Women's Health Base

A look at women, the world and the web

Archive for May, 2009

Trauma during birth results in lower desire

Posted by hannahflynn on May 28, 2009

There is little significant difference in the sexual activity of women after birth who have experienced major trauma during labour compared with women who have experienced minor trauma.

Researchers asked women to complete a twelve point questionnaire know as the Intimate Relationship Scale in the study reported in this month’s Journal of Midwifery and Women’s Health.

The study found 85 percent of women had resumed sexual relations three months after birth and total IRS scores did not differ between trauma groups nor did complaints of pain on intercourse.

However, women who had required perineal suturing had lower IRS scores, and women who had experienced major trauma during birth had less desire to be touched and held by their partners.

The study excluded women who had experienced episiotomy.

Advertisements

Posted in Women's Health | Tagged: | Leave a Comment »

Growing our medicines

Posted by hannahflynn on May 26, 2009

Dr Julian Ma believes the silence on the plant biotechnology front over the past couple of years has been intentional. “Every time we do raise our heads above the parapet you do get shot down” he claims. As the head of Pharma-Planta, a Europe wide consortium of plant scientists devoted to developing plant-produced treatments and vaccines, he feels this was partly to do with the media coverage of the subject, “it was very antagonistic, so a lot of people kept their heads low.”

Back in 2004 when Pharma-Planta was launched the possibility of growing pharmaceuticals in genetically engineered crops was greeted with a lukewarm reception from the public. €12 million was pumped into a consortium of labs across Europe to produce plant crops which could be used for ‘pharming’. Clinical trials were due to start this year, in 2009.

However, progress has been rapid during these past four years with a number of new technologies about to enter clinical trials. Ma also thinks the silence has given the group some time for a shake up. “Plant scientists have little commercial nouse with no idea what it takes to get these technologies onto a commercial platform.” he says. “It’s taken a couple of years to get rid of that mindset.”

After years of low expression levels, rows about patents and mixed opinion on the commercial viability of genetically engineering novel plants crops, pharmaceutical crops appear to be overtaking food crops on most counts. Notable food crops engineered to improve nutritional value of the plants like golden rice, failed to produce high enough levels of these substances to be of any use. This has not been a great concern for pharmaceutical crops. The levels of expression required to be financially profitable are lower than is needed for genetically modified food crops.  

Cheaper and quicker

Last year researchers Charles Arntzen and Richard Levy released results for the first commercial plant-derived vaccine. They had produced a vaccine for non-Hodgekins lymphoma which had successfully completed phase one of its clinical trial. Their success came from a new approach. After isolating antigens from a lymphoma patient, tobacco mosaic virus was used to infect tobacco plants. A week later the plants were harvested, the antigen was purified and a vaccine was produced. The study started after Levy became frustrated with the time it was taking to produce vaccines through conventional animal cell cultures. Then he found the total time taken to produce a vaccine from biopsy to treatment was three or four months: half the time it takes to produce a vaccine from animal cell cultures (Proceedings of the National Academy of Sciences, vol 105 p 10131).  

Ma agrees the use of viral expression systems like tobacco mosaic virus offers hope, “Currently the most promising systems are transient expression systems, driving expression from a virally derived plasmid.” He explains, “This infects the plant cell [where] it divides like a virus inside the cell, so we get multiple copies.”

The plant species used are also important, though currently a diverse number of plants are being used. This is due to the growing number of patents on plant technologies. Around the time of the launch of Pharma-Planta, Ma and his lab looked at which plants were best for their technologies, “We ignored freedom to operate – we took the patent situation out of it. We found tobacco and maize were the best plants to use as they offered the highest expression of the products we were trying to produce.

“But a number of plants are currently being used. Carrot cells are being used by a company in Israel. That’s about to complete its final phase three trial. Human insulin grown in safflower is also close to a commercial lease right now.”

Sembiosys the biotechnology company behind the insulin producing safflower crop highlight the fact that growing human insulin in a safflower crop will reduce manufacturing costs by up to 70 percent, and product cost by 40 percent. This also means just one acre of safflower is needed to produce enough insulin to treat 2,500 patients for a year. A figure not to be sniffed at considering insulin use has tripled in Europe in the last 12 years.

Opposition

Though it is more than four years on, opposition hasn’t changed much. GeneWatch and other environmental groups including Greenpeace are still opposed to any GM technology on the grounds using food crops for non-food products is high risk. Ma does not agree with their conclusions saying that the tiny scale on which pharmaceutical crops are grown compared with genetically engineered food crops means a lot of their risk assessment is outdated. He notes, “Pharmaceuticals are high value, they are for a very tiny niche market that will use specialist growers on a low acreage. The value of these crops is so high we need to protect against pest and failure, so we would have to grow in greenhouses rather than in open fields. It’s not a worry about the pharmaceutical crops getting out, the problem is stopping the food crops getting in.”

Claire Oxborrow, senior food campaigner for Friends of the Earth claims the risks involved in human error are high, but appreciates these can be reduced.  She says, “If things are being contained and they do prevent it happening we still wouldn’t say we were in favour of them, but we would be less opposed. There is always going to be human error and where this involves food crops this is unacceptable. However, if you are talking about tobacco and you are going to grow them in containment then it is going to be further down the risk scale for us.”

The choice of disease targets is also an area which is ripe for controversy. It has been shown costs of drug production can be dramatically reduced, but diabetes and cancer are diseases of Europe and not of the third world. Ma notes that encephalitis is an important disease but as it is not present in the UK there is little research surrounding it. “You have to be careful with your targets. We have always done diseases which affect the developing world like HIV and tuberculosis, but those are pretty important in the UK and Europe as well.”  

Staunch opposition may still be the case from some areas of society but in these stretched times, cheap pharmaceuticals should be welcomed. As other strains of biologically engineered plants, currently being developed, start to enter clinical trials we will be able to see their possible impact and the effect this may have on any public opposition.

(NB this is the box out from the copy)

Improving Nature

Plants have been used since the dawn of civilisation to create medicines, so the ideas behind growing our own drugs isn’t anything new. One of the most notable modern plant derived drugs is Tamoxifen, a drug derived from the Pacific Yew which is used to treat breast cancer and increasingly to prevent it in high risk women as well.

Extraction of taxol which is used to produce Tamoxifen from the plant is often expensive and time consuming as it exists in such low quantities. In the Pacific Yew, taxol is only produced in the bark of the tree and the tree grows extremely slowly. There is also the added problem of the numerous similar compounds which are present and need to be separated from the taxol: a long and expensive process.

Bioengineering of taxol is a possibility, but is hindered by the complicated genetic pathway which controls the production of taxol. There are fifteen genes which control this pathway and have so far been successfully transformed into yeast, but there is still a long way to go.

Previously genetically modified crops have failed to produce the substances they were engineered to provide, because the host plant they were being grown in was too unlike the original organism. The hunt is on to find a fast growing tree which can be engineered to produce taxol in its bark.

Posted in Uncategorized | Tagged: , , , , | 1 Comment »

Air brushed lad’s mags images

Posted by hannahflynn on May 13, 2009

A colleague of mine tweeted these images yesterday, 1 and 2. They are marked up images for a men’s magazine.

I realise they are slightly blurry so here is what I can make out the first one says, moving clockwise from the head: remove shadow, remove eye bags, remove (points at arm pit ‘fat’), smooth line, remove (outer part of arm), smooth veins and lines, smooth (outer leg), blend (on both thighs), remove (pointing to a spot on hand) and smooth (on the arms).

The other one all I can work out is ‘smooth skin’.

However, obviously the most striking part of these pictures is the sheer area of the pictures which is marked for touching up. Also the fact that these are already high quality pictures of slender women with, to my eyes, no ‘flaws’.  If I hadn’t known better I would have assumed these pictures were ready to go.  That is obviously the difference between myself and a picture editor.

Can anyone else decipher what is written on the girls?

Any thoughts on this process?

UPDATE

I have received confirmation from the person who took the photographs that on the first photgraph there is an instruction to “reduce make up” and the second photograph has an instruction to “clean neck”.

More to the point I have heard from a graphic designer that these changes are standard, not just in men’s magazines but accross the board. He also made the point that these photographs are of professional models, much  more needs to be done when ‘normal’ women are in the magazine.

Posted in Women's Health | Tagged: , , , , , , | 1 Comment »

Nanotechnology cure for STIs

Posted by hannahflynn on May 10, 2009

Sexually transmitted infections (STIs) could be treated with new nanotechology which uses DNA similar to the pathogen’s DNA, to silence its effects.

RNAi, interferes (that’s what the ‘i’ is for) with the pathogen’s DNA and ‘sticks’ to it, thus inactivating it. Recent developments in nanotechnology have shown this can be used to treat STIs.

Researchers at Yale created nanoparticles made out of a biodegradable polymer, and used these as a ‘time-release’ vehicle for the RNA which was designed to target a gene found in the mouse reproductive tract.

These particles loaded with the drug agent, were found to have been distributed to the mucosal membranes in the vagina, cervical and uterine regions. These particles could be detected 14 days after administration.

The study will be published in this month’s Nature Materials.

Citation: Nature Materials, advance online publication May 4, 2009.

Posted in Women's Health | Tagged: , | Leave a Comment »

Cervical smears needed for over 50s

Posted by hannahflynn on May 9, 2009

Recently the minimum age for smears has been the cause of much debate, but new evidence suggests the maximum should be considered too.

The study by the Institute of Cancer Researchshowed two thirds of women screened between the ages of 50 and 64 and found to have serious abnormalities, had two previous negative tests in their 40s. This shows cancer cases could be missed if screening was stopped at 50.

Published in the British Journal of Cancer the results were drawn from over 2 million women after questions were raised over the cost effectiveness of screening at this age. The possibility of false positive results for abnormalities was also questioned.

Though it was found the risk of developing cervical cancer did decrease with age, the rising rates of sexually transmitted diseases in the over 40s could change this. This is as exposure to HPV or other STIs can increase the risk of developing cervical cancer.

Posted in Women's Health | Tagged: , | 1 Comment »

Behind the label – Depo-Provera

Posted by hannahflynn on May 3, 2009

depo1

It’s being promoted by health care professionals up and down the country, in fact top gynaecologists are lamenting its lack of popularity amongst women in Britain today. But is this aversion based on fact? Just what is it about free, long term, reversible, effective contraception that is putting people off?

Pros

As just mentioned it is long term, three months to be precise. You just have to pop down to your local surgery and the nurse will give you a jab in your bum. It can also stop your periods, which is nice. It is also reversible in that after three months your natural menstrual cycle should return to normal just like the pill, as this is a hormonal based form of contraception. It is also extremely effective, 99.7% to be exact[1]. It is a form of hormonal contraception but it has lower drug interactions than the pill. This is not just good news for people on long term medication but it is also good news for you when you have the odd bout of something nasty and need a course of antibiotics. Furthermore it is discrete, hopefully you shouldn’t need that in this day and age, but if you can’t stand lugging your pill packet everywhere this might be for you.

Cons

Here is the crunch. Ten percent of women experience what the medical establishment euphemistically term ‘menstrual irregularities’. This means on and off periods for three months. Some women cite permanent bleeding for six to 12 weeks. And in the unlucky few this can last for 18 months (if you stick with it for that long). It is also suggested you do not use Depo Provera for more than 2 years due to a causal link with bone loss (likely to be due to the lack of oestrogen). That potentially gives you just six months of ‘pros’. You have also got to live with the fact that you are taking a drug used as a form of chemical castration in men in some states in the US.

Typical use problems

There are none. As long as you go and get your injection every 12 to 13 weeks, which you will be scheduled in for on the NHS you can’t get it wrong. It’s the most effective, easy to use reversible form of contraception.

Controversies

Like some other forms of long term contraception there are claims of coercion and lack of informed consent among illiterate women.

Who would it be good for?

People who can’t remember to take the pill and forms of barrier contraception and people who absolutely can not have a baby, like women on high risk medication.

 


[1] Trussell, James (2004). “Contraceptive Efficacy”. in Hatcher, Robert A.; Trussell, James; Stewart, Felicia H.; Nelson, Anita L.; Cates Jr., Willard; Guest, Felicia; Kowal, Deborah. Contraceptive Technology (18th rev. ed.). New York: Ardent Media. pp. 773–845. ISBN 0-9664902-5-8.

Posted in Women's Health | Tagged: , , , | Leave a Comment »

How to read a scientific paper on women in 7 easy steps

Posted by hannahflynn on May 2, 2009

The column inches given over to the latest research on why women should not drink during pregnancy is only the tip of the iceberg. In recent months I have seen the columns of both the mainstream media and scientific journals filled with diverse claims about the effect mothers have on their sons, daughters and society in general ranging from the tenuous to the ridiculous.

This has obviously led to a great deal of confusion for journalists, women and obviously mothers. The murky waters of peer-reviewed research can appear an impenetrable forest to the uninitiated, but by following these steps you should be able to make your mind up for yourselves.

 1)      Is it peer reviewed?

The recent scandal involving Merck’s payments to Elsevier to produce publications which looked like peer reviewed journals, but did in fact only publish research showing positive results for the effectiveness of the company’s product, has highlighted the importance of this. Peer review involves the paper being sent to working scientists in the relevant field who will assess the significance of the findings and decide whether the paper warrants publication. They will come to this decision based on whether the findings are original (they have not been published before), reproducible (the experiments be done again and achieve the same results) and significant (the finding is worthy of attention from other scientists in the field).

 2)      What questions are they asking?

This is a very significant question with regards to gender based research. Is the question the right question to be asking in the first place? For example, a lot of research has been done into the effect of drinking in pregnancy on a foetus. This is due to the existence of a syndrome known as Foetal Alcohol Syndrome which can result in low birth weight offspring in alcoholic mothers who abused alcohol during pregnancy. However, these papers rarely look at the effect of very low alcohol consumption in pregnant mothers; a far more significant question for the vast majority of mothers to be. The reason this has not been done is the effects of low alcohol consumption would be far harder to measure.

3)      How big is the sample?

The MMR scare started after a paper with a sample size of 12was publishedin the Lancet. It is impossible to establish a significant result with this sample size, simply because the margin of error would be so large no trend could not be established, meaning any causal link implied would be meaningless.

 A good sample size will depend on what is being looked at. Any trial regarding diet or lifestyle will require a large sample as the variables are so large. A trial looking at a rare disease may have to have a smaller sample size because of the availability of subjects. However, the bigger the sample the smaller the margin of error so the stronger the data.

4)      What are the variables?

The simplest variable is gender. Are the groups, particularly in diet or lifestyle research, divided into gender? This is important as men and women have different metabolisms. It is impossible to eliminate all variables in any biological research as you are working with living organisms. However, it is possible to take all variables into account when planning the methodology and deciding conclusions. A well written experiment will explain how the groups in the trial are sampled, taking into account any variations. Variations which can not be controlled will be referred to in the conclusion as a possible source of error. Natural variation in a sample group need not result in inconclusive data, but if ignored then the whole experiment or trial is based on weak assumptions at best.

 5)      How quantifiable is what they are measuring?

Birth weight, genetic disease and death are all easily quantifiable results which can be used to produce meaning full conclusions. Often problems like ‘learning difficulties’, ‘problems bonding’ and ‘low satisfaction’ are not well defined in papers and can lead the conclusions which may mislead. A good paper should have quantified these in the methodology of the paper, for example learning difficulties could mean something quantifiable like a diagnosed dyslexic.

 6)      Are the results significant?

This is the area that is the most difficult to understand if you do not have a scientific or statistical background. I will try to explain the most commonly used statistic, the p value, to explain significance.

When looking at data from a piece of biological research it is important to calculate what the probability is that the results you have may have happened by chance. If your results are not caused by chance then you have a significant result. This probability is currently set at 5 percent, or p = 0.05. If there is less than a 5 percent chance your data was caused by chance you can claim your date is significant and conclusions can be drawn that there is a causal link. (A good explanation for journalists can be found here.)

 7)      Does more research need to be done?

 If however p = 0.07 there is a 7 percent chance your results are caused by chance. This is not a high enough level of significance to base conclusions on but there is probably enough evidence to base further research in the area on.

 Similarly if the paper has a sample size which does not seem big enough, this does not mean the findings are completely null and void, rather more research needs to be done before conclusions can be drawn.

Extra reading:

For a more in depth analysis of statistics and other Bad Science, read Ben Goldacre’s blog and column in The Guardian. The comments left are often ripe ground for debate on how to interpret scientific papers.

For an irreverent but clear explanation of bad statistics turn to Feedback in New Scientist.

Posted in Women's Health | Tagged: , , , , | 2 Comments »