Early Menarche, Menopause Tied to Higher CVD Risk


Several reproductive factors contributed to a higher risk of cardiovascular disease among women, including early periods and early menopause, researchers found.

A history of hysterectomy was also linked with increased risk of cardiovascular disease (CVD) and coronary heart disease, reported Sanne AE Peters, PhD, and Mark Woodward, PhD, both of the University of Oxford in England.

However, history of oophorectomy, as well as age at first birth, had either no associations or only minor inverse associations with increased risk for cardiovascular disease, the authors wrote in Heart.

They pointed to “increasing evidence” that in addition to traditional risk factors such as elevated blood pressure, smoking, and obesity, certain reproductive factorsmay be linked with later cardiovascular disease, though the evidence is “mixed and inconsistent.”

This cross-sectional analysis of UK Biobank data comprised 267,440 women and 215,088 men ages 40 to 69 without a history of cardiovascular disease. The authors found that during 7 years of follow-up, there were 9,054 cases of cardiovascular disease, 5,782 cases of coronary heart disease, and 3,489 cases of stroke. Women comprised about a third of cardiovascular disease cases, a little under 30% of coronary heart disease cases, and about 40% of stroke cases.

Examining demographic data for women, the mean age was 56, about half were from a higher socioeconomic bracket in the U.K., and 60% said they never smoked.

Results were mixed for certain reproductive factors and increased risk for cardiovascular disease. The mean age for menarche was 13 years, and women who had their first periods prior to age 12 had a higher risk of cardiovascular disease (adjusted HR 1.10, 95% CI 1.01-1.30) than women who had menarche at a later age. Similar increased risks were seen for coronary heart disease (adjusted HR 1.05, 95% CI 0.93-1.18) and stroke (adjusted HR 1.17, 95% CI 1.03-1.32).

 Sixty-one percent of women in the study were postmenopausal, with a mean age at natural menopause of 50 years. But early menopause was also linked with increased risk of cardiovascular disease (adjusted HR 1.33, 95% CI 1.19-1.49), coronary heart disease (adjusted HR 1.29, 95% CI 1.10-1.51), and stroke (adjusted HR 1.42, 95% CI 1.21-1.66).

Likewise, history of hysterectomy was linked with an increased risk of cardiovascular disease (adjusted HR 1.12, 95% CI 1.03-1.22) and coronary heart disease (adjusted HR 1.20, 95% CI 1.07-1.34).

Eighty-five percent of women had been pregnant, and 44% of women had two children, while 42% of men had fathered two children. Compared with women and men without children, there was a significantly higher risk of coronary heart disease in women (adjusted HR 1.21, 95% CI 1.05-1.40). But because these risks were similar among men (adjusted HR 1.13, 95% CI 1.04-1.23), the authors concluded that “this is unlikely to be due to a biological cause.”

The authors suggested that, “More frequent cardiovascular screening would seem to be sensible among women who are early in their reproductive cycle, or who have a history of adverse reproductive events or a hysterectomy, as this might help to delay or prevent their onset of CVD.”

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Early Menarche, Menopause Tied to Higher CVD Risk


More frequent heart screening for women may be useful

Several reproductive factors contributed to a higher risk of cardiovascular disease among women, including early periods and early menopause, researchers found.

A history of hysterectomy was also linked with increased risk of cardiovascular disease (CVD) and coronary heart disease, reported Sanne AE Peters, PhD, and Mark Woodward, PhD, both of the University of Oxford in England.

However, history of oophorectomy, as well as age at first birth, had either no associations or only minor inverse associations with increased risk for cardiovascular disease, the authors wrote in Heart.

They pointed to “increasing evidence” that in addition to traditional risk factors such as elevated blood pressure, smoking, and obesity, certain reproductive factorsmay be linked with later cardiovascular disease, though the evidence is “mixed and inconsistent.”

This cross-sectional analysis of UK Biobank data comprised 267,440 women and 215,088 men ages 40 to 69 without a history of cardiovascular disease. The authors found that during 7 years of follow-up, there were 9,054 cases of cardiovascular disease, 5,782 cases of coronary heart disease, and 3,489 cases of stroke. Women comprised about a third of cardiovascular disease cases, a little under 30% of coronary heart disease cases, and about 40% of stroke cases.

Examining demographic data for women, the mean age was 56, about half were from a higher socioeconomic bracket in the U.K., and 60% said they never smoked.

Results were mixed for certain reproductive factors and increased risk for cardiovascular disease. The mean age for menarche was 13 years, and women who had their first periods prior to age 12 had a higher risk of cardiovascular disease (adjusted HR 1.10, 95% CI 1.01-1.30) than women who had menarche at a later age. Similar increased risks were seen for coronary heart disease (adjusted HR 1.05, 95% CI 0.93-1.18) and stroke (adjusted HR 1.17, 95% CI 1.03-1.32).

Sixty-one percent of women in the study were postmenopausal, with a mean age at natural menopause of 50 years. But early menopause was also linked with increased risk of cardiovascular disease (adjusted HR 1.33, 95% CI 1.19-1.49), coronary heart disease (adjusted HR 1.29, 95% CI 1.10-1.51), and stroke (adjusted HR 1.42, 95% CI 1.21-1.66).

Likewise, history of hysterectomy was linked with an increased risk of cardiovascular disease (adjusted HR 1.12, 95% CI 1.03-1.22) and coronary heart disease (adjusted HR 1.20, 95% CI 1.07-1.34).

Eighty-five percent of women had been pregnant, and 44% of women had two children, while 42% of men had fathered two children. Compared with women and men without children, there was a significantly higher risk of coronary heart disease in women (adjusted HR 1.21, 95% CI 1.05-1.40). But because these risks were similar among men (adjusted HR 1.13, 95% CI 1.04-1.23), the authors concluded that “this is unlikely to be due to a biological cause.”

The authors suggested that, “More frequent cardiovascular screening would seem to be sensible among women who are early in their reproductive cycle, or who have a history of adverse reproductive events or a hysterectomy, as this might help to delay or prevent their onset of CVD.”

8 Reasons It Burns When You Pee


Time to end the misery.
graphic of a roll of toilet paper with fire emojis

Burning pee is the worst. Only a few things should be happening when you pee, and almost bursting into tears isn’t one of them. Ridding your body of waste via your urine? Sure. Wondering why all people with vaginas don’t get the luxury of peeing standing up, thus avoiding any toilet seat germs (as harmless as they may be)? Why not. But if you’re preoccupied while peeing because it feels like hellfire is raining down from your urethra, you’ve got a problem. Luckily, ob/gyns have solutions. Here, the eight most common causes of burning, painful urination, plus how to treat them.

1. You have a urinary tract infection.

This is the biggest culprit behind painful peeing, Sarah Yamaguchi, M.D., ob/gyn at Good Samaritan Hospital in Los Angeles, tells SELF. A UTI happens when bacteria, often E. coli, gets into your urethra. The result: unpleasant symptoms like a persistent urge to hit up the bathroom and burning during urination. “If you’re having burning, particularly at the end of the urinary stream, it might be a sign of a urinary tract infection,” Alyssa Dweck, M.D., a gynecologist in Westchester, New York, and assistant clinical professor of obstetrics and gynecology at Mount Sinai School of Medicine, tells SELF.

If you do, in fact, have a UTI, a doctor can prescribe a round of antibiotics to kick the infection (and pain) to the curb. And if UTIs regularly besiege your poor body, make sure to take preventive measures, like staying hydrated, wiping from front to back, and peeing after you have sex.

2. You have a yeast infection.

An uncomfortable burning sensation while you pee is also a common symptom of yeast infections, which happen due to an overgrowth of yeast in the vagina, Dr. Yamaguchi explains. They’re often accompanied by another telltale symptom: “With a yeast infection, you’ll usually have thicker discharge,” one that basically looks like white cottage cheese, she explains. Antifungal medications can clear up the infection, some of which are OTC, and some of which are prescribed (but it’s smart to see a doctor just in case before grabbing an OTC medication, especially since some sexually transmitted diseases seem like regular ol’ vaginal infections).To avoid recurrent yeast infections, Dr. Yamaguchi recommends maintaining good hygiene, wearing cotton underwear for breathability (or at least underwear that has a cotton crotch), and changing ASAP after you work out instead of lounging around in your sweaty gear.

3. You have bacterial vaginosis.

Oh, bacterial vaginosis, you evil, foul-smelling wench. Yup, this infection, which arises when the “good” and “bad” bacteria in your vagina get thrown out of whack via sex, products you use, and the like, can lead to fish-scented discharge in addition to painful pee, Dr. Dweck says. Once your doctor determines that you have this infection, they’ll prescribe antibiotics for you to take either orally or vaginally.

4. You have a sexually transmitted disease.

Plenty of STDs can cause painful pee as just one of their annoying symptoms (when symptoms show up, that is—in many cases, STDs exhibit no symptoms at all). Herpes, an extremely common viral infection known for causing sores on the mouth and genitals, is one possibility, Dr. Yamaguchi says.

Chlamydia, a bacterial infection especially prevalent in women under 25, and gonorrhea, another bacterial infection that shows up a lot in that age range, are other common causes, Dr. Dweck says. Both chlamydia and gonorrhea can also lead to abnormal discharge, like some that’s yellow or green, so be on the lookout for that as well.

And trichomoniasis, the most common curable STD, can also present with terrible-smelling discharge and pain while peeing.

5. You have some sex-related vaginal tears.

The sharp, sudden pain of burning while peeing might come with a surge of panic that something is really, really wrong, but that’s not always true. “Little abrasions from sex can cause some burning while peeing and irritation,” Dr. Yamaguchi says. To cut back on that yikes-inducing feeling, she recommends pouring warm water over your vaginal area when you’re peeing. “The temperature will help interfere with the nerve pathways,” she says. And to avoid the issue altogether, she suggests making sure you’re plenty lubed up whenever your vagina’s getting some attention. Here’s everything to know before you buy some lube for sex.

6. Or some non-sex-related vaginal tears.

Many women experience burning pee after they give birth. Since all the tissue down below stretches in an impressive way to make room for the baby, vaginal and perineal tears can occur. This is why many new moms, including Chrissy Teigen, rely on perineal irrigation bottles, aka devices that make it even easier to squirt warm water on yourself to dull the pain.

7. You’re using unnecessary feminine hygiene products.

“We’ve been led to believe that the vaginal area is super dirty, and we should be cleaning with deodorizers and perfumes—that’s not the case,” Dr. Dweck says. “The vagina has a good self-cleaning protocol, if you will, to keep its pH in balance and keep things in order.” But when you use products like douches or feminine hygiene washes, you might wind up with irritation that leads to urinary burning. If your skin is super sensitive, this can even happen from fragrant bubble baths, Dr. Dweck explains.

Really, you don’t need anything beyond a gentle, fragrance-free soap and some water to wash your vulva, and you don’t even need to wash your actual vagina. Let it clean itself in peace, please!

8. You’re dealing with post-menopause atrophic vaginitis.

Hormonal changes during menopause can result in a phenomenon known as atrophic vaginitis, or vaginal atrophy, Dr. Yamaguchi says. The skin of the vulva and vagina thin out, which can lead to some burning and irritation during sex, urination, and while just going about your daily life. If you’re dealing with this, chat with your doctor to determine whether hormonal supplementation may help your symptoms, and if not, how to find relief.

Later-onset menarche, menopause associated with longevity


Women with later-onset menarche, later natural or surgical menopause and a longer reproductive lifespan are more likely to live to age 90 years vs. women with early-onset menarche, early menopause or a shorter reproductive lifespan, according to findings published in Menopause. “Our findings suggest that women who began menstruating at age 12 or older, women experiencing menopause at age 50 or older, and women with more than 40 reproductive years (defined as the difference between age at first menstruation and age at menopause) were more likely to live to age 90,”Aladdin H. Shadyab, PhD, MS, MPH, CPH, postdoctoral fellow in rheumatology and aging at University of California, San Diego School of Medicine, told Endocrine Today. “Future studies are needed to examine how lifestyle, genetics and environmental factors explain the link between reproductive lifespan and longevity.”

Aladdin Shadyab

Aladdin H. Shadyab

In a prospective study, Shadyab and colleagues analyzed data from 16,251 postmenopausal women with complete information on ages of menarche and menopause participating in theWomen’s Health Initiative, followed between 1993 and 2014 (mean age at baseline, 75 years). Researchers classified women in the cohort as having survived or died before age 90 years, and used logistic regression models to evaluate the associations between ages at menarche and menopause (natural or surgical) and reproductive lifespan with longevity after adjustment for demographic, lifestyle and reproductive factors. Within the cohort, 8,892 (55%) survived to age 90 years; average age at menarche was 12.8 years; average age at menopause was 49 years; women had a mean 36.1 reproductive years, which correlated with age at menopause (r = 0.98; P < .001). Average age of death in the cohort was 83.7 years. Researchers found that age of menarche modestly increased for longevity (adjusted OR = 1.09; 95% CI, 1-1.19). Compared with women reaching natural or surgical menopause at age 40 years, there was a linear trend toward increased longevity for later age at natural or surgical menopause (P for trend = .01), with adjusted ORs of 1.19 for those reaching menopause from age 50 to 54 years (95% CI, 1.04-1.36) and 1.18 for women reaching menopause at age 55 years or older (95% CI, 1.02-1.36). When separating out natural menopause, it remained associated with increased longevity (P for trend = .02), as did a longer reproductive lifespan (P for trend = .008). When compared with women who had a 33-year reproductive lifespan, women with a reproductive lifespan of at least 40 years were more likely to reach age 90 years (OR = 1.12; 95% CI, 1.02-1.24), followed by women with a reproductive lifespan of 38 to 40 years (OR = 1.17; 95% CI, 1.06-1.29) and those with a reproductive lifespan of 33 to 37 years (OR = 1.09; 95% CI, 0.99-1.2). Shadyab noted that women with later-onset menarche were less likely to have coronary heart disease, and those who experienced menopause at a later age were more likely to be healthy overall, which may help explain the findings. – byRegina Schaffer

Early or Late Menopause Ups Risk for Type 2 Diabetes


Women who had their final menstrual period before age 45 or after 55 have a higher risk of developing type 2 diabetes (hazard ratio [HR], 1.04 and HR, 1.08, respectively, compared with those who had their final period between ages 46 and 55), new study results indicate.

The findings were published online July 27 in Menopause.

Erin S LeBlanc, MD, MPH, with Kaiser Permanente Center for Health Research, Portland, Oregon, and colleagues examined 124,379 women in the Women’s Health Initiative (WHI), a multicenter study launched in 1991 by the National Institutes of Health that looked at preventing disease in postmenopausal women.

Dr LeBlanc and colleagues also found that in related age-adjusted models, women with the shortest reproductive periods (less than 30 years) had a 37% greater risk of developing type 2 diabetes than those with reproductive periods of 36 to 40 years. Likewise, women with the longest reproductive span (more than 45 years) had a 23% higher risk than women with medium-length reproductive years.

Dr LeBlanc told Medscape Medical News the study suggests that lifetime estrogen exposure may play a role in whether a woman develops type 2 diabetes or not and that there may be a “sweet spot” where optimal estrogen exposure meets lowest risk for type 2 diabetes.

The research team had hypothesized that because endogenous estrogen has been known to have protective effects against developing diabetes, cardiovascular disease, and osteoporosis, those with shorter reproductive years would have less protection from diabetes.

Estrogen helps to preserve insulin secretion and stabilize glucose levels. Low estrogen negatively affects body-fat distribution and fat accumulation, important factors in type 2 diabetes risk.
The surprise was that the data showed those with the longest reproductive years also had a higher risk for type 2 diabetes. “I don’t have a good biological explanation for that,” Dr LeBlanc said.

Results Can Help Target Lifestyle Changes

Of course, there’s little women can do about age of menopause, given its strong genetic component, but those in the higher-risk groups can consider lifestyle changes, and clinicians, armed with this new information, can better counsel patients in the higher-risk groups.

“I don’t want women thinking this is something terrible and they’re doomed to get diabetes” if they are in the higher-risk groups, Dr LeBlanc said.

“The point of our study is to give women who have early menopause or late menopause another motivator for adopting a healthy lifestyle, because we know that a healthy lifestyle can substantially reduce a woman’s risk of developing diabetes.”

For clinicians, this is another factor to add to the conversation on why it’s important to maintain a healthy weight, eat a balanced and nutritious diet, and increase exercise levels, she noted.

The authors add that previous work on this topic has had small sample sizes and lacked rigorous, prospective ascertainment of type 2 diabetes.

Strengths of this study include its large size, ability to more clearly characterize participants’ reproductive history, long follow-up, and prospective ascertainment of diabetes.

Other Factors Not Linked to Risk

The researchers examined several other factors, including number of previous pregnancies, age at first birth, whether menopause was surgical or natural, body mass index, and hormone therapy after menopause. But none of these factors had a statistically significant link to risk of developing type 2 diabetes.

Age at which periods started and irregular periods were also not statistically significant in risk for diabetes.

Study limitations included that women were asked to recall their age at start of menstruation, which could have resulted in measurement error. And because medically diagnosed diabetes was not available for all WHI women, the researchers relied on participants’ reports of diabetes.

“[H]owever, self-reports of ‘treated diabetes’ in WHI have been shown to be sufficiently accurate to allow use in epidemiologic studies such as this one,” they write.

The findings by Dr LeBlanc, et al, are aligned with those of a previous European study (Diabetes Care. 2013;36:1012-1019).

“In that nested, prospective case-cohort study of more than 8000 postmenopausal women followed for 11 years, there was a 6% increased risk of type 2 diabetes per standard deviation of lower reproductive lifespan in years,” the authors write.

But it still remains unknown how endogenous estrogen affects type 2 diabetes risk. Exploring that could lead to answers on how a woman could decrease diabetes risk as she ages, Dr LeBlanc and colleagues observe.

Further research could also test whether targeting women in these identified higher-risk groups could bring down the incidence of diabetes, Dr LeBlanc concluded.

Angelina Jolie Talks About Her Menopause . There Is A Reason Why Every Woman Should Read It!


Jolie

 

Angelina Jolie and Brad Pitt’s love story has always given us some major relationship goals. Jolie’s health has time and again gone for a toss, but Brad Pitt has always proved to be one of her biggest strengths! It was in 2013 that as a preventive measure against cancer, Angelina Jolie had to get her ovaries and fallopian tubes removed after undergoing a preventive mastectomy. Due to this, Jolie is experiencing a premature onset of menopause.

While many women in their mid-life crisis dread menopause, Jolie is enjoying this phase. Yes, ‘enjoying’! Angelina confessed that she actually loves being in menopause and that she is very fortunate that she hasn’t had a terrible reaction to it. She further says that she feels older and settled in being older. Angelina further asserts that she is happy that she has grown up and that she doesn’t wants to be young again.

After her surgery in 2013, she had described her stint with surgeries in March saying, “I actually love being in menopause. I will not be able to have any more children, and I expect some physical changes. But, I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared.”

Angelina Jolie

HarpersBazaar

However, Jolie got candid about her biological changes as she went on to say, “I haven’t had a terrible reaction to it, so I’m very fortunate. I feel older, and I feel settled being older.”Mother of six kids, Jolie is taking ‘aging’ as sportingly as she could and she revealed:  “I feel happy that I’ve grown up. I don’t want to be young again.” Jolie also revealed how grateful he is of her husband, Brad Pitt, who was there by her side every step of the way! “

Brad Pitt too added, “It was mature. It was just another one of those things in life that makes you tighter, and she was doing it for the kids, and she was doing it for her family so we could be together.” 

Angelina’s mastectomy… and other medical stories of 2013


With a baby cured of HIV and breakthroughs in dementia, it’s been a year where two of the great scourges of our time have been put on the back foot.

Meanwhile a vision of the future of medicine has emerged, with scientists growing miniature organs -including brains – and performing the first steps of human cloning.

BBC health and science reporter James Gallagher reviews the year in medical science.

HIV baby cure

HIV virus

One of the most remarkable stories of the year was a baby girl in the US seemingly being “cured” of HIV.

Her mother had an uncontrolled HIV infection and doctors suspected the baby would be infected too, so they decided to give antiretroviral drugs at birth.

Normally the drugs hold the virus in check, but the very early treatment seems to have prevented HIV taking hold.

The baby is now three, has been off drugs for more than a year and has no sign of infection.

However, as this analysis explains, a cure for HIV is still a distant prospect. Yet there have been other developments – two patients have been taken off their HIV drugs after bone-marrow transplants seemed to clear the virus.

HIV was once thought to be impossible to cure; now there is real optimism in the field.

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Post-menopausal pregnancy

Dr Kazuhiro Kawamura
Dr Kazuhiro Kawamura of the St Marianna University medical school holding the newborn

Going through an early-menopause used to be seen as the end of a woman’s reproductive life.

But this year a baby was born after doctors, in the US and Japan, developed a technique to “reawaken” the ovaries of women who had a very early menopause.

They removed a woman’s ovaries, activated them in the laboratory and re-implanted fragments of ovarian tissue.

Any eggs produced were then taken and used during normal IVF.

Fertility experts described the findings as a “potential game-changer”.

However, things will not change for women going through the menopause at a normal age as poor egg quality will still be a major obstacle.

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Angelina and Andy

Angelina Jolie and Andrew Marr

The cult of celebrity catapulted two diseases into the public eye this year – breast cancer and strokes.

Hollywood actress Angelina Jolie had a double mastectomy after her doctors said she had an 87% chance of developing breast cancer during her lifetime.

She has a mutation in her DNA, called BRCA1, which greatly increases the odds of both breast and ovarian cancer.

In a newspaper article she said: “I feel empowered that I made a strong choice that in no way diminishes my femininity…for any woman reading this, I hope it helps you to know you have options.”

BBC presenter Andrew Marr had a stroke after an intensive rowing machine session and a year of “heavily overworking”.

It put a spotlight on the standard of care for stroke patients and raised the question why do healthy people have strokes?

He says he’s “lucky to be alive” and is back presenting, although the stroke has affected “the whole left hand side of my body”.

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Lab-grown mini organs

Cross-section of miniature human brains termed cerebral organoids

This purple and green image is of a very special human brain which was grown from skin cells entirely in a laboratory.

The pea-sized “cerebral organoid” is similar to the brain of a nine-week-old foetus.

It has distinct brain regions such as the cerebral cortex, the retina, and an early hippocampus, which would be heavily involved in memory in a fully developed adult brain.

Scientists hope the organoids, which are not capable of thought, will transform the understanding of the development of the brain and neurological disorders.

And it’s not just brains. Japanese researchers said they were “gobsmacked” at making tiny functioning livers in the same way.

They think transplanting thousands of these liver buds could help to reverse liver failure.

On a larger scale, researchers have made full-sized kidneys for rats which were able to make urine.

Their vision is to take a donor kidney and strip it of all its old cells to leave a honeycomb-like scaffold, which would then be used to build a new kidney out of a patient’s own cells.

Expect more from the “grow-your-own organs” field in the coming years.

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Dementia on the back foot

Brain
Loss of tissue in a demented brain compared with a healthy one

Understanding the billions of neurons which make up the human brain, one of the most complex structures in the universe, is one of the greatest challenges in medical science.

This year marked a major breakthrough in defeating neurodegenerative diseases such as Alzheimer’s.

A team of UK Medical Research Council scientists used a chemical to stop the death of brain cells, in a living brain, that would have otherwise died due to a neurodegenerative disease.

This is a first and a significant discovery. One prominent scientist said this moment would “be judged by history as a turning point in the search for medicines to control and prevent Alzheimer’s disease”.

Dementia has also become a major global priority in 2013 amid fears it is rapidly becoming the health and social care problem of a generation.

The G8 group of nations have pledge to fund research aimed at curing the disease by 2025.

It is just one aspect of a flood of money entering brain research.

President Obama has dedicated millions of dollars for mapping the connections in the brain and in Europe the billion pound Human Brain Project to simulate the organ using computers is now under way.

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Human cloning

Row of babies

Human cloning was used to produce early embryos which a group of US scientists described as a “significant step” for medicine.

It has been a long struggle to reach this stage, the same technique was used to produce Dolly the sheep way back in 1996.

No-one is considering attempting to let a cloned embryo develop.

Instead the cloned embryos were used as a source of stem cells, which can make new heart muscle, bone, brain tissue or any other type of cell in the body.

However, it is an ethically charged field of research and there have been calls for a ban.

Meanwhile, the first trial of stem cells produced from a patient’s own body has been approved by the Japanese government.

Scientists will use the cells to attempt to treat a form of blindness – age-related macular degeneration.

And a new era of regenerative medicine could be opened up by transforming tissue inside a living animal back to an embryonic state.

It’s an inherently dangerous thing to do; the tissues became cancerous in the experiments, but if it was controlled then it could be used to heal the body.

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A new role for sleep and body clock resets

Brain in a head

Scientists have found a new explanation for why we sleep – for a spot of housework.

As well as being involved in fixing memories and learning, it seems the brain uses sleep to wash away the waste toxins built up during a hard day’s thinking.

They think failing to clear some toxic proteins may play a role in brain disorders such as Alzheimer’s diseases.

Meanwhile, a separate group of researchers think it may be possible to slow the decline in memory and learning as we age by tackling poor sleep.

And there is no doubt about the impact a poor night’s sleep has on the whole body. The activity of hundreds of genes was altered when people’s sleep was cut to less than six hours a day for a week.

Of course you could blame the moon after a “lunar influence” on sleeping patterns was discovered. It showed that the extra light from a full moon makes it harder to sleep.

There may be good news on the horizon for shift workers and jet setters who will be intimately familiar with the pains of having a body clock out of sync with the world around them.

A team at Kyoto University has found the body clock’s “reset button” inside the brain.

They tested a drug which let the body clock rapidly adjust to new timezones, instead of taking days. It brings the prospect of drugs to avoid jet lag much closer.

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Deadly infections new and old

Coronavirus

Two new viruses have attracted global attention and concern this year.

A new bird flu, H7N9, emerged in China infecting more than 130 people and causing 45 deaths.

However, most were confined to the beginning of the year when the virus first emerged. Closing live poultry markets in affected areas has largely cut the spread of the virus.

And Saudi Arabia is at the centre of an outbreak of Middle East respiratory syndrome coronavirus. The animal source of the virus has not yet been confirmed, although camels are a likely culprit.

Meanwhile, polio has returned to war-torn Syria for the first time in 14 years.

And in the UK, an outbreak of measles infected 1,200 people – as a result of a drop in vaccination during the completely unfounded MMR-autism scare a decade earlier. The World Health Organization warned Europe risked failing to meet its pledge to eliminate measles by 2015.

Odds, ends and an impotent James Bond

The mobile app in action: Scanning the back of the eye

There were many interesting one-off stories this year too – some serious, some not…

A modified smartphone is being tested in Kenya to see if it can prevent blindness in some of the poorest parts of the world.

Doctors warned that antibiotics were running out and could lead to an “antibiotic apocalypse”.

Scientists claimed a milestone moment for cancer after finding 21 major mutations behind that accounted for 97% of the most common cancers.

There was a shift in understanding psychiatric disorders when it was shown autism, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all shared several genetic risk factors.

A surgical knife which can sniff out tumours was developed to improve cancer surgery.

The iKnife

New teeth have been grown out of the most unlikely of sources, human urine.

A treatment to banish bald spots is a step closer after human hair was grown in the laboratory, however, there are still engineering challenges to get the hairs the same shape, size and as long as before.

Another thing to blame your parents and grandparents for…behaviour can be affected by events in previous generations which have been passed on through a form of genetic memory.

A wheelchair was controlled with a pierced tongue.

The UK’s first hand transplant took place in Leeds while in China a severed hand was kept alive on an ankle.

Brain scans showed babies could decipher speech as early as three months before birth.

Lullabies may help sick children by reducing pain and improving their wellbeing.

And finally… James Bond’s sexual prowess was seriously questioned with doctors describing him as an “impotent drunk”.

James Bond
Doctors say James Bond, played here by actor Daniel Craig, has a drink problem

Anesthetic reduced frequency of menopausal hot flashes by half.


Menopausal women treated with a stellate ganglion blockade showed a 50% reduction in moderate-to-severe hot flashes, according to preliminary data presented at Anesthesiology 2013.

Bupivacaine is currently indicated for local or regional anesthesia or analgesia.

“This is the first effective, non-hormonal treatment for hot flashes, which for many women have a serious negative effect on their lives. This treatment will also help breast cancer patients who suffer from hot flashes as a side effect of their treatments of medication. Some breast cancer patients stop taking their medication (tamoxifen) because of hot flashes,”David R. Walega, MD, chief of the division of pain medicine and program director of the multidisciplinary pain medicine fellowship department of anesthesiology at Northwestern University Feinberg School of Medicine, said in a press release.

Researchers randomly assigned 40 menopausal women aged 30 to 65 years with more than 25 vasomotor symptoms per week to an injection of 0.5% bupivacaine 5 mL or sterile saline.

There was a 19% reduction in hot flashes 4 to 6 months after the injection in the bupivacaine group, according to researchers.

Analyses revealed hot flashes decreased 34% from baseline to 6 months among patients in the bupivacaine group vs. placebo. Further, reductions in moderate-to-severe hot flashes were significantly greater among the bupivacaine group vs. the placebo group (RR=0.5; 95% CI, 0.34-0.73), according to data.

“This is a fast, relatively painless, long-lasting and cost-effective treatment for hot flashes,” Walega said. “It has tremendous potential to help not only menopausal women, but also breast cancer patients and women in surgical menopause (whose ovaries have been removed), who have had to put up with ineffective treatments or simply ‘grin and bear it.’”

Source: Endocrine Today.

The Taller the Woman, the Greater the Cancer Risk?


Taller postmenopausal women face higher risks for 10 types of cancer, according to a study in Cancer Epidemiology, Biomarkers and Prevention.

Researchers examined the association between height and cancer risk among some 145,000 Women’s Health Initiative participants. During roughly 12 years of follow-up, 14% received diagnoses of invasive cancer.

After multivariable adjustment, the risk for all cancers increased significantly, by 13%, with each 10-cm (4-inch) increase in height. In particular, risks for the following types of cancer were increased: breast, colon, colorectal, endometrial, melanoma, multiple melanoma, ovarian, rectal, renal, and thyroid. Additional adjustment for cancer screening did not alter the results.

The researchers say height should be considered “a marker for one or more exposures that influence cancer risk rather than a risk factor itself.”

Source:Cancer Epidemiology, Biomarkers & Prevention 

 

Menopausal symptoms more troublesome for cancer survivors.


Recent data suggest that the severity of menopausal symptoms tends to be worse in women who survive cancer compared with other women. However, psychological and social quality of life measures were better among cancer survivors, researchers wrote.

“The reason for this difference in emotional well-being is not known but may be attributable to the better social and psychological support associated with a cancer diagnosis compared with that ofmenopause,” Jennifer L. Marino, MPH, PhD, of the department of obstetrics and gynecology at the University of Melbourne in Australia, and colleagues wrote.

The researchers measured differences in symptoms, severity, impact on quality of life and sexual function between cancer survivors and non-cancer patients at The Menopause Symptoms After Cancer Clinic.

The researchers recorded cancer survivors’ (n=934) and non-cancer patients’ (n=155) menopausal symptoms using the Greene Climacteric Scale; past-week symptoms using the Functional Assessment of Cancer Therapy breast cancer subscale and endocrine symptom

Subscale; and sexual symptoms using Fallowfield’s Sexual Activity Questionnaire.

The majority of patients were previously diagnosed with breast cancer (82%), while a smaller proportion was diagnosed with gynecological cancer (10.5%), or hematologic and colorectal malignancies (7.5%).

According to data, cancer survivors were more likely to be severely affected by vasomotor symptoms such as hot flushes and night sweats (OR=1.71; 95% CI, 1.06-2.74) and reported more frequent (6 vs. 3.1 in 24 hours;P<.001) and more severe (P=.008) hot flushes, compared with non-cancer patients.

 “Seventy-nine percent of cancer survivors and 61% of non-cancer participants reported current severe vasomotor symptoms. Thirty-six percent of cancer survivors and 23% of non-cancer participants scored in excess of the upper bound of the published reference range for vasomotor symptoms,” researchers wrote.

Conversely, cancer survivors demonstrated less psychological and somatic symptoms compared with non-cancer patients (P<.001). Further, they reported better quality of life. However, there were no statistically significant variations in physical or functional well-being, gynecologic symptom severity or sexual function, researchers wrote.

“Both expected and surprising, these results highlight that all menopausal women, including cancer survivors, need effective treatment options for their hot flashes and sexual symptoms,” Margery Gass, MD, executive director of the North American Menopause Society, said in a press release.

PERSPECTIVE

 

JoAnn E. Manson

  • A burgeoning number of women worldwide are both cancer survivors and entering menopause. It is clearly a clinical challenge to treat menopausal symptoms in women with a history of cancer because many are not candidates for estrogen therapy. The study by Marino and colleagues indicates that cancer survivors may have a higher prevalence and severity of vasomotor symptoms than women without a history of cancer. The findings highlight the importance of evaluating cancer survivors for the presence of menopausal symptoms, assessing their needs for treatment and discussing available treatment options. Additional research in this field and an expanded arsenal of nonhormonal treatment options for menopausal symptoms will be essential to improve the clinical care of this growing patient population. In this regard, the recent approval by the FDA of a nonhormonal treatment for vasomotor symptoms is a step in the right direction.
  • JoAnn E. Manson, MD, DrPH, NCMP
  • Past-president of the North American Menopause Society
    Endocrinologist and professor of medicine, Harvard Medical School and Brigham and Women’s Hospital
    Chief of Preventive Medicine, Brigham and Women’s Hospital

 

Source: Endocrine Today

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