Pregnant women who are obese are less able to fight infections than lean women, which could affect their baby's health after birth and later in life, according to research to be presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting in Denver. "Women who are obese before pregnancy have critical differences in their immune function during pregnancy compared to normal weight women, which has negative consequences for both mother and baby," said Sarbattama Sen, MD, lead author of the study and a researcher in the Mother Infant Research Institute at Tufts Medical Center and Floating Hospital for Children in Boston.
Obesity in pregnancy has been associated with an increase in infections such as chorioamnionitis, a condition in which the membranes surrounding the fetus and the amniotic fluid are infected. This can have serious consequences for both the mother and the baby.
Dr. Sen and colleagues from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University sought to determine whether obesity in pregnancy changes women's ability to fight off infections. They drew blood from 30 women who were 24-28 weeks pregnant to measure the presence of different cells and cell proteins that help fight infections. Fifteen women were obese before they became pregnant (body mass index higher than 30), and fifteen women had a normal body mass index (20-25).
Results showed that obese women had fewer CD8+ (cytotoxic T) cells and natural killer cells, which help fight infection, compared to lean women. In addition, obese pregnant women's ability to produce cells to fight infection was impaired.
"Maternal obesity has consequences for the mother and baby, which we are only beginning to understand," Dr. Sen concluded. "As the numbers of obese women of reproductive age increase, it is critical to understand the repercussions of this disease for future generations."
**Source: American Academy of Pediatrics
02 May 2011
Children held captive in smoky vehicles
It is absolutely unacceptable to subject children to any tobacco smoke exposure in cars, according to the authors of an abstract to be presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting in Denver. "An infant strapped into a car seat is involuntarily and intensely exposed to more than 400 toxic chemicals in tobacco smoke," said abstract co-author Jonathan P. Winickoff, MD, MPH, FAAP. "They have no voice and no choice in whether their parents smoke in the car."
Dr. Winickoff and his colleagues conducted the analyses to determine the prevalence of tobacco smoke exposure in cars among children and to examine factors associated with parents strictly enforcing a ban on smoking in their cars.
Parents were invited to participate in a survey after their children had been seen for a well or sick visit at one of seven pediatric practices in six states. Parents who smoked were asked if they had a car, whether they had smoking rules in their car, their child's age and if their pediatrician advised them to have a smoke-free car. Parents were considered to have a strictly enforced car smoking ban if they reported having a smoke-free car rule and that no one had smoked in their car for the past three months.
The results are based on a Pediatric Research in Office Settings (PROS) trial called the Clinical Effort Against Secondhand Smoke Exposure (CEASE), which addressed parental smoking. PROS is a network of pediatric primary care practices established by the American Academy of Pediatrics (AAP) to conduct research on child health problems.
Results showed that 146 of 528 parents who smoked (28 percent) reported having a smoke-free car rule, and 114 (22 percent) reported having a strictly enforced car smoking ban. Factors associated with having a smoking ban included having a younger child and smoking fewer cigarettes per day.
Of the parents who reported smoking in their car, 52 percent said smoking occurred with children present. Only 14 percent of parents said they were advised by a pediatric health care provider to have a smoke-free car.
"Because they have smaller air passages than adults, infants and children are more sensitive to chemicals in tobacco smoke and suffer increased asthma attacks and severe respiratory infections," said Dr. Winickoff, CEASE principal investigator and associate professor of pediatrics at MassGeneral Hospital for Children.
"Coupled with the finding that few pediatric health care providers advise against smoking in cars, these results highlight the need for improved pediatric interventions, public health campaigns and health policy regarding smoke-free car laws to protect children from tobacco smoke toxins," he said. "Setting strict rules about never smoking in cars will benefit the whole family and help reduce tobacco use nationally."
To view the abstract, which will be presented during an AAP Presidential Plenary presentation, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2205.
Other abstracts based on the CEASE data to be presented on Saturday, April 30, during the PAS meeting include:
"Are Strictly Enforced Smoke-free Home and Car Rules Associated with Parent Quit Attempts?" A strictly enforced no-smoking policy in the home and car was associated with recent quit attempts by parents who smoked. "This research suggests that completely protecting children from tobacco smoke in the home and car may also help parents quit smoking," said lead author Stacia Finch. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2614.
"What Factors Are Associated with Smoke-free Homes Among Smoking Parents?" Parents were more likely to report having a smoke-free home if they had a child younger than 10 years old; fewer than three smokers lived in the home; and if parents banned smoking in the car. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_3451.
"Parent/Smoker Identity Conflict and Readiness to Quit." Parents who agreed with the statement, "My being a smoker gets in the way of my being a parent," were considered to have identity conflict and were more likely to be seriously planning to quit smoking than those who disagreed with the statement. "Interventions that increase identity conflict among parents who smoke might increase their readiness to quit smoking," Dr. Winickoff said. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2208.
**Source: American Academy of Pediatrics
Dr. Winickoff and his colleagues conducted the analyses to determine the prevalence of tobacco smoke exposure in cars among children and to examine factors associated with parents strictly enforcing a ban on smoking in their cars.
Parents were invited to participate in a survey after their children had been seen for a well or sick visit at one of seven pediatric practices in six states. Parents who smoked were asked if they had a car, whether they had smoking rules in their car, their child's age and if their pediatrician advised them to have a smoke-free car. Parents were considered to have a strictly enforced car smoking ban if they reported having a smoke-free car rule and that no one had smoked in their car for the past three months.
The results are based on a Pediatric Research in Office Settings (PROS) trial called the Clinical Effort Against Secondhand Smoke Exposure (CEASE), which addressed parental smoking. PROS is a network of pediatric primary care practices established by the American Academy of Pediatrics (AAP) to conduct research on child health problems.
Results showed that 146 of 528 parents who smoked (28 percent) reported having a smoke-free car rule, and 114 (22 percent) reported having a strictly enforced car smoking ban. Factors associated with having a smoking ban included having a younger child and smoking fewer cigarettes per day.
Of the parents who reported smoking in their car, 52 percent said smoking occurred with children present. Only 14 percent of parents said they were advised by a pediatric health care provider to have a smoke-free car.
"Because they have smaller air passages than adults, infants and children are more sensitive to chemicals in tobacco smoke and suffer increased asthma attacks and severe respiratory infections," said Dr. Winickoff, CEASE principal investigator and associate professor of pediatrics at MassGeneral Hospital for Children.
"Coupled with the finding that few pediatric health care providers advise against smoking in cars, these results highlight the need for improved pediatric interventions, public health campaigns and health policy regarding smoke-free car laws to protect children from tobacco smoke toxins," he said. "Setting strict rules about never smoking in cars will benefit the whole family and help reduce tobacco use nationally."
To view the abstract, which will be presented during an AAP Presidential Plenary presentation, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2205.
Other abstracts based on the CEASE data to be presented on Saturday, April 30, during the PAS meeting include:
"Are Strictly Enforced Smoke-free Home and Car Rules Associated with Parent Quit Attempts?" A strictly enforced no-smoking policy in the home and car was associated with recent quit attempts by parents who smoked. "This research suggests that completely protecting children from tobacco smoke in the home and car may also help parents quit smoking," said lead author Stacia Finch. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2614.
"What Factors Are Associated with Smoke-free Homes Among Smoking Parents?" Parents were more likely to report having a smoke-free home if they had a child younger than 10 years old; fewer than three smokers lived in the home; and if parents banned smoking in the car. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_3451.
"Parent/Smoker Identity Conflict and Readiness to Quit." Parents who agreed with the statement, "My being a smoker gets in the way of my being a parent," were considered to have identity conflict and were more likely to be seriously planning to quit smoking than those who disagreed with the statement. "Interventions that increase identity conflict among parents who smoke might increase their readiness to quit smoking," Dr. Winickoff said. To view the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS11L1_2208.
**Source: American Academy of Pediatrics
National Geographic sigue la saga "En el vientre materno"
“En el vientre materno”es un sello de producción avalado por National Geographic Channel que desde hace ya seis años regresa puntualmente a la pantalla del canal de televisión para mostrarnos los diferentes procesos de desarrollo de embarazos, tanto en humanos, como también en animales.
En el vientre materno nos lleva a una serie de increíbles viajes que nos revelan el extraordinario mundo del desarrollo del feto.
Con fotografías nunca antes vistas, efectos especiales de avanzada y sorprendentes imágenes 4D, "En el Vientre Materno" de National Geographic nos lleva a una serie de increíbles viajes que nos revelan el increíble mundo del desarrollo del feto.El documental nos hace testigos del momento en que un simple huevo fertilizado se divide en dos para engendrar a mellizos idénticos.
Exploraremos el intricado proceso que tiene lugar dentro del vientre mientras se forman dos grandes depredadores, el león y el gato.
Observaremos las dos primeras etapas de vida del perro y su antepasado el lobo. Veremos el momento más importante del proceso de reproducción y gestación, incluyendo la evolución del embrión de un tiburón que se transforma en caníbal y de la avispa que invade el cuerpo de otros para alimentar a su cría.
Exploraremos el intricado proceso que tiene lugar dentro del vientre mientras se forman dos grandes depredadores, el león y el gato.
Desde lo bizarro hasta lo increíble, lo llevaremos a través de cuatro viajes únicos para develar los secretos del desarrollo del feto y revelar la vida dentro del vientre materno - como nunca antes fue visto.
LISTADO DE EPISODIOS:
1. En el Vientre materno
Un especial dedicado a la vida dentro del cuerpo de la mujer. Sorpréndete con las imágenes y mira la maternidad desde un punto de vista innovador.
2. En el vientre materno: animales
Por primera vez en televisión podremos presenciar con lujo de detalles el crecimiento en las distintas etapas del feto de un elefante, un delfín y un perro. A diferencia de la corta gestación del perro, el embrión de un elefante sobrelleva una épica gestación de 22 meses, al término de la cual el feto alcanza un peso de 120 kilos.
3. En el vientre materno: Embarazos múltiples
."En el vientre materno: embarazos múltiples" utiliza avances tecnológicos e imágenes generadas por computadora para mostrar a nuestros televidentes el extraordinario mundo de los embarazos múltiples.
4. En el vientre materno: Luchar por sobrevivir (Documental de estreno en National Geographic Channel!)
Este documental explora cuatro historias extraordinarias de embarazos que vencieron obstáculos aparentemente insuperables y terminaron en verdaderos milagros de vida. Este documental se estrenó el Domingo día 1 de Mayo de 2011 a las 21.30h en NG Channel.
En el vientre materno nos lleva a una serie de increíbles viajes que nos revelan el extraordinario mundo del desarrollo del feto.
Con fotografías nunca antes vistas, efectos especiales de avanzada y sorprendentes imágenes 4D, "En el Vientre Materno" de National Geographic nos lleva a una serie de increíbles viajes que nos revelan el increíble mundo del desarrollo del feto.El documental nos hace testigos del momento en que un simple huevo fertilizado se divide en dos para engendrar a mellizos idénticos.
Exploraremos el intricado proceso que tiene lugar dentro del vientre mientras se forman dos grandes depredadores, el león y el gato.
Observaremos las dos primeras etapas de vida del perro y su antepasado el lobo. Veremos el momento más importante del proceso de reproducción y gestación, incluyendo la evolución del embrión de un tiburón que se transforma en caníbal y de la avispa que invade el cuerpo de otros para alimentar a su cría.
Exploraremos el intricado proceso que tiene lugar dentro del vientre mientras se forman dos grandes depredadores, el león y el gato.
Desde lo bizarro hasta lo increíble, lo llevaremos a través de cuatro viajes únicos para develar los secretos del desarrollo del feto y revelar la vida dentro del vientre materno - como nunca antes fue visto.
LISTADO DE EPISODIOS:
1. En el Vientre materno
Un especial dedicado a la vida dentro del cuerpo de la mujer. Sorpréndete con las imágenes y mira la maternidad desde un punto de vista innovador.
2. En el vientre materno: animales
Por primera vez en televisión podremos presenciar con lujo de detalles el crecimiento en las distintas etapas del feto de un elefante, un delfín y un perro. A diferencia de la corta gestación del perro, el embrión de un elefante sobrelleva una épica gestación de 22 meses, al término de la cual el feto alcanza un peso de 120 kilos.
3. En el vientre materno: Embarazos múltiples
."En el vientre materno: embarazos múltiples" utiliza avances tecnológicos e imágenes generadas por computadora para mostrar a nuestros televidentes el extraordinario mundo de los embarazos múltiples.
4. En el vientre materno: Luchar por sobrevivir (Documental de estreno en National Geographic Channel!)
Este documental explora cuatro historias extraordinarias de embarazos que vencieron obstáculos aparentemente insuperables y terminaron en verdaderos milagros de vida. Este documental se estrenó el Domingo día 1 de Mayo de 2011 a las 21.30h en NG Channel.
**National Geographic( http://www.natgeo.tv/)
Un estudio vincula el cáncer de mama con un excesivo uso de anticonceptivos
Una investigación desarrollada por científicos catalanes refuerza la teoría de que tomar anticonceptivos aumenta, en determinadas mujeres, el riesgo de padecer cáncer de mama. El estudio, realizado por investigadores del Centro de Regulación Genómica (CGR) de Barcelona y que publicará a finales de mes la revista «Cancer Research», demuestra que las personas que tienen el gen BRCA1 —que se encarga de equilibrar los niveles de progesterona en el organismo— mutado, al no disponer de ese regulador de la hormona, tienen mucho más riesgo de proliferación celular y también de desarrollar la enfermedad.
-«Una nueva alerta»
Miquel Beato, codirector del trabajo junto a la doctora Verónica Calvo, destaca en declaraciones a ABC la importancia del hallazgo, realizado en base a células de cáncer de mama en cultivo, y considera que «es una nueva alerta sobre las posibles consecuencias del uso de anticonceptivos».
«No todas las mujeres reaccionan de igual modo a la toma de estas hormonas. Por este motivo, debemos ser más cautos a la hora de recetarlas ya que para algunas jóvenes puede ser muy perjudicial tomarlas», aclara el experto, quien recuerda que «sabíamos que ese gen mutado puede desarrollar cáncer de mama en un elevado número de pacientes (un 80%), pero ahora sabemos también los mecanismos de acción de ese gen».
El estudio del CRG, que arrancó hace seis años, revela que cuando el gen BCRA1 está mutado y se expresa mal, la célula tiene más receptores para progesterona, por lo que aumenta su efecto sobre la proliferación celular. Beato, epigenético, experto en genómica y ginecólogo, recuerda que «hasta ahora, otros trabajos señalaban la vinculación entre cáncer de mama y estrógenos; nosotros apuntamos directamente a la progesterona».
Miquel Beato, codirector del trabajo junto a la doctora Verónica Calvo, destaca en declaraciones a ABC la importancia del hallazgo, realizado en base a células de cáncer de mama en cultivo, y considera que «es una nueva alerta sobre las posibles consecuencias del uso de anticonceptivos».
«No todas las mujeres reaccionan de igual modo a la toma de estas hormonas. Por este motivo, debemos ser más cautos a la hora de recetarlas ya que para algunas jóvenes puede ser muy perjudicial tomarlas», aclara el experto, quien recuerda que «sabíamos que ese gen mutado puede desarrollar cáncer de mama en un elevado número de pacientes (un 80%), pero ahora sabemos también los mecanismos de acción de ese gen».
El estudio del CRG, que arrancó hace seis años, revela que cuando el gen BCRA1 está mutado y se expresa mal, la célula tiene más receptores para progesterona, por lo que aumenta su efecto sobre la proliferación celular. Beato, epigenético, experto en genómica y ginecólogo, recuerda que «hasta ahora, otros trabajos señalaban la vinculación entre cáncer de mama y estrógenos; nosotros apuntamos directamente a la progesterona».
-Variar la prescripción
El científico catalán tiene clara la relación entre la toma de anticonceptivos y el aumento del riesgo a padecer este tipo de cáncer hereditario. Por este motivo, aboga por variar la prescripción de este tipo de fármacos. «Siempre me he mostrado escéptico ante los tratamientos hormonales para evitar embarazos. No es sensato recetarlos a todas las mujeres por igual porque no todas son iguales», apunta Beato.
El experto en genómica apuesta por un replanteamiento en la dispensación de estos fármacos para que «no pueda afectar a mujeres que, por su perfil genético, tienen ya mucho riesgo de padecer la enfermedad».
La clave está, a su entender, en la medicina personalizada. «Lo lógico sería que se hubiera avanzado más en el conocimiento del genoma y que supiéramos con detalle qué mujer es suspectible de desarrollar este cáncer, pero ahora sólo lo sabemos si hay antecedentes familiares y las pacientes se realizan la prueba genética», concluye Beato.
El científico catalán tiene clara la relación entre la toma de anticonceptivos y el aumento del riesgo a padecer este tipo de cáncer hereditario. Por este motivo, aboga por variar la prescripción de este tipo de fármacos. «Siempre me he mostrado escéptico ante los tratamientos hormonales para evitar embarazos. No es sensato recetarlos a todas las mujeres por igual porque no todas son iguales», apunta Beato.
El experto en genómica apuesta por un replanteamiento en la dispensación de estos fármacos para que «no pueda afectar a mujeres que, por su perfil genético, tienen ya mucho riesgo de padecer la enfermedad».
La clave está, a su entender, en la medicina personalizada. «Lo lógico sería que se hubiera avanzado más en el conocimiento del genoma y que supiéramos con detalle qué mujer es suspectible de desarrollar este cáncer, pero ahora sólo lo sabemos si hay antecedentes familiares y las pacientes se realizan la prueba genética», concluye Beato.
**Publicado en "ABC"
01 May 2011
El alto consumo de vitamina E podría mejorar las funciones fisiológicas tras sufrir una fractura
Según un nuevo estudio realizado en EE. UU., la alta concentración de vitamina E en sangre podría estar relacionada con una mejor recuperación de los ancianos tras una fractura de cadera.
En el estudio observacional se midieron las concentraciones en suero de las dos formas principales de vitamina E (α-tocoferol y γ-tocoferol) en 148 mujeres de 65 años o más con fracturas de cadera (1). La relación entre la concentración de vitamina E y la función fisiológica (medida con pruebas como el test de marcha en seis minutos) se calculó en las pacientes dos semanas antes de la fractura de cadera (según la información facilitada por las participantes) y también a los dos, a los seis y a los doce meses posteriores a la fractura. Los resultados del estudio mostraron que las altas concentraciones de vitamina E antes y después de la fractura de cadera se relacionan con unas mejores funciones fisiológicas. Esta relación con las funciones fisiológicas se da de forma más significativa con la forma α-tocoferol que con la forma γ-tocoferol.
En cuanto a los posibles mecanismos que causan esta relación, los investigadores observaron que la vitamina E podría tener efectos beneficiosos en la función fisiológica de pacientes con fractura de cadera porque reduce el excesivo estrés oxidativo que resulta del trauma de la fractura de cadera y su posterior reparación quirúrgica. Está demostrado que el estrés oxidativo daña el tejido muscular, y los antioxidantes como la vitamina E podrían evitar problemas en las funciones fisiológicas causados por músculos dañados (2). La vitamina E podría tener una especial importancia para los músculos, ya que se ha descubierto que la suplementación con α-tocoferol reduce el daño muscular durante la cirugía (3). Las propiedades antioxidantes de la forma α-tocoferol podrían ser la razón por la que dicha forma de la vitamina E está por lo general más relacionada con las funciones fisiológicas que la forma γ-tocoferol.
Los investigadores opinan que los adultos de edad avanzada con un alto riesgo de fractura de cadera así como aquellos que se están recuperando de dicha lesión podrían beneficiarse del consumo de vitamina E. Sin embargo, estos hallazgos deberán confirmarse en ensayos clínicos antes de que se pueda recomendar un alto consumo de vitamina E a los pacientes con fractura de cadera.
1. D’Adamo C. R. et al. Serum vitamin E concentrations and recovery of physical function during the year after hip fracture. J Gerontol A Biol Sci Med Sci. 2011.
2. Bonetto A. et al. Are antioxidants useful for treating skeletal muscle atrophy? Free Radic Biol Med. 2009; 47(7):906–916.
3. Novelli G. P. et al. Vitamin E protects human skeletal muscle from damage during surgical ischemia-reperfusion. Am J Surg. 1997; 173(3):206–209.
**Publicado en el BOLETIN NUTRI-FACTS( Mayo 2011)
En el estudio observacional se midieron las concentraciones en suero de las dos formas principales de vitamina E (α-tocoferol y γ-tocoferol) en 148 mujeres de 65 años o más con fracturas de cadera (1). La relación entre la concentración de vitamina E y la función fisiológica (medida con pruebas como el test de marcha en seis minutos) se calculó en las pacientes dos semanas antes de la fractura de cadera (según la información facilitada por las participantes) y también a los dos, a los seis y a los doce meses posteriores a la fractura. Los resultados del estudio mostraron que las altas concentraciones de vitamina E antes y después de la fractura de cadera se relacionan con unas mejores funciones fisiológicas. Esta relación con las funciones fisiológicas se da de forma más significativa con la forma α-tocoferol que con la forma γ-tocoferol.
En cuanto a los posibles mecanismos que causan esta relación, los investigadores observaron que la vitamina E podría tener efectos beneficiosos en la función fisiológica de pacientes con fractura de cadera porque reduce el excesivo estrés oxidativo que resulta del trauma de la fractura de cadera y su posterior reparación quirúrgica. Está demostrado que el estrés oxidativo daña el tejido muscular, y los antioxidantes como la vitamina E podrían evitar problemas en las funciones fisiológicas causados por músculos dañados (2). La vitamina E podría tener una especial importancia para los músculos, ya que se ha descubierto que la suplementación con α-tocoferol reduce el daño muscular durante la cirugía (3). Las propiedades antioxidantes de la forma α-tocoferol podrían ser la razón por la que dicha forma de la vitamina E está por lo general más relacionada con las funciones fisiológicas que la forma γ-tocoferol.
Los investigadores opinan que los adultos de edad avanzada con un alto riesgo de fractura de cadera así como aquellos que se están recuperando de dicha lesión podrían beneficiarse del consumo de vitamina E. Sin embargo, estos hallazgos deberán confirmarse en ensayos clínicos antes de que se pueda recomendar un alto consumo de vitamina E a los pacientes con fractura de cadera.
1. D’Adamo C. R. et al. Serum vitamin E concentrations and recovery of physical function during the year after hip fracture. J Gerontol A Biol Sci Med Sci. 2011.
2. Bonetto A. et al. Are antioxidants useful for treating skeletal muscle atrophy? Free Radic Biol Med. 2009; 47(7):906–916.
3. Novelli G. P. et al. Vitamin E protects human skeletal muscle from damage during surgical ischemia-reperfusion. Am J Surg. 1997; 173(3):206–209.
**Publicado en el BOLETIN NUTRI-FACTS( Mayo 2011)
Greater awareness needed on risks that Addison’s disease poses to patients
Two new studies presented at the European Congress of Endocrinology in Rotterdam show the possible dangers facing patients with Addison’s disease are higher than previously thought. The new research shows that Addison’s patients, who have low levels of cortisol produced by the adrenal glands, are more likely to get infections which may provoke life-threatening adrenal crises.
Addison’s disease is caused by low levels of the hormone cortisol, produced by the adrenal glands. Without treatment, the condition can be fatal. Patients with Addison’s disease can suffer a range of symptoms, including fatigue, dizziness, weight loss, muscle weakness, mood changes and the darkening of regions of the skin if they don’t receive treatment. The most famous Addison’s disease sufferer was John F Kennedy, but it is a comparatively rare condition, affecting about 1 person in 15,000.
Dr Stefanie Hahner, working at University of Würzburg, Germany, looked at the incidence of adrenal crisis in 472 German patients with Addison’s disease. An adrenal crisis is a potentially life-threatening condition which occurs when cortisol levels fall dangerously low, requiring an immediate injection of hydrocortisone. Dr Hahner found that 62 of the patients had an adrenal crisis over the two-year period of the prospective study, with almost two-thirds of those needing to be hospitalised and 9.5% being treated in intensive care. Two patients died from adrenal crises during the study. The study also found that many patients were unprepared to deal with the threat to life presented by crises and further patient education programmes may be warranted.
-Researcher Dr Stefanie Hahner said :
“The number of adrenal crises was higher than we expected from previous studies. Infectious disease provoked 39% of the crises, with psychological stress also causing problems. Ninety-five percent of the patients were aware of the dangers of an adrenal crisis, but only 28% had the emergency injection set. This shows that these crises are largely caused by infectious diseases and stress, but also that patients need to be better prepared to respond to the crises when they arise and that infectious disease has to be treated early and aggressively in this patient group.”
In another study presented at the European Congress of Endocrinology from the University of Utrecht, The Netherlands, Dr Lisanne Smans showed that patients with Addison’s disease were more at risk of suffering infections than the rest of the population.
She identified 390 Addison’s patients from pharmacy records and compared the risk of infections and hospital admissions. Dr Smans found that the risk of infectious disease was 1.5 times that of a control population, (overall incidence rate of 59.2/100 person-years). In addition, Addison’s patients were significantly more likely to be hospitalised for infectious disease than control groups (3.8/100 person years for Addison’s patients, versus 0.8/100 person years for control groups).
-Researcher Dr Lisanne Smans commented:
“We need to raise awareness amongst doctors and patients of the risk of infections in Addison’s patients compared to the general population. We now want to move on to see whether influenza vaccinations can help this patient group.”
-Commenting on the two papers, Professor Peter Trainer, Chair of the European Congress of Endocrinology Programme Organising Committee, said
“These studies reinforce our knowledge of the risks that infections pose to patients with Addison’s disease and serious consequences that can arise. We need to look at ways of making both the medical community and patients more aware of the appropriate medical action needed to treat an adrenal crisis. This really is a case where quick action can save lives. All patients with Addison’s disease should carry an emergency kit containing a hydrocortisone injection that can be given immediately if they fall ill.”
Addison’s disease is caused by low levels of the hormone cortisol, produced by the adrenal glands. Without treatment, the condition can be fatal. Patients with Addison’s disease can suffer a range of symptoms, including fatigue, dizziness, weight loss, muscle weakness, mood changes and the darkening of regions of the skin if they don’t receive treatment. The most famous Addison’s disease sufferer was John F Kennedy, but it is a comparatively rare condition, affecting about 1 person in 15,000.
Dr Stefanie Hahner, working at University of Würzburg, Germany, looked at the incidence of adrenal crisis in 472 German patients with Addison’s disease. An adrenal crisis is a potentially life-threatening condition which occurs when cortisol levels fall dangerously low, requiring an immediate injection of hydrocortisone. Dr Hahner found that 62 of the patients had an adrenal crisis over the two-year period of the prospective study, with almost two-thirds of those needing to be hospitalised and 9.5% being treated in intensive care. Two patients died from adrenal crises during the study. The study also found that many patients were unprepared to deal with the threat to life presented by crises and further patient education programmes may be warranted.
-Researcher Dr Stefanie Hahner said :
“The number of adrenal crises was higher than we expected from previous studies. Infectious disease provoked 39% of the crises, with psychological stress also causing problems. Ninety-five percent of the patients were aware of the dangers of an adrenal crisis, but only 28% had the emergency injection set. This shows that these crises are largely caused by infectious diseases and stress, but also that patients need to be better prepared to respond to the crises when they arise and that infectious disease has to be treated early and aggressively in this patient group.”
In another study presented at the European Congress of Endocrinology from the University of Utrecht, The Netherlands, Dr Lisanne Smans showed that patients with Addison’s disease were more at risk of suffering infections than the rest of the population.
She identified 390 Addison’s patients from pharmacy records and compared the risk of infections and hospital admissions. Dr Smans found that the risk of infectious disease was 1.5 times that of a control population, (overall incidence rate of 59.2/100 person-years). In addition, Addison’s patients were significantly more likely to be hospitalised for infectious disease than control groups (3.8/100 person years for Addison’s patients, versus 0.8/100 person years for control groups).
-Researcher Dr Lisanne Smans commented:
“We need to raise awareness amongst doctors and patients of the risk of infections in Addison’s patients compared to the general population. We now want to move on to see whether influenza vaccinations can help this patient group.”
-Commenting on the two papers, Professor Peter Trainer, Chair of the European Congress of Endocrinology Programme Organising Committee, said
“These studies reinforce our knowledge of the risks that infections pose to patients with Addison’s disease and serious consequences that can arise. We need to look at ways of making both the medical community and patients more aware of the appropriate medical action needed to treat an adrenal crisis. This really is a case where quick action can save lives. All patients with Addison’s disease should carry an emergency kit containing a hydrocortisone injection that can be given immediately if they fall ill.”
Blood test markers link polycystic ovary syndrome with cardiovascular risk
A new study presented at the European Congress of Endocrinology shows that women with polycystic ovary syndrome (PCOS) show higher levels of blood markers associated with cardiovascular disease (CVD) than control groups. These markers show up during a woman’s earlier life, but might indicate a greater CVD markers show up during a woman’s earlier life, but might indicate a greater CVD risk in later life.
PCOS is a common ailment, affecting between 5-10% of women of reproductive age, meaning that there are millions of PCOS sufferers in Europe. Symptoms vary, but women with PCOS can suffer from ovarian cysts, irregular (or missing) periods, acne, higher than normal androgen levels and excess facial and body hair. PCOS may be associated with obesity and/or insulin resistance and is also one of the main causes of female infertility.
Past studies have shown no conclusive link between PCOS and these risk markers. Doctors can test for cardiovascular risk markers during the normal reproductive period of a woman’s life. These markers don’t directly predict cardiovascular risk, but higher levels of these markers are associated with cardiovascular risk in the future. This means that women with raised levels of these markers will, in later years, tend to have a higher rate of cardiovascular disease than is found in the general population.
Working at the Aristotle University of Thessaloniki, Greece, Dr Konstantinos Toulis and co-workers Assistant Professor Dimitrios Goulis and Professor Basil Tarlatzis, carried out a major ‘study of studies’ (meta-analysis) on risk markers for cardiovascular disease in women with PCOS.
They reviewed 130 previous studies, involving in total 6260 women with PCOS and 4546 controls. They looked at whether the levels of biochemical blood markers for CVD differed in women with PCOS compared to controls. They found that 7 of the 10 markers they looked at were elevated in women with PCOS (see table below), meaning that these women might be more susceptible to developing heart disease.
As yet the researchers don’t know if these elevated risk markers lead directly to a higher level of heart disease in PCOS women, but this is the next thing they hope to investigate.
-Researcher Dr Konstantinos Toulis said:
“This analysis shows that increased levels of risk markers for cardiovascular disease are firmly associated with PCOS. PCOS is a difficult condition to study, because the range and severity of symptoms vary so much that it has been difficult to draw conclusions. Recently an expert panel1 reviewed the evidence and concluded that women with PCOS did seem to have an elevated risk of cardiovascular disease in later life. This meta-analysis of biochemical markers shows that the CVD risk factors are present in earlier life, and that they seem to be independent of other factors which can lead to cardiovascular disease in later life, such as obesity. The association between CVD risk and CVD markers depends on the nature of the individual marker and the magnitude of the difference; this, plus the fact that there are several of these biochemical markers raised, is what makes this a potential warning.
“Cardiovascular disease is the number one cause of death for women in the western world, and as so many women suffer from PCOS, then any increase in cardiovascular disease risk may translate into later problems for an appreciable amount of women. We need to remember that at the moment this is just an association between the biochemical markers and cardiovascular disease in PCOS women, rather than proof of a cause and effect. We do need to follow this up by looking at women with PCOS and cardiovascular disease, and seeing if they had shown higher levels of the risk markers.”
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