Circumcision lowers rates of common STDs
Tobian AAR et al. Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. N Engl J Med. 2009;360:1298-1309. Golden MR, Wasserheit JN. Prevention of viral sexually-transmitted infections-foreskin at the forefront. N Engl J Med. 2009; 360:1349-1351.
Three major studies have demonstrated that male circumcision lowers the risk of contracting HIV. One of these studies, however, now shows that circumcision also protects heterosexual men from contracting herpes simplex type 2 (HSV-2) and human papillomavirus (HPV). This study, which took place in Rakai, Uganda, found that circumcision also reduced genital ulcer disease.
This research consisted of two parallel, yet autonomous trials of circumcision that examined 5,534 uncircumcised, HIV-negative participants, ages 15 to 49. These volunteers were randomized into two groups: one to get circumcised at the beginning of the study (intervention group), and one to get circumcised after 24 months (control group). The participants were tested at 6, 12, and 24 months for HIV, HSV-2, and syphilis. In addition, a subgroup was tested for HPV at baseline and 24 months.
The research showed that the members of the intervention group were much less likely to contract HSV-2 and HPV at 24 months than the control group. However, it was also demonstrated that the circumcision had no effect on the risk of contracting syphilis. Regardless, this study provides strong evidence that male circumcision decreases the risk of several sexually transmitted diseases.
Currently, circumcision rates in the United States are declining, especially among demographic groups that have disproportionately higher rates of HIV, HSV-2, and cervical cancer. The researchers strongly encourage that public policy should make circumcision programs widely available.
Pets are responsible for 87,000 fall-related injuries
Stevens J et al. Nonfatal fall-related injuries associated with dogs and cats-United States, 2001-2006. MMWR. 2009; 58:277-281.
Cats and dogs provide people with many benefits: comfort, companionship, exercise, and so on. However, new information from the CDC's National Center for Injury Prevention and Control shows that pets can also be health hazards. In fact, nearly 87,000 Americans go to the ED with injuries sustained from falls related to cats and dogs each year.
To determine the risk of falling that pets actually pose to their owners, the researchers examined ED data from 2001 to 2006 utilizing the National Electronic Injury Surveillance System All Injury Program. The findings were published in the March 27, 2009 issue of Morbidity and Mortality Weekly Report.
The researchers found that falling or tripping over the pet or pet items was the most common cause of injury. Other information gathered in the study included the following:
* Dogs were responsible for nearly 90% of pet-related falls.
* Injury rates were significantly higher with dogs: 12.9 times higher among children up to age 14 and 10.5 times higher among adults ages 65 to 74.
* Females were twice as likely as males to be injured in a pet-related fall.
* Most injuries occurred in or around the home.
* 30.7% of the injuries were fractures, while 26.2% of the injuries were contusions or abrasions.
* Adults age 75 and older had the highest rates of fracture.
The researchers recommend that pet owners receive more education about prevention of pet-fall injuries. In addition, obedience training for dogs is suggested.
Women who give birth to multiple babies are at higher risk for PPD
Choi Y et al. Multiple births are a risk factor for postpartum maternal depressive symptoms. Pediatr. 2009; 123(4):1147-1154.
Data from a recent investigation regarding postpartum depression (PPD) shows that women who deliver twins or other multiples have a 43% higher risk of developing the condition than women who deliver just one baby. These findings are published in the April 2009 issue of Pediatrics.
Multiple births have been on the rise for the past two decades, as has the prevalence of PPD. The Early Childhood Longitudinal Study-Birth Cohort found that not only was there an increased risk of postpartum depressive symptoms in mothers with multiple births, but that only about 25% of these women had sought help from a mental healthcare professional. It is clear from these studies that there is a need for better screening and referral of mothers of multiples.
Early ovarian cancer evades screening
Partridge E et al. Results from four rounds of ovarian cancer screening in a randomized trial. Obstet Gynecol. 2009; 113(4):775-782.
Current research from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Project indicates that annual screening for ovarian cancer was unsuccessful at identifying early-stage disease. In fact, more than 70% of the cancers that were detected during screening had already reached advanced stages of the disease, and required surgery.
The PLCO included 34,261 healthy women ages 55 to 74 with intact ovaries in the ovarian cancer portion of the study. These women underwent annual screening with transvaginal ultrasound and cancer biomarker 125. Results from the first 4 years of screening were reported in the April issue of Obstetrics and Gynecology. Overall, both measures of screening detected a small number of cancers.
Of the 89 ovarian and peritoneal cancers diagnosed, only 60 were identified as a result of the screening. In addition, 72% of the cancers detected by the screenings were at stage III or IV at diagnosis.
Whether annual ovarian cancer screening reduces ovarian cancer mortality still has yet to be determined. This evidence does determine, however, that a more sensitive and more specific test is needed so that unnecessary surgeries and deaths can be avoided by diagnosing the disease at an early stage.
New type of yogurt may prevent gastrointestinal distress
Hatta H et al. Prophylactic effect of an anti-Helicobacter pylori lgY in human volunteer test. ACS. 2009; Abstract 1229589.
A new yogurt, containing urease antibodies, has been shown to prevent Helicobacter pylori from binding to stomach walls and causing infections such as gastritis and stomach ulcers.
This yogurt is made using vaccine-making technology. Urease injected into chickens allowed their immune systems to produce an antibody to urease called lgY-urease. The antibody is then harvested from the chickens' eggs and made into a yogurt containing Lactobacillus acidophilus, Bifidobacterium, and 1% egg yolk lgY-urease.
A small, randomized study was conducted with patients who tested positive for H. pylori. These patients were placed into either a group who consumed plain yogurt, or a group who consumed the yogurt containing the antibody. After eating yogurt three times a day for 4 weeks, patients in the antibody group reported a substantial decline in urea levels compared with the control group, which indicated reduced bacterial activity.
The antibody was eventually destroyed by stomach acid, but it had already manifested beneficial antibacterial effects. Additionally, there were no adverse reactions, and one could not detect any change in the taste of the yogurt compared to the plain yogurt.
Despite these findings, the yogurt does not appear to be as effective as antibiotics for reducing levels of H. pylori, and patients with dairy or egg allergies should not consume the yogurt. Nevertheless, this yogurt is particularly significant in developing countries where standard-of-care treatments like antacids and antibiotics are either unavailable or unaffordable.
The yogurt is currently available in Japan, Korea, and Taiwan. The researchers are confident that their findings could bring the product to the United States.
Windmill pitch causes shoulder injuries
Rojas IL et al. Biceps activity during windmill softball pitching. Am J Sports Med. 2009; 37:558.
In softball, pitchers frequently need to be benched because of anterior shoulder pain. New research on different pitches indicate that the "windmill" windup pitch most often used in softball may cause injury to the bicep and shoulder due to overuse and overextension. These findings are reported in the March 2009 issue of the American Journal of Sports Medicine.
The study involved three college softball players and four professionals, who underwent photographic motion analysis and surface electromyography analysis of the biceps during both windmill and overhand throws.
Both pitches reached the same speed. However, the peak biceps brachii muscle activation during the windmill pitch was twice what it was with the overhand throw.
Since the windmill pitch is so much a part of the game of softball, the researchers do not recommend avoiding it. Rather, they suggest that if pitchers are suffering from anterior shoulder pain, they should undergo throwing-motion analysis to identify problems with elbow flexion or forearm rotation that may be the culprit of the strain to the biceps.