Coffee drinkers 'less likely to be depressed'

?Women who drink two or more cups of coffee a day are less likely to get depressed,? said the BBC today, explaining that the caffeine in coffee may alter the brain?s chemistry.

The story comes from a study of over 50,000 women looking at whether those who drank more coffee were at less risk of getting depressed. It found that the more caffeinated coffee women drank, the lower their risk of developing depression. The same effect was not found for decaffeinated coffee.

This large study has some strengths but several limitations and is not robust evidence that coffee can prevent depression. It is possible the results are a case of ?reverse causation? and that the women who were depressed avoided drinking coffee. Also, it is possible that other factors such as family history or other circumstances influenced the risk of depression, although researchers tried to take account of these.

Overall, this study is not a reason to start drinking more coffee and further research is required to explore the possibility that caffeinated coffee may reduce the risk of depression.

�

Where did the story come from?

The study was carried out by researchers from Harvard School of Public Health, Brigham and Women?s Hospital, Harvard Medical School and Columbia University, US. It was funded by the National Institutes of Health.

The study was published in the peer-reviewed medical journal Archives of Internal Medicine.

Overall, the research was accurately reported by the papers and other media outlets. Both the BBC and The Telegraph pointed out the study has some limitations, the main one being that this type of observational study cannot prove cause and effect, in other words that coffee lowers risk of depression. The BBC also reported comments from an independent expert. The Mirror did not report any of the study?s limitations.

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What kind of research was this?

This was a prospective cohort study that followed a total of 50,739 women for 10 years to find out if their intake of caffeine had any association with their risk of developing depression. This type of study is often used to investigate possible links between lifestyle interventions (such as coffee consumption) and health outcomes. The study was prospective and followed people over time.�Therefore, is thought to be more reliable than a study in which researchers investigate lifestyle habits retrospectively or by questionnaire once the outcome (depression or not) is known.

The researchers point out that caffeine is the world?s most widely used stimulant and that 80% of caffeine is consumed through drinking coffee. They also say that previous studies in men have found that caffeine consumption decreases the risk of depression.

However, relatively few studies have examined this possible relationship. Furthermore, the possible association between caffeine use and the risk of depression, a chronic illness that affects twice as many women as men, is poorly understood.

�

What did the research involve?

Data from a large US cohort study was used to examine the possible association between caffeine and depression risk. The original research involved 121,700 American female nurses who were aged 30 to 55 when they enrolled in 1976. They provided researchers with updated information about their health and lifestyle every two years through mailed questionnaires.

The current study began in 1996 and looked at data on coffee consumption and depression from this date onwards. The researchers excluded women who could have had depression in the past, and anyone who had incomplete depression histories or whose data may have been incomplete or incorrect. This left them with 50,739 women, with an average age of 63 years, who were considered free of depressive symptoms at that time.

This group was followed up until 2006. Their consumption of coffee and other drinks, both caffeinated and non-caffeinated, was measured using validated questionnaires that the participants had completed every two years from 1980 through to 2004. Participants were asked about their coffee, tea, soft drink and chocolate consumption for the previous year.

The researchers classified participants into five categories of coffee drinking, ranging from one cup a week or less, to four cups a day or more. They used food composition data from official sources to calculate the amount of caffeine in a cup of coffee.

They then looked at whether the women had reported suffering depression from 1996 onwards. This was carried out through the questionnaire asking the women if they had been newly diagnosed with the condition by a doctor or had started using antidepressants regularly. This information was collected from 2000 and updated every two years until 2006.

The researchers also collected information about other factors that might have affected the results including lifestyle, medical history, age, weight, smoking status, exercise and social community group involvement.

Using the women?s reports of caffeine consumption, the researchers computed their average consumption of caffeine and other drinks. To investigate whether there was an association between caffeine consumption and depression, they allowed for a two-year ?latency period?. For example, data on caffeine consumption from 1980 through to 1994 was used to look at new episodes of depression from 1996 to 1998, while data on consumption from 1980 to 1998 was used to look at new episodes from 2000 to 2002.

The analysis used standard statistical methods and the researchers adjusted their results for other factors that might affect the risk of depression, such as marital status, social involvement, smoking status, physical activity and other medical disorders.

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What were the basic results?

During 10 years of follow-up (1996-2006), 2,607 new cases of depression were identified.

• women consuming two to three cups of caffeinated coffee daily had 15% less risk of depression (95% confidence interval [CI], 0.75 to 0.95), and those consuming four cups or more daily, had a 20% lower risk (95% CI 0.64 to 0.99) than women consuming one cup or less a day
• of the five caffeine consumption categories, women with the highest caffeine intake (500mg/d or more) had 20% less risk of depression than those consuming less than 100mg/day (95% CI, 0.68 to 0.95)
• decaffeinated coffee was not associated with depression risk
• there was no relationship between caffeine from non-coffee sources and depression risk

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How did the researchers interpret the results?

The researchers say they found that depression risk decreased with increasing consumption of caffeinated coffee. They say that further investigations are needed to confirm this finding and to determine if caffeinated coffee can help to prevent depression.

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Conclusion

The strengths of this well-conducted study include its large sample size, its prospective design and its use of a validated food frequency questionnaire, which was sent out seven times over 22 years.

However, the study had several limitations, as the authors acknowledge, which could affect its results. For example:

• It relied on women remembering and self-reporting their consumption of coffee and other drinks over the previous year.
• It also relied on women self-reporting their diagnoses of depression, rather than using other more reliable sources such as medical records.
• Although researchers tried to control for other factors (called confounders) that might influence the risk of depression, it is possible that some of these confounders were not taken into account and affected the results. It is possible that ?reverse causation? played a role in the results ? in other words women who were depressed (but had not been diagnosed), might also be likely to drink less coffee. The authors tried to minimise this possibility by excluding at the start 10,280 women with severe depression. They also applied a two-year latency period when they computed the cumulative average of caffeinated and non-caffeinated drinks.

Overall, further research is required to explore the possibility that caffeine may reduce the risk of depression.

Links To The Headlines

Coffee may prevent depression, scientists say.�BBC News, September 27 2011

Women who drink 4 or more cups of coffee a day are less likely to be depressed.�Daily Mail, September 27 2011

Coffee 'lowers depression risk'.�The Daily Telegraph, September 27 2011

Four cups of coffee a day help women beat depression, study claims.�Daily Mirror, September 27 2011

Links To Science

Lucas M, Mirzaei F, Pan A, et al.�Coffee, Caffeine, and Risk of Depression Among Women. Archives of Internal Medicine 2011; 171: 1571-1578

Source: http://www.nhs.uk/news/2011/09September/Pages/coffee-risk-depression-women.aspx

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When is best to screen for bowel cancer?

The Daily Mail reported today that, ?thousands of lives could be saved if the age at which men are screened for bowel cancer is lowered by 10 years.?

This news story is based on a large Austrian study that aimed to determine the correct age to screen men and women for bowel cancer. It found that the number of screening colonoscopies needed to detect one case of bowel cancer (called the number needed to screen or NNS) was significantly lower in men compared to women across all ages. The NNS in men who were 55-59 years old was similar to women 10 years older (75 versus 81.8 colonoscopies respectively). This and other similar findings led the authors to suggest a need to reduce the screening age in men by approximately 10 years.

This robust study provides important information about the difference in prevalence of bowel cancer in men and women of different ages who took part in a national colonoscopy screening programme.

The applicability of the findings from this Austrian study to the UK is limited in some ways. For instance, in Austria, men and women aged 50 are invited to be screened for bowel cancer using a procedure called a colonoscopy where a camera is used to examine the bowel. In the UK, screening does not take place until men and women reach age 60, at which point screening is performed using a different sort of test called a faecal occult blood (FOB) test, which can be done at home. Doctors then use these test results to decide whether further investigation is needed. Colonoscopy is frequently used to investigate patients who have an abnormal FOB test result.

Nevertheless, this is a valuable study for policy makers in the UK. While the UK does not have a national colonoscopy screening programme in the same way as Austria, this study improves knowledge about the pattern of abnormalities found. A similar study of the UK programme could help identify if the same sex and age differences exist for people who are being investigated for signs of bowel cancer by colonoscopy after a positive FOB test.

�

Where did the story come from?

The study was carried out by researchers from the University of Vienna, Austria. Funding was provided by the Fund for Preventative Check-ups and Health Promotion.
�
The study was published in the peer-reviewed medical journal Journal of the American Medical Association (JAMA).

The coverage of this story was generally good with both the Mail and the Telegraph acknowledging that the UK does not have the same national screening programme as used in the study, but that the results may still be helpful. They also point out that both men and women are screened from 60 years of age in England, 10 years later than is the standard in the Austrian study.

Both reports also highlight that people in Scotland are already screened at a lower age (50 years) than in England and include quotes from the Beating Bowel Cancer campaign group who advocate lowering the age limit to 50 years of age across the entire UK.

�

What kind of research was this?

This was a cohort study using adult participants of a national screening colonoscopy programme over a four-year period (2007 to 2010) in Austria.

The researchers state�that the typical age for screening for colorectal cancer (bowel cancer) in many countries (including the US and Austria) is 50 years for both men and women. The goal of bowel cancer screening is to find and remove abnormal growths in the bowel known as polyps. Once removed, the polyps can be tested in the lab to see if they are small and harmless (adenomas), slightly larger and potentially harmful (advanced adenoma), or already cancerous.

The authors say that previous research has suggested that men typically develop more advanced adenomas and have a higher prevalence of bowel cancer, so it has been suggested that men should be screened earlier than women should.

This research aimed to determine the correct age to screen men and women for bowel cancer.

�

What did the research involve?

This study followed 44,350 participants aged between 50 and 79 years old who were screened over a period of four years (2007 to 2010) as part of the national screening colonoscopy programme in Austria. Colonoscopy is the screening method used in Austria to detect early signs of bowel cancer. A colonoscopy is when a flexible tube attached to a small camera and light is used to examine your entire bowel.

The results of the colonoscopies, including laboratory tests, video and photo documentation, were reviewed for signs of adenoma, advanced adenoma and colorectal cancer (bowel cancer).

If more than one adenoma was found they were characterised (either as: harmless, potentially harmful or cancerous) by the most advanced one identified.

The researchers analysed their results in five-year age band separately for men and women. The prevalence and number needed to screen (NNS) were calculated. NNS was used to predict the number of colonoscopies that would need to be undertaken to detect one case of adenoma, advanced adenoma or bowel cancer. These were calculated separately for men and women at different five-year age bands ranging from 30-34 to over 95 years old. Most of those screened were aged between 50 and 79 years old.

This type of analysis is appropriate for this sort of study, and because it takes into account the different number of people screened in each age band, the NNS is a better assessment of the efficiency of the programme than the raw number of cancers detected.

�

What were the basic results?

A total of 22,598 (51%) women and 21,752 (49.0%) men were screened during the four-year period. The average age (median) for men and women was similar at 60.7 and 60.6 years respectively and ranged from 54.5 years to 67.6 years. Relatively few adults under 50 years old were screened.

Small abnormal growths (polyps) in the colon were found in 34.4% of individuals, colon cancer in 0.4% and rectal cancer in 0.2%.

Adenomas

Adenomas were found more frequently in men (24.9%) compared with women (14.8%) for all ages groups combined, suggesting that men have an extra 10% absolute risk of having adenomas. The prevalence of adenomas in 50 to 54-year-old men was 18.5%, significantly greater than the prevalence among women in the same age group, but similar to the prevalence among 65 to 69-year-old women (17.9%).

The NNS to detect adenomas was 4.0 (95% confidence interval [CI] 3.9 to 4.1) for men and 6.7 (95%CI 6.6 to 7.0) for women. In 50 to 54-year-old women, the NNS was nearly twice as high as the NNS in men of the same age (9.3 versus 5.4). The NNS among 45 to 49-year-old men (5.9) was similar to that in women aged 60-64 (6.0).

Advanced adenomas

The prevalence of advanced adenomas was much higher in men (8.0%) than women (4.7%) for all age groups combined. The prevalence of advanced adenoma in men aged 50-54 (5.0%) was higher then women of the same age (2.9%) but was similar to women 10 years older (5.1%).

NNS to find an advanced adenoma were 21.5 (95%CI 20.3 to 22.8) for women and 12.6 (95%CI 12.0 to 13.2) for men.

Bowel cancer

The prevalence of bowel cancer was twice as high in men compared to women (1.5% versus 0.7% respectively) for all age groups combined. The number of colonoscopies needed to detect one case of bowel cancer was significantly lower in men compared to women for all ages combined (66.7 versus 137.0 respectively). The NNS in men who were 55-59 years old was again similar to women in the group 10 years older (75.0 versus 81.8 respectively).

�

How did the researchers interpret the results?

The authors concluded that being male was a significant risk factor in the development of bowel cancer, and that this indicates that ?new sex-specific age recommendations for screening? should be considered. They suggest that it may be important to start screening men earlier than 50 years to avoid early abnormalities being missed that could later develop into the observed higher prevalence of cancer in men. They also discuss the idea that women could be screened later due to their lower risk and prevalence of bowel cancer.

�

Conclusion

This study showed that the prevalence of adenoma, advanced adenoma and bowel cancer was significantly higher in men than in women of comparable age in Austrian adults taking part in a national colonoscopy screening programme.

This difference was shown using a large group of individuals within the age range that is currently screened for in Austria and the US. While the study?s size is a strength, it is important to acknowledge that it also has some limitations.

• The study of prevalence only looked at differences in cancer prevalence between ages and sex. It did not look at whether other influences such as family history of bowel cancer, diet or ethnicity affected the age-sex relationship. Further studies with appropriate adjustment for these, and other potentially influencing factors, are warranted before the age-sex differences can be generalised with some confidence to different groups of people.
• Only a relatively small number (n= 1,630) of people under the age of 50 years old were screened. Hence, the results obtained from these younger groups were more prone to uncertainty than larger, older groups.
• This study tested screening for bowel cancer using colonoscopy; this is not the standard method in all countries. In England, Wales and Northern Ireland, patients over 60 years old are invited to be screened using a faecal occult blood (FOB) test kit that can be done at home. Those in Scotland can be screened from the age of 50 years old. The FOB tests for blood in the faeces. If blood is detected, an invitation of further investigation into the cause of the bleeding, which may include a colonoscopy, is made.
• The age and sex differences for screening using the FOB test are not considered in this study and these findings are not as applicable to the UK as they would be to countries with a national colonoscopy screening programme such as Austria and the US.

This robust study provided important information about the difference in the prevalence of adenoma, advanced adenoma and bowel cancer in men and women of different ages taking part in a national colonoscopy screening programme in Austria.

While the UK does not have a national colonoscopy screening programme exactly like this, this study added to what is known about bowel cancer risk and the information may be valuable in helping policy makers make decisions about the future of the screening programme here.

Links To The Headlines

Lower bowel cancer screening age for men, study suggests.�The Daily Telegraph, September 28 2011

'Screen men at 50 for bowel cancer' and save thousands of lives, says charity.�Daily Mail, September 28 2011

Links To Science

Ferlitsch M, Reinhart K, Pramhas S, et al.�Sex-Specific Prevalence of Adenomas, Advanced Adenomas, and Colorectal Cancer in Individuals Undergoing Screening Colonoscopy. JAMA 2011; 306: 1289-1395

Source: http://www.nhs.uk/news/2011/09September/Pages/bowel-cancer-screening-age.aspx

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Breast cancer drug offers fresh hope

He said: "This novel and targeted approach has shown that we are now able to stop the cancer in its tracks while reducing many of the common side effects normally associated with standard chemotherapy treatment."

The trial results, presented at the European Multidisciplinary Cancer Congress conference in Stockholm, also showed far fewer side-effects suffered by those given the new treatment.

While two thirds of those given standard treatment suffered hair loss, as a result of chemotherapy, less than five per cent of the women given T-DM1 lost their hair.

Half as many of the most serious side effects, requiring hospitalisation, were reported among those given the new treatment.

Cancer Research UK said targeted treatments which avoided damage to healthy cells were vital to improve survival, but said larger scale trials were needed to test the drug's potential.

Nell Barrie, senior science information officer, said: "This approach combines two effective treatments but until we have results from larger, longer term trials we won't know for sure how beneficial this could be for patients with this particular type of breast cancer."

Around 10,000 women in Britain are diagnosed with HER2-positive cancer each year, making up around 20 to 30 per cent of all breast cancer cases.

The diagnosis means women have been found to have large quantities of a protein known as HER2 on the surface of the tumour cells, which makes the disease more aggressive.

In recent years, Herceptin, which targets this protein, had been hailed as the best solution for such women.

The new trial appears to show that the addition of the antibody DM1 prevents the cell division which spreads cancer.

The combination drug is not yet licensed, and could take three to five years to be available in this country.

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/18d722dc/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C87869960CBreast0Ecancer0Edrug0Eoffers0Efresh0Ehope0Bhtml/story01.htm

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Health Tip: Gestational Diabetes May Endanger Mother and Baby

[unable to retrieve full-text content]Title: Health Tip: Gestational Diabetes May Endanger Mother and Baby
Category: Health News
Created: 9/29/2011 8:05:00 AM
Last Editorial Review: 9/29/2011

Source: http://www.medicinenet.com/guide.asp?s=rss&a=149964&k=Womens_Health_General

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HIV vaccine passes phase 1 trial

The Daily Telegraph reported that a ?vaccine could reduce HIV to ?minor infection??. The news story reports on a phase I clinical trial that assessed the safety of a new HIV vaccine in a small group of people in Spain.

The researchers recruited 30 people who did not have HIV and gave 24 of them three injections of the new HIV vaccine, which was based on a smallpox vaccine. The other six people received placebo injections. The researchers followed the volunteers for 48 weeks.

The researchers found that the vaccine appeared to be well-tolerated over this time and there were no serious side effects. More than three-quarters of the volunteers had a detectable immune response to the vaccine. However, the primary aim of this preliminary study was to assess safety not effectiveness. It is not known whether the immune response caused by the vaccine would be sufficient to protect against HIV infection or to lower HIV levels in people who are already HIV positive. It is likely that further safety trials in a larger group of people will be performed before the effectiveness of this vaccine is assessed.

�

Where did the story come from?

The study was carried out by researchers from The Hospital Clinic-IDIBAPS, Barcelona, Spain, the CentroNacional de Biotecnologia, CSIC, Madrid, Spain and other Spanish, Swedish, Swiss and British research institutions. It was funded by three Spanish research foundations, FIPSE, FIS and HIVACAT.

The study was published in the peer-reviewed medical journal Vaccine.

The research was covered well by The Daily Telegraph, the Daily Mail and the Daily Mirror, which all said that further tests would need to be carried out. The Daily Telegraph detailed what the researchers had said the next steps would be.

�

What kind of research was this?

This was a phase I clinical trial to assess the safety of an HIV/AIDS vaccine and how well it could provoke an immune response, which is a sign that a vaccine is having an effect. Phase I studies are studies that test the preliminary safety of a treatment in a small group of people. Often these types of studies do not have a control group. In this case, there were 24 people who received the vaccine and six who received a placebo. Importantly, this type of trial is not designed to test effectiveness and the researchers were not trying to assess how well the vaccine would protect people from contracting HIV. However, they did look at how strong the immune response to the vaccine was. Immune response is a marker for eventual success of the vaccine and a sign that the vaccine is having an effect.

The vaccine was based on a smallpox vaccine that had been adapted with HIV genes. The vaccine was called MVA-B. The idea was that the vaccine would prime the body to recognise HIV so that it would mount a rapid immune response. If used to treat people who have already contracted HIV, this would potentially allow the body to clear the HIV to levels that don?t cause disease. If used to prevent people from getting HIV, it would hopefully prevent the virus from entering cells in the first place.

�

What did the research involve?

The study was carried out in Spain. The researchers recruited 30 men and women who were free from HIV and at low risk of infection. The participants were between 18 and 55 years of age, and 24 were men. The participants had no history of a previous smallpox vaccination. The researchers randomly allocated six people to receive placebo and 24 people to receive the vaccine.

The 24 people received three injections of the vaccine into their muscle, and the control group received placebo injections. Both groups received these injections at the start of the study, after four weeks and after 16 weeks. The participants were then followed for 48 weeks.

The participants were asked to use an effective method of contraception with their partner from 14 days prior to the first vaccination until four months after the last one.

The primary endpoints (the measures considered to be most important by the researchers) were serious side effects and how well the body mounted an immune response. They looked, in particular, at a type of immune cell called a T-cell. The researchers also took into account less severe side effects and how well the body produced antibodies against the vaccine.

Screening for side effects was performed throughout the study. Blood tests were performed at the study start and at weeks four, eight, 16, 20 and 48. The participants were given safe sex counselling and an HIV test at the screening interview and at weeks four, 16 and 48.

�

What were the basic results?

The researchers said that, overall, the vaccine was well-tolerated. A total of 169 adverse events were reported during follow-up. Five of these were grade-three adverse events, which would be considered serious. However, although the five serious adverse events were all in the vaccination group, these were not considered to be related to the study drug. For example, one volunteer had tonsillitis, one volunteer had a traffic accident, one volunteer had both pneumonia and two asthmatic attacks. Of the 145 reported milder adverse events (grade one and two), 52 were considered to be definitely related to the vaccination. The most common mild adverse events were pain at the site of the injection and headaches.

The researchers found that positive T-cell immune responses were detected in 75% of volunteers and that these were maintained until week 48 in 68% of the participants. The proportion of responders increased after the second dose. Ninety-five per cent of the participants had antibodies against the vaccine at week 18 and 72% had antibodies at week 48.

�

How did the researchers interpret the results?

The researchers say that in this first phase I trial with the HIV/AIDS vaccine candidate MVA-B in healthy volunteers the vaccine was safe and well-tolerated and elicited strong and durable T-cell responses in 75% of volunteers. They say that their data support further exploration of MVA-B as an HIV vaccine candidate.

�

Conclusion

This phase I trial showed that this HIV vaccine was well-tolerated and did not lead to serious adverse effects in a small group of healthy volunteers. The vaccine was also shown to cause a T-cell immune response in 75% of the 24 participants and to cause antibody responses in 95%.

These results are encouraging and will probably mean that the researchers go on to look at safety and immune response to this vaccine in a larger group of people. There are two potential ways in which vaccines could be used to fight HIV. A vaccine may either be used as a prophylactic to stop people being infected with the virus, or therapeutically, to help the body to lower HIV levels once a person has already been infected. The aim of therapeutic use would be to reduce disease symptoms.

This study did not look at the effectiveness of the vaccine, including how well it could protect against infection with HIV or lower HIV levels in the body of people already infected.

Further research is needed to test the vaccine in these two areas - preventing HIV infection or reducing the number of virus particles in infected people. Also, other studies are looking at potential HIV vaccines, and research will be needed to test how well this vaccine compares to these.

Links To The Headlines

New HIV vaccine could turn deadly condition into 'minor infection like herpes'.�The Daily Telegraph, September 29 2011

Vaccine could reduce HIV to 'minor infection'.�The Daily Telegraph, September 29 2011

HIV vaccine could turn condition into "minor chronic infection" like herpes, experts claim.�Daily Mirror, September 29 2011

Links To Science

Garc�a F, L�pez Bernaldo de Quir�s JC, G�mez CE, et al.�Safety and immunogenicity of a modified pox vector-based HIV/AIDS vaccine candidate expressing Env, Gag, Pol and Nef proteins of HIV-1 subtype B (MVA-B) in healthy HIV-1-uninfected volunteers: A phase I clinical trial (RISVAC02). Vaccine 2011 [Available via ScienceDirect]

Source: http://www.nhs.uk/news/2011/09September/Pages/hiv-vaccine-phase-1-trial.aspx

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The decade's 10 biggest food-borne illness outbreaks

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Source: http://rss.cnn.com/~r/rss/cnn_health/~3/1TJPOA0ehzM/index.html

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How Safe Is Your Nail Salon?

Is a trip to the nail salon for a manicure and/or pedicure on your weekly schedule?

While the majority of nail salons follow their states' rules and regulations for safe, hygienic manicures, there are some nail salons that don't. Nail salons that fail to follow these hygiene rules and regulations can lead to all kinds of health problems. In fact, just having cracks or broken skin around your fingernails can lead to HIV / AIDS, as well as other infections.

The good news is that by following a few simple tips for hygienic manicures can mean the difference between fingernail infections and healthy fingernails.

Source: http://womenshealth.about.com/b/2011/09/13/hygienic-nail-salons-equal-healthy-fingernails.htm

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[CDC, Office of Women's Health, Health Matters for Women] September is Gynecologic Cancer Awareness Month

In the United States in 2007,* 80,976 women were told that they had a gynecologic cancer, and 27,739 died from a gynecologic cancer.? CDC provides information and educational materials for women and health care providers to raise awareness about the five main gynecologic cancers (cervical, ovarian, uterine, vaginal, and vulvar).

*Latest year for which statistics are available. ?Source: USCS.

Features

Free or Low-Cost Pap Tests
The National Breast and Cervical Cancer Early Detection Program offers low-cost breast and cervical cancer screening to low-income, uninsured, and underinsured women.

New Educational Materials
The Inside Knowledge campaign has developed new fact sheets, posters, a comprehensive brochure, and more.

Gynecologic Cancer Research

?Be Brave? Video with Jenny Allen

You need the Flash plugin to view this video.

Source: http://www2c.cdc.gov/podcasts/download.asp?af=h&f=8620933

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Not All Males Aspire To Have Chiseled Bodies Idealized By Popular Culture

Main Category: Men's health
Article Date: 28 Sep 2011 - 1:00 PDT email to a friend � printer friendly � opinions �

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Male bodies are increasingly objectified by mass media. Consider Michael 'The Situation' Sorrentino, a cast member of MTV's Jersey Shore reality show, who garnered fame by flashing his chiseled abs before cameras.

Such objectification should send young men running to gyms or fretting before mirrors, right? Not quite. A new study from Concordia University and the University of Manitoba, published in the journal Men and Masculinities, found most boys simply want an average physique.

"Not all boys aspire to have lean, muscular or idealized male bodies that are commonplace in popular culture," says Moss E. Norman, who led the study as a post-doctoral fellow at Concordia's Simone de Beauvoir Institute.

"In many cases, boys who took part in our study were staunchly critical of idealized male images," he continues. "They found it problematic, feminine or vain to be overly concerned with appearances. Sculpted bodies were seen as unnatural, the product of steroids or zealous weight-lifting."

A total of 32 Toronto-area boys, aged 13 to 15, were recruited from a community centre and private school to participate in this research. While the sample group was small, the study lasted nine months and included four in-depth interviews and 19 focus groups.

Discussions centered on male bodies, health, diet and physical activity. Participants were asked to comment on popular culture images, such as the animated character Homer Simpson, shirtless models featured in Bowflex home gym commercials and cut athletes from Ultimate Fighting Championships.

"One of the surprises from this study was how comfortable boys were in expressing, analyzing and comparing bodies - their own, their peers' and those ideals depicted by media," says Norman, who is now a professor at the University of Manitoba's Faculty of Kinesiology and Recreation Management.

"Although they felt pressure to be fit, they displayed a distant, disinterested and cool relationship to their bodies," he adds. "Some participants also admitted to desiring particular masculine ideals and working on their bodies to achieve such idealized forms."

Some body concerns

This study builds on previous research that found boys can face the same anxieties, fears and body image disorders experienced by girls and women. Common body concerns among boys who took part in this particular study included height, muscularity, obesity, skin complexion and style.

"Being overweight was seen as undesirable and associated with a sedentary, immoral lifestyle," says Norman. "

The majority of participants viewed sports as a fun and masculine way to build muscle, while managing calories and body fat. "They felt sports could naturally produce a healthier, fitter and more attractive man," says Norman. "Sports are used to deflect, obscure and erase their bodily anxieties and desires."

Most teenaged boys, Norman concludes, simply want an average physique that doesn't stand out: "Any bodies that fell outside that norm were labeled unnatural, unhealthy or just too much. Boys want a body that's neither too fat nor too skinny; too tall nor too short; too muscular nor too weak."

Article adapted by Medical News Today from original press release.

Visit our men's health section for the latest news on this subject.

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Source: http://www.medicalnewstoday.com/releases/235085.php

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Women in charge 'have less sex'

Researchers analysed data from surveys in Ghana, Malawi, Mali, Rwanda, Uganda, and Zimbabwe that asked survey participants to indicate the day, week, month and year they last had sexual intercourse.

Survey participants were also asked to indicate the person in the household who typically had the final say on the following decisions: health care, large household purchases, household purchases for daily needs and visiting family and friends. Researchers also examined socio-demographic and relationship factors such as age, wealth, parity, husband?s residence, and marital duration.

The majority of women participating in the survey reported sexual intercourse within the last month.

For men, making decisions by themselves was not related to the timing of sex.

Carie Muntifering, a co-author of the study, said: ?Understanding how women?s position in the household influences their sexual activity may be an essential piece in protecting the sexual rights of women and helping them to achieve a sexual life that is both safe and pleasurable.?

The research will be published in the October issue of the Journal of Sex Research.

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/18caca47/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C87833530CWomen0Ein0Echarge0Ehave0Eless0Esex0Bhtml/story01.htm

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[CDC, Office of Women's Health, Health Matters for Women] CDC?s Sudden Unexpected Infant Death Initiative

Since 1998, it appears that medical examiners and coroners are moving away from classifying deaths as SIDS and calling more deaths accidental suffocation or unknown cause, suggesting that diagnostic and reporting practices have changed. Inconsistent practices in investigation and cause-of-death determination hamper the ability to monitor national trends, ascertain risk factors, and design and evaluate programs to prevent these deaths.

As a response, CDC's Division of Reproductive Health?s (DRH) began the Sudden Unexpected Infant Death (SUID) Initiative. CDC and its partners began activities aimed at improving the investigation and reporting practices of Sudden Infant Death Syndrome (SIDS) and other SUID.

The CDC?s research on SUID and SIDS focuses on efforts to standardize and improve data collected at infant death scenes and to promote consistent classification and reporting of cause and manner of death for SUID cases.�By improving national reporting of SUID, we aim to prevent SUIDs by using improved data to monitor trends and identify those at risk.

SUID Initiative Goals and Activities

The goals of the SUID Initiative are to?

1. Standardize and improve data collected at death scene.
2. Promote consistent classification and reporting of cause of death.
3. Improve national reporting of SUID.
4. Reduce SUID by using improved data to identify those at risk.

To accomplish these objectives, the CDC SUID Initiative collaborated with a number of organizations to?

1. Revise the 1996 Sudden Unexplained Infant Death Investigation Reporting Form (SUIDIRF).
2. Develop a training curriculum and materials for investigators of infant deaths.
3. Train medicolegal professionals and child advocates to conduct comprehensive infant death investigations.
4. Develop and implement a state-based SUID Case Registry.

Sudden Unexplained Infant Death Investigation Reporting Form

In 2003, CDC led activities aimed at revising the 1996 Sudden Unexplained Infant Death Investigation Reporting Form and Guidelines for the scene investigation, as well as actively educating and disseminating training materials on infant death scene investigations.

In March 2006, a revised reporting form known as the SUIDIRF was released. Along with the revised SUIDIRF, the CDC and partners developed training materials and conducted train-the-trainer regional academies for medical examiners, coroners, investigators, and child advocates across the United States.

Training Materials

When the CDC published the 1996 SUIDIRF, an evaluation suggested that more medicolegal professionals were likely to use the form if there were training to accompany the form (Hauck, 2001).

The SUID Initiative and collaborative partners created the following training materials:

These training materials were used in conducting the five regional Sudden Unexplained Infant Death Investigation Training Academies.

Training Academies

As a means of disseminating Sudden Unexplained Infant Death Investigation training curriculum and materials, CDC conducted train-the-trainer academies in five U.S. regions from 2006 to 2008. These regional, multidisciplinary academies provided training for every state, as well as American Indian/Alaska Native teams. The academies produced more than 250 trainers, including medical examiners, coroners, law enforcement officers, child advocates, college faculty members, and medicolegal death scene investigators. Individuals participating in these academies were expected to conduct additional trainings at conferences, meetings, and courses in their respective states.

Topics covered at the training academy included how to?

• Complete the SUIDIRF.
• Interview families.
• Conduct death scene investigations including doll reenactments.
• Assess infant growth and development.

The SUIDIRF and training curriculum have been endorsed by several national organizations representing law enforcement, medical examiners, and coroners. More than 20,000 individuals have been trained, and many jurisdictions report that they are using the new SUIDIRF. View map SUIDI Training Academies.

SUID Surveillance System Feasibility Study

In 2007, CDC conducted a SUID surveillance feasibility study with seven states in collaboration with CDC?s National Violent Death Reporting System (NVDRS). NVDRS is a state-based surveillance system that links data from law enforcement, coroners and medical examiners, and vital statistics, etc. The feasibility study indicated that the most efficient way to develop a surveillance system would be to use the Child Death Review (CDR) system already in place. CDC partners suggested calling a future surveillance system the SUID Case Registry.

SUID Case Registry

Planning and Development

In 2008, partners with an interest in SIDS and SUID came together to discuss the logistics of the SUID Case Registry and Surveillance System. Partners supported the idea of building upon and enhance the CDR system, as it would strengthen multidisciplinary team reviews already in place and avoid duplication of efforts. Discussion also focused around creating a program model, delineating objectives, and questions that a SUID Case Registry could answer, and defining a limited set of variables.

The SUID Case Registry aims to generate public health surveillance information about SUID at the national, state, and local levels that is more detailed than what is currently available. Instead of creating an entirely new system, the SUID Case Registry enhances the National Center for Child Death Review program and their Case Reporting System.

The SUID Case Registry generates public health surveillance information that can comprehensively describe the circumstances and events surrounding SUID cases. This will allow researchers, medicolegal investigators, and program prevention planners to better understand characteristics associated with SUID, evaluate case investigation practices, and ultimately prevent infant deaths.

The SUID Case Registry?s objectives are to?

1. Create state-level surveillance systems that build upon Child Death Review activities.
2. Categorize SUID using standard definitions.
3. Monitor the incidence of different types of SUID and describe demographic and environmental factors.
4. Determine similarities and differences among SUID unexplained by autopsy.
5. Inform interventions and potentially save lives.

In July 2009, five state participants were announced to receive funding for the SUID Case Registry Pilot Study as part of a cooperative agreement. Colorado, Georgia, Michigan, New Jersey, and New Mexico began entering information about SUID cases in January 2010. They use a modified version of the National Center for Child Death Review?s Web-based data collection system already place specific to SUID. An additional two states (New Hampshire and Minnesota) were added to the SUID Case Registry in July 2010.

Hauck F. Final Report: National Survey to Evaluate Use of the Sudden Unexplained Infant Death Investigation Report Form (SUIDI RF). Charlottesville, VA: University of Virginia Health System; 2001 (unpublished).

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Source: http://www2c.cdc.gov/podcasts/download.asp?af=h&f=8621107

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Costs of cancer treatments questioned

The Daily Mail has reported that doctors do not support giving life-extending drugs to patients with terminal cancer. The newspaper says that a new report has said the treatments ?give false hope and are too costly for the public purse?.

The news story is based on an extensive international report that examined the cost and value of cancer care in developed countries. In the report doctors, health economists and patient advocates voice their opinions and suggest potential policy changes that could make cancer care more affordable�for both patients and society.�However, the report does not actually suggest that life-extending drugs should be withheld from terminal cancer patients, rather that there is a greater need to understand whether treatments at this stage will actually extend life, and whether resources would be better directed at improving patients? quality of life through options such as palliative care. The report also suggests several policy areas that could be targeted to improve quality of care while reducing its cost.

This report is likely to stimulate discussions on policy relating to cancer care, but it is not policy itself. The report is of great interest but a broad agreement within the health service would be needed if it were to change the manner in which care is provided in the UK.

�

Where did the story come from?

The report was created by researchers from a variety of institutions from the UK, US, Australia, Canada and across Europe. These institutions include King?s College London, CancerPartnersUK, North of England Cancer Network, Northumbria Healthcare, the Institute of Nuclear Medicine, the Association of the British Pharmaceutical Industry, the University of London and Oxford University.

The Lancet states that the commission was peer reviewed and funded by The Lancet Oncology, where it was published.

The media focused on futile care, which is a particular issue highlighted in the report. This is addressed under the issue of ?overutilisation? in general, and is not the primary focus of the report. That said, the report does recommend that special attention should be paid to end of life cancer care. They say that improving the ability to predict the effectiveness of treatment could spare patients side effects and false hope from ineffective care, and also spare the healthcare system the cost of ineffective care. However, some life-extending drugs are valuable for people with terminal illness and the authors do not say that all of these give false hope or are too expensive.

�

What kind of research was this?

This is a discursive policy report written by a panel of international cancer experts. The report is intended to guide public debate on cancer care in developed countries, including the UK. The report attempts to identify the drivers of high-cost cancer care, as well as to propose solutions for these issues.

The extensive report looks at many of the different factors that drive the cost of cancer care. It gathers opinions from a variety of experts, including clinicians, patient advocates, policy makers and cancer survivors. The authors examined the cost and effectiveness of cancer care, and identified issues that drive up the cost of care but that may not provide great improvements in health outcomes. Among the issues examined are the economics of cancer care, the individual and societal impact of cancer treatments, areas where new technology could be improved or developed, predicted rates of cancer in the years to come and whether current methods for evaluating evidence are appropriate.

�

What did the research involve?

The authors collected opinions from a wide variety of experts on the status of cancer care costs and the effectiveness of cancer treatment in developed countries.�They examined the role that cost drivers, evolving patterns of disease and trends in the provision of care play in determining the amount of money spent on cancer care. They then examined the value of cancer care from various perspectives, including the role played by:

• health research and research into cost-effectiveness
• available treatment options, such as surgery, radiation and imaging technologies
• the possibilities offered by new testing technologies, including genetic testing
• anti-cancer drugs, the pharmaceutical industry and the processes for developing new drugs
• patients? involvement in treatment and their ability to express their wishes

They also examined current approaches to addressing the affordability of cancer care in different countries.

The authors say that there are several areas that could be addressed to reduce cost and improve the quality of cancer care. These are as follows.

�

Cost of care

The authors first examined the cost of cancer care, and specifically ?cost drivers?. These are those interventions that account for most of the costs. They examined the cost of cancer from the perspective not only of the price paid for treatments, but also in terms of the economic impact of patients not being able to function normally due to illness or early death.

�

Burden of disease

The authors also looked at the patterns of disease, the complexity of illness and how research accounted for these patterns. They then examined how this burden of disease translates into the cost of treating individual patients and�the cost of treating cancer in society as a whole.

�

Technological development

The authors next highlight the process by which technologies are developed and the cost of this process, and suggest ways in which these costs could be reduced without forfeiting benefits in terms of health outcomes.

�

Overutilisation

The report looks at how ?overutilisation? of cancer technologies and services can drive costs without adding any additional benefit in terms of health outcomes, for example the use of expensive diagnostic tests that provide no greater benefit than cheaper alternatives. The authors identified areas of care that could be reduced without reducing health outcomes.

�

What were the basic results?

The study is extensive so the following section only provides a very brief overview of its findings. The authors identified multiple sources of high cancer costs, and outlined recommendations for improving care and reducing costs in each of the identified areas.

�

Cost of care

The authors found that the absolute amount spent on cancer care is increasing in all developed countries, and that the rate of this increase is going up year by year. They say that this is not simply due to the increasing number of cancer cases seen, but that the rise is also driven by factors such as the use of increasingly individualised treatments that are expensive to develop and the use of inappropriate cancer products (although they say this is more of an issue in the US than in the UK). They found that in 2009-2010, the NHS spent �5.86 billion on cancer care, which is 5.6% of the UK?s total health spend.

They recommend that countries attempt to drive the development of new low-cost technologies by increasing the use of off-patent products and rethinking the pathway of care that patients follow when they have cancer.

�

Burden of disease

The report says that one of the main drivers of cancer care costs is the ageing population (more people are being diagnosed with cancer) and the increasing complexity of disease, including patients with multiple illnesses. They say that the increase in cancer care costs is due both to the amount spent per patient and the number of patients diagnosed.

The authors found that current clinical research often fails accurately to reflect the burden of disease seen in the real world. Patients with multiple illnesses are often excluded from clinical trials, so that the evidence base for new technologies does not accurately reflect the way in which cancer occurs and will be treated in the real world. The researchers recommend that clinical research into new treatments be reflective of this real-world burden of disease for society, and take into account patient frailty and multiple illnesses.

�

Technology development

The authors found that many technologies that provide little additional benefit are taken all the way through the technology development phase, which becomes increasingly expensive the further along it goes. They recommend that the technology development process be changed, and that the design of early clinical trials be improved. They say that technologies that show little additional benefit should be halted earlier in the development process so that they do not reach the most expensive phases. The researchers say that this should result not only in reduced research costs, but also in more rigorous standards of evidence.

�

Overutilisation

The report found that overutilisation of cancer services is an issue in all areas of care. The authors say that the need to treat cancer promptly plays a role in overutilisation as it may be quicker and easier for medical staff to discuss a plan for treatment than to discuss why other treatments may not be suitable for use. They say that clinicians are also increasingly relying on technology and scans to assess new symptoms rather than physical examinations, but that the costs of using imaging techniques are also increasing per patient. The sheer amount of information on new technologies may also prevent clinicians from thoroughly understanding the evidence base needed to decide on the most appropriate treatment plan for a patient.

The report recommends six indicators of when interventions may be suitable for reduction, where cutting the use would have minimal effect on health outcomes. These include interventions that:

• provide no benefit
• result in little increased benefit
• have no clearly defined benefit
• are not desired by patients
• are duplicates of other tests or services
• are more expensive than an equally effective alternative treatment

�

How did the researchers interpret the results?

The authors say that ?in general, there are two primary mechanisms to control costs. We can lower the cost of cancer-care services or interventions, or we can reduce [their use]?. They say that examining current policy can result in decreased utilisation of ineffective services, and increased utilisation of effective services. This, they say, is the way to improve efficiency and value of cancer care. They further say that rethinking how research, policy and clinical practice interact can result in reduced costs and improved quality of cancer care.

�

Conclusion

This is an extensive expert opinion piece looking at the high cost of cancer care. The authors examined cost drivers from a variety of policy and clinical perspectives ? from epidemiology to research to technology development and health economics. The report identifies key areas that they feel could be addressed to reduce the cost and improve the quality of cancer care. Although the paper discusses specific treatments and national healthcare systems (including the NHS) it is not a specific analysis of where changes in individual systems would be beneficial. Instead, the document raises many issues pertaining to whether cancer care strategies need to be examined and reformed in terms of both cost-effectiveness and clinical benefit.

However, the media generally focused on one specific recommendation outlined in the report - the suggestion that attempts to use cancer-fighting therapies to lengthen the lives of terminal-stage cancer patients may not always be appropriate. Newspaper coverage may not fully reflect the tone and context of the report, which arguably raises questions on the issue rather than attempting to provide a definitive verdict on the current situation.

For example, rather than suggesting that medical care should be withdrawn from cancer patients within their last few weeks of life, the report says that continuing care strategies such as chemotherapy may be problematic for patients, and that focusing on palliative care may improve their quality of life and possibly prolong their survival. In short, the researchers question whether spending could be directed at cheaper, potentially better methods for helping people with late-stage cancer, and (contrary to some news coverage) do not suggest that they should not be helped at all.

The researchers also suggest that there is a need for clinical measures that can accurately determine which late-stage patients would and would not benefit from further disease-fighting therapy, highlighting that they are not advocating the withdrawal of appropriate care options for terminal patients.

The authors say that each health system now needs to consider how much is spent on cancer care and prevention compared with other healthcare priorities. This should include funding the most effective interventions, and insistence on a strong evidence base before adopting newly available medical technology.

The authors say that focusing on areas of care that provide little or no benefit, increasing the use of low-cost technologies and refocusing care pathways on high-quality, cost-effective and value-based care can reduce the cost of cancer care without sacrificing benefits. They also say that countries could further address cancer care costs by developing new ways of financing cancer care, including evaluating the pricing of drugs.

Overall, this is a valuable and intriguing exploration of the nature of current cancer treatment and, contrary to the impression given by media reports, these authors do not suggest that all end of life care should be stopped. Instead the report focuses on value, saying that the benefits of cancer care should be weighed from both an individual and societal perspective, and that the cost of care, in terms of price as well as side effects, should be balanced against the benefits, including quality as well as extension of life.

Links To The Headlines

Dying cancer patients should not be given 'futile' drugs. The Daily Telegraph, September 27 2011

Don't give out cancer drugs if it's just to extend life: Treatment costs can't be justified, say experts. Daily Mail, September 27 2011

Cancer cost 'crisis' warning from oncologists. BBC News, September 27 2011

Links To Science

Sullivan R, Peppercorn J, Sikora K et al. Delivering affordable cancer care in high-income countries. The Lancet Oncology, Volume 12, Issue 10, Pages 933 - 980, September 2011

Source: http://www.nhs.uk/news/2011/09September/Pages/cost-of-advanced-cancer-drugs-questioned.aspx

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Ovarian Cysts, Fibroids, and Polyps

Women's Health Forum: After having a very bad pain a few days ago, on my left side, I had a vaginal ultrasound. They found various problems, like intramuraual fibroids, suserours fibroids, follicles, polyps and the thing that is worrying me the most, a couple of cysts. One is said to be "avascular complex cystic" "low level echoes"... I don't have a clue what this means. What are the chances of this being malignant?

I would like to hear from someone that has a some information that could help me understand this, before seeing the gynecologist. I have to make an appointment to see him, and would like to have some questions ready when I go. Thanks to anyone that can help me better understand this...What would you ask the doctor?

Source: http://womenshealth.about.com/b/2011/09/21/ovarian-cysts-fibroids-and-polyps.htm

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Check Plastic Surgeon's Credentials or Risk Tragic Results, Experts Warn

By Alan Mozes
HealthDay Reporter

MONDAY, Sept. 26 (HealthDay News) -- "I was in shock," recalled 40-year old Dinora Rodriguez. "It was a nightmare."

Rodriguez had woken up from cosmetic surgery only to find that she could not move her arms or even close her eyes. And so begins a harrowing account of plastic surgery, in her case involving breast implants and a facial scar, gone terribly wrong.

As a cautionary tale, Rodriguez' experience highlights the urgency behind a new safety campaign launched this week by the American Society of Plastic Surgeons (ASPS).

The goal: to draw attention to the physical disfigurement and emotional torment that can follow when patients fail to check a surgeon's credentials before they go under the scalpel.

"I already had implants put in five years earlier, in Mexico," explained Rodriguez, who lives in Los Angeles. "And that time, the first time, I had no problems. But I wondered if they were still OK, or if it was time to replace them."

"So I had this friend who recommended this doctor to me," she continued. "She said she had had liposuction done on herself, and both her daughters also went to this woman. So I went. I never checked on her background or if she was certified. I just went."

"And she told me," remembers Rodriguez, "that I needed a mammogram [to check the implant]. And after, she told me that it showed that one of the implants was leaking, and I needed to replace them right away because it was not good for my health."

It would be months before Rodriguez would find out the truth: her doctor had lied. There was no leakage, and thus no need for new implants.

"But that wasn't all," she said. "That day she also discussed a scar I had on my face [near the eyes], because of an accident. She said she could fix it. And I said I would think about it. On the day of the implant surgery she asked again, about my eyes. She said she could fix it at the same time. That it was simple. But I said no. I said, 'I don't want to deal with two pains at the same time.'"

"But when I woke up I found that she had operated on my eye, on both my eyes, without my permission! I was shocked and upset. And in pain. So much pain."

As it turns out, Rodriguez's physician had removed so much skin from around the eyes that Rodriguez was no longer able to fully close them. What's more, the breast surgery had been botched as well, the result of two breast implants having been inserted into one packet.

"We hear these stories over and over again," warned ASPS president Dr. Malcolm Z. Roth. "And worse. Situations arising from 'my friend who gave me the reference.' And to that I say: you spend time researching buying a car. You look for a safe car, and you put on your seatbelt. You take it seriously. But unfortunately people often think that getting cosmetic surgery is something else. It's not. It's serious. You're taking your life into your hands."

"Because these are not emergency procedures, you have an opportunity to do the homework," noted Roth, who is also chief of plastic surgery at the Albany Medical Center in Albany, NY. "You make sure that the person you're considering going to is first off a physician, of course. And most important, that they're board-certified in plastic surgery by the ASPS. Not in some other field."

Because appearances can be misleading. Part of the new ASPS campaign is focused on a problem the group calls "white coat deception": the fact that just because a doctor has a medical license does not mean he or she is properly trained and qualified to perform plastic surgery.

The problem stems from the fact that only four states (California, Florida, Louisiana, and Texas) have laws on the books requiring that physicians take steps to disclose the specifics of their medical background. In all other states, no such regulations exist. That leaves a pediatrician or a gastroenterologist, for example, free to cross over into the role of plastic surgeon at will and without disclosure.

"And because cosmetic surgery by it's nature can be done in an outpatient facility, doctors can -- and do -- promote themselves as a plastic surgeon, even if they have never held a knife in their life, and there's no one there to stop them," Roth said.

Some so-called plastic surgeons may not even be doctors at all, but con artists preying on vulnerable individuals. Last July a 22-year-old California woman died after being given silicone injections in the buttocks in an operation run by two sisters who did not have medical licenses to practice in the United States, according to Los Angeles Times.

To avoid such potentially deadly scenarios, the ASPS calls on patients to search for certification credentials at the organization's website (www.plasticsurgery.org), and confirm that properly sealed credentials are readily viewable in the physician's office.

"All our members have a minimum of six years of surgical training in plastic surgery," Roth said. "All have completed oral and written examinations, and continue to pursue 50 hours a year of continuing education, with an important emphasis on patient safety. And none operate in a facility unless it is accredited with all the bells and whistles needed for the rare occasion when there is a problem."

Unfortunately, Rodriguez was not so lucky.

"I looked deformed" after the surgery, Rodriguez said. The uncertified surgeon "tore skin from my cleavage, and I looked like I only had one breast. But she told me that she had done nothing wrong, that my breasts were only swollen, that I needed a couple of months to heal, and that my eye scar had looked so ugly that I 'needed' the surgery."

Unable to fully move her arms or even lay down comfortably, Rodriguez returned to the doctors a few months later, still racked with pain and unable to close her eyes. But the physician turned her away, declaring: 'I don't want to see you; you are not my patient anymore. I can fix it, but there's nothing I can do until you pay me more money.'"

That was four years ago. In the intervening years, Rodriguez said enduring pain has been accompanied by deep and recurring bouts of depression, at one point culminating in a suicide attempt.

On a positive note, reconstructive surgery conducted at a different facility has done much to restore the appearance of Rodriguez's breasts. But nerve and muscle damage lingers. And to date her eyes remain, in her words, "a permanent mess."

"This should be a wake-up call to anyone considering plastic surgery," stressed Roth. "The most important thing is patient safety. You don't want plastic surgery to be a game of Russian roulette."

Copyright � 2011 HealthDay. All rights reserved.

SOURCES: Malcolm Z. Roth, MD, president, American Society of Plastic Surgeons (ASPS), and chief, division of plastic surgery, Albany Medical Center, Albany, NY; Dinora Rodriguez, Los Angeles

Source: http://www.medicinenet.com/guide.asp?s=rss&a=149824&k=Womens_Health_General

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Do Women's Voices Really Allow Men To Detect Ovulation?

Main Category: Sexual Health / STDs
Also Included In: Women's Health / Gynecology
Article Date: 23 Sep 2011 - 0:00 PDT email to a friend � printer friendly � opinions �

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The voice can reveal a lot about a person - their sex, their age, how they are feeling - and recent studies have even suggested that women's voices might also contain cues that men can read about how close they are to ovulation. A new study, however, published in the journal PLoS ONE, challenges the view that women broadcast reproductive information in their voice.

Previous studies in this area have typically relied on the comparison of voices recorded in just two phases in the cycle: high conception risk vs. low conception risk. This new work, on the other hand, looked at variation in the voice throughout the entire menstrual cycle - a crucial step to evaluate the potential information contained in any observed voice changes.

Their results showed that the overall variation in women's vocal quality throughout the whole cycle precludes unequivocal identification of the period with the highest conception risk. Specifically, while they found that the women studied spoke with the highest tone (suggested by previous studies to be associated with attractiveness) just prior to ovulation, the tone rose again to levels indistinguishable from pre-ovulation shortly after ovulation, making it a very poor mating clue. Furthermore, they found that the men studied showed only a very slight preference for pre-ovulation voices relative to voices recorded during ovulation.

The authors conclude that women's voices do not provide reliable information about the timing of ovulation, confirming the view that information about reproductive state is 'leaked' rather than broadcast. In an interesting further finding, the study found that women's voice were harsher and more irregular during menstruation, providing scientific data to explain why female opera singers may be granted 'grace days' during menstruation.

Funding: The authors have no support or funding to report.

Competing Interests: The authors have declared that no competing interests exist.

Article adapted by Medical News Today from original press release.

Visit our sexual health / stds section for the latest news on this subject.

The international collaborative study was led by Prof Julia Fischer (German Primate Centre), Dr Stuart Semple (Roehampton University, London) and Dr Ofer Amir (Tel-Aviv University).
Citation: Citation: Fischer J, Semple S, Fickenscher G, Jurgens R, Kruse E, et al. (2011) Do Women's Voices Provide Cues of the Likelihood of Ovulation? The Importance of Sampling Regime. PLoS ONE 6(9): e24490. doi:10.1371/journal.pone.0024490
LINK TO THE SCIENTIFIC ARTICLE: http://dx.plos.org/10.1371/journal.pone.0024490
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Source: http://www.medicalnewstoday.com/releases/234829.php

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Glee Season Premiere Is Tonight! WH Talks to Lea Michele And Heather Morris

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GLEE SEASON 3

Susan Rinkunas

Attention Gleeks: Season 3 of Glee kicks off tonight at 8/7 central on Fox! In honor of the highly anticipated premiere, we revisited WH's interviews with two of the show's leading ladies!

The Broadway Veteran
Lea Michele plays Rachel Berry, the star singer of William McKinley High School's glee club, New Directions. Lea?a Broadway veteran whose credits include Les Mis�rables, Fiddler on the Roof, and Spring Awakening?appeared on our cover in June 2010 (left, above).

The Bronx native stays in shape with rock climbing, hiking, and yoga. She switches between vegan and macrobiotic diets, so she eats fish, but no other animal products. Her favorite indulgences? "I love organic wine and dark chocolate!"

Video: Go behind the scenes with Lea Michele at her WH cover shoot!

The Dancing Queen
Heather Morris, who graced our June 2011 cover, plays Cheerio [cheerleader] Brittany Pierce. Fun fact: As a former backup dancer for Beyonce, Heather was initially called in to teach the cast the "Single Ladies" choreography, only to be hired for a small role on the show.

"Between takes, Heather would do these hysterical impersonations," recalls Zach Woodlee, Glee coproducer and choreographer. "The writers began to latch on to her, and that's how [Brittany] came to be a speaking part."

Heather, who grew up in Scottsdale, Arizona, still takes dance classes, mostly because they keep her mentally tough. She also loves piloxing, a turbo-charged interval program that combines Pilates, boxing, and dance moves. "I went to Piloxing before the Golden Globes because I'm crazy!" she explains with a laugh. "I was wearing a skintight dress, and I wanted to look hot."

Video: Go behind the scenes with Heather Morris at her WH cover shoot!

Tell us: Which female cast member of Glee would you like us to interview next?

RELATED: Get the Dancer's Body Workout!

Last Updated: September 20, 2011 - 5:11pm

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Source: http://www.womenshealthmag.com/health/glee-season-3

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