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Older mums at birth of last child and exceptional longevity

Women who had their children later in life will be happy to learn that research suggests an association between older maternal age at birth of the last child and greater odds for surviving to an unusually old age.  

In the study which used Long Life Family Study data, 311 women who survived past the oldest fifth percentile of survival (according to birth cohort-matched life tables) were identified as cases, along with 151 women who died at ages younger than the top fifth percentile of survival who were identified as controls. Looking at the cases of all 462 women, the study found a significant association for older maternal age, whereby women who had their last child beyond age 33 years had twice the odds for survival to the top fifth percentile of survival for their birth cohorts compared with women who had their last child by age 29 years. More specifically, women between the ages of 33 and 37 having their last child had an odds ratio of 2.08. The odds ratio for older women was 1.92.

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Why you need olive oil on your salad

A diet that combines unsaturated fats with nitrite-rich vegetables, such as olive oil and lettuce, can protect you from hypertension, suggests a new study led by King's College London. The findings, published in the journal PNAS, help to explain why some previous studies have shown that a Mediterranean diet can reduce blood pressure.

The Mediterranean diet typically includes unsaturated fats found in olive oil, nuts and avocados, along with vegetables like spinach, celery and carrots that are rich in nitrites and nitrates.

When these two food groups are combined, the reaction of unsaturated fatty acids with nitrogen compounds in the vegetables results in the formation of nitro fatty acids.

The study used mice to investigate the process by which these nitro fatty acids lower blood pressure, looking at whether they inhibited an enzyme known as soluble Epoxide Hydrolase which regulates blood pressure.

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Premature ovarian failure - genetic cause

The disorder, affects about 1 percent of women and results in infertility due to premature ovarian failure.

The study demonstrates for the first time that mutation in STAG3 gene is the major cause of human fertility disorders as it provokes a loss of function of the protein it encodes.

STAG3 encodes a meiosis-specific subunit of the cohesin ring, the biological process through which, from a diploid somatic cell, a haploid cell or gamete is produced. Cohesins are protein complexes that bind two straps of DNA and are implicated in its repair, replication and recombination, as well as in its chromosomal stability, transcription regulation, stem-cell pluripotency, and cell differentiation.

Alberto M. Pendás, CSIC researcher at the Cancer Research Center (USAL/CSIC), states: "Our work enables us to causally relate mutations in a gene of the cohesin complex with human infertility. It also demonstrates for the first time in humans that POF and azoospermia, a disorder that impedes normal sperm production, are probably the two faces of the same genetic disease".

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Postmenopausal calcium and vitamin D improve cholesterol

Calcium and vitamin D supplements after menopause can improve women's cholesterol profiles. And much of that effect is tied to raising vitamin D levels, finds a new study from the Women's Health Initiative (WHI) published online in Menopause.[1]

Whether calcium or vitamin D can indeed improve cholesterol levels has been debated. And studies of women taking the combination could not separate the effects of calcium from those of vitamin D on cholesterol. But this study, led by NAMS Board of Trustees member Peter F. Schnatz, DO, NCMP, is helping to settle those questions because it looked both at how a calcium and vitamin D supplement changed cholesterol levels and how it affected blood levels of vitamin D in postmenopausal women.

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Menopause for Medical Students

Essential menopause curriculum for medical students 
Position Statement from European Menopause and Andropause Society (EMAS)

The menopause, or the cessation of the menstrual cycle, is the result of ovarian aging and is a natural event experienced by most women in their late 40s or early 50s. With increasing longevity the menopause can now be considered to be a midlife event. Thus managing postmenopausal health is a key issue for all health professionals, not just gynaecologists.

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Ovarian cancer under the spotlight

woman with bloat painEach year more than 1200 Australian women are diagnosed with ovarian cancer. The main risk factor for ovarian cancer is getting older. Over 80 per cent of women diagnosed are over 50 years of age but ovarian cancer can occur at any age. 

Ovarian cancer can be difficult to diagnose at an early stage, largely because symptoms can be vague and similar to those of other common illnesses. 

But most women diagnosed with the disease experience symptoms, it is simply that they do not link them to cancer.

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Variation in worldwide usage of FRAX

One of the most important advances in osteoporosis management of the past decade has been the advent of fracture risk assessment algorithms. Today, rather than relying on bone mineral density values alone, doctors use tools such as FRAX, a widely available calculator, to help identify patients in need of treatment.

A new position paper by the International Osteoporosis Foundation (IOF) Epidemiology and Quality of Life Working Group has assessed the uptake of FRAX worldwide. The study concludes that there were approximately 2.3 million FRAX calculations during a one-year period beginning in May 2012, with enormous variation in worldwide usage.

What is FRAX?

FRAX (WHO Fracture Risk Assessment Tool) calculates an individual's 10-year probability of a major osteoporotic fracture based on clinical risk factors. It integrates the weight of clinical risk factors for fracture and mortality risk, with or without information on bone mineral density (BMD) values. Each calculator is country specific, calibrated to the national epidemiology of fracture and mortality.

Now with specific models for 53 countries, FRAX is widely used by physicians around the world to help assess their patients' fracture risk in the course of a clinical assessment. The use of the tool improves risk assessment compared to the use of BMD alone, allowing physicians to make more informed treatment decisions.

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HRT therapy may increase risk of acute pancreatitis

Women who use postmenopausal hormone replacement therapy (HRT) may be at increased risk of acute pancreatitis, found a new study in CMAJ (Canadian Medical Association Journal).

Acute pancreatitis, a sudden inflammation of the pancreas, has symptoms that range from mild discomfort to severe, debilitating pain and may, in some cases, even lead to death.

Although several case reports have indicated that there may be an association between use of HRT and risk of acute pancreatitis, the evidence from large studies is sparse. To understand whether there is an association, the researchers looked at data on 31 494 Swedish postmenopausal women aged 48 years at the start of the 13-year study from 1997 to 2010. At the start of the study, 13 113 (42%) of the women were current users of HRT, 3660 (12%) were previous users, and the remainder had never used the therapy. Of the current users of HRT, 6795 (52%) used systemic therapy for hot flashes, 4148 (32%) used local therapy for vaginal dryness, and 2170 (16%) used both therapies.

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Dance and virtual reality: A promising treatment for urinary incontinence in elderly women

Virtual reality, dance and fun are not the first things that come to mind when we think of treating urinary incontinence in senior women. However, these concepts were the foundations of a promising study by Dr. Chantal Dumoulin, PhD, Canada Research Chair in Urogynaecological Health and Aging, a researcher at the Institut universitaire de gériatrie de Montréal, and an associate professor in the Physiotherapy Program of the Rehabilitation School at Université de Montréal, and her master's student, Miss Valérie Elliott.

Dr Eling D. de Bruin, Ph.D., researcher at the department of Health Sciences and Technology, Swiss federal Institute of Technology, Zurich, Switzerland collaborated in this study for his expertise in the use of exergame in geriatric rehabilitation. The results of their feasibility study were published in Neurourology and Urodynamics.

For the study, the researchers added a series of dance exercises via a video game console to a physiotherapy program for pelvic floor muscles. What were the results for the 24 participants? A greater decrease in daily urine leakage than for the usual program (improvement in effectiveness) as well as no dropouts from the program and a higher weekly participation rate (increase in compliance).

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