- Email: [email protected]
Women With PCOS Actively Seek Treatment
requires high-level monitoring not available in small community hospitals or developing countries,” he said. “This approach costs thousands of dollars a day and the delivery systems themselves run tens of thousands of dollars. Our findings demonstrate this has potential to be done in an easier and more cost-effective manner.” Nitrite is also available for human use as an antidote for cyanide poisoning and is used in meat curing. Further research is necessary to determine the safety and efficacy of inhaled nitrite for human use. Plans are under way to begin clinical trials by early 2005.
New Device for Uterine Fibroids he ExAblate 2000 System, a new medical device that uses magnetic resonance image–guided focused ultrasound to target and destroy uterine fibroids, noncancerous masses located in the uterus, has been given the green light by the FDA. The device is intended to treat women who have completed child bearing or do not intend to become pregnant. FDA expedited review of the device because it offers significant advantages over existing treatments for uterine fibroids. ExAblate combines two systems—a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map the volume of fibroid tissue to be treated and monitor the temperature of the uterine tissue after heating, and a focused ultrasound beam that heats and destroys the fibroid tissue using high-frequency, high-energy sound waves. This is the first time these two systems have been combined and the first time MRI has been used to monitor tissue temperature. The treatment requires repeated targeting and heating of fibroid tissue while the patient lies inside the MRI
T
500
AWHONN Lifelines
machine. The procedure can last as long as three hours. The new device can be used to treat some—but not all—fibroids. Fibroids close to sensitive organs such as the bowel or bladder and those outside the image area cannot be treated. Approximately 20 percent to 40 percent of women 35 and older have fibroids. Although many of these women do not experience any symptoms, in others the location and size of fibroids can cause heavy and prolonged menstrual periods; pain in the back, legs or pelvis; pressure on the bladder or bowels; and pain during sexual intercourse. The ExAblate treatment is not intended for women who desire future pregnancy. The procedure could alter the composition and strength of the uterine tissue, and the effects of the treatment on the ability to become pregnant and carry a fetus to term or on the development of the fetus have not been determined. FDA is requiring InSightec to conduct a three-year postmarket study to better assess the long-term safety and effectiveness of the ExAblate System. The study will include additional numbers of African American women because, as a group, these women have a greater incidence of uterine fibroids but were underrepresented in the original study.
Women With PCOS Actively Seek Treatment omen with polycystic ovary syndrome (PCOS), an incurable hormonal disorder that affects 10 percent of all reproductive-age women, understand the importance of and seek self-help lifestyle modification support services, according to the results of a consumer survey conducted by PCOStrategies Inc. and the Reproductive Associates of Delaware.
W
PCOS, which previous research has shown is best treated through lifestyle intervention, is a leading cause of infertility, and if left untreated, longterm risks include the development of chronic diseases such as diabetes, heart disease and endometrial cancer. The survey found that women with PCOS understand the importance of professional services that focus on their health, fertility and emotional well-being. They recognize the value and would even embrace referrals by their physicians to group and/or individualized life-management programs, with • 78 percent expressing an interest in life-management programs • 49 percent preferring weekly group sessions • 44 percent desiring individualized counseling Respondents indicated that they would prefer more frequent visits to their health care providers while working to heal their underlying metabolic syndrome, with 57 percent desiring weekly visits. However, access to insurance reimbursements for these activities may prove to be a hindrance for many women, as only 15 percent of women with 25 percent or less insurance coverage expressed a willingness to participate. The most common endocrine disorder in women, PCOS is a complex hormonal disorder affecting approximately 10 percent of reproductive-age women worldwide. Previous research has pinpointed its cause to the body’s failure to respond to insulin correctly, resulting in an excess of insulin, which further creates an imbalance with other bodily hormones. PCOS symptoms include lack of, infrequent or irregular menstrual cycles, infertility, hirsutism or excessive body or facial hair growth, weight gain, obesity, baldness and thinning hair, adult acne, depression, skin tags
Volume 8
Issue 6
or teardrop-shaped pieces of skin and acanthosis nigricans or patches of rough brown to black skin. For more information, visit http://www.asrm. org/ or http://www.pcostrategies.org/.
Women Want Advice Regarding Alterative Menopause Therapies omen want information from their health care providers about menopause alternatives but perceive their providers as unwilling to talk about alternatives with them, according to a study conducted by researchers at Stanford University and presented at the 15th Annual Meeting of the North American Menopause Society (NAMS) in Washington, DC. The survey gathered information about women’s experiences with menopause symptoms, familiarity with research developments such as the Women’s Health Initiative (WHI) results, use and perceptions of prescription and alternative treatment options and interactions with health professionals around these issues. The WHI results initiated a 74 percent decrease in prescriptions for Prempro and other forms of estrogen in 2003, leaving many women looking for alternatives for symptom relief. The survey yielded rich insight into what women are currently using to relieve menopause symptoms and the factors that influence treatment decisions. The survey found:
W
• Nearly as many women (29 percent) have taken herbal or soy remedies as those taking hormone therapy (HT) (35 percent), and almost half of HT users have tried alternative supplements to ease their menopause symptoms • Of the women surveyed, 43 percent either consider herbal and soy products helpful or are increasingly
December 2004 | January 2005
Scare Tactics Harmful in Violence Prevention rograms that rely on “scare tactics” to prevent children and adolescents from engaging in violent behavior are not only ineffective, but may actually make the problem worse, according to an independent state-of-thescience panel convened this week by the National Institutes of Health (NIH). The panel found that group detention centers, boot camps and other “get tough” programs often exacerbate problems by grouping young people with delinquent tendencies, where the more sophisticated instruct the more naive. Similarly, the practice of transferring juveniles to the adult judicial system can be counterproductive, resulting in greater violence among incarcerated youth. The panel highlighted two programs that are clearly effective in reducing arrests and out-of-home placements:
P
• Functional Family Therapy • Multisystemic Therapy Among the important characteristics that these programs have in common are a focus on developing social competency skills, a long-term approach and family involvement.
curious about their use for relieving menopause symptoms • A vast majority of premenopausal (91 percent) and peri-/ postmenopausal women (80
percent) had not discussed herbal products with their health care providers • Only half (53 percent) of peri-/ postmenopausal women taking
AWHONN Lifelines
501
New Device for Uterine Fibroids he ExAblate 2000 System, a new medical device that uses magnetic resonance image–guided focused ultrasound to target and destroy uterine fibroids, noncancerous masses located in the uterus, has been given the green light by the FDA. The device is intended to treat women who have completed child bearing or do not intend to become pregnant. FDA expedited review of the device because it offers significant advantages over existing treatments for uterine fibroids. ExAblate combines two systems—a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map the volume of fibroid tissue to be treated and monitor the temperature of the uterine tissue after heating, and a focused ultrasound beam that heats and destroys the fibroid tissue using high-frequency, high-energy sound waves. This is the first time these two systems have been combined and the first time MRI has been used to monitor tissue temperature. The treatment requires repeated targeting and heating of fibroid tissue while the patient lies inside the MRI
T
500
AWHONN Lifelines
machine. The procedure can last as long as three hours. The new device can be used to treat some—but not all—fibroids. Fibroids close to sensitive organs such as the bowel or bladder and those outside the image area cannot be treated. Approximately 20 percent to 40 percent of women 35 and older have fibroids. Although many of these women do not experience any symptoms, in others the location and size of fibroids can cause heavy and prolonged menstrual periods; pain in the back, legs or pelvis; pressure on the bladder or bowels; and pain during sexual intercourse. The ExAblate treatment is not intended for women who desire future pregnancy. The procedure could alter the composition and strength of the uterine tissue, and the effects of the treatment on the ability to become pregnant and carry a fetus to term or on the development of the fetus have not been determined. FDA is requiring InSightec to conduct a three-year postmarket study to better assess the long-term safety and effectiveness of the ExAblate System. The study will include additional numbers of African American women because, as a group, these women have a greater incidence of uterine fibroids but were underrepresented in the original study.
Women With PCOS Actively Seek Treatment omen with polycystic ovary syndrome (PCOS), an incurable hormonal disorder that affects 10 percent of all reproductive-age women, understand the importance of and seek self-help lifestyle modification support services, according to the results of a consumer survey conducted by PCOStrategies Inc. and the Reproductive Associates of Delaware.
W
PCOS, which previous research has shown is best treated through lifestyle intervention, is a leading cause of infertility, and if left untreated, longterm risks include the development of chronic diseases such as diabetes, heart disease and endometrial cancer. The survey found that women with PCOS understand the importance of professional services that focus on their health, fertility and emotional well-being. They recognize the value and would even embrace referrals by their physicians to group and/or individualized life-management programs, with • 78 percent expressing an interest in life-management programs • 49 percent preferring weekly group sessions • 44 percent desiring individualized counseling Respondents indicated that they would prefer more frequent visits to their health care providers while working to heal their underlying metabolic syndrome, with 57 percent desiring weekly visits. However, access to insurance reimbursements for these activities may prove to be a hindrance for many women, as only 15 percent of women with 25 percent or less insurance coverage expressed a willingness to participate. The most common endocrine disorder in women, PCOS is a complex hormonal disorder affecting approximately 10 percent of reproductive-age women worldwide. Previous research has pinpointed its cause to the body’s failure to respond to insulin correctly, resulting in an excess of insulin, which further creates an imbalance with other bodily hormones. PCOS symptoms include lack of, infrequent or irregular menstrual cycles, infertility, hirsutism or excessive body or facial hair growth, weight gain, obesity, baldness and thinning hair, adult acne, depression, skin tags
Volume 8
Issue 6
or teardrop-shaped pieces of skin and acanthosis nigricans or patches of rough brown to black skin. For more information, visit http://www.asrm. org/ or http://www.pcostrategies.org/.
Women Want Advice Regarding Alterative Menopause Therapies omen want information from their health care providers about menopause alternatives but perceive their providers as unwilling to talk about alternatives with them, according to a study conducted by researchers at Stanford University and presented at the 15th Annual Meeting of the North American Menopause Society (NAMS) in Washington, DC. The survey gathered information about women’s experiences with menopause symptoms, familiarity with research developments such as the Women’s Health Initiative (WHI) results, use and perceptions of prescription and alternative treatment options and interactions with health professionals around these issues. The WHI results initiated a 74 percent decrease in prescriptions for Prempro and other forms of estrogen in 2003, leaving many women looking for alternatives for symptom relief. The survey yielded rich insight into what women are currently using to relieve menopause symptoms and the factors that influence treatment decisions. The survey found:
W
• Nearly as many women (29 percent) have taken herbal or soy remedies as those taking hormone therapy (HT) (35 percent), and almost half of HT users have tried alternative supplements to ease their menopause symptoms • Of the women surveyed, 43 percent either consider herbal and soy products helpful or are increasingly
December 2004 | January 2005
Scare Tactics Harmful in Violence Prevention rograms that rely on “scare tactics” to prevent children and adolescents from engaging in violent behavior are not only ineffective, but may actually make the problem worse, according to an independent state-of-thescience panel convened this week by the National Institutes of Health (NIH). The panel found that group detention centers, boot camps and other “get tough” programs often exacerbate problems by grouping young people with delinquent tendencies, where the more sophisticated instruct the more naive. Similarly, the practice of transferring juveniles to the adult judicial system can be counterproductive, resulting in greater violence among incarcerated youth. The panel highlighted two programs that are clearly effective in reducing arrests and out-of-home placements:
P
• Functional Family Therapy • Multisystemic Therapy Among the important characteristics that these programs have in common are a focus on developing social competency skills, a long-term approach and family involvement.
curious about their use for relieving menopause symptoms • A vast majority of premenopausal (91 percent) and peri-/ postmenopausal women (80
percent) had not discussed herbal products with their health care providers • Only half (53 percent) of peri-/ postmenopausal women taking
AWHONN Lifelines
501