A “Two-fer” for Women?

Digital mammograms may offer benefits beyond screening for early stage breast cancer.  A new study suggests that mammograms may also help in detecting heart disease in women before clinical symptoms develop.  How?  It turns out that a retrospective study found a strong correlation between calcification in the arteries of the breast seen on mammograms and calcification of the coronary arteries seen on chest CT scans – a recognized risk for heart disease.  The positive predictive value of breast arterial calcification (BAC) identifying coronary artery calcification (CAC) in the study was almost 70%.

While this finding will need to be confirmed in other studies, it should be easy for mammographers to document BAC in their reports.  This information could be used by internists to help identify women at increased risk for heart disease and to redouble their efforts to reduce smoking, obesity, high cholesterol, hypertension, and diabetes before a heart attack occurs.  Conservatively, this translates into approximately 4 million women nationwide undergoing screening mammography who will exhibit BAC and 2-3 million with premature coronary atherosclerotic disease.

Remember: half of all women will die of heart disease, yet many have no or unrecognized symptoms compared to men.  Any intervention that may help identify women at high risk for a cardiac event, especially one already routinely utilized in cancer screening, is worth pursuing.

                  

                                        Judith Wolf, MD

Associate Director, WHEP

                                                                                                          

For more information, see original article and accompanying editorial.

L. Margolies, M. Salvatore, H.S. Hecht, et al.  Digital mammography and screening for coronary artery disease.  J Am Coll Cardiol Img, 9 (2016)

K. Nasir and JW MCEvoy. Recognizing Breast Arterial Calcification as Atherosclerotic CVD Risk Equivalent From Evidence to Action.  J Am Coll Cardiol Img, 9 (2016)

 

    

           

                                                                                                      

 

                                                                                                                               

What Makes You Beautiful?

 

 

What makes you beautiful? Some would say it’s the color of your hair or its texture; the color of your eyes, or the subtle hew of your complexion.  Eighty percent of women agree that every woman has something about her that is beautiful but do not see their own beauty.

Although beauty is in the eye of the beholder, society has and to continues to formulate the essence of what makes up beauty. Some of society’s ‘norms’ on beauty are dependent on one’s weight, race, and age; girls are affected more by these societal guidelines than boys.  Nine out of 10 girls want to change at least one aspect of their physical appearance; only 4% of women around the world consider themselves beautiful.

 A study evaluating self esteem and body weight in adolescent girls, showed strong associations between girls with higher BMIs and increased risk of low self-esteem.  Girls who consider themselves to be over weight have also demonstrated higher risk of depression.  

 Society’s depiction of beauty is also heavily reliant on race, e.g., light, dark, or fair complexion; ‘African’ or ‘European’ features.   It’s these critical self-evaluations that dilute the richness of ones heritage, ones ancestry and the eloquence of someone’s unique characteristics.

 The notion of a ‘youthful look’ has also made the ‘impressionable list’ of ‘accepted’ beauty.  Studies show that women over the age of 50 still feel the pressure of ‘keeping up’ with their appearance, more so than men in the same age bracket. Results from a Dove research study showed that beauty-related pressure increases, and body confidence decreases, as girls and women grow older; 72% of girls feel tremendous pressure to be beautiful.

In a world made up so many cultures, history and traditions, a melting pot per se, how can we standardize beauty and how far are we willing to go to fit its ‘suggested’ mold? We are saturated with advertisement, i.e., media, internet, billboards dictating the guideline to beauty.  Since 2012, beauty-related sales increased by 14%, $392 million on revenues from make-up alone.   Nearly half of women in the United States feel that wearing makeup makes them feel in control; 82% of women believe wearing make-up makes them feel more self-confidence, while 86% of women find that wearing makeup improves their self-image.

Luckily, we can, with guided effort and support, seek healthier, more gratifying techniques to relinquish and embrace our beauty.   Experts recommend we focus on techniques that help generate a deeper sense of self-confidence, i.e., focus on what you have NOT on what you don’t, don’t forget to smile, spend some time with yourself, eat healthy nutritious food, work out and practice ‘radical’ acceptance, just to name of a few.  Beauty is beyond the topical surface that society tends to gravitate towards, it is among many things, utter acceptance of oneself.

For more information: 

http://www.oprah.com/spirit/How-to-Feel-Beautiful-and-Boost-Confidence

http://www.dove.us/Our-Mission/Girls-Self-Esteem/Our-Research/default.aspx

 

                                                                                                                       Lidyvez Mejia

                                                                                                                  Research Assistant

                                                                                              Office of Urban Health Equity, Education & Research

Everyone's Talking About Zika

                           Every year about this time, commercials advertising getaways to Caribbean, Central and South American destinations seem particularly enticing.  But before you pack your bags, know what you might encounter besides palm trees and tropical breezes – these days, the talk is all about arboviruses.  These are viruses spread by mosquitos and ticks and can cause potentially debilitating, sometimes fatal diseases. So it’s important to take appropriate precautions (light weight long-sleeved clothing, a good mosquito repellent, and a strong dose of common sense) when you travel to endemic locales.  

For the last few weeks we’ve been inundated with reports about Zika virus, an arbovirus that may be linked to microcephaly in infants of infected pregnant women.  Though a causal relationship has not been definitively confirmed, circumstantial evidence linking a 20-fold increase in cases of microcephaly in Brazil where concomitant Zika virus transmission is ongoing is creating panic. 

Zika is not the first, nor is it likely to be the last arbovirus that has generated alarm in the Americas.  It joins West Nile virus, dengue and chikungunya, all of which spread from Africa eastward to the western hemisphere.  Because the presenting symptoms can overlap somewhat, distinguishing between these viral syndromes can be difficult.  Zika infection does not result in hemorrhagic fever or death the way dengue can.  In fact, most often it is very mild or asymptomatic.  However, it may present with an initial flu-like illness (fever, arthralgia, conjunctivitis) and rash characteristic of the other viruses.

  So why all of the concern?  Two reasons:  an observed increase in cases of Guillain-Barre syndrome (a paralyzing neurologic syndrome) and fetal microcephaly (small brain size) in areas where Zika infection has become established.   In fact, if a causal relationship is proven, Zika would be the first flavivirus to have teratogenic effects.

There have also been recent reports of sexually transmitted Zika virus infection.  It is not yet clear how effectively it might be spread through blood and other body fluids, but the CDC and WHO have issued multiple advisories urging precaution and use of barrier protection (condoms) when engaging in sexual intercourse.

Given the potential for congenital Zika virus infection, pregnant women are strongly urged to avoid travel to endemic areas.  In addition, if a pregnant woman’s male partner has recently traveled to these areas, condoms should consistently be used during sexual intercourse.  There are no commercially available tests at this time, but if Zika infection is suspected, testing of serum samples (RT-PCR and serologies) can be performed at the CDC.  If positive, fetuses should be monitored for the development of microcephaly or brain calcification via serial ultrasound.  No vaccines or specific antiviral treatment are currently available. 

For more information, visit http://www.cdc.gov/zika/




                                                                                                                                        Judith Wolf, MD
                                                                                                                              Associate Director, WHEP