However the push and public perception against HIV has waned somewhat since its discovery in the 1980s and its incidence in developed countries, such as the US and UK has not been much reduced in the past decade. Obviously public health efforts need to be stepped up again.
There were uncertainties about the cause-and-effect relationship of heavy drinking and HIV infection. Researchers weren't sure if alcohol consumption caused HIV via unsafe sex, or whether certain personality traits in individuals, such as sensation-seeking or a disposition to risky behavior in general, would lead to both alcohol use and unsafe sex.
The study, published in the January 2012 issue of the journal Addiction, presents the results of 12 experiments that analyzed this cause-and-effect relationship in a more systematic way.
Researchers collated their results and discovered that alcohol consumption affects decision-making, and that this impact rises with the amount of alcohol consumed.
"In other words, the more you drink, the stronger becomes your intention to engage in unsafe sex," editors wrote in a summary published on the journal's website.
Researchers said unprotected sex is the most important pathway to HIV infection and therefore this research about the impact of alcohol should be included in HIV prevention materials.
The study examined the results of 12 experiments that tested the cause-and-effect relationship between unsafe sex and alcohol consumption, the journal's editors wrote. An increase in blood alcohol level of 0.1 mg/mL resulted in a 5% increase in the likelihood of engaging in unprotected sex, the study concluded.
"This result also helps explain why people at risk often show this behaviour despite better knowledge: alcohol is influencing their decision processes," said Dr. J. Rehm, the study's Principal Investigator.
Lot of evidence exists about the use of acupuncture for nausea and vomiting in pregnancy, but not much is known about the efficacy of acupuncture for other dyspepsia complaints. So, researchers João Bosco Guerreiro da Silva and colleagues from Department of Internal Medicine, Rio Preto Medical College, Sao Jose do Rio Preto, Brazil, conducted a study to observe the effects of acupuncture on symptomatic dyspepsia during pregnancy and to compare this with a group of patients undergoing conventional treatment alone. This study was approved by the Research Ethics Committee of the Federal University of São Paulo, Brazil. The results appeared in Acupuncture in Medicine, scientific journal published by the BMJ group.
A total of 42 subjects in the age group of 15 to 39 years at 15 to 30 weeks of pregnancy and dyspepsia symptoms were chosen for the study. These women were randomly placed into ‘to be treated with acupuncture’ and ‘not to be treated with acupuncture’ groups. Six women dropped out - one in the acupuncture group and five in the control group. Acupuncture was performed once a week, (sometimes twice if necessary) during 8 weeks. Traditional acupuncture, using sterilized stainless steel needles of 40 mm in length and 0.2 mm diameter, was performed respecting the classical acupuncture points including depth of insertion.
During the first trimester, the focus of the treatment is to reduce the likelihood of miscarriage and address any early pregnancy symptoms such as nausea, morning sickness and fatigue.
Acupuncture during the second semester aims to maintain the balance and address many of the common complaints of pregnancy mentioned above.
Acupuncture during the third trimester prepares the body for labour and delivery by relaxing and softening ligaments, aiding cervical dilation, nourishing the body’s ‘’Qi’’ and blood, as well as relieving any muscular pain or discomfort. This is also the time where Acupuncture is used to turn breach babies.
It is recommended to start this treatment as soon as you learn that the baby is in breach position (around 33-36 weeks)
During the whole pregnancy, special attention will be given at diet and lifestyle.
Treatment for labour induction can be given any time after 39 weeks if there are no complications with the pregnancy.
Acupuncture for delayed labour has been used in China for at least 2,300 years, but Acupuncture for labour pain was rarely used because, according to Chinese culture and oriental tradition, women were expected to experience the pain of childbirth! The first occurrence in Chinese medical literature was in 1970 in ‘A barefoot doctor’s manual’ (my first book on Acupuncture),
The manual drew on the practical expertise of local health workers, often self-taught, who went from house to house to administer medical attention in the form of Acupuncture and herbal medicine.
It was around the same time the interest in Acupuncture Analgesia became the focus of much research in Europe and the western world in general.
In 1972 Christian Ehrstroem performed the first Acupuncture delivery in the west in Stockholm.
In 1974 Darras in France reported 20 electro-acupuncture deliveries by primiparea and multiparea. Since then, Acupuncture has rapidly become more popular for women in childbirth, mainly because it is a natural pain-reliever with no harmful side effects for mother or baby. Moreover, women like to feel in control during their labour and delivery, a feeling of which they may be deprived by some of the more potent conventional analgesic techniques used in today’s maternity units.
Acupuncture is also used in ‘difficult’ labour. Difficult labour can result from abnormality of the uterine contractions, cephalo-pelvic disproportion (that is imbalance between the size of the maternal pelvis and the baby’s head), or malposition and malpresentation of the baby.
Acupuncture can be of help in the first of these, but not the others. It is important to note that ‘malposition’ of the baby should not be confused with ‘malpresentation’: the latter occurs when the baby’s bottom (breach); shoulder; face or brows present first as opposed to the head - as in normal cephalic presentation. ‘Malposition’ means incorrect positioning of the head, which includes occipito-posterior position and deflection of the head. Acupuncture can help in ‘malpresentation’, but not ‘malposition!’
Women's health research has suggested postpartum women may need to be screened for tuberculosis (TB).
Researchers at the Health Protection Agency (HPA) and the University of East Anglia in the UK analysed data relating to 192,801 women with a total of 264,136 pregnancies from 460 practices across the UK between 1996 and 2008.
They found the TB rate for postpartum women was significantly higher than in the general population, but there did not appear to be any substantial difference in the likelihood of infection among pregnant females.
However, consultant in public health at the HPA's Respiratory Diseases Department Dominik Zenner said that there "is almost certainly" an increased risk for those carrying a child as well.
"Given our results, targeted screening of pregnant and postpartum women in high-risk groups may be warranted, given that delays in treatment initiation are associated with poorer outcomes for both mothers and their children," he stated.
In a joint study between scientists at the Health Protection Agency (HPA) and the University of East Anglia, researchers analysed data on all women with pregnancies between 1996 and 2008 from the General Practice Research Database.
A total of 192,801 women who had a total of 264,136 pregnancies were included in the study and over the 12 year period of study there were 177 TB cases among this group.
After adjusting for age, region and socio-economic status, post natal women had a significantly higher TB risk outside pregnancy, whereas no significant increase during pregnancy was observed. Overall the researchers calculated that the rate of TB among pregnant and post natal women was 15.4 per 100,000 people, which is significantly higher than the rate outside of pregnancy - 9.1 per 100,000.
Lead author Ibrahim Abubakar, head of TB surveillance at the HPA and Professor of infectious disease epidemiology at the University of East Anglia said: “This study clearly shows that future guidance to healthcare workers, especially midwives and health visitors, should take into account that the risk of TB may be increased during pregnancy or shortly after giving birth.
“Those looking after pregnant and post natal women should be encouraged to look out for the signs and symptoms of the disease, particularly among women in high risk groups such as immigrants from countries with a high burden of TB, as early diagnosis and appropriate treatment is essential. TB is a preventable and treatable condition but, if left untreated, can be life threatening.”
There is no rhyme, reason, or way to predict if a woman will experience lymphedema following surgery or radiation to treat breast cancer. Swelling of the arm, breast, or chest may begin shortly after breast cancer surgery or radiation, but some women experience lymphedema months—or even years—later. According to the American Cancer Society, most women who have had breast cancer do not develop lymphedema, but the many who do can take steps to manage the swelling and pain, which can range from mild to severe.
Lymphedema results when lymph nodes and vessels are removed or scarred during breast cancer surgery. With fewer lymph nodes and vessels, it is more difficult for the upper body to drain lymph fluid. When excess lymph fluid builds up, pain and swelling occurs. Radiation for breast cancer also affects the flow of lymph fluid in the arm, chest, and breast area, and can cause lymphedema.
“Lymphedema is always a risk when a woman has had any lymph nodes removed or radiation for breast cancer,” says Monique Tiffany, R.N., nurse navigator at the Total Care Breast Center at Los Alamitos Medical Center. Tiffany advises women about lymphedema not only as a breast cancer care nurse, but also as a breast cancer survivor. She celebrated being cancer-free for 10 years this month.
Tiffany says she remains aware that lymphedema can still occur, even after a decade. “I still have to think about it if I’m going to get on a plane,” she says. Air travel can cause lymphedema to flare up.
Unfortunately, there is no way to prevent lymphedema prior to breast cancer surgery or radiation. Tiffany recommends that women get measured for a compression sleeve right after surgery, so the sleeve is available if needed. However, a woman newly diagnosed with breast cancer may find information about lymphedema overwhelming on top of everything else she is dealing with, so not all women will have the measurement done until lymphedema becomes an issue.
To manage the pain and swelling immediately after surgery, women are advised to raise the affected arm above heart level two to three times a day for 45 minutes, and to open and close their fist gently to help move lymph fluid out of the arm. Physical therapy and special exercises can help regain full range of motion in the weeks after surgery or radiation. A compression sleeve or special bandaging may be needed when pain and swelling persist.
Because cuts, burns, or bug bites on the affected arm make the body respond with extra lymph fluid, causing or worsening lymphedema, it’s important to avoid these injuries. Wearing gloves while cleaning or gardening, a mitt while handling hot foods, and a thimble while sewing can help prevent cuts and burns. Cuts and scratches on the affected arm need to be treated right away with antibiotic ointment.
Heat can make lymphedema worse, so hot tubs, saunas, or heating pads are on the list of things to avoid, along with harsh soaps, which can dry the skin and make it more prone to cracking.
Lymphedema can seem particularly onerous when it begins several years after breast surgery or radiation. Having to deal with compression sleeves and massaging and elevating the arm comes as a newly inconvenient and unwelcome after-effect of breast cancer treatment.
“Lymphedema can occur at any time,” notes Barbara Stone, physical therapist at MemorialCare Todd Cancer Institute at Long Beach Memorial Medical Center. Stone sees patients at the outpatient Lymphedema Program at Memorial, which is part of the MemorialCare Rehabilitation Institute. The Lymphedema Program is open to anyone in the community who needs treatment for lymphedema.
Stone recently encountered a patient who just developed lymphedema, although her mastectomy was 25 years ago. “She recently began using a walker, and the extra strain on that arm may have caused the excess fluid,” she explains. In another case, a breast cancer survivor developed lymphedema three years after her breast cancer surgery while caring for her ill husband. Helping him up and turning him in bed strained her affected arm, and she developed lymphedema. While lymphedema can’t be cured, it can be treated, even when it occurs long after breast cancer surgery or radiation.
The study indicated that there might be common and treatment-specific ways that cancer therapies negatively affect cancer survivors' mental abilities.
Previous research had suggested that chemotherapy could cause problems with memory and concentration in breast cancer survivors.
To compare the effects of different types of cancer treatment on such mental abilities, Paul Jacobsen, PhD, of the Moffitt Cancer Centre and Research Institute in Tampa, and his colleagues examined 62 breast cancer patients treated with chemotherapy plus radiation, 67 patients treated with radiation only, and 184 women with no history of cancer.
Study participants completed neuropsychological assessments six months after completing treatment and again 36 months later.
The study confirmed that chemotherapy could cause cognitive problems in breast cancer survivors that persist for three years after they finish treatment.
In addition, the investigators found that breast cancer survivors who had been treated with radiation (and not chemotherapy) often experienced problems similar to those in breast cancer survivors treated with both chemotherapy and radiation.
They did not find that hormonal therapy (such as tamoxifen) caused cognitive difficulties.
"These findings suggest that the problems some breast cancer survivors have with their mental abilities are not due just to the administration of chemotherapy," said Dr. Jacobsen.
"Our findings also provide a more complete picture of the impact of cancer treatment on mental abilities than studies that did not follow patients as long or look at mental abilities in breast cancer survivors who had not been treated with chemotherapy.
