November 4, 2008
Depression symptoms early in pregnancy foreshadow preterm delivery
Among nearly 800 pregnant women in a study from California’s Kaiser Permanente program, those who experienced depressive symptoms early in their pregnancies were more likely to deliver preterm babies. The report is published early online in the journal Human Reproduction.
The likelihood of preterm delivery was exacerbated by:
* obesity
* lower education levels and
* a history of fertility problems
This echoes a smaller prospective study published last year. UCLA researchers found the same phenomenon, but they linked it to the medication rather than to the symptoms.
Enter “pregnancy depression” in the search box, and scroll down the page. You’ll see another new study in the American Journal of Psychiatry suggesting that this is fundamentally a circadian rhythm problem, which might be solved by a benign strategy: light therapy.
Psychiatric Times
Which antidepressants are safest in pregnancy? Find the answer in a recent review in Psychiatric Times by clicking on the dedicated link in the left column that searches this publication only.
Complementary Medicine
How about starting with the alternative remedy St. John’s wort? A search on “St. John’s wort pregnancy” in this category reveals that the herbal treatment for depression may not be innocuous to the fetus
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Alternative Medicine, Depression, Family Medicine, Psychiatry, Women | Tagged: antidepressants, Depression, pregnancy, premature birth, St. John's wort | 
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October 21, 2008
Expert review calls LHRH agonists “acceptable” for early breast cancer
LHRH agonists probably reduce the risk of recurrence and increase survival in premenopausal women with early breast cancer, whether used alone or in combination with tamoxifen. They’re an “acceptable alternative” to ovarian ablation or radiotherapy, concludes a systematic review from the Cochrane Collaboration.
They appear to reduce recurrence and mortality when used in combination with adjuvant chemotherapy. But evidence to date is too weak to draw strong conclusions, say the authors.
Perhaps results will be stronger when studies are done with the aid of genotyping.
Premenopausal women taking goserelin lose bone mass, but this is preventable with zoledronic acid, according to new results from an Austrian trial.
Research/Reviews
Why did it take so monopolize on endocrine factors in treating breast cancer (compared to HER-2, for instance)? Authors from Johns Hopkins’ Kimmel Center ponder the question in a recent review found in this category.
Clinical Trials
Use this article category to find current clinical trials testing tamoxifen or goserelin for breast cancer in premenopausal women.
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Breast, Cancer, Women | Tagged: early breast cancer, goserelin, LHRH agonists, tamoxifen | 
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October 7, 2008
CDC says far too few tots get influenza vaccine, urges shots from 6 months
All children older than six months should get the flu shot, according to a new advisory from the Centers for Disease Control and Prevention.
Infants between six and 23 months old are at particular risk of hospitalization with influenza. Yet last year only one in five tots in this age range received the influenza vaccine.
The agency is paving the way for your conversation with parents, using a major mass media campaign that targets consumer health blogs and parenting websites.
Twenty two leading agencies, including the American Academy of Family Physicians and the American Academy of Pediatrics, joined last month in a new alliance to bolster public confidence in immunization.
Infants younger than six months can be protected from influenza if the expectant mother gets a flu shot, according to a new study in the New England Journal of Medicine.
Practice Guidelines
Quickly find the latest guidelines on prevention and treatment of influenza in children.
Patient Education
Here’s the place to find reliable information for parents on the question of preventing and treating flu in their kids.
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Adolescent, Family Medicine, Influenza, Internal Medicine, Pediatrics, Women | Tagged: pregnancy, Influenza, vaccinations, children, flu | 
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August 26, 2008
Substantial recurrence risk shown to follow systemic breast cancer therapy
MD Anderson researchers found a 20% recurrence risk 10 years after breast cancer patients were declared disease-free following five years of adjuvant treatment. Results of the retrospective registry study appear in the August Journal of the National Cancer Institute.
No guidelines address this situation for premenopausal women. But the range of risk would justify adjuvant or neoadjuvant therapy at the time of diagnosis, according to the authors.
Predictors of late recurrence include:
* Hormone-positive tumors not treated with endocrine therapy
* Higher stage
Very recently the same team reported on the prognostic significance of Her2 status in inflammatory breast cancer.
Practical Articles/News
The query “breast cancer anxiety” in this article category delivers a recent review of psychological factors that predict emotional distress in breast cancer patients.
Research/Reviews
Two recent reports in this article category correlate receptor subtype with location of tumor recurrence in breast cancer.
No Comments » | Breast, Cancer, Women | Tagged: adjuvant therapy, Breast, her-2, neoadjuvant therapy | Permalink
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August 12, 2008
Calories—not sugar, carbs, or fat—cause type 2 diabetes in those at risk
What people eat controls what they weigh, and that (setting aside genes and exercise) seems to determine the risk of type 2 diabetes—not the types of macronutrients themselves. That’s the upshot of two new studies in the Archives of Internal Medicine, according to a review in the same issue.
It’s not the sugar in soft drinks or juices but the poundage they so easily add that predisposes to type 2 diabetes, according to a study of young African-American women in the July 28 issue of Archives.
It was probably weight loss per se, not the low-fat or high-fiber diet, that reduced glycemia among postmenopausal women in the other study.
Which is best for weight loss: low carbs, low fat, or the Mediterranean diet? Depends on the patient’s underlying risk profile. The latter may be best for people at risk of diabetes, according to another new report, this one in the New England Journal of Medicine.
Related searches
Mediterranean diet diabetes
obesity children juice
menopause metabolic syndrome testosterone
Research/Reviews
How much exercise do patients need to maintain weight loss? Find more new reports in this article category.
Patient Education
Look in this category for trustworthy information for patients about physical activity and diabetes.
No Comments » | Adolescent, Cardiovascular, Diabetes_Endocrine, Family Medicine, Gastrointestinal, Geriatrics, Internal Medicine, Pediatrics, Women | Tagged: calories, carbohydrates, Diabetes_Endocrine, fat, menopause, obesity, weight loss | Permalink
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July 22, 2008
No Comments » | Depression, Family Medicine, Mood Disorder, Women | Tagged: smoking, Depression, pregnancy, psychosis, drug abuse, mental illness, alcohol abuse, postpartum depression, teratology, prenatal care | Permalink
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March 18, 2008
How many breast cancer patients (and MDs) ignore the greater risks?
The odds are about 50:50 that a breast cancer survivor over 60 will die as a result of something else – most likely heart disease or osteoporosis – according to a new report in the Journal of the National Cancer Institute. It calls for greater attention to these women’s other medical problems.
Another study in the same issue finds that women diagnosed with ductal carcinoma in situ (DCIS) radically overestimated their risk of progression to cancer or metastasis. They also showed “notable declines” in general health, vitality, and mental health during the 18 months after diagnosis.
A companion editorial to this study (look for the link at the bottom of the abstract) tentatively suggests a trial of “watchful waiting” for DCIS—rather than knee-jerk mastectomy. If it works for prostate cancer, then why not for this pre-malignant condition?
These articles aren’t full of advice about how to help patients who fret about their condition. But there are ideas elsewhere on SearchMedica.
Clinical Trials
Find the new trial mentioned in the DCIS editorial that is testing brief hormonal therapy before surgery. Researchers are looking for changes in tumor volume, with a goal of finding nonsurgical means to avert progression.
Patient Education
Find something worth sending home with a patient who will be thinking a long time about her diagnosis of early breast cancer.
No Comments » | Breast, Cancer, Mood Disorder, Women | Tagged: Breast, DCIS, heart disease, mastectomy, osteoporosis | Permalink
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