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| Dr. Enrique Jacome |
3D mammograms could provide significant improvements in cancer detection and decreasing false positives when used in collaboration regular 2D mammograms, according to a new study by a team of Italian and Australian researchers.
The finding, published in The Lancet Oncology, analyzed whether using 2D and 3D screenings together was more accurate at detecting cancers and decreasing false positives than just 2D screenings.
Led by associate professor Nehmat Houssami, at the University of Sydney's School of Public Health in Australia, the researchers screened 7,292 women with an average age of 58 years in Verona and Trento, Italy. First, their screens were documented using 2D mammograms, and then using a combination of 2D and 3D mammograms.
The investigators found 59 cancers in total in 57 different patients. Approximately two-thirds of the cancers that were found (66%) were detected in both 2D and the combination of 2D and 3D screenings. However, a third (33%) were not seen when only using the 2D - and were only found when using the combination of the 2D and 3D screenings.
These results are the same as a rate of 5.3 cancers per 1000 screens found by 2D alone, and 8.1 cancers found for every 1000 screens by the combination of 2D and 3D screenings.
Earlier studies have looked at the advantages of 3D mammography. However, the current study is the first to draw conclusions about the effectiveness 3D screening in a large sample of women.
Additionally, the researchers found that the combination of 2D and 3D screenings was associated with a decreased number of false positives - when screening finds an unusual abnormality that ends up not being accurate in further testing.
Among all the false positives that happened during the current study, 141 of them happened using 2D screening only, compared with just 73 using the combination of 2D and 3D screenings. Overall, 181 false positives took place at both screen readings - suggesting that this is still a significant problem that needs to be dealt with during breast screening.
According to Professor Houssami:
"Although controversial, mammography screening is the only population-level early detection strategy that has been shown to reduce breast cancer mortality in randomized trials. Irrespective of which side of the mammography screening debate one supports, efforts should be made to investigate methods that enhance the quality of, and hence potential benefit from, mammography screening.
We have shown that integrated 2D and 3D mammography in population breast-cancer screening increases detection of breast cancer and can reduce false-positive recalls depending on the recall strategy. Our results do not warrant an immediate change to breast-screening practice, instead, they show the urgent need for randomised controlled trials of integrated 2D and 3D versus 2D mammography."
Last year, a study published in JAMA suggested that ultrasound screening or MRI in addition to regular mammography screening actually increases breast cancer detection rates among women.
Expenses related to new technologies like 3D mammograms may become a concern. For instance, a study in JAMA Internal Medicine revealed that medicare is putting out as much money screening for breast cancer as it does treating it. Screening expenses for breast cancer in the Medicare program surpassed over $1 billion per year in the fee-for-service program during 2006 to 2007.
www.fleurwomanshealth.com
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| Dr. Enrique Jacome |
Women who had sufficient amounts ofvitamin D were 32 percent less likely to develop fibroids than women with insufficient vitamin D, according to a study from researchers at the National Institutes of Health.
Fibroids, also known as uterine leiomyomata, are noncancerous tumors of the uterus. Fibroids often result in pain and bleeding in premenopausal women, and are the leading cause of hysterectomy in the United States.
The study of 1,036 women, aged 35-49, living in the Washington, D.C., area from 1996 to 1999, was led by Donna Baird, Ph.D., a researcher at the National Institute of Environmental Health Sciences (NIEHS), part of NIH. Baird and her collaborators at The George Washington University and the Medical University of South Carolina screened participants for fibroids using ultrasound. They used blood samples to measure the primary circulating form of vitamin D, known as 25-hydroxy D. Those with more than 20 nanograms per milliliter of 25-hydroxy D were categorized as sufficient, though some experts think even higher levels may be required for good health. The body can make vitamin D when the skin is exposed to the sun, or vitamin D can come from food and supplements.
Study participants also completed a questionnaire on sun exposure. Those who reported spending more than one hour outside per day also had a decreased risk of fibroids. The estimated reduction was 40 percent. Although fewer black than white participants had sufficient 25-hydroxy D levels, the estimated reduction in prevalence of fibroids was about the same for both ethnic groups.
"It would be wonderful if something as simple and inexpensive as getting some natural sunshine on their skin each day could help women reduce their chance of getting fibroids," said Baird.
Baird also noted that, though the findings are consistent with laboratory studies, more studies in women are needed. Baird is currently conducting a study in Detroit to see if the findings from the Washington, D.C., study can be replicated. Other NIEHS in-house researchers, led by Darlene Dixon, D.V.M., Ph.D., are learning more about fibroid development, by examining tissue samples from study participants who had surgery for fibroids.
"This study adds to a growing body of literature showing the benefits of vitamin D," said Linda Birnbaum, Ph.D., director of NIEHS and the National Toxicology Program.
www.fleurwomanshealth.com
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| Dr. Enrique Jacome |
Women are more likely to know about intimate beauty treatments than they are about serious health issues that could make them six times more likely to miscarry or give birth prematurely.
Research published this week by Balance Activ reveals that women are much more aware of bikini waxing (67%) and vajazzles (48%) than they are about their own intimate health, with nearly two thirds of all women questioned (61%) unaware or unsure of health problems that could lead to fertility problems, miscarriage and increased risk of STI's.
BV (Bacterial Vaginosis) affects one in three women* and because very few know about it the symptoms are often confused with other infections. It is twice as prevalent as thrush and if left untreated during pregnancy the condition can lead to serious implications:
- Pregnant women with BV are six times more likely to miscarry and twice as likely to give birth prematurely than other women
- It's thought BV is responsible for one in three of all premature births in the UK
- BV can put women at risk of contracting STIs such as Gonorrhoea and Chlamydia
It seems intimate women's health is the last taboo as over a third of women questioned (38%) admit they would only feel comfortable getting health advice from online forums while nearly a fifth (19%) are too embarrassed to speak with a GP.
The research, carried out to coincide with National BV Day (Tuesday 16th April), reveals 63% of women feel angry that more information on intimate health conditions is not made available. Health experts are now calling for more awareness of intimate health and the serious side effects that can be the result of untreated conditions.
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| Dr. Enrique Jacome |
Research led by David H. Martin, MD, Professor and Chief of Infectious Diseases at LSU Health Sciences Center New Orleans, has found that a common sexually transmitted infection-causing parasite "cultivates" bacteria beneficial to it, changing thinking about which comes first - infection or bacteria. The researchers also discovered a previously unknown species of these bacteria.
The research was published ahead of print online in Advance Access in the Journal of Infectious Diseases, and was published online in Research Highlights in Nature Reviews Urology.
Trichomonas vaginalis is a parasite and is a common sexually transmitted infection (STI) in women where it causes vaginal discharge, a higher rate of premature deliveries, and greater susceptibility to infection with the AIDS virus. Many women have this infection and do not know it.
It is known that a change in vaginal bacteria causes a problem known as bacterial vaginosis, and women with this condition are at increased risk of acquiring a trichomonas infection. The researchers wondered if, among women with bacterial vaginosis, there were unique bacterial communities which would make women more susceptible to infection with trichomonas.
"We discovered that there are two unique bacterial communities that are very strongly associated with trichomonas infection," notes Dr. Martin. "In part what is unique about these communities is high concentrations of bacteria known as mycoplasmas. In fact one of these is a completely unknown bacterium which we have named Mnola because it is a mycoplasma discovered in NOLA."
The mycoplasma associated with the other unique bacterial community is Mycoplasma hominis, a well known bacterial pathogen. The data indicate that women with trichomonas and this unique bacterial community suffer from worse disease than the other trichomonas-infected women. They have greater amounts of discharge and redness of the vaginal wall.
"We think that this group might also be at especially high risk for infection with HIV," adds Dr. Martin.
An especially interesting result of this research is that the evidence suggests that the trichomonas parasite is responsible in some way for the appearance these unique mycoplasma dominated bacterial communities.
"So instead of these unique communities predisposing a woman to infection as originally thought, we now believe that trichomonas takes on the role of a farmer in the vaginal environment by cultivating bacterial communities that are in some way beneficial to itself. Proving this hypothesis and figuring out how these bacteria interact with trichomonas will be the subject of future research," concludes Dr. Martin.
www.fleurwomenshealth.com
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| Dr. Enrique Jacome |
Women reaching the age of 40 tend to be less vigilant about birth control because they think the risk of pregnancy is low - or that birth control can cause health problems - but a review of the evidence by a team that includes a Women & Infants Hospital of Rhode Island physician recently underscored the need to be vigilant about contraception even in perimenopause.
"Despite declining fertility, women over age 40 still require effective contraception if they want to avoid pregnancy," according to Rebecca H. Allen, MD, MPH, of Women & Infants' Department of Obstetrics and Gynecology Division of Research. "In addition, the benefits of birth control outweigh the risk. Even for women with risk factors, there are methods that can be safely used."
The research, entitled "Contraception in women over 40 years of age," was published recently in the Canadian Medical Association Journal (CMAJ). The goal is to educate women and help physicians find the best methods of contraception for their patients.
Women over 40, Dr. Allen explains, need to talk with their primary care provider about which choice of contraception is best for them given their health. Even if they've used a specific method in the past, it might be less appropriate now because of other medical conditions.
Contraception should be used until a woman is assured she has gone through menopause, she adds. Menopause can be assumed after a woman age 50 or older has no menstrual cycle for a year.
In addition to helping to prevent pregnancy, women can find relief from some perimenopausal symptoms with the right contraceptive. This includes:
- Estrogen-containing oral contraceptives or the progestin-releasing intrauterine device for help stemming the heavy menstrual bleeding that can occur in the perimenopause
- Estrogen-containing contraceptives can help vasomotor symptoms such as hot flashes and night sweats
- Estrogen-containing oral contraceptives might possibly prevent declines in bone density, according to one study
- Combined oral contraceptives decrease a woman's risk of developing endometrial cancer by 50%, according to the results of two large studies
