Scientists find way to predict timing of menopause

LONDON, June 27 (Reuters) – Iranian scientists say they have developed a way of using a simple blood test to predict accurately when women will reach the menopause, offering the chance for women to plan for family and career far in advance.

The test, which measures levels of a hormone produced by cells in the ovaries, was able to predict the age at which women reached menopause to within an average of 4 months, according to data to be presented at the conference of the European Society of Human Reproduction and Embryology in Rome on Monday.

“The results … could enable us to make a more realistic assessment of women’s reproductive status many years before they reach menopause,” said Ramezani Tehrani of the Shahid Beheshti University of Medical Sciences in Tehran, who led the study.

Experts commenting on the work agreed it was promising, but said its findings would need to be confirmed in larger trials.

“The possibility of an accurate predictor for menopause is very exciting. People have been looking for something like this for years,” said Dagan Wells of the Nuffield Department of Obstetrics and Gynaecology at Oxford University.

The average age for menopause is 51, with ovulation in most women ending sometime between age 40 and 60. But it can happen later or earlier, making it difficult for women who want to develop a career before having babies to know how long to wait.

Tehrani’s team took blood samples from 266 women aged between 20 and 49 who were also taking part in another study called the Tehran Lipid and Glucose Study, which started in 1998.

They then measured concentrations of a hormone called the anti-Mullerian Hormone (AMH) that is produced by cells in women’s ovaries. AMH controls the development of follicles in the ovaries from which eggs develop, and the scientists suspected it might be useful for judging ovarian function.

STATISTICAL MODEL

The researchers took two more blood samples at three yearly intervals and also collected information on the women’s socioeconomic background and reproductive history.

“We developed a statistical model for estimating the age at menopause from a single measurement of AMH concentration,” Tehrani explained in a report on the study. “Using this model, we estimated mean average ages at menopause for women at different time points in their reproductive life span.”

Tehrani said the results showed “a good level of agreement” between predicted and actual age at menopause for the 63 women in the group who reached menopause during the study.

The average difference between the predicted age and the women’s actual age at menopause was a third of a year, and the maximum margin of error was three to four years.

Wells said Tehrani’s team appeared to have hit upon a “fairly accurate algorithm” for predicting menopause.

But said it would be important to see if the method could also help predict the time when fertility effectively ends.

“A woman may cease monthly ovulation and experience menopause at 50, but she will probably have been effectively infertile for several years prior to this,” he said. “It will be important to let patients know that fertility will have declined greatly in the years preceding the final ovulation.”

PM pledges 5,000 new doctors

Prime Minister Kevin Rudd has announced the Government will spend $632 million to train more than 5,000 new doctors.

Unveiling the plan at Queanbeyan Hospital near Canberra today, Mr Rudd said the money would be spent over 10 years to train 5,500 GPs and 680 specialists.

The new funds will also pay for 5,400 junior doctors to take part in general practice placements before gaining their final qualifications.

The Government says the money will fund training for a “record” number of doctors and will be funded from within the budget.

The funding includes $145 million for specialist training where shortages are identified in areas such as general surgery, pathology, radiology, obstetrics and gynaecology.

Almost $340 million will be spent to fund the 5,500 GP training positions and $148 million will be used to allow junior doctors to take a placement in general practice before they become fully qualified.

“To maintain current levels of GP and primary care services alone it is estimated that an additional 3,000 GPs will be needed by 2020,” Mr Rudd said.

“We believe the time for action has come.”

Health Minister Nicola Roxon says the medical community realises the need for more doctors and specialists to treat people out of hospital.

“Some services are not being provided in the community because of a poor distribution of specialists and a poor distribution of GPs,” she said.

“We can pull our weight, that’s what this announcement is doing, and we certainly will be expecting the colleges to pull their weight.”

The announcement comes as Mr Rudd continues to negotiate with the states to secure agreement on his plan to take over hospital funding.

Mr Rudd has met with the premiers of New South Wales, Victoria and Queensland and says he will be travelling the country to seal the deal ahead of a Council of Australian Governments (COAG) meeting on April 11.

The Government has proposed to take back 30 per cent of GST funding from the states in order to directly fund a 60 per cent of hospitals.

The Commonwealth will also take full control of primary health care.

But there has been resistance from some states, who say they will not sign up to the plan until he releases the full details of his health and hospitals funding overhaul.

Opposition Leader Tony Abbott has criticised the announcement, saying Mr Rudd is big on new plans that are never implemented.

“This is a Government which is very good at announcements but very bad at program delivery,” he said.

“But to get the training places you’ve got to have arrangements in place with the state governments, with the universities, with the public hospitals.”

Pregnant women recommended not to use fetal heart rate monitors

London, August 21 (ANI): Pregnant women are being recommended against the use of Doppler devices, an ultrasound transducer used to detect the baby’s heartbeat, at home.

Dr Thomas Aust and colleagues from the Department of Obstetrics and Gynaecology at Arrowe Park Hospital, in British Medical Journal, explained the case of 27-year-old woman who presented to their labour ward with reduced fetal movements.

The authors said the woman first observed a reduction in her baby’s activity two days earlier but reassured herself after using her own Doppler device, which is not intended to replace recommended antenatal care.

The antenatal care team monitored the fetal movements, which were less than comforting, and a caesarean section was carried out later that evening to deliver the baby, who remained on the special care baby unit for eight weeks.

Though the experts did not determine if self-monitoring altered the outcome in this case, posters in their antenatal areas advising that patients do not use these devices had been put up. (ANI)

Cancer survivors face higher birth complications risk

Washington, July 2 (ANI): A new study has shown that survivors of childhood cancer run particular risks when pregnant.

Dr. Sharon Lie Fong, of the Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands, and colleagues studied data on the pregnancies of 40 women who had been treated for cancer during their childhood, the majority of them for leukaemia, but also for solid tumours. Six had had radiation treatment directly to the abdomen.

The data were compared with those from a control group of more than 9,000 women who had not had cancer treatment.

All data were obtained from The Netherlands Perinatal Register, a nationwide database of pregnancy outcomes. Data were matched for age at pregnancy, year and month of delivery, and the number of times the woman had given birth.

“This is the first such study on pregnancy outcome in childhood cancer survivors as compared with normal, healthy women,” said Dr. Lie Fong.

“Although we found no differences between most of the survivors and the control group, the women treated with abdominal radiotherapy delivered more prematurely. These women also had more postpartum haemorrhages – the loss of more than one litre of blood after delivery,” Dr. Lie Fong added.

The study has been presented at the 25th annual conference of the European Society of Human Reproduction and Embryology heard today (Wednesday 1 July). (ANI)

Complications in previous pregnancies may affect health of next baby

Washington, June 29 (ANI): Dutch researchers say that complications early in pregnancy or in previous pregnancies can help predict further risk in current or subsequent pregnancies.

Dr Robbert van Oppenraaij, a medical doctor and PhD student in the Department of Obstetrics and Gynaecology at Erasmus MC University Medical Centre (Rotterdam, The Netherlands), believes that the new findings may help predict more easily which women might need greater care and supervision during pregnancy.

“There were several interesting findings,” said the researcher.

“To name two: firstly, we found that after any first trimester complication or event, the risk of preterm or very preterm delivery is increased in the subsequent or ongoing pregnancy.

“Secondly, we found that increased risks of adverse obstetric outcome are, in all cases, related to the severity or recurrence, or both, of the first trimester complication or event,” he added.

The researchers have found that a history of one or more miscarriages nearly doubles the risk in an ongoing pregnancy of preterm premature rupture of the membrane that surrounds the baby in the womb.

It also increases the risk of premature or very premature delivery (earlier than 37 or 34 weeks respectively).

If a previous pregnancy had to be terminated for any reason, that may increase the risk of premature rupture of the membrane, premature and very premature delivery in subsequent pregnancies.

“While it is true that most conditions are difficult to prevent, with improved monitoring in high risk pregnancies it is possible to reduce perinatal or postnatal foetal complications,” Dr van Oppenraaij added.

For example, in pregnancies with increased risk of preterm or very preterm delivery or intrauterine growth restriction, extra ultrasonic measurement of the cervical length and foetal growth can provide a better prediction of pregnancies at risk and better therapeutic care can be given, such as bed rest, corticosteroids and monitoring of the baby’s heart beat.

“Events and complications in early pregnancy are amongst the most common complications in women during their pregnancy and can be extremely distressing for them,” van Oppenraaij added.

The findings were presented at 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam. (ANI)

Hirsute women have no reason to feel helpless

London, Apr 17 (ANI): Excessive hairiness can be more than just a cosmetic problem, but women shouldn’t feel helpless because of it.

British doctors have warned that hirsutism is likely to be a sign of an underlying medical condition. But, worry not, for help is at hand.

The docs said that five to 15 percent of women have excess hair, and a hormone disorder the most likely cause in many cases.

Polycystic ovary syndrome (PCOS) is the cause in 70 percent to 80 percent of cases.

Report author, Dr Rebecca Swingler, a specialist registrar in obstetrics and gynaecology at St Michael’s Hospital in Bristol, said the condition can be particularly upsetting for young women.

In addition to PCOS, rarer causes of excessive hairiness include certain tumours and thyroid dysfunction, as well as the use of certain drugs.

According to Swingler, mild cases can be treated cosmetically, but in moderate to severe cases, hormone therapy, such as the oral contraceptive pill and other treatments are present.

Weight loss may also help reduce high levels of the male hormone testosterone which can be an underlying factor in cases of excess hair.

“Often women have spent many years trying to cope with their hirsutism before they seek professional help,” The BBC quoted Swingler, as saying.

“Women need to look at themselves in the context of their family and ethnicity and what is ‘normal’ for them.

“If they notice a change in the pattern of hair growth or they notice they having to wax more often then they should seek help,” she said. (ANI)

Genetic variations help prevent cervical cancer

Washington, Mar 13 (ANI): Certain gene variations in some women may protect them against cervical cancer, according to scientists at Albert Einstein College of Medicine of Yeshiva University.

The researchers say that if the presence or absence of such genetic variants is known, doctors can easily tailor treatment strategies.

Virtually all cases of cervical cancer are caused by persistent infections from several of the human papillomaviruses (HPV) – a family of viruses that also cause common skin warts and genital warts.

HPV is the most commonly sexually transmitted infection in young adults, yet only a small subset of these infections lead to cervical cancer.

“Some people are better able than others to mount an immune response that suppresses their HPV infection. We suspected that this advantage was probably due to variations in genes that play key roles in the body’s immune response,” said Mark H. Einstein, M.D., associate professor of obstetrics and gynaecology and women’s health at Einstein.

For the study, the researchers enrolled 480 women and divided them into two groups: those with high-grade cervical intraepithelial neoplasia (CIN), a pre-malignant condition caused by HPV that can lead to cervical cancer; and a control group of women who had tested positive for HPV but had not developed high-grade CIN.

Taking cells from the women, the researchers searched for genetic differences between the two groups. hey focused on a gene called TAP, known to be crucial to the immune system’s ability to recognize viruses and eliminate them from the body.

The researchers found that study participants had key differences at two locations in their TAP genes.

Those women who possessed one or the other of these two gene variants were less than half as likely as other women to have developed high-grade CIN. Even women infected with the HPV types most likely to lead to cervical cancer were afforded protection by these variants.

The findings suggest that knowledge of these genetic variants, known as polymorphisms, can provide important information regarding protection against cervical cancer.

“We’re hopeful that our findings will lead to a genetic test that will help us predict which patients with persistent HPV infection are most likely to develop high-grade CIN and, ultimately, cervical cancer,” said Einstein.

He added: “That knowledge should help us in mapping out effective treatment plans that are tailored to the individual patient. This trend of personalized medicine is becoming more common as new technologies offer hope of better tests.”

The study paper has been published in the journal Clinical Cancer Research. (ANI)

Magnesium sulphate therapy cuts preemies’ cerebral palsy risk

Washington, Jan 21 (ANI): Giving magnesium sulphate to woman at risk of pre-term birth can significantly reduce the risk of cerebral palsy in infants, according to a new study.

Cerebral palsy is a disabling condition that affects around one in every 500 newborn babies overall, and up to one-in-ten very premature babies.

“There is now enough evidence to support giving magnesium sulphate to women at risk of very preterm birth as a protective agent against cerebral palsy for their baby,” said lead researcher, Lex Doyle, who works at the Department of Obstetrics and Gynaecology at the Royal Women’s Hospital and the University of Melbourne in Australia.

It is usually given as a slow infusion through a vein, but can also be given as an injection into the muscle.

Although it’s not clear how magnesium protects the brain, but it is essential for many processes that keep cells working normally.

It may protect against harmful molecules that can damage or kill cells, and it improves blood flow under some circumstances.

For the study, Cochrane researchers reviewed data from five trials of antenatal magnesium sulphate therapy, which together included 6,145 babies.

Overall, 63 women at risk of very pre-term birth had to be given magnesium sulphate to prevent one case of cerebral palsy in the baby.

The side effects of the treatment included flushing, sweating, nausea, vomiting, headaches and palpitations.

However, according to the researchers, there was no increase in major complications in mothers due to magnesium therapy. (ANI)