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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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Re-analysis of WHI data shows breast cancer growth, not de novo tumor formation, for 5 year EPT users

Richard J. Santen, MD, professor of medicine, endocrinology and metabolism at the University of Virginia, gave the Plenary Joint Lecture at the Conjoint Meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine and said the WHI study led by JoAnn Manson, MD, DrPH, should be commended for its concentration on absolute risk, rather than relative risk, but commented on the breakdown of risk per 10,000 women for one year of HT.

Most women take hormone therapy for 3, 4 or 5 years so if you express the risk per 1 year, you’re really underemphasizing the risk.

Santen and colleagues presented data from the WHI re-analysis and looked at 5 years of HT, focusing on women aged 50 to 59 years because this cohort would be making immediate decisions about HT.

The average age of the participants in the entire WHI study was 63 years, whereas the WHI re-analysis looked at the subset ages 50-59.

The 5-year data showed an increased risk of three women per 1,000 with estrogen plus progestin therapy (EPT), but a 2.5 per 1,000 risk reduction with estrogen alone, which Santen attributed to apoptosis if a breast cancer tumor had been deprived of estrogen for some time. In addition, Santen applied a previously published model that took the doubling time of breast cancer tumors into consideration, suggesting that only 6% of cancers seen in the WHI study were de novo tumors. The others were most likely growths of undetected tumors present at the start of the study.

Santen contends that hormone therapy does not cause breast cancer, it causes existing breast cancer to grow more rapidly.

Read the full article here: 

Re-analysis of WHI data shows breast cancer growth, not de novo tumor formation, for 5 year EPT users

See also: 

Prentice RL, Manson JE, Anderson GL, Lacroix AZ, Shumaker SA, Chlebowski RT, Howard BV, Stefanick ML, Jackson RD, Wactawski-Wende J, Rossouw JE. Women's Health Initiative View of Estrogen Avoidance and All-Cause Mortality. Am J Public Health. 2013 Dec;103(12):e2. doi: 10.2105/AJPH.2013.301604. Epub 2013 Oct 17.

Content created 18 November 2013 

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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.


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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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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Oestrogen avoidance and mortality rates

Dr P M Sarrel and fellow researchers reviewed and analysed the effect of oestrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years in the United States.

They derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women's Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in oestrogen use observed between 2002 and 2011.

Over a 10-year span, starting in 2002, the authors found that a minimum of 18,601 and as many as 91,610 postmenopausal women died prematurely because of the avoidance of oestrogen therapy.

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