Researchers presented data at the 104th Annual Scientific Meeting of the American Urological Association (AUA) showing that uterus sparing surgery is an effective and safe treatment for women who want to preserve the integrity of vaginal function after pelvic organ prolapse. Hysterectomy may not be the only option for women with pelvic organ prolapse.
In the first long-term follow-up study of uro-genital prolapse repair associated with uterus preservation, researchers showed that the surgery can be effective (vaginal prolapse of less than or equal to grade 2 and cervix and/or vaginal apex remaining well supported more than six centimeters above the hymen plane). Researchers also found that 82.97 percent of the 47 patients were satisfied with the treatment results. None of the patients required further surgery and few patients reported persisting symptoms. Three patients reported persistence of voiding symptoms and six patients reported persistence of storage symptoms. Two patients reported de novo urgency and four reported de novo urinary incontinence. Sexual activity was maintained in 95.5 percent of patients.
"This study is important because it is the first long-term look at uterus sparing surgery for pelvic organ prolapse," said Anthony Y. Smith, MD, an AUA spokesman. "The findings are encouraging, not only because the procedures were so effective, but also because they will help to dispel the myth that a hysterectomy is the only treatment for pelvic organ prolapse."
Costantini, E; Lazzeri, M; Zucchi, A; Mearini, L; Del Zingaro, M; Porena, M. Long-term follow-up of uterus sparing surgery for pelvic organ prolapse (POP). J Urol, suppl. 2009: 181, 4, abstract 1355.
Source:
Lacey Dean
American Urological Association
четверг, 23 февраля 2012 г.
четверг, 16 февраля 2012 г.
Bill Introduced To Help Improve Heart Disease, Stroke Prevention Efforts Among Women
A bipartisan group of female lawmakers earlier this month introduced a bill (S 2278) that would require health information currently reported to the federal government to specify gender to improve efforts to prevent heart disease and stroke among women, CQ HealthBeat reports. The HEART for Women Act also would call for annual recommendations to Congress on efforts to improve the treatment of heart disease and eliminate disparities in care. In addition, the legislation would make available in all 50 states a CDC program that provides heart disease and stroke tests to low-income, uninsured women at no cost. The program currently is available in 14 states. Bill co-sponsor Sen. Debbie Stabenow (D-Mich.) said, "We all have to stop thinking of heart disease as a 'man's disease' and start insisting on improvements in the prevention, diagnosis and treatment of heart disease among women." Supporters of the legislation include the American Heart Association, the American Stroke Association, the National Coalition for Women with Heart Disease and the Association of Black Cardiologists (Hopkins, CQ HealthBeat, 2/22).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . ?© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . ?© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 9 февраля 2012 г.
For Comfort, Mom's Voice Works As Well As A Hug
"Reach out and touch someone" - good advertising slogan, or evolutionary imperative?
How about both?
What Madison Avenue knew decades ago has been observed in brain chemistry. A simple phone call from mom can calm frayed nerves by sparking the release of a powerful stress-quelling hormone, according to researchers at the University of Wisconsin-Madison.
Biological anthropologist Leslie Seltzer tested a group of seven- to 12-year-old girls with an impromptu speech and series of math problems in front of a panel of strangers, sending their hearts racing and levels of cortisol - a hormone associated with stress - soaring.
"Facing a challenge like that, being evaluated, raises stress levels for a lot of people," says Seth Pollak, psychology professor and director of UW-Madison's Child Emotion Lab.
Once stressed, one-third of the girls were comforted in person by their mothers - specifically with hugs, an arm around the shoulders and the like. One-third were left to watch an emotion-neutral 75-minute video. The rest were handed a telephone. It was mom on the line, and the effect was dramatic.
"The children who got to interact with their mothers had virtually the same hormonal response, whether they interacted in person or over the phone," Seltzer says.
The girls' levels of oxytocin, often called the "love hormone" and strongly associated with emotional bonding, rose significantly and the stress-marking cortisol washed away.
"It was understood that oxytocin release in the context of social bonding usually required physical contact," Seltzer says. "But it's clear from these results that a mother's voice can have the same effect as a hug, even if they're not standing there."
And the reprieve from stress or anxiety is a lasting one.
"It stays well beyond that stressful task," Pollak says. "By the time the children go home, they're still enjoying the benefits of this relief and their cortisol levels are still low."
The findings - which were published Wednesday in the journal Proceedings of the Royal Society B - square with a "tend and befriend" theory explaining how stress regulation may differ between males and females. Confronted with a threat, males may be more likely to choose between fight and flight. A female with offspring in tow or slowed by pregnancy, however, may have to make different choices.
"You might not be able to run with a child or defend yourself without endangering both of you," Seltzer said.
Instead, Seltzer explained, it might make more sense for a female to create or use a social bond to deal with a stressor - either through touch or soothing vocal communication.
"Apparently this hormone, oxytocin, reduces stress in females after both types of contact, and in doing so may strengthen bonds between individuals," she said.
From a modern perspective, the new understanding of oxytocin release helps explain the popularity of tearjerker long distance telephone commercials and shifts Pollak's reaction to his own students.
"For years I've seen students leaving exams and the first thing they do is pull out their cell phone and make a call," Pollak says. "I used to think, 'How could those over-attentive, helicopter parents encourage that?' But now? Maybe it's a quick and dirty way to feel better. It's not pop psychology or psychobabble."
"It's hard to get cortisol up. It's hard to get oxytocin up," he says. "That a simple telephone call could have this physiological effect on oxytocin is really exciting."
UW-Madison endocrinologist and study co-author Toni Ziegler developed with Seltzer a non-invasive test to measure oxytocin levels without inducing more stress in study subjects.
Seltzer has moved on to testing the oxytocin wake of other communication methods - like text messaging - and hopes to see the research spread out from human subjects
"It's not just us, of course. Lots of very social species vocalize," she says. "On the one hand, we're curious to see if this effect is unique to humans. On the other we're hoping researchers who study vocal communication will consider looking at oxytocin release in other animals and applying it to broader questions of social behavior and evolutionary biology."
Source:
Seth Pollak
University of Wisconsin-Madison
How about both?
What Madison Avenue knew decades ago has been observed in brain chemistry. A simple phone call from mom can calm frayed nerves by sparking the release of a powerful stress-quelling hormone, according to researchers at the University of Wisconsin-Madison.
Biological anthropologist Leslie Seltzer tested a group of seven- to 12-year-old girls with an impromptu speech and series of math problems in front of a panel of strangers, sending their hearts racing and levels of cortisol - a hormone associated with stress - soaring.
"Facing a challenge like that, being evaluated, raises stress levels for a lot of people," says Seth Pollak, psychology professor and director of UW-Madison's Child Emotion Lab.
Once stressed, one-third of the girls were comforted in person by their mothers - specifically with hugs, an arm around the shoulders and the like. One-third were left to watch an emotion-neutral 75-minute video. The rest were handed a telephone. It was mom on the line, and the effect was dramatic.
"The children who got to interact with their mothers had virtually the same hormonal response, whether they interacted in person or over the phone," Seltzer says.
The girls' levels of oxytocin, often called the "love hormone" and strongly associated with emotional bonding, rose significantly and the stress-marking cortisol washed away.
"It was understood that oxytocin release in the context of social bonding usually required physical contact," Seltzer says. "But it's clear from these results that a mother's voice can have the same effect as a hug, even if they're not standing there."
And the reprieve from stress or anxiety is a lasting one.
"It stays well beyond that stressful task," Pollak says. "By the time the children go home, they're still enjoying the benefits of this relief and their cortisol levels are still low."
The findings - which were published Wednesday in the journal Proceedings of the Royal Society B - square with a "tend and befriend" theory explaining how stress regulation may differ between males and females. Confronted with a threat, males may be more likely to choose between fight and flight. A female with offspring in tow or slowed by pregnancy, however, may have to make different choices.
"You might not be able to run with a child or defend yourself without endangering both of you," Seltzer said.
Instead, Seltzer explained, it might make more sense for a female to create or use a social bond to deal with a stressor - either through touch or soothing vocal communication.
"Apparently this hormone, oxytocin, reduces stress in females after both types of contact, and in doing so may strengthen bonds between individuals," she said.
From a modern perspective, the new understanding of oxytocin release helps explain the popularity of tearjerker long distance telephone commercials and shifts Pollak's reaction to his own students.
"For years I've seen students leaving exams and the first thing they do is pull out their cell phone and make a call," Pollak says. "I used to think, 'How could those over-attentive, helicopter parents encourage that?' But now? Maybe it's a quick and dirty way to feel better. It's not pop psychology or psychobabble."
"It's hard to get cortisol up. It's hard to get oxytocin up," he says. "That a simple telephone call could have this physiological effect on oxytocin is really exciting."
UW-Madison endocrinologist and study co-author Toni Ziegler developed with Seltzer a non-invasive test to measure oxytocin levels without inducing more stress in study subjects.
Seltzer has moved on to testing the oxytocin wake of other communication methods - like text messaging - and hopes to see the research spread out from human subjects
"It's not just us, of course. Lots of very social species vocalize," she says. "On the one hand, we're curious to see if this effect is unique to humans. On the other we're hoping researchers who study vocal communication will consider looking at oxytocin release in other animals and applying it to broader questions of social behavior and evolutionary biology."
Source:
Seth Pollak
University of Wisconsin-Madison
четверг, 2 февраля 2012 г.
Many Women Not Using Safest Brands Of Contraceptive Pill, UK
Many women are not using the safest brands of oral contraceptive pill with regard to the risk of venous thrombosis (deep vein thrombosis and pulmonary embolism), finds a study published on bmj today.
The risk differs by type of progestogen and dose of oestrogen, and the safest option is an oral contraceptive containing levonorgestrel combined with a low dose of oestrogen, say the authors.
Since 1961, several large studies have shown a twofold to sixfold increased risk of deep venous thrombosis associated with oral contraceptive use. As a result, the oestrogen dose in combined oral contraceptives has been reduced. But it is still unclear which hormonal contraceptive is safest with regard to the risk of venous thrombosis.
So a team of researchers at Leiden University Medical Center in the Netherlands assessed the thrombotic risk associated with currently available oral contraceptives. Their focus was on dose of oestrogen and type of progestogen.
The findings are based on data from a large study of 1,524 women aged 18-50 years with a first deep venous thrombosis and 1,760 healthy controls.
In line with results of previous studies, they found that women taking oral contraceptives have a five-fold increased risk of venous thrombosis compared with non users.
This risk differed by type of progestogen. For example, pills containing desogestrel were associated with a twofold increased risk of venous thrombosis compared with pills containing levonorgestrel. The risk of venous thrombosis was also positively associated with oestrogen dose and was highest during the first three months of use, irrespective of the type of pill used.
The authors conclude that the choice of oral contraceptive should be based on the smallest increase of side effects and, as such, the safest option with regard to the risk of venous thrombosis is an oral contraceptive containing levonorgestrel combined with a low dose of estrogen.
These findings are supported in a second study, also published today. Researchers in Denmark assessed the risk of venous thrombosis among healthy Danish women aged 15-49 years who were using different types of hormonal contraception from 1995 to 2005. A total of 10.4 million woman years were recorded and 4,213 venous thrombotic events were observed.
They found that the risk of venous thrombosis decreased with duration of use and decreasing oestrogen dose. For the same dose of oestrogen and the same length of use, oral contraceptives containing levonorgestrel conferred a significantly lower risk of venous thrombosis than pills containing other types of progestogens.
Progestogen only pills and hormone releasing intrauterine devices were not associated with any increased risk of venous thrombosis.
The authors stress that the absolute risk of venous thrombosis with use of any types of combined oral contraceptives in young women is less than one in 1,000 user years. And for women of normal weight and without known genetic predispositions, they recommend a low dose combined pill as first choice for contraception.
Despite their different designs, these two studies produce remarkably similar results and confirm past studies of the risk of venous thromboembolism with the pill, says Dr Nick Dunn from the University of Southampton in an accompanying editorial. However, he points out that the absolute risk of having venous thromboembolism is low, even when taking the pill, and agrees that the products of choice should be those containing either levonorgestrel or norethisterone, with as low a dose of oestrogen as possible.
An evidence based review of information on all contraceptive methods currently available for women is also published on bmj.
Link to Dutch paper
Link to Danish paper
Link to Editorial
Link to Clinical Review
Source
British Medical Journal
The risk differs by type of progestogen and dose of oestrogen, and the safest option is an oral contraceptive containing levonorgestrel combined with a low dose of oestrogen, say the authors.
Since 1961, several large studies have shown a twofold to sixfold increased risk of deep venous thrombosis associated with oral contraceptive use. As a result, the oestrogen dose in combined oral contraceptives has been reduced. But it is still unclear which hormonal contraceptive is safest with regard to the risk of venous thrombosis.
So a team of researchers at Leiden University Medical Center in the Netherlands assessed the thrombotic risk associated with currently available oral contraceptives. Their focus was on dose of oestrogen and type of progestogen.
The findings are based on data from a large study of 1,524 women aged 18-50 years with a first deep venous thrombosis and 1,760 healthy controls.
In line with results of previous studies, they found that women taking oral contraceptives have a five-fold increased risk of venous thrombosis compared with non users.
This risk differed by type of progestogen. For example, pills containing desogestrel were associated with a twofold increased risk of venous thrombosis compared with pills containing levonorgestrel. The risk of venous thrombosis was also positively associated with oestrogen dose and was highest during the first three months of use, irrespective of the type of pill used.
The authors conclude that the choice of oral contraceptive should be based on the smallest increase of side effects and, as such, the safest option with regard to the risk of venous thrombosis is an oral contraceptive containing levonorgestrel combined with a low dose of estrogen.
These findings are supported in a second study, also published today. Researchers in Denmark assessed the risk of venous thrombosis among healthy Danish women aged 15-49 years who were using different types of hormonal contraception from 1995 to 2005. A total of 10.4 million woman years were recorded and 4,213 venous thrombotic events were observed.
They found that the risk of venous thrombosis decreased with duration of use and decreasing oestrogen dose. For the same dose of oestrogen and the same length of use, oral contraceptives containing levonorgestrel conferred a significantly lower risk of venous thrombosis than pills containing other types of progestogens.
Progestogen only pills and hormone releasing intrauterine devices were not associated with any increased risk of venous thrombosis.
The authors stress that the absolute risk of venous thrombosis with use of any types of combined oral contraceptives in young women is less than one in 1,000 user years. And for women of normal weight and without known genetic predispositions, they recommend a low dose combined pill as first choice for contraception.
Despite their different designs, these two studies produce remarkably similar results and confirm past studies of the risk of venous thromboembolism with the pill, says Dr Nick Dunn from the University of Southampton in an accompanying editorial. However, he points out that the absolute risk of having venous thromboembolism is low, even when taking the pill, and agrees that the products of choice should be those containing either levonorgestrel or norethisterone, with as low a dose of oestrogen as possible.
An evidence based review of information on all contraceptive methods currently available for women is also published on bmj.
Link to Dutch paper
Link to Danish paper
Link to Editorial
Link to Clinical Review
Source
British Medical Journal
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