Hormone Replacement Might Relieve Arthritis

TUESDAY, March 30 (HealthDay News) — Hormone replacement therapy directed to joint fluid may help regenerate damaged cartilage tissue in people with advanced osteoarthritis, according to German researchers.

Their study aimed to examine the regenerative potential of a type of cell — chondrogenic progenitor cells, or CPCS — that is present in the late stages of osteoarthritis. The researchers speculated that these cells might be influenced by the sex hormones estrogen, which has been shown to affect bone metabolism, and testosterone.


They analyzed tissue samples from 372 men and women with arthritis who’d had a total knee replacement. Most were in their early 70s.

In the joint fluid of the participants, they found 17 beta-estradiol, a form of estrogen, which they said increases calcium deposition in both sexes. And, in the osteoarthritic tissue, they found CPCs positive for estrogen receptors and androgen receptors.

The researchers, also found that unique CPCs were present in the cartilage of people with late-stage osteoarthritis (OA).

“We were able to isolate CPCs in 95.48 percent of female patients and 96.97 percent of male patients, making these cells a good target for future therapeutic intervention for a very large number of OA patients,” Dr. Nicolai Miosge, from August University in Goettingen, said in a news release from Wiley-Blackwell, which publishes Arthritis & Rheumatism.

The findings are reported in the journal’s April issue.

“Hormone replacement therapy in joint fluid may help mitigate the effects of OA,” Miosge concluded, adding that further investigation was needed.

More information

The Arthritis Foundation has more about osteoarthritis.

— Robert Preidt

SOURCE: Wiley-Blackwell, news release, March 30, 2010

Last Updated: March 30, 2010

Copyright © 2010 HealthDay. All rights reserved.

High-Impact Sports Might Not Harm Knee Replacements

FRIDAY, March 12 (HealthDay News) — Patients who get a total knee replacement are usually advised to avoid high-impact sports to preserve their new body part. But a new study suggests sport participation is not only safe — it may even help people gain better knee function.

”Initially, we though high-impact sports were terrible for the prosthesis,” said Dr. Sebastien Parratte, a research collaborator at the Mayo Clinic in Rochester, Minn., and an assistant professor at the Aix-Marseille University Center for Arthritis Surgery at Hospital Sainte-Marguerite in Marseille, France.


“Our eight-year results have shown it is not the case,” he said.

He is the lead author of the study, scheduled for presentation Friday at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans.

More than a half million total knee replacements are performed annually in the United States, according to the American Academy of Orthopaedic Surgeons. Parratte and his colleagues conducted the study knowing that patients routinely ignore their doctor’s advice to take it easy after receiving a knee replacement. In fact, about one of six patients engage in high-impact activities post-implantation, experts say.

Parratte’s team followed 535 patients in all. A total of 218 underwent knee replacement and then performed heavy manual labor or engaged in a non-recommended sport, such as high-impact aerobics, football, soccer, baseball, jogging or power lifting. The control group of 317 patients had knee replacement but did not engage in sports that were not recommended.

The researchers evaluated the patients clinically and with X-rays. About eight years after surgery, they found no significant radiological differences and no significant differences in the implant durability between groups.

In fact, the sport group had slightly higher knee function scores than the control group.

A first comparison found that the control group had a 20 percent higher need to repeat the operation because of mechanical failure of the knee (from wear, fracture or loosening) compared to the sport group. But when they took into account other health problems such as obesity or diabetes, the sport group had a 10 percent higher risk of mechanical failure compared to the control group, but the difference wasn’t statistically significant.

”The control group was more likely to have high blood pressure, obesity and diabetes,” Parratte added.

He said he doesn’t know why the sport group’s knees held up better.

Still, the study findings are no reason to tell patients with knee replacements to exercise in a high-impact way, said Dr. Christian Christensen, an orthopedic surgeon and head of adult reconstruction at the Lexington Clinic in Lexington, Ky.

“I think it’s a good study and certainly a worthwhile one,” he said. “Would it encourage me to tell my patients to play football? No way.”

More research is needed to evaluate what’s happening, he said. It’s possible that the people with the best results may be the ones engaging in high-impact sports. “People with the knees that feel great, who have excellent results,” are perhaps the ones who can engage in the high-impact sports without ill effect, he said.

Another possibility, he said, is that the follow-up may just not be long enough, that ill effects may show up later. Christensen said he’ll continue to tell his knee-replacement patients to avoid high-impact sports. “Implants aren’t meant to tolerate high-impact sports,” he said.

Dr. Benjamin Bengs, another expert, called the new study findings promising. It shows these devices are long-lasting, can lead to lifelong pain relief and excellent functioning and activity in patients, said Bengs, an orthopedic surgeon at Santa Monica-University of California Medical Center and Orthopaedic Hospital.

But more time and study are needed before we completely release people to all high-impact activities, he said.

”One study is not enough to change the recommendations,” Parratte agreed. He plans to study the topic further.

More information

To learn more about total knee replacement, visit the American Academy of Orthopaedic Surgeons.

By Kathleen Doheny
HealthDay Reporter

SOURCES: Sebastien Parratte, M.D., Ph.D., orthopedic surgeon, Mayo Clinic, Rochester, Minn., and Aix-Marseille University, Center for Arthritis Surgery, Hospital Sainte-Marguerite, Marseille, France; American Academy of Orthopaedic Surgeons annual meeting, March 12, 2010, New Orleans; Christian Christensen, M.D., head of adult reconstruction at the Lexington Clinic, Lexington, Ky.; Benjamin Bengs, M.D., orthopedic surgeon, Santa Monica–University of California Medical Center and Orthopaedic Hospital, Santa Monica, Calif., and assistant professor, orthopedic surgery, UCLA David Geffen School of Medicine, Los Angeles

Last Updated: March 12, 2010

Copyright © 2010 HealthDay. All rights reserved.

Low Vitamin D Levels Tied to Obesity in Kids

FRIDAY, April 29 (HealthDay News) — Vitamin D deficiency is common in American children and linked with obesity and different types of fat distribution in white and black youngsters, new research shows.

Vitamin D is found in certain foods, but humans synthesize most of the nutrient they need via the action of sunlight on exposed skin. Supplements can also boost levels of vitamin D.

In the study, researchers checked vitamin D levels in 237 healthy obese and non-obese white and black children, aged 8 to 18. They found that most of them were vitamin D deficient. Low levels of vitamin D were associated with higher body mass index and fat levels, and lower levels of “good” high-density lipoprotein (HDL) cholesterol.

Among those with vitamin D deficiency, white children were more likely to have higher levels of fat between their internal organs (visceral adipose tissue), while black children were more likely to have higher levels of fat just under the skin (subcutaneous adipose tissue), the investigators found.

The study is published in the May issue of the Journal of Clinical Endocrinology & Metabolism.

“Vitamin D deficiency is rampant in American youth, and there is some suggestion in adults that low levels of vitamin D may be playing a role in the increasing rates of type 2 diabetes. It is possible the same may be true for youth with type 2 diabetes,” lead author Dr. Silva Arslanian, of the University of Pittsburgh, said in a news release from the Endocrine Society.

“Besides therapeutic interventions to correct the high rates of vitamin D deficiency in youth, benefits of vitamin D optimization on fat levels, lipid [blood fat] profile and risk of type 2 diabetes need to be explored,” Arslanian added.

More information

The American Academy of Pediatrics has more about children and vitamin D.

– Robert Preidt

SOURCE: The Endocrine Society, news release, April 27, 2011

Last Updated: April 29, 2011

Copyright © 2011 HealthDay. All rights reserved.

Tall, Obese Men More Prone to Leg Clots: Study

By Randy Dotinga
HealthDay Reporter

THURSDAY, April 28 (HealthDay News) — Men who are both obese and tall face a much higher risk for developing potentially fatal blood clots, though overall the risk remains quite small, according to a new study.

The researchers report that extra weight and extra inches together seem to raise the risk more than either alone.


“Tall and obese men had more than a fivefold higher risk, compared to short and lean men,” said the study’s co-author, Sigrid K. Braekkan, who warns the vertically and horizontally gifted to avoid sitting in one place for too long.

Women also face a higher risk if they’re both obese and tall, but just being tall alone doesn’t seem to be a problem, the study found.

The clots lead to a condition known as deep vein thrombosis, which may be best known as an affliction that strikes passengers on long plane flights who don’t have much chance to move around. Immobilization of the legs can contribute to the condition.

Other causes include injury and a genetic condition that makes people’s blood more likely to clot. “And there are some people who seem to get clots when they don’t have any clear, obvious risk factors,” said Dr. Victor Tapson, director of the Center for Pulmonary Vascular Disease at Duke University.

Though the clots start in the leg, they can move to the lung, where they may cause a deadly pulmonary embolism. Venous thromboembolism is the term used to describe the two conditions — deep vein thrombosis and pulmonary embolism — together.

In the new study, published online April 28 in Arteriosclerosis, Thrombosis and Vascular Biology, researchers collected data on 26,714 people from 1994 to 2007, including 461 reports of venous thromboembolism.

Obese and tall men — those at least six feet tall — had more than five times the risk for a clot, compared with normal-weight men shorter than 5 feet 7 inches. The risk was three times higher for women who were obese and at least 5 feet 6 inches than for normal-weight women shorter than 5 feet 3 inches.

The higher risk for tall people appears to be related to their circulatory system. “The distance for blood to return to the heart and lungs is longer,” Braekkan said. “Since the blood must be pumped upwards against the force of gravity by the calf-muscle pump, the longer distance may cause reduced flow in the legs and, thereby, higher risk of clotting.”

He said that obesity causes pressure in the abdomen that may hinder the ability of the calf-muscle pump to send blood back up into the body.

The study found, however, that the risk for developing blood clots remained low, even for the tall and obese.

But what should obese and tall people do to lower their risk even more? Until pounds can be shed, the best thing to do is to avoid situations where you’re not moving for long periods of time, Tapson said.

Even in the cramped space of a plane, try “just moving your legs, shifting your legs, going up and down on your toes and flexing your feet back and forth to keep your calf muscles stimulated,” he said. It’s also a good idea to keep hydrated (and alcohol doesn’t help on that front). Some people use elastic socks, although Tapson said they may be troublesome if they crimp the legs.

More information

The U.S. National Heart, Lung and Blood Institute has more on deep vein thrombosis.

SOURCES: Sigrid K. Braekkan, Ph.D., researcher, Hematological Research Group, University of Tromso, Norway; Victor Tapson, M.D., professor, medicine, and director, Center for Pulmonary Vascular Disease, Duke University Medical Center, Durham, N.C.; April 28, 2011, Arteriosclerosis, Thrombosis and Vascular Biology, online

Last Updated: April 28, 2011

Copyright © 2011 HealthDay. All rights reserved.

Soaring Costs Deprive Some Children of Medical Care

MONDAY, May 2 (HealthDay News) — Because of soaring health care costs in the United States, some parents are reluctant to take their children to the doctor or to buy prescription drugs, according to a new study.

Researchers examined data from 6,273 families with at least one child who took part in Medical Expenditure Panel Surveys between 2001 and 2006.

One thing that increased the chances that families would delay or go without care was excessive financial burden, defined as insurance premiums or out-of-pocket health care expenses exceeding 10 percent of family income.

Other factors were having a child with an ongoing activity limitation, and a parent with intermittent insurance.

The study also found significant racial/ethnic and income-related disparities. For example, white families were more likely than black families to report delayed or foregone care. Families with a household income below the federal poverty level were more likely to delay or go without care than those with incomes at or above 400 percent of the poverty level.

The study was to be presented Monday at the annual meeting of the Pediatric Academic Societies. Research presented at meetings is considered preliminary because it has not been subject to the scrutiny required for publication in a peer-reviewed journal.

“Every U.S. family has a finite amount of resources available to them, and every day they have to make decisions about how to allocate those resources. This is especially true in today’s economy where you hear people talk about ‘feeling the pinch,’” study leader Lauren E. Wisk, a doctoral student and graduate research assistant at the School of Medicine and Public Health, University of Wisconsin, Madison, said in an American Academy of Pediatrics news release.

“This study shows the unfortunate reality of the situation,” Wisk added. “Families aren’t choosing to spend their money on going to the doctor when someone is sick because of how much it cost them to see the doctor last time. They’re sacrificing their health because it costs too much to be healthy.”

More information

The U.S. Agency for Healthcare Research and Quality has more about health care costs.

— Robert Preidt

SOURCE: American Academy of Pediatrics, news release, May 2, 2011

Last Updated: May 02, 2011

Copyright © 2011 HealthDay. All rights reserved.

Blacks With Cancer More Inclined to Exhaust Funds to Prolong Life: Study

TUESDAY, April 26 (HealthDay News) — White patients with lung or colorectal cancer are less willing than patients of other races or ethnicities to use up their personal financial resources to prolong their life, a new study finds.

U.S. researchers analyzed data from 4,214 participants in the Cancer Care Outcomes Research and Surveillance study of patients with newly diagnosed lung or colorectal cancer.


The patients were interviewed about various aspects of their care, including their willingness to deplete their personal financial resources for life-prolonging treatment rather than receive less costly treatment that would not extend their lives as long.

Those who said they would spend all their money to live longer included 80 percent of black patients, 72 percent of Asians, 69 percent of Hispanics and 54 percent of whites.

After researchers accounted for factors such as income, disease stage, quality of life, patients’ age, patients’ perceived time left to live and other medical illnesses, the researchers determined that black patients were 2.4 times more likely than whites to say they’d exhaust their personal finances to extend life.

Hispanic and Asian patients were also less inclined to spend all of their money than blacks, but more likely than whites to do so.

The study appears online April 26 in the journal Cancer.

Further research is needed to determine the reasons for these differences among the races, said Michelle Martin of the University of Alabama at Birmingham and colleagues in a journal news release. Learning more about this issue may lead to cancer care that consistently reflects patient values and preferences, they added.

More information

The U.S. National Cancer Institute offers fact sheets about coping with cancer.

— Robert Preidt

SOURCE: Cancer, news release, April 26, 2011

Last Updated: April 26, 2011

Copyright © 2011 HealthDay. All rights reserved

Early Adversity May Shorten Child’s Life

WEDNESDAY, May 18 (HealthDay News) — Deprivation and neglect can cause premature aging of children’s chromosomes, a new study suggests.

Researchers examined DNA samples collected from institutionalized children (62 boys and 47 girls) in Romania taking part in a long-term study. Some of the children remained in the institution, while others were transferred to high-quality foster care at different ages.


Children who spent more time in an institution before age 5 had premature shortening of chromosome tips (telomeres) when they reached ages 6 to 10, the researchers found.

“The telomere is designed to protect the chromosome, so accelerating how early in life telomeres lose length correlates with shortened life span,” principal investigator Charles Nelson, director of the Laboratories of Cognitive Neuroscience at Children’s Hospital Boston, said in a hospital news release. “Children institutionalized early in life have shortened telomeres, which may lead to health consequences downstream, including premature aging.”

He and his colleagues found differences between girls and boys. The strongest predictor of telomere shortening for girls was the amount of time spent in the institution before 22 months of age. For boys, it was the amount of time spent in the institution before 54 months of age.

The study was published online May 17 in the journal Molecular Psychiatry.

Previous research has linked shorter telomere length in adults with cognitive defects and increased rates of cardiovascular disease and cancer.

“One question we are currently studying is whether telomere length can recover as a child spends more time in foster care, or whether the shortening we observed reflects a permanent change,” Nelson said.

More information

The University of Utah has more about telomeres.

– Robert Preidt

SOURCE: Children’s Hospital Boston, news release, May 17, 2011

Last Updated: May 18, 2011

Copyright © 2011 HealthDay. All rights reserved.

Skin Infestation a Delusion, Study Says

By Anne Harding

MONDAY, May 16, 2011 (Health.com) — For years, dermatologists have been aware of—and baffled by—people who feel a constant creepy-crawly sensation beneath their skin, which they believe is due to bugs, worms, or eggs below the surface.

Now, in the largest study to date to examine skin samples from patients with these symptoms, doctors have firm proof that these infestations
—known as delusional parasitosis or delusional infestation—are not real. The researchers acknowledge, however, that the findings may not be enough convince many of these patients.

Patients often feel dismissed when doctors reassure them that the infestation is all in their head, and many continue to believe they are teeming with bugs even when skin biopsies come back negative.

“It’s almost impossible to get them to shake this belief, no matter how much evidence you produce to the contrary,” says Mark D. P. Davis, MD, a professor of dermatology at the Mayo Clinic, in Rochester, Minn.


Antipsychotic drugs are the standard treatment for delusional infestation. But, Dr. Davis says, “A lot of patients with this disorder don’t want to take these drugs because they don’t feel they have a delusional disorder.”

Some patients who experience this skin-crawling sensation believe it is caused by textile-like fibers produced by an unknown organism. Along with a group of sympathetic doctors and advocates, these patients have pushed for the condition to be officially recognized as Morgellons disease, and have lobbied—successfully—for the Centers for Disease Control and Prevention (CDC) to investigate it.

However, most doctors maintain that the condition is psychological rather than physical. In a new study, published this week in the Archives of Dermatology, Dr. Davis and his colleagues sought to confirm this view by presenting the results of skin biopsies taken from patients who were diagnosed with delusional infestation at the Mayo Clinic between 2001 and 2007.

The researchers performed 80 biopsies. As expected, none showed evidence of skin infestation, although 49 patients did have some skin inflammation, known as dermatitis. This inflammation might be due to some underlying cause, such as allergies, or it could have been caused by the patient’s efforts to remove the bugs or objects by digging them out or even trying to burn them, Dr. Davis says.

In addition, 80 of the study participants—including some who also had biopsies taken—supplied their own skin samples to the doctors. Ten of these specimens contained insects, such as a mite or tick, but only one such bug was actually capable of causing an infestation; it was a pubic louse, but the patient’s biopsy did not show any signs that his or her skin was infested with the lice.

The CDC recently completed its own study of the condition, which the agency refers to as unexplained dermopathy, but the results have not yet been published.

Teen Headaches Tied to Alcohol, Coffee

MONDAY, June 7 (HealthDay News) — A new German study links drinking and smoking to higher rates of migraine and tension headaches among teens and young adults.

An estimated 5 to 15 percent of high school students surveyed reported suffering from migraines, and 15 to 25 percent said they have tension headaches. Migraines were more common among those who drank coffee and didn’t get much exercise.


Astrid Milde-Busch, a researcher at Ludwig-Maximilians-University in Munich, Germany, and colleagues surveyed 1,260 students aged 14 to 20 about headaches and their activities.

Of the students, 83 percent said they’d had a headache within the previous six months.

“Our study confirms that adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks,” Milde-Busch said. “In teens suffering from migraine, a low coffee consumption should also be suggested.”

Young adults who skipped meals weren’t at higher risk of headache, the researchers found.

The study was published online June 7 in the journal Headache.

More information

For more about headaches, see the U.S. National Library of Medicine.

– Randy Dotinga

SOURCE: Wiley, press release, June 7, 2010

Last Updated: June 07, 2010

Copyright © 2010 HealthDay. All rights reserved.

New Migraine Drug Might Be Safer for Some

THURSDAY, April 22 (HealthDay News) — A drug under development could help patients with migraines, while an existing epilepsy drug might prevent the headaches from developing in the first place, new research suggests.

The report, published April 21 in The Lancet, examines the migraine drug telcagepant, which is not yet available, and topiramate (Topamax), an epilepsy drug sometimes used to treat migraines when they occur.


Telcagepant relieves pain in a similar way to the drugs known as triptans that are used to treat migraine. But it doesn’t cause blood vessels to constrict, a troublesome side effect for people with heart disease, the report says.

Triptans often don’t work, and they can cause side effects like dizziness, throat tightness, chest discomfort and numbness. For its part, telcagepant can cause side effects like dry mouth, dizziness, nausea and drowsiness.

Telcagepant is a “promising compound,” writing the study authors, but add that further investigation is needed.

Also in the report, the authors say topiramate is showing promise as a preventive treatment for migraines. It’s cost-effective and typically leads to weight loss instead of weight gain, they report.

The authors write that the drug “should especially be considered for adult patients who are overweight, or have epilepsy or a contraindication to beta blockers. It is generally safe and well-tolerated. Thus topiramate is an important drug for difficult cases.”

The report authors are Dr. Lars Edvinsson of University Hospital in Lund, Sweden, and Dr. Mattias Linde of the Norwegian University of Science and Technology in Trondheim, Norway.

More information

The U.S. National Library of Medicine has more about migraine headaches.

— Randy Dotinga

SOURCE: The Lancet, news release, April 21, 2010

Last Updated: April 22, 2010

Copyright © 2010 HealthDay. All rights reserved.

Early Menstruation Lowers Odds of Surviving Ovarian Cancer

THURSDAY, July 9 (HealthDay News) — Among women with ovarian cancer, those who had their first menstrual period before the age of 12 and who had the most menstrual cycles over a lifetime are more likely to die of the cancer than those who had fewer ovulatory cycles, a new study shows.

U.S. researchers analyzed data on 410 women, aged 20 to 54, who had ovarian cancer and were enrolled in the Cancer and Steroid Hormone (CASH) study between 1980 and 1982.


Using data that included in-depth patient interviews, reproductive history, contraceptive use and personal and family medical history, the researchers divided the women into groups based on their total number of ovulatory cycles.

There were 212 deaths among the participants during a median follow-up of 9.2 years, the study authors noted.

Women in the group who had the highest number of lifetime ovulatory cycles had a 67 percent greater chance of dying during the study follow-up, which ranged up to about 17 years.

The findings were independent of a woman’s age at the time of the study, which would of course have a significant impact on the number of menstrual cycles a woman had had, said study author Cheryl Robbins, an epidemiologist at the U.S. Centers for Disease Control and Prevention.

Ovarian cancer patients whose age at menarche, or first menstrual cycle, was younger than 12 were 51 percent more likely to die from the cancer than those whose age at menarche was 14 or older, according to the study, published in the July issue of Cancer Epidemiology, Biomarkers & Prevention.

Ovarian cancer is the fifth-leading cause of cancer deaths among women. The high mortality is due, in part, because the disease is typically discovered after it has spread. Only about one-fifth of ovarian cancers are detected when the cancer is still localized, the study authors noted.

Previous research has linked age at first menstrual period and number of lifetime menstrual cycles with the risk of ovarian cancer, while use of oral contraceptives and hysterectomy or tubal ligation, which halt ovulation, have also been shown to reduce the risk of developing ovarian cancer.

Other studies have also found that having children earlier in life, having multiple children and breast-feeding provide protection, but the results are inconsistent, the researchers noted.

But less is known about the impact of those hormonal and reproductive factors on survival rates for women who already have the cancer.

“Although we have relatively good knowledge about the influence of reproductive factors on the risk of developing ovarian cancer, knowledge is rather limited regarding the reproductive factors that may influence survival after diagnosis with this serious disease,” Robbins said.

Though the exact mechanism isn’t understood, researchers believe that the surge of hormones brought on by ovulation, or the insult to the cells that occurs during ovulation, may be associated with more aggressive tumors, Robbins said.

In the current study, while age at first period and total lifetime menstrual cycles impacted survival, other factors, including number of pregnancies, breast-feeding and menopausal status did not show a statistically significant impact on survival rates.

Dr. Mary B. Daly, director of the Personalized Cancer Risk Assessment Program at the Fox Chase Cancer Center in Philadelphia, said the results shed more light on the role reproductive hormones play in ovarian cancer, potentially providing clues for developing new treatments for aggressive cancers.

Yet the study has its limitations, Daly added. Women’s recollections could have been flawed, and the study participants were younger than the typical ovarian cancer patient and so may not be truly representative. Additionally, the women in the study had ovarian cancer nearly 30 years ago and would not have been receiving today’s more advanced chemotherapy treatments.

Nor is the research definitive enough to suggest that women should go out and start taking contraceptive pills or having babies earlier to increase their chances of surviving ovarian cancer.

“The paper may suggest other avenues of research into what is it about the hormonal profile of women that could affect the biology of their ovarian cancer,” Daly said. “As of right now, it doesn’t translate into something you could clinically do differently.”

More information

The U.S. National Cancer Institute has more on ovarian cancer.

By Jennifer Thomas
HealthDay Reporter


SOURCES: Cheryl L. Robbins, Ph.D., epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; Mary B. Daly, M.D., Ph.D., director, Personalized Cancer Risk Assessment Program, Fox Chase Cancer Center, Philadelphia; July 2009 Cancer Epidemiology, Biomarkers & Prevention

Last Updated: July 09, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Childhood Sexual Abuse Might Spur Early Periods

THURSDAY, May 21 (HealthDay News) — The younger they were when they started menstruating, the more likely black women were to have suffered childhood sexual abuse, U.S. researchers report.

The finding suggests childhood sexual abuse may increase the likelihood of early periods.

Researchers looked at more than 35,000 women,
aged 21 to 69, taking part in the Black Women’s Health Study and found that 43 percent reported physical abuse and 18 percent reported sexual abuse when they were children.

The study found that women who suffered one to three incidents of childhood sexual abuse were 26 percent more likely to have had menstrual periods before age 12, while those who experienced four or more incidents of childhood sexual abuse were 34 percent more likely to have had early periods.

There was a weaker association between early periods and childhood physical abuse, according to the study, published online in the American Journal of Public Health.

It’s biologically plausible that childhood sexual abuse could influence age of menstruation, said study author Lauren A. Wise, an epidemiologist at the Slone Epidemiology Center and an assistant professor of epidemiology at Boston University School of Public Health.

“A link between sexual abuse and early menarche [periods], if real, could have important public health implications, because early menarche is associated with earlier age at initiation of sexual activity and first pregnancy, and is a risk factor for several adult conditions, including gynecologic disorders, cardiovascular disease and cancer,” Wise said in a Boston University Medical Center news release.

More information

The American Academy of Child and Adolescent Psychiatry has more about childhood sexual abuse.

— Robert Preidt

SOURCE: Boston University Medical Center, news release, May 18, 2009

Last Updated: May 21, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Blood Test May Be Able to Predict Menopause

MONDAY, June 28, 2010 (Health.com) — A simple doctor’s-office blood test may one day be able to predict when a woman will start menopause, possibly even in women in their 20s.

Pending validation in future studies, the test could help women make reproductive decisions, say the authors of a study that will be presented Monday at the annual meeting of the European Society of Human Reproduction and Embryology in Rome.


“Women may want to know if they’re OK waiting to start a family till they’re 41,” says Jennifer Wu, MD, an obstetrician/gynecologist at Lenox Hill Hospital, in New York City, who was not involved with the study. “If they know they’re going to start menopause at 45, they may not want to wait.”

But the test definitely isn’t ready for prime time and may not be used primarily to guide family planning decisions, even if it is eventually brought to market, other experts say.

“I’m not sure that this would help with family planning decisions [although] it’s a very interesting first, small, observational study,” says Steven Goldstein, MD, president-elect of the North American Menopause Society (NAMS). “It would be helpful to do a larger trial and see if it pans out and, if so, to what degree of accuracy.”

In the study, researchers from Shahid Beheshti University of Medical Sciences, in Tehran, Iran, measured blood levels of anti-mullerian hormone (AMH) in 266 women who were ages 20 to 49.

AMH is proportional to the number of viable eggs left in the ovaries, which produce the hormone, says James A. Grifo, MD, PhD, program director of the NYU Langone Fertility Center, in New York City.

Fertility Drug Shows Potential Against Hot Flashes

WEDNESDAY, Sept. 16 (HealthDay News) — A powerful fertility drug may have another use for older women: stopping hot flashes.

In a letter to the editor in the Sept. 17 issue of the New England Journal of Medicine, researchers from the Netherlands report that in three cases, the injectable medication cetrorelix (Cetrotide) helped ease hot flash symptoms.

“It is a very exciting new approach for an extremely common problem with an enormous psychosocial impact that is often ignored or underestimated,” said the lead author of the letter, Dr. Hans de Boer, an endocrinologist at Rijnstate Hospital in Arnhem, the Netherlands.

Not everyone is convinced that this drug is a viable option for treating menopausal symptoms, however.

“This letter describes three cases and has no controls. This drug works on receptors in the brain and no one knows what the long-term consequences might be,” said Dr. Lila Nachtigall, director of the Women’s Wellness Program at the NYU Langone Medical Center, and a professor at the New York University School of Medicine in New York City.

Nachtigall said she would never recommend such a drug to her patients when there are other, often more well-studied options available to treat hot flashes.

Cetrorelix blocks the brain receptors for luteinizing hormone-releasing hormone (LHRH), which the letter’s authors suggest may be involved in the development of hot flashes. The medication is primarily used by doctors to stop premature ovulation in women taking fertility drugs but it is also being studied for use in women with hormone-sensitive cancers, such as breast, ovarian and endometrial cancer, as well as in endometriosis treatment.

Although they might not sound serious, hot flashes — sometimes called hot flushes — can greatly affect the quality of a woman’s life. A sudden sensation of increased heat is often accompanied by perfuse perspiration. The sweating can be severe enough that women need to change their clothes. Besides causing discomfort, hot flashes can seriously disturb sleep quality.

The three women that de Boer and his colleagues reported on all entered menopause as the result of the removal of their ovaries, which had occurred several years earlier. One patient was 65 years old and began having severe hot flashes after estrogen-replacement therapy was discontinued. The second patient was 49 years old and had survived breast cancer, while the third patient — 59 years old — had survived endometrial cancer.

All underwent daily injections of cetrorelix for at least 20 weeks, according to the letter. And, hot flash symptoms were reduced between 60 percent and 80 percent, according to de Boer, who added that they saw no serious adverse events associated with the use of cetrorelix. He also said that he didn’t expect any serious long-term side effects.

But, he cautioned that the “research in this area is very preliminary. It may take several years before everything is sorted out and therapy is available on a regular basis.”

Nachtigall said that one of her biggest issues with this case report is that other researchers, including the top researcher in the field, have come to believe that LHRH is not behind hot flashes. “We just don’t know the true cause,” she said.

And, more importantly, “we do have other options for treating hot flushes,” said Nachtigall.

She said that most women can safely take estrogen as they’re entering menopause for as long as a few years. And, she said, some antidepressant medications in the SSRI class have also been shown to be helpful in reducing hot flashes. There are also some alternative therapies that women have found effective.

“The bottom line is we do have ways to fight it. You don’t have to take a drug we know nothing about. For fertility, this is used for 10 days or so, maybe once or twice in a woman’s life. This drug works on receptors in the brain, and no one knows what effects long-term use might have,” she said.

More information

To learn more about treatments for menopausal symptoms, like hot flashes, visit the U.S. National Women’s Health Information Center.

By Serena Gordon

HealthDay Reporter

SOURCES: Hans de Boer, M.D., Ph.D., endocrinologist, Rijnstate Hospital, Arnhem, the Netherlands; Lila Nachtigall, M.D., director, Women’s Wellness Program, NYU Langone Medical Center, and professor, New York University School of Medicine, New York City; Sept. 17, 2009 New England Journal of Medicine

Last Updated: Sept. 16, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Birth Control Pills Linked to Lupus Risk

THURSDAY, April 9 (HealthDay News) — Women taking birth control pills, especially those who have just started taking them, may face an increased risk of developing the autoimmune disease lupus, a new study suggests.

Although the link between lupus and oral contraceptives has been debated for some time, this new study adds weight to earlier studies — including the Nurses’ Health Study — that have shown a link between oral contraceptives and lupus, the study authors said.


The findings were published in the April issue of Arthritis Care & Research.

Lupus is characterized by acute and chronic inflammation of various tissues of the body. The immune system mistakenly attacks healthy cells and tissues, potentially damaging joints, skin, blood vessels and organs, according to the U.S. National Library of Medicine.

For the new study, a team led by Dr. Samy Suissa of the Centre for Clinical Epidemiology at Jewish General Hospital of McGill University in Montreal collected data on more than 1.7 million women whose medical records were in the U.K. General Practice Research Database. The women all had prescriptions for oral contraceptives.

During eight years of follow-up, 786 women developed lupus. The researchers matched each of these women with 10 women who did not have the disease.

Suissa’s team found that oral contraceptives were associated with a 1.5-fold increased risk of developing lupus. The risk was greatest during the first three months after starting “the Pill” — when there was a 2.5-fold increased risk.

The researchers speculated that increased estrogen from oral contraceptives could be responsible for the increased risk. Estrogen can affect the body’s immune response, which could trigger a genetic predisposition to the disease, the scientists said.

Suissa’s team also noted that newer oral contraceptives, which contain lower doses of estrogen, are substantially less likely to heighten the risk of lupus, compared to the second-generation contraceptives used in the study.

For most women, the increased risk of lupus is quite small, said Dr. Noel Rose, director of the Autoimmune Disease Research Center at Johns Hopkins University, who was not involved in the study. “One shouldn’t oversell this. Women taking oral contraceptives need to weigh the risk/benefit of unexpected pregnancy versus a very small increase in lupus.”

The increased risk isn’t the same for all women taking oral contraceptives, Rose said. “This is probably a risk that only people who are genetically predisposed are likely to ever encounter,” he said.

Dr. Bevra Hahn, chief of rheumatology and arthritis at the David Geffen School of Medicine at the University of California, Los Angeles, thinks the new study can be helpful in prescribing oral contraceptives.

“The higher the dose of estradiol in women who have been started on oral contraceptives in the past three months, the higher the risk for developing” lupus, Hahn said. “That’s the highest risk I’ve ever seen — meaning women have a little over three times the chance of developing lupus in the first three months of taking an oral contraceptive.”

“That is very useful information in terms of what oral contraceptive one prescribes,” she said.

Hahn agreed that women need to weigh the risk of developing lupus to the risk of getting pregnant. “There isn’t any effective treatment I know of that isn’t accompanied by some risk. So she just has to decide which risk she thinks is greater.”

More information

For more on lupus, visit the U.S. National Library of Medicine.

SOURCES: Noel Rose, M.D., Ph.D., director, Autoimmune Disease Research Center, Johns Hopkins University, Baltimore; Bevra Hahn, M.D., chief of rheumatology and arthritis, David Geffen School of Medicine, University of California, Los Angeles; April 2009, Arthritis Care & Research

By Steven Reinberg
HealthDay Reporter

Last Updated: April 09, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Blood Cancer Drug Shows Promise Against Lupus

SUNDAY, June 8 (HealthDay News) — A drug used to treat multiple myeloma, a cancer of the white blood cells, may also be a treatment for the chronic autoimmune disease lupus, German researchers report.

The drug, Velcade (bortezomib), which is a proteasome inhibitor, worked against the disease and prolonged survival in mice with lupus. The finding could one day offer treatment options for other antibody-associated diseases, too, the researchers said.


“Autoantibody-mediated diseases such as autoimmune hemolytic anemia, immune thrombocytopenia, myasthenia gravis and systemic lupus erythematosus are often difficult to treat,” said lead researcher Dr. Reinhard Voll, of the University of Erlangen-Nuremberg.

A big problem is that plasma cells, which are the predominant producers of the disease-causing autoantibodies, can’t be efficiently attacked with current treatments, Voll said.

Lupus is a so-called autoimmune disease in which the immune system attacks healthy cells and tissues by mistake, leading to damage to joints, skin, blood vessels and organs. There are many kinds of lupus, with the most common type being systemic lupus erythematosus, which affects many parts of the body. There’s no one test to diagnose lupus, and it may take months or years to make the diagnosis. There’s also no cure, but medicines and lifestyle changes can help control the disease, according to the U.S. National Institutes of Health

For the new study, Voll’s team found that bortezomib efficiently eliminated the plasma cells in the mice, leading to a drastic decrease in autoantibodies and prolonged survival. And, the drug had no effect on other cells, he said.

“Proteasome inhibitors may be beneficial in refractory human diseases caused predominantly by autoantibodies,” Voll said. “Proteasome inhibitors can selectively deplete plasma cells, which are resistant to current treatments.”

Outside experts were divided on the findings, published in the June 8 online edition of Nature Medicine.

“This is a very exciting study that explores a novel mechanism for treating lupus erythematosus,” said Dr. Jennifer Grossman, an assistant professor of medicine at the University of California, Los Angeles.

“The fact that antibodies almost completely disappeared is encouraging. I look forward to hearing more about this treatment in the future,” she said.

But, another expert expressed concern that the treatment could adversely affect other cells in the human body.

“I think they’re onto something important, it looks as if it has a remarkable therapeutic effect,” said Dr. Noel Rose, director of the Autoimmune Disease Research Center at Johns Hopkins University. “The downside is that this is a proteasome inhibitor, and there is no reason to think that it would be specific for plasma cells. It does affect other rapidly proliferating cells.”

Rose noted that many drugs may appear safe during an initial trial. “I’m still really suspicious that if this is used clinically, there are going to be side effects like effects on intestinal or other rapidly dividing cells,” he said. “The question is, are the side effects going to be severe enough to prevent the use of this drug?”

More information

To learn more about lupus, the U.S. National Library of Medicine.

SOURCES: Reinhard Voll, M.D., University of Erlangen-Nuremberg, Erlangen, Germany; Jennifer Grossman, M.D., assistant professor of medicine, University of California, Los Angeles; Noel Rose, M.D., director, Autoimmune Disease Research Center, Johns Hopkins University, Baltimore; June 8, 2008, Nature Medicine, online

By Steven Reinberg
HealthDay Reporter

Last Updated: June 09, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.