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Ovarian cancer under the spotlight

woman with bloat painEach year more than 1200 Australian women are diagnosed with ovarian cancer. The main risk factor for ovarian cancer is getting older. Over 80 per cent of women diagnosed are over 50 years of age but ovarian cancer can occur at any age. 

Ovarian cancer can be difficult to diagnose at an early stage, largely because symptoms can be vague and similar to those of other common illnesses. 

But most women diagnosed with the disease experience symptoms, it is simply that they do not link them to cancer.

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Variation in worldwide usage of FRAX

One of the most important advances in osteoporosis management of the past decade has been the advent of fracture risk assessment algorithms. Today, rather than relying on bone mineral density values alone, doctors use tools such as FRAX, a widely available calculator, to help identify patients in need of treatment.

A new position paper by the International Osteoporosis Foundation (IOF) Epidemiology and Quality of Life Working Group has assessed the uptake of FRAX worldwide. The study concludes that there were approximately 2.3 million FRAX calculations during a one-year period beginning in May 2012, with enormous variation in worldwide usage.

What is FRAX?

FRAX (WHO Fracture Risk Assessment Tool) calculates an individual's 10-year probability of a major osteoporotic fracture based on clinical risk factors. It integrates the weight of clinical risk factors for fracture and mortality risk, with or without information on bone mineral density (BMD) values. Each calculator is country specific, calibrated to the national epidemiology of fracture and mortality.

Now with specific models for 53 countries, FRAX is widely used by physicians around the world to help assess their patients' fracture risk in the course of a clinical assessment. The use of the tool improves risk assessment compared to the use of BMD alone, allowing physicians to make more informed treatment decisions.

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HRT therapy may increase risk of acute pancreatitis

Women who use postmenopausal hormone replacement therapy (HRT) may be at increased risk of acute pancreatitis, found a new study in CMAJ (Canadian Medical Association Journal).

Acute pancreatitis, a sudden inflammation of the pancreas, has symptoms that range from mild discomfort to severe, debilitating pain and may, in some cases, even lead to death.

Although several case reports have indicated that there may be an association between use of HRT and risk of acute pancreatitis, the evidence from large studies is sparse. To understand whether there is an association, the researchers looked at data on 31 494 Swedish postmenopausal women aged 48 years at the start of the 13-year study from 1997 to 2010. At the start of the study, 13 113 (42%) of the women were current users of HRT, 3660 (12%) were previous users, and the remainder had never used the therapy. Of the current users of HRT, 6795 (52%) used systemic therapy for hot flashes, 4148 (32%) used local therapy for vaginal dryness, and 2170 (16%) used both therapies.

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Dance and virtual reality: A promising treatment for urinary incontinence in elderly women

Virtual reality, dance and fun are not the first things that come to mind when we think of treating urinary incontinence in senior women. However, these concepts were the foundations of a promising study by Dr. Chantal Dumoulin, PhD, Canada Research Chair in Urogynaecological Health and Aging, a researcher at the Institut universitaire de gériatrie de Montréal, and an associate professor in the Physiotherapy Program of the Rehabilitation School at Université de Montréal, and her master's student, Miss Valérie Elliott.

Dr Eling D. de Bruin, Ph.D., researcher at the department of Health Sciences and Technology, Swiss federal Institute of Technology, Zurich, Switzerland collaborated in this study for his expertise in the use of exergame in geriatric rehabilitation. The results of their feasibility study were published in Neurourology and Urodynamics.

For the study, the researchers added a series of dance exercises via a video game console to a physiotherapy program for pelvic floor muscles. What were the results for the 24 participants? A greater decrease in daily urine leakage than for the usual program (improvement in effectiveness) as well as no dropouts from the program and a higher weekly participation rate (increase in compliance).

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Screening helps prevent cervical cancer in older women

Research from Queen Mary University of London reveals women over the age of 50 who don't attend cervical screening are four times more likely to be diagnosed with cervical cancer in later life.

The study, published in PLoS Medicine and funded by Cancer Research UK, underlines the importance of screening women over 50 for cervical cancer to prevent the disease, and provides the evidence that women with normal screening results between 50- 64 have a lower risk of cervical cancer into their eighties.

Researchers examined data taken from 1,341 women who were screened aged 50 to 64 and the number of cervical cancers diagnosed between 65 to 83. They included nearly all 65 to 83-year old women in England and Wales diagnosed with cervical cancer between 2007 and 2012.
Women who had not been screened after 50 had a six fold higher risk of being diagnosed with cervical cancer than those who had been screened but had a normal result during this time - with 49 cancers being diagnosed per 10,000 unscreened women over 20 years, compared to eight cancers per 10,000 women with normal screening results.

Women who had been screened regularly but had a positive (abnormal) screening result between 50 and 64 had a risk of 86 per 10,000 women over 20 years.

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Using progesterone for hot flushes shown safe for women's cardiovascular health

Treatment with progesterone, a naturally occurring hormone that has been shown to alleviate severe hot flushes and night sweats in post-menopausal women, poses little or no cardiovascular risk, according to a new study by the University of British Columbia and Vancouver Coastal Health.

The findings, published in PLOS ONE, help to dispel a major impediment to widespread use of progesterone as a treatment for hot flashes and night sweats, said lead author Dr. Jerilynn C. Prior, a professor of endocrinology and the head of Centre for Menstrual Cycle and Ovulation Research.

For decades, women used a combination of synthetic estrogen and progesterone to reduce the frequency and severity of hot flashes and night sweats, as well as to prevent osteoporosis. Use of this so-called "hormone replacement therapy" dropped dramatically after 2002, when a large study revealed that it increased risk of heart disease, breast cancer, strokes and other serious conditions.

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Web predicts disease outbreak

The habit of Googling for an online diagnosis before visiting a GP can provide early warning of an infectious disease epidemic.

In a new study published in Lancet Infectious Diseases, internet-based surveillance has been found to detect infectious diseases such Dengue Fever and Influenza up to two weeks earlier than traditional surveillance methods.

Senior author of the paper titled Internet-based surveillance systems for monitoring emerging infectious diseases , QUT Senior Research Fellow Dr Wenbiao Hu said when investigating the occurrence of epidemics, spikes in searches for information about infectious diseases could accurately predict outbreaks of that disease.

Dr Hu, based at QUT's Institute for Health and Biomedical Innovation, said there was often a lag time of two weeks before traditional surveillance methods could detect an emerging infectious disease.

"This is because traditional surveillance relies on the patient recognising the symptoms and seeking treatment before diagnosis, along with the time taken for health professionals to alert authorities through their health networks," Dr Hu said.

"In contrast, digital surveillance can provide real-time detection of epidemics."

Dr Hu said the study found by using digital surveillance through search engine algorithms such as Google Trends and Google Insights, detecting the 2005-06 avian influenza outbreak "Bird Flu" would have been possible between one and two weeks earlier than official surveillance reports.

"In another example, a digital data collection network was found to be able to detect the SARS outbreak more than two months before the first publications by the World Health Organisation (WHO)," he said.

"Early detection means early warning and that can help reduce or contain an epidemic, as well alert public health authorities to ensure risk management strategies such as the provision of adequate medication are implemented."

Dr Hu said the study found social media and microblogs including Twitter and Facebook could also be effective in detecting disease outbreaks.

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Diet rich in tomatoes may lower breast cancer risk

A tomato-rich diet may help protect at-risk postmenopausal women from breast cancer, according to new research accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Breast cancer risk rises in postmenopausal women as their body mass index climbs. The study found eating a diet high in tomatoes had a positive effect on the level of hormones that play a role in regulating fat and sugar metabolism.
"The advantages of eating plenty of tomatoes and tomato-based products, even for a short period, were clearly evident in our findings," said the study's first author, Adana Llanos, PhD, MPH, who is an Assistant Professor of Epidemiology at Rutgers University. Llanos completed the research while she was a postdoctoral fellow with Electra Paskett, PhD, at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. "Eating fruits and vegetables, which are rich in essential nutrients, vitamins, minerals and phytochemicals such as lycopene, conveys significant benefits. Based on this data, we believe regular consumption of at least the daily recommended servings of fruits and vegetables would promote breast cancer prevention in an at-risk population."

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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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