Low Sex Drive In Women May Be A Heart Problem

According to a new study, women with low—or no—sex drive may have a heart problem, not on an emotional basis, rather a medical basis. The study showed that low heart rate variability, the variation in the time that lapses between one heartbeat and the next, was an indicator of low sex drive. The results might offer a way for doctors to determine which women will benefit from libido-increasing drugs. The findings were published online in Applied Psychophysiology and Biofeedback by researchers at the Department of Psychology, The University of Texas at Austin; and The Kinsey Institute for Research on Sex, Gender, and Reproduction.

Your Partner About Having a Low Libido

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The authors note that heart rate variability is a valuable non-invasive test to assess autonomic nervous system activity. The autonomic nervous system influences the function of internal organs. It is a control system that acts mainly at an unconscious level and regulates bodily functions such as the heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal. The authors explain that several studies have found an association between low resting heart rate variability and mental health conditions including depression, anxiety, and alcohol dependence; thus, indicating these disorders may be related to an imbalance in autonomic activity.

The researchers examined the feasibility of using heart rate variability as an index of women’s self-reported sexual arousal function. Sexual arousal function, overall sexual function, and resting heart rate variability were examined in 72 women, aged 18–39.They measured the women’s heartbeats while they watched film about a neutral subject. The women then answered the 19-question Female Sexual Function Index, which involves topics such as arousal, lubrication, orgasm, and sexual pain.

The investigators found that women with below average heart rate variability were significantly more likely to report sexual arousal dysfunction and overall sexual dysfunction than both women with average heart rate variability and women with above average heart rate variability.

The investigators concluded that low heart rate variability may be a risk factor for female sexual arousal dysfunction and overall sexual dysfunction. They noted that measuring heart rate variability might be a useful marker of treatment-related improvements in sexual arousal function, and it may be used as an index of sexual arousal function in clinical trials of medications developed to treat female sexual arousal disorders, such as the recently FDA approved flibanserin, which has been termed “Women’s Viagra”.

Low Sex Drive In Women

Source: http://www.edtreatmentindia.com/

Most Heart Failure Patients Not Referred For Cardiac Rehab

Despite strong evidence that such exercise programs improve quality of life and reduce the likelihood of future hospitalizations, a new UCLA-led study has found that only 1 in 10 heart failure patients is referred to a cardiac rehabilitation program after being hospitalized, The study was published online on August 17 in the Journal of the American College of Cardiology and will appear in the August 25 print edition.

Man on Treadmill with Health Care Cardiac Rehabilitation Exercise Training

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For the study, the researchers reviewed data from a national database of more than 100,000 individuals with heart failure who were discharged from hospitals between 2005 and 2014 and were eligible for cardiac rehabilitation programs. “Although we expected some under-referral to cardiac rehabilitation in the heart failure population, the results of this study are startling,” explained senior author Gregg Fonarow, MD, the Eliot Corday Chair in Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA. He added, “Given the individual and the public health benefits of such programs and the escalating healthcare expenditures related to heart failure hospitalizations, our findings point to the need for better strategies to increase physicians’ and patients’ awareness about the importance of cardiac rehabilitation.” Center.

Each year, 870,000 Americans are newly diagnosed with heart failure, a condition in which the heart is unable to pump enough blood and oxygen to support other organs in the body; overall, congestive heart failure affects an estimated 6 million individuals and accounts for more than 1 million hospitalizations annually and more than $30 billion in direct costs.

With the heart not able to pump effectively, heart failure can lead to symptoms such as fatigue and shortness of breath due to the accumulation of fluid and congestion in the lungs. A number of studies have reported that patients who undergo a dedicated 36-week cardiac rehabilitation program focused on aerobic exercise training are more capable of controlling symptoms related to shortness of breath and are better able to perform daily activities such as walking to the grocery store and climbing stairs.

After a notable 2007 study (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training, or HF–ACTION) found that individuals who underwent exercise training following hospitalization for heart failure had an improved ability to perform normal daily living tasks, were less likely to be re-hospitalized and had a lower mortality rate, the American College of Cardiology and American Heart Association issued guidelines recommending cardiac rehabilitation for medically stable heart failure patients. In 2013, the federal Centers for Medicare and Medicaid Services approved cardiac rehabilitation for eligible patients with heart failure; thus, making it available to a broader group of Medicare patients. The new UCLA study is the first since those guidelines were issued to evaluate how often physicians refer their patients to such programs upon discharge from the hospital, and the first to examine factors associated with the referrals.

The investigators reviewed data on 105,619 hospitalized heart failure patients from the national Get With The Guidelines–Heart Failure registry, which is a component of an American Heart Association program. They discovered that during the study period, only 10.4% of eligible patients were referred to a cardiac rehabilitation program when they were discharged from the hospital. The referral rates did increase during the study period; however, they remained low. The researchers found that patients referred for cardiac rehabilitation tended to be younger than those who were not, and men were referred more often than women. Patients who received referrals were also more likely to receive guideline-recommended heart failure medications when they were discharged.

“Physicians who are more likely to incorporate state-of-the-art therapies in the management of heart failure patients appear also to be more likely to refer their patients to cardiac rehabilitation programs,” noted Dr. Fonarow. He added, “This suggests that raising awareness about the benefits of these programs may be an effective strategy for increasing referrals.” The authors noted that, of equal importance, are efforts to increase insurance coverage and reduce copayments for such programs, as well as expanding the responsibilities of home health nurses, physical therapists, and other healthcare providers to widen the scope of home- and community-based cardiac rehabilitation.

Cardiac Rehab for Healthy Heart

Source: http://www.edtreatmentindia.com/

UCLA Stem Cell Research May Lead To Improved Prostate Cancer Treatment

Researchers at UCLA’s Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research have made another breakthrough in the fight against prostate cancer. They found that two types of malignant prostate cancer cells can develop in one type of stem cell; thus, making prostate cancer stem cells a “moving target” for treatments. The researchers note that the finding could lead to new and improved treatments that can target prostate cancer cells. They published their findings online on November 26 in the Proceedings of the National Academy of Sciences.

Stem Cell (Cancer Cell)

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Adult stem cells are regenerative cells that replace diseased or damaged cells in organs. The researchers previously reported that prostate cancer can originate in basal type stem cells. The new study, based on that research, showed that tumors can start in basal stem cells that evolve to luminal cells that result in aggressive spread of the cancer and that these luminal cells can change in their characteristics over time; thus, making them resistant to treatment.

Study author Dr. Andrew Goldstein explained, “People have begun to think about cancers as being driven by stem cells in the same way that many of our adult organs are maintained by dedicated stem cells. Based on this new understanding, a lot of excitement surrounds the concept of going right to the root of the tumor and targeting those stem cells to eradicate the cancer.”

Patients with aggressive prostate cancer are often treated with anti-androgen (anti-male hormone) therapy; the basal stem cells that develop into the cancer cells look different from the luminal cells that maintain the aggressive disease. In addition, the tumor stem cells that are not destroyed by the anti-androgen treatment look different from the previous two. Because of this process, in order to develop an appropriate treatment, the researchers must identify cell types that evolve as the disease and its treatment develop. Now that the researchers have determined that prostate cancer stem cells can change what their appearance, he investigators are now searching for possible elements that are consistent within the stem cells and do not change through stem cell evolution. 

They are of the opinion that this knowledge will help develop drugs that target the evolving cancer stem cells. Thus , they are now attempting to detect some of the factors that define a stem cell regardless of its external appearance. They stress that it is extremely important to understand the continual evolution of the stem cell’s physical appearance, particularly as tumors adapt to become resistant to new and more potent therapies.

Prostate Cancer Treatment

Source: http://m.edtreatmentindia.com/

Tamoxifen Reported to Produce Cognitive Decline

Tamoxifen is commonly administered to women with breast cancer. It is an ant-estrogen that slows or prevents the recurrence of breast cancer in women who have hormone receptor positive breast cancers. A new study has reported that it may cause cognitive decline. The findings were published online on June 23 in the journal Menopause.

Tamoxifen Overview

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The study authors note that endocrine therapy is commonly used—and often for many years—in women with breast cancer. However, they explain that little is known about the effect of long-term tamoxifen use on cognitive function. Therefore, they evaluated cognitive function approximately three years after diagnosis in postmenopausal women with breast cancer who were treated with tamoxifen.

The investigators accessed data from women who underwent breast cancer surgery with or without radiotherapy, women who received tamoxifen, and healthy controls. They administered neuropsychological tests to the women. In addition, the women completed questionnaires regarding health-related quality of life (Quality of Life Questionnaire Core 30 and Breast Cancer-Specific Quality-of-Life Questionnaire), menopausal symptoms (Functional Assessment of Cancer Therapy-Breast endocrine symptom subscale), and anxiety and depression (Hopkins Symptom Checklist).

The study group comprised a total of 107 (tamoxifen group: 20 women; surgery/radiotherapy group: 43 women; healthy control group: 44 women). The women in the tamoxifen group had received tamoxifen for an average 18.6 months (range: 15-79 months); they performed worse on verbal memory than the surgical operation/radiotherapy group and the healthy control group. Participants in the adjuvant tamoxifen group performed worse on measures of fluency than the healthy controls. In addition, women in the tamoxifen group reported worse cognitive function than women in the surgery/radiotherapy group or the healthy control group.

The authors concluded that their findings provide insights into cognitive function in women who receive long-term tamoxifen treatment. By adding the surgery/radiotherapy group, they could control for the mental and physical influences of the diagnosis and treatment of breast cancer. They noted that cognitive domains that rely on verbal abilities (verbal memory and fluency) appear to be at risk for deterioration after treatment with tamoxifen.

Tamoxifen in the Treatment of Breast Cancer

Take home message:

As with any medication, risks and benefits exist. Thus, if you are on long-term tamoxifen therapy, discuss this study with your physician.

Source: http://m.edtreatmentindia.com/

Wrong diagnosis: Breast Cancer

A diagnosis of breast cancer is devastating; however, a wrong diagnosis can be more devastating. Unfortunately, misdiagnosis can occur; a patient with breast cancer will be told she does not have cancer, and a patient who does not have breast cancer can be told that she does have it. Obviously, either of these errors can cause significant harm to a patient. Fortunately, a diagnostic service is available that can reduce diagnostic errors: know error®. To obtain the facts regarding diagnostic errors, I consulted with Dr. David Brousseau, director of Radiology of Los Angeles Center for Women’s Health and Laura Beggrow, president of Strand Diagnostics/Know Error. The accompanying slide show explains how diagnostic errors can occur.

Breast Biopsies System

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The know error system uses bar coding, forensic principles, and DNA matching to confirm that surgical biopsy samples being evaluated belong exclusively to the patient being diagnosed. (Forensic principles are the use of science or technology in the investigation and establishment of facts or evidence.) The know error system for breast biopsies is in use in medical practices across the nation. Since the test was launched in September 2012 nearly 13,000 breast cancer patients have been tested using the know error system. (The know error test was first launched in prostate cancer in 2010. From 2010- September 2013- over 106,000 prostate cancer patients have been tested)

The cost of medical services is of major importance to most Americans. The good news is that the know error system kits are provided to physicians practices at no charge to the patient nor practice. Ms. Beggrow told me that the patient’s insurance company is billed for the molecular diagnostic testing performed. Reimbursement varies and currently averages around $400 per patient. Strand Diagnostics makes testing available to all appropriate breast cancer patients regardless of their insurance, providing comprehensive assistance and support for all patients throughout the reimbursement process. The know error system is a DNA Specimen Provenance Assignment (DSPA) molecular diagnostic test billed to governmental and commercial insurance providers. Therefore, patients will only be responsible for the in-network deductible, co-insurance, and co-pay amounts applied by their carriers.

Ms. Beggrow told me that they are discovering diagnostic errors in 1.18% of the breast patients that they test. Whether or not the patient received a false positive diagnosis is a function of the diagnosis of the "complementary" tissue. That is, if a patient DOES have breast cancer and her tissue is switched with someone that ALSO has breast cancer, then by chance, neither patient will receive a false reading of cancer. (Although the grade and volume of cancer may have been different, neither would have received a false cancer diagnosis.) The bottom line is that know error can reduce that approximately 1% chance of error to zero.

I asked Dr. Brousseau how often diagnostic errors occurred and if they were increasing. He told me that Specimen Provenance Complications (SPCs) can occur as a result of human error during any step in the complex biopsy diagnostic testing cycle. Some examples of SPCs include mislabeling, specimen transposition, and foreign cell contamination. Approximately 3.5% of cases receiving a positive cancer diagnosis are subject to undetected SPCs, which could lead to a cancer diagnosis being assigned to the wrong patient. Conversely this could lead to a delay in women with breast cancer receiving their diagnosis, potentially delaying life-saving treatment.

The Centers for Disease Control and Prevention (CDC) estimates that more than 200,000 women are diagnosed with breast cancer annually in the United States, meaning approximately 2,000 women per year could be incorrectly diagnosed with breast cancer. Since the issue continues to be undetected and under-reported that number will continue to increase. The error rate provided only includes healthy patients who are diagnosed with cancer; however, it does not include those who are told they do not have cancer but later on do in fact receive a positive biopsy result. These mistakes can set in motion the overtreatment of thousands of patients annually as well as delay the potentially life-saving treatments of women with cancer.

Dr. Brousseau noted that the attention to detail, particularly with respect to specimen labeling, varies widely among medical institutions. At his institution, the Los Angeles Center for Women’s Health, specimens are processed and labeled immediately. He stressed that avoiding batch processing at the point of acquisition is important for patient safety. Nonetheless, many if not most, institutions now utilize third party services to process the specimens before they are reviewed for diagnosis. Since this part of the process is beyond their direct control, they feel very comfortable with the knowledge that the know error system helps them avoid any transposition issues which could potentially occur in subsequent processing. Fortunately, they have not discovered any mislabeling or transposition errors since we began using this system about nine months ago.

Dr. Brousseau told me that issues of cross-contamination are becoming of greater concern to the medical community as tissue specimens undergo more frequent gene testing to predict prognosis and gene testing is employed in decision-making about the use of chemotherapeutic agents. Although cross-contamination itself may not lead to a cancer diagnosis in the wrong patient, it could have a significant effect on a choice about the subsequent treatment. In summary, he said, “Patients that hear those dreaded words - you have breast cancer - and how many are actually getting the wrong diagnosis. Now, with the help of a DNA test, physicians around the Country are aiming to lower the rate at which these errors occur.”

At nearly every step of the 20-step biopsy diagnostic process there is room for mix-ups to hide, undetected. This can be caused by two errors: (1) the patient's sample is switched with another's and (2) the patients sample is contaminated with one or more patient's DNA tissue. Over 200,000 woman are diagnosed with breast cancer per year. This means that treatment recommendations (including removal of healthy breasts and prostates, chemotherapy, radiation) are being made for cancer-free patients and life-saving treatment is being delayed in some cases as well.

Breast Biopsy; Uses, Side Effects, Procedure, Results

Now, when a patient comes into the physician’s office to have a surgical biopsy- where the physician takes a sample of the mass in the breast - they are also given a DNA test (know error system) via cheek swab. When the biopsy sample comes back to the lab and tests positive for cancer, it is then sent to the lab and the DNA from the cheek swab is matched with the DNA from the biopsy sample. From here, it can be determined if the biopsy sample is in fact that patients. This test is a simple, non-invasive way to reassure the patient their diagnosis is their own and, if they do have cancer, then they are receiving the accurate treatment.

Source: http://m.edtreatmentindia.com/

Tips for good sex after the menopause

A few generations ago, many women just got old when menopause struck. Currently, many women live for a number of the decades after the menopause, during which they can enjoy good health—and a satisfying sex life. Some problems can occur after the menopause that can impact sex relationships. Tara Allmen, MD is a board certified obstetrician gynecologist and a nationally certified menopause practitioner from The Center of Menopause, Hormonal Disorders and Women’s Health. I consulted with her on the topic

Dr. Allmen notes that menopause is inevitable—barring an untimely death, every woman will experience menopause. With menopause and post-menopause come natural health challenges or questions that are totally normal and need to be addressed. Talking about these topics is never easy with your friends or partner—or even with your doctor. However, it is important to become educated so you understand your symptoms and how to best manage them. It is also important for postmenopausal women to understand they are not alone.

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A common problem impacting menopausal women is vaginal dryness, which is due to a drop in estrogen. The condition can make sexual relations painful and even impossible. For these women, Dr. Allmen recommends the Estring, which is a ring that is inserted into the vagina and releases a small amount of estradiol for three months before it needs to be replaced. When in place, neither the woman nor her partner is aware of its presence. Hormone replacement therapy (HRT) can restore vaginal health; however, some women have health conditions that preclude their use or are reluctant to take HRT because of it has been reported to increase the risk of breast cancer or other illnesses.

Dr. Allmen concurred with me that many gynecologists have busy practices that preclude conversations about an intimate topics. Both she and I agree that a woman should not be afraid to speak up and request time to discuss the situation. Before discussing the situation with a healthcare professional, a woman should educate herself regarding issues of the menopause. She recommends two websites: estring.com for information regarding the Estring ring and www.edtreatmentindia.com, which is the website of the North American Menopause Society (NAMS). Another good source of information for women is www.acog.org, the website of the American Congress of Obstetricians and Gynecologists (ACOG).