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Postmenopausal Women Should Still Steer Clear of HRT: Task Force: MedlinePlus Health News

Postmenopausal Women Should Still Steer Clear of HRT: Task Force: MedlinePlus Health News

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Postmenopausal Women Should Still Steer Clear of HRT: Task Force

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Tuesday, December 12, 2017
TUESDAY, Dec. 12, 2017 (HealthDay News) -- Yet again, the nation's leading authority on preventive medicine says postmenopausal women should avoid hormone replacement therapy (HRT).
The U.S. Preventive Services Task Force is standing by its original recommendation that women who have already gone through menopause should avoid using female hormones to guard against osteoporosis or diabetes, said task force chairman Dr. David Grossman, a senior investigator at the Kaiser Permanente Washington Health Research Institute in Seattle.
"Basically, the task force concluded there was no overall benefit from taking hormones to prevent chronic conditions," Grossman said. "There are some benefits, but we believe those potential benefits are outweighed by the harms, making this essentially no net benefit overall."
The advisory covers all formulations of hormone replacement therapy, the task force said. The therapy can consist of pills or patches containing either estrogen or an estrogen/progesterone mix.
However, women undergoing menopause can use hormone replacement therapy short-term to treat symptoms such as hot flashes and vaginal dryness, said Dr. Suzanne Fenske, an assistant professor of obstetrics, gynecology and reproductive science with the Icahn School of Medicine at Mount Sinai in New York City.
"Hormone replacement therapy does still have a benefit to women with menopause whose symptoms do not respond to other treatment options," Fenske said. "It really should be used to manage menopausal symptoms, rather than being used for any sort of preventative medicine."
The task force first recommended against hormone replacement therapy for postmenopausal women in 2012. It updates its recommendations every four years to make sure they reflect the latest medical evidence.
In its evidence review, the task force considered results from 18 clinical trials including more than 40,000 women.
All of the evidence suggests that combined estrogen and progesterone increase older women's risk of breast cancer and heart disease, while estrogen alone increases risk of stroke, blood clots and gallbladder disease, the task force said.
Those risks outweigh hormone therapy's benefits in preventing brittle bones and diabetes, the task force concluded.
"When hormone replacement therapy first was brought out on the market in the 1960s, it was touted as a way to keep feminine forever," Fenske said. "Then in the 1980s they began to see there were some potential benefits otherwise, like [preventing] osteoporosis.
"Then the infamous and famous Women's Health Initiative [WHI] study came out, which kind of put the kibosh on hormone replacement therapy," Fenske added.
Results from the WHI trials were published in the early 2000s; the trials were halted early after linking hormone therapy with increased risk of breast cancer, heart disease and stroke.
The updated task force recommendation contains the latest long-term follow-up data from the WHI trials, Grossman said.
"It didn't change our conclusion, but there is new information available that we incorporated into our evidence review," Grossman said.
Dr. Stephanie Faubion, director of the Mayo Clinic Office of Women's Health in Rochester, Minn., took issue with the task force's recommendation.
"I think this report is going to scare women," Faubion said. "Even those who are having symptoms and not excluded from hormone therapy according to this guideline are going to avoid it because they're afraid of it."
For example, the guideline does not apply to women who go through menopause early or prematurely, at age 45 or younger, Faubion said.
"Those women actually have adverse health consequences if they don't use hormone therapy at least until the natural age of menopause," Faubion said.
She said she also takes issue with a blanket recommendation covering all age groups.
"This is a key issue," Faubion said. "If you do break it down by age, there are more clear benefits for women in their 50s than women in their 60s and 70s.
"The task force is trying to make this more black-and-white than it can ever be," Faubion concluded.
Fenske said women in menopause suffering from hot flashes, vaginal dryness and other related symptoms can still safely turn to hormone therapy to ease their discomfort.
There are no clear guidelines for how long a menopausal woman can remain on hormone replacement therapy, or what dose is best for treating menopause symptoms, Fenske said. In large part, doctors are urged to be cautious because of the long-term health risks.
"It should be the smallest dose possible for the shortest period of time necessary," Fenske said.
Women interested in using hormone therapy to treat their menopause symptoms should talk with their doctor, because there is a lot of false and misleading information out there, Fenske said.
The task force recommendation was published online Dec. 12 in the Journal of the American Medical Association.
SOURCES: David Grossman, M.D., M.P.H., pediatrician and senior investigator, Kaiser Permanente Washington Health Research Institute, Seattle; Suzanne Fenske, M.D., assistant professor, obstetrics, gynecology and reproductive science, Icahn School of Medicine at Mount Sinai, New York City; Stephanie Faubion, M.D., director, Mayo Clinic Office of Women's Health, Rochester, Minn.; Dec. 12, 2017, Journal of the American Medical Association
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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First Drug Approved for Rare Condition That Inflames Blood Vessels: MedlinePlus Health News

First Drug Approved for Rare Condition That Inflames Blood Vessels: MedlinePlus Health News

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First Drug Approved for Rare Condition That Inflames Blood Vessels

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By Scott Roberts
Tuesday, December 12, 2017
TUESDAY, Dec. 12, 2017 (HealthDay News) -- Nucala (mepolizumab) has been approved by the U.S. Food and Drug Administration as the first remedy to treat adults with eosinophilic granulomatosis with polyangiitis, a rare autoimmune disease that leads to inflammation of the blood vessels.
Other symptoms of the condition, formerly called Churg-Stress syndrome, include asthma and an overabundance of an infection-fighting white blood cell called an eosinophil. The inflamed blood vessels may affect the lungs, intestines, skin, heart and nervous system.
The condition affects a total of about 11 out of every one million people in United States, the FDA said Tuesday in a news release.
"Patients taking Nucala in clinical trials reported a significant improvement in their symptoms," said Dr. Badrul Chowdhury, director of the FDA's Division of Pulmonary, Allergy and Rheumatology Products.
Nucala, a once-monthly injection, was first approved in 2015 to treat people 12 and older with a certain type of severe asthma, the FDA said. The drug's most common side effects include headache, injection-site reaction, back pain and fatigue.
People who are prone to a "hypersensitive" allergic reaction shouldn't take the drug, and those who are taking an inhaled corticosteroid medication to treat asthma should not abruptly stop the asthma remedy, the agency warned.
Nucala is produced by the British pharma firm GlaxoSmithKline, whose U.S. headquarters are in Warren, N.J.
SOURCE: Dec. 12, 2017 press release, U.S. Food and Drug Administration
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Dinosaurs Dealt With Pesky Ticks, Too: MedlinePlus Health News

Dinosaurs Dealt With Pesky Ticks, Too: MedlinePlus Health News

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Dinosaurs Dealt With Pesky Ticks, Too

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By Robert Preidt
Tuesday, December 12, 2017
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TUESDAY, Dec. 12, 2017 (HealthDay News) -- Dinosaurs probably didn't do "tick checks," but even they had to put up with the blood-sucking critters, a piece of fossilized amber reveals.
Researchers say they've found a 100-million-year-old piece of Burmese amber that contained an extinct type of tick grasping a dinosaur feather.
It's the first direct fossil evidence that ticks fed on dinosaurs, the scientists reported in the Dec. 12 issue of Nature Communications.
"Ticks are infamous blood-sucking, parasitic organisms, having a tremendous impact on the health of humans, livestock, pets and even wildlife. But until now clear evidence of their role in deep time has been lacking," lead author Enrique Penalver, of the Spanish Geological Survey, said in a University of Oxford news release.
The newly discovered tick was dubbed Deinocroton draculi, which translates to "Dracula's terrible tick." It's the oldest species of tick discovered so far, Penalver's group said.
And sorry, "Jurassic Park" fans, the tick is not likely to provide any dinosaur DNA. In fact, all attempts to extract DNA from specimens in amber have failed because DNA has such a short life, the researchers noted.
The feather the tick is grasping is similar in structure to modern-day bird feathers, the findings showed. That makes the fossil the first direct evidence of an early parasite-host relationship between ticks and feathered dinosaurs.
According to study co-author Ricardo Perez-de la Fuente, "The fossil record tells us that feathers like the one we have studied were already present on a wide range of theropod dinosaurs, a group which included ground-running forms without flying ability, as well as bird-like dinosaurs capable of powered flight." Perez-de la Fuente is a research fellow at Oxford University Museum of Natural History.
"So although we can't be sure what kind of dinosaur the tick was feeding on, the mid-Cretaceous age of the Burmese amber confirms that the feather certainly did not belong to a modern bird, as these appeared much later in theropod evolution according to current fossil and molecular evidence," he explained in the news release.
SOURCE: University of Oxford, news release, Dec. 12, 2017
HealthDay
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Will 'AI' Be Part of Your Health-Care Team?: MedlinePlus Health News

Will 'AI' Be Part of Your Health-Care Team?: MedlinePlus Health News

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Will 'AI' Be Part of Your Health-Care Team?

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Tuesday, December 12, 2017
TUESDAY, Dec. 12, 2017 (HealthDay News) -- Artificial intelligence is assuming a greater role in many walks of life, with research suggesting it may even help doctors diagnose disease.
One new study suggests artificial intelligence (AI) might someday detect breast cancer that has spread to the lymph nodes.
Researchers found that several computer algorithms outperformed a group of pathologists in analyzing lymph tissue from breast cancer patients.
The technology was specifically better at catching small clusters of tumor cells -- known as micrometastases.
"Micrometastases can easily be missed during the routine examination by pathologists," said lead researcher Babak Ehteshami Bejnordi, of Radboud University Medical Center in the Netherlands.
But the algorithms "perform very well in detecting these abnormalities," he said.
"I think this is exciting, and will likely be the key element for enhancing the efficiency and quality of pathologists' diagnoses," Bejnordi said.
Clinical pathologists examine samples of body tissue to help diagnose diseases and judge how serious or advanced they are.
It's painstaking work -- and the hope, Bejnordi said, is that artificial intelligence can help pathologists become more efficient and accurate.
The study is the latest to delve into the idea of using artificial intelligence to improve medical diagnoses.
Most of the algorithms in the study were "deep learning"-based, where the computer system essentially mimics the brain's neural networks.
"To build the system," Bejnordi explained, "the deep learning algorithm is exposed to a large dataset of labeled images, and it teaches itself to identify relevant objects."
Dr. Jeffrey Golden is a pathologist at Brigham and Women's Hospital in Boston. He agreed that artificial intelligence holds promise for "making pathologists more efficient."
However, there's a lot of work to be done before that is a reality, said Golden, who wrote an editorial published with the findings.
The study has its limits, he said. The computer-versus-human test was only a simulation exercise -- and not truly reflective of the conditions that clinical pathologists work under.
So it's not really clear how the algorithms would compare against pathologists in the workplace, Golden said.
Plus, there will be practical obstacles to overcome, he added.
At this point, the field of pathology is only beginning to use digital technology, Golden explained.
That's key because for any computer algorithm to work, there have to be digital images of tissue specimens to analyze.
Cost and education -- training pathologists in how to use the technology -- are other issues, Golden pointed out.
For now, one thing seems certain: "Artificial intelligence will never replace the pathologist," Golden said. "But it may improve their efficiency."
The study tested 32 computer algorithms that were developed by different research teams for an international competition. The challenge was to create algorithms that could detect the spread of breast tumor cells to nearby lymph nodes, which is important in estimating a woman's prognosis.
The algorithms were tested against the performance of 11 pathologists, who independently analyzed 129 digitized images of patients' lymph nodes. The doctors were given a time limit to accomplish the task.
In a separate test, the algorithms were pitted against one pathologist who was free of time constraints.
It turned out that some algorithms bested the pathologists who were under time limits. In particular, they outperformed humans when it came to detecting micrometastases.
Even the best-performing pathologist missed 37 percent of cases where the lymph tissue contained only micrometastases, the study found.
Ten of the computer algorithms performed better than that.
However, Golden said, the pathologists were facing obstacles they would not face in the real world.
"The limits were artificial," he said. "We're never in a position where there's a deadline."
And, he noted, the computer was not better than the pathologist who had no time pressure.
Bejnordi acknowledged the study's limitations, and said the technology has to be tested in real-world practice. But in general, he said, the health-care field is increasingly seeing the potential of artificial intelligence.
"We are now at a turning point where computers perform better than clinicians at specific tasks," Bejnordi said.
Another new study tested a computer algorithm for diagnosing diabetes-related eye damage.
In that study, Dr. Tien Yin Wong of Singapore National Eye Center and colleagues found that the algorithm accurately picked up all cases of vision-threatening damage to the retina. It also correctly gave a negative result to 91 percent of people who did not have severe retinopathy.
Both studies were published Dec. 12 in the Journal of the American Medical Association.
SOURCES: Babak Ehteshami Bejnordi, M.S., Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, the Netherlands; Jeffrey Golden, M.D., professor, pathology, Brigham and Women's Hospital, Harvard Medical School, Boston; Dec. 12, 2017, Journal of the American Medical Association, online
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News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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Protecting Your Health From Wildfire Smoke: MedlinePlus Health News

Protecting Your Health From Wildfire Smoke: MedlinePlus Health News

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Protecting Your Health From Wildfire Smoke

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By Robert Preidt
Tuesday, December 12, 2017
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TUESDAY, Dec. 12, 2017 (HealthDay News) -- Fire and smoke from the wildfires raging in Southern California aren't just destroying homes and lives, they're a serious health risk, as well.
The smoke can irritate the eyes, nose, throat and lungs and can cause coughing, wheezing or breathing problems, according to the American Thoracic Society.
The smoke can be especially dangerous to those with lung diseases such as asthma, chronic obstructive pulmonary disease, emphysema and pulmonary fibrosis, the organization said. It's also harmful to people with heart disease, pregnant women, seniors and children.
People in those high-risk groups should ask their doctor about specific precautions, the society advised.
For the general population, suggested actions to gain protections from the wildfire smoke include:
  • Limiting physical activity.
  • Staying indoors with the windows and doors closed. Reduce other sources of indoor air pollution, such as tobacco smoke, wood-burning stoves and frying meat. Do not vacuum anywhere in the house.
  • Using central air conditioners or filters. Setting your home's heater to fan mode may help filter out some smoke particles by recirculating indoor air through the filter.
  • Using air purifiers with HEPA filters. Do not use filters that produce ozone, such as "super oxygenators."
  • Creating a "clean room" in your home. Choose an interior room with fewer doors and windows and, if possible, run an air conditioner or room air cleaner in the room.
  • Keeping windows closed when traveling in a vehicle. Run the air conditioner and set airflow to recirculate.
To help reduce inhalation of airborne particles, the organization suggests a properly fitted mask rated at N95 or greater. A surgical or simple dust mask does not protect against these particles, and none of these masks protects against dangerous gases.
People with lung disease should consider evacuating to areas with better air quality, according to the organization. People with asthma should keep taking their maintenance or controller medications, or discuss an appropriate plan with their doctor.
SOURCE: American Thoracic Society, news release, Dec. 11, 2017
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.