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The case for treating mild hyperthyroidism

Ob/gyns are increasingly being called upon to manage subclinical thyroid disease. In this concluding article of a two-part series, two experts clarify the controversy over when to treat mild hyperthyroidism. Do treat a mildly overactive thyroid in elderly patients, they say, because low bone density and cardiac abnormalities can do substantial harm.

Grand Rounds: Unmasking the many faces of maternal and fetal thrombocytopenia

Although most cases of mild-to-moderate maternal disease are caused by gestational thrombocytopenia and rarely cause problems, the OB is obliged to rule out more serious causes. And for far-less-common fetal disease, these experts help you differentiate the potentially life-threatening fetal alloimmune thrombocytopenia from a benign drop in platelet count.

Infertility patients keep getting younger

While fertility treatments have traditionally been aimed at women in their late 30s and 40s, an increasing number of infertility patients are in their 20s, college educated and aware that they are in their prime years to conceive. Many of these young women are reportedly seeking medical help after trying to conceive for just a few months.

Not all women benefit from access to contraceptives and abortions

A recent report from the Guttmacher Institute has found a "reproductive health gap between poor women and higher-income women." According to the report, unplanned pregnancy rates for poor women have risen 29% since 1994, while the rates for higher-income women dropped 20%-this, despite greater access to contraceptives and legal abortions over the past three decades. Income also seems to have an influence over the timing of abortions: Lower-income women take up to 3 weeks longer than higher-income women to obtain an abortion-a delay that could put poorer women at greater risk.

Do federally funded programs provide misleading abortion info?

It seems so according to a report from tje office of U.S. Rep. Henry Waxman, D-Calif. The report notes that crisis pregnancy centers that are federally funded receive monies funneled through the abstinence-only-until-marriage program. It also found that 87% of these centers provided "false and misleading information about the physical and mental health effects of abortion and exaggerated the medical risks of abortion," reported the American College of Obstetricians and Gynecologists government relations newsletter Inside Scoop (07/21/2006).

CEE doesn't increase Br Ca risk in women without a uterus

Long-term treatment with conjugated equine estrogens (CEE) does not increase the risk of breast cancer in postmenopausal women who have had a prior hysterectomy, but it may increase the likelihood that mammographic screening results would require short-interval follow-up, according to the latest data from the Women's Health Initiative Estrogen-Alone trial.

Prophylactic salpingo-oophorectomy in BRCA1/2 carriers

Prophylactic salpingo-oophorectomy has been widely recommended for women with BRCA1 or BRCA2 mutations based on evidence from retrospective studies that have found a strong protective effect against cancers of the ovary and fallopian tube. Now a new international prospective study that included approximately 1,800 women with germline BRCA1 or 2 mutations has found the procedure reduces the overall risk of ovarian, tubal and peritoneal cancers by 80%.

Vitamin K supplementation reduces bone loss

Oral vitamin K (phytonadione and menaquinone-4) is associated with increased bone mineral density and reduced fracture incidence of up to 80% for hip fractures, according to a meta-analysis. Pooling the results of seven trials with fracture outcomes, researchers calculated an odds ratio favoring menaquinone of 0.40 (95% CI; 0.25–0.65) for vertebral fractures, 0.23 (95% CI; 0.12–0.47) for hip fractures, and 0.19 (95% CI; 0.11–0.35) for all nonvertebral fractures.

No chest x-rays for BRCA1/2 mutation carriers?

The amount of ionizing radiation conferred by an ordinary chest x-ray significantly increases the already high risk of breast cancer in young women with BRCA1/2 germline mutations, according to a recent international retrospective cohort study.

Trastuzumab may cause cardiac toxicity, but effects are usually reversible

In women with HER2-positive metastatic breast cancer, trastuzumab can cause cardiac toxicity, which can be reversed with beta-blockers and ACE inhibitors. Additional trastuzumab treatment can be considered after recovery of cardiac function, according to a study published online August 14 in the Journal of Clinical Oncology.

Women with more body fat at birth have reduced fertility and higher cancer risk as adults

Women who have more body fat at birth do not exhibit ovarian suppression after moderate physical exercise and have higher levels of estradiol as adults compared to women with less body fat, which may reduce fertility and increase cancer risk, according to a study published online August 14 in the Proceedings of the National Academy of Sciences Early Edition.

Radiotherapy cuts recurrence in ductal carcinoma in situ

Radiotherapy after local excision of ductal carcinoma in situ (DCIS) of the breast reduces the risk of local recurrence for up to 10 years, according to results from a European Organisation for Research and Treatment of Cancer trial.