HIV infects women through healthy tissue: U.S. study

Instead of infiltrating breaks in the skin, HIV appears to attack normal, healthy genital tissue, U.S. researchers said on Tuesday in a study that offers new insight into how the AIDS virus spreads.

They said researchers had assumed the human immunodeficiency virus, or HIV, sought out beaks in the skin, such as a herpes sore, in order to gain access to immune system cells deeper in the tissue.

Some had even thought the normal lining of the vaginal tract offered a barrier to invasion by the virus during sexual intercourse.

"Normal skin is vulnerable," said Thomas Hope of Northwestern University's Feinberg School of Medicine said in a telephone interview.

"It was previously thought there had to be a break in it somehow," said Hope, who is presenting his findings at the American Society for Cell Biology meeting in San Francisco.

He said until now, scientists had little understanding of the details of how HIV is transmitted sexually in women.

Hope and colleagues at Northwestern in Chicago and Tulane University in New Orleans developed a new method for seeing the virus at work. They studied newly removed vaginal tissue taken from hysterectomy surgeries, and introduced the virus which carried fluorescent, light-activated tracers.

Then they watched under a microscope as the virus penetrated the outer lining of the female genital tract, called the squamous epithelium. They also observed this same process in non-human primates.

In both cases, they found HIV was able to quickly move past the genital skin barrier to reach immune cells, which the virus targets.

Hope said the study suggests the virus takes aim at places in the skin that had recently shed skin cells, in much the same way that skin on the body flakes off.

The finding casts doubt on the prior theory of the virus requiring a break in the skin or gained access through a single layer of skin cells that line the cervical canal.

And it might explain why some prevention efforts have failed. Hope said one clinical trial in Africa in which women used a diaphragm to block the cervix had no effect at reducing transmission of the virus. Nor have studies of drugs designed to prevent lesions in genital herpes proven effective.

Hope said the findings emphasize the need for treatments such as a vaccine to prevent infection.

And it makes clear the need for the use of condoms, which are highly effective at preventing infection.

"People need to remember that they are vulnerable," Hope said. "The sad part is if people just used a condom, we wouldn't have this problem," he said.

In the United States, HIV is mostly passed among men who have sex with men. Females account for 26 percent of all new HIV cases in the United States, according to the U.S. Centers for Disease Control and Prevention.

Globally, HIV is more commonly spread by heterosexual sex. The virus has infected 33 million people globally and has killed 25 million.

Breast Cancer Prevention

The breast consists of lobes, lobules, and bulbs that are connected by ducts. The breast also contains blood and lymph vessels. These lymph vessels lead to structures that are called lymph nodes. Clusters of lymph nodes are found under the arm, above the collarbone, in the chest, and in other parts of the body. Together, the lymph vessels and lymph nodes make up the lymphatic system, which circulates a fluid called lymph throughout the body. Lymph contains cells that help fight infection and disease.

When breast cancer spreads outside the breast, cancer cells are most often found under the arm in the lymph nodes. In many cases, if the cancer has reached the lymph nodes, cancer cells may have also spread to other parts of the body via the lymphatic system or through the bloodstream.

Significance of breast cancer

Breast cancer is second only to lung cancer as the leading cause of cancer death among women in the United States. Breast cancer occurs in men also, but the number of new cases is small. Early detection and effective treatment is expected to reduce the number of women who die from breast cancer, and development of new methods of prevention continue to be studied.

Breast cancer prevention

Breast cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided.

Selective Estrogen Receptor Modulators (SERMs) for Prevention of Breast Cancer: SERMs are drugs that act like estrogen on some tissues in the body such as bones, but block the effect of estrogen on other tissues. Tamoxifen is a SERM that blocks the effect of estrogen on breast cancer cells. A large study has shown that tamoxifen lowers the risk of getting breast cancer in women who are at elevated risk of getting breast cancer. However, tamoxifen may also increase the risk of endometrial cancer, stroke, and blood clots in veins and in the lungs. Women who are concerned that they may be at an increased risk of developing breast cancer should talk with their doctor about whether to take tamoxifen to prevent breast cancer. It is important to consider both the benefits and risks of taking tamoxifen.

Raloxifene is another SERM that is being studied for the prevention of breast cancer. A study of postmenopausal women with osteoporosis has shown that raloxifene lowered the risk of breast cancer for women at both high risk and low risk of developing the disease. It is not known if women who do not have osteoporosis would benefit in the same way. Like tamoxifen, raloxifene may increase the risk of blood clots in veins and in the lungs, but does not appear to increase the risk of endometrial cancer.

Hormonal Factors: Hormones produced by the ovaries appear to increase a woman's risk for developing breast cancer. The removal of one or both ovaries reduces the risk. The use of drugs that suppress the production of estrogen may inhibit tumor cell growth. The use of estrogen-progestin therapy, also called combination hormone replacement therapy (HRT), is associated with an increased risk of developing breast cancer. The use of oral contraceptives may also be associated with a slight increase in breast cancer risk.

Beginning to menstruate at an older age and having a full-term pregnancy reduces breast cancer risk. Also, a woman who has her first child before the age of 20 experiences a greater decrease in breast cancer risk than a woman who has never had children or who has her first child after the age of 35. Beginning menopause at a later age increases a woman's risk of developing breast cancer.

Radiation: Studies have shown that reducing the number of chest x-rays, especially at a young age, decreases the risk of breast cancer. Radiation treatment for childhood Hodgkin's lymphoma may put women at a greater risk for breast cancer later in life. A small number of breast cancer cases can be linked to radiation exposure.

Diet and Lifestyle: Diet is being studied as a risk factor for breast cancer. Studies show that in populations that consume a high-fat diet, women are more likely to die of breast cancer than women in populations that consume a low-fat diet. It is not known if a diet low in fat will prevent breast cancer. Eating a diet rich in beta-carotene may decrease the risk of breast cancer. Exercise, especially in young women, may decrease hormone levels and contribute to a decreased breast cancer risk. Breast feeding may also decrease a woman's risk of breast cancer. Postmenopausal weight gain, especially after natural menopause and/or after age 60, may increase breast cancer risk.

Alcohol: Drinking alcohol may be linked to increased breast cancer risk. The more alcohol a woman drinks, the more the risk of breast cancer may increase, compared to a woman who drinks no alcohol. In addition, a diet rich in beta-carotene, folate, and vitamins A and C may reverse the higher risk of breast cancer linked to alcohol use.

Prophylactic Mastectomy: Following cancer risk assessment and counseling, the removal of both breasts may reduce the risk of breast cancer in women with a family history of breast cancer.

Genetics: Women who inherit specific genes are at a greater risk for developing breast cancer. Research is underway to develop methods of identifying high-risk genes.

Acknowledgement given to the National Cancer Institute as originator of the information provided herein, with the NCI web site www.cancer.gov as the source.

How is breast cancer treated?

When breast cancer is detected at an early stage of development, a number of effective treatment options are available. A woman and her physician will choose the treatment that is right for her, based on the location and extent of the cancer, her age and preferences, and the risks and benefits of each treatment. The basic treatment choices for breast cancer are surgery, radiation, chemotherapy, and hormonal therapy. Local treatments such as breast surgery and radiation therapy are focused on the breast itself to remove or destroy the cancer cells confined to the breast. Systemic treatments such as chemotherapy and hormonal therapy aim to destroy the cancer cells that may have spread throughout the body.

Breast cancer cells can be estrogen receptor positive or estrogen receptor negative. Estrogen receptor positive cells are those that have a protein to which the hormone estrogen will bind. Cancer cells that are ER+ need estrogen to grow, and may stop growing when treated with hormones that block estrogen from binding.

Estrogen receptor negative refers to cells that do not have a protein to which the hormone estrogen will bind. Cancer cells that are ER- do not need estrogen to grow, and usually do not stop growing when treated with hormones that block estrogen from binding.

Surgery has an important role in breast cancer treatment. Most women have the option to choose between breast-conserving surgery (lumpectomy, plus radiation) or removal of the breast (mastectomy). Clinical trials have proven that both options provide the same long-term survival rates for most types of early stage breast cancer.

Lumpectomy removes a small tumor and a margin of normal tissue around the tumor` The surgeon also removes some of the lymph nodes under the arm to find out if the cancer has spread. Lumpectomy followed by radiation therapy to destroy any remaining cancer cells is the standard care. A clinical trial on lumpectomy and radiation is currently underway.

Modified radical mastectomy is surgery to remove the entire breast, some of the lymph nodes under the arm, and the lining over the chest muscles. It may be appropriate when the breast tumor is large or if cancer is found in more than one part of the breast.

Radical mastectomy involves removal of the breast, chest muscles, and all lymph nodes under the arm. It was the standard treatment many years ago, but it is used now only when a tumor has spread to the chest muscles.

Radiation therapy uses high-energy x-rays to destroy cancer cells. It is usually used after lumpectomy to destroy any cancer cells that still may remain in the breast after surgery. It is sometimes used to shrink tumors before surgery.

Chemotherapy uses drugs, usually a combination of drugs, that travel through the body to slow the growth of cancer cells or to kill them.

Hormonal therapy prevents cancer cells from getting the hormones they need to grow. If a breast tumor relies on the body's natural hormones to grow, it is described as estrogen receptor-positive or progesterone-positive. This means that any cancer cells that remain after surgery may continue to grow when these hormones are present in the body. Hormonal therapy can reduce the amount of the body's natural hormones or block the hormones from reaching any remaining cancer cells.

Women who have received treatment for breast cancer may be at risk of developing lymphedema, a condition in which excess fluid collects in tissue and causes swelling, according to the National Cancer Institute. Lymphedema may occur in the arm or leg after lymph vessels or lymph nodes in the underarm or groin are removed or treated with radiation.

Stages of Breast Cancer

After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.

The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

The following stages are used for breast cancer:

Stage 0 (carcinoma in situ)

There are 2 types of breast carcinoma in situ:

* Ductal carcinoma in situ (DCIS) is a noninvasive, precancerous condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive.
* Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.

Stage I

In stage I, the tumor is 2 centimeters or smaller and has not spread outside the breast.

Stage IIA

In stage IIA:

* no tumor is found in the breast, but cancer is found in the axillary lymph nodes (the lymph nodes under the arm); or
* the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or
* the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.

Stage IIB

In stage IIB, the tumor is either:

* larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
* larger than 5 centimeters but has not spread to the axillary lymph nodes.

Stage IIIA

In stage IIIA:

* no tumor is found in the breast, but cancer is found in axillary lymph nodes that are attached to each other or to other structures; or
* the tumor is 5 centimeters or smaller and has spread to axillary lymph nodes that are attached to each other or to other structures; or
* the tumor is larger than 5 centimeters and has spread to axillary lymph nodes that may be attached to each other or to other structures.

Stage IIIB

In stage IIIB, the cancer may be any size and:

* has spread to tissues near the breast (the skin or chest wall, including the ribs and muscles in the chest); and
* may have spread to lymph nodes within the breast or under the arm.

Stage IIIC

In stage IIIC, the cancer:

* has spread to lymph nodes beneath the collarbone and near the neck; and
* may have spread to lymph nodes within the breast or under the arm and to tissues near the breast.

Stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

In operable stage IIIC, the cancer:

* is found in 10 or more of the lymph nodes under the arm; or
* is found in the lymph nodes beneath the collarbone and near the neck on the same side of the body as the breast with cancer; or
* is found in lymph nodes within the breast itself and in lymph nodes under the arm.

In inoperable stage IIIC breast cancer, the cancer has spread to the lymph nodes above the collarbone and near the neck on the same side of the body as the breast with cancer.

Stage IV

In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Acknowledgement given to the National Cancer Institute as originator of the information provided herein, with the NCI web site www.cancer.gov as the source.

Early Detection of Breast Cancer

One of the earliest signs of breast cancer can be an abnormality that shows up on a mammogram before it can be felt.

The most common signs of breast cancer are a lump in the breast; abnormal thickening of the breast; or a change in the shape or color of the breast. Finding a lump or change in your breast does not necessarily mean you have breast cancer. Additional changes that may also be signs of breast cancer include:

* Any new, hard lump or thickening in any part of the breast
* Change in breast size or shape
* Dimpling or puckering of the skin
* Swelling, redness or warmth that does not go away
* Pain in one spot that does not vary with your monthly cycle
* Pulling in of the nipple
* Nipple discharge that starts suddenly and appears only in one breast
* An itchy, sore or scaling area on one nipple

Asthma Patient Takes Heed Stroke

ASTHMA can groan whosoever. Research express, the disease increases heart sickness risk and stroke.

Asthma disease is caused existence of continuous and chronic inflammation within stripper. Asthma comes from Greek with the meaning “ asphyxia “.

Immunology allergy expert from “Divisi Alergi Imunologi Klinik”, Department of Pathology In from RSCM, Dr Iris Rengganis SpPD KAI, mentions asthma is disease groaning bronchi at lung. " Asthma is stricture disease of breath channel, " says it.

Rengganis explains, asthma is differentiated become two kinds. Firstly, asthma kardial is relating to heart disparity, and bronchial asthma which is bronchi disease.

Extrinsic bronchial asthma patient, has hyperactive and is hypersensitive to kinds of excitement from outside. " Excitement from outside this for example like dirt around the area, weather, or smoke," says Rengganis which also instructor staff in Indonesia University Faculty Of Mediciness.

As for intrinsic bronchial asthma or non-alergik generally emerges when patient to get psychical trouble, stres, athletics berat,dan change of drastic weather. " Thus, all asthma cases has as result and different therapy, depended from asthma type suffered by someone and not based on gender," calls it.

a research reported by American kardiologi journal lays open, strarting asthma emerges when someone to bolt adult can increase heart attack risk and stroke at woman. the on unique, the thing is not happened at man.

Dr Stephen J Onufrak from US Department of Agriculture, Stoneville, Mississippi, mentions, asthma happened at the time of adult someone, like other surprise attack of which is proportional not experienced by by woman, for example rheumatoid arthritis ( chafes joint) and lupus, it is possible that is big risk for heart attack and stroke.

Onufrak and the friends using research data of Atherosclerosis Risk investigating bearing between asthmas, heart attack risk, and stroke based on gender.

They find, compared to them which is not mengidap asthma, adult woman mengidap asthma has 2,10 improvement of heart attack and 2,36 improvement stroke.

Have no relation between asthmatic men during child or adult and heart attack or stroke, with woman which mengidap asthma and heart or stroke during child.

When this research gets implication in treatment, Onufrak tells, " I am sure result of this needs replication in other group study to give recommendation which more concreete."

Answers to result of the research, Rengganis tells, the research must be seen former of the case. Does the asthma happened at lung or at heart. " Actually the case has not many happened. We must see former of case that is actually," she said.

Green Tea for Weight Control

Green tea is a good choice for people on a weight-loss programme because it can help them to lead a healthier lifestyle. For example, substituting green tea for coffee with cream and sugar not only saves calories but also supplies a lot of healthy substances, such as polyphenols and flavonoids, that can help improve one’s overall health.

Green tea contains a small amount of caffeine, so it serves as a mild appetite suppressant as well.

How much is usually taken by dieters?

Test tube studies suggest that green tea extracts high in catechins may inhibit fat digestion and a preliminary human study found a green tea extract increased calorie burning.1 2 A preliminary human study found that people taking a green tea extract containing 375 mg per day of total catechins (of which 270 mg per day was epigallocatechin gallate) for three months lost an average of 4.6% of their body weight without dieting.3 Double-blind trials are needed to confirm this effect.

Are there any side effects or interactions?

Green tea is generally free of side effects. The most common adverse effects reported from consuming large amounts (several cups per day) of green tea are insomnia, anxiety, and other symptoms caused by the caffeine content in the herb.

An extract of green tea taken by healthy women with a meal inhibited the absorption of non-haem iron (e.g., the form of iron in plant foods) by 26%.4 Frequent use of green tea could, in theory, promote the development of iron deficiency in susceptible individuals.

There are a few case reports of people developing liver damage while consuming weight-loss products that contained concentrated extracts of green tea.5 A cause–effect relationship was not proven, and most of the products contained other ingredients in addition to green tea extract. Nevertheless, researchers have cautioned against the use of large amounts, or concentrated extracts, of green tea.

Are there any drug interactions?
Certain medicines may interact with green tea. Refer to drug interactions for a list of those medicines.

Parts used and where grown

All teas (green, black, and oolong) are derived from the same plant, Camellia sinensis. The difference is in how the plucked leaves are prepared. Green tea, unlike black and oolong tea, is not fermented, so the active constituents remain unaltered in the herb. The leaves of the tea plant are used both as a social and a medicinal drink.

Resources

See a list of books, periodicals, and other resources for this and related topics.


*Dieters and weight-management advocates may claim benefits for green tea based on their personal or professional experience. These are individual opinions and testimonials that may or may not be supported by controlled clinical studies or published scientific articles on green tea. For more complete and detailed information, including references and safety information, see Green Tea as an herbal remedy.

References

1. Juhel C, Armand M, Pafumi Y, et al. Green tea extract (AR25) inhibits lipolysis of triglycerides in gastric and duodenal medium in vitro. J Nutr Biochem 2000;11:45–51.

2. Dulloo AG, Duret C, Rohrer D, et al. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. Am J Clin Nutr 1999;70:1040–5.

3. Chantre P, Lairon D. Recent findings of green tea extract AR25 (Exolise) and its activity for the treatment of obesity. Phytomedicine 2002;9:3–8.

4. Samman S, Sandstrom B, Toft MB, et al. Green tea or rosemary extract added to foods reduces nonheme-iron absorption. Am J Clin Nutr 2001;73:607–12.

5. Bonkovsky HL. Hepatotoxicity associated with supplements containing Chinese green tea (Camellia sinensis). Ann Intern Med 2006;144:68–71.