Monthly Archives: June 2013

Health, Medical, Research, Science

HRT and the menopause: benefits now thought to outweigh risks…

After more than a decade of controversy, medical experts say that Hormone Replacement Therapy (HRT) for women in their 50s is safe in combating the menopause.

Taking medication to reduce the symptoms of the menopause is now deemed safe and the benefits for women on HRT are now thought to far outweigh the potential risks. Freshly released guidance from the British Menopause Society (BMS) has sought to reassure patients.

Medical experts say hundreds of thousands of women have suffered unnecessarily as a result of the decade-long controversy over the effects of HRT.

They say that General Practitioners (GPs) should prescribe the treatment to any woman who has unpleasant menopausal symptoms, such as hot flushes and mood changes. HRT is also known to provide bone protection in later life.

However, the debate over HRT use is likely to rage on as The Royal College of Obstetricians and Gynaecologists continues to advise HRT prescription only for women with serious menopausal symptoms ‘for the shortest time possible’.

After a period of five years doctors are not expected to continue prescribing HRT medication without discussing potential risks with their patients.

Uptake of HRT halved after two studies linked it to an increased risk of heart disease and breast cancer. An estimated one million women in the UK stopped having the treatment.

But the emerging consensus now is that the benefits of HRT outweighed the risks for most women, and that GPs should consider the updated BMS advice when treating the condition.

Consultant Endocrinologist Dr Helen Buckler, from the University of Manchester, speaking at the Cheltenham Science Festival, said the two studies linking HRT to breast cancer and heart disease were ‘scientifically unreliable’.

She said:

… The new advice is HRT should be used for a slightly wider age, if need be. If a woman has symptoms affecting the quality of her personal or professional life, then the benefits outweigh the risk.

The scare of taking HRT began in 2002, when the US Women’s Health Initiative study was halted some three years early because researchers claimed women using HRT were at a higher risk of breast cancer, heart disease and strokes. Yet, this contradicted previous (and later) research which suggested its use guarded against heart problems.

HRT is normally prescribed to menopausal women in their 50s, but according to the WHI study it was also given to women in their 60s and 70s who had gone through the menopause more than a decade earlier.

Shortly afterwards the UK Million Women Study, part funded by Cancer Research, a charity, said HRT doubled breast cancer risk, but a review in 2012 said it was ‘unreliable and defective’.

The advice from Cancer Research remains that there is still convincing evidence that women who take HRT have an increased risk of breast cancer. Dr Buckler, though, said the organisation was ‘out of step’ and its approach had tended to ‘put women off’ taking the treatment.

Some younger doctors have never prescribed HRT because they assume the risks outweigh the benefits.

Cancer Research UK said there was ‘convincing evidence’ that women who take HRT have an increased risk of breast cancer, but says that risk returns to normal around five years after the medication is stopped being used.

The BMS guidance is also opposed to the ‘arbitrary’ five year limit on treatment, and says it should be continued if symptoms persist.

The BMS, a registered charity and medical foundation, receives no government funding. Its medical advisory council comprises leading international experts in post reproductive health management, who regularly draw up guidelines for health professionals.

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Arts, History, Science

Quantum Leaps: Blaise Pascal, 1623-1662…

PASCAL

Blaise Pascal, a Frenchman who passed away at the age of just thirty-nine, his time on earth unfortunately cut short by poor health, made significant contributions to the fields of mathematics and science – this, despite his abandonment of scientific study in favour of religious devotion in 1655.

During his twenties Pascal spent a large amount of time undertaking experiments in the field of physics. The most important of these involved measuring air pressure. An Italian scientist, Evangelista Torricelli (1608 – 47), had argued that air pressure would decrease at higher altitudes. Pascal set out to prove this by using a mercury barometer. He took initial measurements in Paris and then, at the 1200m-high Puy de Dome in 1646, confirmed in no uncertain terms that Torricelli’s speculation was true.

  • Pascal’s Law

More significantly, though, his studies in this area led him to develop Pascal’s Principle or Law, which states that pressure applied to liquid in an enclosed space distributes equally in all directions. This became the basic principle from which all hydraulic systems derived, such as those involved in the manufacture of car brakes, as well as explaining how small devices such as the car jack are able to raise a vehicle. This is because the small force created by moving the jacking handle in a sizeable sweep equates to a large amount of pressure sufficient to move the jack head a few centimetres. Applying the lessons of his studies in a practical way, Pascal went on to invent the syringe and, in 1650, the hydraulic press.

  • Child prodigy

In spite of these developments, however, Pascal is probably better remembered for his work in the area of mathematics. It was here that he showed his genius from an early age. For example, having independently discovered a number of Euclid’s theorems for himself by the age of just eleven, he went on to master The Elements, the great mathematician’s definitive text, a year later. When he was sixteen he published mathematical papers which his older contemporary Descartes at first refused to believe could have been written by someone so young. In 1642, still only nineteen, Pascal began work on inventing a mechanical calculating machine which could add and subtract. He had finished what was effectively the first digital calculator by 1644 and presented it to his father to help him in his business affairs.

  • Theory of Probability

It was not until later in his short life, around 1654, that Pascal jointly made the mathematical discovery which would have the most impact on future generations. It had begun with a request by an obsessive gambler, the Chevalier de Méré, for assistance in calculating the chance of success in the games he played. Together with Pierre de Fermat, another French mathematician, Pascal developed the theory of probabilities, using his now famous Pascal’s Triangle, in the process. As well as its obvious impact upon all parts of the gambling industry, the importance of understanding probability has had subsequent application in areas stretching from statistics to theoretical physics.

The SI unit of pressure – the pascal – and the computer language, Pascal (named in honour of his contribution to computing through his invention of the early calculator), are named after him in recognition of two of his main areas of scientific success.

Seven of the calculating devices that he produced in 1649 survive to this day.

  • Pascal’s Wager

Like many of his contemporaries, Pascal did not separate his science from philosophy, and his book Pensees, he applies his mathematical probability theory to the perennial philosophical problem of the existence of God. In the absence of evidence for or against God’s existence, says Pascal, the wise man will choose to believe, since if he is correct he will gain his reward, and if he is incorrect he stands to lose nothing, an interesting, if somewhat cynical argument.

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Syria, United Nations

UN Report on Syria: ‘Conflict at new levels of brutality’…

A picture taken on April 26, 2013 shows smoke rising after shelling in Houla in Syria’s Homs province. The opposition National Coalition has accused the regime of using chemical weapons in the northern province of Aleppo, in Homs in central Syria, and in rebel-held areas near Damascus. (Photo credit: AFP/Getty Images)

The Syrian conflict is now two and a half years into a violent and civil bloody war between the Syrian regime of President Bashar al-Assad and various rebel groups. According to a recent report from United Nations investigators, the bloodshed is only intensifying: in a survey of events in Syria between Jan 15 and May 15, the U.N. Human Rights Council’s independent commission on the civil war says it has reached ‘new levels of cruelty and brutality’ – and that there’s no reason to believe the carnage will abate any time soon.

This week, commission chair Paulo Pinheiro told the Human Rights Council that ‘Syria is in free-fall… no one is winning… more weapons will only lead to more dead civilains and wounded.’

Investigators report that there are ‘reasonable grounds’ to believe that chemical agents of an unspecified variety had been deployed in civilian areas. The commission found no conclusive proof determining whether one or both sides in the conflict have deployed chemical weapons, but warn there to be a heightened risk in the future.

On top of the grave risk that nerve gas and other chemical agents could be deployed in civilian areas, ‘non-combatants’ are continually under attack from all sides of the conflict. More than 70,000 civilians have died (with some estimates as high as 100,000) and millions more have been displaced since the civil war broke out over two years ago. The commission concludes that both Assad’s forces and many factions within the rebels are guilty of war crimes against civilains, including torture and rape. Nearly 7 million people, half of them children, are ‘in need of urgent assistance’ due to lack of medical care and food shortages instigated by the conflict.

The U.N. commission ends its report with a strong recommendation for a negotiated settlement:

… A diplomatic surge is the only path to a political settlement. Negotiations must be inclusive, and must represent all facets of Syria’s cultural mosaic.

In the United States, foreign policy hawks such as Sen. John McCain, continue to call on the White House to militarily intervene. Mr McCain believes that America could intervene by launching cruise missiles from the US naval fleet in the region. This, he says, would decapitate Assad’s air defences and would not require boots on the ground or the establishment of a no-fly zone (NFZ).

President Barack Obama has previously said that the use of chemical weapons on civilains would cross a ‘red line’ and therefore may justify intervention. Last month, the White House said it was supportive of Israeli air strikes within the country.

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