Six-Month Delay In Onset Of Nevirapine-Based Antiretroviral Therapy Can Prevent Drug Resistance Following Single-Dose Nevirapine During Labor

Delaying the start of a nevirapine-based antiretroviral therapy by six months can prevent the development of drug resistance in HIV-positive women who took single-dose nevirapine during labor to prevent mother-to-child transmission of the virus, according to a study published on Thursday in the New England Journal of Medicine, the New York Times reports (McNeil, New York Times, 1/11). For the study, Harvard University researchers beginning in 2001 followed 218 HIV-positive women in Botswana who had taken single-dose nevirapine during labor along with a short treatment of antiretrovirals during pregnancy. Sixty women began nevirapine-based antiretroviral therapy within six months of giving birth, and 158 began the treatment six months after delivery. The researchers found that in the group of women who started the treatment within six months of delivery, 41% experienced treatment failure. Of the women who waited six months, 12% experienced treatment failure (Donnelly, Boston Globe, 1/11). According to the study, HIV-positive women who wait at least six months after delivery to start an antiretroviral treatment regimen that includes nevirapine are 70% more likely to benefit from treatment than women who begin treatment earlier (McAlary, VOA News, 1/10). Shahin Lockman, the study’s lead author and an assistant professor at the Harvard School of Public Health, said the women who waited six months to begin treatment likely had better results because the amount of HIV that is resistant to nevirapine decreases over time. Implications, Reaction
According to the Globe, HIV prevention efforts in recent years have been “set back” by findings that pregnant women who received single-dose nevirapine during delivery developed resistance to the drug (Boston Globe, 1/11). A study published in April 2006 in the journal Proceedings of the National Academy of Sciences found that more than one-fifth of HIV-positive pregnant women who took single-dose nevirapine to prevent mother-to-child HIV transmission have some resistance to the drug one year after treatment (Kaiser Daily HIV/AIDS Report, 5/3/06). An estimated 10% of HIV-positive pregnant women in sub-Saharan Africa have access to interventions aimed at preventing MTC HIV transmission. In cases in which antiretrovirals are available, single-dose nevirapine at birth often is the only option, according to the Globe. Some researchers estimate that more than 875,000 women and children in developing countries have received single-dose nevirapine at birth (Boson Globe, 1/11). The study’s findings, therefore, have “implications for poor women” worldwide, the Times reports. “This is a real glimmer of hope,” Catherine Hankins, chief scientific adviser for UNAIDS, said, adding, “There was real concern that single-dose nevirapine was blowing the use of that whole class of drugs” (New York Times, 1/11). The study’s findings also should “give greater confidence” to many African countries to promote the use of nevirapine during delivery to prevent MTC HIV transmission, the Globe reports. Max Essex, chair of HSPH AIDS Initiative and a study author, urged health care workers to exercise good judgment when treating HIV-positive women who have just given birth (Boston Globe, 1/11). “If you can wait six months to administer nevirapine-based ART, do so,” Essex said, adding, “If not, treat only with combinations of drugs that do not contain nevirapine or nevirapine-related drugs. Implementing this policy can improve the health of women who need AIDS treatment” (Emery, Reuters, 1/10). According to Lynne Mofenson — chief of research on child, adolescent and maternal AIDS at NIH’s National Institute of Child Health and Human Development — the study’s findings are in line with a World Health Organization guideline that limits single-dose nevirapine to pregnant HIV-positive women who are able to wait six months after birth for nevirapine-based treatment (VOA News, 1/10).

NPR’s “All Things Considered” on Wednesday reported on the study. The segment includes comments from Lockman and James McIntyre, director of Perinatal Research Unit at Baragwanath Hospital in South Africa (Wilson, “All Things Considered,” 1/10). Audio of the segment is available online.

The study is available online.

“Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

ACOEM Adopts Rigorous Methodology For Updates To Its Occupational Medicine Practice Guidelines

The American College of Occupational and Environmental Medicine (ACOEM) has adopted a new more meticulous strength-of-evidence rating methodology for the updates to its Occupational Medicine Practice Guidelines, 2nd Edition. The enhanced methodology incorporates the highest scientific standards for reviewing evidence-based literature, thus ensuring the most rigorous, reproducible, and transparent occupational health guidelines available. The State of California recently published intended modifications to its medical treatment utilization schedule regulations. The proposed revisions reaffirm that ACOEM’s Guidelines are the foundation for the State’s utilization schedule, and also propose adoption of ACOEM’s new methodology.

The new methodology features a number of improvements, including advances in: 1) criteria to grade scientific articles; 2) determining strength-of-evidence ratings for studies; 3) applying a rating of potential for bias; and 4) developing evidence-based recommendation categories. “The new methodology ensures that ACOEM’s Guidelines are maintained at the highest achievable scientific standards for evidence-based literature,” said Tee L. Guidotti, MD, MPH, President of ACOEM. “Improving or restoring the health of workers with occupationally related illnesses or injuries is a fundamental principle of occupational and environmental medicine and ACOEM’s new methodology ensures that our practice guidelines fulfill that mission.”

Michael S. Weiss, MD, MPH, Chair of the Guidelines Methodology Committee, stated that the changes were made “to provide greater consistency, clarity and transparency in the evidence-based medicine methodology.” He further noted that “the criteria to rate articles are purposefully more detailed than in other available guidelines and that by providing these explicit ratings and ultimately mapping them to the strength of the evidence, the entire process becomes more reproducible.” It also becomes possible for others to critique the process, analyses, and recommendations, thereby resulting in continual quality improvement.

“The new methodology allows users to more readily determine what was done, why it was done, and how it was done,” said Charles M. Turkelson, PhD, who represented the American Association of Orthopaedic Surgeons (AAOS) as a member of the Methodology Committee. “As a result, all interested parties should have much more confidence in the recommendations that emanate from these guidelines,” he stated.

ACOEM created the Guidelines to improve the efficiency and specificity of medical diagnosis of workplace-related injuries and diseases, enhance the effectiveness of treatment, and help occupational and environmental physicians manage growing caseloads. Currently there are not any guidelines for the care of workers produced in the United States that are both as rigorous and multidisciplinary in scope as are the ACOEM Guidelines.

The Guidelines were first published in 1997 and revised in 2004. They are presently undergoing a three-year rotating update. The first update will deal with elbow complaints and is scheduled for publication later this month. Updates to the spine and hip chapters are scheduled for mid and late 2007 respectively.

The Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, 2nd Edition, is published by ACOEM. To inquire about the electronic version or order a print copy of the Guidelines, call ACOEM at 847/818-1800, or visit http://www.acoem.org. The Guidelines are $175 for ACOEM members; $199 for non-members.

American College of Occupational and Environmental Medicine

25 Northwest Point Blvd.

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Elk Grove Village, IL 60007-1030

http://www.acoem.org

SCAI Issues Clinical Alert On Drug-eluting Stents And Late Thrombosis

The Society for Cardiovascular Angiography and Interventions (SCAI) has released a clinical alert advising physicians on practical steps for reducing the risk of a rare but serious complication associated with the use of drug-eluting stents. The document follows hearings held by the Food and Drug Administration’s Circulatory Systems Device Panel regarding the use of these devices. The panel supported the continued use of these devices but also suggested more research to determine whether the devices contribute to an increased likelihood of heart attack and death in complex heart disease patients who receive these stents (see http://www.fda.gov/cdrh/news/010407.html).

SCAI’s clinical alert, published online in SCAI’s official journal, Catheterization and Cardiovascular Interventions, focuses on the importance of careful patient selection, meticulous stent implantation, and consistent use of medications to prevent the delayed formation of blood clots that can block blood flow to the heart, a condition known as late stent thrombosis.

“Practicing physicians and their patients are naturally concerned by the recent finding of a very small, but important risk of very late stent thrombosis. Since SCAI’s membership includes the vast majority of practicing interventional cardiologists, we felt it was critical to give some practical advice and guidance in an attempt to ensure optimal outcomes for our patients with coronary artery disease. Coronary artery disease is still the number one cause of death in the Western world, and anything we can do to maximize therapy while minimizing risk is welcome.” said John McB. Hodgson, M.D., FSCAI, the lead author of the clinical alert, a Past President of SCAI, and Chief of Academic Cardiology at St. Joseph’s Hospital and Medical Center in Phoenix, AZ.

Drug-eluting stents are mesh tubes that prop open narrowed arteries in the heart while slowly releasing a medication that prevents the build-up of scar tissue inside the stent. These tiny devices have been very successful in preventing renarrowing, or restenosis, of the coronary arteries, reducing the rate of this complication by 40-60 percent compared to their bare metal counterparts. However, several recent analyses that tracked patient outcomes for four to five years after stent placement showed that blood clots were slightly more likely to form inside a drug-eluting stent than inside a bare metal stent. It is not yet clear how large the difference in risk is, but available data suggest that in the types of lesions treated in the original controlled trials it is about 0.2% excess (compared to bare metal stents) per year after year one. When this occurs, the patient may suffer a heart attack or even die.

“Given this new information, treatment decisions hinge on assessing the balance between the risk of restenosis and risk of late stent thrombosis,” Dr. Hodgson said. “It is important for the clinician to consider the risk-benefit ratio for each individual patient. Interventionalists are encouraged to involve patients, whenever possible, in these discussions.”

This clinical alert has been designed to provide interventional cardiologists with practical advice on how to evaluate and minimize the risk of late stent thrombosis. Its recommendations include the following:

* Prior to any stent implantation, patients should meet accepted criteria for coronary intervention as described in guidelines jointly published by the ACC, AHA, and SCAI.

* The decision to treat a patient with a drug-eluting stent–rather than a bare metal stent or bypass surgery–must be made on an individual patient basis, considering the relative risks and benefits of each therapy. This determination will vary according to each patient’s medical history, coexisting illnesses, and lesion characteristics.

* Patients must be carefully evaluated for their ability to adhere to long-term therapy with dual anti-clotting medications.

* Careful attention must be paid to stent implantation technique, including the use of intravascular ultrasound, screening for arterial calcification, and pretreatment of complex lesions in some cases.

* Patients should take dual anti-clotting medication for at least three to six months, preferably for 12 months unless there is a high risk for bleeding. In patients with a higher-than-average risk for late stent thrombosis–for example, those with diabetes–physicians should consider not only continuing dual anti-clotting medication for longer than 12 months, but also testing responsiveness to these medications and adjusting dosages as needed.

* Discontinuation of dual anti-clotting medication requires careful consideration and must be individualized for each patient.

Several large multicenter trials to better define the risk of late stent thrombosis and assess strategies to prevent this complication are in progress or will soon begin enrolling patients. In the meantime, drug-eluting stents remain an important treatment option for many patients.

“Patients should be reassured that the implantation of a drug-eluting stent, after careful consideration with their physician, remains a very effective method for the treatment for symptoms associated with the disabling problem of coronary artery disease,” Dr. Hodgson said.

Poniard Pharmaceuticals And The Scripps Research Institute Broaden Research Collaboration

The expanded collaboration will include the discovery of focal adhesion kinase (FAK) inhibitors to treat cancer and will be co-led by David Schlaepfer, Ph.D., associate professor in the Department of Immunology at The Scripps Research Institute in La Jolla, Calif., and Chris Liang, Ph.D., director of medicinal chemistry at Scripps Florida.

Poniard and Scripps’ initial scientific collaboration represented the first major biotech collaboration for Scripps Florida, a division of The Scripps Research Institute in Palm Beach County. In addition to FAK inhibitors, the research initiative is focusing on discovering novel, small-molecule protein kinase inhibitors as therapeutic agents, including cancer treatments.

“We are pleased to have negotiated this broadened research collaboration with The Scripps Research Institute under the terms of our existing agreement, which enables us to access scientific expertise at both the Scripps La Jolla and Palm Beach County sites,” said Jerry McMahon, Ph.D., chairman, president and CEO of Poniard. “Dr. Schlaepfer is an international expert in the study of FAK, and we believe that he will be an invaluable resource in our drug discovery efforts on this exciting and promising new cancer target.”

Dr. Schlaepfer’s research at Scripps focuses on molecular signaling that regulates cell motility and invasion. During cancer progression, tumor cells can acquire a highly motile and invasive phenotype. These properties directly promote tumor spread and metastasis. As FAK is commonly overexpressed in malignant human tumors, Dr. Schlaepfer is employing multiple strategies to inhibit FAK activity within tumor cells. He is the author of several papers on this topic, including those published in the Journal of Cell Biology, Cancer Research, Nature Cell Biology and Oncogene.

“FAK is associated with the invasion and metastasis of tumor cells and has recently been implicated in chemoresistance,” added Dr. McMahon. “It is possible that inhibitors of FAK may enhance the activity of picoplatin in the treatment of solid tumors. We are looking forward to collaborating with Dr. Schlaepfer on this critical research.”

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Article adapted by Medical News Today from original press release.
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About The Scripps Research Institute

The Scripps Research Institute is one of the world’s largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Currently operating from temporary facilities in Jupiter, Scripps Florida will move to its permanent campus in 2009.

About Poniard Pharmaceuticals

Poniard Pharmaceuticals, Inc. is a specialty pharmaceutical company focused on the discovery, development and commercialization of innovative oncology products to impact the lives of people with cancer. Picoplatin, the Company’s lead product candidate, is a new generation platinum therapy with an improved safety profile. An intravenous chemotherapeutic agent, it is designed to overcome and prevent platinum resistance associated with chemotherapy in solid tumors. Picoplatin is currently being studied in clinical trials for the treatment of small cell lung, colorectal and hormone-refractory prostate cancers. As part of the Company’s strategic goal of building a diverse oncology pipeline, the Company is collaborating with Thecripps Research Institute on the discovery of novel, small-molecule, multi-targeted protein kinase inhibitors and focal adhesion kinase (FAK) inhibitors. For additional information please visit http://www.poniard.com/.

This release contains forward-looking statements, including statements regarding the Company’s business model, drug development program and strategic collaborations and goals. The Company’s actual results may differ materially from those indicated in these forward looking statements based on a number of factors, including anticipated operating losses, uncertainties associated with research, development, clinical trials, the results of later clinical testing and related regulatory approvals, future capital needs and uncertainty of additional financing, competition, uncertainties associated with intellectual property, dependence on third-party manufacturers, suppliers and collaborators, lack of sales and marketing experience, loss of key personnel, uncertainties associated with market acceptance, technology change and government regulation, general market conditions and the other risks and uncertainties described in the Company’s current and periodic reports filed with the Securities and Exchange Commission, including the Company’s Annual Report on Form 10-K for the year ended December 31, 2005, and its Quarterly Report on Form 10-Q for the quarter ended September 30, 2006. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this release. The Company undertakes no obligation to update any forward-looking statement to reflect new information, events or circumstances after the date of this release or to reflect the occurrence of unanticipated events.

© 2007 Poniard Pharmaceuticals, Inc. All Rights Reserved.

Poniard and Poniard Pharmaceuticals are trademarks of Poniard Pharmaceuticals, Inc.

For Further Information:

Poniard Pharmaceuticals

Private-Label Version Of Abbott’s XIENCE(TM)V Drug-Eluting Coronary Stent System Launches In Europe

A private-labelversion of Abbott’s XIENCE(TM) V Everolimus Eluting Coronary Stent Systemhas launched in Europe, Boston Scientific Corporation announced today. ThePROMUS(TM) Everolimus-Eluting Coronary Stent System is designed, studiedand manufactured by Abbott and supplied to Boston Scientific as part of adistribution agreement between the two companies announced last year.Abbott secured CE mark and launched the XIENCE V stent system in Europe inOctober 2006, and it is currently available in most major European andAsia-Pacific markets. The company expects to launch XIENCE V in the U.S. inthe first half of 2008.

“We are pleased with today’s announcement, as it allows more patientsto have access to the advanced next-generation drug eluting stenttechnology that underlies the XIENCE V system,” said John M. Capek, Ph.D.,president, Abbott Vascular.

Additional Clinical Trial Results in 2007

Abbott will present results from the randomized portion of the SPIRITIII pivotal trial in the first half of 2007. SPIRIT III is a large-scalepivotal clinical trial comparing the XIENCE V Everolimus Eluting CoronaryStent System to Boston Scientific’s TAXUS(R) Paclitaxel-Eluting CoronaryStent System. The XIENCE V system is currently an investigational device inthe United States and Japan.

Earlier this fall, Abbott presented 6-month results from its SPIRIT IIclinical trial at the World Congress of Cardiology conference in Barcelona,Spain, that demonstrated superiority of the XIENCE V Everolimus ElutingCoronary Stent System compared to the TAXUS Paclitaxel-Eluting CoronaryStent System with respect to the study’s primary endpoint, which wasangiographic in-stent late loss at six months.

About the XIENCE V Everolimus Eluting Coronary Stent System

The XIENCE V Everolimus Eluting Coronary Stent System is based upon thehighly deliverable and proven MULTI-LINK VISION(R) coronary stent platform.

Higher Homicide Rates In States With Higher Levels Of Gun Ownership

Firearms are used to kill two out of every three homicide victims in America.. In the first nationally representative study to examine the relationship between survey measures of household firearm ownership and state level rates of homicide, researchers at the Harvard Injury Control Research Center found that homicide rates among children, and among women and men of all ages, are higher in states where more households have guns. The study appears in the February 2007 issue of Social Science and Medicine.

Matthew Miller, Assistant Professor of Health Policy and Injury Prevention at Harvard School of Public Health, and his colleagues David Hemenway and Deborah Azrael, used survey data from the Center for Disease Control and Prevention’s 2001 Behavioral Risk Factor Surveillance System, the world’s largest telephone survey with over 200,000 respondents nationwide. Respondents in all 50 states were asked whether any firearms were kept in or around their home. The survey found that approximately one in three American households reported firearm ownership.

Analyses that controlled for several measures of resource deprivation, urbanization, aggravated assault, robbery, unemployment, and alcohol consumption found that states with higher rates of household firearm ownership had significantly higher homicide victimization rates for children, and for women and men. In these analyses, states within the highest quartile of firearm prevalence had firearm homicide rates 114% higher than states within the lowest quartile of firearm prevalence. Overall homicide rates were 60% higher. The association between firearm prevalence and homicide was driven by gun-related homicide rates; non-gun-related homicide rates were not significantly associated with rates of firearm ownership.

These results suggest that it is easier for potential homicide perpetrators to obtain a gun in states where guns are more prevalent. “Our findings suggest that in the United States, household firearms may be an important source of guns used to kill children, women and men, both on the street and in their homes,” said Miller.

This study was supported by the Joyce Foundation.

Miller M., Hemenway D., Azrael D. “State-level homicide victimization rates in the US in relation to survey measures of household firearm ownership, 2001-2003″Soc Sci Med. 2007 Feb;64(3):656-64. Epub 2006 Oct 27.

Contact: Robin Herman
Harvard School of Public Health

Scientists Sequence Genome Of Parasite Responsible For Common Sexually Transmitted Infection

Researchers have decoded the genetic makeup of the parasite that causes trichomoniasis, one of the most common sexually transmitted infections (STIs), revealing potential clues as to why the parasite has become increasingly drug resistant and suggesting possible pathways for new treatments, diagnostics and a potential vaccine strategy. The genome sequencing project, funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), is detailed in the January 12 issue of Science.

“The progress that continues to be made in deciphering the genomes of organisms, such as the Trichomonas vaginalis parasite, helps to further our collective scientific understanding of these organisms, so that we can better address public health issues,” says NIH Director Elias A. Zerhouni, M.D.

“By better understanding the genetic makeup of the Trichomonas vaginalis parasite that causes trichomoniasis, we can target our efforts to developing the most effective medicines to treat the infection and potentially create a way to prevent infection altogether,” says NIAID Director Anthony S. Fauci, M.D.

Trichomoniasis is a sexually transmitted infection that affects both men and women and results in roughly 7.4 million new cases in the United States each year, according to the U.S. Centers for Disease Control and Prevention.

In women, trichomoniasis infection commonly occurs in the vagina, resulting in heavy yellow-green or gray vaginal discharge, vaginal odor, discomfort during sexual intercourse and urination, irritation and itching of the genital area and, in rare cases, lower abdominal pain. In men, trichomoniasis is most common in the urethra; however, infected men often do not have symptoms. Those that do may experience irritation inside the penis, mild discharge, or a slight burning sensation after urination or ejaculation. Symptoms in both men and women generally appear within five to 28 days of exposure to the parasite.

Both men and women with trichomoniasis have an increased susceptibility to HIV infection and may transmit HIV to their sexual partners. Pregnant women with trichomoniasis may deliver a low birthweight (less than five pounds) or premature infant. Although the prescription drugs metronidazole and tinidazole usually cure trichomoniasis, drug resistance has become an increasing concern.

T. vaginalis is pear-shaped with thread-like flagella that propel its movement. Once it attaches to cells lining the host’s urinary or genital tract, it flattens out and begins to ingest the cells, as well as white and red blood cells, causing direct damage to the urinary and vaginal tissues and resulting in inflammation. T. vaginalis also consumes bacteria that may be present in the urinary and genital areas, including the bacteria necessary for maintaining a normal healthy environment in the vagina. As a result, women infected with trichomoniasis become more susceptible to becoming infected by HIV and other STIs.

In generating the genetic blueprint for the parasite, researchers were surprised to find such a large and highly repetitive genome comprising nearly 26,000 predicted genes as determined by computer models and previously sequenced parasitic genomes. Repetitive genes accounted for roughly 65 percent of the genome.

“Parasites generally have smaller amounts of DNA than non-parasitic organisms, but in this case, there was ten times as much DNA than we originally thought there would be,” says lead author Jane M. Carlton, Ph.D., who led the project while at The Institute for Genomic Research (TIGR), a not-for-profit research organization based in Rockville, Maryland. Dr. Carlton is now an associate professor in the Department of Medical Parasitology at New York University’s School of Medicine.

Although it is not entirely clear why the genome is so large and repetitive, researchers theorize that the parasite evolved over time, previously inhabiting the intestine and later moving to the urogenital tract, which resulted in increased cell size and, subsequently, a considerably expanded genome.

The researchers also discovered more than 150 instances where bacterial genes may have transferred into the parasite’s genome, suggesting that bacteria may have influenced the development of the parasite’s metabolism. The decoded genome also revealed 800 genes for surface proteins that likely enable T. vaginalis to adhere to cells in the urinary and genital tracts and cause infection. Additionally, the researchers were able to analyze proteins thought to be linked to the parasite’s hydrogenosome–its energy source and the target of the two drugs approved to treat trichomoniasis–and identified possible ways the parasite may become resistant to these medications. Understanding how T. vaginalis causes infection and developing methods to prevent it could also help curb the transmission of other STIs often found in connection with trichomoniasis, including chlamydia and gonorrhea, according to the researchers.

“Although trichomoniasis is very prevalent as a sexually transmitted infection, it has not received the attention given to other STIs,” says Carlton. “Women are the population most affected by it, yet routine gynecological check-ups do not test for this particular infection, and it’s not an STI that generally requires public health notification under state statutes. By better understanding the parasite’s genetic structure, we hope to better understand how best to prevent and/or treat the infection it causes.”

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Article adapted by Medical News Today from original press release.
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For an image of the T. vaginalis parasite, see
http://www3.niaid.nih.gov/news/newsreleases/2007/TvaginalisParasite_photo.htm.

NIAID is a component of the National Institutes of Health. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on basic immunology, transplantation and immune-related disorders, including autoimmune diseases, asthma and allergies.

2006 Women’s Health Highlights

The year 2006 marked milestones and significant developments in women’s health news. Excerpts from an interview with Julie Abbott, M.D., medical editor of Mayo Clinic Women’s HealthSource and a preventive medicine specialist, highlight recent women’s health developments and some goals for 2007 in the newsletter’s January issue. Some of those highlights are:

Sexually transmitted diseases:

New in 2006 was the licensing of the human papillomavirus (HPV) vaccine, which will ultimately help prevent cervical cancer. The year also marked the 25th anniversary of AIDS. Both are reminders that women need to be concerned about preventing sexually transmitted diseases and taking responsibility for their health as it pertains to sexual activity.

Breast imaging:

Ultrasound and magnetic resonance imaging (MRI) drew attention in 2006 as ways to help diagnose breast cancer and that’s exciting news. But women are still not taking full advantage of standard screening technology namely mammography.

Women over the ages of 50 and 60 are not getting mammograms as frequently as women in their 40s, yet mammograms are more effective in reducing deaths from breast cancer as women age.

Heart disease prevention:

Possible heart disease predictors such as C-reactive protein, lipoprotein (a), fibrinogen and homocysteine have been touted in many medical publications as helping to estimate cardiovascular risks more accurately. But further analysis has shown that the long well-established risk factors elevated blood pressure, smoking, diabetes, excess weight, a sedentary lifestyle are nearly as precise in predicting this disease risk. According to Dr. Abbott, if we were able to optimally manage all we know about prevention, we would be able to prevent half of all the deaths in the United States. That’s a profound statistic, one that shows how pursuing a healthy lifestyle continues to be a powerful weapon in the arsenal against disease.

Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
http://www.mayoclinic.com/

Weight Concerns More Impairing For Those With Body Dysmorphic Disorder

In a new study on Body dysmorphic disorder (BDD) – a distressing or impairing preoccupation with an imagined or slight defect in one’s appearance – researchers from Bradley Hospital and Brown Medical School found that individuals who are concerned about their weight are more impaired than those whose appearance-concerns are not weight-related. This is particularly important, as weight-related preoccupations have at times not been considered diagnostic of BDD.

Researchers looked at a group of 200 individuals, between the ages of 14 and 64, with BDD. They compared two groups of participants: those who listed weight as “area of concern”, and those who did not. The most frequent BDD areas of concern were: skin, hair, nose, stomach, teeth and weight. The study found that individuals with BDD who had weight concerns (29 percent of the sample) also had more overall areas of body image concern, poorer social functioning, more BDD symptoms overall, more frequent suicide attempts, and higher levels of comorbidity than BDD sufferers who did not endorse weight concerns.

In addition, participants who listed weight concerns were significantly younger and more likely to be female. They also more frequently cited the stomach as an area of concern and were more likely to diet, excessively change their clothes and exercise in an attempt to improve their appearance.

The study appears in the January 2007 issue of the journal Eating Behaviors.

“This is important because although we know that it is a serious and disabling condition, in many ways BDD remains poorly understood,” says lead author Jennifer Kittler, PhD, a child psychologist at Bradley Hospital and the department of psychiatry and human behavior at Brown Medical School.

In particular, there is controversy within the field as to whether individuals with preoccupations that focus on weight should be considered to have BDD (instead of, for example, an eating disorder). This study indicates that BDD sufferers who have weight concerns may actually be more impaired than other BDD patients, further underscoring the importance of obtaining more information about this population, and of correctly diagnosing and treating those with impairing and preoccupying concerns about their weight, the authors note.

“We know that BDD is a disorder associated with severe symptoms and high levels of comorbidity. This study indicates that the presence of weight-related concerns and preoccupations among individuals with BDD may actually be associated with even higher levels of distress and impairment,” says Kittler.

The correct diagnosis and treatment of individuals with weight-related preoccupations, in the absence of eating disorder symptoms, is obviously crucial, as these preoccupations are associated with a high level of psychopathology and distress, the authors write.

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Article adapted by Medical News Today from original press release.
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Founded in 1931, Bradley Hospital (http://www.bradleyhospital.org/) was the nation’s first psychiatric hospital operating exclusively for children. Today, it remains a premier medical institution devoted to the research and treatment of childhood psychiatric illnesses. Bradley Hospital, located in Providence, RI, is a teaching hospital for Brown Medical School and ranks in the top third of private hospitals receiving funding from the National Institutes of Health. Its research arm, the Bradley Hasbro Children’s Research Center (BHCRC), brings together leading researchers in such topics as: autism, colic, childhood sleep patterns, HIV prevention, infant development, obesity, eating disorders, depression, obsessive-compulsive disorder (OCD) and juvenile firesetting. Bradley Hospital is a member of the Lifespan health system.

Contact: Carol L. Vieira
Lifespan

People Urged To Protect Themselves During The Coldest Part Of The Year, UK

Tomorrow (13.01.07) is St Hilary’s day, the coldest day of the year,according to folklore. This dates back to 1086 when a great frostheld the country in its grip until late March. It remains true to thepresent day that this time of year is often the coldest, leavingthose most vulnerable at risk from the drop in temperature.

The Department of Health and the Home Heat Helpline (0800 33 66 99),a free telephone advice line funded by Britain’s energy retailers,are together urging people to protect themselves against the cold,particularly as January often signals the coldest part of the year.At least 20,000 people die each year in England and Wales as a resultof the cold weather and in especially cold winters, deaths have risento as high as 40,000.

The Department of Health’s Keep Warm Keep Well campaign offers adviceto older people, disabled people, those on low incomes and anyoneelse who needs it on keeping warm and staying healthy during thecolder months. A free NHS winter ‘Keep Warm Keep Well’ guide givesplenty of practical tips as well as information on financial supportthat might be available, such as grants for home improvements to helpmake houses warmer or help to meet the cost of heating bills.

Callers to the Home Heat Helpline, run by the Energy RetailAssociation, talk to specially trained staff who provide advice onhome heating bills, including information on grants available to makehomes more energy efficient, help arrange alternative payment methodsto make bills easier to manage, provide access to a priority serviceteam of specialist advisors and linking to other support agencies.The helpline can also take calls from intermediaries, such asfriends, family, carers, social workers or health visitors calling onbehalf of vulnerable people.

Caroline Flint MP, Minister of State for Public Health said:

“It’svital to look after yourself and each other to keep warm and wellduring the cold winter months. I’m pleased to say that the Departmentof Health and Energy Retail Association are joining forces to makeinformation about winter warmth accessible to all who need it.

“Look after yourself and your neighbours or relatives in the winter