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