Solucion impotencia

In a speech at a private event on Friday, first lady Michelle Obama urged women to push for health reform, saying that President Obamas plan would help achieve “true equality” for women, the Washington Post reports. Speaking to about 140 health care industry and womens group representatives, Obama called the current health system “a status quo that is just unacceptable” and tied efforts to change it with the battle for womens rights, according to the Post.

Obama, a former vice president in the University of Chicago hospital system, said, “In many states, insurance companies can still discriminate because of gender. And this is still shocking to me.” She added, “These are the kind of facts that still wake me up at night, that women in this country have been denied coverage because of preexisting conditions like having a [caesarean] section or having had a baby” or being a domestic violence survivor (Gerhart, Washington Post, 9/19). “For two years on the campaign trail, this was what I heard from women, that they were being crushed, crushed by the current structure of our health care,” she said (Babington, AP/Atlanta JournalConstitution, 9/18).

Women often pay more than men of the same age for the same level of insurance coverage under individual policy plans. One study found the disparity can be as high as 48%, the Post reports. A similar study in 2008 by the National Womens Law Center found that only 10 states prohibit gender rating (Washington Post, 9/19).

Using personal stories to illustrate her point, Obama said that women are “disproportionately affected by this issue because of the roles we play in our families.” She said, “Women are affected because of the jobs we do in this economy. … Women are more likely to work parttime, or work in small businesses, jobs that dont always provide health insurance,” adding, “Women are affected because in many states, insurance companies can still discriminate because of gender.”

She pledged that under the Obama administrations health plan, “insurance companies will no longer be able to drop your coverage when you get too sick, or refuse to pay for the care you need, or set a cap on the amount of coverage you can get.” She continued, “And it will limit how much they can charge you for outofpocket expenses. Because getting sick in this country shouldnt mean that you go bankrupt.” She also noted that because of the higher premiums that women often are charged, “more than half of women report putting off needed medical care because they cant afford it” (Henderson, Politico, 9/18).

Obama called on the events attendees to “mobilize like youve never mobilized before” to help educate others about the presidents health reform plan. “No longer can we sit by and watch the debate take on a life of its own,” the first lady said, adding, “It is up to us to get involved, because what we have to remember is that now more than ever, we have to channel our passions into change” (Rhee, Boston Globe, 9/19).

Marcia Greenberger, founder and copresident of NWLC, said, “Putting this effort into the long context of struggles that womens organizations have made was very moving and very true.” She added, “She made the case, I have to say, in a way that I thought was more compelling than I ever had heard it made before” (Washington Post, 9/19).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Cuba, Egypt, Iran and Sudan “have mounted a lastminute campaign to delay ratification” by the U.N. general assembly of a new agency, “which would have a budget of around $1 billion and consolidate four existing bodies that deal with womens issues,” the Guardian reports. “If a U.N. resolution goes through by Monday, the four underpowered agencies dealing with gender issues the U.N. Development Fund for Women (Unifem), the Office of the Special Adviser on Gender Issues, the U.N. Division for the Advancement of Women and U.N. International Research and Training Institute for the Advancement of Women (Instraw) would be consolidated into a fully fledged U.N. agency,” the newspaper writes.

Though a 2006 panel “endorsed an agency for women headed by an undersecretary general,” Egypt is arguing that other issues addressed by the panel “the U.N.s governance and finance have taken a back seat in favour of the womens agency,” according to the Guardian. The four countries opposing the new agency “are in a position to block the will of the majority as the U.N. general assemblys 192 members especially the G77 group of developing countries are notoriously reluctant to hold a vote when a consensus is lacking. The lastminute delaying tactics have sparked outrage from nongovernmental groups, who fear that yet another delay will shelve the idea indefinitely.”

Susan Rice, the U.S. ambassador to the U.N., has said that an agency focusing on women is necessary to handle violence against women and other issues. Stephen Lewis, codirector of AIDSFree World, said, “There is tremendous anger at the potential sabotage from these malcontents.” He added that if ratification is delayed, “it will be a terrible slap in the face of the secretary general, Ban Kimoon, and the deputy secretary general (AshaRose Migiro) who have campaigned hard for the agency.” According to Lewis, 60 percent of the 23 million people with HIV in subSaharan Africa are women. That percentage is between 75 percent and 80 percent among women ages 1524 (Tran, 9/11).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

Researchers warn in a study just published on bmj.com that many women with ovarian cancer can go undiagnosed for months because their symptoms are not always being investigated without delay.

Three key symptoms associated with ovarian cancer are identified in the study. They should help clinicians decide whether to investigate further. However, one of these symptoms is not included in current guidance for urgent investigation.

Accounting for 4 percent of all cancers in women, ovarian cancer has the worst prognosis of all gynecological cancers. In the past, ovarian cancer was thought to have few symptoms and was often dubbed the “silent killer”. But recent studies have shown that symptoms are frequent and that their early identification has the potential to improve prognosis.

Researchers at the University of Bristol set about classifying the key symptoms that could indicate ovarian cancer in women presenting to primary care. They also estimated the positive predictive value for each symptom which is the probability that a woman with a particular symptom actually has ovarian cancer.

The study involved 212 women aged over 40 with a diagnosis of primary ovarian cancer. It also included 1,060 healthy controls from 39 general practices in Devon, England.

Seven symptoms were associated with ovarian cancer
• abdominal distension
• urinary frequency
• abdominal pain
• postmenopausal bleeding
• loss of appetite
• rectal bleeding
• abdominal bloating

Some women presenting with the first three of these symptoms waited at least six months before the diagnosis was made.

All symptoms had positive predictive values below 1 percent, except for abdominal distension, which had a positive predictive value of 2.5 percent. The authors explain that this means that it carries the highest risk and warrants rapid investigation. Yet persistent abdominal distension is not included in present guidance for urgent investigation. If it were, some women could have their diagnosis speeded up by many months.

The authors mention that the fact that symptoms are common and often reported is encouraging. This means there is some possibility of identifying early ovarian cancer by using symptoms. “This study provides an evidence base for selection of patients for investigation, both for clinicians and for developers of guidelines”, they write in conclusion.

In an associated note Dr Robin Fox writes that there is now increasing evidence that ovarian cancer is not a “silent killer” but one that presents with vague symptoms that have a low positive predictive value for cancer.

He writes that this study adds to the evidence base derived from primary care of red flag symptoms for several cancers, and is essential as the majority of patients in the United Kingdom present at first to primary rather than secondary care.

In an accompanying editorial, Joan Austoker from the University of Oxford adds that “the diagnosis of ovarian cancer will continue to be a challenge for primary care doctors.”

She argues that there is a need for further research to improve our knowledge of the predictive value of different symptoms in ovarian cancer. For now, she says it is important for both women and primary care doctors that ovarian cancer is no longer regarded as a silent killer.

“Risk of ovarian cancer in women with symptoms in primary care population based casecontrol study”
William Hamilton, consultant senior lecturer, Tim J Peters, professor, Clare Bankhead, university research lecturer, Deborah Sharp, professor
BMJ 2009; 339b2998

“Commentary Diagnosing ovarian cancer more problems than answers”
Robin Fox, honorary general practice research associate
doi=10.1136/bmj.b3233

“Diagnosis of ovarian cancer in primary care”
Joan Austoker, Director
doi=10.1136/bmj.b3286
bmj.com

Oral contraceptives that contain the hormone levonorgestrel carry a lower risk of venous thrombosis, or blood clots, than other contraceptives, and many women do not use the brands with the lowest risk of thrombosis, according to two studies in the British Medical Journal, Reuters Health reports.

For the first study, A. van Hylckama Vlieg and colleagues from Leiden University Medical Center in the Netherlands analyzed data from 1,524 female thrombosis patients and 1,760 women without the condition in order to evaluate various oral contraceptives. All of the study participants were premenopausal, younger than age 50, not pregnant, and not using an intrauterine device containing hormones or a depot contraceptive. In addition, none of the study participants had given birth in the previous four weeks.

According to the study, the use of an oral contraceptive increased the odds of venous thrombosis but oral contraceptives with levonorgestrel had the lowest risk. The study also found that the risk of venous thrombosis was directly related to the estrogen dose and was highest during the first months of use.

For the second study, Ojvind Lidegaard and colleagues from Copenhagen University evaluated the risk of venous thrombosis by assessing data on Danish women who were ages 15 to 49 and had no history of malignant or cardiovascular disease. The findings aligned with those of the first study, where an increased risk of venous thrombosis correlated with an increase in dosage. The risk similarly fell as the duration of use increased. In addition, the second study also found that oral contraceptives with levonorgestrel had a lower risk of venous thrombosis compared with other contraceptives with the same dose and duration of use.

Nick Dunn of the University of Southampton Medical School in the United Kingdom said in a related editorial, “Despite their different designs, (these studies) produce remarkably similar results and confirm past studies of the risk of venous thromboembolism with the pill” (Reuters Health, 8/14).

CBS “The Early Show” recently examined the studies results. According to CBS News medical correspondent and obgyn Jennifer Ashton, it is helpful for women and their doctors to recognize which types of oral contraceptives carry a decreased risk of thrombosis, despite the relatively low risk of developing a blood clot from taking the pill. She said, “The majority of women, they think (birth control pills are) all the same, and they dont ask the doctor about the differences” (”The Early Show,” CBS, 8/14).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

UroToday.com Ureaplasma urealyticum and Mycoplasma Hominis are members of a unique group of microorganisms commonly identified in the genital tract of women. With the onset of sexual intercourse the prevalence of Mycoplasma increases dramatically an isolation is strongly dependent on the number of sexual partners. Convincing evidence of an infection caused by genital Mycoplasma is not easy, because they usually are not isolated in pure culture, making the evaluation even more difficult.

Dr. Stavroula Baka and colleagues from Athens, Greece evaluated the prevalence of U. urealyticum and M hominis in women presenting with chronic urinary symptoms, and the subsequent improvement, if any, of symptom severity and urinary frequency after appropriate therapy targeting these microorganisms. The 153 patients who completed the study had symptoms including dysuria, pelvic pain, urgency, frequency, and dyspareunia. They had either failed a course of antimicrobial therapy or had negative routine cultures. Urine samples (midstream and catheter specimens), and urethral, vaginal, and cervical swabs were obtained. U. urealyticum was detected from 1 or more sites in 52.9% and M. hominis was detected in 5 women, all of whom were positive for U. urealyticum. In 82.3% of patients positive for U. urealyticum, other pathogens were also identified. A singledose regimen of 1 gram azithromycin was given to all culture positive patients and recommended for their sexual partner. Those with a positive culture one month after therapy (4.9%) were successfully treated with 7 days of doxycycline 100mg twice daily.

Significant improvement was observed in all symptoms. When the mean difference in the urinary symptom scores before and after treatment in women with positive cultures for Mycoplasma only was compared with those from women with Mycoplasma and other organisms as well, dysuria, dyspareunia, urinary urgency, and urinary frequency had improved significantly, while there was no difference in pelvic pain between the groups.

The authors conclude that the significant improvement noted in all symptom scores after treatment in women with positive cultures for U. urealyticum and M. hominis suggests that these pathogens might have been involved in the etiology of chronic urinary symptoms experienced in this group of patients.

Baka S, Kouskouni E, Antonopoulou S, Sioutis D, Papakonstantinou M, Hassiakos D, Logothetis E, Liapis A
Urology. 2009 Jul;74(1)626
10.1016/j.urology.2009.02.014

Written by UroToday.com Contributing Editor Philip M. Hanno, MD, MPH

UroToday the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go tourotoday.com

Sen. Lindsey Graham (RS.C.) on Wednesday said he intends to vote for Supreme Court nominee Sonia Sotomayor, making him the fifth Republican senator to endorse the nominee, USA Today reports. Meanwhile, Senate Minority Whip Jon Kyl (RAriz.) became the 10th Republican to say that he will vote against her confirmation. During Sotomayors confirmation hearings last week, both Graham and Kyl “grilled her extensively,” USA Today reports (Kiely/Brettschneider, USA Today, 7/23). According to Politico, Republicans privately estimate that Sotomayor could receive upward of 70 votes (Kady, Politico, 7/23). The Senate Judiciary Committee is scheduled to vote on the nomination Tuesday, followed by a full Senate vote late next week or the first week of August (Stanton, Roll Call, 7/22).

According to CQ Today, Grahams support could encourage other conservatives to back Sotomayor (Perine, CQ Today, 7/22). Graham said that Sotomayor “is definitely more liberal” than any Supreme Court nominee a Republican president would have chosen but that she also is “one of the most qualified” nominees in decades. He added, “I do believe that elections have consequences, and its not like we hid from the American people during the campaign that the Supreme Court nomination was at stake. The American people spoke” (USA Today, 7/23). Graham also said that he believes that Sotomayor “follows precedent” and “would not be an activist judge” (CQ Today, 7/22). He continued, “On balance, I do believe that the court will not dramatically change in terms of ideology with her selection,” adding, “On some issues, quite frankly, (she) may be more balanced in her approach” (Hirschfeld Davis, AP/Boston Globe, 7/22).

Kyl said, “Unfortunately, I have not been persuaded that Judge Sotomayor is absolutely committed to setting aside her biases and impartially deciding cases based upon the rule of law,” adding, “And I cannot ignore her unwillingness to answer senators questions straightforwardly” (Politico, 7/23).

Broadcast Coverage

NPRs “All Things Considered” on Wednesday reported on Grahams support of Sotomayor (Shapiro, “All Things Considered,” NPR, 7/22).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

A “new set of antiabortion actors” who are “antiwar, anticapital punishment, proenvironment prolifers” have “emerged as the face of a new and improved antiabortion movement,” Salon columnist Frances Kissling writes. Although these advocates supported President Obama in the 2008 election, they “suffer from the same lack of understanding of womens nature and identity as do oldline antiabortionists,” Kissling writes. She notes that this group has “already decided that a political effort to make abortion illegal is hopeless, which helps the prochoice cause.” According to Kissling, “Taking legality off the table” increases the prospects for “rational public discourse about all the factors at play in womens decisions not to continue pregnancy and not to become mothers,” but “[w]e are … far from common ground between the new antiabortionists and the prochoice advocates.”

Members of this new group believe that data suggesting that many women decide to have abortions for financial reasons prove that “better economic support” for pregnant women “will result in more continued pregnancies and more women embracing motherhood,” Kissling writes. In addition, they “assert that if adoption policies were friendlier,” more women would choose adoption over abortion, according to Kissling. “But facts have little place in their strategy,” as the policies they support “are already in place in much of Europe,” and “few women who face unintended pregnancies in those countries opt out of abortion,” Kissling writes. She adds, “Something much deeper influences a womans decision about what to do when she is pregnant and does not want to become a mother and the new antichoicers dont seem to have a clue about what this might be.” For this group, “the outcome [of pregnancy] the new person is obviously so much more valuable than whatever shortterm loss or pain the women might experience,” Kissling writes. Therefore, they believe it is “not asking much of a woman who faces an unwanted, difficult or unintended pregnancy to shift the plan she had for this time in her life and continue the pregnancy,” according to Kissling.

Kissling lists four “positions taken by the new antiabortionists [that] illuminate this flawed thinking.” The first is “[d]enying the need for abortion,” she writes. Secondly, their “same sense of pregnancy as no big deal influences the new antiabortionists unwillingness to embrace contraception,” Kissling says. She adds that “[i]f we really understood what it meant for women to consent to becoming mothers, we would want them to be able to meet their moral obligation to their own identity by avoiding becoming pregnant.” The third position is an attempt to make “sex sacred,” Kissling writes, adding that if “creating new life is sacred, then we want men and women to have the tools necessary to fulfill the obligation to create life responsibly and not create it when they cannot or choose not to bring it to fruition.” The fourth position is “[r]edefining adoption,” Kissling continues. She asks whether adoption is “now a process of finding children for needy parents,” adding, “Might it not be more generous of us as a society to work harder to make it possible for women to keep their children if they so wish?”

Kissling writes that the “challenge to the new antiabortionists” is whether “womens perspectives on the meaning of pregnancy and motherhood will be considered in their project” or if “their ethical frame will remain focused on the fetus.” She asks, “How many of these womens decisions will the new antiabortionists be able to say yes to?” Kissling concludes, “So far it seems that it is far more than abortion that is a stumbling block to common ground” (Kissling, Salon, 7/20).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

A bill (HR 20, S 324) in Congress that would mandate funding for research, services and public education related to postpartum depression has sparked debate over whether all women should be screened for the condition, Time reports. The Melanie BlockerStokes Postpartum Depression Research and Care Act, also known as the Mothers Act, passed the House and is before the Senate. The bill does not specifically include funding for PPD testing, though an earlier version did; regardless, critics say it would still lead to greater screening. According to Time, the issue at the center of the debate is whether PPD screening identifies actual cases “or simply contribute[s] to the potentially dangerous medicalization of motherhood.” Ingrid JohnstonRobledo, director of womens studies at the State University of New York, said that experts on both sides of the debate agree about increased support for women. “The problem with womens reproductive health issues is that they tend to be ignored or exaggerated,” JohnstonRobledo said. She added, “We need to find a way to come down in the middle acknowledge womens depression but not assume that all women who struggle with the transition to motherhood are depressed.”

Critics of the bill argue that mental health screenings are notorious for giving false positives. They also contend that increased testing is a bid by pharmaceutical companies to sell more medication to women who do not need it. Some psychologists argue that universal PPD screening would be misdirected because the greatest risk factor for the condition is previous depression, not giving birth. Paula Caplan, a clinical and research psychologist, said, “(We) should be addressing the social factors causing women to be upset after they give birth, not locating the problem within the women.”

Some proponents of PPD screening say it is not supposed to be used as a diagnostic tool but as a way to identify which patients require further evaluation. According to Time, studies suggest that PPD affects as many as one out of seven women who have recently given birth and that leaving it untreated exposes women and their infants to unwarranted risk. Katherine Wisner, a psychiatrist at the University of Pittsburgh Medical Center, said, “Postpartum depression is not a benign, uncommon thing.” She added, “We screen all infants for (the genetic disorder) phenylketonuria, which is extremely rare. Why dont we screen women for this?” (Elton, Time, 7/20).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Colorado Right to Life and Personhood USA are proposing a 2010 state ballot initiative with a different version of 2008s defeated “personhood” amendment to the state constitution, the Colorado Springs Gazette reports. The groups intend to submit their proposal to the Colorado Legislative Council this week. In the November 2008 election, 73% of state voters opposed the previous version, known as Amendment 48, which was sponsored by Colorado for Equal Rights.

The new version includes modified language that its supporters say will clarify its intent. Rather than defining a person as “any human being from the moment of fertilization,” the new version would establish personhood as “every human being from the beginning of the biological development of that human being.” The initiatives sponsors also said that they will be better funded and articulate a clearer message than in 2008, when a college student launched the campaign.

According to the Gazette, abortionrights supporters “werent overly concerned” about the new initiative. Jacy Montoya, head of the Colorado Organization for Latina Opportunity and Reproductive Rights, said that the 2008 vote demonstrated that Colorado residents are “uncomfortable with the government and strangers making personal decision for families.” Lynn Paltrow, executive director of National Advocates for Pregnant Women, said that the new attempt “gives us another opportunity to explain how personhood amendments threaten all pregnant women, including those going to term” (Barna,Colorado Springs Gazette, 6/29).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

A research published today on bmj.com reports that Caucasian British women are more likely to have had a mammogram. And there is more probability that women owning cars or homes have had a mammogram.

The authors are Kath Moser and team at the University of Oxford. They draw attention to the need for more information on patient´s ethnicity, as well as some indicators of their socioeconomic status. Data should be collected consistently in general practice in order to document inequalities in health screening.

Women in England aged from fifty to seventy are invited by the NHS Cancer Screening Programmes for breast screening every three years. And, women aged from twenty five to sixty four are encouraged to submit to cervical screening every three to five years.

The authors commissioned ONS to ask women aged between forty and seventy four in the National Statistics Omnibus Survey “Have you ever had a mammogram (xray of your breasts)?” and “Have you ever had a cervical screening (the smear test or Pap test)?” and if so, the date of the last time they were screened. Between 2005 and 2007, more than 3,000 women were interviewed.

An encouraging fact is that the findings report that 84 percent of the eligible women have had both breast and cervical screening. Only 3 percent of women have never had either. Results also show that there is a higher probability for women living in households with cars and owning their home (and not renting) to have had a mammogram.

A key factor in determining if women attend cervical screening is ethnicity. White British women are far more likely to have had a cervical screening than women from other ethnic backgrounds. Cervical screening attendance was also higher among more educated women. However, it was not linked to wealth (car or home ownership) or the region of the country where women lived.

In conclusion, the authors remark that this study is important for the reason that “it provides new evidence on inequalities in screening showing that they are characterized by indicators of household wealth in the case of breast screening and ethnicity in the case of cervical screening. It therefore also demonstrates the need for patient ethnicity and some indicator of socioeconomic position to be routinely collected in general practice. This would facilitate the routine monitoring of coverage of screening among different ethnic and socioeconomic groups and could be used to inform policies to reduce inequalities in coverage.”

Professor Julietta Patnick, Director, NHS Cancer Screening Programmes, explained

“This is the first time weve asked women directly to tell us about their experiences of breast and cervical screening. The findings have been very interesting with women saying they were more likely to have had a mammogram if they owned their own homes and had a car, no matter what their background or where they came from. This differed from cervical screening where ethnicity and education levels were found to have a direct link with the likelihood of being screened”.

“The challenge for the screening programmes is to make sure our services reach all parts of the population so we can reduce health inequalities. On the one hand we need to look at where mammography is available to make it easy for women to get to their appointments without having to travel too far; while with cervical screening, we need to ensure were providing information in an accessible way so all women can make informed decisions about whether or not to take up their invitation.”

“Inequalities in reported use of breast and cervical screening in Great Britain analysis of cross sectional survey data”
Kath Moser, senior researcher, Julietta Patnick, visiting professor, director, Valerie Beral, director
BMJ 2009; 338b2025
doi10.1136/bmj.b2025
bmj.com