Michigan State University researchers have identified a potential genetic target for treating an especially painful and invasive form of endometriosis.

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PEMBROKE PINES, Fla. – While ovarian cancer is rare in women of childbearing age, when it happens, it can create fears about a woman’s future fertility.

In an effort to preserve the ability to conceive, more doctors are performing fertility sparing procedures in cases of borderline ovarian tumors, one-third of which affect women under the age of 40.

“In instances where these are diagnosed, there’s a possibility to remove only one ovary while leaving in the other ovary and fallopian tube, as well as the uterus to maintain fertility in these patients,” said Dr. Jonathan Black, with The Center of Gynecologic Oncology in Pembroke Pines.

Black said studies have shown a 99% chance of survival, even with a cancer recurrence in the remaining ovary for women who undergo fertility sparing surgery.

Also in today’s health news, a University of Miami study found that the coronavirus may affect male fertility.

Researchers found the virus present in both living men previously infected with COVID-19, as well as six men who died from the virus.

“What was most surprising about our study was that we found the virus in the testes of a man who was previously infected and now recovered and was asymptomatic,” said Dr. Ranjith Ramasamy, the study lead author with the UHealth-Miller School of Medicine.

Investigators said it makes sense that the testes are a target for infection because the virus is drawn to receptors in many of the body’s organs, including the lungs, heart, intestines, kidneys and testicles.

Questions still remain about whether the virus can be sexually transmitted and the exact impact on fertility.

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Suppose you’re a teen or young woman who starts putting on fat, mainly in your legs. Doctors say you’re obese – but no matter how much you diet and exercise, you can’t lose the fat. After years of weight gain, pain, and swelling, you’re finally diagnosed with lipedema – a common but “enigmatic” disease of the peripheral fat. That’s the experience of women with lipedema surveyed in the December issue of Plastic and Reconstructive Surgery , the official medical journal of the American Society of Plastic Surgeons (ASPS).

To gain insights into this misunderstood condition, Anna-Theresa Bauer, MD, of Technical University Munich, Germany, and colleagues, surveyed 209 women with lipedema who were treated with liposuction. Lipedema is a congenital disease, causing disproportionate accumulations of fat, most often in the legs.

Occurring almost exclusively in women, lipedema is usually misdiagnosed as obesity – but the abnormal fat deposits don’t respond to diet or exercise. In addition to cosmetic concerns, the fat accumulations cause pain, easy bruising, and progressive swelling. Lipedema seems to run in families, as most patients have affected relatives.

The women in the survey averaged 38 years of age. However, most noticed the first signs of lipedema in their teens or young adult years: average time to diagnosis was 15 years. “Frequently, lipedema patients go through a long period of uncertainty and self-doubt, before their disease is finally properly diagnosed,” Dr. Bauer and coauthors write. “They are helpless against their weight gain and their pain and also the social withdrawal they often experience.”

Most of the women had other health problems besides lipedema, most commonly an underactive thyroid gland. Other common problems included depression and migraine headaches. But the patients had low rates of common obesity-related conditions, including high blood pressure, high cholesterol, and diabetes.

The patients underwent multiple sessions of liposuction to treat the abnormal fat deposits, most commonly in the thighs, calves, buttocks, back, and abdomen. The average amount of “pure fat” removed by liposuction was 10 liters, but was much higher in some patients.

In nearly all of the women, liposuction led to decreased pain, bruising, and swelling. Other benefits were also apparent, including reduced frequency and severity of migraine attacks. “Liposuction yields long-lasting positive effect in lipedema patients, leading to a marked increase in their quality of life,” Dr. Bauer and coauthors write.

The authors note some important limitations of their patient survey study. However, it adds to a growing body of evidence supporting the benefits of liposuction in reducing symptoms and improving quality of life for women with lipedema. The findings may also provide new clues into the causes of lipedema – particularly hormonal factors. Dr. Bauer and colleagues emphasize the need for further, in-depth studies to gain a clearer picture of the “physiological mechanisms underlying this progressive disease.”

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PORTLAND, Oregon — Most pre-licensure nursing students said that they were willing to provide nursing care for transgender clients, a researcher reported here.

The Qualtrics survey was sent to 245 pre-licensure BSN students enrolled in an adult health nursing course, 23% of whom responded. One-third of the participants reported providing nursing care to a transgender client as a student, and nearly all participants reported positive attitudes towards transgender clients, according to Joseph De Santis, PhD, RN, NP, of the University of Miami School of Nursing and Health Studies in Coral Gables, Florida.

“All participants said they were willing to perform sexual health counseling, including HIV risk reduction and safer sex practices counseling. All of the participants reported a willingness to provide nursing skills with the exception of a small number of students who were unwilling to perform genital or anal-related assessments or procedures,” De Santis and co-author, Mary McKay, DNP, ARNP, also of the same institution, reported in a poster at the Association of Nurses in AIDS Care annual meeting.

“These students are a lot younger than those of us who grew up without really knowing much about transgender persons, even though there were all around us,” De Santis told MedPage Today. “But these students, who are [average age 25.83] have been exposed to transgender persons most of their life.”

However, their institution does have a gender reassignment surgery clinic so “most of our students have had contact with those patients,” he added. “So given their age and their previous contact with patients, they are probably more willing that others who haven’t had these contacts.”

De Santis and McKay noted that the majority of the survey sample was female, almost 25% identified as a member of the LGBT community, and one participant self-identified as transgender. “The results require cautious interpretation because of small sample size,” they stated.

De Santis toldMedPage Today that some of the students expressed concern about not having the appropriate training to care for transgender patients, “So our next plan is to help these students build skills; to give them the skills and tools to take care of the transgender individuals.”

Of one student who reported unwillingness to administrating rectal medications, administering enemas, performing dressing changes, or other tasks involved in caring for transgender patients, De Santis stated, “I applaud that person, his or her honesty, at least. But this would be a person you would not assign to treat a transgender person on your unit.” He acknowledged that nurses should not be assigned to patients based on their own biases, but “it happens.”

Survey participants completed a demographic questionnaire and the Transgender Attitudes and Beliefs Survey. They indicated their willingness to provide care and completed a checklist based on the clinical skills performed in an adult health nursing course, such as psychomotor and sexual health counseling.

Deborah Michell, RN, of Johns Hopkins University in Baltimore, noted that, at her institution, there is a HIV-dedicated unit, “but when [patients with HIV] would end [up] on other floors, due to overcrowding or some other reason, we did observe the nursing staff showing a reluctance to treat these individuals, even if they were just HIV patients, let along transgender patients. There were always some kinds of snide remarks. In general, there is a bias that persists among providers against these patients.”

Michell, who was not involved in the study, added that the current study “indicates that things are going in the right direction, as far as care for these patients is concerned. Things are much better now, thank God.”

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NEW YORK, Sept 11 ― A preliminary new study has found that having high blood pressure later in life may speed up cognitive decline, but treating the condition may also help slow it down.

Carried out by researchers at Columbia University Mailman School of Public Health, USA, the new study looked at data gathered from nearly 11,000 adults in China to assess how high blood pressure and its treatment may be linked with cognitive decline.

The researchers interviewed each of the study participants about their high blood pressure treatment and asked them to perform cognitive tests, such as recalling words as part of a memory quiz.

High blood pressure was defined as having a systolic blood pressure of 140 mmHg or higher and a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive treatment. The American Heart Association defines high blood pressure as starting with slightly lower measurements, and having a systolic blood pressure of 130 mmHg or higher or a diastolic reading of 80 mmHg or higher.

The findings, presented at the American Heart Association’s Hypertension 2019 Scientific Sessions, showed that overall, cognition scores declined over the four-year study. However, participants who were age 55 and older and who had high blood pressure showed a quicker rate of cognitive decline compared with those who did not have high blood pressure or who were being treated for high blood pressure.

In fact, the rate of cognitive decline was similar between those without high blood pressure and those taking treatment for the condition.

As an observational study, the researchers cannot establish cause and effect. The team also did not investigate why or how high blood pressure treatments may have slowed down cognitive decline, or which treatments were the most effective.

Nevertheless, senior author L.H. Lumey commented that, “The findings are important because high blood pressure and cognitive decline are two of the most common conditions associated with ageing, and more people are living longer, worldwide.”

Study author Shumin Rui also added, “We think efforts should be made to expand high blood pressure screenings, especially for at-risk populations, because so many people are not aware that they have high blood pressure that should be treated.”

“This study focused on middle-aged and older adults in China, but we believe our results could apply to populations elsewhere as well. We need to better understand how high blood pressure treatments may protect against cognitive decline and look at how high blood pressure and cognitive decline are occurring together.”

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Long before I became president and director of Seattle’s Fred Hutchinson Cancer Research Center, I learned all-too-well the link between infectious disease and cancer.

As a medical student at the University of California, San Francisco during the 1980s, I witnessed the early days of the AIDS epidemic. Young men with HIV were dying in that city by the thousands of unusual opportunistic infections such as pneumocystis pneumonia and rare cancers such as Kaposi sarcoma.

I worked at San Francisco General Hospital on a medical team with Dr. Sue Desmond-Hellmann, who was also profoundly influenced by the suffering there; she went on to a successful career in oncology and infectious disease. Her star kept rising. At the biotechnology pioneer Genentech, she was responsible for the development of a plethora of novel cancer drugs including monoclonal antibodies such as trastuzumab, or Herceptin, for breast cancer and rituximab for B-cell malignancies. Then she returned to lead UCSF as chancellor, and today she is chief executive officer of our good neighbors in Seattle, the Bill & Melinda Gates Foundation.

While our paths have crossed frequently over the years, it was particularly meaningful recently when we met again — this time in, of all places, Kampala, Uganda.

For two pivotal years beginning in 1989, Sue had lived in that city studying HIV/AIDS and cancer at the Uganda Cancer Institute. Last month, she revisited Kampala, and together we walked through the UCI-Fred Hutch Cancer Centre, which is jointly operated by UCI and Fred Hutch’s Global Oncologyprogram. It is a world-class facility with a wonderful staff; and it is a place where the link between infectious diseases and cancer is witnessed daily.

Both of us found it humbling and inspiring to observe the great work being done by many young researchers working in challenging situations where so many cancer patients are also infected with HIV.

In sub-Saharan Africa, 33% of all cancers are caused by infectious agents; and HIV, which severely impairs a person’s immune system, can make that person even more prone to infection by other viruses that can lead to cancers. For example, about 85% of patients at UCI with Kaposi sarcoma — caused by a herpes virus that existed long before AIDS — are HIV-positive as well.

Kaposi sarcoma often presents as dark or purple lesions on the skin of individuals infected with HIV. Until effective antiviral drugs against HIV were developed, it was literally the face of AIDS in the United States. It still takes a toll in Uganda, despite a laudable program to provide these drugs to people there living with HIV.

While at UCI-Fred Hutch, Sue and I met a young woman, Margaret Sunday, who had arrived there with severe Kaposi sarcoma lesions covering her feet and legs. She had been under care for HIV and had been taking antiviral drugs. Sadly, despite this medical attention, her cancer had not been diagnosed early and had gone untreated.

It was immediately apparent that we are still missing something in the screening and treatment of HIV in sub-Saharan Africa. In the United States, HIV screeners also look for cancers. We look for other viral infections, like human papillomavirus, or HPV, that can lead to cervical cancer, understanding that the risk of cervical cancer in women with HIV — nearly all of whom also have HPV — is increased more than fivefold. For patients in the US with HIV, where treatment is widely available, the leading cause of death is no longer opportunistic infection as it was in the 1980s — rather, it is cancer. If we treat HIV but not the cancer, it is as if we are treating half the patient.

In Uganda, I believe we are making progress. The UCI-Fred Hutch Collaboration expands local capacity in scientific research, training and patient care, serving as a great model for addressing global health challenges.

Because of the challenges we face in treating cancer with chemotherapy and radiation therapy in a resource-limited environment, it is critically important that we reduce the cancer burden on patients in this region. We must strengthen all facets of cancer and HIV care — including screening, early diagnosis and all stages of treatment. We must strengthen the bonds between cancer prevention and infectious disease prevention. That is why UCI-Fred Hutch nurses who screen for HIV are also trained to tie the screening for cervical cancer to HIV testing and care.

I was gratified to see Sue reunite with some of the amazing people she worked with in Kampala in the 1980s. We saw staff equipped with advanced facilities and technologies that did not exist or were unthinkable three decades ago: a specimen-receiving lab, a histopathology lab for processing biopsies, a lab for genomic sequencing.

Sue and I also visited the medical records room containing paper records stacked to the ceiling dating back more than 50 years to the inception of the UCI. Remarkably, UCI-Fred Hutch staff pulled several charts from 1989–1990 with handwritten notes by Sue herself — very comprehensive notes I might add, with complete differential diagnoses included!

As vaccine programs are a central focus of the Gates Foundation, we further discussed our efforts to ensure broad vaccination with HPV vaccines. At the Hutch we are especially focused on HPV vaccines as they were developed with the help of insights from investigators like Dr. Denise Galloway, who holds the Paul Stephanus Memorial Endowed Chair. These were but a few of the truly memorable “full-circle” moments during our visit.

We will continue to work in close collaboration with our African colleagues to gain ground against both cancer and infectious diseases. We are all committed to using our understanding of the linkage between infectious disease and cancer to better treat — and prevent — them both.

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