Keep abreast of what your patients are currently seeing in the media with our round-up of popular news stories, available from WHF as abstracts with links to the full-text articles.

From the week of April 7, 2008

Exercise During Pregnancy Has Baby Benefits, Too

According to a new study on pregnant women, expectant moms benefit both themselves and their babies when they exercise. The cardiac benefits realized from exercise extend to fetuses, so when a pregnant women works out she not only lowers her own heart rate but also the heart rate of her fetus. The exercise can ultimately aid in the development of the fetus’ heart. Researchers monitored fetuses of women who were exercising regularly and who were not exercising at all through fetal breathing and body and mouth movements. At the end of the study, the fetuses who were exposed to exercise by their mothers had significantly lower heart rates than the fetuses who were not exposed, regardless of gestational age.

Read the full story on healthday.com

Potential for Harm in Dietary Supplements

Although not as widely publicized as alcohol or drug abuse, abusing legally-sold dietary supplements is also a form of substance abuse, and can be just as hazardous to one’s health. Taken in large doses or in combination with too many other supplements, over-the-counter vitamins, minerals, and herbal and homeopathic remedies can have dangerous side effects. Ephedra, a supplement that was marketed to consumers as an over-the-counter weight-loss aid, publicized the danger of some dietary supplements when it was discovered that it could be deadly. Other supplements cause problems when taken in large doses or when a consumer takes several supplements together. Patients tend not to report supplement use to their doctors when questioned about what medicines they use, but some supplements can interact poorly with prescribed medications, or aggravate certain conditions. Therefore, all supplement use—even vitamins—should be reported to one’s doctor. Common supplements such as calcium; magnesium; iron; folic acid; and vitamins A, B6, B12, C, and E can have adverse effects when combined with prescription drugs, yet users rarely attribute problems to their dietary supplements. It is also important for consumers to understand the difference between dietary supplements, homeopathic remedies, and over-the-counter medications, as they all fall under different regulatory guidelines. Over-the-counter medications—ibuprofen, inhalers, acid reflux inhibitors—have to be approved by the FDA and shown to be safe and effective. Dietary supplements do not have to show any evidence of their safety or effectiveness before being put on the market; they can only be removed by the FDA if proven dangerous to consumers. Homeopathic remedies come under the least regulation; they do not have to demonstrate safety or effectiveness, but they are allowed to make claims of positive medical effects. Consumers can be easily taken by the marketing of such remedies. The FDA does not have the authority to regulate these practices, thus, consumers must take it upon themselves to become educated about the supplements they use, and they should always report such use to their doctors.

Read the full story on nytimes.com

Estrogen Supplements May Raise Odds of Benign Breast Disease

Women who use estrogen for hormone replacement therapy during menopause more than double their risk for developing certain types of benign breast disease. Benign proliferative breast disease, one of the conditions developed by women using estrogen supplements, has been linked with an increased risk for breast cancer. Although previous studies have pointed out the risks of using hormone replacement therapy and its association with increasing one’s risk for breast cancer, a recent study published in the Journal of the National Cancer Institute is the first randomized study on the effect of conjugated equine estrogen (CEE)—a type of hormone therapy—on the risk of developing benign proliferative breast disease. This large-scale randomized trial confirms evidence that other smaller studies have suggested at. Benign proliferative breast disease has been known to progress into proliferative disease with cell abnormalities, which can then develop into localized cancer. The association between estrogen therapy and breast disease stems from estrogen’s stimulation of breast tissue activity. For some women, such stimulation develops into benign breast disease, while others develop malignant cancers over time.

Read the full story on healthday.com

In Shift to Digital Mammograms, More Recalls With Nothing Wrong

Digital mammography has been found to be more accurate than traditional X-ray film at finding tumors in younger women and women with dense breast tissue, as well as picking up small calcium deposits which can be a sign of cancer. An increasing number of radiologists are now switching from using film to using digital technology, but the transition period has caused a stressful side effect for many women. While radiologists are still adjusting to using the new technology, they are being more conservative in reading mammograms and determining which women need to be called back for a second evaluation. It is also more complicated to compare past X-ray film mammograms with new digital mammograms, making it difficult to track a patient’s mammograms over time. During the transition period of film to digital, most radiologists are choosing to take the safe route and call back every women whose mammogram comes back even slightly questionable. Additional tests, including a second mammogram, and ultrasound, and sometimes even a biopsy can be performed to confirm whether the patient has a tumor. When the follow-up tests all come back negative, it seems like being called back to the radiology center was a costly and stressful ordeal; however, for the woman who has a tumor detected early by a radiologist conservatively reading her mammogram, it can be life-saving.

Read the full story on nytimes.com