UroToday - Symptoms characteristic of IC have been reported to occur in more than 2% of women. Far more common conditions can result in confounding symptomatology. Dr. Jeffrey Dell and colleagues from Knoxville, Tennessee and New Brunswick, NJ remind us of some of these more common disorders.
Urinary tract infections (UTI) are very common among women. Over half of all women will experience a urinary tract infection during their lifetimes. Many BPS/IC patients are mistakenly diagnosed with recurrent UTI, and the importance of documenting the presence of true infection in patients with dysuria and frequency is self-evident if one does not want to miscategorize and mistreat this group of patients.
Endometriosis, the presence of endometrial glands and stroma outside the uterus, is a common gynecological condition occurring in up to 50% of premenopausal women and in 71-87% of women with chronic pelvic pain. Patients with endometriosis may present with chronic pelvic pain in addition to urinary frequency, dysuria, and hematuria, particularly if the bladder wall is involved. Dyspareunia is another common symptom. The pain of endometriosis is typically cyclical. The diagnosis is based on history, physical examination, laparoscopic examination, and confirmation by histology.
Chronic pelvic pain (CPP) is generally defined as pain that 1) localizes to the anatomic pelvis, the anterior abdominal wall at or below the umbilicus, the lumbosacral back, or the buttocks; 2) is of sufficient severity to lead to medical care or functional impairment; 3) lasts for greater than 6 months. Best estimates are that 15-20% of women aged 18-50 years have suffered from CPP. It is truly difficult to differentiate from other disorders,
Vulvodynia is defined as chronic vulvar burning, stinging, or pain in the absence of clear pathology. Limited epidemiologic data suggest a lifetime prevalence of 10-28%. While BPS/IC is often associated with dyspareunia, its association with vulvodynia as defined is somewhat unclear, and the definition of each disorder should clearly help the clinician make the distinction.
Finally, overactive bladder has prevalence up to 10 times that of BPS/IC. It is characterized by urinary urgency with or without urge urinary incontinence and usually with frequency and nocturia in the absence of obvious pathology. The conditions of BPS/IC and overactive bladder may be differentiated by the presence of pain in BPS. Care should be taken to attribute a failure of efficacy of antimuscarinics in suspected overactive bladder to the presence of BPS, as many patients with overactive bladder may not experience significant efficacy with antimuscarinic therapy.
This is a nice article which brings out issues of importance to the clinician involved with the diagnosis of BPS and confounding disorders.
Dell JR, Mokrzycki ML, Jayne CJ
Eur J Obstet Gynecol Reprod Biol. 2009 Jun;144(2):105-9.
doi:10.1016/j.ejogrb.2009.02.050
UroToday Contributing Editor Philip M. Hanno, MD, MPH
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четверг, 15 декабря 2011 г.
четверг, 8 декабря 2011 г.
Georgia Bill Would Increase Regulation Of In Vitro Fertilization Procedures
Georgia lawmakers have introduced a bill (S.B. 169) that would place restrictions on the number of embryos that could be implanted in a woman during an in vitro fertilization procedure, the Wall Street Journal reports. The bill "appears to be the most sweeping state legislation of its kind introduced in the wake of the case" of 33-year-old Los Angeles resident Nadya Suleman who gave birth to octuplets via IVF, the Journal reports. The bill, which is scheduled for a legislative hearing this week, would limit the number of embryos that may be implanted in women age 40 and older to three and limit the number to two for women ages 39 and younger. The bill would also make it illegal to create more embryos in one cycle than the number to be transferred.
The antiabortion-rights group Georgia Right To Life helped to draft the bill. The group seeks regulation that would treat embryos as human beings, the Journal reports. Daniel Becker, president of GRTL, said, "To us it's a human rights issue," adding that embryos should be legally protected as "living human beings and not as property." State Sen. Ralph Hudgens (R), one of the sponsors of the bill, said, "Nadya Suleman is going to cost the state of California millions of dollars over the years; the taxpayers are going to have to fund the 14 children she has," adding, "I don't want that to happen in Georgia."
According to the Journal, several IVF experts and scientists oppose the proposal, arguing that more than two or three embryos need to be implanted in some cases to achieve a pregnancy. The bill's limits would prevent women from freezing unused embryos for future procedures, they say. Sean Tipton, director of public affairs for the American Society for Reproductive Medicine -- a scientific organization that issues medical guidelines and standards for the infertility industry -- said supporters of the bill "don't understand the complicated medicine behind it." The society's guidelines urge doctors to limit the number of embryos implanted to two in women younger than age 35 and to no more than five for women older than age 40. The guidelines are not mandatory and can vary according to the condition of a woman's embryos and her individual diagnosis. Barbara Collura, executive director of Resolve -- a national infertility association based in McLean, Va. -- said, "It's the right of the person who has gone through this procedure to decide what they can do with those embryos, not their doctor, and certainly not the government" (McKay, Wall Street Journal, 3/3).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
The antiabortion-rights group Georgia Right To Life helped to draft the bill. The group seeks regulation that would treat embryos as human beings, the Journal reports. Daniel Becker, president of GRTL, said, "To us it's a human rights issue," adding that embryos should be legally protected as "living human beings and not as property." State Sen. Ralph Hudgens (R), one of the sponsors of the bill, said, "Nadya Suleman is going to cost the state of California millions of dollars over the years; the taxpayers are going to have to fund the 14 children she has," adding, "I don't want that to happen in Georgia."
According to the Journal, several IVF experts and scientists oppose the proposal, arguing that more than two or three embryos need to be implanted in some cases to achieve a pregnancy. The bill's limits would prevent women from freezing unused embryos for future procedures, they say. Sean Tipton, director of public affairs for the American Society for Reproductive Medicine -- a scientific organization that issues medical guidelines and standards for the infertility industry -- said supporters of the bill "don't understand the complicated medicine behind it." The society's guidelines urge doctors to limit the number of embryos implanted to two in women younger than age 35 and to no more than five for women older than age 40. The guidelines are not mandatory and can vary according to the condition of a woman's embryos and her individual diagnosis. Barbara Collura, executive director of Resolve -- a national infertility association based in McLean, Va. -- said, "It's the right of the person who has gone through this procedure to decide what they can do with those embryos, not their doctor, and certainly not the government" (McKay, Wall Street Journal, 3/3).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
четверг, 1 декабря 2011 г.
New Studies Indicate Age Is Important In Hormone Therapy Use
Five years ago this summer the National Institutes of Health's stopped early a major portion of the Women's Health Initiative (WHI), a large and ambitious study to address the most common causes of death, disability and impaired quality of life in postmenopausal women.
One part of the WHI sought to determine whether hormone therapy has a positive or negative impact on cardiovascular disease, cancer, and osteoporosis. The estrogen plus progestin hormone therapy trial for women with their uteruses intact was stopped in July 2002 after investigators found that the associated health risks of the combination hormone therapy outweighed the benefits.
Less than two years later, in March 2004, NIH announced that it had stopped another portion of the WHI, the estrogen-alone hormone therapy study for women who have had a hysterectomy, in the interest of safety after careful consideration of preliminary data and an average follow-up of nearly seven years.
The abrupt end of the studies and the news stories that followed left many patients confused or scared. Questions still remained about the safety and efficacy of hormone therapy, about who could take it, and for what purpose and what duration.
More information was needed about the risks and benefits of estrogen-alone hormone therapy, long-term risks for short-term use of hormone therapy, the appropriate timing of hormone therapy use in relation to a woman's onset of menopause, and the effects for women who take hormone therapy well after menopause has ended.
The medical community has learned more about hormone therapy since the WHI trials were stopped. A study published in the July 11 issue of the British Medical Journal confirmed that hormone replacement therapy should not be prescribed for the purpose of preventing chronic conditions such as heart disease in older women who are well past menopause. That same study, however, concluded that hormone therapy may be a safe, short-term option for younger women in early menopause to relieve symptoms and improve quality of life.
"If the woman is healthy and has no risk factors, low dose hormone replacement therapy use for a short period of time should confer a small risk to her health," says Helen Roberts, M.D., M.P.H., a senior lecturer of women's health issues at the University of Aukland in New Zealand. Roberts, who wrote an accompanying editorial to the British Medical Journal study, also said women with risk factors such as a previous heart attack, stroke, blood clots, breast cancer or high risk of cardiovascular disease should not use hormone therapy.
Although confusion about hormone therapy persists, this study solidifies some thinking on the issue. Short-term use of hormones in healthy women going through early menopause may not pose serious health risks. Long-term use of hormone therapy to prevent chronic diseases in older women, who begin the therapy many years after menopause, may actually increase their risk of blood clots and heart disease, and should be discouraged.
A limitation of the WHI is that it primarily studied women who began taking hormone therapy long after they had passed menopause. Researchers are still trying to determine the effects of taking hormone therapy for long periods of time if the treatment begins in the early stages of menopause. Some data suggests the health risks are lower for these women, but more studies are needed.
"There has been mounting evidence that a woman's age and amount of time since onset of menopause influence her health outcomes on estrogen, particularly her risk of heart disease," said JoAnn Manson, M.D., Dr.P.H., chief of preventative medicine at Brigham and Women's Hospital in Boston, professor of medicine at Harvard Medical School, and one of the principle investigators of the WHI. "We've recently reported in April of 2007 that when you combine the findings from the estrogen plus progesterone trial and the estrogen alone trial, there is a suggestion of a lower risk of heart disease in the women who were less than ten years since onset of menopause."
By contrast, Manson's analysis shows an increased risk of heart disease for women who were more than 20 years past menopause.
Manson's research team reported in the June 21 issue of the New England Journal of Medicine that women who were in their 50s in the estrogen alone trial tended to have less coronary artery calcium, if they received estrogen compared to placebo.
"Coronary artery calcium is a marker for plaque build-up in the arteries, hardening of the arteries and it's a strong predictor of future risk of cardiovascular, of coronary heart disease," Manson said. "So these results lend support to the theory that estrogen may slow early stages of atherosclerosis."
As research continues, taking hormone replacement therapy is an individual decision for women that depends on many factors. Women should speak with their health care providers about the potential benefits and risks that may be relevant to them as individuals.
Society for Women's Health Research (SWHR)
1025 Connecticut Ave. NW, Ste. 701
Washington, DC 20036
United States
womenshealthresearch
One part of the WHI sought to determine whether hormone therapy has a positive or negative impact on cardiovascular disease, cancer, and osteoporosis. The estrogen plus progestin hormone therapy trial for women with their uteruses intact was stopped in July 2002 after investigators found that the associated health risks of the combination hormone therapy outweighed the benefits.
Less than two years later, in March 2004, NIH announced that it had stopped another portion of the WHI, the estrogen-alone hormone therapy study for women who have had a hysterectomy, in the interest of safety after careful consideration of preliminary data and an average follow-up of nearly seven years.
The abrupt end of the studies and the news stories that followed left many patients confused or scared. Questions still remained about the safety and efficacy of hormone therapy, about who could take it, and for what purpose and what duration.
More information was needed about the risks and benefits of estrogen-alone hormone therapy, long-term risks for short-term use of hormone therapy, the appropriate timing of hormone therapy use in relation to a woman's onset of menopause, and the effects for women who take hormone therapy well after menopause has ended.
The medical community has learned more about hormone therapy since the WHI trials were stopped. A study published in the July 11 issue of the British Medical Journal confirmed that hormone replacement therapy should not be prescribed for the purpose of preventing chronic conditions such as heart disease in older women who are well past menopause. That same study, however, concluded that hormone therapy may be a safe, short-term option for younger women in early menopause to relieve symptoms and improve quality of life.
"If the woman is healthy and has no risk factors, low dose hormone replacement therapy use for a short period of time should confer a small risk to her health," says Helen Roberts, M.D., M.P.H., a senior lecturer of women's health issues at the University of Aukland in New Zealand. Roberts, who wrote an accompanying editorial to the British Medical Journal study, also said women with risk factors such as a previous heart attack, stroke, blood clots, breast cancer or high risk of cardiovascular disease should not use hormone therapy.
Although confusion about hormone therapy persists, this study solidifies some thinking on the issue. Short-term use of hormones in healthy women going through early menopause may not pose serious health risks. Long-term use of hormone therapy to prevent chronic diseases in older women, who begin the therapy many years after menopause, may actually increase their risk of blood clots and heart disease, and should be discouraged.
A limitation of the WHI is that it primarily studied women who began taking hormone therapy long after they had passed menopause. Researchers are still trying to determine the effects of taking hormone therapy for long periods of time if the treatment begins in the early stages of menopause. Some data suggests the health risks are lower for these women, but more studies are needed.
"There has been mounting evidence that a woman's age and amount of time since onset of menopause influence her health outcomes on estrogen, particularly her risk of heart disease," said JoAnn Manson, M.D., Dr.P.H., chief of preventative medicine at Brigham and Women's Hospital in Boston, professor of medicine at Harvard Medical School, and one of the principle investigators of the WHI. "We've recently reported in April of 2007 that when you combine the findings from the estrogen plus progesterone trial and the estrogen alone trial, there is a suggestion of a lower risk of heart disease in the women who were less than ten years since onset of menopause."
By contrast, Manson's analysis shows an increased risk of heart disease for women who were more than 20 years past menopause.
Manson's research team reported in the June 21 issue of the New England Journal of Medicine that women who were in their 50s in the estrogen alone trial tended to have less coronary artery calcium, if they received estrogen compared to placebo.
"Coronary artery calcium is a marker for plaque build-up in the arteries, hardening of the arteries and it's a strong predictor of future risk of cardiovascular, of coronary heart disease," Manson said. "So these results lend support to the theory that estrogen may slow early stages of atherosclerosis."
As research continues, taking hormone replacement therapy is an individual decision for women that depends on many factors. Women should speak with their health care providers about the potential benefits and risks that may be relevant to them as individuals.
Society for Women's Health Research (SWHR)
1025 Connecticut Ave. NW, Ste. 701
Washington, DC 20036
United States
womenshealthresearch
четверг, 24 ноября 2011 г.
Preventive Ovary Removal Linked To Early Death In Younger Women
Death rates rise when women under 45 years old undergo bilateral ovariectomy -- surgical removal of both ovaries -- and do not receive proper hormone replacement therapy, according to a new Mayo Clinic study to be published in the October 1 issue of The Lancet Oncology. Mortality from all causes increased 1.7 times for women in this age category, and was particularly increased for estrogen-related cancers and diseases of the brain and cardiovascular system. The increased risk was mainly restricted to those women who were not given estrogen after the surgery until at least age 45 (within five years of the approximate age of normal menopause). Also, the increased risk became evident only 10 or more years after the ovariectomy.
Walter Rocca, M.D., Mayo Clinic neurologist, epidemiologist and lead study investigator, made these discoveries serendipitously while investigating links between ovary removal and brain diseases such as Parkinson's disease and dementia.
"These findings reopen the debate about preventive removal of the ovaries for younger women," says Bobbie Gostout, M.D., Mayo Clinic gynecologic surgeon who is not a study author but consulted with Dr. Rocca. "We don't see a dramatic increase in risk for early death from any one condition, but Dr. Rocca's study did show some increase in risk of death from breast and uterine cancers, and neurologic and vascular conditions. Collectively, this information tells us that a procedure that previously looked advantageous in protecting women's health may actually have disadvantages. We need to be very thoughtful about ovariectomy, as it may put younger women at risk for an earlier death."
Dr. Rocca says that if a woman under 45 has ovarian cancer or a benign disease in the ovaries that requires removal, however, compelling reason remains to remove the ovaries. Removal may also be considered in older women and in women with a very high risk of ovarian cancer, he says.
Dr. Gostout indicates that these findings will change her surgical practice for women under age 45.
"For me this changes the nature of the discussion," she says. "Women in whom we've discovered ovarian cancer or benign disease of the ovary will still be counseled to have it treated, including ovariectomy. We will use the findings from the Mayo Clinic study to guide the discussion on estrogen replacement therapy and will encourage most young women to take estrogen until age 50. But, for women with average risk for breast and ovarian cancer where we might have considered preventive ovariectomy, the discussion will have more of an emphasis on conserving the ovaries for protecting the health of the woman."
Continuing preventive ovariectomies in average-risk younger women and emphasizing estrogen replacement therapy thereafter may not be an adequate solution to diminish the risk, however, as compliance is poor for taking estrogen replacement therapy, says Dr. Gostout. Dr. Rocca adds that the protective effect from endogenous estrogen -- estrogen coming naturally from one's own ovaries with daily and monthly cyclic variations -- may not be the same as the effect of estrogen replacement therapy.
The study's investigators propose several theories to explain the finding of increased early deaths for younger women who have preventive ovariectomy without adequate estrogen replacement:
-- Premature estrogen deficiency following the surgery increased the risk for various diseases that in turn reduced survival
-- The surgery revealed an underlying pre-existing condition in these women that caused early death following surgery
-- These women may have a genetic predisposition to uterine diseases or other symptoms that prompted hysterectomy, which then prompted preventive ovariectomy, while the same predisposition also increased the risk of cancer or other causes of death following the surgery
The study findings also have general research implications for the role of estrogen, according to Dr. Rocca. "Our results confirm that estrogen is probably protective of the brain and cardiovascular system," he says. "They also further establish that the effects of estrogen are age-dependent: estrogen may be clearly useful and protective at younger ages, but it may become less important after menopause and then may have no effect or may be disadvantageous if given as treatment in later years."
To conduct this study, Dr. Rocca and colleagues followed women who had undergone unilateral or bilateral ovariectomy between 1950 and 1987 while residing in Olmsted County, Minn., home of Mayo Clinic. All of these women had the surgery prior to menopause and for reasons other than cancer. The study evaluated 1,293 women with unilateral ovariectomy, 1,097 women with bilateral ovariectomy and, for comparison, 2,390 women who had not undergone ovariectomy. All women were followed until their deaths or until the end of the study, which was staggered between 2001 and 2006, via a combination of interviews with the women or a surviving relative, medical records and death certificates. A unique strength of this study, according to the investigators, was a 25- to 30-year median follow-up time. A total of 1,292 women died during the follow-up; 33 of them died after undergoing bilateral ovariectomy for cancer prevention before age 45. Only a long-term study such as this can reveal these changes in death rates, says Dr. Rocca.
In the United States, 1.2 million ovariectomies are performed annually. Half are unilateral, in which one ovary is removed, and in the other half both ovaries (bilateral) are removed. Half of bilateral ovariectomies are prophylactic -- done to prevent the possibility of future ovarian cancer (approximately 300,000 women per year). The American Cancer Society has estimated approximately 20,000 new cases of ovarian cancer will occur in 2006, and approximately 15,000 women will die from the disease this year.
Study authors also include Brandon Grossardt; Mariza de Andrade, Ph.D.; George Malkasian, M.D.; and Joseph Melton III, M.D. Dr. Gostout consulted with Dr. Rocca about how these findings may affect ovariectomy practice at Mayo Clinic.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
Mayo Clinic
Walter Rocca, M.D., Mayo Clinic neurologist, epidemiologist and lead study investigator, made these discoveries serendipitously while investigating links between ovary removal and brain diseases such as Parkinson's disease and dementia.
"These findings reopen the debate about preventive removal of the ovaries for younger women," says Bobbie Gostout, M.D., Mayo Clinic gynecologic surgeon who is not a study author but consulted with Dr. Rocca. "We don't see a dramatic increase in risk for early death from any one condition, but Dr. Rocca's study did show some increase in risk of death from breast and uterine cancers, and neurologic and vascular conditions. Collectively, this information tells us that a procedure that previously looked advantageous in protecting women's health may actually have disadvantages. We need to be very thoughtful about ovariectomy, as it may put younger women at risk for an earlier death."
Dr. Rocca says that if a woman under 45 has ovarian cancer or a benign disease in the ovaries that requires removal, however, compelling reason remains to remove the ovaries. Removal may also be considered in older women and in women with a very high risk of ovarian cancer, he says.
Dr. Gostout indicates that these findings will change her surgical practice for women under age 45.
"For me this changes the nature of the discussion," she says. "Women in whom we've discovered ovarian cancer or benign disease of the ovary will still be counseled to have it treated, including ovariectomy. We will use the findings from the Mayo Clinic study to guide the discussion on estrogen replacement therapy and will encourage most young women to take estrogen until age 50. But, for women with average risk for breast and ovarian cancer where we might have considered preventive ovariectomy, the discussion will have more of an emphasis on conserving the ovaries for protecting the health of the woman."
Continuing preventive ovariectomies in average-risk younger women and emphasizing estrogen replacement therapy thereafter may not be an adequate solution to diminish the risk, however, as compliance is poor for taking estrogen replacement therapy, says Dr. Gostout. Dr. Rocca adds that the protective effect from endogenous estrogen -- estrogen coming naturally from one's own ovaries with daily and monthly cyclic variations -- may not be the same as the effect of estrogen replacement therapy.
The study's investigators propose several theories to explain the finding of increased early deaths for younger women who have preventive ovariectomy without adequate estrogen replacement:
-- Premature estrogen deficiency following the surgery increased the risk for various diseases that in turn reduced survival
-- The surgery revealed an underlying pre-existing condition in these women that caused early death following surgery
-- These women may have a genetic predisposition to uterine diseases or other symptoms that prompted hysterectomy, which then prompted preventive ovariectomy, while the same predisposition also increased the risk of cancer or other causes of death following the surgery
The study findings also have general research implications for the role of estrogen, according to Dr. Rocca. "Our results confirm that estrogen is probably protective of the brain and cardiovascular system," he says. "They also further establish that the effects of estrogen are age-dependent: estrogen may be clearly useful and protective at younger ages, but it may become less important after menopause and then may have no effect or may be disadvantageous if given as treatment in later years."
To conduct this study, Dr. Rocca and colleagues followed women who had undergone unilateral or bilateral ovariectomy between 1950 and 1987 while residing in Olmsted County, Minn., home of Mayo Clinic. All of these women had the surgery prior to menopause and for reasons other than cancer. The study evaluated 1,293 women with unilateral ovariectomy, 1,097 women with bilateral ovariectomy and, for comparison, 2,390 women who had not undergone ovariectomy. All women were followed until their deaths or until the end of the study, which was staggered between 2001 and 2006, via a combination of interviews with the women or a surviving relative, medical records and death certificates. A unique strength of this study, according to the investigators, was a 25- to 30-year median follow-up time. A total of 1,292 women died during the follow-up; 33 of them died after undergoing bilateral ovariectomy for cancer prevention before age 45. Only a long-term study such as this can reveal these changes in death rates, says Dr. Rocca.
In the United States, 1.2 million ovariectomies are performed annually. Half are unilateral, in which one ovary is removed, and in the other half both ovaries (bilateral) are removed. Half of bilateral ovariectomies are prophylactic -- done to prevent the possibility of future ovarian cancer (approximately 300,000 women per year). The American Cancer Society has estimated approximately 20,000 new cases of ovarian cancer will occur in 2006, and approximately 15,000 women will die from the disease this year.
Study authors also include Brandon Grossardt; Mariza de Andrade, Ph.D.; George Malkasian, M.D.; and Joseph Melton III, M.D. Dr. Gostout consulted with Dr. Rocca about how these findings may affect ovariectomy practice at Mayo Clinic.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
Mayo Clinic
четверг, 17 ноября 2011 г.
Tufts Researchers Discover New Neuron Development In Brains Of Nulliparous Mothers
Maternal behavior itself can trigger the development of new neurons in the maternal brain independent of whether the female was pregnant or has nursed, according to a study released by researchers at Tufts University's Cummings School of Veterinary Medicine. These findings performed in adult, virgin rats were published in Brain Research Bulletin and are available online at dx.doi/10.1016/j.brainresbull.2009.08.011.
In the study, virgin, or nulliparous, rats were exposed to foster pups each day until they began to exhibit maternal behavior, including crouching over the young, grouping them, or retrieving them back to the nest. Data from the study showed that the nulliparous rats exposed to pups have increased numbers of new neurons.
The research was undertaken by Cummings School Department of Biomedical Sciences researchers Miyako Furuta and Robert Bridges, who is the head of the Cummings School's reproduction and neurobiology section.
Previous research has found that exposure to young can stimulate maternal behavior not only in rats, but also mice, hamsters, monkeys, and even humans. Increased creation of new neurons, or neurogenesis, has also been shown during pregnancy and lactation in rodents and associated with maternal behavior, but studies analyzing neurogenesis in nulliparous animals exhibiting maternal behavior had not been done. The area of the brain that was the focus of the present study was the subventricular region - a region involved in the production of cells that affect odor recognition and possibly recognition of young. Bridges and Furuta found increased numbers of new neurons in the subventricular zone in adult, nulliparous rats that behaved maternally compared with numbers in subjects that either were not exposed to young or exposed to young, but did not behave maternally.
What stimulates increased new neuron production in the nulliparous mothers is not known. One possibility is that the hormone prolactin, which stimulates both the onset of maternal behavior as well as production of neurons during pregnancy, may play a role in the production of new neurons in nulliparous females exhibiting maternal behavior. However, this possibility remains to be investigated. A second possibility is that stimulation received from the young themselves may, in fact, play a crucial role in stimulating maternal neuron production.
"As with all scientific studies, these findings trigger more questions than answers," said Dr. Robert Bridges, section head of reproduction and neurobiology at Tufts University's Cummings School of Veterinary Medicine. "Next, we hope to determine what role this neurogenesis plays in terms of the female's behavior and physiological processes. Where do these new cells migrate to within the brain and what do they do? For example, do they affect how a female subsequently perceives her young through recognition of baby odors? These are the questions we hope to answer."
The study was funded by a National Institutes of Health grant.
In addition to clinical research, the Cummings School of Veterinary Medicine at Tufts University receives National Institutes of Health funding for basic science research in four major areas: Bridges' reproduction and neurobiology section, infectious diseases, pulmonology, and liver/gastrointestinal function.
Source: Tom Keppeler
Tufts University, Health Sciences
In the study, virgin, or nulliparous, rats were exposed to foster pups each day until they began to exhibit maternal behavior, including crouching over the young, grouping them, or retrieving them back to the nest. Data from the study showed that the nulliparous rats exposed to pups have increased numbers of new neurons.
The research was undertaken by Cummings School Department of Biomedical Sciences researchers Miyako Furuta and Robert Bridges, who is the head of the Cummings School's reproduction and neurobiology section.
Previous research has found that exposure to young can stimulate maternal behavior not only in rats, but also mice, hamsters, monkeys, and even humans. Increased creation of new neurons, or neurogenesis, has also been shown during pregnancy and lactation in rodents and associated with maternal behavior, but studies analyzing neurogenesis in nulliparous animals exhibiting maternal behavior had not been done. The area of the brain that was the focus of the present study was the subventricular region - a region involved in the production of cells that affect odor recognition and possibly recognition of young. Bridges and Furuta found increased numbers of new neurons in the subventricular zone in adult, nulliparous rats that behaved maternally compared with numbers in subjects that either were not exposed to young or exposed to young, but did not behave maternally.
What stimulates increased new neuron production in the nulliparous mothers is not known. One possibility is that the hormone prolactin, which stimulates both the onset of maternal behavior as well as production of neurons during pregnancy, may play a role in the production of new neurons in nulliparous females exhibiting maternal behavior. However, this possibility remains to be investigated. A second possibility is that stimulation received from the young themselves may, in fact, play a crucial role in stimulating maternal neuron production.
"As with all scientific studies, these findings trigger more questions than answers," said Dr. Robert Bridges, section head of reproduction and neurobiology at Tufts University's Cummings School of Veterinary Medicine. "Next, we hope to determine what role this neurogenesis plays in terms of the female's behavior and physiological processes. Where do these new cells migrate to within the brain and what do they do? For example, do they affect how a female subsequently perceives her young through recognition of baby odors? These are the questions we hope to answer."
The study was funded by a National Institutes of Health grant.
In addition to clinical research, the Cummings School of Veterinary Medicine at Tufts University receives National Institutes of Health funding for basic science research in four major areas: Bridges' reproduction and neurobiology section, infectious diseases, pulmonology, and liver/gastrointestinal function.
Source: Tom Keppeler
Tufts University, Health Sciences
четверг, 10 ноября 2011 г.
Cedars-Sinai's Women's Cancer Research Institute Recognized As One Of The Nation's Top Centers For Gynecologic Oncology
Cedars-Sinai Medical Center's Gynecologic Oncology Division was named among the nation's top 10 programs by Contemporary OB/GYN, a leading publication read by the nation's obstetricians and gynecologists.
The award recognizes institutions for overall expertise as well as for leadership in research, patient care and community outreach. Cedars-Sinai's Women's Cancer Research Institute was the only center in the Los Angeles area to receive the award.
"We're pleased to be included in this list of Centers of Excellence for gynecologic cancers," said Beth Karlan, M.D., director of Cedars-Sinai's Women's Cancer Research Institute at the Samuel Oschin Comprehensive Institute and an internationally recognized cancer surgeon and research scientist. "The innovative research as well as the level of care and support we offer our patients at Cedars-Sinai truly merits this recognition."
The award was determined by information provided by key opinion leaders in the field, self-reported data and other information, and included criteria such as number of research protocols, patient satisfaction, level of technological equipment onsite, outcome data and national awards and recognition.
Other Centers of Excellence recognized included M.D. Anderson Cancer Center, Yale Cancer Center and Duke University Medical Center.
According to Contemporary OB/GYN, the purpose of the list was to provide physicians with information on top-notch treatment centers so that they could refer their patients with gynecologic cancers to some of the best centers in the United States.
Source
Cedars-Sinai's Women's Cancer Research Institute
The award recognizes institutions for overall expertise as well as for leadership in research, patient care and community outreach. Cedars-Sinai's Women's Cancer Research Institute was the only center in the Los Angeles area to receive the award.
"We're pleased to be included in this list of Centers of Excellence for gynecologic cancers," said Beth Karlan, M.D., director of Cedars-Sinai's Women's Cancer Research Institute at the Samuel Oschin Comprehensive Institute and an internationally recognized cancer surgeon and research scientist. "The innovative research as well as the level of care and support we offer our patients at Cedars-Sinai truly merits this recognition."
The award was determined by information provided by key opinion leaders in the field, self-reported data and other information, and included criteria such as number of research protocols, patient satisfaction, level of technological equipment onsite, outcome data and national awards and recognition.
Other Centers of Excellence recognized included M.D. Anderson Cancer Center, Yale Cancer Center and Duke University Medical Center.
According to Contemporary OB/GYN, the purpose of the list was to provide physicians with information on top-notch treatment centers so that they could refer their patients with gynecologic cancers to some of the best centers in the United States.
Source
Cedars-Sinai's Women's Cancer Research Institute
четверг, 3 ноября 2011 г.
Nomination Of Sebelius For HHS Secretary Consistent With Obama's 'Pro-Choice Agenda,' Washington Post Columnist Says
"It is probably not a coincidence" that President Obama has nominated a Roman Catholic -- Kansas Gov. Kathleen Sebelius (D) -- to serve as HHS secretary and "implement" many policies in his "pro-choice agenda," Michael Gerson writes in a Washington Post opinion piece. According to Gerson, the "coercion of those who disagree" with this agenda is "a common thread" for Obama. Although the president "has every right to a pro-choice Cabinet," the nomination of Sebelius "seems designed to provide religious cover" and "also smacks of religious humiliation -- like asking a rabbi to serve the pork roast or an atheist to bless the meal," Gerson says. He continues, "Sebelius, though strongly pro-choice, was capable of occasional compromise. But she consistently fought against the serious enforcement of Kansas' late-term abortion restrictions." Sebelius is in the group of "Catholics who assert the sanctity of life while defending legal abortion," he writes.
According to Gerson, Catholics who support abortion rights have various explanations for their stance. He says, "Some say they will not impose their private religious views on others. But moral beliefs about human dignity are not religious dogmas such as transubstantiation or the Trinity." He asks, "Couldn't a Catholic politician support women in crisis and effective protection for viable children?" Catholic abortion-rights supporters say that "legal remedies on abortion have been exhausted, so we might as well focus on the common-ground issue of abortion reduction -- a cause that does deserve support," Gerson says. However, he also contends that "legal remedies have not been exhausted; they have been preempted by the courts." He continues, "The exercise of democracy on abortion would probably lead to broader protections for viable children. And it is difficult to imagine how anyone committed to the principle that 'all life is sacred' could oppose such a democratic outcome." Gerson adds that "if a politician believes life is sacred, the destruction of more than a million lives a year cannot be merely one issue among many." He concludes that Sebelius and other Catholic politicians who support abortion rights "are disagreeing with their church on a fundamental issue of justice -- which is their right;" however, "It is also the right of their church to point out their incoherence" (Gerson, Washington Post, 3/11).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
According to Gerson, Catholics who support abortion rights have various explanations for their stance. He says, "Some say they will not impose their private religious views on others. But moral beliefs about human dignity are not religious dogmas such as transubstantiation or the Trinity." He asks, "Couldn't a Catholic politician support women in crisis and effective protection for viable children?" Catholic abortion-rights supporters say that "legal remedies on abortion have been exhausted, so we might as well focus on the common-ground issue of abortion reduction -- a cause that does deserve support," Gerson says. However, he also contends that "legal remedies have not been exhausted; they have been preempted by the courts." He continues, "The exercise of democracy on abortion would probably lead to broader protections for viable children. And it is difficult to imagine how anyone committed to the principle that 'all life is sacred' could oppose such a democratic outcome." Gerson adds that "if a politician believes life is sacred, the destruction of more than a million lives a year cannot be merely one issue among many." He concludes that Sebelius and other Catholic politicians who support abortion rights "are disagreeing with their church on a fundamental issue of justice -- which is their right;" however, "It is also the right of their church to point out their incoherence" (Gerson, Washington Post, 3/11).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
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