Drexel University College of Medicine Women’s Health Education Program
Women’s Health News
Mediterranean Diet Helps Women's Hearts: Study Shows
Reduction in Stroke and Heart Risk With Mediterranean Diet
By Caroline Wilbert
WebMD Health News
Feb. 16, 2009 -- Pass the olive oil,
please. There's more good news
today for people who eat a traditionally Mediterranean diet. American
women whose diets are high in
monosaturated fat, plant proteins,
whole grains, and fish are significantly less likely to develop heart
disease and stroke, according to a
study published in Circulation.
Researchers looked at data on
74,886 women who participated in
the Nurses' Health Study between
1984 and 2002. The women were
between the ages of 38 and 63 in
1984. During 20 years of follow-up,
women whose diets most closely
matched the Mediterranean diet had
a 29% reduced risk of heart disease
and a 13% reduced risk of stroke.
The Mediterranean-style eaters
also had a 39% reduced risk of
dying from either heart disease
or stroke. These risk reduction
statistics are comparable to those
associated with taking cholesterol-lowering medications
called statins. Shifting to a
Mediterranean-style diet means
getting more protein from plant
sources, such as beans and nuts,
instead of meat. Fish should be
eaten once a week, while red
meat should only be eaten once
or twice a month. Researchers
note that Americans may take a
slightly different approach to the
diet, which is traditional in
Greece and Southern Italy. For
instance, in those countries, olive
oil, high in monosaturated fat, is
the primary cooking oil and is
even used for dipping bread at
the table (instead of butter). In
the U.S., Mediterranean-style
dieters may get more monosaturated fat from canola oil or peanut butter. "I think the Mediterranean diet is by far one of the
easiest to follow because there
are no extremes," researcher
Teresa T. Fung, says in a news
release. Fung is associate professor at Simmons College and
adjunct associate professor in
nutrition at the Harvard School
of Public Health. "It does not
require you to cut out something or eat only a few number
of foods. The types of food
common to the Mediterranean
diet are pretty easy to get as
well. It has a good amount of
plant oils, so you are not cutting out fats."
History of Women in Medicine: Clara Barton
Born on
December
25, 1821
in Oxford,
Mass., the
y oungest
of 5 children in a
middleclass family, Barton was educated at home, and at
15 started teaching school. Her
most notable antebellum achievement was the establishment of a
free public school in Bordentown,
N.J. Though she is remembered as
the founder of the American Red
Cross, her only prewar medical
experience came when for 2 years
V O LU M E 5 , I S S U E 3
she nursed an invalid brother. In
1861 Barton was living in Washington, D.C., working at the U.S.
Patent Office. When the 6th Massachusetts Regiment arrived in the
city after the Baltimore Riots, she
organized a relief program for the
soldiers, beginning a lifetime of
philanthropy.
When Barton
learned that many of the wounded
from First Bull Run had suffered,
not from want of attention but
from need of medical supplies,
she advertised for donations in the
Worcester, Mass., Spy and began
an independent organization to
distribute goods. The relief operation was successful, and the following year U.S. Surgeon General
William A. Hammond granted her
M A RCH 2 009
a general pass to travel with
army ambulances "for the purpose of distributing comforts for
the sick and wounded, and nursing them." For 3 years she followed army operations throughout the Virginia theater and in
the Charleston, S.C., area. Her
work in Fredericksburg, Va.,
hospitals, caring for the casualties from the Battle of the Wilderness, and nursing work at
Bermuda Hundred attracted national notice. At this time she
formed her only formal Civil
War connection with any organization when she served as superintendent of nurses in Maj. Gen.
Benjamin F. Butlers command.
She also expanded her concept
of soldier aid, traveling to
Camp Parole, Md., to organize
a program for locating men
listed as missing in action.
Through interviews with Federals returning from Southern
prisons, she was often able to
determine the status of some
of the missing and notify
families. By the end of the
war Barton had performed
most of the services that
would later he associated with
the American Red Cross,
which she founded in 1881. In
1904 she resigned as head of
that organization, retiring to
her home at Glen Echo, outside Washington, D.C., where
she died 12 Apr. 1912.
V O LU M E 5 , I S S U E 3
P A GE 2
Racial Gap in Cancer Deaths Almost Unchanged Since 1981
The gap in cancer mortality rates between
blacks and whites remains as wide as it
was in 1981, even though cancer death
rates have dropped among all groups,
according to an American Cancer Society
study released on Wednesday, USA Today
reports. According to the report, blacks
are more likely to develop cancer and to
die from the disease than any other racial
group. Black patients also live a shorter
time after diagnosis than other groups.
According to the study, black women are
16% more likely to die from the disease
than white women, compared with 14% in
1981. Cancer death rates among black
men are 33% higher than among whites -a rate that is almost unchanged since
1981, the study found. However, accord-
ing to the study, the overall
death rate among black men
has decreased faster than
among white men because
fewer black men are dying
from lung and prostate tumors. Study co-author Ahmedin Jemal said that blacks
are more likely to live in poverty and have
lower education levels compared with
whites. Cancer mortality among black and
white patients with at least a high school
education was twice the rate of patients
who had a college education, according to
the study, but the rate remained higher
among blacks even when they had the
similar educational backgrounds as
whites. The study also found that blacks
are less likely to undergo screening
for colorectal cancers and are more
likely to be overweight and less
active than whites, which contributes
to an increased risk for developing
cancer. Peter Bach of the Memorial
Sloan-Kettering Cancer Center, who
was not involved in the study, said
advanced-stage diagnoses are more common among blacks than whites, and they
also are less likely to receive high-quality,
timely treatment that could make a difference in their survival rate. Bach said the
study suggests that reducing racial disparities in cancer needs a "global approach" that
deals with each of the factors that contribute
to the cancer mortality rate among blacks
(Szabo, USA Today, 2/18).
Central-Line-Associated MRSA Infections Declined by 50%
in Hospital Intensive Care Units Over 10 Years
The rate of intravenous tuberelated methicillin-resistant
Staphylococcus aureus infections in hospital intensive care
units dropped by nearly 50%
over 10 years, according to a
recent CDC report published on
Wednesday in the Journal of
the American Medical Association, the Los Angeles Times reports. For
the report, CDC researchers examined the
rate of IV tube-related infections of
MRSA in more than 1,600 ICUs from
1997 to 2007 (Engel, Los Angeles Times,
2/18). Researchers found that in 1997
there were an estimated 43 MRSA infections per 100,000 ICU patients who were
hooked up to IV tubes for at least one day,
compared with the 2007 rate of 21
MRSA infections per 100,000
ICU patients with the tubes. Researchers also found that rates of
more treatable staph infections in
ICUs declined during the 10-year
study period. Researchers attributed the declines to increased
prevention efforts -- frequent
hand-washing, instrument sterilization and
other measures -- by physicians and
nurses. Researchers also found that during the 10-year period, MRSA became a
more common cause of the ICU infections
examined than more easily treated staph
infections. Nearly 2,500 MRSA infections
were linked to IV tubes during the time
period, accounting for nearly 8% of all
bloodstream infections associated with the
IV tubes. More treatable types of staph infections accounted for less than 5%. Lead
author Deron Burton of CDC said despite
the study's limitations, "We think that this is
still a very important success story." In an
editorial that accompanied the report, Michael William Climo, an infectious disease
specialist at a Hunter Holmes McQuire
Veterans Affairs Medical Center in Richmond, Va., wrote that the report shows substantial, but limited progress because
MRSA became a more common cause of
the ICU infections examined than more
easily treated staph infections. In addition,
the study only examined MRSA infections
in ICUs, not in all hospital departments
(AP/Chicago Sun-Times, 2/18).
Medical Care, Services Have Improved for Immigrant Children
Medical care and other services since
2003 have improved for immigrant children held after arriving in the U.S. without
parents or guardians, but some of those
children continue to face inadequate services, according to a report released on
Wednesday by the Women's Refugee
Commission and Orrick, Herrington &
Sutcliffe, the AP/Kansas City Star reports.
For the report, researchers visited more
than 30 facilities in Arizona, California,
Florida, Indiana, New York, Oregon,
Pennsylvania, Texas, Virginia and Washington state between April 2007 and February 2008 to examine the effects of a 2003
change in the federal system for oversight
of such children. In 2007, authorities apprehended more than 90,000 such children
along the southern U.S. border, with about
8,000 of those placed in U.S. custody and
transferred to the HHS Division of Unaccompanied Children's Services, a program
established in 2003; previously, the Immigration and Naturalization Service held
such children. According to the report, since
2003 such children have received improved
medical care, psychological treatment and
education. However, among other problems,
such children have limited access to therapeutic programs for gang violence, sexual
abuse or abandonment, according to the report. Michelle Brane of the Women's Refugee Commission said, "These kids are really
traumatized," adding, "It's a challenge to
provide them with services" (Garay,
AP/Kansas City Star, 2/4).
W OM EN ’ S H E A L TH N E W S
P A GE 3
Truth Be Told: What teens don't know about contraceptives
could hurt them
By Maggie Koerth-Baker for MSN Health
& Fitness
Peanut butter. Plastic bags. Mountain
Dew. You might not think they have a lot
in common but, according to Michelle
Blomgren’s former classmates, all three
are methods of birth control. If that
sounds ridiculous, don't worry. It is. None
of those things will help prevent pregnancy. Even Blomgren, an 18-year-old
who lives in Rockville, Ill., knew better.
But rumors like these spread like wildfire
at her old high school, she says, and many
teenagers she knew bought into even the
most outlandish ideas. To be fair, people
have been accepting (and spreading) incorrect information about birth control
since there was any information to spread.
But, as sex has become less taboo in
American culture, it should be relatively
simple to get the facts. Unfortunately, this
isn't necessarily true. "Our sex-saturated
society bombards teens with sexual images every day," says Dr. Vanessa
Cullins, vice president of medical affairs
for the Planned Parenthood Federation of
America, "but it doesn't always give teens
the tools they need to protect their health
and their futures, such as comprehensive
sex education." In fact, in some cases,
young people aren't even getting accurate
information in sex education classes.
Blomgren says that the climate of misin-
formation among her classmates was only
made worse by fallacies spread by her
teachers. "I attended a Lutheran school my
freshman year and in health class we were
taught that condoms were only 60 percent
effective when used properly," she says.
"We were taught that there was no birth
control out there that was over 80 percent
effective." "That is just absolutely false,"
Dr. Cullins says. Even with typical use—
that is, even when couples use them incorrectly—condoms are effective about 85
percent of the time. When used correctly,
they are 98 percent effective. And hormonal birth control, like the pill, can be 92
percent to 98.7 percent effective, depending on how well it's used. Plus, condoms
protect you from STDs as well. They offer
nearly 100 percent protection against
HIV/AIDS and significantly reduce the
risk of transmitting other STDs. This disparity in what teenagers know about sex
and what they know about safe sex is further complicated by fears of being caught
and sometimes-confusing ideas about what
counts as "good" behavior. Dr. Donnica
Moore, a multimedia women's health educator, says that homemade birth control
methods, like peanut butter, might appeal to
teens simply because there's no stigma
associated with buying it. "Girls have all
kinds of negative ideas about carrying a
condom," she says. "They think it's OK to
have sex, but only if you haven't planned
for it ahead of time. They seem to think that
if you carry a condom, it means you're a
slut." According to Cullins and Moore, the
only way to counteract all the bad information and crippling embarrassment is to improve sex education. If we're really serious
about preventing teen pregnancies and the
spread of sexually transmitted diseases,
they contend, it's vitally important for today's teenagers to have access to literature
and lessons that cover more than just the
reasons not to have sex and provide information about more than just one or two
forms of protection. If that's not available,
they say that teens—ideally with help from
their parents—should work to educate
themselves. Moore recommends the book
Our Bodies, Ourselves and Cullins suggests
checking out Planned Parenthood's Web
site.
Genes Help Cancer-Linked Viruses Elude Immune System:
Pathogens such as HPV tweak their DNA to escape detection, study suggests
TUESDAY, Feb. 10 (HealthDay News) -The DNA of cancer-related viruses may
actually change to disguise themselves
from the immune system, a new study has
found. An international team of scientists
studied the entire genomes of three common viruses -- Epstein-Barr, the human
papilloma virus (HPV) and
hepatitis B. Each of these
pathogens can progress
into cancer -- for example,
HPV is strongly linked to
cervical tumors, and hepatitis B has been tied to liver
cancer. About 15 percent
of all cancer cases worldwide are linked to
a viral infection. The researchers found
that the genomes were generally similar
between people who had the virus but no
symptoms, those with the disease caused
by the virus, and those who developed the
virus-related cancer. However, the epigenome -- a layer of biochemical
reactions that turns genes on
and off -- appeared much different, with the virus increasingly experiencing methylation
in patients who had developed
cancer. According to the researchers, methylation (an en-
zyme-mediated modification to DNA)
may prove to be a type of camouflage to
help the virus elude the body's natural
defense system. The findings were published online in Genome Research. "This
a very exciting result that can explain why
some of these viruses can survive for such
prolonged times in our body," senior author Manel Esteller, of the Bellvitge Institute for Biomedical Research (IDIBELL)
in Barcelona, said in a news release issued
by the journal. DNA methylation could
possible serve as a disease biomarker or as
a route to attack the viruses and their associated diseases, Esteller said.
The Women’s Health Education Program
Drexel University College of Medicine
Women’s Health Education Program
Women’s Health Education Program
Drexel University College of Medicine
2900 Queen Lane, Room 228
Philadelphia, PA 19129
Phone: 215-991-8450
Fax: 215-843-0253
http://www.drexel.edu/whep
Women’s Health
Seminar Series
Held Tuesday
Evenings,
5:30PM—7:00PM
SAC B,
Queen Lane Campus
and videoconferenced to the New
College Building
(refreshments are served
at both sites)
Open to anyone
interested in attending.
For more information, please visit
our office, call, or email.
Begun in 1993 as a vanguard innovative educational center to address holistic, contextual
comprehensive care to women and girls, the Women’s Health Program of Drexel University
College of Medicine is part of a nationally designated Center of Excellence in Women’s
Health. In addition to curricular efforts, community health outreach programming, and community participatory health services research, WHEP maintains an existing resource listing
that includes articles, books, videotapes, and journals, that address sex and gender medicine.
If you’re interested in more information, please see our resources on the WHEP website at
http://webcampus.drexelmed.edu/whep/index.html
If you’re looking for information about girls’ or women’s health topics; information about
health fairs or community activities or health education research; or just information about
our bulletin boards or how to get involved, please stop by and visit us at room 228 Queen
Lane, or call/email us anytime for more information.
Growth of clinical trial outsourcing raises issues
(CNN) -- The practice of moving
research involving human subjects from wealthy countries to
less wealthy countries has grown
in recent years, raising a number
of ethical and scientific issues
that need to be addressed, researchers said in a journal article
Wednesday. "The question is
proportionality," said Dr. Kevin
Schulman, director of the Center
for Clinical and Genetic Economics at Duke University
Medical Center in Durham,
North Carolina, and one of the
study authors. "We should test
products where we are going to
market them. The populations
who take risks to participate in
clinical research should be the
ones that we anticipate will get
the benefits of the research." He
and his co-authors reported in
the NEJM that in November
2007, about one-third of clinical
trials (157 of 509) were being
carried out entirely outside the
United States, many of them in
developing countries. Between
1995 and 2005, the number of
countries where such trials were
being carried out more than doubled, while the number in the
United States and Western
Europe decreased, the researchers at Duke University said. The
shift appears to have been driven
at least in part by economics -- a
top medical center in India
charges about a tenth what a
second-tier U.S. medical center
would charge per case report, the
authors said. Another incentive
to move such work abroad: other
countries' regulatory environments can be less burdensome.
The authors reported one study
that found only 56 percent of
670 researchers surveyed in
developing countries said their
work had been reviewed by a
local institutional review board
or a health ministry. Another
study reported that 18 percent
of published trials carried out
in China in 2004 adequately
discussed informed consent for
subjects considering participating in research. In addition,
recruitment of study subjects
can be easier in developing
countries, where a trial subject
may get more than a year's pay
to participate or participation
could be his or her sole means
of being able to get treatment,
the authors said. Transparency
is yet another issue. "We know
little about the conduct and
quality of research in countries
that have relatively little clinical research experience," they
wrote. Schulman put it more
bluntly. "We've seen problems
with people cheating on clinical trials," he said.
He acknowledged that similar problems have arisen in the United
States, but said such misdeeds
were less likely to be found out
when they happened abroad.
Of critical importance is the
fact that some populations'
genetic makeup may affect
their response to medication,
the authors said. For example,
they said, some 40 percent of
people of East Asian origin
have a genetic trait that impairs
ethanol metabolism and limits
response to nitroglycerin treatment. "This finding may affect the relevance of trials involving cardiac, circulatory and
neurologic disorders that are
treated with nitroglycerin or
nitric oxide-dependent therapies," they said. The authors
called for regulations governing trials to be reduced while
ensuring ethical conduct, for
greater use of centralized
oversight boards and for research contracts to be written
using standardized terms.
"Key strategies for clinical
trials should be outlined in
formal clinical-development
plans, publicly vetted, and
submitted to regulatory agencies," they said. Alan Goldhammer, VP for scientific and
regulatory affairs at the Pharmaceutical Research and
Manufacturers of America,
said the industry will study the
suggestions and weigh
whether to incorporate them.
"We're constantly taking a
fresh look at all our documents and revising them as
appropriate," he said. "The last
thing any company wants to
have happen is for a trial site
to be called into question and
that data then not used for
review by the regulatory
agency, which could put its
approval status in limbo." The
matter has gained in importance with the announcement
by the Obama administration
that the government will carry
out tests to determine which
drugs work best. A spokeswoman for the FDA, who said
she could not be identified
because she had not sought
permission to talk to the news
media, said the agency has
begun training and educating
regulators in countries where
clinical trials are being carried
out for companies that are
seeking U.S. approval for their
drugs.