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Wrist fracture significantly raises risk of hip fracture

A new study supports widespread evidence that individuals who have suffered a fracture are at significantly increased risk of subsequent hip fractures. In fact, previous studies have shown that half of patients presenting with hip fractures have suffered a prior fracture.

Researchers T.-L. Huang and C.-W. Chen from the China Medical University in Chinese Taipei, studied whether Colles' fracture (fracture of the distal radius in the forearm, i.e. wrist fracture) increased hip fracture risk within one year, in an Asian population.

The investigators extracted data for patients with newly diagnosed Colles' fracture from records of both ambulatory and in-patient care during the years 2000–2006 and compared fracture risk in this group to a cohort without Colles' fracture. Both study groups were followed up for one year to measure the incidence of hip fracture using three different calculation models.

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Regular exercise in middle age protects against muscle weakness later in life

A cross-sectional study by investigators from Tokyo University has found that exercising in middle age is a protective factor against sarcopenia and effective in maintaining muscle strength and physical performance. Sarcopenia is a disease associated with the ageing process, resulting in loss of skeletal muscle mass and muscle strength and/or function in the elderly. The multiple adverse health outcomes include physical disability, poor quality of life and premature death.

The study assessed the prevalence of sarcopenia and its association with physical performance in 1000 elderly Japanese participants (349 men and 651 women aged ≥65 years) enrolled in the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) Study. Handgrip strength, gait speed, and skeletal muscle mass were measured and other information collected, including exercise habits in middle age.

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Hong Kong study shows lower survival rates after second hip fractures

Research presented at the 4th Asia-Pacific Osteoporosis Meeting showed that second hip fractures are more deadly than first hip fractures. Based in Hong Kong, the study evaluated the overall incidence of a second hip fracture and subsequent mortality in 43,832 patients, aged 65 or above, with operatively treated first hip fracture during the years 2000-2011. The patients' mean age was 82±7.38 and the male to female ratio was 3:7. A total of 2,399 second hip fractures were identified.

On average, second hip fractures occurred 2 years and 8 months after the primary hip fracture. Females had a higher incidence of second hip fracture. The overall incidence of a second fracture was 0.88% at 6 months, 1.81% at 1 year, 6.91% at 5 years and 9.95% at 10 years. A total 75% of second fractures occurred within around 4 years after the initial fracture.

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Intimate chats about STIs are important in theory but difficult in bed

Having sex can be fun; and talking about sex can be fun. Talking about sexually transmitted infections with a sexual interest, however, is a totally different matter, according to new research from Indiana University's Center for Sexual Health Promotion.

The study, discussed during the American Public Health Association's annual meeting, found a disconnect between the public health messages that promote STI testing as a way to prevent STIs such as HIV and chlamydia and the conversations - or lack of them - occurring in bedrooms.

"Talking to partners about STIs is an important conversation to have," said Margo Mullinax, lead researcher for "Talk about testing: What sexual partners discuss in relation to STI status and why." "However, findings from this study suggest public health campaigns need to promote specific messages, concrete tips and tools around sexual health conversations stratified by relationship status. Campaigns should also address STI stigma and promote messages of normalcy with regard to talking about STIs."

STIs, if untreated, can lead to a range of health problems including infertility, so a growing public health emphasis has been on preventing STIs through testing. Mullinax said little was known, however, about how STI testing figured into actual conversations between lovers, particularly among the college-age crowd that accounts for a disproportionate number of new STI cases nationwide.

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Dementia may be delayed with speaking a second language

People who speak more than one language and who develop dementia tend to do so up to five years later than those who are monolingual, according to a study.

A team of scientists examined almost 650 dementia patients and assessed when each one had been diagnosed with the condition. The study was carried out by researchers from the University of Edinburgh and Nizam's Institute of Medical Sciences in Hyderabad (India).

They found that people who spoke two or more languages experienced a later onset of Alzheimer's disease, vascular dementia and frontotemporal dementia.

The bilingual advantage extended to illiterate people who had not attended school. This confirms that the observed effect is not caused by differences in formal education.
It is the largest study so far to gauge the impact of bilingualism on the onset of dementia – independent of a person's education, gender, occupation and whether they live in a city or in the country, all of which have been examined as potential factors influencing the onset of dementia.

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One dose of HPV vaccine may be enough

Women vaccinated with one dose of a human papillomavirus (HPV) vaccine had antibodies against the viruses that remained stable in their blood for four years, suggesting that a single dose of vaccine may be sufficient to generate long-term immune responses and protection against new HPV infections, and ultimately cervical cancer, according to a study recently published [1]. 

"The latest Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention on vaccination coverage indicates that in 2012, only 53.8 percent of girls between 13 and 17 years old initiated HPV vaccination, and only 33.4 percent of them received all three doses," said Mahboobeh Safaeian, Ph.D., an investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute (NCI) in Bethesda, Md.

"We wanted to evaluate whether two doses, or even one dose, of the HPV 16/18 L1 VLP vaccine [Cervarix] could induce a robust and sustainable response by the immune system," she added. "We found that both HPV 16 and HPV 18 antibody levels in women who received one dose remained stable four years after vaccination. Our findings challenge previous dogma that protein subunit vaccines require multiple doses to generate long-lived responses." 

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Neck injections for hot flushes

A shot in the neck of local anesthesia may reduce hot flushes by as much as 50 percent for at least six months, a recent Northwestern Medicine® study found.

"We think we are resetting the thermostat in women who are experiencing moderate to very severe hot flushes without using hormonal therapies," said David Walega, MD, chief of the Division of Pain Medicine at Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine. Walega presented the results of the initial study at a recent American Society of Anesthesiologists annual meeting. 

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Women’s Health Initiative - Update 2013

Hormone replacement therapy (HRT) has been under considerable scrutiny since 2002 when a large US government study, the Women’s Health Initiative (WHI) reported that HRT, specifically the combination of estrogen and progestin together, increased the risk for blood clots, stroke, breast cancer and heart attacks.

The WHI, which consisted of three clinical trials and an observational study, was conducted to address major health issues causing morbidity and mortality in postmenopausal women. The study was stopped early by the researchers and they concluded that the risks of HRT outweighed the benefits.

Although the WHI study was designed to evaluate the role of HRT in the prevention of diseases related to aging, many women and their doctors also abandoned HRT as therapy for menopausal symptoms.

Additional research over the past 10 years, has found shown that the level of risk with HRT depends on the individual woman, her health history, age, and the number of years since her menopause began. It is women below the age 60 years and recently started menopause, who are at a lower risk when taking low doses of HRT compared with women over 60.

The paper by Manson JE, Chlebowski RT, Stefanick ML, et al.(1) published in the October 3, 2013 issue of the Journal of the American Medical Association, sets out to report a comprehensive, integrated overview of findings from the two WHI hormone therapy trials with extended postintervention follow-up.

Reference

1 Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013;310(13):1353-1368

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International Menopause Society (IMS)

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Use of Pharmacologic Interventions for Breast Cancer Risk Reduction:

American Society of Clinical Oncology Clinical Practice Guideline

The updated pharmacologic interventions for breast cancer risk reduction from the 2009 American Society of Clinical Oncology (ASCO) guideline was published by the American Society of Clinical Oncology in July 2013.

The authors undertook a systematic review of randomized controlled trials and meta-analyses published from June 2007 through June 2012 using MEDLINE and Cochrane Collaboration Library. The primary outcome of interest was breast cancer incidence (invasive and noninvasive). The secondary outcomes included breast cancer mortality, adverse events, and net health benefits. Guideline recommendations were revised based on an Update Committee's review of the literature.

Nineteen articles met the selection criteria and six chemoprevention agents were identified: tamoxifen, raloxifene, arzoxifene, lasofoxifene, exemestane, and anastrozole.

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Calcium and vitamin D help hormones help bones

Should women take calcium and vitamin D supplements after menopause for bone health? Recommendations conflict, and opinions are strong. But now, an analysis from the major Women's Health Initiative (WHI) trial throws weight on the supplement side—at least for women taking hormones after menopause. The analysis was published 26 June 2013 in Menopause, the journal of The North American Menopause Society.

Among the nearly 30,000 postmenopausal women in the hormone trial, some 8,000 took supplemental calcium (1,000 mg/day) and vitamin D (400 iu/day), and some 8,000 took look-alike placebos. These women came from all the hormone groups in the study—those who took estrogen plus a progestogen (required for women with a uterus), those who took estrogen alone, and those who took the hormone look-alike placebos. The researchers looked at how the rates of hip fracture differed among women who took hormones and supplements, those who took hormones alone, and those who took neither.

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