the deficits seen in memory did not indicate that women were suffering from dementia, nor were they experiencing shortfalls in memory that were impacting daily life. Instead, it was simply indicative that women who experienced memory deficits often recognized the changes occurring.

Previous research focusing on women’s transitions through menopause also found that hot flushes during the nighttime were the best predictors of memory performance in women. This leads researchers within the Women’s Mental Health Research Program at UIC, to believe that sleep disturbances and stress hormones may play integral roles in memory and hot flushes.

The good news for women concerned about the transition through menopause is that the cognitive decline that occurs appears to only be temporary, with performance rebounding early into post-menopause. Further, for those who want to keep both their minds and bodies at peak performance, research indicates that leading a non-sedentary lifestyle, keeping mentally active, and having a healthy diet can be the best preventers of cognitive decline.  To learn more about menopause, visit menopausenu.org, a new web site that helps women evaluate their overall health and menopause symptoms.

Are You At Risk of Contracting Swimmer’s Itch This Summer?
Posted by on August 5, 2013 - 2:38pm

You may have heard of swimmer’s itch—it’s an itchy skin rash that occurs after swimming in fresh shallow waters during the early summer. Maybe your kids have come home from camp with an itchy rash in areas their bathing suit didn’t cover them? Even though swimmer’s itch is reported worldwide, most cases in the US occur in northern states, particularly in those bordering the Great Lakes, including Illinois.

Swimmer’s itch occurs when larval stages of certain microscopic flatworms, called “cercariae,” leave their temporary host (freshwater snails) in search of their definitive host (waterfoul and certain mammals), but instead come into contact with humans. We can’t see cercariae in the water, since they are microscopic. Once a person comes out of the water, larvae burrow into the skin as water evaporates and die within the skin shortly after. Rather than producing an infection, dead larvae are recognized as foreign proteins by the immune system, inducing the development of an allergic reaction manifesting as a skin rash.

Swimmer’s itch initially manifests with a tingling skin sensation, followed by the development of small, reddish skin spots. These are generally short-lived and give rise to raised, reddish bumps. The later can become intensely itchy, and may last up to 15 hours, and can then turn into blisters. Blisters disappear within 2-3 days, leaving residual dark spots, which eventually fade away within a month or longer.

Here are some tips to minimize risk of getting swimmer’s itch:

1. It is important not to feed water foul to prevent them from accumulating in water areas frequented by people.

2. While swimming, try to avoid swimming close to the shore, as cercariae tend to get drift to the shore.

3. The longer you spend in infested waters, the greater the likelihood cercariae enter your skin. Swimming for extended periods of time should therefore be avoided.

4. Finally, since cercariae burrow as water evaporates from the skin, toweling off immediately after emerging from the water may prevent this from happening.

Most cases of swimmer´s itch do not require specialized medical attention. Applying cool compresses to affected areas may relieve symptoms. Nevertheless, if itching is severe, you may seek medical attention from a dermatologist. In most cases, topical steroids may accelerate resolution of skin lesions, whereas oral antihistamines may be useful in reducing itching.

By: Guest Blogger, Monica Rani, MD
Departments of Dermatology and Internal Medicine
Northwestern University, Feinberg School of Medicine

Sources: State of Alaska Epidemiology Bulletin, Swimmer's Itch, and Koralova L, et al. Cercarial dermatitis: a neglected allergic disease. Clin Rev Allergy Immunol, 2012.

Facelifts: are they about age or beauty?
Posted by on August 5, 2013 - 11:42am

Facelifts Don't Turn Ducks into Swans

Blinded ratings of before-and-after pictures of individuals who underwent facelifts confirmed that the patients looked younger, but did not make them any more attractive.

In a study conducted by plastic surgeons at Lenox Hill Hospital in New York City, 50 raters were asked to guess the ages of patients in the photographs and to rate their attractiveness on a 10-point scale. No rater saw both the "before" and "after" pictures of any individual patient.

On average, the raters estimated that patients were 2.1 years younger than their real ages before surgery, and 5.2 years younger afterward, for a net benefit of 3.1 "years saved," reported A. Joshua Zimm, MD, and colleagues, online in JAMA Facial & Plastic Surgery.

But mean attractiveness scores hardly budged, with as many patients showing decreases as there were with increases.

Drug Use in Pregnant Women Reveals an Increase Since 2000
Posted by on August 2, 2013 - 2:36pm

Recent data from the Treatment Episode Data Set reveal that 4.8% of female substance abuse admissions (between the ages of 15 to 44) are pregnant at the time of entry. While this percentage has remained fairly stable since 2000, the percentage of these pregnant women reporting drug abuse has increased to 63.8%, an increase of almost 13% since 2000. Non-pregnant female admissions in the same age range reveal a similar pattern for drug use, while percentages for both groups reporting alcohol abuse has decreased. The report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) writes that these trends “may highlight the need to focus greater attention on addressing drug abuse among this population.”

Any substance abuse by pregnant women can result in miscarriage or premature birth, as well as a plethora of other health-related and developmental problems for the baby and mother both. In light of these recent trends, it is clear more educational outreaches must be available to prevent this statistic from climbing any higher. SAMHSA Administrator Pamela S. Hyde calls for increased access to “prevention, support, and recovery services” that meet the specialized need of pregnant and postpartum women. SAMHSA’s already active Residential Treatment Program for Pregnant and Postpartum Women is a step in the right direction. This program encompasses comprehensive residential treatment and educates women on prevention, treatment, and recovery. Furthermore, the family-centered approach they take strengthens relationships beyond the substance users to encompass all affected victims. More programs modeled after the SAMHA platform would improve the education and prevention of life-threatening abuses to women across the globe.

Please click here to review the full report.

The Love Hormone is Two-faced: Oxytocin
Posted by on July 25, 2013 - 11:00am

It turns out the love hormone oxytocin is two-faced. Oxytocin has long been known as the warm, fuzzy hormone that promotes feelings of love, social bonding and well-being. It’s even being tested as an anti-anxiety drug. But new Northwestern Medicine® research shows oxytocin also can cause emotional pain, an entirely new, darker identity for the hormone.

Oxytocin appears to be the reason stressful social situations, perhaps being bullied at school or tormented by a boss, reverberate long past the event and can trigger fear and anxiety in the future.

That’s because the hormone actually strengthens social memory in one specific region of the brain, Northwestern scientists discovered.

If a social experience is negative or stressful, the hormone activates a part of the brain that intensifies the memory. Oxytocin also increases the susceptibility to feeling fearful and anxious during stressful events going forward.

(Presumably, oxytocin also intensifies positive social memories and, thereby, increases feelings of well being, but that research is ongoing.)

The findings are important because chronic social stress is one of the leading causes of anxiety and depression, while positive social interactions enhance emotional health. The research, which was done in mice, is particularly relevant because oxytocin currently is being tested as an anti-anxiety drug in several clinical trials.

“By understanding the oxytocin system's dual role in triggering or reducing anxiety, depending on the social context, we can optimize oxytocin treatments that improve well-being instead of triggering negative reactions,” said Jelena Radulovic, the senior author of the study and the Dunbar Professsor of Bipolar Disease at Northwestern University Feinberg School of Medicine.  The paper was published July 21 in Nature Neuroscience.

To read more about this story and oxytocin click HERE

Closing Racial and Ethnic Disparity Gaps for Women
Posted by on July 19, 2013 - 11:57am

For all intents and purposes, the Affordable Care Act (ACA), the President’s signature piece of legislation, will provide more health care coverage to poor and underserved populations. Persistently disadvantaged communities have much further to go than those with insurance, and new means of accessing and paying for care will benefit them disproportionately. Nevertheless, with more than 20 percent of the nation’s Black population uninsured, more than 30 percent of Hispanics uninsured and a country still grappling with understanding and properly addressing disparities, just how far does the ACA take uninsured women in the US?

By mandating individual health insurance coverage and expanding the list of covered preventative services, ACA legislation should, theoretically, improve the quality of health care for women at a disproportionate risk of being uninsured and having low incomes. However, research has shown that having health insurance itself does not necessarily have a substantial impact if women cannot find a doctor to see them, do not have proper information about accessing resources, or are not treated in a culturally and environmentally competent manner.

Moreover, when the number of uninsured could be decreased by more than half, but being uninsured is not equitable across racial and ethnic groups in the US, what happens to our countries most vulnerable women and children?

It has been well documented that low-income women and those without employee-sponsored insurance (ESI) are more likely to be women of color. Kaiser and US Census estimates indicate that there are significant differences in insurance rates by race and ethnicity, with national averages approximating there are almost three times as many uninsured Hispanics as Whites. In Louisiana, for example, it is believed that more than 50% of the state’s Hispanics are uninsured, while only 18% of Whites are. In the same state, it is estimated that 30% of Blacks are uninsured, reiterating just how unbalanced our country remains and how terribly far we have to go to eliminate inequalities.

Even in Massachusetts, where health reform has been a success, the number of Blacks and Hispanics that remain uninsured is two and three times that of Whites, respectively.

Although the ACA takes us a step forward in giving many of the countries uninsured woman an insurance card, the US must address what to do about probable provider shortages that will result from a lack of primary care physicians and different utilization in care between races, ethnicities and gender. We must be prepared to understand both to cultural differences in demand and pent-up demand of the previously uninsured, as well as start to really face how to deal with persistent racial and ethnic inequality in this nation that shows itself in our health care system every day.

Preventing Heat-related Illness
Posted by on July 17, 2013 - 11:54am

Extreme heat can be very dangerous, leading to heat stroke and death. Heat stroke occurs when your temperature rises quickly and your body cannot cool down. This condition is life-threatening, but it is preventable.

Tips for Preventing Heat-Related Illness

  • Stay in air-conditioned space if possible. If your home is not air-conditioned, go to a public library, heat-relief shelter, or other cool location.
  • Drink plenty of non-alcoholic fluids (check with your doctor if you are usually supposed to limit your fluids).
  • Wear loose-fitting, lightweight clothing.
  • Cut back on exercise.
  • Closely watch those who are at high risk of heat-related illness, including older adults, young children, and individuals with physical and/or mental illnesses.
  • NEVER leave anyone in an enclosed, parked vehicle.

If you believe that you or someone else may be suffering from heat stroke or another heat-related illness, get help right away. It could be a life or death emergency.

Teresa Woodruff leads Endocrine Society
Posted by on July 15, 2013 - 2:12pm

Teresa Woodruff, PhD, director of the Women’s Health Research Institute and chief of fertility preservation at Northwestern University was  inaugurated as president of the Endocrine Society- the world’s oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology.  She was handed the gavel at their 95th Annual Meeting at the end of June.

“Worldwide, the endocrinology community is facing a variety of challenges, including the colliding epidemics of obesity and diabetes, growing awareness of the health risks associated with endocrine-disrupting chemicals, the tension between global population expansion and personal reproductive needs, and the need to support scientific research in an environment with limited resources,” said Woodruff, also the Thomas J. Watkins Memorial Professor of Obstetrics and Gynecology. “As president of the Endocrine Society, I am looking forward to working with the talented clinicians and researchers in our membership to develop tactics and offer continued scientific leadership to address these issues.”

A reproductive endocrinologist, Woodruff has dedicated much of her research career to studying female reproductive health and infertility. So-Youn Kim, a postdoctoral fellow in Woodruff’s laboratory, presented the team’s research on ways to preserve the fertility of women who are treated for cancer during the recent four day meeting in San Francisco.

 

Pages