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Why Measuring Absolute Risk Of Fracture Could Save Many Broken Bones
A person"s absolute risk of fracture over the next 5 or 10 years can be predicted with reasonable accuracy according to their age, sex, bone density and history of fractures and falls.
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Opinion Piece Examines If Abortion Access Should Ever Be Restricted
"Just because something is legal -- and should be legal -- does not mean it is always ethical," Frances Kissling, former president of Catholics for Choice, writes in a Salon opinion piece, adding that "sometimes the right thing to say to a woman [seeking abortion] is "I am so sorry, I cannot do what you ask."" According to Kissling, there has "always been a fear in the choice movement that if we deal with "morality," we are going to lose." However, "tough issues come up more frequently than they did in the first years after" Roe v. Wade, and such issues "should make us pause and think hard," Kissling writes, adding, "The thought of putting every woman through the indignity of meeting with an ethics committee, or getting a doctor to sign off on her reasons for abortion, has forced most of us to stick with the principle that women must be allowed to make their own private ethical decisions, without the state getting involved." However, Kissling comments that "we express moral views about every other issue under the sun." She continues, "Expressing our views about controversial issues is how society develops norms and shared values."Kissling adds that if abortion-rights supporters "follow the example of those opposed to abortion and present only one value -- a woman"s right to make this decision -- as the only ethical consideration worth discussing in difficult cases, do we not become as extremist as we say they are?" She continues, "Is there not, in an ethical sense, an important weighing of women"s rights and needs against a respect for life, even the life of nonpersons? Is there a point in pregnancy when our respect for life might outweigh a woman"s right to make this choice?" Kissling asks, "[I]s the fact that we have avoided it part of the reason that polls show that more people are willing to call themselves pro-life than ever before?"According to Kissling she has "come to believe that women"s autonomy does not require that all efforts be made to protect women from pain or from hearing the word "no."" Kissling writes, "I still have a twinge of doubt when I write these words," adding, "For most of my years as an advocate of a woman"s right to decide, I stepped back from this conclusion" and "could not bring myself to say that there are circumstances in which I would force a woman to continue a pregnancy." The piece continues, "What changed for me? ... Mostly, I feared that single value ethics about abortion, on either side of the debate, would result in a coarsening of our respect for both women and for life" (Kissling, Salon, 6/21).
News of the day
Researchers Looking At Climate Change, Culture To Predict Land Abandonment In Russia
Kirsten de Beurs, an assistant geography professor in Virginia Tech"s College of Natural Res, has received a NASA grant to direct a large international land abandonment study in Russia with Grigory Ioffe of Radford University, Geoffrey Henebry of South Dakota State University, and in-country collaborator Tatyana Nefedova.
Diagnostics

Advanced Preventive Women's Clinic For Women With Menopause Symptoms Who Are At Risk For Heart Disease

Women who are at risk for heart disease and who are also experiencing menopause symptoms now have an added re a highly specialized clinic in the Division of Cardiology at the Cedars-Sinai Heart Institute. The Advanced Preventive Women"s Clinic at the Women"s Heart Center recently opened and is offering comprehensive cardiac risk assessments designed specifically for women who are in menopause. The clinic also offers menopausal patients state-of-the-art screenings, as well as personalized medicine therapies and counseling, including high-risk hormone counseling. "This clinic is designed for women who are at higher risk for heart disease and who are seeking to treat their menopause symptoms while simultaneously taking steps to prevent heart problems," said Chrisandra Shufelt, M.D., assistant director of the Cedars-Sinai Women"s Heart Center. "Menopause is a time to assess your heart health so that the next chapter of your life can be as productive as your youth." Each woman who comes to the clinic completes a comprehensive questionnaire that includes her heart risk factors as well as her own menopause symptoms. This personalized medicine approach enables her doctors to tailor a treatment plan that is uniquely hers one that is based on her medical history, risk factors and symptoms. Risk factors include a family history of heart disease, elevated blood pressure, obesity, and a woman"s own medical history such as pre-diabetes, complex blood cholesterol disorders or resistant high blood pressure. "Hormone treatment counseling is important for all women experiencing menopause, but it"s especially important for women who are also at risk for heart disease," said Shufelt. "Before menopause, a woman"s natural estrogen levels often help maintain a healthy balance between HDL (good cholesterol) and LDL (bad cholesterol) levels. However, during menopause, as a woman"s estrogen levels shift, so, too, do her cholesterol levels, with the bad cholesterol levels typically increasing, which can lead to heart disease." The Advanced Preventive Women"s Clinic offers hormone therapy counseling as well as non-hormonal options, said Shufelt. The decision as to which provides the better treatment for each individual is determined by the woman"s own symptoms, risk factors and medical history. Some women especially those who have had a prior heart attack, bypass surgery or mini-strokes -- may not be appropriate for hormone therapy, but no one needs to suffer with menopause symptoms, Shufelt said. In cases where hormone therapy is not advisable, there are other non-hormonal options and lifestyle modification to consider. "Hormones can be a confusing area," said Shufelt. "While there are some compound hormones or mixed hormones available on the market, these are not FDA regulated, and we do not offer them," she said. Instead, the Clinic offers only FDA-approved synthetic or bio-identical hormones, which are a form of hormone that are made from natural substances such as yams. Bio-identical hormones mimic the body"s own form of estrogen. Beyond hormone counseling, the Clinic also provides lifestyle recommendations. Avoiding alcohol and caffeine can help reduce hot flashes, said Shufelt. Other tips include layering clothing and choosing fabrics that wick away moisture. Research is also part of the equation. "There is currently a study underway to evaluate the possible benefits of acupuncture for women who experience hot flashes, and there have also been studies on the benefits of yoga and meditation for women with heart disease," said Shufelt. "Many women who have already been on hormone therapy for an extended period of time (more than five years), have questions," said Shufelt. "We work with them to provide the information they need to be a part of their own treatment planning. Women who are on hormone therapy should be re-evaluated each year to assess their risks and benefits and determine the course of action that is best for them." About the Cedars-Sinai Heart Institute and the Women"s Heart Center The Cedars-Sinai Women"s Heart Center provides risk assessment, diagnosis and heart disease care that is specifically tailored to women. It is part of the Division of Cardiology at the Cedars-Sinai Heart Institute, which is internationally recognized for outstanding heart care built on decades of innovation and leading-edge research. Much of the Women"s Heart Center research and education is supported by The Edythe L. Broad Women"s Heart Research Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, and the Barbra Streisand Women"s Cardiovascular Research and Education Program. From cardiac rehabilitative and preventive care and heart transplantation to the training of the heart specialists of tomorrow and leading-edge research that is deepening medical knowledge and practice, the Cedars-Sinai Heart Institute is known around the world for excellence and innovations. Cedars-Sinai Medical Center


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