Louisiana, Massachusetts Take Action On Abortion, Sex Education Measures

The following highlights recent state actions on abortion and sex education-related legislation.

Abortion
Louisiana: Gov. Kathleen Blanco (D) on Friday signed two bills (HB 614, SB 161) that would ban so-called "partial birth" abortion in the state and create criminal penalties for physicians who perform the procedure, the New Orleans Times-Picayune reports (Anderson, New Orleans Times-Picayune, 7/14). Under the House bill, doctors who provide the procedure could receive fines up to $100,000 and jail sentences of up to 10 years. The ban would allow exceptions when the life of the pregnant woman is in danger (Kaiser Daily Women's Health Policy Report, 6/27). The Senate measure contains the same provisions as the House bill, but there are "slight differences" between the two, according to the Times-Picayune. Although both bills went into effect when Blanco signed them, the Louisiana Law Institute, a technical legal panel that works with the Legislature, will distinguish the differences in the bill and codify the statutes, Blanco Executive Counsel Terry Ryder said. He added that the Senate measure takes precedence because it passed after the House bill. Blanco last week also signed a bill (HB 25) that would require a woman seeking an abortion to be told of the availability of anesthesia, which would "eliminate or alleviate organic pain to the unborn child." The statute requires that the brochure given to women states that at 20 weeks' gestation "the unborn child has the physical structures necessary to experience pain. ... Anesthesia is routinely administered to unborn children who are 20 weeks' gestational age or older who undergo prenatal surgery." The law takes effect Aug. 15 (New Orleans Times-Picayune, 7/14).

Sex Education
Louisiana: Blanco last week vetoed a provision of a state budget measure that would have provided $500,000 for the Louisiana Governor's Program on Abstinence, the New Orleans Times-Picayune reports. According to the Times-Picayune, the provision, which was added by Rep. Gary Beard (R), would have taken effect only if the governor's program stopped receiving federal funding. Blanco said she vetoed the measure because it could have force cuts to other public health programs (New Orleans Times-Picayune, 7/13).

Massachusetts: Gov. Deval Patrick (D) on Thursday vetoed a provision in the state budget measure that would have accepted a $700,000 federal grant for abstinence-only sex education classes, the Boston Herald reports (Fargen, Boston Herald, 7/13). According to the Sexuality Information and Education Council of the United States, eight other states have rejected the funding, which requires that sex education curricula promote abstinence until marriage, and 12 additional states are considering not applying for the grant. In rejecting the funding, Patrick's administration cited a study commissioned by Congress and released last month that found students who participate in abstinence-only programs are as likely to have sex as students who do not participate in the programs (Kaiser Daily Women's Health Policy Report, 5/7). According to the Herald, the Dorchester, Mass.-based Healthy Futures -- which teaches abstinence education to 7,000 middle school students annually -- will lose about $500,000, or about 50% of its annual budget. Rep. Brad Jones (R) said he will call on the Republican leadership in the Legislature to attempt to override Patrick's veto. However, Patrick could still decide not to apply for the grant if his veto is overridden, the Herald reports (Boston Herald, 7/13).















"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.

FDA Approves Perrigo's Vaginal Suppositories For Treatment Of Yeast Infections

Michigan-based pharmaceutical company Perrigo, which manufactures nonprescription drugs, on Tuesday announced that it has received FDA approval to sell its terconazole vaginal suppositories for the treatment of yeast infections, Marketwatch reports. Terconazole is the generic version of Ortho McNeil's Terazol 3 vaginal suppositories, an antifungal medication used to treat yeast infections (Marketwatch, 3/21). Perrigo products typically carry store-brand labels (AP/Business Week, 3/21). Shipments of the drug are expected to begin immediately, the company said (Marketwatch, 3/21).


"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.

URMC Research Confirms Possible Use Of Drug For Painful Fibroids

Research continues to show that the controversial abortion drug mifepristone might have another use, as a therapeutic option besides hysterectomy for women who suffer from severe symptoms associated with uterine fibroids.



The University of Rochester Medical Center in 2004 began investigating mifepristone, in a class of drugs known as progesterone receptor modulators (PRMs), to treat fibroids, which affect roughly half of all women younger than 50. Results showed the drug shrank the fibroids and greatly improved the quality of life for the women involved in the clinical trial.



But concern over whether PRMs could cause tissue changes that signal uterine cancer dampened a growing interest in the drug. The latest URMC study demonstrates that PRMs do not appear to trigger cancerous or pre-cancerous lesions in the lining of the uterus, at least in the short term, according to an article in the journal Human Pathology.



"Our biggest concern was cancer, and although we saw significant changes in the endometrial tissue specific to the action of PRMs, all of the changes were benign and well characterized in the laboratory," said lead investigator Julietta Fiscella, M.D., clinical assistant professor of Pathology and Laboratory Medicine at URMC and Director of Pathology at Highland Hospital, an affiliate of URMC.



Fiscella analyzed 152 tissue samples from 53 premenopausal women in the Rochester, N.Y., area, who volunteered to take mifepristone at very low doses for up to 18 months to alleviate miserable symptoms such as pain and heavy bleeding. She compared samples of unexposed endometrial tissue to samples from women who took the drug in 2.5 mg or 5 mg dosages. (To end an unwanted pregnancy, mifepristone is given in a single-day dose of 200 to 600 mg.)



The changes most evident in the drug-exposed tissue included fluid-filled glands that appeared as scattered, benign cysts of varying size, and some abnormal blood vessels. These features were consistent in 86 percent of the drug-exposed samples, with no statistical differences between the two doses, the study said.



An international panel of pathology experts also conducted a blind review of the 152 samples and confirmed Fiscella's findings, she said. The results suggest that if mifepristone or PRMs with similar properties are eventually approved for treatment of uterine fibroids, pathologists will have a reliable way to track and compare the effects of different doses and treatment schedules (weekly versus daily) on patients during their childbearing years.


Notes:


The National Institute for Child Health and Human Development funded the study.



Fiscella said larger studies with longer follow-up are needed to more fully characterize the low-dose effect of mifeprisone, and to confirm that changes in the uterus resolve after a woman stops taking the drug.



The U.S. Food and Drug Administration approved mifepristone in 2000 for the sole purpose of ending unwanted pregnancies, and has since issued warnings due to a small number of deaths that occurred at the highest doses. Distribution of the drug is strictly controlled, although the FDA does allow it to be studied by qualified physicians. In addition to research into its effect on common gynecological conditions, scientists in California reported in the journal Science in 2006 that mifepristone blocked the formation of breast tumors in mice, suggesting a potential new path to interfere with the hormone progesterone's role in breast cancer. Since then mifepristone has been actively studied by other scientists as a potential cancer treatment.



Leiomyoma, the medical term for uterine fibroids, routinely causes iron-deficiency anemia due to excessive menstrual bleeding. Thousands of women annually opt for hysterectomies, a major surgery, or have the fibroids removed through minimally invasive embolization because no other medical treatment has been proven effective.



Source:

Leslie Orr

University of Rochester Medical Center

Fibroids Common, But Women Have Options

Small fibroids located just beneath the lining of the uterus (submucosal) are more likely to move to the endometrial cavity after uterine artery embolization (UAE) but usually don't cause major complications, according to a new study.


The study included 49 patients with 140 fibroids who underwent an MRI examination before and after UAE. The study found that 39 of these were submucosal. Of these, 33% migrated to the endometrial cavity after UAE, said Sachit Verma, MD, lead author of the study. "At the beginning of our study, we suspected that all submucosal fibroids became endocavitary following UAE irrespective of their area of contact with the endometrium (ID ratio)," said Dr. Verma. "By further analyzing our results we realized that submucosal fibroids with an ID ratio greater than 0.55 at pre-procedural MRI have a higher risk of becoming endocavitary following UAE," he said


The majority of these fibroids are expelled spontaneously without significant symptoms, Dr. Verma said. However it is good to know if patients are at higher risk of this situation occurring so they can be better counseled regarding risk of post procedural complications and symptoms such as menorrhagia, acute pelvic pain or persistent vaginal discharge, he said. Patients may also choose an alternative treatment option, such as hysteroscopic resection and/or myomectomy, said Dr. Verma.


In a recent commentary written in conjunction with the study, by Fred Burbank, MD adds patients contemplating UAE should anticipate that fibroids bordering on or inside the uterine cavity may require cervical dilatation or hysteroscopic resection for removal. The addition of either of these gynecology procedures shouldn't necessarily be regarded as a UAE complication or treatment failure, he says.


Both the study and commentary appear in the May issue of the American Journal of Roentgenology.


American Roentgen Ray Society (ARRS)

44211 Slatestone Ct.

Leesburg, VA 20176-5109

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arrs

New Project To Analyze Why Polycystic Ovary Syndrome And Insulin Resistance Are So Closely Linked

Understanding the link between Polycystic Ovary Syndrome (PCOS) and insulin resistance is the aim of a new project, funded by the charity WellBeing of Women.



It is known that women with PCOS have a 3-fold increase in their risk of developing type-2 diabetes, where the body does not produce enough insulin or cannot use insulin properly. Insulin resistance is an important factor in the condition, which is the most common female hormone disorder. PCOS affects between 5 and 10 per cent of women and is a major cause of infertility.



The new ??97K project aims to identify a defective point on the insulin signalling pathway in women with PCOS. The researchers, from Imperial College London, hope this will enable the development of new therapies which target this part of the pathway, to counter the insulin resistance and the fertility problems that PCOS can cause.



Insulin is released from cells in the pancreas after eating and it signals insulin-sensitive tissues (such as fat and muscle) to take up glucose, keeping glucose levels in the bloodstream normal. In people with insulin resistance, normal amounts of insulin are not adequate to produce a normal glucose response, meaning that levels of insulin in the bloodstream need to be higher to achieve normal blood sugar levels.



Insulin resistance (and/or the compensatory excess of insulin in the bloodstream), may contribute to abnormalities in function of the ovaries that lead to many of the symptoms of PCOS. These include irregular periods, or no periods at all; fertility problems; weight gain; acne; and excessive hair growth (hirsutism).



A longer term concern is that insulin resistance also predisposes people to diabetes. In some patients the pancreas is unable, in the long-term, to produce enough insulin to compensate for the resistance of the tissues to insulin action. Consequently, blood sugar levels rise. What is not known is why PCOS and insulin resistance are so closely related.



The researchers hope that the new project will explain the link between PCOS and insulin resistance and how the link manifests itself at the level of individual cells.



The researchers will be looking at how ovarian cells metabolise glucose in women both with and without PCOS.



Professor Stephen Franks said: "PCOS gives rise to a range of symptoms. These may be very distressing not only because of problems with irregular periods and with fertility but also because of excess body hair, acne or alopecia. We still do not fully understand the underlying cause or causes of PCOS but insulin resistance plays an important part in many patients.



"These studies will give us the chance to look directly at the mechanism of insulin resistance at the level of an important target tissue - the ovary. We expect the results of these studies to give us information that will help to devise new and more effective methods of treatment for this very common hormone problem," he added.






Contact: Laura Gallagher


Imperial College London

New Research Finds Better-Educated Women Are A Healthier Weight

Better-educated women are a healthier weight, new research reveals but men have higher body mass the more educated they are - except in United States



A new comparison of multi-national data, released this month, reveals that highly educated women have a healthier average weight than less educated women, but that the meaning of "healthier" changes according to a nation's relative wealth. In countries where malnutrition is prevalent, better-educated women weigh more. But in wealthier countries - with rapidly growing rates of obesity - better-educated women weigh less.



"As a population moves through the nutrition transition, it is the most educated, and highest income, who are the first to exit under-nutrition. They are also the first to adjust their diet and physical activity to avoid the deleterious effects of being overweight," explained John Strauss, professor of economics at the University of Southern California.



"It appears that it is women who tend to lead this transition," he added.



More than half of the adult population is underweight in Bangladesh, the poorest country analyzed by Strauss and Duncan Thomas (Duke University). In Bangladesh, average female body mass increased with every additional year of schooling.



In contrast, only 1 percent of people in the United States are underweight. Better-educated women in the United States, the wealthiest country in the study, had a lower average body mass index the more education they'd received, the researchers found.



"Obesity rates rise with economic development which is troubling given the relationship between obesity and cardiovascular disease, stroke, diabetes and possibly cancer," Strauss said. For example, the researchers show that almost twice as many women are now overweight as are underweight in China.



Furthermore, in developing countries worldwide, women are more likely than men to be overweight or obese. The gender gap is largest in South Africa, where more than one-third of women are obese, compared with about 10 percent of South African men.



However, Strauss and Thomas show that once women receive a certain amount of schooling, average body mass index (BMI) falls and they are more likely to be at a healthy weight.



"Behavioral changes have important impacts on health outcomes," Strauss said.



For example, the average BMI of a Mexican woman - where 74 percent of the women are overweight or obese - declines for every year of schooling she receives in excess of just five years. There is a similar sharp decline in the average female's BMI in South Africa after five years of education.
















BMI is a widely used measure that accounts for both weight and height.



The United States was the only nation surveyed in which better-educated men had a lower average BMI than less-educated men. In every other country, the average male body mass increased with every additional year of schooling.







The findings appear in the latest volume of the Handbook of Development Economics, edited by Strauss and T. Paul Schultz (Yale University). The new book is the first update in more than 13 years to the Handbook of Development Economics, which has counted at least six Nobel Prize laureates among its contributors.



"Data has vastly improved since the last volume," said Strauss, who is also the principal investigator for the long-term Indonesia Family Life Survey, which tracks more than 30,000 individuals.



An unmatched resource for scholars, the Handbook of Development Economics summarizes and synthesizes important research about economic development, including the role of institutions such as schools, medical facilities and fair court systems. Nobel Prize laureate Amaryta Sen wrote the first chapter of the first volume of the Handbook in Development Economics in 1988.



Topics explored in the latest volume, released in April 2008, include the decline of agricultural employment, the effects of changing fertility through availability of contraception or family planning programs, child labor and political corruption.



Schultz, T.P. and John Strauss. Handbook of Development Economics: Volume 4, (Amsterdam: North-Holland Press, 2008).



Source: Suzanne Wu


University of Southern California

Sen. Judiciary Chair Leahy Urges Chamber To Confirm Judicial Nominees

Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) on Wednesday urged the chamber to confirm several of President Obama's judicial and executive nominees before the end of the year, CQ Today reports. There are five circuit court nominees and four district court nominees pending on the committee's calendar, as well as 10 executive branch nominees -- including Dawn Johnsen to head the Office of Legal Counsel in the Justice Department.

Three of Obama's 12 circuit court nominees and seven of his 17 district court nominees have received Senate confirmation so far. It is not clear if any other nominees will be voted on before the end of 2009 because of the current debate on health care reform. Senate Republicans have said that Obama's judicial nominees are being processed more quickly than those of President George W. Bush, adding that it is up to the Democratic leadership to set a schedule for nominations. "I hope that instead of withholding consent and threatening filibusters of President Obama's judicial nominees, Senate Republicans will treat nominees of President Obama fairly," Leahy said (Perine, CQ Today, 12/9).


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.

Actress Sally Field Takes Bone Health Message To Capitol Hill

When actress Sally Field was diagnosed with osteoporosis in 2005, it was a disappointing development.


"I had always eaten right, I had always exercised, and I had always taken calcium," Field said last Thursday in Washington, D.C. "I tried to be a good girl all the way down the line, but it was going to get me."


Field was in town to talk to legislators at a Capitol Hill briefing sponsored by the Society for Women's Health Research and the National Osteoporosis Foundation. The event took place during National Women's Health Week and National Osteoporosis Month, encouraging women to protect their bone health at all ages.


"Eighty percent of the 10 million Americans affected by osteoporosis are women," said Phyllis Greenberger, president and CEO of the Society for Women's Health Research. "An additional 34 million Americans are at risk for this disease and, as our population ages, osteoporosis will only become a greater public health threat."


Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly. It is about more than broken bones and hunchbacked old ladies. It can cost you your life.


"A hip fracture can kill you," said Ethel Siris, M.D., president of the National Osteoporosis Foundation. "There is a 20 percent increased mortality in the year after a hip facture."


For individuals who survive a hip fracture, their quality of life will likely never be the same.


"Most people, at least 50 percent, will need a cane or walker for the rest of their life," said Laura Tosi, M.D., a Society for Women's Health Research board member.


Fortunately for Field, her doctor had been monitoring her bone health for several years leading up to her diagnosis because she was at heightened risk for osteoporosis. Field received a bone density test to establish a baseline and then follow up tests in later years to determine her rate of bone loss.


As a small-boned, thin Caucasian woman over the age of 50 with a family history of fractures as an adult, Field was at great risk. Although osteoporosis is most common in Caucasian and Asian women, African American and Hispanic women are also at significant risk for the disease.


Field's doctor let her know that she was losing bone at a very rapid rate and needed to start treatment immediately. The danger she faced became crystal clear a short time later while playing with her grandchildren.


"I had a five-year old on my back and a seven-year old in a wagon, pulling them up my steep driveway," Field said. "I realized, 'I'm at risk. I may not make it up this steep driveway.'"


Field's osteoporosis is now being treated with medication in addition to continuing exercise and a proper diet that includes adequate calcium and vitamin D, which helps the body absorb calcium.















Thanks to aggressive care, Field will likely avoid the painful and debilitating fate that so many women before her have suffered through osteoporosis, including her grandmother.


"My grandmother Joy was in great pain the last years of her life, in her 90s, because of a broken back" Field said. "She broke her back by sitting down on a bench." Field didn't know of her grandmother's osteoporosis and bone breaks until Field's mother shared the story with her.


With increased bone health knowledge and improved care, women can now prevent or reduce osteoporosis problems.


Every woman should receive a bone density test by age 65 to determine if she has osteoporosis or is at high risk for the disease. Starting at age 40, you should talk to your doctor or nurse about your risk factors for osteoporosis to determine if you need earlier or more frequent screening.


The key to good bone health starts when you are young.


"Until you're about 30, your bones are still growing," Siris said. "You can build more bone. After 30 you build the rest of your body to support your bones."


To build strong bones, young girls, adolescents, and young women need to exercise regularly and maintain good nutrition, with an emphasis on calcium and vitamin D.


The simple act of increasing vitamin D and calcium consumption reduced the risk of stress fractures by 25 percent in new recruits in the U.S. Navy, Tosi said, referring to a recent study.


What was Field's message for members of Congress?


"I urge them to look after themselves," Field said. "Two-thirds of the women in Congress are over 50. We need for them to stay healthy so they can go home and talk to their constituents about this important issue."


To learn more about osteoporosis and bone health, visit the Society for Women's Health Research online at womenshealthresearch and the National Osteoporosis Foundation at nof.


Society for Women's Health Research (SWHR)

1025 Connecticut Ave. NW, Ste. 701

Washington, DC 20036

United States

womenshealthresearch

Young Hyperactive Girls More Likely To Have Serious Problems As Adults

Young girls who are hyperactive are more likely to get hooked on smoking, under-perform in school or jobs and gravitate towards mentally abusive relationships as adults, according to a joint study by researchers from the Universit?© de Montr?©al and the University College London (UCL).


The study, published in the latest issue of the Archives of General Psychiatry, followed 881 Canadian girls from the ages of six to 21 years to see how hyperactive or aggressive behaviour in childhood could affect early adulthood. The research team found that one in 10 girls monitored showed high levels of hyperactive behaviour. Another one in ten girls showed both high levels of hyperactive and physically aggressive behaviour.


"Few studies have looked at the consequences of aggressive and hyperactive behaviour in girls," said UCL lead researcher, Nathalie Fontaine. "This study shows that hyperactivity combined with aggressive behaviour in girls as young as six years old may lead to greater problems with abusive relationships, lack of job prospects and teenage pregnancies."


Girls with hyperactive behaviour (restlessness, jumping up and down, a difficulty keeping still or fidgety), while girls exhibiting physical aggression (fighting, bullying, kicking, biting or hitting) were found to have a high risk of developing adjustment problems in adulthood.


The study also found that hyperactive or aggressive girls were more vulnerable to grow into smoking, psychologically abusive partners and poor performance in school. What's more, females with both hyperactivity and physical aggression reported physical and psychological aggression towards their partner, along with early pregnancy and dependency on welfare.


"Our study suggests that girls with chronic hyperactivity and physical aggression in childhood should be targeted by intensive prevention programmes in elementary school, because they are more likely to have serious adjustment problems later in life," cautioned Dr. Fontaine. "Programmes targeting only physical aggression may be missing a significant proportion of at-risk girls. In fact, our results suggest that targeting hyperactive behaviour will include the vast majority of aggressive girls."


Not all hyperactive and physically aggressive girls, however, grow up with serious adjustment problems, according to co-author Richard Tremblay, a professor of psychology, pediatrics and psychiatry and director of the Research Unit on Children's Psycho-Social Maladjustment at the Universit?© de Montr?©al and Sainte-Justine Hospital.


"We found that about 25 per cent of the girls with behavioural problems in childhood did not have adjustment problems in adulthood, although more than a quarter developed at least three adjustment problems," Dr. Tremblay said, noting additional research is needed into related social aggression such as rumour spreading, peer group exclusion. "We need to find what triggers aggression and how to prevent such behavioural problems."















"Girls' Hyperactivity and Physical Aggression During Childhood and Adjustment Problems in Early Adulthood - A 15-Year Longitudinal Study"

Nathalie Fontaine, PhD; Ren?© Carbonneau, PhD; Edward D. Barker, PhD; Frank Vitaro, PhD; Martine H?©bert, PhD; Sylvana M. C??t?©, PhD; Daniel S. Nagin, PhD; Mark Zoccolillo, MD; Richard E. Tremblay, PhD

Arch Gen Psychiatry. 2008;65(3):320-328.

Click here to see Abstract online


Partners in research:


This study was funded by the CQRS, SSHRC, FCAR, NHRDP/CIHR, US NSF, US NIMH and NCOVR. The study was carried out by the Universit?© de Montr?©al UCL, King's College London, Laval University, University of Quebec, McGill University, Carnegie Mellon University and Inserm in France.


About UCL:


Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. UCL is in the top 10 world universities in the 2007 THES-QS World University Rankings, and the fourth-ranked UK university in the 2007 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Marie Stopes, Jonathan Dimbleby, Lord Woolf, Alexander Graham Bell, and members of the band Coldplay.


About the Universit?© de Montr?©al:


Deeply rooted in Montreal and dedicated to its international mission, the Universit?© de Montr?©al is one of the top universities in the French-speaking world. Founded in 1878, the Universit?© de Montr?©al today has 13 faculties and together with its two affiliated schools, HEC Montr?©al and ?‰cole Polytechnique, constitutes the largest centre of higher education and research in Qu?©bec, the second largest in Canada, and one of the major centres in North America. It brings together 2,400 professors and researchers, accommodates more than 55,000 students, offers some 650 programs at all academic levels, and awards about 3,000 masters and doctorate diplomas each year. On the Web: umontreal.

Former Abortion Clinic Administrator Arrested On Misdemeanor Charges, Alabama AG King Says

Janet Onthank King -- former administrator at the Summit Medical Center abortion clinic in Birmingham, Ala. -- on Friday was arrested on misdemeanor charges, including performing illegal abortions at the clinic, according to the Alabama Attorney General's Office, the Birmingham News reports (Garrison/Walton, Birmingham News, 12/9). Summit in June yielded its license in response to a suspension order issued by the Alabama Department of Public Health on May 17 and has been closed since May 18. State health officials said a clinic staff member in February performed an ultrasound on a woman seeking an abortion and determined she was at six weeks' gestation, when she actually was almost full-term. A nurse practitioner gave the woman mifepristone, which when taken with misoprostol can cause a medical abortion, even though her blood pressure was too high. The woman six days later went to an emergency department and delivered a six-pound, four-ounce stillborn infant, according to the state health department. State Attorney General Troy King (R) and the Alabama Board of Medical Examiners are investigating the clinic for possible criminal charges (Kaiser Daily Women's Health Policy Report, 8/11). According to the News, Onthank King, who is a registered nurse, faces two charges of "knowingly or recklessly" performing abortions as a nonphysician and one charge of making false entries in required equipment sterilization reports. "She is definitely surprised and shocked that they would charge her," Richard Jaffe, Onthank King's lawyer, said, adding, "Her involvement in [the February] incident was minor. She performed no procedures, she prescribed no medications; in short, she committed no crime." Onthank King surrendered to the Jefferson County sheriff's office on Friday and was released on a $3,000 bond (Garrison/Walton, Birmingham News, 12/9). If convicted, she faces a maximum of six months in prison and a $1,000 fine for each charge, the AP/Decatur Daily reports. Jaffe said Onthank King's nursing license in Alabama was "still in place" (AP/Decatur Daily, 12/9).

"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

New Report Reveals Two-Thirds Of Spinal Fractures Remain Undiagnosed And Untreated

A new report issued by the International Osteoporosis Foundation (IOF) for World Osteoporosis Day puts the spotlight on the severe impact of spinal fractures and calls on health professionals to recognize the signs of these fractures in their patients.



Often dismissed as simple back pain or arthritis, spinal fractures caused by osteoporosis frequently remain undiagnosed and untreated, leaving individuals at risk of further fractures and long term disability. Untreated, as many as one in five women with a spinal fracture will sustain another within twelve months.



'The Breaking Spine', authored by Professor Harry K. Genant of the University of California and Dr. Mary Bouxsein of Harvard Medical School, reveals the serious impact of these fractures and calls on health professionals to take action to diagnose patients and refer them for treatment. "Doctors must look out for evidence of spinal fractures, especially in their patients over 50 - stooped back, loss of height, and sudden, severe back pain are the three tell-tale signs, says Professor Genant. "It is essential that doctors refer these patients for further testing and that radiology reports clearly identify spinal fractures as 'FRACTURED' to avoid ambiguity." Currently, only about 40% of older women with spinal fractures visible on X-ray are tested for osteoporosis. The figure is even lower in men (less than 20%).



IOF President, Professor John A. Kanis states, "These fractures must not be ignored. Their repercussions can be severe, resulting in stooped back, acute and chronic back pain, loss of height, immobility, depression, increased number of bed days, reduced pulmonary function and even premature death." In Canada, individuals aged 50 or older who have suffered spinal fractures have a one in six chance of dying within 5 years.



Globally, spinal fractures represent a huge socio-economic burden. It is estimated that one spinal fracture occurs every 22 seconds worldwide. Studies have shown that as many as 20-25% of Caucasian women and men over 50 years of age have a current spinal fracture. Costs associated with all osteoporotic fractures are predicted to rise markedly over the next few decades as the population ages.



"At least 2 million Canadians have osteoporosis and as many as 65% of spinal fractures go undetected - their devastating consequences are clear, and it's critical to pay attention to identifying them and preventing them, " says Dr. Famida Jiwa, Acting President & CEO, Osteoporosis Canada.



The report was issued on the occasion of the North American launch of IOF's World Osteoporosis Day campaign, in cooperation with Osteoporosis Canada. Marked on October 20th, World Osteoporosis Day 2010 focuses on spinal bone health and calls for the prevention of osteoporotic fractures, including spinal fractures, as a key public health goal.



Source:

L. Misteli


International Osteoporosis Foundation

Sen. Kennedy, Rep. Waxman Write HHS Secretary Leavitt Asking For Documents Related To Former Surgeon General Carmona's Tenure

Sen. Edward Kennedy (D-Mass.) and Rep. Henry Waxman (D-Calif.) on Wednesday sent letters to HHS Secretary Mike Leavitt asking for documents related to former Surgeon General Richard Carmona's four-year tenure, Reuters reports (Dunham, Reuters, 7/11).

Carmona, a former professor of surgery and public health at the University of Arizona, was nominated by President Bush to serve as surgeon general from 2002 to 2006. Carmona on Tuesday in a hearing with the House Committee on Oversight and Government Reform said the Bush administration routinely blocked him from speaking out or issuing reports on human embryonic stem cell research, abstinence-only sex education, emergency contraception and other sensitive public health issues while he was serving in the position.

He also said the administration often edited his speeches for politically controversial content and encouraged him to attend internal political meetings. Carmona did not disclose the names of the administration officials who pressured him to support a political agenda over a scientific one. However, he said the officials included assistant HHS secretaries and top political appointees outside the department (Kaiser Daily Women's Health Policy Report, 7/11).

Waxman, chair of the House government reform committee, asked for documents related to Carmona's tenure by July 25, and Kennedy, chair of the Senate Health, Education, Labor and Pensions Committee, asked for documents by July 27 (Reuters, 7/11).


Kennedy's letter and Waxman's letter are available online. Note: You will need Adobe Acrobat to view Waxman's letter.

Editorials
Several newspapers published editorials in reaction to Carmona's comments. Summaries appear below.


New York Times: Carmona's testimony "sounds so ham-handedly partisan that it would be laughable if it weren't so damaging to the public's understanding of important public health issues," a Times editorial says. House and Senate oversight committees "must look for ways to protect" the surgeon general from "future political interference," the Times writes, adding that Congress could give the surgeon general's office its own staff and budget and could "ban any effort to censor or delay the surgeon general's reports and speeches" (New York Times, 7/12).














Philadelphia Inquirer: "What happened to Carmona was a sickening politicization of an appointed post that should be a source of unassailable credibility on public health issues," and it "fits a pattern in the Bush White House of willfully ignoring science when the research clashes with political goals," an Inquirer editorial says. The editorial concludes that Congress should take actions to ensure the surgeon general is "on call for the public, not for a political party" (Philadelphia Inquirer, 7/12).

USA Today: Although it does not "speak well of Carmona that he accepted the muzzling" of the Bush administration, his "forthrightness" is "at least timely" because of confirmation hearings scheduled for his nominated successor, James Holsinger. The editorial concludes that despite difficulties in "bucking" a president's policy, "independent leaders" are needed to protect the public's health (USA Today, 7/12).

Wall Street Journal: Officials of any administration are "expected" to "support the policies of an elected president," and if Carmona "really thinks that the surgeon general should be above politics, 'naive' is not the first adjective that comes to mind," a Journal editorial says. If Carmona "disagreed so profoundly" with Bush's policies, he could have resigned or spoke "up anyway and face[d] the consequences," the editorial says, concluding that either option would have been "more honorable" than his "late hit on the president who appointed him" (Wall Street Journal, 7/12).

"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.

Antiabortion-Rights Advocates 'Keep Hammering Away' At Rights, Opinion Piece Says

Republican-led state legislatures in six states "want to deny women insurance coverage for abortions, even those willing to pay for a special rider with their own dollars," despite the national health reform law's (PL 111-148) ban on federal funding for abortion services, Business Week columnist Ann Woolner writes. "You would think abortion is illegal, or that everyone in the country holds the same religious view on when life begins," Woolner writes, adding, "But for those who oppose abortion rights, there is always another way to make it as difficult and as expensive as possible to exercise them."

State lawmakers are using a provision in the reform law to introduce bills that would "prevent all insurance plans in yet-to-be-formed exchanges from offering any kind of abortion coverage," as well as to prohibit women who "pay extra, with their own money, to buy abortion coverage," Woolner writes. Four states "already forbid most private insurance plans from offering abortion coverage except when the woman's life is in danger," and a fifth state "allows coverage in cases of rape and incest, too," she continues, noting that "customers can pay extra for insurance riders" in those states, but "[w]hether anyone actually buys the riders is a very good question."

"Regardless of who pays for what coverage, access to abortion is already shrinking," as states "keep enacting more and more barriers," Woolner says. "My point is that antiabortion forces have become so powerful that by the time the Supreme Court decides to reconsider Roe v. Wade, there won't be many abortion rights to strike down or protect," she continues. "Until they can win an outright ban, the antiabortion-rights people keep hammering away at access," Woolner writes, concluding, "They know that a right isn't much good if people can't actually use it" (Woolner, Business Week, 4/8).


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.


© 2010 The Advisory Board Company. All rights reserved.

Kansas AG Kline's Request For Late-Term Abortion Records "Key Issue" In State Attorney General Race

Kansas Attorney General Phill Kline's (R) request for the medical records of 90 women and girls who in 2003 underwent late-term abortions at two clinics and the lack of resulting prosecutions have become "key issue[s]" in the November election, the AP/Kansas City Star reports (Hanna, AP/Kansas City Star, 9/28). Kline in 2004 subpoenaed the records from the two clinics -- Comprehensive Health, which is operated by Planned Parenthood of Kansas and Mid-Missouri in Overland Park, Kan., and Women's Health Care Services in Wichita, Kan. -- because he believes there is probable cause that each record contains evidence of a felony. The original subpoena asked that the records include each patient's name, medical history, birth control practices, psychological profile and sexual history and asked for the records of all women and girls who sought abortions at or after 22 weeks' gestation. The clinics in March 2005 filed a brief with the state Supreme Court requesting that the court block Kline's subpoena. The Kansas Supreme Court in February ruled that Kline can seek access to the records but that he must return to Shawnee County, Kan., District Court and present his reasons for seeking the subpoenas and any information not related to potential violations of state laws on late-term abortions or child abuse must be eliminated from the records (Kaiser Daily Women's Health Policy Report, 8/31). According to attorneys for the two clinics, Kline has not received the requested medical records.

Comments
Kline on Thursday said, "There are prosecutions resulting from information that has been obtained" from the medical records, adding that cases have been referred to six Kansas counties and to prosecutors in Illinois, Missouri and New York. Pedro Irigonegaray, an attorney representing one of the clinics, said, "I am disturbed that Mr. Kline continues to make suggestions and allegations about record he has never seen. ... I find it abhorrent that anyone would consider using those records for their political benefit." According to the AP/Star, Kline on Thursday said that a recently filed case in Marshall County, Kan., is an example of a prosecution that resulted from his investigation of the medical records. Kline would not say how he obtained the documents, the AP/Star reports. Mark Simpson, campaign manager for Johnson County District Attorney Paul Morrison (D), who is running against Kline for state attorney general, said, "Phill Kline knows that these cases have nothing to do with the inquisition into the private medical records of 90 Kansans," adding, "It is disingenuous to try to distract Kansans from his serious invasion of privacy by referring to unrelated cases." Morrison has said that Kline's request to obtain the records was an invasion of medical privacy and that he would drop the order if elected (AP/Kansas City Star, 9/28).

"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.

Blogs Comment On Health Reform Repeal Attempts, Crisis Pregnancy Centers, Other Topics

The following summarizes selected women's health-related blog entries.

~ "None of Your Business: Bus Driver Refuses To Bring Women to Planned Parenthood," Micole Allekotte, National Women's Law Center's "Womenstake": Allekotte, a health fellow at NWLC, writes that a Texas bus driver is suing a transportation company that allegedly fired him because he refused to drive women to a Planned Parenthood affiliate. The driver "claims that the employer must accommodate his religious beliefs against abortion by allowing him to refuse to do his job," Allekotte states. She continues, "The driver's prejudice against Planned Parenthood and the women who go there is especially egregious because Planned Parenthood performs many services in addition to abortion, including routine gynecological exams, cancer and [sexually transmitted infection] screenings, family planning counseling, birth control distribution, and men's sexual health screenings." Ultimately, "[i]t is none of a bus driver's business where his passengers are going or why," Allekotte writes, adding, "We should all promote the principle that each person is entitled to make his or her own medical decisions free of imposed impediments from those who disagree" (Allekotte, "Womenstake," National Women's Law Center, 8/6).

~ "Republicans Plan To Exploit Abortion Issue To Defund Health Law," Igor Volsky, Think Progress' "Wonk Room": Conservative critics of the federal health reform law (PL 111-148) "are now focusing on defunding some of the most unpopular provisions" of the legislation through the appropriations process, Volsky writes, adding that a recent American Spectator article by Philip Klein shows that "the idea is picking up some serious traction." According to Volsky, Republicans might attempt to add abortion-related language to the defunding amendments to "peel off the votes of several old members of the so-called Stupak coalition" -- antiabortion-rights Democrats who opposed related provisions of the law until the last minute. Klein wrote that this tactic "would provoke a fight in which pro-choice Democrats would once again have to choose between" the reform law and limiting private coverage of abortion services. Volsky continues, "Depending on how the midterm elections turn out, some of these strategies may, in fact, prove successful," he cautions that if Republicans do attempt this strategy "it's far from certain that they'll succeed." He notes that Gail Wilensky, a CMS administrator under President George H.W. Bush, said recently that "it has been very difficult historically to do this type of a starving unless you have a very large majority behind you" (Volsky, "Wonk Room," Think Progress, 8/9).














~ "Little Women: Early Puberty and What It Means for Girls," Melanie Abrahams, International Women's Health Coalition's "Akimbo": "In recent years, the transition from girlhood to womanhood has seemed to come faster" and placed "the sexual maturity of young girls in the spotlight," Abrahams writes. A new study showing that U.S. girls are reaching puberty at younger ages "complicates the issue," she continues. While "there's been a lot of brouhaha over naming the culprit of early physical maturation of girls," Abrahams argues that "instead of pointing fingers, we need to face the facts and focus on the changing need of girls in our lives and around the world." She writes that the urgency of providing "early, age appropriate and comprehensive sexuality education" is "far greater when a girl is already menstruating and could be at risk for early pregnancy, or is having to negotiate sexual pressures." In addition, "early puberty illuminates the crucial need to fight child marriage on a global scale," she argues, noting that in some countries, puberty is considered the benchmark for when girls are ready for intercourse. "People might not like the idea that little girls are, physically speaking, growing up faster -- but that doesn't mean we can afford to simply stick our heads in the ground or focus only on how to stop early maturation," Abrahams states, concluding, "Puberty is scary and confusing at any age -- and as girls face it earlier and earlier, it's our responsibility to offer them any help we can" (Abrahams, "Akimbo," International Women's Health Coalition, 8/9).

~ "Unmasking Fake Clinics: The California Edition of '12th and Delaware,'" Alexa Cole, RH Reality Check: The premiere of the HBO documentary "12th and Delaware" "gave vivid examples of threats [crisis pregnancy centers] pose to women's freedom and privacy," Cole writes. Although the documentary was filmed in Florida, Cole writes that a NARAL Pro-Choice California Foundation investigation into CPCs "demonstrate[s] that the pro-choice state of California is under attack from the 'fake clinic' arm of the anti-choice movement." According to Cole, 91% of California counties have at least one CPC, while only 59% of counties have an abortion provider. "What's happening in Florida, as seen in '12th and Delaware,' is not only happening here in California but all over the country," she continues. The investigation "highlights that though California has long been considered the top state for respecting women's reproductive privacy, it is not immune to the threats that are being documented around the country" (Cole, RH Reality Check, 8/10).



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.


© 2010 National Partnership for Women & Families. All rights reserved.

Women's Health Policy Report Highlights Studies From Recent Breast Cancer Conference

The following summarizes findings reported last week at the San Antonio Breast Cancer Symposium.

~ Anthracyclines: New research suggests that anthracyclines -- a class of chemotherapy drugs commonly used to treat breast cancer -- could cause more harm than benefits for breast cancer patients because they can be damaging to the heart, the Wall Street Journal reports. Researchers from the Breast Cancer International Research Group studied the effects of two courses of breast cancer treatment: anthracyclines taken in conjunction with Herceptin -- which is used to treat women who have HER-2-positive cancer -- and Herceptin taken with non-anthracycline drugs. A third control group was treated with just anthracyclines, such as doxorubicin and epirubicin. At the symposium, researchers presented data from the five years of the 10-year study showing that women in both Herceptin groups were more likely to remain alive after five years than women in the control group. There was no significant difference in mortality between the two Herceptin groups, but the study did detect significantly higher levels of heart damage, including congestive heart failure, for women in the Herceptin plus anthracycline group. That group also experienced higher leukemia rates, a secondary consequence of the chemotherapy treatment. According to the Journal, the results "renewed a debate over whether ... anthracyclines, which have been around since the 1960s, should remain the standard of care in treating breast cancer, or whether newer drugs should be used more frequently" (Wang, Wall Street Journal, 12/14).

~ Bone drugs: Women who take oral bisphosphonates to prevent bone loss developed about one-third fewer breast cancers than other women, according to two new observational studies, the New York Times reports. The research comes from a retrospective analysis of data from the Women's Health Initiative and a separate Israeli observational study of several thousand postmenopausal women. The WHI, a federal study, included 151,592 postmenopausal women who were followed for an average of 7.8 years, with 2,216 of the women taking oral bisphosphonates at the start of the study. There were 3.29 cancers per 1,000 women taking the bone-loss drugs over the course of one year, compared with 4.38 cancers per 1,000 women not taking the medications. The analysis found that there were 32% fewer new breast cancers among users of the bone-loss drugs after researchers adjusted for various risk factors among women from both groups, according to the Times. The Israeli study included 4,575 postmenopausal women and found that women who used the drugs for more than one year had a 29% relative reduction in risk for breast cancer. The study also found that breast cancer tumors developing among the bone-loss drug users were more likely to be estrogen receptor-positive, the Times reports (Rabin, New York Times, 12/11). Although the results "provide the best evidence to date" of the drugs' efficacy at reducing breast cancer risk, it is still too early for women to use the drugs for the purpose of preventing cancer, according to Gad Rennert, the lead investigator of the Israeli study and director of the National Israeli Cancer Control Center (Wang, Wall Street Journal, 12/11).














~ Tykerb: In a second trial involving Herceptin, researchers found that women who were treated with a combination of Herceptin and a second treatment, Tykerb, lived nearly five months longer than women treated with Tykerb alone, the AP/Philadelphia Inquirer reports. The study targeted women with very advanced breast cancer for whom other treatments are no longer effective. Doctors said they hope benefits of the combined treatments will be more pronounced for women with less-advanced breast cancer. Herceptin and Tykerb are both designed to treat HER-2-positive breast cancer, albeit in different ways (Marchione, AP/Philadelphia Inquirer, 12/11). The findings could help lessen doctors' reliance on chemotherapy in favor of more targeted treatments, according to lead researcher Kimberly Blackwell of Duke University (Wang, "Health Blog," Wall Street Journal, 12/11).


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.

View drug information on Herceptin; Tykerb.

Vaginal Bacteria Vary Among Healthy Women

Silence may impact women's health since few women or their doctors are comfortable talking about vaginal health openly. This hesitation, combined with a limited understanding of the differences between women, can lead to misinformation, misdiagnosis and potentially ineffective treatments. Research at the University of Idaho is helping to increase understanding about normal vaginal biology so that physicians can better identify conditions that make women prone to infections and other diseases, and avoid the development of health problems.


"Women suffer from insidious health problems, including bacterial vaginosis and yeast infections, and those problems send them in droves to seek medical treatment," said Larry Forney, a professor of biology at the University of Idaho. "Unfortunately, prescribed treatments aren't necessarily effective because doctors don't understand distinctive differences in the microbial composition of the vagina among women."


Forney's interdisciplinary team of researchers found that the microbial ecosystem of the human vagina varies greatly among women. Those differences can lead to conditions that, if not diagnosed and treated correctly, may leave some women susceptible to a range of infections, including sexually transmitted diseases such as HIV.


His research team compared the type of vaginal bacteria in a representative group of Caucasian and black women in North America. Three major findings emerged from the study: there are at least eight kinds of normal vaginal bacterial communities, each community is different, and, among the eight kinds of communities, some bacterial communities are unique to one or the other racial group.


"Understanding the differences between these normal vaginal communities is the key to developing effective treatment and keeping women healthy," Forney said. "For example, with this new insight into the vaginal ecosystem, we will be able to better understand a woman's risk to disease and individual health care needs, and assist doctors and women to make more informed decisions about health issues and treatment plans."


"It's important for us to understand that the bacterial landscape in vaginas is different in different women and that's normal," Forney said. "Every speck of the human body has bacteria and those bacteria, including bacteria in the vagina, play a role in maintaining the body's health."


A healthy vagina is populated with lactic acid-producing bacteria, explained Forney. The environment maintains a low pH balance that inhibits the growth of pathogens. "The vagina is elegant in its simplicity," he said. "A healthy vagina maintains itself and is able to self-correct when minor imbalances occur."


When conditions in the vagina change the pH balance dramatically, harmful bacteria can invade and cause infections. When the pH is imbalanced, a condition known as bacterial vaginosis can develop; the condition is not well understood and is marked by several indicators including elevated pH levels and vaginal discharge. If left untreated or if treatment fails, the condition can predispose a woman to harm from sexually transmitted disease, including HIV.















Forney stressed the importance of the research team's findings because they may:



-- shed light on why some women have recurrent vaginal yeast infections, while others have never had one;


-- partly explain differences in susceptibility to infection in the two racial groups, based upon the relative frequency of different kinds of bacterial communities in women.


Forney also said differences in the kinds of bacteria normally present in the vagina might mean that vaginal odor is normal for some women and not an indication of an underlying health problem.


The research has personal meaning for Forney as well. "I am vitally concerned about women's health issues because I've got two daughters and I know that these issues will affect them."


Forney's team includes Xia Zhou, Celeste Brown and James Foster, from the department of biological sciences, University of Idaho; and Zaid Abdo and Paul Joyce, from the departments of mathematics and statistics department, University of Idaho.


About the University of Idaho


Founded in 1889, the University of Idaho is the state's flagship higher-education institution and its principal graduate education and research university, bringing insight and innovation to the state, the nation and the world. University researchers attract nearly $100 million in research grants and contracts each year; the University of Idaho is the only institution in the state to earn the prestigious Carnegie Foundation ranking for high research activity. The university's student population includes first-generation college students and ethnically diverse scholars. Its high academic performers include 42 National Merit Scholars and a 2006-07 freshman class with an average high school grade point average of 3.42. Offering more than 150 degree options in 10 colleges, the university combines the strengths of a large university with the intimacy of small learning communities. For information, visit uidaho.edu.


University of Idaho

PO Box 443221

Moscow, ID 83843

United States

uidaho.edu

Link Discovered Between Trans Fats, Increased Endometriosis Risk And Omega-3-Rich Food

Women whose diets are rich in foods containing Omega-3 oils might be less likely to develop endometriosis, while those whose diets are heavily laden with trans fats might be more likely to develop the debilitating condition, new research suggests.



The study - which is the largest to have investigated the link between diet and endometriosis risk and the first prospective study to identify a modifiable risk factor for the condition - found that while the total amount of fat in the diet did not matter, the type of fat did. Women who ate the highest amount of long-chain Omega-3 fatty acids were 22% less likely to be diagnosed with endometriosis than those who ate the least and that those who ate the most trans fats had a 48% increased risk, compared with those who ate the least.



The findings from 70,709 American nurses followed for 12 years, published online in Europe's leading reproductive medicine journal Human Reproduction [1], not only suggest that diet may be important in the development of endometriosis, but they also provide more evidence that a low fat diet is not necessarily the healthiest and further bolster the case for eliminating trans fats from the food supply, said the study's leader, Dr. Stacey Missmer, an assistant professor of obstetrics, gynaecology and reproductive biology at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, USA.



"Millions of women worldwide suffer from endometriosis. Many women have been searching for something they can actually do for themselves, or their daughters, to reduce the risk of developing the disease, and these findings suggest that dietary changes may be something they can do. The results need to be confirmed by further research, but this study gives us a strong indication that we're on the right track in identifying food rich in Omega-3 oils as protective for endometriosis and trans fats as detrimental," Dr. Missmer added.



Endometriosis occurs when pieces of the womb lining, or endometrium, is found outside the womb. This tissue behaves in the same way as it does in the womb - growing during the menstrual cycle in response to oestrogen in anticipation of an egg being fertilized and shedding as blood when there's no pregnancy. However, when it grows outside the womb, it is trapped and cannot leave the body as menstruation. Some women experience no symptoms, but for many it is very incapacitating, causing severe pain. The tissue can also stick to other organs, sometimes leading to infertility. It afflicts about 10% of women. The cause is poorly understood and there is no cure. Symptoms are traditionally treated with pain medication, hormone drugs or surgery.



In the study, the researchers collected information from 1989 to 2001 on 70,709 women enrolled in the U.S. Nurses Health Study cohort. They used three food-frequency questionnaires spaced at four-year intervals to record the women's usual dietary habits over the preceding year. They categorized consumption of the various types of dietary fat into five levels and related that information to later confirmed diagnoses of endometriosis. A total of 1,199 women were diagnosed with the disease by the end of the study. The results were adjusted to eliminate any influence on the findings from factors such as total calorie intake, body mass index, number of children borne and race.
















Long-chain Omega-3 fatty acids are found mostly in oily fish. They have been linked to reduced heart disease risk. In the study, the highest contributor was mayonnaise and full-fat salad dressing, followed by fatty fish such as tuna, salmon and mackerel.



Trans fats are artificially produced through hydrogenation, which turns liquid vegetable oil into solid fat. Used in thousands of processed foods, from snacks to ready-meals, they have already been linked to increased heart disease risk. Some countries and municipalities have banned them. The major sources of trans fats in this study were fried restaurant foods, margarine and crackers.



"Women tend to go to the Internet in particular to look for something they can do. The majority of the dietary recommendations they find there are the ones prescribed for heart health, but until now, those had not been evaluated specifically for endometriosis," Dr. Missmer said. "This gives them information that is more tailored and provides evidence for another disease where it is the type of fat in the diet, rather than the total amount, that is important."



Besides confirming the finding, a next step could be to investigate whether dietary intervention that reduces trans fats and increases Omega-3 oils can alleviate symptoms in women who already have endometriosis, Dr. Missmer added.



Notes:

The U.S. National Institutes of Health funded the study.



[1] A prospective study of dietary fat consumption and endometriosis risk. Human Reproduction journal. doi:10.1093/humrep/deq044



Source:

Emma Ross

European Society of Human Reproduction and Embryology

Blogs Comment On Health Care Reform, Protests To Afghan 'Rape Law,' Obama Nominees, Other Topics

The following summarizes selected women's health-related blog entries.

~ "What's At Stake for Women in Health Care Reform," Marcia Greenberger, Huffington Post blogs: All women in the U.S. "should have a guarantee of high quality, affordable" health care coverage, Greenberger, co-president of the National Women's Law Center, writes. "Health care reform that results in accessible care for women means making sure that everyone has access to affordable coverage and health care, and ending unfair insurance practices," she writes. "To meet the needs of women, health care reform must result in coverage that is affordable -- meaning that it must include income-based subsidies for health care premiums and all out-of-pocket expenses; elimination of annual or lifetime caps on services and prescriptions; and a strengthened and expanded Medicaid program," Greenberger continues, adding that reform must also "provide comprehensive health and prescription drug benefits with coverage for a full range of health services, including wellness, prevention and reproductive health services." Greenberger concludes that "millions of Americans simply can't afford to wait for meaningful reform that will bring a guarantee of quality, affordable comprehensive health care for us all" (Greenberger, Huffington Post blogs, 4/16).

~"Three Cheers for Afghan Women," Nicholas Kristof, New York Times' "On the Ground": Kristof writes that he is "awed by the courage of those 300 Afghan women who endured stones, jeers and threats" in the country's capital, Kabul, to protest a new law that applies only to Shiites and "obliges women to sleep with their husbands on demand." Kristof adds that he "can't imagine the guts it would take to be a [minority] woman walking with a banner demanding equal rights through an enraged mob of stone-throwing, spitting fundamentalists." Although Kristof writes that he is "enormously impressed by the courage of these women," he adds that he "do[es] worry about a backlash," as Afghans are "very nationalistic" and the protesters "were denounced as pawns of Christians and foreigners." He concludes that Afghanistan "can't develop economically and achieve stability so long as girls are kept home and women are mostly barred from the work force" (Kristof, "On the Ground," New York Times, 4/15).

~ "Don't Give the Right Wing a Win on Obama's Nominees," Nancy Keenan, Huffington Post blogs: "The blogosphere is abuzz with stories of GOP obstructionism of some of President Obama's nominees to crucial posts," Keenan writes, adding, "Random and ridiculous reasons have been given for various nominees," particularly judicial nominee David Hamilton; assistant attorney general for the Office of Legal Council nominee Dawn Johnsen; and HHS secretary nominee Kansas Gov. Kathleen Sebelius (D). Keenan continues that antiabortion-rights advocates are "attacking" these three nominees "simply because they've taken pro-choice positions," adding that the antiabortion-rights advocates are "engag[ing] in an all out effort to use anti-choice rhetoric and the threat of a filibuster." She writes, "If they succeed, they will be emboldened to shred the credibility of future nominees simply to appease their right-wing base." Keenan asks, "[C]ould it be that anti-choice activists are opposing someone solely based on pro-choice positions?" She concludes, "The right wing has made these nominees their test case on how to derail President Obama's efforts to put qualified persons in key posts," adding that groups like NARAL Pro-Choice America aim to "make sure they fail this test" (Keenan, Huffington Post blogs, 4/16).














~ "Zero Tolerance for Maternal Mortality," Abdelhadi Eltahir, RH Reality Check: "Maternal and newborn care is one of the biggest challenges in international health," and it is "unacceptable -- and in many ways shameful -- for the international health and development community" to allow preventable illnesses to cause maternal deaths, Eltahir -- senior maternal and newborn care adviser at Pathfinder International -- writes in a blog entry. According to Eltahir, the "availability of emergency blood is not commonly practiced in the developing world -- and sub-Saharan Africa in particular -- due to cultural, physical and/or resource barriers." He continues, "But with the right systems and training, many of these barriers are addressed and emergency blood made available." Eltahir writes that it is "imperative that we rededicate ourselves to ending maternal mortality." He notes that "ensuring maternal and newborn survival" calls for "broad ranging and innovative approaches," including increasing access to family planning, "managing emergency obstetric care and involving communities in identifying and addressing their own community health needs." He writes that along with more attention and funding directed toward "quality health services," increased pressure on leaders is needed "to highlight this as a major issue going forward." He concludes, "I look forward to a new time of zero tolerance and more women being saved through such simple, yet vital, acts as accessible blood" (Eltahir, RH Reality Check, 4/16).

~ "Teens and Sex Education at the Doctor's Office," Deborah Kotz, U.S. News & World Report's On Women: Some parents whose children receive abstinence-only sex education at schools are beginning to "rely on a gynecologist to answer the kinds of questions about sex that their daughters may not feel comfortable asking or that they themselves may not know the answers to," Kotz writes, citing a recent Houston Chronicle article about Texas parents who are using gynecologists to help educate their teenage daughters. Kotz writes that "[u]sing a trusted gynecologist, preferably one who specializes in adolescent medicine, as a resource for health information is probably a wise choice, given the other sex-education options teens are turning to." She continues that teens' friends "can be a wealth of misinformation," as can many Web sites. Kotz discusses the findings of a study from Lucile Packard Children's Hospital that found that many popular sexual health Web sites for teens include information "often fraught with errors and omissions," including insufficient or inaccurate information about purchasing emergency contraception, side effects from birth control pills, safety of intrauterine devices and when to begin Pap smears (Kotz, U .S. News & World Report's On Women, 4/15).

~ "Rape Law in Afghanistan Goes Down," Taylor Marsh, Huffington Post blogs: "The Shiite feminists in Afghanistan won this one for themselves" when they "took to the streets" and "stood up amidst a mob of men ... to stand up for their rights," Marsh, political analyst and commentator, writes in a blog entry about reports on CNN that Afghan President Hamid Karzai plans to change a recent law that critics say legalizes rape within Shiite marriages. According to Marsh, the law spurred an "outcry raucous from across the globe," including a statement from President Obama that legalized rape is "abhorrent" and similar concerns from Secretary of State Hillary Rodham Clinton. However, Marsh writes, "nothing could have made a bigger difference than the women standing up for themselves, 300 to 500, taking to the streets protesting their life as property." She continues that the women's protests, "manifested in President Karzai changing the law, makes their actions the stuff of heroes" (Marsh, Huffington Post blogs, 4/16).


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.

Ortho Biotech Announces NDA Submission For Trabectedin For The Treatment Of Relapsed Ovarian Cancer

Ortho Biotech Products, L.P. announced the submission of a new drug application (NDA) to the U.S. Food and Drug Administration (FDA) for trabectedin when administered in combination with DOXIL(R) (doxorubicin HCI liposome injection)for the treatment of women with relapsed ovarian cancer (ROC). If approved, trabectedin combined with DOXIL will provide a new, non-platinum treatment option for these patients in the United States.


The application follows the completion of a multicenter, randomized Phase III study, ET743-OVA-301, one of the largest studies conducted in ROC, comparing the combination of trabectedin and DOXIL to DOXIL alone in 672 patients. The study showed that patients treated with the combination treatment had a statistically significant improvement in the primary endpoint of progression-free survival (PFS, or the length of time during and after treatment in which the disease does not progress) compared to patients treated with DOXIL alone.


"This is a significant milestone in the development of trabectedin, an agent with a novel mechanism of action that holds promise for patients with relapsed ovarian cancer," said Craig Tendler, M.D., Vice President, Medical Affairs, Oncology/ Nephrology, Ortho Biotech Products, L.P. "We are confident in the strength of the data supporting the application and look forward to working with the FDA throughout the regulatory review process."


Relapsed ovarian cancer refers to epithelial carcinoma of the ovary that recurs after treatment. According to the National Cancer Institute (NCI), it is estimated that 21,650 women will be diagnosed with, and 15,520 women will die from ovarian cancer in the U.S. in 2008.


Trabectedin is being developed under a license from PharmaMar, and DOXIL is marketed by Ortho Biotech Products, L.P. in the U.S.


About the ET743-OVA-301 Study


Patients were enrolled at 124 centers in 21 countries. Per the study protocol, the data were evaluated by a blinded, independent radiology review and a blinded, independent oncology review. The trabectedin/DOXIL combination demonstrated a statistically significant improvement in PFS compared to DOXIL alone (median PFS 7.3 versus 5.8 months, respectively) and a statistically significant reduction of 21% in the risk of progression or death during the observation period in the independent review of patients with radiologically measurable disease (HR=0.79, 95% CI (0.65;0.96), p=0.0190). This result is consistent with the results of the independent oncology review that takes into account clinical as well as imaging data in the assessment of progression. In this review, there was a 28% risk reduction for disease progression or death with the trabectedin/DOXIL combination (HR=0.72, 95% CI (0.60; 0.88), p=0.0008).















Secondary endpoints included response rate, overall survival, and safety. A statistically significant increase in response rate was seen with the trabectedin and DOXIL combination (28%) compared to DOXIL alone (19%), as measured by the independent radiology review. A final protocol-specified survival analysis is planned after the occurrence of 520 events. The safety profile in the study was consistent with previous experience with trabectedin and DOXIL.


The most common adverse reactions (greater than or equal to 20%) for the trabectedin/DOXIL combination compared to DOXIL alone, respectively, were:



-- Hematological reactions including neutropenia (77% versus 38%, with febrile neutropenia occurring in 8% of the cases and sepsis in 1% of the cases), leucopenia (48% versus 26%), anemia (48% versus 25%) and thrombocytopenia (36% versus 8%);



-- Gastrointestinal reactions including nausea (74% versus 42%), vomiting (56% versus 30%) and diarrhea (26% versus 19%);



-- Liver enzyme (transaminase) elevations were more common in the combination arm, but were generally reversible and not associated with evidence of chronic liver damage or other clinical consequences. These included increased alanine aminotransferase (55% versus 9%) and increased aspartate aminotransferase (40% versus 10%); and



-- Fatigue (46% versus 36%).


Additionally, commonly associated DOXIL adverse events, such as hand-foot syndrome (HFS) and stomatitis, occurred in fewer patients receiving the combination compared to DOXIL alone (24% versus 54% and 20% versus 33%, respectively).


About Trabectedin


Trabectedin is a novel cytotoxic antitumor agent that was originally derived from the Caribbean tunicate, Ecteinascidia turbinate ("sea squirt"). The compound is now produced synthetically. Trabectedin binds to the minor groove of DNA, interfering with cell division and genetic transcription processes and DNA repair machinery. Trabectedin is currently in Phase III development in ovarian cancer and to expand its uses in sarcoma.


According to the licensing agreement, PharmaMar has rights to market the compound in Europe and Japan, while Ortho Biotech Products, L.P. has marketing rights for the product in the rest of the world.


About Ortho Biotech Products, L.P.


Ortho Biotech Products, L.P. is a leading biopharmaceutical company devoted to helping improve the lives of patients with cancer and with anemia due to multiple causes, including chronic kidney disease. Since it was founded in 1990, Ortho Biotech and its worldwide affiliates have earned a global reputation for researching, manufacturing and marketing innovative products that enhance patients' health. Located in Bridgewater, N.J., Ortho Biotech is an established market leader in anemia management. The company also markets treatments for recurrent ovarian cancer, rejection of transplanted organs and other serious illnesses. For more information, visit orthobiotech.


Ortho Biotech Products, L.P. is a member of the Johnson & Johnson Family of Companies.


Forward-Looking Statement


This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or unknown risks or uncertainties materialize, actual results could vary materially from the Company's expectations and projections. Risks and uncertainties include general industry conditions and competition; economic conditions, such as interest rate and currency exchange rate fluctuations; technological advances and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approvals; domestic and foreign health care reforms and governmental laws and regulations; and trends toward health care cost containment. A further list and description of these risks, uncertainties and other factors can be found in Exhibit 99 of the Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended December 30, 2007. Copies of this Form 10-K, as well as subsequent filings, are available online at sec, jnj or on request from Johnson & Johnson. The Company does not undertake to update any forward-looking statements as a result of new information or future events or developments.


Ortho Biotech Products, L.P.

orthobiotech



View drug information on Doxil.

Women Over 50 Live In Fear Of Violence, Study Finds

Forget fearing old age, it seems as women grow older those on lower incomes are more likely to fear the threat of violence, a Queensland University of Technology nationwide study has found.



The Australian Active Ageing (Triple A) Study has shown women need and want to protect themselves against violence as they get older.



QUT Associate Professor Jan Lovie-Kitchin, from the Faculty of Health, said the study looked at older women's perceptions of vulnerability and their expressed need to learn to protect themselves against violence.



"It is clear that as women grow into the older years, they experience increased feelings of vulnerability," Professor Lovie-Kitchin said. "They need information and want opportunities to learn about ways to protect themselves against violence."



Professor Lovie-Kitchin said being able to live free of fear and with the confidence to participate in social life beyond the home was an important part of improving the quality of life for older women.



"Fear of violence needs to be recognised as a barrier to older people's social connectedness and the health and wellbeing of older women specifically."



Professor Lovie-Kitchin said women on lower incomes reported feeling vulnerable when managing their money, accessing transport, and ensuring their homes were safe and secure.



"Older women might experience feelings of exposure to danger because of their smaller size and lesser strength," she said. "But they could also feel vulnerable because of their limited finances and lack of knowledge which might force them to depend on people they don't necessarily trust.



She said some ideas to alleviate women's perceptions of risk and fears of violence included providing education and information about money management, access to safe transport, and assistance with home security and safety."



"There also needs to be recognition of the influence of media in generating feelings of exposure to danger due to age," she said.



"Sensationalised crimes in the media are often the only form of contact with the outside environment for many older and isolated people, and can heighten their sense of defencelessness.



"While the media may negatively impact on older women's perceptions of violence, it also has the capacity to educate and inform about protective measures for older women."






The Triple A Study, which is being undertaken in collaboration with the National Seniors, involved 2620 adults aged 50 years and over, and looked at how different elements of a person's life contribute to active ageing.



Contact: Sandra Hutchinson


Queensland University of Technology

Microbicide Films For HIV Prevention To Be Developed By Pitt

With the support of an $11.8 million, five-year federal grant, researchers at the University of Pittsburgh and their collaborators are developing a quick-dissolving vaginal film containing a powerful drug that reduces the risk of HIV infection, and they plan to begin testing it locally within a year.



A small film, like those used to deliver breath fresheners, could have several advantages over vaginal microbicide gels that are already being tested overseas, said Sharon Hillier, Ph.D., professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, senior investigator at Magee-Womens Research Institute (MWRI), and co-principal investigator of the new project, which is funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.



"Multiple films could be packaged in discrete cartridges without the need for refrigeration, making them portable and easier to store and distribute, and therefore probably cheaper than a gel," she noted. "And, because they aren't likely to be as messy as a gel, women might be willing to use them routinely, perhaps on a daily basis."



Led by co-principal investigator Lisa Cencia Rohan, Ph.D., associate professor, University of Pittsburgh School of Pharmacy, and MWRI associate investigator, the researchers will first develop a film version of the anti-retroviral drug tenofovir and establish the necessary processes to make it on a large scale for human use. Tenofovir in its pill form is used as an HIV treatment, and South African researchers recently showed that a gel formulation of the drug cut the risk of HIV infection by more than half among women who were most conscientious about applying it before and after intercourse; the gel reduced the infection risk by 39 percent among women who were less vigilant.



The film would provide an alternative dosage form that preclinical testing suggests can release the drug faster and more efficiently than the gel version.



"An effective microbicide strategy should include different forms of the product," Dr. Rohan said. "Women will have preferences, and having options to meet those needs will lead to greater use and therefore better protection from infection."



In addition to tenofovir, the researchers will develop and test a second film containing another anti-HIV agent that has yet to be determined.



Project collaborators include Bernard J. Moncla, Ph.D., and Charlene Dezzutti, Ph.D., both of Pitt and MWRI; researchers from the University of Washington; the New York State Institute for Basic Research; Johns Hopkins University; and CONRAD.



Source:

Anita Srikameswaran

University of Pittsburgh Schools of the Health Sciences