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Surgery prevents breast cancers in high-risk women Print
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Women with mutations in the well-known BRCA1 or BRCA2 genes who have their breasts and ovaries removed are much more likely to survive than women who do not get preventive surgery.

The study shows the benefits of genetic tests that give women with a family history of cancer the chance to take steps to increase their chances of survival, they said.

"This is the first study to prove women survive longer with these preventive surgeries and shows the importance of genetic testing when there is a family history of early breast or ovarian cancer," Dr. Virginia Kaklamani of Northwestern University in Chicago wrote in a commentary about the study published in the Journal of the American Medical Association.

Women with mutations in the BRCA1 or BRCA2 genes have a 56 to 84 percent higher risk of developing breast cancer during their lifetimes.

Those with the BRCA1 mutation also have a 36 to 63 percent higher risk of ovarian cancer and those with the BRCA2 mutation have a 10 to 27 percent higher risk of ovarian cancer.

Because of this, many women make the difficult choice to have their breasts or ovaries and fallopian tubes surgically removed to reduce their risk.

Dr. Susan M. Domchek of the University of Pennsylvania School of Medicine in Philadelphia and colleagues studied the effectiveness of these procedures, comparing rates of cancer and death in 2,482 women who had the surgery with those who decided against it in favor of frequent cancer screenings.

No woman who had a mastectomy developed breast cancer during the three years of follow-up testing.

Seven percent of women who decided against a mastectomy were diagnosed with breast cancer in the same period.

"Our results confirm that risk-reducing mastectomy is associated with a significant reduction in breast cancer risk," Domchek and colleagues wrote.

Women with BRCA1 and BRCA2 mutations who had their ovaries and fallopian tubes removed had similar results.

About 10 to 20 percent of breast and ovarian cancers are due to BRCA1 or BRCA2 genes. "Most of these women will die of ovarian cancer, so you can save 20 percent of them with the prophylactic surgery," Kaklamani said.

"And you can save the majority of women who would have died of their breast cancer," she added.

She said primary care physicians, gynecologists and women "need to be more aware that these tests exist."

Dr. Sandhya Pruthi, a breast cancer expert at the Mayo Clinic in Rochester, Minnesota, who counsels women with BRCA mutations, said the study adds more evidence that the surgery can help save lives, but the choice is never easy.

"It's not cookie-cutter medicine," Pruthi, who was not involved in the study, said in a telephone interview.

She said women need to come to terms with the psychological issues involved in having their breasts removed, and younger women who have their ovaries removed must contend with early menopause symptoms.

"It's not a decision made on a single visit," she said.

According to the American Cancer Society and the International Agency for Research on Cancer, 1.3 million new breast cancer cases are diagnosed around the world every year and it kills 465,000 women annually, making it the leading global cancer killer of women.

 

                                                                                                                                                                     2010-09-04

 
How to treat mycotic vaginitis correctly Print
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Vulvovaginal candidiasis is a common, easily cured, the key is to select the suitable method of treatment.

1. simple Vulvovaginal candidiasis: vaginal medication-based

Symptoms of vulvar lighter, although an itch, but is not very serious, easy to cure. Preferred vaginal medication, shower with warm water flush genital. Oral medication and therapeutic drugs. Also, do not use liquid, do not sit in a bath.

2. severe candidiasis: mainly oral medication

Symptoms of more serious, generally expressed as Dingbat negative is rubbish, genital Erythema, edema, often accompanied by scratches, peeling skin chapped skin, vagina, erosion, cervical hyperemia symptoms, while oral medication, preferred vaginal douche after drug (non-menstrual period).

In addition, it is necessary to regularly clean the vulva, 4% of soda water to clean the vagina, it is best to go to the hospital cleaning, because in the hospital can be attached to the vaginal wall of germs clean and impulse, assure complete and clean, generally one day cleaning price is cheaper.

3.Recurrence vulva vagina moniliasis: After the strengthening, treats consolidated

Some females cure, in one year manifests suddenly 4 times or above. Uses treatment including strengthened treatment and consolidated treatment, after the strengthened treatment achieves the fungus cure, consolidated treatment at least a half year.

The recurrence vulva vagina moniliasis medication aspect needs to pay attention, because after some medicine use, possibly has the drug resistance, needs to make the bacilliculture and the medicine experiments sensitively, chooses the medicine according to the result.

4. pregnancy merge vulva vagina moniliasis: Pregnancy merge vulva vagina moniliasis resists the rosary fungus with medicine

To treat the effect cautiously to be slow, easy to recur. The partial treatment, chooses to the embryo harmless vagina medication, on 7th the therapy effect is good.if
 
 the vulva vagina moniliasis symptom is serious, possibly will cause the miscarriage, the premature delivery. Moreover, will affect embryo's health, the embryo easy to infect the bacterium, after the childbirth, baby easily mouth diseases and so on goose sore, dermatitis.

 5. breast-feeding period mycotic vaginitis: The vagina applies drugs 

The breast-feeding period the female should better do not use the mouth to take medicine, may choose the vagina medication.

6. no sex: drug use is not affected

For not having sex while infected with fungus vaginitis, don't worry about your medication will be affected, even if you choose the correct vaginal medication, do not damage the hymen.

 

                                                                                                                                          2010-09-02

 
Are allergies associated with heart disease? Print
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Common allergies that bring on wheezing, sneezing and watery eyes could be next to join the list of factors linked to heart disease, suggests a large new study.

However, the researchers stress that the findings do not prove that allergies actually cause heart disease, the leading cause of death in the U.S.

To look for ties between common allergic symptoms and heart disease, Dr. Jongoh Kim of Albert Einstein Medical Center in Philadelphia, Pennsylvania and colleagues analyzed data on more than 8,600 adults aged 20 or older who participated in the National Health and Nutrition Examination Survey conducted between 1988 and 1994.

They found that common allergies and heart disease frequently paired up.

Eighteen percent of the adults reported wheezing and 46 percent suffered bouts of a stuffy nose or itchy and watery eyes -- a combination of allergic symptoms known as rhinoconjunctivitis.

Heart disease was present in 6 percent of the adults overall. It was found in 13 percent of wheezing cases, 5 percent of rhinoconjunctivitis cases and 4 percent of people without any allergic symptoms.

After adjusting for other related factors, such as age and asthma, there was a 2.6-fold increased risk of heart disease with wheezing and a 40 percent increased risk with rhinoconjunctivitis, compared to no allergies. The association was mainly seen in women younger than age of 50.

Kim suggests that the intermittent inflammation that comes with allergies may lead to the thickening of artery walls, and eventually heart disease. It could also be that some people simply carry genes that are linked to the development of both allergies and heart disease, Kim added.

But given the nature of the study, the researchers are not yet able to say if allergies truly have a role to play in the development of heart disease.

Much more study is needed to "clearly see" whether there is a cause and effect relationship, Kim said. "And even if there is a cause and effect, it is not clear whether treating allergic disease can reduce the risk," Kim noted.

Dr. Carlos Iribarren, a research scientist at Kaiser Permanente in Oakland, California, who was not involved in the study, said: "Because common allergic symptoms are highly prevalent in asthma, these findings are consistent with prior research conducted at Kaiser Permanente showing a significant association between self-report of asthma and future risk of coronary disease, particularly among women."

But he cautioned, in an email to Reuters Health, against jumping to any "premature conclusion, consumer-level advice or public health recommendation based on these findings."

Iribarren also noted that study subjects with allergy (particularly wheezing) had a greater burden of heart disease risk factors (for example, smoking, obesity, high blood pressure), compared with allergy-free subjects. Therefore, "allergists, internists and cardiologists should be made aware of this link and intensify cardiovascular risk profile assessment and modification among patients presenting with allergy."

Dr. Viola Vaccarino, of the Rollins School of Public Health at Emory University School of Medicine in Atlanta, told Reuters Health that the current findings also fit with studies she and her colleagues have done, "finding of an association of chronic inflammatory conditions such as asthma and other allergic conditions with coronary disease in women but not in men."

"Young women may have a stronger inflammatory response due to allergic conditions than men, perhaps due to estrogens," explained Vaccarino, who was also not involved in the current study.

It's also possible, she said, that "people with history of coronary heart disease are sicker with respiratory symptoms just because they have coronary heart disease and not vice-versa."

"I really wouldn't draw any strong message from this study," said Vaccarino. "I would not alarm the public with the news that common allergic symptoms (other than asthma) increase the risk of coronary heart disease in women, based on this study."

 

                                                                                                                                                                      2010-09-01

 
Infertlity,you feel anxious about it Print
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Subfertility is defined by involuntary failure to conceive after a couple having unprotected intercourse for a year. Infertility can be either primary or secondary. The incidence of primary infertility affected at least 12% of couples.  For diagnosis of infertility, coital history is essential and both partners should be investigated.

Primary infertility refers to a couple that never become pregnant after a year of unprotected sexual intercourse.

Secondary infertility means a couple have been pregnant at least once in their lifetime however have difficulty to become pregnant again.

Causes of infertility:

Infertility factor Type Percentage
Female factor Tubal problemAnovulationOther 15%20%10%
Male factor Ejaculation and erection dysfunction and reduce sperm quality 40%
Unknown IdiopathicSexual problem 25%5%

The total of causes are more than 100% because most of the time there is more than one factor that cause the infertility. Management of infertility is different for each problem. In severe case, assisted reproduction will be necessary.

Infertility – female factor

Female factor infertility is the inability to conceive or carry a pregnancy to term due to one or more problems specific to females. For example, if a couple is struggling to achieve pregnancy and the male has adequate sperm count, motility, and shape, but the woman has polycystic ovarian syndrome, then their inability to conceive is likely due to female factor infertility.

There are several conditions that contribute to female factor infertility, including uterine and pelvic abnormalities, secondary infertility, polycystic ovarian syndrome, and hostile cervical mucus.

It is important to understand, however, that infertility, whether male infertility or female infertility, is not the same thing as sterility - conception and successful pregnancy are possible in many cases. Likewise, secondary infertility (the inability of a couple to conceive after having already achieved a successful pregnancy or pregnancies) can often be treated.

Infertility – male factor

Approximately 15% of couples attempting their first pregnancy meet with failure. Most authorities define these patients as primarily infertile if they have been unable to achieve a pregnancy after one year of unprotected intercourse. Conception normally is achieved within twelve months in 80-85% of couples who use no contraceptive measures, and persons presenting after this time should therefore be regarded as possibly infertile and should be evaluated. Data available over the past twenty years reveal that in approximately 30% of cases pathology is found in the man alone, and in another 20% both the man and woman are abnormal. Therefore, the male factor is at least partly responsible in about 50% of infertile couples.
 
Important issues related to the evaluation of the male factor include the most appropriate time for the male evaluation, the most efficient format for a comprehensive male exam, and definition of rationale and effective medical and surgical regimens in the treatment of these disorders. It is extremely important in the evaluation of infertility to consider the couple as a unit in evaluation and treatment and to proceed in a parallel investigative manner until a problem is uncovered. It has been shown that the longer a couple remains subfertile, the worse their chance for an effective cure. Many couples experience significant apprehension and anxiety after only a few months of failure to conceive. Unduly prolonged unprotected intercourse should not be advocated before a workup of the man is instituted. Initial screening of the man should be considered whenever the patient presents with the chief complaint of infertility. This initial evaluation should be rapid, non-invasive and cost effective. Of interest is the fact that pregnancy rates of up to 50% have been reported when only the woman has been investigated and treated even when the man was found to have moderately severe abnormalities of semen quality.

 

                                                                                                                                                         2010-08-31

 
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