Main Category: Depression
Also Included In: Women’s Health / Gynecology;  Genetics
Article Date: 18 May 2012 – 1:00 PDT

Current ratings for:
‘Women At Risk Of Post Natal Depression May Be Identified By Blood Test‘

Patient / Public:
Healthcare Prof:

Researchers at Warwick Medical School have discovered a way of identifying which women are most at risk of postnatal depression (PND) by checking for specific genetic variants. The findings could lead to the development of a simple, accurate blood test which checks for the likelihood of developing the condition.

Presenting the research to the International Congress of Endocrinology/European Congress of Endocrinology, Professor Dimitris Grammatopoulos, Professor of Molecular Medicine at the University of Warwick, said that approximately one in seven women who give birth suffer from PND, which normally starts around two weeks after childbirth.

He explained: “Current screening policies rely on the opportunistic finding of PND cases using tools such as the Edinburgh Postnatal Depression Score (EPDS), but such tests cannot identify women at risk, ahead of them developing the condition.”

The researchers assessed a group of 200 pregnant women for PND using the EPDS, once during their first visit to the ante-natal clinic, and again two to eight weeks after they had given birth. They found that the women who developed PND were more likely to have specific genetic variants of the bcl1 and rs242939 single nucleotide polymorphisms (SNPs)[2] of the glucocorticoid receptor and the corticotrophin-releasing hormone receptor-1 genes, respectively.

These receptors control the activity of the hypothalamo-pituitary adrenal (HPA) axis – an endocrine system that is activated in response to stress. The hypothalamus is part of the brain that monitors many aspects of the state of the body’s systems and is closely linked with the pituitary gland, which releases a number of hormones into the blood stream that control vital body functions.

The finding appears to show that postnatal depression is a specific subgroup of depression with a distinct genetic element which means that some women are genetically more reactive to the environmental factors which trigger depression.

“Although we knew already that there was an association of the HPA axis with depression, ours is the first study to show a link between specific elements of this pathway and the particular case of PND,” said Professor Grammatopoulos.

“We now intend to conduct further research on other genetic variants of the HPA axis in a larger, multi-centre study involving women from Coventry, Birmingham, and London.

“We think that we have made an important step forward in characterising the prospective risks and are therefore paving the way for timely, appropriate medical treatment for women who are likely to develop PND.”

PND is a serious condition, the researchers say, and quite different from the ‘baby blues’, which is milder and shorter-lived. Symptoms include sadness, changes in eating and sleeping patterns, crying episodes, reduced libido, anxiety and irritability.

Effects on children can be significant; for example, depressed mothers are less likely to be affectionate towards and to play with their children and they may use less ‘baby talk’ which is designed to engage the child’s attention. This may lead to learning and emotional difficulties for the children in later life.

Although it may seem evident that PND is caused by some kind of hormonal upheaval but the role of the HPA axis in this form of depression has not been proved until now.

“We believe that we have made a discovery with important clinical and social implications. If we can identify women likely to suffer from PND in advance so that they can be treated appropriately and at an early stage, we will have improved the lives not just of the parents, but also of their children,” Professor Grammatopoulos concluded.

• Additional
• References
• Citations

Main Category: Psychology / Psychiatry
Also Included In: Women’s Health / Gynecology
Article Date: 17 May 2012 – 0:00 PDT

Current ratings for:
‘Women Seen As Objects, Not People In Sexualized Images‘

Patient / Public:
Healthcare Prof:		5 (1 votes)

Perfume ads, beer billboards, movie posters: everywhere you look, women’s sexualized bodies are on display. A new study published in Psychological Science, a journal of the Association for Psychological Science, finds that both men and women see images of sexy women’s bodies as objects, while they see sexy-looking men as people.

Sexual objectification has been well studied, but most of the research is about looking at the effects of this objectification. “What’s unclear is, we don’t actually know whether people at a basic level recognize sexualized females or sexualized males as objects,” says Philippe Bernard of Université libre de Bruxelles in Belgium. Bernard cowrote the new paper with Sarah Gervais, Jill Allen, Sophie Campomizzi, and Olivier Klein.

Psychological research has worked out that our brains see people and objects in different ways. For example, while we’re good at recognizing a whole face, just part of a face is a bit baffling. On the other hand, recognizing part of a chair is just as easy as recognizing a whole chair.

One way that psychologists have found to test whether something is seen as an object is by turning it upside down. Pictures of people present a recognition problem when they’re turned upside down, but pictures of objects don’t have that problem. So Bernard and his colleagues used a test where they presented pictures of men and women in sexualized poses, wearing underwear. Each participant watched the pictures appear one by one on a computer screen. Some of the pictures were right side up and some were upside down. After each picture, there was a second of black screen, then the participant was shown two images. They were supposed to choose the one that matched the one they had just seen.

People recognized right-side-up men better than upside-down men, suggesting that they were seeing the sexualized men as people. But the women in underwear weren’t any harder to recognize when they were upside down – which is consistent with the idea that people see sexy women as objects. There was no difference between male and female participants.

We see sexualized women every day on billboards, buildings, and the sides of buses and this study suggests that we think of these images as if they were objects, not people. “What is motivating this study is to understand to what extent people are perceiving these as human or not,” Bernard says. The next step, he says, is to study how seeing all these images influences how people treat real women.

• Additional
• References
• Citations

Main Category: Women’s Health / Gynecology
Also Included In: Fertility
Article Date: 17 May 2012 – 1:00 PDT

Current ratings for:
‘Fertility For Older, Highly Educated Women Has Risen Since The 1990s, According To New Research‘

Patient / Public:
Healthcare Prof:

An increasing number of highly educated women are opting for families, according to a national study co-authored by a University at Buffalo economist.

Qingyan Shang, an assistant professor at UB, says the study uncovers what may be the reversal of a trend by highly educated women.

She says it is still too early to be certain, but the research clearly shows fertility rising for older, highly educated women since the 1990s. (Fertility is defined as the number of children a woman has had.) Childlessness also declined by roughly 5 percentage points between 1998 and 2008.

“Women born in the late 1950s are the turning point,” said Shang.

Members of this group initially showed low fertility. But Shang said fertility increased for those members in their late 30s and early 40s.

The paper, co-authored by Bruce A. Weinberg, professor of economics at Ohio State University, appears online in the Journal of Population Economics and will be published in a forthcoming print edition.

Shang said two previous studies which examined fertility among highly educated women had limitations and came to conflicting conclusions.

One study focused only on women in their late 20s. Another study examined fertility for women in managerial positions.

Using a sample of professional women makes the results difficult to interpret because women who have more children may switch to other occupations, according to Shang.

“We did a more comprehensive study,” said Shang. “We instead define the sample using education, which is less responsive to short-term fertility decisions.”

The conclusions are derived from data gathered by the June Current Population Survey, compiled by the U.S. Bureau of Labor Statistics and U.S. Census Bureau. The researchers also used the Vital Statistics Birth Data from the National Center for Health Statistics as a second data set.

While the research did not directly address what factors might be contributing to the fertility increase, “We did list some possible explanations based on previous research,” said Shang.

Shang mentioned the idea of “the learning story,” where the decisions of previous generations inform later decisions by subsequent generations. There has also been an increased supply of personal services that have reduced childcare expenses. Other research shows men may be taking more responsibility for child care.

Shang and Weinberg also could not determine whether women are opting for families instead of their careers or in addition to their careers.

“We know these women are opting for families,” said Shang. “We don’t know if they in turn are opting out of the labor market.”

The researchers discovered an increase in multiple birth rates around 1990, suggesting fertility treatments may have played a role.

“The data does not include information about whether women used fertility treatment,” Shang said. “But we use the trends in plural birth rates to impute the share of the increase in fertility among highly educated women that is attributed to fertility treatment.”

Shang said the study shows that fertility would have increased even in the absence of fertility treatments.

• Additional
• References
• Citations

Editor’s Choice
Main Category: Pregnancy / Obstetrics
Also Included In: Women’s Health / Gynecology
Article Date: 15 May 2012 – 16:00 PDT

Current ratings for:
‘Finding Willing Doctors To Perform Vaginal Delivery After Caesarean Sometimes A Challenge‘

Patient / Public:
Healthcare Prof:

After a series of Caesarean sections and vaginal deliveries, Melissa Lunsford wants a vaginal delivery for her fourth child. To find a willing doctor or hospital that would enable a vaginal delivery for her fourth pregnancy proved to be a challenge.

An advocate of vaginal births after Caesarean section (VBAC) from the Ben Taub General Hospital, one of the top VBAC hospitals in Texas says that many women share Mrs. Lunsford’s plight.

Dr. Christina Marie Davidson, chief, Obstetrics and Gynecology Services at the Ben Taub General Hospital, and assistant professor at the Department of Obstetrics and Gynecology at the Division of Maternal Fetal Medicine at the Baylor College of Medicine declares:

“For some physicians and hospitals, the prospect of offering a trial of labor after a Caesarean delivery is too risky. While risks exist, the possibility of delivering vaginally is still a viable option for many women.”

To find a physician and hospital that offers VBAC procedures can be a challenging task. The majority of doctors or hospitals have no access to around-the-clock hospital coverage by specialists, including obstetricians, gynecologists and anesthetists, or specialist facilities, such as neonatology with a neonatal intensive care unit, operating room availability for emergent Caesarean deliveries, massive blood banking and expert nursing.

The Harris County Hospital District, which includes the Ben Taub General Hospital and Lyndon B. Johnson General Hospital, as well as the Women and Infant Services have all necessary facilities and medical coverage make the option to have a vaginal birth after a C-section delivery a viable option, including for those who previously had multiple C-section deliveries.

According to a 2009 report by the Texas State Department of Health Services, the Ben Taub and LBJ hospital share the state’s highest VBAC rate of all hospitals, with 27.86% and 29.58% respectively. In comparison with the VBAC national rate of 8%, the rates of both hospitals are generally three times higher. Davidson comments:

“We believe women should have that choice. We can’t guarantee that they’ll have a VBAC delivery every time, but we can certainly plan for it.”

• Previous successful vaginal delivery or VBAC 

• If the previous C-section was for other reasons than cervix complications or infant not descending through birth canal
• 

• Natural onset of labor 

• Women below the age of 35 years



Mrs Lunsford was repeatedly discouraged by being informed about the inherent risks and dangers and decided to conduct her own research on the Internet. Encouraged by successful testimonials she set out to search for a VBAC-friendly doctor.

She says:

“Everyone I talked to, including my friends, basically told me it was silly to think of delivering vaginally again after a Caesarean. But, it is important to me and something I knew I wanted.”

She finally came across Dr. Davidson after having contacted 10 doctors already, who is not only an expert but also a passionate supporter of VBACs.

Dr. Davidson says:

“Women who choose to have a vaginal birth after Caesarean should have that option and not be discouraged because of a lack of knowledge or resources.”

Mrs Lunsford adds that the chance to deliver her son as naturally as possible is worth the effort, saying: “It is important to me and important to my entire healthcare team.”

Written Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Women’s Health / Gynecology;  Eating Disorders
Article Date: 16 May 2012 – 0:00 PDT

Current ratings for:
‘Differences Seen In Brain Circuitry Between Women With Anorexia And Those With Obesity‘

Patient / Public:
Healthcare Prof:

Why does one person become anorexic and another obese? A study recently published by a University of Colorado School of Medicine researcher shows that reward circuits in the brain are sensitized in anorexic women and desensitized in obese women. The findings also suggest that eating behavior is related to brain dopamine pathways involved in addictions.

Guido Frank, MD, assistant professor director of the Developmental Brain Research Program at the CU School of Medicine and his colleagues used functional magnetic resonance imaging (fMRI) to examine brain activity in 63 women who were either anorexic or obese. Scientists compared them to women considered “normal” weight. The participants were visually conditioned to associate certain shapes with either a sweet or a non-sweet solution and then received the taste solutions expectedly or unexpectedly. This task has been associated with brain dopamine function in the past.

The authors found that during these fMRI sessions, an unexpected sweet-tasting solution resulted in increased neural activation of reward systems in the anorexic patients and diminished activation in obese individuals. In rodents, food restriction and weight loss have been associated with greater dopamine-related reward responses in the brain.

“It is clear that in humans the brain’s reward system helps to regulate food intake” said Frank. “The specific role of these networks in eating disorders such as anorexia nervosa and, conversely, obesity, remains unclear.”

Scientists agree that more research is needed in this area. The study was published in Neuropsychopharmacology.

• Additional
• References
• Citations

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Women’s Health / Gynecology;  Pediatrics / Children’s Health
Article Date: 16 May 2012 – 0:00 PDT

Current ratings for:
‘The Importance Of Human Breast Milk Ingredient In Gastrointestinal Health‘

Patient / Public:
Healthcare Prof:

A new University of Illinois study shows that human milk oligosaccharides, or HMO, produce short-chain fatty acids that feed a beneficial microbial population in the infant gut. Not only that, the bacterial composition adjusts as the baby grows older and its needs change.

Even though HMO are a major component of human milk, present in higher concentration than protein, many of their actions in the infant are not well understood. Furthermore, they’re virtually absent from infant formula. The scientists wanted to find out what formula-fed babies were missing.

“We refer to HMO as the fiber of human milk because we don’t have the enzymes to break down these compounds. They pass into the large intestine where the bacteria digest them.

“We’re curious about the role they play in the development of the breast-fed infant’s gut bacteria because the bacteria found in the guts of formula-fed infants is different,” said Sharon Donovan, the U of I’s Melissa M. Noel Endowed Professor in Nutrition and Health.

With this study, Donovan is gaining insight into the mystery. For the first time, scientists have shown that a complex mixture of HMO and a single HMO component produce patterns of short-chain fatty acids that change as the infant gets older.

A healthy microbiome has both short- and long-term effects on an infant’s health. In the short term, beneficial bacteria protect the infant from infection by harmful bacteria. In the long term, beneficial bacteria strengthen the immune system so that it can fend off chronic health problems like food allergies and asthma, she said.

In the study, breast milk was obtained from mothers of preterm infants at Chicago’s Rush University Medical Center, and the HMO were isolated and analyzed. The scientists tested bacteria from 9- and 17-day-old sow-reared and formula-fed piglets. Because piglets grow so rapidly, these ages reflect approximately three- and six-month-old human infants.

The colon bacteria were added to test tubes containing HMO and two prebiotics commonly used in infant formulas. These mixtures were allowed to ferment and then sampled to see how the bacterial population was changing over time and what products were being produced by the bacteria.

“When the HMOs were introduced, the bacteria produced short-chain fatty acids, at some cases at higher levels than other prebiotics now used in infant formula. The short-chain fatty acids can be used as a fuel source for beneficial bacteria and also affect gastrointestinal development and pH in the gut, which reduces the number of disease-causing pathogens,” she said.

Further, different HMOs produced different patterns of short-chain fatty acids, and the composition of bacteria in the gut changed over time. “It was distinctly different at 9 vs. 17 days, making it likely that the functions of HMO change as the human infant gets older,” she said.

According to Donovan, HMO are critically important in understanding how breastfeeding protects babies.

“Several companies are now able to synthesize HMO, and in the future, we may be able to use them to improve infant formula. There’s evidence that these compounds can bind to receptors on immune cells and, to our knowledge, no current prebiotic ingredient can do that,” she said.

• Additional
• References
• Citations

Editor’s Choice
Main Category: Sexual Health / STDs
Also Included In: Women’s Health / Gynecology
Article Date: 15 May 2012 – 6:00 PDT

Current Article Ratings:

Patient / Public:
Healthcare Prof:

Some non-oral hormonal contraceptives, such as vaginal rings, implants and skin patches carry a higher risk of venous thromboembolism – blood clots – when compared to oral contraceptive pills, researchers from the University of Copenhagen revealed in the BMJ (British Medical Journal). The authors wrote that some patients should change over to oral, hormonal contraceptives to reduce their risk of developing clots.

Venous thrombosis is a collective term for DVT (deep vein thrombosis) and pulmonary embolism. The researchers explained that most studies have focused on the clot risk for females on oral contraceptive pills. There are very few studies that focus on other contraceptives; referred to as non-oral hormonal contraceptives.

Non-oral hormonal contraceptives release hormones into the body more continuously.

Professor Øjvind Lidegaard and colleagues set out to determine what health effects, specifically venous thrombosis, non-oral hormonal contraceptives have on Danish females aged between 15 and 49 years, dating from 2001 to 2010. None of the women in the study were pregnant or had any medical history of cancer or blood clots before the study started.

They took into account a number of factors which could distort the findings, including the women’s education level and their age.

Non-oral hormonal contraceptives, such as the vaginal ring, are linked to a higher risk of developing blood clots, compared to oral contraceptive pills

Over a period of 9,429,128 observation years, a total of 3,434 diagnoses of first-time venous thrombosis were made. The authors reported the following findings for females aged from 15 to 49 years:

• 2 venous thrombosis events per 10,000 exposure years for those not using any type of hormonal contraception
• 6.2 venous thrombosis events per 10,000 exposure years for those on a levonorgestrel-containing combined oral contraceptive pill
• 9.7 venous thrombosis events per 10,000 exposure years for those using a contraceptive skin (transdermal) patch
• 7.8 venous thrombosis events per 10,000 for those using a vaginal ring
• Women using a progestogen-only subcutaneous implant were found to have a slightly higher chance of blood clots
• Women using a progestogen-only intrauterine device either had no higher risk at all, or possibly a lower risk

Women who used a patch or vaginal ring for a long time did not experience any reduced risk later on.

The researchers worked out that of the women they studied, 2,000 of the vaginal ring users and 1,250 of the skin patch users should switch over to a combined levonorgestrel-containing oral pill to reduce the risk of a venous thrombosis event in one year.

Written by Sarah Glynn B.A. (Psych)
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Main Category: Anxiety / Stress
Also Included In: Women’s Health / Gynecology;  Depression
Article Date: 14 May 2012 – 1:00 PDT

Current Article Ratings:

Patient / Public:
Healthcare Prof:

Women are more likely to suffer post-traumatic stress than men after leaving an intensive care unit (ICU), finds a new study published in BioMed Central’s open access journal Critical Care. However, psychological and physical ‘follow-up’ can reduce both this and post-ICU depression.

Patients in the ICU often suffer post-traumatic stress, anxiety, or depression due, not only to the illness or trauma that put them there, but to the very nature of the ICU and life-saving treatment. As a result, follow-up schemes have been put in to place to help alleviate these psychological problems. Researchers from the Karolinska University Hospital Solna and the Karolinska Institutet compared patient’s recovery from 2006, before a follow-up scheme was started, with that of patients in 2007 and 2008.

The scheme consisted of non-compulsory meetings at three, six and 12 months after being discharged from ICU with a nurse, physician and a physiotherapist, revisiting the ICU, and in severe cases being referred to a psychiatric unit for further therapy.

Before the use of the follow-up scheme women had much higher scores on the Impact Event Scale (IES), which measures post-traumatic stress, than men. For women, after the introduction of follow-up, these scores were significantly reduced. However, the scheme had no effect on the IES score of men.

Dr Peter Sackey, who led this study, explained, “In general, for the same event, women are twice as likely to suffer post-traumatic stress disorder, recover more slowly, and are more prone to suffer long-term effects. We found this was also true in ICU survivors. The women with the highest IES scores were the ones who were most helped by the follow-up scheme. While it is not clear whether the scheme only helps patients at severe risk of PTSD, it does mean that these people have access to the treatment they need.”

• Additional
• References
• Citations

Main Category: Psychology / Psychiatry
Also Included In: Women’s Health / Gynecology;  Eating Disorders
Article Date: 11 May 2012 – 0:00 PDT

Current Article Ratings:

Patient / Public:
Healthcare Prof:

Women with high family support and limited pressure to achieve the ‘thin and beautiful’ ideal have a more positive body image. That’s according to a new study looking at five factors that may help young women to be more positive about their bodies, in the context of a society where discontent with appearance is common among women.

The work by Dr. Shannon Snapp, from the University of Arizona in the US, and colleagues is published online in Springer’s journal, Sex Roles.

Many women in contemporary Western cultures are dissatisfied with their bodies, a risk factor for eating problems. Snapp and team examined factors that make women more resilient when it comes to their body image, in a bid to help those women at risk of eating disorders. They focussed on young college women who are likely to experience self-consciousness as they compare themselves with peers and become involved in social groups and organizations that place a high value on appearance.

A total of 301 first-year college women, from two universities in the US, completed questionnaires based on the Choate theoretical model. This model hypothesizes that family support and low levels of pressure to attain the thin ideal are related to the rejection of the superwoman ideal, positive views of physical competence, and effective stress-busting strategies. These factors are associated with well-being, which in turn is linked to positive body image in women. The researchers put this model to the test in a ‘real life’ situation.

They found that young women with high family support and low levels of perceived socio-cultural pressure from family, friends and the media regarding the importance of achieving a ‘thin and beautiful’ ideal had a more positive body image. These same women also rejected the superwoman ideal, had a positive physical self-concept, and were armed with skills to deal with stress.

Practical recommendations for prevention programs aimed at young women at risk of eating disorders include helping women to evaluate and become comfortable with the multiple and often contradictory expectations placed upon them in today’s society; teaching them to use effective coping skills; fostering a positive view of their physical competence through exercise and health; and promoting holistic well-being and balance in their lives.

The authors conclude: “It is particularly important for women to develop a sense of self-worth that is not solely based on appearance, and to build resilience to pressures they may receive from family, friends and the media.”

• Additional
• References
• Citations

Main Category: Breast Cancer
Also Included In: Endocrinology;  Women’s Health / Gynecology
Article Date: 11 May 2012 – 0:00 PDT

Current Article Ratings:

Patient / Public:
Healthcare Prof:

Researchers at Albert Einstein College of Medicine of Yeshiva University have discovered a molecule that inhibits the action of estrogen. This female hormone plays a key role in the growth, maintenance and repair of reproductive tissues and fuels the development of endometrial and breast cancers. The molecule, discovered in animal studies, could lead to new therapies for preventing and treating estrogen-related diseases in humans. The findings were published online in the PNAS Plus.

The hormones estradiol (the most important form of estrogen) and progesterone prepare the uterus for pregnancy. They trigger a series of cell proliferation and cell differentiation events that prepare the uterine lining (endometrium) for implantation of a fertilized egg. Although this process is tightly controlled, uterine cells sometimes proliferate abnormally, leading to menstrual irregularities, endometrial polyps, endometriosis, or endometrial cancer – the most common female genital tract malignancy, causing six percent of cancer deaths among women in the U.S. and a higher proportion worldwide.

“The molecular mechanisms that underlie these pathologies are still obscure – and so are the mechanisms involved in normal hormonal regulation of cell proliferation in the endometrium, which is essential for successful pregnancy,” said lead author Jeffrey Pollard, Ph.D., professor of developmental and molecular biology and of obstetrics & gynecology and women’s health at Einstein. He also holds the Louis Goldstein Swan Chair in Women’s Cancer Research and is the deputy director of the Albert Einstein Cancer Center.

In studies involving rodents, Dr. Pollard discovered that a molecule called KLF15 (Kruppel-like transcription factor-15) controls the actions of estradiol and progesterone in the endometrium by inhibiting the production MCM2, a protein involved in DNA synthesis.

“Our findings raise the possibility that it may be feasible to prevent or treat endometrial and breast cancer and other diseases related to estrogen by promoting the action of KLF15,” said Dr. Pollard.

• Additional
• References
• Citations