Gender gap in stroke treatment likely due to delay by women seeking care

Gender gap in stroke treatment likely due to delay by women seeking care

Women with clot-caused strokes are less likely than men to arrive at the hospital in time to receive the best treatment, according to a European study reported in the American Heart Association journal Stroke.

In the study, 11 percent of women with acute ischemic strokes were treated with the clot-dissolving medication alteplase, compared with 14 percent of men. Study participants included 5,515 patients at 12 hospitals in the Netherlands.

Researchers found no gender gap when they looked only at patients who arrived at the hospital within four hours of the onset of symptoms in this study. Forty-two percent of men and women arriving within the four-hour window received alteplase.

"Our study showed that women in the Netherlands were treated just as often with thrombolytic agents as men once they arrived in time for treatment," said Inger de Ridder, M.D., lead author of the study and AIOS Resident of Neurology at Erasmus University Medical Center in Rotterdam, The Netherlands.

The gender gap in treatment may be due to delays in getting to the hospital, researchers said. Women arrived at the hospital an average 27 minutes later than men, and a smaller percentage of women (27 percent) than men (33 percent) arrived at the hospital within the four-hour window.

Furthermore, women in the study were an average four years older and may consequently have been more likely to live alone, which would make it more difficult to summon help. Stroke severity was similar for men and women.

"More education about stroke symptoms is needed, and also more research to find out why women arrive later at the hospital," de Ridder said.

The findings may also apply to patients in the United States, researchers said.

Stroke symptoms include: drooping or numbness in the face; weakness or numbness in the arms; and speech difficulty. Stroke is the No. 4 cause of death and the leading preventable cause of disability in the United States.

Self-evaluation of menopausal symptoms underestimates true burden, Pitt study finds

Self-evaluation of menopausal symptoms underestimates true burden, Pitt study finds

Physicians should consider a more in-depth evaluation of their menopausal patients' symptoms, as current approaches might not accurately reflect the number of hot flashes and night sweats each woman experiences, a new University of Pittsburgh School of Medicine study finds.

Patients tend to underestimate how often they have hot flashes and night sweats, clinically known as vasomotor symptoms (VMS), particularly if they suffer from anxiety, and overestimate nighttime VMS if they experience sleep disturbances, according to the study published today in the journal Menopause. New studies designed to treat VMS rely on patients reporting their symptoms, so improving their accuracy directly impacts patient care.

"We think physicians may want to consider probing deeper when evaluating their menopausal patients, to determine if anxiety or sleep problems might be influencing the way they perceive their VMS," said Rebecca Thurston, associate professor of psychiatry and epidemiology and director of the Women's Biobehavioral Health Laboratory at the University of Pittsburgh, the study's primary investigator. "Typically we use end-of-the-day and morning diaries to measure VMS, but these may not be the best approaches to testing how well our treatments reduce VMS, particularly if the treatments impact anxiety or sleep."

Dr. Thurston's study evaluated three different types of VMS reporting. Women were asked to either record their symptoms at the end of each day and in the morning upon waking, or to report their symptoms at the time of VMS occurrence. At the same time, their symptoms were monitored via a portable hot flash monitor worn around the waist that continuously measures skin conductance, a validated biological measure of hot flashes.

"We found that when women recorded their symptoms at the end of the day, they tended to underestimate the number of VMS they experienced, particularly if they were anxious. Conversely, when women woke up in the morning and were asked to recall how many VMS they had overnight, they tended to overestimate how many VMS they experienced, particularly if they had poor sleep," said Dr. Thurston. "These disparities are important because accurate measurement of VMS is instrumental to adequately testing treatment options.

Hot-flashes and night sweats are among the most common menopausal symptoms that women discuss with their doctors. Women with these symptoms visit their doctors more frequently than those who don't experience them.

"While very common in menopausal women, hot flashes and night sweats can disrupt a woman's quality of life significantly," added Dr. Thurston. "We are eager to develop new treatments for VMS. Women deserve a range of safe and effective treatment options for their VMS, and we are not there yet. In order to test new treatments, we need to be sure we are assessing a woman's VMS as accurately as possible."

The study is part of the Study of Women's Health Across the Nation (SWAN), a multisite, multiethnic, longitudinal study that aims to characterize biological and psychosocial changes during the menopausal transition. At their 10th annual visit for SWAN, a subset of women (25 African-American women and 27 white women) from the Pittsburgh site were invited to participate in this ancillary study.

These findings reveal:

End of the day and morning diaries may not precisely assess the number of VMS a woman is having;

Mood and sleep may impact the way a woman perceives and reports her VMS, and

Clinicians and researchers should consider assessing sleep and mood to better understand how a woman is experiencing her VMS.

Removing a woman's ovaries during a hysterectomy for noncancerous disease

Removing a woman's ovaries during a hysterectomy for noncancerous disease

While ovary removal during hysterectomy protects against future risk of ovarian cancer, the decision to conserve the ovaries and the hormones they produce may have advantages for preventing heart disease, hip fracture, sexual dysfunction, and cognitive decline. Other than a woman's cancer risk, the most important factor that should determine ovarian conservation vs. removal is her age - whether she is older or younger than 50 - according to a Review article published in Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available on the Journal of Women's Health website.

Catherine Matthews, MD, University of North Carolina, Chapel Hill, emphasizes the difficult choice women must often make in the article "A Critical Evaluation of the Evidence for Ovarian Conservation Versus Removal at the Time of Hysterectomy for Benign Disease."

Conflicting data regarding the potential benefits of removing a woman's healthy ovaries at the time of a hysterectomy have led to confusion. When there is no acute reason to remove a woman's ovaries at the time of hysterectomy and she has no increased genetic risk for ovarian cancer, the accumulated data indicate that elective bilateral ovary removal should be discouraged in women younger than 50 years. The withdrawal of ovarian hormones can have negative health consequences in this population. However, in postmenopausal women, it is advisable to remove the ovaries to protect against ovarian cancer, as the medical literature shows that elective ovary removal is not likely to have an adverse effect on heart disease, hip fracture, sexual dysfunction, or cognitive function at this stage of a woman's life.

"As 600,000 hysterectomies for benign disease are performed annually in the U.S. alone, it is imperative that we have clear guidelines for retaining versus removing normal ovaries," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.

The taller the woman, the higher her cancer risk

The taller the woman, the higher her cancer risk

The ability to reach items on high shelves and easily see through a crowd may no longer have the same appeal for some women. A study recently published in Cancer Epidemiology, Biomarkers & Prevention finds a link between postmenopausal women's height and cancers.

According to the study, the taller a woman's stature is, the higher her risk of cancer at a number of different sites, including breast, colon, endometrium, kidney, ovary, rectum and thyroid. Additionally, taller women have a greater risk of developing multiple myeloma and melanoma.

All of these associations did not change after adjusting for known influencers of these cancers, such as age, weight, education, smoking habits, alcohol intake and hormone therapy. The researchers say that height even had more influence over cancer risk than a common measure of obesity, body mass index (BMI).

Researchers studied 144,701 women aged 50 to 79 who participated in the Women's Health Initiative from 1993 to 1998. After a follow-up 12 years later, in total, 20,928 cancers were identified within the group.

Results showed that for every 10-centimeter increase in height (3.94 inches), there was a 13% increase in likelihood of developing cancer.

Specifically:

An increase in risk of 13-17% for breast, ovary, endometrium and colon cancers, as well as for melanoma, and

An increase in risk of 23-29% for kidney, rectum, thyroid and blood cancers.

There were 19 cancers studied in total, none of which displayed a negative association with height.

Geoffrey Kabat - senior epidemiologist in the department of epidemiology and population health at Albert Einstein College of Medicine, Yeshiva University, New York, NY - says:

"We were surprised at the number of cancer sites that were positively associated with height. In this data set, more cancers are associated with height than were associated with body mass index.

Ultimately, cancer is a result of processes having to do with growth, so it makes sense that hormones or other growth factors that influence height may also influence cancer risk."

Various studies in the past have looked at personal characteristics in relation to cancers. For example, a recent study linked height and BMI to ovarian cancer. An interesting note made by the current researchers is that both height and BMI have been increasing by about 1 cm each decade in high-income countries, potentially increasing the risk for cancer in the process.

Few previous studies have adjusted for other known influencers of cancer when researching the effect of height.

Dr. Geoffrey Kabat makes the obvious point that, unlike other risk factors such as diet and lifestyle, height is not something we can change. He adds, however:

"Although it is not a modifiable risk factor, the association of height with a number of cancer sites suggests that exposures in early life, including nutrition, play a role in influencing a person's risk of cancer."

While the researchers found an association between cancer and height, the medical evidence shows it is a complex disease that cannot be linked purely to one factor.

Written by Marie Ellis

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Adolescent girls who walk to school experience improved cognitive performance when compared to other modes of transport

Adolescent girls who walk to school experience improved cognitive performance when compared to other modes of transport

Cognitive performance of adolescent girls who walk to school is better than that of girls who travel by bus or car. Moreover, cognitive performance is also better in girls who take more than 15 minutes than in those who live closer and have a shorter walk to school.

These are some of the conclusions of a study published in Archives of Pediatrics & Adolescent Medicine. The results come from findings of the nationwide AVENA (Food and Assessment of the NutritionalStatus of Spanish Adolescents) study, in which the University of Granada has participated together with the Autonomous University of Madrid, University of Zaragoza and the Spanish National Research Council in Madrid. They constitute the first international study that associates mode of commuting to school and cognitive performance.

The authors analysed a sample of 1700 boys and girls aged between 13 and 18 years (808 boys and 892 girls) in five Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza).

They studied variables of mode of commuting to school, cognitive performance, anthropometrics - like body mass index and percentage of overweight and obesity - and participants' extracurricular physical activity. They also gathered data on their families' socio-economic status using the mother's level of educational achievement (primary school, secondary school or university) and the type of school (state-funded or private) that participants attended.

Information on mode of commuting to school came from a question asking participants how they usually travelled to school and giving the following response options: on foot, by bicycle, car, bus or subway, motorcycle, and others. They were also asked how long the journey to school took them.

Cognitive performance was measured by applying the Spanish version of an educational ability test. Participants completed this standardized test that measures intelligence and the individual's basic ability for learning. The test assesses command of language, speed in performing mathematical operations, and reasoning.

In adolescence, the plasticity of the brain is greatest. The researchers affirm that, during adolescence, "the plasticity of the brain is greater than at any other time of life, which makes it the opportune period to stimulate cognitive function". However, paradoxically, adolescence is the time of life that sees the greatest decline in physical activity, and this is greater in girls. Therefore, the authors of the study think that "inactive adolescents could be missing out on a very important stimulus to improve their learning and cognitive performance".

"Commuting to school on foot is a healthy daily habit, which contributes to keeping the adolescent active during the rest of the day and encourages them to participate in physical and sports activities. This boosts the expenditure of energy and, all in all, leads to a better state of health", say Palma Chilln, researcher in the Department of Physical and Sports Education of the University of Granada, and David Martnez-Gmez, of the Department of Physical and Sports Education and Human Movement (Faculty of Teacher Training and Education) of the Autonomous University of Madrid, who have both participated in the study.

Breast Enlargement Workouts

The media convinces some women to believe that they should have big breasts to become more attractive and even considering a breast augmentation surgery to achieve this. In fact, there are simple breast massage or breast enlargement work-outs that could promote a bigger bust size and could make the breasts look tighter, firmer and toned.

Breast enlargement can be achieved with pectoral (chest) exercises. Primarily, the breasts of women are composed of fat tissue and rest on top of the pectoral muscles. The pectoral muscle is the chest muscle under the breasts. A larger bust size and more muscle mass can be achieved by exercising and training the pectoral muscles.

Breast enlargement workouts are also a measure in preventing early breast sagging. No matter how your breasts look right now, breast enlargement exercises will help you get in better shape and tone.

Here are some breast enlargement work-outs that are easy to follow and help in achieving tight, firm and toned looking breasts:

Proper posture

- Correcting your posture by straightening neck and keeping spine straight would not only perk up your breasts but can also boost self-confidence.

Floor Push - ups - This is a common exercise that could help in toning up the breasts. The palms should be on the floor and the knees must not touch each other to provide the proper amount of pressure on the pectoral muscles. Repeat the exercise 15 to 20 times every day.

Wall Push - ups

- Raise arms to shoulder level and place your palms on the wall, a little outside of your shoulders and your feet two feet away from the wall. The elbows should be flexed and the back not arched. Go back and forth, inhale as you go near the wall and exhale when you are away from, the wall. Repeat this procedure 15 to 20 times every day.

Chest Dips.

- This requires dip bars (a u-shaped bar fitness equipment that surrounds the waist and are used for dip exercises). Pull the body up by grabbing onto the bars. Incline your body outwards so that your chest gets more attention. Descend to your original position, keeping your chest in the same forward position. Repeat the exercise 20 to 30 times every day.

Use of Dumbbells.

-The need of weights will provide additional resistance that will further build your pectoral muscles. The easiest way to incorporate weights into your workout is by using dumbbells. Your current strength level will determine how much weight you will need. If you are just starting out, use the lightest weight possible (1 to 3 lbs) and increase the amount as you begin to gain strength. To perform the dumbbell chest press, lie on your back and hold the weight in each hand at shoulder width. Slowly raise your arms, extending them into the air above you. Be careful not to fully lock your elbows. Repeat this as many times as you can.

Remember that before starting any work-out regimen it is best to consult your doctor. Wearing a sports bra while exercising is advised to be able to perform the exercises well and help in supporting the breasts properly. Warm -up by stretching before you work-out and drink plenty of fluids when exercising. Consistency is important in achieving this. Do not get discouraged when results do not show after a few weeks. It takes time and effort to have larger, tighter, firmer and toned breasts so don't give up breast massage will help you get firmer breasts and keep them that way.

Stop Chronic Candidiasis Once and For All

Candida albicans are naturally occurring organisms in the human body that are normally harmless if kept in check but if disturbed could cause candidiasis or yeast infections on the mouth, skin, stomach, urinary tract and on the genital area. There are reports that about 75% of women will experience vaginal yeast infection at least once in their lifetime. People with compromised immune system like those who have HIV/AIDS are at high risk of developing candidiasis. Infants are more susceptible to oral candidiasis or oral thrush. Suffering from recurring candida infections can be very uncomfortable and painful so it is important to know how to stop chronic candidiasis to free yourself from pain and discomfort.

Symptoms of candidiasis can make one's life miserable. For oral thrush, eating could be difficult because of the presence of white patches on the throat and painful skin cracks on the corners of the mouth. Blisters and skin rashes commonly occur on skin folds like under the breasts, in between the fingers of the hands and feet. For genital candidiasis, itchiness and genital discharge are the common symptoms. Imagine suffering from these symptoms over and over again if you failed to stop chronic candidiasis.

Overgrowth of Candida is the main cause of candidiasis. The normal amount of Candida is kept in check by good bacteria but once the good bacteria are overpowered by Candida, candidiasis could happen. The bacterial balance can be disturbed by weakened immune system, certain drugs like antibiotics and birth control pills, pregnancy, bacterial infections and health conditions like diabetes.

If you suspect that you have candidiasis, it is best to seek professional help to get the right diagnosis especially if you have recurring infections. There are many cases that people are taking antifungal medications for candidiasis but they actually do not have candidiasis. If you are sure that you have yeast infections or candidiasis, it is time to know the treatment options to stop chronic candidiasis.

Drug therapies. Antifungal medicines are the common treatments for candidiasis. Medicines can be over the counter medications or your doctor can prescribe antifungal medications depending on your symptoms. Medications may range from tablets and oral rinse for oral thrush and antifungal medicines in the form or creams or vaginal suppositories for genital candidiasis. With drug therapies, it is crucial to use or take the right medicine for your condition to stop chronic candidiasis.

Alternative treatments. Aside from drug therapies there are also alternative treatments that can be very helpful to stop chronic candidiasis.

Diet modification to stop the growth of Candida. Sugar feeds Candida so you have to cut down on sweets. It is also important to avoid foods that contain yeast like bread, cheese and beer.

Maintain or stay at the proper weight. A person is healthier if not overweight or underweight. A healthy body has high resistance to viruses and infections.

Avoid irritants that could aggravate yeast infections like perfumed soap, scented toilet paper. For women, avoid douching and vaginal deodorant must be avoided unless prescribed by your doctor.

Live organisms lactobacillus acidophilus found in plain yogurt helps restore the normal balance of bacteria in the body and prevents build-up of Candida.

If you are taking antibiotics, talk to your doctor. Antibiotics could kill the friendly bacteria that keeps Candida in its normal level. Your doctor may recommend alternatives to antibiotics if you are suffering from chronic yeast infection.

Herbs have medicinal properties and could be very helpful in treating diseases and strengthening the body's resistance to infections. Garlic is one herbal treatment that could help stop chronic candidiasis with its antifungal properties. Of course you have to take caution in eating garlic if you have other health conditions because garlic could increase your risk of bleeding if you are taking blood thinning medications. Ask your health provider before talking any herbal treatment.

It is a challenge to fight Candidiasis but with conscious effort and the right treatment, yeast infections can be beaten. To know more about yeast infections alternative treatments visit Quick Relief for Yeast Infection.

Cellulite Removal After Pregnancy

Although recently pregnant women may be thrilled at being a new mother, they may also be less than thrilled with their body following pregnancy. The truth is that pregnancy can be very hard on the body. In addition to hormonal changes, swollen and tender breasts, and abdominal stretch marks, hardened fat (known as cellulite) may also gather on the hips, buttocks, and thighs. Fortunately, professional, medical-grade treatments can reduce, and in some cases eliminate, the appearance of stubborn cellulite. The American College of Plastic Surgeons estimates that in 2011, more than 37,000 women underwent treatment for cellulite.

What Is Cellulite?

Cellulite develops when displaced fat becomes trapped above the fibrous bands of connective tissue in the dermal layer of the skin. The connective tissue is designed to evenly distribute fat below the skin. This cellulite reduces blood flow to the area and causes the distinctive rippled, lumpy look to the skin that is sometimes called "cottage cheese" because of its appearance. Cellulite is most commonly deposited on the thighs, hips, and buttocks.

Interestingly, cellulite is less common in men. Furthermore, the appearance of cellulite may have nothing whatsoever to do with obesity. Thinner women may also develop cellulite. Age, diet, hormones, smoking, and genetics can all play a role in the development of cellulite.

How Can Cellulite Be Removed from the Body?

There are three basic treatment methods to remove cellulite from the body. Two of them work very similarly to liposuction, which uses a vacuum to remove subcutaneous fat from specific areas of the body.

VelaShape and Endermologie: These techniques use a combination of a gentle vacuum and rollers to loosen the cellulite and reduce its appearance. In doing so, this procedure increases blood flow to the targeted areas of the body. It can take anywhere from 30 minutes to an hour, depending upon the extent of the treatment. The main advantage to this treatment is that there are no injections.

Cellulaze: This procedure works very similarly to ultrasound to loosen up fat for liposuction. In the Cellulaze procedure, a laser is used to loosen up the cellulite and improve blood circulation in the targeted areas.

Mesotherapy: In this procedure, small amounts of medications, amino acids, and vitamins are injected into the mesoderm layer of the skin. This helps break down the cellulite and improves blood circulation. Though this procedure enjoyed some popularity in the mid-2000s, it is rarely performed today due to potential risks and lack of evidence about the effectiveness of the treatment.

Cellulite Removal Side Effects and Risks

There may be some bruising and swelling at the locations targeted for cellulite removal. Because Cellulaze and Mesotherapy require injections, there is a small risk of infection at the injection sites. Patients should also be aware that it may take several treatments in order to begin to see results from cellulite removal. According to the American Association of Plastic Surgeons, the average cost for cellulite removal is $165 per treatment.

Those women who are striving to gain back their "pre-baby" body may find that cellulite removal can help them target those troublesome areas that cannot necessarily be dealt with just by diet and exercise. A consultation with a trained cosmetic surgeon may help them get on their way to looking as fit and trim as ever.

Female cancer patients unhappy with insufficient fertility support

Female cancer patients unhappy with insufficient fertility support

Young female cancer patients are unhappy about the way fertility preservation options are discussed with them by doctors before starting cancer treatment, according to a new study by researchers from the University of Sheffield and The Children's Hospital, Sheffield.

The pioneering study discovered that only 40 per cent of young female cancer patients were happy with the way their doctors discussed the options they had to preserve fertility, before undergoing chemotherapy or radiotherapy which can have a harmful effect on a patient's fertility.

Researchers conducted the ground breaking study by asking 290 young cancer patients attending support group conferences organised by the Teenager Cancer Trust in 2004 and 2011.

Their views were collected anonymously using 'Who wants to be a millionaire?' style handsets to answer questions projected onto a big screen. All questions were answered by both male and female cancer patients aged between 13 and 22 years old who had been treated for a variety of cancers in UK hospitals.

Steph Hayter, 23, from Hampshire was diagnosed with Acute Lymphoblastic Leukemia age 19. She said: "Having a family has always been important to me so when the doctors told me the treatment would damage my fertility I was devastated.

"I knew I needed to start treatment quickly but it would have been nice to be given some choice in the matter or at least the chance to talk to a fertility expert.

"Neither was offered and I felt like I had lost all control. It was as if health professionals didn't think that it was a big deal because I was just a teenager; that made me feel silly for being so upset".

The findings, published in Pediatric Blood and Cancer, revealed that in 2004 just 38 per cent of young female patients recalled their doctor talking to them about fertility preservation opinions, such as egg freezing, before starting treatment.

In 2011 this number grew significantly to 69 per cent; however a staggering 50 per cent of patients were unhappy about the discussion - effectively the same as in 2004.

Dr Allan Pacey, a fertility expert from the University of Sheffield's Department of Human Metabolism, said: "Fertility issues are important for cancer patients because some chemotherapy and radiotherapy treatments can lead to infertility.

"Whilst we have been banking sperm for cancer patients for over 30 years, we are only just able to start offering fertility preservation for females by banking eggs. However, unfortunately this is more complex to perform and is not a realistic option if cancer treatment cannot be delayed."

Researchers also discovered that the majority of young male cancer patients (64 per cent) were broadly happy with what was discussed with them with roughly the same percentage recalling their doctors talking through fertility issues with them before their cancer treatment started.

Dr Dan Yeomanson, Consultant Pediatric Oncologist for Sheffield Children's NHS Foundation Trust, said: "This study highlights the need to discuss fertility issues with young patients, especially females, before treatment begins even if there are no options available for fertility preservation.

"Given the wealth of information that needs to be given before treatment begins, it is easy to see why fertility issues are sometimes not handled as well as they could be. While all oncologists aim to provide the best possible care to teenagers and young adults, this study has highlighted some important gaps which are clearly of key significance to patients."

The researchers suggest that collecting data in this way serves a bellwether providing an overview of practice across the UK and calls for a rethink of how fertility issues are discussed with young people diagnosed with cancer, both in terms of timing of discussions and their content.

The authors intend to conduct the survey again in 2018 with the same age group to see if the situation has improved.

Simon Davies, Chief Executive of Teenage Cancer Trust said: "Young people have a fundamental right to be made aware of the fertility problems cancer treatments can cause.

"Fertility is something many young people won't even have considered yet and it is incredibly important that these issues are discussed and that all options are understood. Health professionals have a duty to give clear information about all the long term effects of treatments and hopefully this work will help keep this front of mind for those working with young people with cancer."

Suicide risk increased by teen eating disorders

Suicide risk increased by teen eating disorders

Is binge eating a tell-tale sign of suicidal thoughts?

According to a new study of African American girls, by Dr. Rashelle Musci and colleagues from the Bloomberg School of Public Health, Johns Hopkins University in the US, those who experience depressive and anxious symptoms are often dissatisfied with their bodies and more likely to display binge eating behaviors. These behaviors put them at higher risk for turning their emotions inward, in other words, displaying internalizing symptoms such as suicide.

The study is published online in Springer's journal, Prevention Science.

With the focus on appearance in Western culture, it is not uncommon for many girls and women to have eating behavior problems. The most frequently occurring problem eating behaviors are binge eating, or eating large amounts of food in a short period of time and feeling out of control while eating. This behavior leads to shame, embarrassment, distress and an attempt to conceal it.

Musci and team investigated how depressive and anxious symptoms may be precursors to binge eating behaviors and suicidal outcomes in 313 black females followed for 11 years, from the ages of approximately 6-17 years old. Teacher, parent, and child interviews were carried out, examining levels of anxiety, depression, satisfaction with physical appearance, and eating behaviors, particularly binge eating. The researchers also noted who had reported a suicide attempt during the study period. The African American females demonstrated dissatisfaction with their physical appearance, which predicted the development of depressive and anxious symptoms in adolescence. These, in turn, predicted binge eating behaviors. Adolescent girls with more binge eating behaviors also reported more suicide attempts. The authors conclude: "The relationships found in this study offer prevention scientists a unique opportunity to target individuals at high risk of psychiatric problems by intervening in the case of binge eating problems. Our results also support the importance of developing prevention programs that are culturally relevant to individuals."

How to Prevent Candida Albicans Overgrowth

Candida albicans is a fungal agent that exists throughout the digestive tract. Almost everyone has candida albicans in their throat perpetually. The problem arises when Candida overgrowth occurs and the population of Candida becomes too large. This may be caused by high sugar levels in the body. The body tries to fight the fungus by producing other bacteria to neutralize. If the Candida overgrowth persists, symptoms such as fatigue,oral thrush, dizziness, headache or stress may appear. The good news is that it curable by consulting a doctor or following the Candida diet which reduces levels of Candida in the body. Below are ways through which one can prevent the candida overgrowth.

Reduce consumption of processed foods.
Nowadays food stuffs are made with many different chemicals, many of which may encourage the growth of Candida leading to an overgrowth. Vegetables are highly regarded since they contain fiber which moderates the growth of Candida albicans. Foods high in protein also tend to contain lower levels of sugars and starches and are better choices when trying to eliminate Candida overgrowth.

Avoid a stressful life.
Living with stress stimulates the growth of the Candida albicans. This can be avoided by engaging in regular relaxation practices such as meditation. While this is not necessary in itself, it's important to remember that stress is toxic to the body and reduces immune function, making you more prone to diseases.

Avoiding contraceptive pills.
Some of these pills provide a conducive environment for the growth of the candida albicans. They may change acidity levels in the vagina, leading to the overgrowth of Candida and resulting in yeast infection.

Avoid alcohol and other fermented foods.
Alcohol and other fermented foods can have a largely negative effect on the body when trying to cope with or prevent Candida albicans overgrowth. This is because the probiotic gut bacteria that break down Candida become preoccupied with digesting the other yeast products in the digestive tract. To this end, it's important to avoid fermented products such as liquor, beer, marmite and even bread when looking to prevent Candida overgrowth.

By observing the above recommendations, you have a great chance of avoiding or prevent Candida albicans overgrowth. Eating healthy foods boosts your immune function and helps to maintain a healthy gut flora which actively kills Candida albicans and helps you digest food efficiently. The Candida Diet is the most reliable holistic way to stave off yeast infections for good.

Kidney stones associated with modest increased risk of coronary heart disease in women, but not men

Kidney stones associated with modest increased risk of coronary heart disease in women, but not men

An analysis of data from three studies that involved a total of more than 240,000 participants found that a self-reported history of kidney stones was associated with a statistically significant increased risk of coronary heart disease among women but no significant association was evident for men, according to a study in the July 24/31 issue of JAMA.

"Nephrolithiasis [kidney stones] is a common condition, with the prevalence varying by age and sex. A recent estimate from the National Health and Nutrition Examination Survey, a representative sample of the U.S. population, reported the prevalence of a history of kidney stones of 10.6 percent in men and 7.1 percent in women. The overall prevalence has increased from 3.8 percent (1976-1980) to 8.8 percent (2007-2010)," according to background information in the article. Kidney stone disease may be associated with an increased risk of coronary heart disease (CHD). "Previous studies of the association between kidney stones and CHD have often not controlled for important risk factors, and the results have been inconsistent."

Pietro Manuel Ferraro, M.D., of Columbus-Gemelli Hospital, Rome, and colleagues analyzed the relation between kidney stones and risk of incident CHD for individuals with a history of kidney stones. The analysis included 45,748 men and 196,357 women in the United States without a history of CHD at baseline who were participants in the Health Professionals Follow-up Study (HPFS) (45,748 men 40-75 years of age; follow-up from 1986 to 2010), Nurses' Health Study I (NHS I) (90,235 women 30-55 years of age; follow-up from 1992 to 2010), and Nurses' Health Study II (NHS II) (106,122 women 25-42 years of age; follow-up from 1991 to 2009). The diagnoses of kidney stones and CHD were updated biennially during follow-up. Coronary heart disease was defined as fatal or nonfatal myocardial infarction (MI; heart attack) or coronary revascularization.

Of a total of 242,105 participants, 19,678 reported a history of kidney stones. After up to 24 years of follow-up in men and 18 years in women, 16,838 incident cases of CHD occurred. "Multivariable-adjusted analysis of individual outcomes confirmed an association in NHS I and NHS II participants between history of kidney stones and myocardial infarction and revascularization. After pooling the NHS I and NHS II cohorts, women with a history of kidney stones had an increased risk of CHD, fatal and nonfatal myocardial infarction, and revascularization," the authors write.

After multivariable adjustment, there was no significant association between history of kidney stones and CHD in the men's cohort.

"Our finding of no significant association between history of kidney stones and risk of CHD in men but an increased risk in women is difficult to explain, even though we could not determine whether this was due to sex or some other difference between the male and female cohorts. However, differences by sex are not infrequent in studies analyzing the association between nephrolithiasis and either CHD or risk factors for CHD," the researchers write.

"Further research is needed to determine whether the association is sex-specific and to establish the pathophysiological basis of this association."

Estrogen-only therapy after hysterectomy may be a lifesaver

Estrogen-only therapy after hysterectomy may be a lifesaver

The widespread rejection of estrogen therapy after the 2002 Women's Health Initiative (WHI) study has most likely led to almost 50,000 unnecessary deaths over the last 10 years among women aged 50 to 69 who have had a hysterectomy, Yale School of Medicine researchers reveal in a study published in the American Journal of Public Health.

Led by Philip Sarrel, M.D., emeritus professor in the Departments of Obstetrics, Gynecology & Reproductive Sciences, and Psychiatry, the researchers analyzed United States census data, hysterectomy rates, and estimates of decline in hormone use in women aged 50 to 59 between 2002 and 2011.

Before 2002, it was standard practice for doctors to recommend estrogen therapy for this slice of the population, and more than 90% of these women used it to treat symptoms such as hot flashes, and to prevent osteoporosis and other diseases related to menopausal hormone deficiency. Today, about 10% of these women use estrogen.

This sharp decline in estrogen usage was linked to results from one part of the large, federally funded WHI study in 2002. Women and their doctors became frightened of the dangers of post-menopausal hormones. But according to Sarrel and his colleagues, this was a report about women with a uterus, who took pills that combined estrogen and a progestin. Women who have a uterus must take a second hormone (a progestin) to avoid a risk of uterine cancer. But these results did not apply to women with no uterus who use estrogen-only therapy.

"Sadly, the media, women, and health care providers did not appreciate the difference between the two kinds of hormone therapy," Sarrel said. "As a result, the use of all forms of FDA-approved menopausal hormone therapy declined precipitously."

Sarrel added that for the women taking combined hormone therapy (at least the particular drug, Prempro, used in the WHI study), it was probably a good decision to avoid it because the WHI study showed a significant increase in breast cancer, heart disease, stroke, and blood clots in women who used this drug compared to placebo. However, for the women taking estrogen-only therapy, avoiding treatment does not appear to have been a good decision.

Results from the second part of the WHI study, which followed women who had no uterus and who took either estrogen-only or placebo, were very different. A series of papers published by the WHI between 2004 and 2012 showed that estrogen-only therapy had mostly positive health outcomes. For example, in 2011 and 2012 the WHI reported that women who received estrogen compared to those who received placebo had fewer deaths each year for 10 years and were less likely to develop breast cancer and heart disease. For each of the 10 years the death rate among those not taking estrogen was 13 more per 10,000. Most of these women died from heart disease while breast cancer accounted for almost all the other deaths.

"Estrogen avoidance has resulted in a real cost in women's lives every year for the last 10 years - and the deaths continue," said Sarrel. "We hope this article will stir an overdue debate and raise consciousness about the health benefits of estrogen-only therapy for women in their 50s with no uterus."

The marriage rate has declined by almost 60 percent since 1970

The marriage rate has declined by almost 60 percent since 1970

Fewer women are getting married and they're waiting longer to tie the knot when they do decide to walk down the aisle. That's according to a new Family Profile from the National Center for Family and Marriage Research (NCFMR) at Bowling Green State University.

According to "Marriage: More than a Century of Change," the U.S. marriage rate is 31.1, the lowest it's been in over a century. That equals roughly 31 marriages per 1,000 married women. Compare that to 1920, when the marriage rate was a staggering 92.3.

Since 1970, the marriage rate has declined by almost 60 percent. "Marriage is no longer compulsory," said Dr. Susan Brown, co-director of the NCFMR. "It's just one of an array of options. Increasingly, many couples choose to cohabit and still others prefer to remain single."

Furthermore, a woman's average age at first marriage is the highest it's been in over a century, at nearly 27 years old. "The age at first marriage for women and men is at a historic highpoint and has been increasing at a steady pace," states Dr. Wendy Manning, co-director of the Center.

There has also been a dramatic increase in the proportion of women who are separated or divorced. In 1920, less than 1 percent of women held that distinction. Today, that number is 15 percent. "The divorce rate remains high in the U.S., and individuals today are less likely to remarry than they were in the past," reports Brown.

The marriage rate has declined for all racial and ethnic groups, but the greatest decline is among African Americans. Similarly, the education divide in marriage has grown. In the last 50 years there have been only modest changes in the percentage of women married among the college educated and the greatest declines among women without a high school diploma.

Researchers used data from the National Vital Statistics "100 Years of Marriage and Divorce Statistics United States 1867-1967," the Centers for Disease Control and Prevention/National Center for Health Statistics, and the U.S. Census Bureau.

Withholding estrogen therapy cost tens of thousands of lives

Withholding estrogen therapy cost tens of thousands of lives

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Nearly 50,000 women died unnecessarily over the last ten years because estrogen therapy was not given to patients aged 50 to 69 who had undergone a hysterectomy after the 2002 Women's Health Initiative (WHI) study.

In 2002, doctors and patients were seriously put off using HRT (hormone replacement therapy) because two trials - HERS and WHI - suggested that one type might raise the risk of cardiovascular problems. Up to that time, HRT had been seen as the savior for women who were in medical menopause; those who had undergone hysterectomy.

Dr. Philip Sarrel, emeritus professor in the Departments of Obstetrics, Gynecology & Reproductive Sciences, and Psychiatry, Yale University, and colleagues gathered and analyzed U.S. census data and hysterectomy rates, and estimated how much hormone replacement therapy had declined among female patients aged 50 to 59 between 2002 and 2011.

Before 2002, over 90% of these patients had been prescribed estrogen-only therapy for medical menopause symptoms, including hot flashes, as well as to prevent osteoporosis and other diseases caused by menopausal hormone deficiency.

Dr. Sarrel explained that the 2002 WHI study applied to women who took the combined estrogen plus progestin HRT - for patients with a uterus. Unfortunately, the study scared doctors away from any kind of HRT, including those who had undergone a hysterectomy.

Women who have a uterus (womb) are given the combination HRT because the progestin helps reduce the risk of cancer of the uterus.

Dr. Sarrel said:

"Sadly, the media, women, and health care providers did not appreciate the difference between the two kinds of hormone therapy," Sarrel said. "As a result, the use of all forms of FDA-approved menopausal hormone therapy declined precipitously."

The Yale researchers explained in the American Journal of Public Health (July 18th issue) that for those on the combined HRT, it was probably right to advise against taking it, because the WHI study demonstrated a heightened risk of blood clots, stroke, heart disease and breast cancer.

However, for the patients on just estrogen therapy, avoiding treatment appears to have been a bad decision that cost thousands of lives.

The second part of the WHI study, which focused on women who had had hysterectomies and compared estrogen-only patients with those on placebo, the results were quite different. Women on estrogen-only therapy had "mostly positive health outcomes", the authors wrote.

The WHI study in 2011 and 2012 found that over a ten-year period, fewer women on estrogen-only therapy died, or developed heart disease or breast cancer. The annual death rate over that decade for women not taking estrogen was 13 more per 10,000. The majority of them died from heart disease, while nearly half of the remainder died from breast cancer.

Dr. Sarrel said:

"Estrogen avoidance has resulted in a real cost in women's lives every year for the last 10 years - and the deaths continue. We hope this article will stir an overdue debate and raise consciousness about the health benefits of estrogen-only therapy for women in their 50s with no uterus."

In an Abstract in the journal, the authors wrote "Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency."

HRT has been a controversial subject for nearly a decade. Studies have produced conflicting results:

HRT reduced heart failure, heart attack, and early death risk - a ten-year Danish study involving 1,001 women and published in the BMJ (British Medical Journal) reported that women who were prescribed HRT soon after the menopause had a significantly lower risk of dying early or having a heart attack or heart failure, compared to their counterparts not on HRT.

Scientists from the UCLA Medical Center and the Fred Hutchinson Cancer Research Center reported in the Journal of the National Cancer Institute that hysterectomized women on estrogen alone had a lower risk of breast cancer, while women with a uterus who were prescribed estrogen in addition to progestin had a higher risk.

Estrogen only protects younger hysterectomized women but not older ones - Professor Andrea Z. LaCroix, of the Fred Hutchinson Cancer Research Center, and team wrote in JAMA (Journal of the American Medical Association) (April 2011 issue) that a hysterectomized woman in her 50s on estrogen-only replacement hormone therapy has a significantly lower risk of health problems, while a woman in her 70s is more likely to develop chronic disease, colorectal cancer and to die early.

Written by Christian Nordqvist

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Impaired Glucose Tolerance Can Lead To Cognitive Dysfunction

Impaired Glucose Tolerance Can Lead To Cognitive Dysfunction

People with impaired glucose tolerance - the precursor to Type 2 diabetes - often show impaired cognitive function that may be alleviated through a diet designed specifically for their condition, according to a panel discussion at the 2013 Institute of Food Technologists (IFT) Annual Meeting & Expo®.

Impaired glucose tolerance is a pre-diabetic state of hyperglycemia that is associated with insulin resistance and a higher risk of cardiovascular disease. It can precede Type 2 diabetes by several years, and some lifestyle changes, such as getting to a normal weight and increasing exercise, can help pre-diabetic people avoid that progression completely.

Louise Dye, Ph.D., professor of nutrition and behavior in the Human Appetite Research Unit at the Institute of Psychological Sciences, University of Leeds, presented research in which she examined 31 previous studies regarding cognitive performance under various dietary conditions. She found that the impaired glucose tolerance group showed difficulties in 12 of 27 cognitive test outcomes, including word recognition, visual verbal learning test, visual spatial learning test, psychomotor test and Corsi block-tapping. The impaired glucose tolerance group was made up of all middle-aged women who appeared to be in general good health.

"There was significant impairment in those women who were impaired glucose tolerant," Dye said. "To me, that feels like a ticking time bomb. We need to use food - the diet and food industry - to help us shift these people back from impaired glucose tolerance. By the time they get to Type 2 diabetes, the impairments are much more evident."

She pointed to a 2009 Japanese study of 129 people in their 80s, 55 of whom had impaired glucose tolerance or Type 2 diabetes. All the subjects in the study consumed more than 30 grams of dietary fiber per day and exercised two to four times per week over a two-year period. Within that timeframe, the 36 people with impaired glucose tolerance showed improvements in delayed recall and block design tests. The Type 2 diabetes group showed improvement in dementia, delayed recall and their mental state.

"That tells us something about how improving glucose regulation through dietary fiber and exercise could improve cognitive functions," Dye said.

She called on the food industry to continue researching the best products for consumers with glucose tolerance issues, such as those foods with increased fiber and those with limited glycemic impact.

Another panelist, Nicholas Bordenave, Ph.D., associate principal scientist in the analytical department of PepsiCo Global R&D, said a key aspect to consider in these foods is satiety. He said two proven avenues for doing that are a shift toward slowly digestible starch and resistant starch in foods and enhanced viscosity of food through digestion. However, he noted that the challenge for food manufacturers is to create foods with these components that taste appealing to consumers.

"From the consumer standpoint there is still a lot to understand," he said. "Right now, people think in terms of satiety. They are not aware yet of the effect of glucose delivery on their mental performance. It's really about consumer education."

Endocrine-disrupting chemicals may increase odds of women developing mild hypothyroidism

Endocrine-disrupting chemicals may increase odds of women developing mild hypothyroidism

Exposure to perfluorinated chemicals is linked to changes in thyroid function and may raise the risk of mild hypothyroidism in women, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Perfluorinated chemicals, or PFCs, are compounds used to manufacture fabrics, carpets, paper coatings, cosmetics and a variety of other products. Among humans and wildlife, PFC exposure is widespread, according to the National Institutes of Health's National Institute of Environmental Health Sciences. Because these chemicals break down very slowly, it takes a long time for PFCs to leave the body.

"Our study is the first to link PFC levels in the blood with changes in thyroid function using a nationally representative survey of American adults," said one of the study's authors, Chien-Yu Lin, MD, PhD, of En Chu Kong Hospital in Taiwan.

Women who had higher levels of a PFC called perfluorooctanoate (PFOA) in their blood tended to have elevated levels of the thyroid hormone triiodothyronine (T3). The study also found an increase in levels of T3 and the thyroid hormone thyroxine (T4) in women with higher concentrations of the PFC perfluorohexane sulfonate (PFHxS) in their blood. The levels rose without the pituitary gland signaling the thyroid to produce more hormones, which is the body's natural mechanism for adjusting thyroid hormone levels. Men exposed to higher amounts of PFHxS, however, tended to have lower levels of the T4 hormone.

Even though people with a history of thyroid diseases were excluded from the study, researchers found an association between subclinical, or mild, hypothyroidism and elevated levels of PFOA, PFHxS and perfluorooctane sulfonate (PFOS) in women. Hypothyroidism occurs when the thyroid gland does not produce enough hormones and can cause symptoms such as fatigue, mental depression, weight gain, feeling cold, dry skin and hair, constipation and menstrual irregularities. This relationship needs to be explored and confirmed through additional research, Lin said.

The researchers analyzed data from 1,181 participants in the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey (NHANES), a population-based survey conducted by the Centers for Disease Control and Prevention (CDC). The study reviewed levels of four different PFCs as well as thyroid function.

"Although some PFCs such as PFOS have been phased out of production by major manufacturers, these endocrine-disrupting chemicals remain a concern because they linger in the body for extended periods," Lin said. "Too little information is available about the possible long-term effects these chemicals could have on human health."

What is breast augmentation? What are breast implants?

What is breast augmentation? What are breast implants?

Augmentation mammoplasty, or breast augmentation is a surgical procedure to increase the size, shape or fullness of a woman's breasts. The surgeon places silicone, saline or alternative composite breast implants under the chest muscles or breast tissue.

Breast augmentation is done to:

Enlarge breasts that are naturally small.

Restore breast size and shape after pregnancy, weight loss or breastfeeding.

Restore symmetry when the breasts are asymmetrical

Restore the breast(s) after surgery as treatment for breast cancer or some other condition or event that affected the size and shape of the breast.

Breast enlargement boosts self-esteem - women usually experience a significant boost in self-esteem and positive feelings about their sexuality after undergoing breast enlargement, researchers from the University of Florida reported in Plastic Surgery Nursing.

The authors emphasized that although plastic surgery is not a panacea for feelings of sexual attractiveness or self-worth, it is important for health-care professionals to understand the psychological benefits of these procedures.

Study leader, Prof. Cynthia Figueroa-Haas, said "Many individuals, including health-care providers, have preconceived negative ideas about those who elect to have plastic surgery, without fully understanding the benefits that may occur from these procedures."

According to an article published in Plastic and Reconstructive Surgery (May 2013 issue), 98% of women who underwent breast augmentation surgery said the results met their expectations. Dr. Eric Swanson, a plastic surgeon who conducted the prospective outcome study, added that women also reported improvements in quality of life and self-esteem after their procedure.

Dr. Swanson reported that the average patient was 34 years old, and most opted for the 390 cc saline-filled breast plant under the muscle.

The study, involving 225 women who were followed for five years, found that:

Patients said they were "back to normal" within 25 days of their surgery

85% said their new breast size was "just right"

13% said a larger size would have been better

Less than 2% would have preferred a smaller size

1% were not happy with their scars, which are usually in the crease under the breast

75% thought their breast firmness was "just right"

98% said their results met with their expectations

According to the American Society of Plastic Surgeons, there were 307,190 breast augmentations procedures in the USA in 2011, as well as 22,271 breast implant removals.

Women with breast implants can still breastfeed - no part of the implant gets into the breast milk.

What are breast implants?

A breast implant is a medical prosthesis that is placed inside the breast to augment, reconstruct or create the physical form of the breast.

The outer layer of breast implants is made of firm silicone. The inside of the implant is filled either with salt water (saline solution), silicone gel, or a composite of alternative substances. Makers of breast implants say they should last for at least ten years.

Breast implants filled with saline solution

There are three main types of breast implants:

Saline implants - filled with a sterile saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.) which is held within an elastomer silicone shell. These implants can be filled with different amounts of saline solution, which may affect the feel, firmness and shape of the breast.

If this type of implant leaks, the solution will be absorbed and expelled by the body naturally.

A breast implant filled with silicon gel

Silicone implants - filled with a viscous silicone gel which is held within an elastomer silicone shell.

If a silicone-filled implant leaks, the gel will either stay in the shell or escape into the breast implant pocket. A leaking silicone-filled implant might not collapse. Patients choosing this type of implant should carry out more regular checks with their doctor compared to those on saline solution implants. The condition of the implants can be determined with an MRI or ultrasound scan.

Although the US FDA recommends regular follow-up MRI scans for women with silicone implants, a study published in Plastic and Reconstructive Surgery (March 2011 issue) says there are significant flaws supporting this recommendation. The authors wonder how effective MRI screening is for women with silicone implants.

There are five generations of this type of implant. The latest one is made of a semi-solid gel that has virtually completely eliminated silicone gel bleed (filler leakage) and silicone migration from the breast to other parts of the body, according to manufacturers.

Alternative composite implants - these may be filled with polypropylene string, soy oil or some other material.

What happens during the breast augmentation procedure?

Anesthesia

The patient may have a choice of general or local anesthesia. Under local anesthesia the patient is awake and only the surgical area is numbed. However, in most cases the procedure is done under general anesthesia.

The incision

The surgeon and patient should discuss incision options. The doctor should explain which are most suitable for the patient and her desired outcome.

The following incision options are possible:

Inframmammary incision - in the crease under the breast.

Transaxillary incision - in the armpit (axilla)

Periareolar incision - around the nipple

The choice of which incision to use depends on several factors, including the degree of enlargement, the patient's anatomy, the type of implant, and surgeon-patient preference.

Inserting and placing the breast implant

1. Breast after subglandular augmentation.
2. Breast after submuscular augmentation.

The breast implant is inserted into a pocket. Today, there is a choice between two types of placements:

A submuscular placement - under the pectoral muscle. When placed here the patient may take slightly longer to recover, compared to subglandular placement, and may also experience a little more post-operative pain.

A submammary (subglandular) placement - behind the breast tissue, over the pectoral muscle.

Techniques used today for placing breast implants have significantly improved recovery times.

Dr. Lucian Ion talks about some basic principles behind choosing placement of the breast implants:

The incisions are closed

The surgeon closes the incisions with layered sutures (stitches) in the breast tissue, and with skin adhesives, sutures and surgical tape to close the skin and keep it closed.

Initially, there will be evident incision lines. These will fade with time.

View the results

Breast augmentation results are visibly evident straight away. There will be some swelling caused by the surgery, which will resolve within a couple of weeks. As the swelling dies down and the incision lines fade, the patient will have a better idea of whether the procedure met her expectations.

Recovering after the breast augmentation procedure

As the anesthetic wears off, the patient will be given painkillers to relieve the pain.

Nobody should drive immediately after anesthesia, because it affects coordinating and reasoning skills for at least 24 hours. Ideally, the patient should have a relative or friend stay with them for a day if they go home soon after the operation.

In most cases, the woman should not engage in strenuous physical activities for about six weeks. She will probably be encouraged to do some post-operative exercises, such as flex and move her arms to relieve pain and discomfort.

Thanks to more advanced techniques today, including submuscular and subglandular placements, recovery times have improved considerably.

It is important to follow the surgeon's advice regarding what type of bra to wear, and when to wear it.

If the surgeon used sutures that do not dissolve, or placed drainage tubes near the breasts, the patient will need a follow-up appointment to have them removed.

Absorbable (dissolvable) sutures usually disappear within six weeks.

If there is any sign of infection, such as fever, or warmth and redness in the breast area, the surgeon or his/her nurse should be contacted immediately. If the patient experiences chest pains, unusual heart beats, or shortness of breath, the surgeon needs to be told straight away.

The patient should have received the following instructions from her medical team

How to care for her breasts after the procedure

How to use the medications which have been prescribed

When to come for a follow-up visit

When to call the doctor

The patient should have asked the following questions before the surgery:

After my surgery is complete, where will I be taken?

What medications will I be given and which do I need to buy after the procedure?

What dressings or bandages will I have after the surgery?

When will the dressing/bandages be removed?

When is my follow-up appointment?

When can I exercise?

When can I go back to work, or resume my normal activities?

Women whose implants were inserted beneath the chest muscles (submuscular placement) will take longer to recover, and will also experience slightly more pain, because of the healing of the incisions to the chest muscles.

What are the risks and complications linked to breast augmentation?

Every surgical procedure has risks, and breast enlargement is no exception. A good surgeon will explain all the risks to the patient.

Below are some of the risks and complications associated with breast augmentation:

Capsular contracture - hardening of the area around the implant, this can distort the shape of the implant, and can also cause pain

Painful breasts

Infection

Nipple and/or breast sensation may change - this is nearly always temporary

The implant ruptures or leaks

Bleeding

Fluid Accumulation

Anaplastic large cell lymphoma (ALCL) - the US FDA (Food and Drug Administration) carried out a review in 2011 which found that women with saline and silicone gas-filled breast implants have a higher risk of developing anaplastic large cell lymphoma.

The FDA reported in 2011 that 20% of women who received silicone gel-filled breast implants had to have them removed within ten years.

There is a risk that the scars become red and thick, as well as painful. Sometimes they require further surgery.

The skin on the breast above where the implant is can become wrinkly or with ripples. Very thin women, or those who suddenly lose a lot of weight have a higher risk.

Below is an informational video from the American Society of Plastic Surgeons about breast augmentation

Questions to ask the surgeon

In order to be fully informed, and also for the surgeon to completely understand the needs of the patient, you should make a list of questions. Tick each one off as the surgeon answers them.

Below are examples of some questions you could ask regarding breast augmentation:

Are you a certified/licensed plastic surgeon. In the USA the surgeon should be certified by the American Board of Plastic Surgery.

Have you been specifically trained in plastic surgery?

What is your experience in plastic surgery? How long have you been doing it for?

How many procedures do you perform each month?

On average, how many revisions of your work do you perform?

Have patients sued you?

Do you have hospital privileges to carry out this procedure? If so, where?

Do you consider that I am a good candidate for this procedure?

What do I have to do in order to achieve the best results?

Where will the surgery take place?

How will you do the surgery?

Is the place where the surgery will take place equipped to deal with emergencies?

What do you recommend for me, regarding placement site, incision site, surface texturing, size and shape?

How long will it take me to recover?

Will I need help during my recovery? If so, what kind?

What are the risks and complications linked to breast augmentations?

What happens when there is a complication? What do you do? What should I do?

During my lifetime, how many additional procedures and/or implants will I probably have?

If I am not happy with the results, what are my options?

If I want the implants taken out one day without replacements, how will my breasts look?

Could you show me before-and-after photos? Of these photos, show me one that might be a reasonable result for me.

Should I go on a special diet before or after the procedure?

How long should I be off work?

Choosing a surgeon you can trust is crucial

It is important that the surgeon you chose is licensed and recognized by a competent professional plastic surgery association of your country.

USA

In the USA, the surgeon should be a member of the American Society of Plastic Surgeons (ASPS). Go to this web page to Find an ASPS certified plastic surgeon.

You will then be sure that he/she:

Has done five years of surgical training, which includes at least two years in plastic surgery.

Has experience and professional training in all plastic surgery procedures, including face, body and breast reconstruction.

Works only in accredited medical facilities

Complies with a strict code of ethics

Adheres to medical education requirements, which include standards and innovations in patient safety

Is certified by The American Board of Plastic Surgery

United Kingdom

If you are in the UK, you should seek out a plastic surgeon certified by The British Association of Aesthetic Plastic Surgeons. Go to this web page "Aesthetic Plastic Surgeon by Region".

Canada

The Canadian Society for Aesthetic Plastic Surgery is the only recognized professional body of Canadian plastic surgeons. Click here to find a CSAPS member near your area.

Australia

The Australian Society of Plastic Surgeons Inc (ASPS) is the peak body for Specialist Plastic Surgeons (both reconstructive and cosmetic). Click here to find an accredited plastic surgeon in your area.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Breastfeeding Mothers Need Support And Encouragement

Breastfeeding Mothers Need Support And Encouragement

More support is needed to help women overcome doubts in the hope that they will breastfeed their babies for longer, says a University of Alberta nutrition researcher.

A study conducted by the University of Alberta in Canada found that new moms are weaning their infants early instead of feeding them just breast milk for the first six months of life, said Anna Farmer, an associate professor in the Department of Agricultural, Food and Nutritional Science and the Centre for Health Promotion Studies. That falls below recommendations made by the World Health Organization and endorsed in 2004 by Health Canada and the Canadian Paediatric Society.

"Women's attitudes towards breastfeeding even before the baby is born can predict whether or not moms are going to breastfeed, so it is important that everything from the home environment to public spaces supports nursing moms," said Farmer. "We need to address their concerns and misconceptions about breastfeeding, especially young first-time mothers."

Farmer and her colleagues surveyed 402 pregnant women at three months postpartum and 300 of them again at the six-month mark, and found that though almost 99 per cent of the women started out breastfeeding their babies, only 54 per cent were still exclusively breastfeeding three months after giving birth. That number dropped again to 15 per cent by six months, in line with the national average, which is also low for breastfeeding.

The study, published recently in BMC Pediatrics, found that 54 per cent of the women had neutral attitudes towards breastfeeding, as did 53 per cent of the mothers who fed their infants formula during the first six months after birth. More than half of the women in the study stopped breastfeeding because of their perceptions of milk inadequacy or other problems.

The study also found that women with post-graduate university degrees were 37 per cent more likely to breastfeed exclusively for six months as opposed to those without a degree. As well, mothers with previous children were more likely to breastfeed for longer.

Farmer advises new moms to breastfeed for as long as possible, even on a partial basis. "Some breast milk is better than none."

Farmer hopes the research findings will help doctors, nurses and other health practitioners provide advice to pregnant women with a focus on what may or may not be known about exclusive, long-term breastfeeding, to help promote the practice beyond the first few months after birth.

The study also recommends more policy provision for nursing rooms in public facilities. "The social environment needs to be more open. Women need spaces where they can breastfeed quietly without feeling ashamed," Farmer said.

What is breast pain? What is mastalgia?

What is breast pain? What is mastalgia?

Breast pain, also known as mastalgia, mammalgia and mastodynia, is common and may include a dull ache, heaviness, tightness, a burning sensation in the breast tissue, or breast tenderness. If the pain is linked to the menstrual cycle it is known as cyclical mastalgia (cyclical breast pain).

According to the Breast Cancer Foundation, breast pain includes any pain, tenderness or discomfort in the breast or underarm region, and can occur for a number of different reasons. In most cases, the Foundation adds, breast pain is not a sign of breast cancer. The National Health Service, UK, says that cyclical breast pain is not linked to a higher risk of developing breast cancer.

In most cases, breast pain affects the upper, outer area of both breasts - the pain can sometimes spread to the arms.

In the majority of cases, mastalgia starts between one and three days before the woman's period starts, and gets better by the end of her period. For some women, the pain starts many more days before the beginning of their periods.

Although older (postmenopausal) women can have breast pain, it is much more common in perimenopausal (around the menopause) and premenopausal females.

The California Pacific Medical Center estimates that between 50% and 70% of women have breast pain in the USA. Health Authorities in the UK say that up to 66% of women between 30 and 50 years of age experience breast pain

What are the signs and symptoms of breast pain?

A symptom is felt by the patient and described to the doctor, nurse, friends or family. A sign can be seen or detected by other people. An example of a symptoms is pain, while a sign could be a skin rash.

Breast pain is usually classified as "cyclic" (cyclical) or "non-cyclic" (non-cyclical).

The signs and symptoms of cyclical breast pain

The pain comes cyclically, just like the menstrual cycle does.

The breasts may become tender.

Patients describe the pain as a heavy, dull ache. Some women describe it as a soreness with heaviness, while others say it is like a stabbing or burning pain.

The breasts may swell.

The breasts may become generally lumpy (not with a single, hard lump).

Both breasts are typically affected, especially the upper, outer portions.

The pain can spread to the underarm.

Pain becomes more intense a few days before the period comes. In some cases pain may start a couple of weeks before menstruation.

It is more likely to affect younger women. Postmenopausal women may experience similar pains if they are on HRT (hormone replacement therapy).

The signs and symptoms of non-cyclical breast pain

It generally affects just one breast, usually just within a quadrant of the breast, but may spread across the chest.

It is more common among post-menopausal women.

The pain does not come and go in a menstrual cycle time-loop.

The pain may be continuous or sporadic.

Mastitis - if the pain is caused by infection within the breast, the woman may have a fever, generally feel ill (malaise), some breast swelling and tenderness, and the painful area may feel warm. There may be redness. The pain is usually described as a burning sensation. For lactating mothers, the pain is more intense while breastfeeding.

Extramammary pain - pain that feels as if the source is within the breast, but it is actually elsewhere. Sometimes called "referred pain". This may occur in some chest wall syndromes, such as costochondritis (inflammation where the rib and the cartilage meet).

You should see your doctor if:

One or both breasts change in size or shape

There is a discharge from either nipple

There is a rash around the nipple

There is dimpling on the skin of the breasts

You feel a lump or swelling in one of your armpits

You feel pain in your armpits or breast that is not related to your menstrual cycle

You notice a change in how your nipple looks

You notice an area of thickened tissue, or a lump in your breast

Diagnosing breast pain

If the woman is pre-menopausal, the doctor will try to determine whether the breast pain might be cyclical. The patient will probably be asked:

How much caffeine she consumes

Where within the breasts the pain is

Whether both breasts are painful

Whether she is a smoker

Whether she is on any medication or the combined contraceptive pill

Whether she might be pregnant

Whether there are any other symptoms, such as nipple discharge or a lump

The physician will listen to the patient's lungs and heart, and also check her chest and abdomen to rule out other possible conditions and illnesses.

The doctor may also conduct a clinical breast exam to determine whether there are any lumps, changes in nipple appearance, or nipple discharge. The lymph nodes in the lower neck and armpit will also be checked to determine whether they are swollen or tender to the touch.

If a breast lump or unusual thickening of an area of tissue is detected, or a specific area of breast tissue is particularly painful, the doctor may order further tests:

Mammogram - this is an X-ray exam of the breast. Also known as mammography.

Ultrasound scan - sound waves produce images of the breasts. Even if the mammography does not detect anything, an ultrasound scan is usually done as well.

Breast biopsy - if anything suspicious is detected, the doctor will surgically remove a small sample of breast tissue and send it to the laboratory for analysis.

The patient may be asked to complete a breast pain chart, which can be used to confirm diagnosis and help the doctor decide on the best therapy.

What are the causes of breast pain?

It is not always possible in every case to determine exactly why breast pain occurs. The following factors are associated with possible breast pain:

Acid reflux

Alcoholism with liver damage

Angina

Anxiety, stress and depression

Benign breast tumors

Bornholm disease

Breast cancer

Breast cysts

Breast trauma - e.g. previous breast surgery

Breastfeeding related - possible infection

Cervical and thoracic spondylosis/radiculopathy

Chest wall pain

Coronary artery disease

Costochondritis

Cyclical breast pain

Diet - especially caffeine

Fibromyalgia

Herpes zoster

Mastitis

Medications - including digitalis, chlorpromazine, oxymetholone, some diuretics, spironolactone, and methyldopa

Peptic ulcer

Pericarditis

Pleurisy

Pregnancy

Psychological

Puberty

Pulmonary embolism

Rib fracture

Shingles

Shoulder pain

Sickle cell anaemia

Trauma to the chest wall

What are the treatment options for breast pain?

In the majority of cases, it is possible to solve cyclical breast pain by taking OTC (over-the-counter) painkillers and wearing well-fitted bras. Cyclical breast pain is often unpredictable - it may well just go away in time, and then come back periodically.

Being diagnosed with cyclical breast pain, as opposed to something more serious, can reassure many patients who then decide their condition is easier to live with.

Women with non-cyclical breast pain may need therapy to treat the underlying cause, e.g. for infectious mastitis the patient will be prescribed a course of antibiotics.

Some self-help tips for breast pain

During the daytime, wear a well-fitting bra

Many women swear by evening primrose oil. You need to take the capsules daily in order to feel any benefits, which may take two to three months to appear. A study in the American Journal of Obstetrics and Gynecology, however, found that evening primrose oil offered no benefits for breast pain.

Pregnant women, those planning to become pregnant, and people with epilepsy should not take evening primrose oil without checking with their doctor first.

To relieve the pain, take OTC medications, such as acetaminophen (paracetamol, Tylenol) or ibuprofen.

Wear a soft-support bra during sleep.

When exercising, wear a good sports bra.

Some topical NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen gel or diclofenac gel can be rubbed directly on to the painful areas. Do not rub NSAID gels onto broken skin. ("Topical" means you apply it directly onto the skin).

Coffee, caffeine and breast pain - a study published in The Nurse Practitioner found that "caffeine restriction is an effective means of management of breast pain associated with fibrocystic disease."

The Society of Obstetricians and Gynaecologists of Canada says that caffeine does not cause breast pain. Even though many women say their symptoms of pain are reduced when they cut out caffeine, no studies have been able to back this up. (Outside the USA, 'Gynecologist' is spelled 'Gynaecologist').

The following contain caffeine - some OTC cold/pain medications, cocoa, chocolate, cola drinks, green and black tea, and coffee.

Flaxseed for breast pain - in its Clinical Guidelines for Mastalgia, the Society of Obstetricians and Gynaecologists of Canada (SOGC) quotes a Canadian study on 116 women with severe cyclical mastalgia. Half of them ate 25 grams of flaxseed in a muffin each day for four menstrual cycles. The other half ate an "identical" muffin with no flaxseed.

In this double blind trial (neither the doctors nor the participants knew which muffin they were eating) breast pain was reduced significantly more among the women eating flaxseed. According to the SOGC "This one study shows promise and merits further research."

Smoking and breast pain - several health authorities, hospitals and health groups advise women with breast pain to stop smoking. The argument being that nicotine constricts the blood vessels and smoking is more likely to cause inflammation.

However, a study published in Climacteric, the Journal of the International Menopause Society, found that "smoking reduces the incidence of breast tenderness in women receiving oral EPT (estrogen-progestogen therapy)".

Prescription medications for breast pain

If breast pain symptoms are severe and none of the therapies mentioned above helped, the doctor may recommend a prescription drug.

The following medications may help alleviate the symptoms of breast pain:

Danazol - approved for the treatment of fibrocystic breast disease, a condition that causes non-cancerous growths to develop in the breasts. Patients may experience the following side effects - hair growth on the face (hirsutism), acne, a deepening voice (possibly permanent), weight gain, skin rash, nausea and dizziness.

Bromocriptine - approved for treating certain breast conditions. Side effects may include constipation, headaches, hypotension (low blood pressure), and nausea.

Tamoxifen - approved for breast cancer treatment. Tamoxifen is also prescribed off label for mastalgia. Possible side effects include hot flashes (UK: hot flushes), vaginal bleeding, vaginal discharge, higher risk of endometrial cancer, and/or thromboembolism.

Goserelin - also approved for breast cancer therapy and used as an off label treatment for mastalgia. Side effects may include depression, decreased sex drive, hot flashes and vaginal dryness.

Toremifene - another breast cancer drug that is used off label for breast pain. Possible side effects include DVT (deep vein thrombosis), vaginal bleeding, vaginal discharge, hot flashes, and nausea.

If the woman is on a contraceptive pill, the doctor may consider making adjustments or switching to another birth control pill.

The doctor may also consider adjusting the dosage of hormone replacement therapy.

Breast Pain: Should You be Concerned?

In the video below, Dr. Katharine Lee, from the Cleveland Clinic, talks about the different types of breast pain.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Can Workplace Flexibility Give Parents Time With Their Children?

Can Workplace Flexibility Give Parents Time With Their Children?

Parents are increasingly experiencing a 'time squeeze' as they struggle to navigate the pressures of full-time employment and the demands of caring for their children. Research in the Journal of Marriage and Family examines if flexible working schemes are helping or adding to this pressure.

The authors examined how the introduction of ROWE (Results Only Work Environment) has impacted parents' perceptions of their time. Under this scheme employees are paid for results, rather than their time.

The data showed that both parents saw changes in working hours such as ROWE as a major factor to their time, yet only mothers reported increased schedule control and improved time adequacy. However, this change was shown to be in perception only, as little change was reported in the actual time spent with children beyond evening meals.

"ROWE helped mothers feel that they were spending enough time with their children, even though it didn't change the actual amount of time for most parents," said Rachelle Hill from the University of Minnesota. "Mothers who participated in ROWE and ate fewer than three meals with their children per week were able to eat one additional family meal with their children compared to mothers in traditional departments."

Women Severely Sexually Traumatized In Childhood Benefit Most From Intervention

Women Severely Sexually Traumatized In Childhood Benefit Most From Intervention

A UCLA-led study of HIV-positive women who were sexually abused as children has found that the more severe their past trauma, the greater their improvement in an intervention program designed to ease their psychological suffering.

The study, conducted by researchers at UCLA's Collaborative Center for Culture, Trauma and Mental Health Disparities, suggests that such interventions should be tailored to individuals' experience and that a "one size fits all" approach may not be enough to successfully reduce women's depression, post-traumatic stress and anxiety symptoms.

"This study shows that those who suffer early and severe trauma can improve their psychological symptoms," said primary investigator Dorothy Chin, an associate research psychologist at the Semel Institute for Neuroscience and Human Behavior at UCLA. "Indeed, those who improve the most are those who suffered the most trauma."

The research findings are published in the peer-reviewed journal Psychological Trauma: Theory, Research, Practice and Policy.

For the study, researchers used data on women who had participated in the Healing Our Women program, a clinical trial testing an HIV/trauma intervention for HIV-positive women who had suffered sexual abuse as children. Previous research demonstrated that this program was successful at reducing psychological distress among these women. The question for the current study was: Who benefited the most?

The trial used a psycho-educational group intervention called the enhanced sexual health intervention (ESHI), which linked these women's early sexual abuse-related trauma to their current sexual risk behavior and taught them ways of coping and emotional problem-solving.

The 121 women who participated in the trial were recruited from community-based organizations, health clinics, physicians' offices, hospitals and HIV support groups in the Los Angeles area. The researchers randomly assigned 51 of them to the ESHI group, an 11-week intervention that included writing exercises, group processing, strategies for identifying and coping with potentially risky or stressful situations, and problem-solving.

The other 70 were assigned to a standard control-group intervention, also 11 weeks, which consisted of one face-to-face session in which the women were provided with information and pamphlets on HIV prevention and child sexual abuse, as well as weekly calls and referrals to support services. At the end of the 11 weeks, 27 women from the control group moved to the ESHI intervention, for a total of 78 women in the treatment group.

The women's psychological symptoms were assessed both before and after the intervention program. The researchers found among the women in the ESHI intervention, those whose sexual abuse was most severe as children showed the greatest overall improvement in reducing their symptoms of depression, post-traumatic stress and anxiety.

Chin suggests that the most severely traumatized women improved the most because the insights they gained between their past and present experiences, as well as the problem-solving strategies they learned, "resonated more" with them than with the others.

"This is somewhat surprising at first glance, as one might assume that the more trauma, the more difficult it is to improve one's symptoms," Chin said. "But this shows that these focused interventions have targeted the right groups of people and need to continue to target the most traumatized."

The authors noted that the small sample size was not ideal and that more research is needed. The next step, they said, is to replicate these findings with larger samples, as well as to target the most severely traumatized women.

Female Survivors Of Childhood Cancer Often Go On To Have Successful Pregnancies In Adulthood

Female Survivors Of Childhood Cancer Often Go On To Have Successful Pregnancies In Adulthood

Although women who survived childhood cancer face an increased risk of infertility, nearly two-thirds of those who tried unsuccessfully to become pregnant for at least a year eventually conceived, according to clinical researchers at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Brigham and Women's Hospital. This is comparable to the rate of eventual pregnancy among all clinically infertile women.

"Most women think that if they had cancer as a child, then they'll never have children. It turns out that many of them can get pregnant. It just might be a little harder," said senior author Lisa Diller, MD, chief medical officer of Dana-Farber/Boston Children's and medical director of the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute.

The paper, published in Lancet Oncology, is the first large-scale study of female childhood cancer survivors that examines outcomes for those who experienced infertility, as defined by the typical clinical definition of infertility (attempting to conceive for a year or more without success).

Overall, 15.9 percent of women who survived childhood cancer were affected by infertility, with 12.9 percent trying to conceive for at least one year without success. The remainder of survivors included in the infertile group had ovarian failure and may not have even attempted pregnancy. In a comparison group comprised of sisters of childhood cancer survivors, 10.8 percent experienced infertility. This translates to a roughly 50 percent higher risk of infertility among the survivors of childhood cancer.

The new study is based on data from the Childhood Cancer Survivor Study, a cohort study of five-year survivors from 26 institutions who were under 21 when diagnosed with cancer between 1970 and 1986. Researchers studied 3,531 sexually active female survivors, age 18-39, and a control group of 1,366 female siblings of participants in the large-scale survivor study.

"This is the first study to examine direct questions about infertility and the use of infertility services," said lead author Sara Barton, MD, a clinical fellow of reproduction and infertility at Brigham and Women's Hospital at the time of the research. "Previous studies used surrogate markers. Parenthood. Pregnancy. Births. These don't take into account people's intent. They don't take into account how long it took to achieve pregnancy."

Among survivors of childhood cancer who had been trying unsuccessfully to get pregnant for at least a year, 64 percent conceived after, on average, another six months, compared with an average of five months for clinically infertile women in the control group who eventually conceived.

Women whose cancer was treated with alkylating agent chemotherapy or high-dose radiation to the abdomen or pelvis were most at risk of infertility. Although pediatric oncologists have changed a number of treatment protocols over the last several decades to reduce late effects, alkylating agents and radiation continue to be used.

"Women getting alkylating agents or radiation to the pelvis or abdomen should be triaged for fertility preservation. In addition to being at highest risk to report infertility, female cancer survivors who received those cancer therapies were the least likely to conceive once they had infertility," said Barton, who is now a staff physician at the Heartland Center for Reproductive Medicine and clinical professor at the University of Nebraska Medical School. The new research, she added, will help clinicians offer guidance to current patients based on the treatment protocol for their cancer. "If you're newly diagnosed with Hodgkin's lymphoma, for instance, you may be slightly more likely to experience infertility, but I don't necessarily think you need to delay your therapy to freeze your eggs."

The researchers also found that only 42 percent of cancer survivors who sought treatment for infertility were prescribed medication, compared with 75 percent in the control group. Both groups - 69 percent of survivors and 73 percent in the control group - were similarly likely to seek medical help for their infertility.

Prior research has found that survivors of childhood cancer face a greater risk of infertility but, once pregnant, are not at greater risk for miscarriage or stillbirth.

"What we found delivers a really nice message to clinicians," Diller said. "If you have a patient who is a childhood cancer survivor and is self-reporting clinical infertility, the chances are good that she will become pregnant. Women who have a history of childhood cancer treatment should consider themselves likely to be fertile. However, it might be important to see an expert sooner rather than later if a desired pregnancy doesn't happen within the first six months."

Risk Of Gallstones Increased By Higher BMI, Especially In Women

Risk Of Gallstones Increased By Higher BMI, Especially In Women

New research reveals a causal association between elevated body mass index (BMI) and increased risk of gallstone disease. Results published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show women are at greater risk of developing gallstones.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) describe gallstones as pebble-like material, which can develop when there is excess cholesterol - accounting for 80% of all gallstones - bile salts or bilirubin in bile stored in the gallbladder. Gallstone disease is one of the most common and costly gastrointestinal diseases - accounting for $5.8 billion (Sandler et al., May 2002). Prior studies have shown that greater BMI is associated with increased risk of gallstone disease; however it is unclear if it is the cause of the disease.

To further understanding of the connection between BMI and gallstone risk, a team led by Dr. Anne Tybjrg-Hansen from Rigshospitalet, Copenhagen University Hospital in Denmark studied 77,679 participants from the general population, employing a Mendelian randomization approach - a method using genetic variation to study the impact of modifiable risk factors as the cause of a disease. There were 4,106 participants who developed symptomatic gallstone disease during the 34 years of follow-up.

Participants with gallstone disease were more likely to be older, female, and less physically active. Researchers found that those with gallstones often used hormone replacement therapy and drank less alcohol than those without the disease. Analyses show that increased BMI was associated with gallstone disease risk with an overall hazard ratio (HR) of 2.84. When looking at BMI and gender, the team found that women had a higher risk of developing gallstone disease than men (HR=3.36 and 1.51, respectively).

Findings indicate that gallstone disease risk increased 7% for every 1 kg/M2 increase in BMI. "Obesity is a known risk factor for gallstone disease and our study suggests that elevated BMI likely contributes to the development of this disease," concludes Dr. Tybjrg-Hansen. "These data confirm that obesity adversely affects health, and lifestyle interventions that promote weight loss in overweight and obese individuals are warranted."

Higher BMI Increases Risk Of Gallstones, Especially In Women

Higher BMI Increases Risk Of Gallstones, Especially In Women

New research reveals a causal association between elevated body mass index (BMI) and increased risk of gallstone disease. Results published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show women are at greater risk of developing gallstones.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) describe gallstones as pebble-like material, which can develop when there is excess cholesterol - accounting for 80% of all gallstones - bile salts or bilirubin in bile stored in the gallbladder. Gallstone disease is one of the most common and costly gastrointestinal diseases - accounting for $5.8 billion (Sandler et al., May 2002). Prior studies have shown that greater BMI is associated with increased risk of gallstone disease; however it is unclear if it is the cause of the disease.

To further understanding of the connection between BMI and gallstone risk, a team led by Dr. Anne Tybjrg-Hansen from Rigshospitalet, Copenhagen University Hospital in Denmark studied 77,679 participants from the general population, employing a Mendelian randomization approach - a method using genetic variation to study the impact of modifiable risk factors as the cause of a disease. There were 4,106 participants who developed symptomatic gallstone disease during the 34 years of follow-up.

Participants with gallstone disease were more likely to be older, female, and less physically active. Researchers found that those with gallstones often used hormone replacement therapy and drank less alcohol than those without the disease. Analyses show that increased BMI was associated with gallstone disease risk with an overall hazard ratio (HR) of 2.84. When looking at BMI and gender, the team found that women had a higher risk of developing gallstone disease than men (HR=3.36 and 1.51, respectively).

Findings indicate that gallstone disease risk increased 7% for every 1 kg/M2 increase in BMI. "Obesity is a known risk factor for gallstone disease and our study suggests that elevated BMI likely contributes to the development of this disease," concludes Dr. Tybjrg-Hansen. "These data confirm that obesity adversely affects health, and lifestyle interventions that promote weight loss in overweight and obese individuals are warranted."