Women's Health Practice News

June 2005, Volume 5, Issue 2

Special Points of Interest (click topic)

Research News-Currently Enrolling Studies
Advances in Male Hormonal Contraception
Fingernail Health
Seasonal Disorders
Historical Fact
Staff Update
AAAHC Accreditation
Electronic Medical Records
Some Good Websites

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__________________________

Suzanne Trupin, MD, FACOG
2125 South Neil Street, Champaign, IL 61820
PHONE (217)356-3736
FAX (217) 356-5849
www.womenshealthpractice.com

Research News

Currently Enrolling Studies

STUDY - Heavy Menstrual Bleeding

Do you experience heavy menstrual bleeding on 2 to 5 days of your regular menstrual period? Does heavy menstrual bleeding keep you from your normal social and work activities?

If you answered yes to these questions, you may qualify for a research study of an investigational drug for heavy menstrual bleeding. This investigational drug is not a hormone.

You must:

• Be a generally healthy woman between the ages of 18 and 49
• Have regular menstrual cycles with heavy bleeding
• Not have any other bleeding disorder

If you qualify you will receive study drug and study related procedures including physical exams, electrocardiograms, eye exams and laboratory tests at no cost. You will also receive compensation for your time and travel.

For more information, please call 217- 356-3736.

STUDY - Anemic? New Baby?

Having a baby can leave some women with low blood levels of iron. Your doctor will help you understand whether or not you suffer from low iron levels—sometimes called anemia. Iron deficiency anemia can make you feel excessively tired and low on energy. You may have trouble concentrating or feeling like your old self. Anemia is usually treated with iron supplements.

Women's Health Practice is looking for women who require treatment for low iron levels to participate in a research study of an investigational medication for iron deficiency. Qualified study participants will receive study related: exams, tests, investigational medication, and care by a board-certified physician. Also, compensation for study-related time and travel may be provided. For more information, please call 217-356-3736.

STUDY - Osteoporosis/Osteopenia — The Silent Disease

Up to half of all women 50 and over will suffer at least one osteoporosis-related fracture in their lives. Risk factors for developing Osteoporosis/Osteopenia include:

• Family history
• Postmenopausal
• Physically inactive
• Small frame
• Smoke cigarettes
• Diet low in calcium

Osteoporosis Research Study

We are seeking volunteers to participate in a clinical trial evaluating a once-yearly investigational medication for the prevention of osteoporosis.

To qualify, you must be:

• A woman between the age of 45-75
• NOT currently taking:
  • Oral/IV bisphosphonate (Fosamax® Actonel® pamidronate, etidronate)
  • Estrogen replacement therapy, Evista®
  • Stronium, PTH

If you qualify, you will receive during the study:

• Physical exams
• Bone density test
• Clinical thermometer
• Calcium and Vitamin D supplements

STUDY - Postmenopausal Women Needed For A Research Study

Are you a postmenopausal woman who has stopped taking your weekly osteoporosis medication because of gastrointestinal (GI) problems? If so, you may qualify for a one year research study evaluating an investigational medication for the treatment of osteoporosis.

Eligible participants will be provided study-related procedures and study medication at no cost. In addition, participants may receive reasonable reimbursement for time and travel.

If you are interested in finding out more information about this research study, please contact Women's Health Practice at 217-356-3736.

STUDY - Menopause Research Study

Wish you could find a way to control your menopausal symptoms? According to the North American Menopause Society, about 4,000 women in the United States and Canada reach menopause each day. 80-85% of menopausal women experience symptoms such as:

• hot flushed/flashes
• heart palpitations/irregularities sleep disorders, including night sweats
• mood swings
• irritability
• decreased libido
• feminine dryness

30% of menopausal women will have severe symptoms. These symptoms can make daily life uncomfortable and unmanageable.

A research study is being conducted to evaluate the safety and effectiveness of an investigational medication in menopausal women with persistent symptoms.

Women interested in volunteering for the study must be between the ages of 30 and 65; be menopausal, with or without hysterectomy, with at least one intact ovary; have persistent menopausal symptoms, including hot flashes; have been taking standard estrogen therapy for at least 8 weeks.

Participation in the study requires at least five office visits over a period of up to 22 weeks, and includes study related medical care, including health assessments, lab tests, and study medications.

Women interested in volunteering or learning more about the study can contact: Women's Health Practice at 217-356-3736, www.womenshealthpractice.com

STUDY - Do You Have Abnormal Periods?

Are you a female with abnormal menstrual bleeding, between the ages of 18-45? Have you not had a period for 90 days or more or have you already been diagnosed with amenorrhea and taking hormones?

You may be a candidate for study testing the effects of the investigational use of an FDA approved medication on secondary amenorrhea. The lack of a
regular menses can pose serious health risks for women.

Eligible participants will be compensated for participation in the study and will receive study-related medical care.

STUDY - Endometriosis — Does Pain Persist Despite Surgery?

• If you have been diagnosed with endometriosis by surgery.
• Are your menstrual periods extremely painful?
• If you have pain with sexual intimacy.
• Have pain even to sit, stand, walk, or exercise.
• If you have pelvic pain throughout your cycle.
• You may be eligible to participate in a clinical research study.
• Study-related testing and investigational medication is at no charge to you.

If you suffer from any of these symptoms and want to learn more, call now.

SURVEY - Postmenopausal Osteoporosis

Have you been diagnosed with Postmenopausal Osteoporosis? If so, YOU may be eligible to participate in a 3 question survey. Women's Health Practice at 217-356-3736. Call now to see if you are eligible.

Advances in Male Hormonal Contraception

Hormone treatments to temporarily stop sperm growth are being explored as a new method of birth control.

Intramuscular injections, implants of slow-release pellets, transdermal patches and gels and oral tablets are all used to deliver hormone treatment that interferes with sperm growth. Testosterone and progesterone, the most commonly employed hormones in male hormonal contraception, decrease sperm growth by blocking follicle-stimulating hormone (FSH) and lutenizing hormone (LH). In normal spermatogenesis, FSH and LH are released from the pituitary gland in the brain and travel to the testicles to stimulate sperm growth.

In one study by the World Health Organization (WHO), six months of weekly injections of testosterone led to azoospermia, absence of live sperm, in 60% of subjects. For the following year, azoospermic men continued the weekly testosterone treatments as their only method of birth control. Of the 157 participants, only one pregnancy was reported.

The extent to which sperm growth must be arrested in order to avoid pregnancy is not known. Azoospermia is considered the gold standard for male hormonal contraception. But, oligozoospermia, which is a significant reduction in live sperm (< 3 million / ml), may be adequate.

A second WHO study investigated how much sperm suppression is needed for contraception. No pregnancies occurred for azoospermic men, and four pregnancies were reported for oligospermic men. Interestingly, the failure rate for male hormonal contraception was lower than the failure rate for condoms, demonstrating that hormone treatment may be more effective than condoms. Male hormonal contraception was also temporary, in that restoration of normal sperm production occurred 112-203 days after treatment ended.

One of the mysteries of the male hormonal contraception field is that numerous reports reveal that Asian men are more sensitive than non-Asian men to hormone treatments that cause azoospermia. For example, 95% of Asian men, compared with 68% of non-Asian men, showed azoospermia following testosterone treatment. Ethnic differences in anatomy, cell function, and the effects of diet on testosterone production may explain why hormonal contraception is more effective in Asian men.

Other studies show that men treated with testosterone and progesterone showed oligospermia sooner than men treated with testosterone only. Progesterone treatment also allowed for a lower dose of testosterone to be effective.

So far, hormonal contraception does not change physical and mental well-being in most men. Other side effects, reported mainly in non-Asian men, include increases in body weight, acne, and sexual desire. Testosterone treatment decreased high-density lipoprotein (HDL) in non-Asian men, but did not change HDL in Asian men.

Research for safe, reversible, and easily administered treatments for male hormonal contraception has been ongoing since the 1970s. Recent advances in these methods were reviewed recently in the fall 2004 issue of Dialogues in Contraception, a publication from the Keck School of Medicine of the University of California in Los Angeles.

- Adapted from the Fall 2004 issue of "Dialogues in Contraception," by the Keck School of Medicine of the University of Southern California.

Fingernail Health Can Indicate Overall Health

Do your fingernails break easily? Do they have ridges or strange colors? The health of your fingernails can indicate your overall health. Vertical ridges and white splotches are normal, but discoloration, thickening, or indentation may indicate disease. Remove nail polish before visiting your doctor, in case he or she inspects your nails for underlying health problems.

Routine care of healthy nails:

• Do not bite your nails
• Do not pick your cuticles
• Frequently moisturize your nails

Use these tips to treat weak nails:

• Keep nails trimmed with the tips squared and slightly rounded
• Moisturize after washing hands
• Use a nail hardener without toluene sulfonamide or formaldehyde
• Avoid using nail polish remover more than twice a month. Instead, paint over chipped polish.
• Use nail glue or clear nail polish to fix tears

Did you know?

• Nail growth averages 1/10 inch a month
• Nails on your dominant hand grow faster
• Nails grow more in the summer than in the winter

Do You Bite Your Nails?

• Nail biting (onychophagia) is commonly thought of as a nervous habit, but it can occur during boredom too.
• Nail biting is most frequent during puberty.
• Most nail biters stop biting by adulthood.
• Nail biting can cause sore fingertips and cuticle bleeding. Infections of the nail bed and mouth may also occur.

- Adapted from www.webmd.com and www.pamf.org.

Seasonal Disorders

The onset or severity of some health conditions change with the seasons. Below are some conditions that may improve and others that may worsen during the summer months:

Improves

• Seasonal Affective Disorder (SAD)
  • Symptoms: Sleep and appetite changes, weight gain, irritability, heaviness of legs.
  • Diagnosed after 2 consecutive years of symptoms.
  • Phototherapy can help.
• Acne
  • Most studies show that acne improves during the summer.
  • But one study reported more acne in the summer, perhaps due to greater sweating and increased humidity.
  • Acne may vary according to regional weather differences.
• Urinary Tract Infections
  • In a study performed in Finland, most diagnoses were in November.
• Cardiovascular Conditions
  • Blood pressure is lower in the summer.
  • Strokes and heart attacks are less frequent in summer.

Worsens

• Melasma
  • Common skin condition in which sun exposure darkens skin on the forehead, cheeks, and upper lip.
  • Unlike a regular suntan, individuals with melasma have splotchy discoloration of skin.
  • Sunscreen and staying out of the sun can help.
• Kidney Stones
  • Exposure to light increases vitamin D, which causes increased calcium absorption from food, which then is excreted in urine.
  • Calcium, from urine, form kidney stones.

Other Seasonal Changes in Health Conditions

• Reproductive Events
  • First episode of menstruation occurs most often during the summer.
  • Increased birth rates in spring and fall.
  • More extramarital births in February (conception in May-June), due to increased incidence of intercourse during spring and summer.
  • More intercourse in spring and summer, less in winter.
• Cancers
  • Increased diagnosis of cervical cancer in February, August, and November.
  • Breast cancer diagnosis may occur more often in April.
  • Epidemiological studies showing a lower risk of hormone-dependent cancers in people living in the dimly-lit Arctic suggest that exposure to light increases risk for breast cancer.

Historical Fact

In 1921, Dr, John A. Sampson described endometriosis as being due to menstrual blood eggressing from the uterus into the abdominal cavity by way of the fallopian tubes. To this day, it is known that simple suppression of menstrual periods, by hormonal contraception or pregnancy, is helpful in the prevention of endometriosis progression.

Staff Update

JoAnn Davis, R.N., B.S.N., joined WHP/MSC in March 2005. She received her R.N. degree from Parkland College in 1995 and B.S.N. in 2000 from Indiana Wesleyan University. She has ten years experience as a staff nurse and is certified in neonatal intensive care. We are excited to have JoAnn as a WHP/MSC staff member. Please join us in welcoming her!

WHP/MSC Achieves Accreditation

Women's Health Practice/Midwest Surgical Center (WHP/MSC) has achieved accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC/Accreditation Association), according to Suzanne Trupin, M.D., F.A.C.O.G.

Status as an accredited organization means WHP/MSC has passed a series of rigorous and nationally recognized standards for the provision of quality health care, set by the Accreditation Association. Over 2,200 ambulatory health care organizations across the United States are accredited by the AAAHC.

“Accreditation underscores our longstanding commitment to providing the highest possible levels of quality care to the community we serve,” said Dr. Suzanne Trupin. “We are pleased and proud to have our efforts recognized with this accreditation.”

Ambulatory health care organizations seeking accreditation by the AAAHC undergo an extensive on-site, peer-based survey of its facilities and services. Not all ambulatory health care organizations seek accreditation; not all undergoing the onsite survey are granted accreditation.

Since 1945, WHP has offered comprehensive health care for every phase of a woman's life. MSC was established in 2004 for our existing ambulatory surgical center.

Electronic Medical Records

Electronic medical record systems (EMRs) are changing the concept of medical records and are the wave of the future. WHP/MSC implemented its EMRs in 2002. Clear advantages of EMRs include:

• Instant access—no longer a need to search through shelves of paper charts.
• Call backs and telephone triage easier and more efficient
• Remote access—not possible with a paper chart which can only be in one place at one time.
• Avoids duplication—relevant information can be found more easily; EMRs never forget anything!
• Computer generated documents are easier to read and interpret by all healthcare professionals. Illegible handwriting is no longer an issue—the computer's handwriting is excellent!
• Improved communication
• Management of medications—drug alerts and checks for drug interactions, reducing errors in prescriptions.
• Enhanced decision support—up to date test records, alerts, and reminders,
• Patient education
• Safe storage and backup—backup copies at an off site location (a catastrophe, such as flood or fire, would destroy paper charts)

EMRs offer enormous benefits to our patients. Decreasing tedious paper work allows us to focus on you and your healthcare needs.

Some Good Websites…

http://www.bonebalance.org (osteoporosis, take the “Bone Health Quiz”)
http://travel.state.gov/family/adoption/adoption_485.html (international adoption)
http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof (risk assessment tool for estimating 10-year risk of developing hard coronary heart disease)
http://www.femalesexualdysfunctiononline.org (sexual dysfunction)
http://www.nlm.nih.gov/medlineplus/sunexposure.html (sun exposure and sunburn)