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vineri, 9 decembrie 2011

Bilateral Oophorectomy Associated With Higher Prevalence Of Low Bone Mineral Density And Arthritis In Younger Women

Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics
Article Date: 09 Dec 2011 - 2:00 PST

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Women who underwent surgery to remove their ovaries before the age of 45 years were more likely to have arthritis and low bone mineral density compared with women with intact ovaries, researchers found.

Anne Marie McCarthy, Sc.M., a doctoral candidate in epidemiology at Johns Hopkins Bloomberg School of Public Health, presented the results at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"Our study suggests that some women with oophorectomy, particularly at a young age, can experience clinically relevant decreases in bone mineral density (BMD). Clinicians need to be aware of this so they can intervene early if required," McCarthy said.

She and senior investigator Kala Visvanathan, M.D., MHS, associate professor at Johns Hopkins Sidney Kimmel Cancer Center and Bloomberg School of Public Health, examined associations of oophorectomy with arthritis and BMD in the Third National Health and Nutrition Examination Survey (NHANES III), a nationally representative survey conducted from 1988 to 1994.

The BMD analysis included 3,660 women, and the arthritis analysis included 4,039 women. Women aged 40 years and older who had no cancer history and reported a bilateral oophorectomy or intact ovaries were included for analysis.

Researchers used dual-energy X-ray to measure BMD in the femoral neck.

Women who had both ovaries removed before 45 years of age and who never used HRT had a lower BMD on average than women with intact ovaries (0.691 g/cm2 vs. 0.729 g/cm2, respectively). They were also twice as likely to have very low bone mineral density compared to women with intact ovaries.

Participants were also asked if they had been diagnosed with arthritis. Researchers found that 45.4 percent of women who had oophorectomy reported arthritis compared with 32.1 percent of women with intact ovaries. They found a higher prevalence of arthritis 47.7 percent among women who had undergone oophorectomy before 45 years of age.

"[The study] highlights the need for more research in this area to identify those women at risk and to determine appropriate screening and preventive strategies for these young women," McCarthy said.

She added that NHANES III is a cross-sectional study, so "therefore, we cannot make statements on whether oophorectomy actually causes osteoporosis or arthritis at this time."

Article adapted by Medical News Today from original press release. Source: American Association for Cancer Research
Visit our arthritis / rheumatology section for the latest news on this subject. American Association for Cancer Research Please use one of the following formats to cite this article in your essay, paper or report:

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American Association for Cancer Research. (2011, December 9). "Bilateral Oophorectomy Associated With Higher Prevalence Of Low Bone Mineral Density And Arthritis In Younger Women." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/238916.php.

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joi, 8 decembrie 2011

Burden Of Injury In The UK Is 2.6 Times Higher Than Previously Thought

Main Category: Public Health
Article Date: 08 Dec 2011 - 0:00 PST

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When using data and information derived from patient experiences, combined with additional morbidity data on patients treated in emergency departments and those admitted to hospital, the absolute burden of injury in the UK is much higher than previously estimated, according to a study published in this week's PLoS Medicine.

The authors of the study, led by Ronan Lyons from Swansea University, in Wales, UK, say: "Whilst considerable uncertainties remain, our best estimate is that injury-related DALYs [disability-adjusted life years] are 2.6 times greater than previously thought, and even if we accept a very conservative approach of assuming no residual disability in all losses to follow-up the population estimate would be 1.6 times earlier estimates."

Furthermore, the authors also found that the vast majority of injuries were unintentional and that the home was the most frequent location of injury.

The authors recruited patients aged over 5 years with a wide range of injuries (including fractures and dislocations, lacerations, bruises and abrasions, sprains, burns and scalds, and head, eye, chest and abdominal injuries) from hospitals in four English cities - Swansea, Nottingham, Bristol, and Guildford - between September 2005 and April 2007.

In the four study sites, a total of 1,517 injured people (median age of 37.4 years and 53.9% male) participated in the study. Using the data and information collected from patient questionnaires about their injuries and the effect on their lives, the authors found that in 2005, there were an estimated 750,999 injury-related hospital admissions, 7,982,947 emergency department attendances, and 22,185 injury-related deaths, translating to a rate per 100 000 of 1,240, 13,339, and 36·8 respectively. Putting all the information together, the authors estimated that the disability life adjusted years (DALYs) related to injury was 1,771,486 in 2005.

The authors say: "Whilst this study was carried out in the UK, the principal findings are relevant across the globe." They continue: "Our results suggest that if the pattern of underestimation seen in the UK was mirrored across the world then injuries may account for up to a quarter of global DALYs rather than a sixth as previously estimated...undoubtedly the global proportion of DALYs from injury is larger than previously estimated."

The authors conclude: "There is already evidence that policy and research responses to injury are grossly inadequate, based upon the previous estimates of the burden."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our public health section for the latest news on this subject. Funding: This work is based on independent research commissioned and funded by the Policy Research Programme in the Department of Health (reference number 0010009: Moving from Observation to Intervention to reduce inequalities in injuries, http://www.dh.gov.uk/en/Aboutus/Researchanddevelopment/Policyresearchprogramme/D H_533). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: DK's research is/has been funded by the NIHR, The Department of Health, the MRC, the US Dept of Health and Human Services, the Nottinghamshire, Derbyshire and Lincolnshire Research Alliance. Nottingham Fire and Rescue Service, the Royal Society for the Prevention of Accidents, the European Commission, the Office of the Deputy Prime Minister and the Royal College of General Practitioners. DK was a co-opted member of the National Institute for Health and Clinical Excellence guideline development group for public health guidance 29 - strategies to prevent unintentional injury in children aged under 15 years and provided expert testimony to the guideline development group on inequities in child injury. All other authors have declared that no competing interests exist.
Citation: Lyons RA, Kendrick D, Towner EM, Christie N, Macey S, et al. (2011) Measuring the Population Burden of Injuries—Implications for Global and National Estimates: A Multi-centre Prospective UK Longitudinal Study. PLoS Med 8(12): e1001140. doi:10.1371/journal.pmed.1001140
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Breast Cancer Mortality Higher In Hispanic Women

Main Category: Breast Cancer
Article Date: 08 Dec 2011 - 2:00 PST

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Hispanic women are more likely to die from breast cancer than non-Hispanic white women, according to research presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"This difference may be associated with a tumor phenotype that is less responsive to chemotherapy," said Kathy B. Baumgartner, Ph.D., professor of epidemiology and associate dean for faculty affairs in the School of Public Health and Information Sciences at the University of Louisville in Kentucky. "Increased awareness of this ethnic disparity is needed to improve survival in Hispanic women with breast cancer."

Breast cancer is the most common cancer and is the second cause of cancer death in women in the United States. Incidence and survival rates vary by ethnicity, and previous research has demonstrated a trend toward poorer survival in Hispanic women.

From 1992 to 1996, Baumgartner and colleagues conducted the New Mexico Women's Health Study (NMWHS), a statewide, population-based, case-control breast cancer study that examined the difference between Hispanic and non-Hispanic white women for breast cancer risk. In all, 692 women with a first primary breast cancer participated.

In a recent study, researchers followed the 577 women with invasive breast cancer through 2008 to assess differences in long-term survival between Hispanic and non-Hispanic white women in the NMWHS.

Hispanic women were about 20 percent more likely to die from breast cancer than non-Hispanic white women, which is consistent with other reports, Baumgartner said. After adjusting for age, stage, lymph node involvement and estrogen receptor (ER) status, the researchers saw the risk drop considerably to almost equal that of non-Hispanic white women suggesting that "the ethnic difference in breast cancer mortality may be mostly biologically based," Baumgartner said.

In addition, Hispanic women who received chemotherapy were about 1.5 times more likely to die from breast cancer compared with non-Hispanic white women who received chemotherapy, after adjusting for age and the characteristics noted above.

"It is not clear how much of this ethnic difference in survival is due to socioeconomic factors influencing access to screening and treatment or to biological ones," Baumgartner said. "Some studies suggest that Hispanic women are more likely to develop ER-negative tumors that are resistant to chemotherapy."

She added, "Altered response to chemotherapy may partly explain the Hispanic vs. non-Hispanic white disparity in breast cancer survival."

There was no difference between Hispanic and non-Hispanic white women for all-cause or non-breast cancer mortality.

Baumgartner and her colleagues will continue to monitor this cohort for the long term. This research was supported by a grant from the National Cancer Institute and the James Graham Brown Cancer Center.

Article adapted by Medical News Today from original press release. Source: American Association for Cancer Research
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8 Dec. 2011. APA

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