One Incredible Gift Changes the Lives of Many Families

Posted by Brigham and Women's Hospital December 6, 2016

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Christine (left) became a living donor earlier this year to help people in kidney failure. Her kidney donation sparked a chain that resulted in dozens of transplants. Christine is pictured here with Henrietta (right), the final recipient in the chain.

In 2012, Christine Gentry, a high school teacher, was scrolling through Facebook and came across a post from an old friend. In the post, her friend, Julia, sadly announced that she was suffering from kidney failure and needed a kidney transplant. All of Julia’s family members had been tested, but none were suitable donors for her. Julia was sending a final plea.

Christine immediately contacted Julia and offered to help. After testing, Christine was told that she was not a direct match for Julia, but she was an ideal living kidney donor who may still be able to help Julia through a paired exchange donation. Read More »

Why is Breast Density Important?

Posted by Brigham and Women's Hospital October 31, 2016

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This image shows a negative screening mammogram of 45-year-old woman with dense breast tissue.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the final in our series, discusses breast density.

Breasts contain fibrous, glandular, and fatty tissue. Generally, breasts are considered dense if they contain a lot of fibrous and glandular tissue and less fat. Breast density is classified on a mammogram report in one of four ways:

  • Almost entirely fatty
  • Scattered areas of fibroglandular density
  • Heterogenously dense
  • Extremely dense

According to the American College of Radiology, 80 percent of women in the United States fall into one of the middle two categories, 10 percent have almost entirely fatty breasts, and the remaining 10 percent have extremely dense breast tissue.

Breast density is important for several reasons. Dense breast tissue may increase a woman’s chance of developing breast cancer. Also, detection of breast cancer using mammography is more difficult in women with dense breast tissue. Read More »

Could Genes be the Cause of Your Family’s Heart Disease?

Posted by Brigham and Women's Hospital October 26, 2016

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Dr. Christine Seidman, Director of the Cardiovascular Genetics Center at Brigham and Women’s Hospital, and her team have developed novel approaches to evaluate and care for patients with inherited heart disease and their families.

In some families, heart disease occurs more frequently than in the general public. Researchers at Brigham and Women’s Hospital have spent years studying heart disease in these families to pinpoint genetic changes that lead to the development of heart disease.

“Our team has pioneered diagnostic testing for patients at risk for genetic forms of heart disease,” said Dr. Christine Seidman, Director of the Cardiovascular Genetics Center at BWH. “We can now determine if an individual carries a dangerous genetic variant and intervene to treat or help prevent damage to the heart.”

Examples of inherited heart diseases include hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmias, Marfan syndrome, and inherited aortic aneurysms. Caring for someone with an inherited heart disease includes the patient’s family, particularly the patient’s siblings and children. Genetic testing can be performed to determine risk in these family members. Preventative measures or therapies Read More »

Who is Reading Your Mammogram?

Posted by Brigham and Women's Hospital October 21, 2016

Radiology technician examens mammography test on location

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms and has radiologists who are dedicated to breast imaging.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the second in our series, discusses the importance of specialized training in reading mammograms.

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms. Preferably, the radiologists in the center should be dedicated to breast imaging. Breast imaging specialists devote their time exclusively to breast imaging, including mammography, breast MRI, and breast ultrasound.

The detection of very subtle changes in early breast cancer can be very challenging. Studies have shown that radiologists specializing in breast imaging outperform non-specialist radiologists in detecting breast cancer.  Furthermore, the more mammograms and other breast images that radiologists read, the better they become at identifying these subtle changes, with higher accuracy. Read More »

The Broad Reach of Violence

Posted by Brigham and Women's Hospital October 5, 2016

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Interpersonal violence affects the health and wellbeing of millions of Americans. In the United States today, nearly 20 people per minute are physically abused by an intimate partner, homicide remains among the leading causes of death in adolescents and young adults, and violence in the community has become a major public health issue.

In today’s post, Marta P. Chadwick, JD, Director of Violence Intervention and Prevention Programs in the Center for Community Health and Health Equity at Brigham and Women’s Hospital (BWH), provides some key information on the prevalence and extensive impact of violence today. Read More »

Breast Cancer Screening: Understanding the Guidelines

Posted by Brigham and Women's Hospital October 4, 2016

Digital 3D mammography (digital breast tomosynthesis), the latest technology used in mammography, takes multiple images of each breast from different angles. It has been shown to improve earlier detection of breast cancers and reduce the number of call backs for repeat imaging.

Contributor: Dr. Catherine Giess is Chief of the Division of Breast Imaging at Brigham and Women’s Hospital and Assistant Professor of Radiology at Harvard Medical School.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). This post is designed to outline breast cancer screening guidelines.

“Mammography is a very important screening tool for early breast cancer detection, but there are several different guidelines for when to start and how often to undergo mammography,” says Dr. Giess.  “This can be confusing for many women.”

The American College of Radiology recommends annual screening mammography beginning at age 40.  The ACS guidelines (outlined below) emphasize screening based on a woman’s individual risk of developing breast cancer and her personal preferences.

 

When should I start?

A woman’s first mammogram serves as a baseline to compare results of subsequent mammograms.

  • Women should begin discussing breast cancer screening with their health care providers at age 40. From 40-44 years of age, women have the option to begin annual screening if they choose to do so.  All women should begin yearly mammograms by age 45.
  • Women who are at higher risk for developing breast cancer, such as women with a family history of breast or ovarian cancer, should discuss their own personal risk factors with their health care providers, and may need to start screening earlier.

Read More »

Can Cocoa Extract and a Multivitamin Help Prevent Heart Disease and Cancer?

Posted by Brigham and Women's Hospital October 3, 2016

The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health.

Contributor: Dr. JoAnn Manson is Chief of the Division of Preventive Medicine at Brigham and Women’s Hospital (BWH). She is leading the COSMOS trial with BWH Dr. Howard Sesso, an associate epidemiologist at BWH.

Researchers at Brigham and Women’s Hospital and the Fred Hutchinson Cancer Research Center are collaborating in a new research study, known as the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), for the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health, including preventing heart disease and cancer.

Previous studies of cocoa flavanols conducted by researchers at BWH and other institutions have found that cocoa may reduce the risk of heart disease (including a short-term decrease in blood pressure), as well as slow age-related cognitive decline. BWH researchers have also previously found that multivitamin use modestly reduced cancer risk in a trial of more than 14,000 male physicians.

“COSMOS will allow us to further explore these promising nutritional supplements in both men and women as part of a large-scale national clinical trial,” said Dr. JoAnn Manson, Chief of the Division of Preventive Medicine at BWH and Co-Director of COSMOS with BWH epidemiologist Dr. Howard Sesso.

Read More »

Allergic to Essential Medication?

Posted by Brigham and Women's Hospital September 22, 2016

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Serious allergic reactions, including anaphylaxis, occur when mast cell chemicals flood the body, causing an array of acute symptoms.

What do you do when your body is not tolerating a medication that you need?

Patients fighting cancer, severe infections, autoimmune disorders, and many other conditions may become sensitized to the very drugs that are most effective in treating their diseases. These patients can suffer serious allergy symptoms, such as hives, flushing, itching, shortness of breath, wheezing, hypotension, and even anaphylaxis – a severe life-threatening allergic reaction.

Because of the potential allergic reaction upon re-exposure to these drugs, these patients are often told that they can no longer be treated with their best medication. A technique called drug desensitization can be used to help these patients get back on their medications.

Read More »

High-risk Pregnancy Care: When Is It Needed?

Posted by Brigham and Women's Hospital September 9, 2016

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Chelsea received specialized high-risk pregnancy care at BWH when she was diagnosed with a failing heart valve during her pregnancy with her daughter Aria.

Contributor: Louise Wilkins, Haug, MD, PhD, Division Director of Maternal-Fetal Medicine at Brigham and Women’s Hospital and a Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.

When 29-year-old Chelsea was in the second trimester of her pregnancy with her daughter Aria, she began experiencing dizziness and shortness-of-breath. An echocardiogram revealed that one of her heart valves had deteriorated.

Chelsea was referred to the Cardiovascular Disease and Pregnancy Program at Brigham and Women’s Hospital (BWH), where a team including high risk pregnancy (maternal-fetal medicine) specialists, cardiologists, and cardiac surgeons worked together to develop a specialized plan for her care. This included delivering her baby in a hybrid operating suite at BWH to enable the team to quickly respond with a range of treatments for Chelsea’s heart condition if needed during the delivery. Chelsea delivered a healthy baby girl and had successful valve replacement surgery at BWH the following week.

Who is at Risk for Pregnancy Complications?

Women with heart disease like Chelsea, are one of several groups that may benefit from high risk pregnancy care. Thesegroups include women with other pre-existing medical conditions, women who develop complications during pregnancy, women at risk for premature birth, and women of advanced maternal age (35 years of age or older). Maternal-fetal medicine specialists provide individualized care before, during, and after pregnancy for women who are considered high risk.

“Our goal is to ensure a healthy pregnancy and safe delivery for each mother and baby through careful planning, medical expertise, and team-based care,” said Dr. Wilkins-Haug.

Consultation and planning before pregnancy (pre-conception planning) is very important for women with pre-existing medical conditions, such as diabetes, heart disease, lupus, and psychiatric illnesses. High-risk pregnancy specialists often work closely with other specialists (such as cardiologists, rheumatologists, gastroenterologists, and psychiatrists) to make adjustments to a woman’s medications prior to and during pregnancy. They also recommend key nutritional supplementation and lifestyle changes to help reduce risks during pregnancy.

During high-risk pregnancy, there may be concerns about how the baby is developing. In addition to closely monitoring the mother’s condition, high-risk pregnancy specialists track the baby’s development and may provide treatment to support the baby’s developing systems. In some cases, they may be able to correct certain conditions before the baby is born.

How Pregnancy Complications Affect Long-term Health

Conditions that develop during pregnancy also can place the mother at long-term risk for health complications. Up to 60 percent of women who have gestational diabetes end up with Type 2 diabetes, and women who experience preeclampsia (a condition characterized by high blood pressure) have a higher risk of developing cardiovascular disease throughout their lifetime. High-risk pregnancy specialists help women after delivery and work with their primary care physicians with the goal of improving their health for many years after pregnancy.

Learn more about high-risk pregnancy care in this video with Dr. Wilkins-Haug.

Related links:

-Jessica F.

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Preventing Preterm Birth

Posted by Brigham and Women's Hospital August 18, 2016

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Medical and surgical treatment approaches can help prevent or delay preterm birth.

Contributor: Thomas McElrath, MD, PhD, Director of the Preterm Birth Clinic in the Division of Maternal-Fetal Medicine at Brigham and Women’s Hospital (BWH) and Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.

There are a number of effective treatment approaches that can help prevent or delay preterm birth depending on a mother’s condition.

“Medications and, in some cases, surgery can be used to minimize risks associated with preterm delivery,” says Dr. McElrath.

One in nine babies in the United States is born prematurely (before 37 weeks of pregnancy). These babies have a higher risk of short- and long-term complications, and the risk increases the earlier the delivery.

To provide additional support to the cervix and help prevent preterm labor, specialists sometimes use a soft flexible ring (pessary) or a stitch (cerclage) at the cervical opening. Other approaches include the use of progesterone, a hormone, to prolong pregnancy.

In addition to a history of preterm delivery, other risk factors for preterm birth include prior cervical surgery, reproductive tract or uterine anomalies, multiple gestation pregnancy (twins, triplets, or more), low or high maternal age, and high blood pressure.

“Preconception planning and specialized care are key for women at high risk for preterm birth,” says Dr. McElrath. “A multidisciplinary team dedicated to evaluating, treating, and monitoring these patients will be able to ensure the best possible outcomes for babies and their families.”

Related links:

-Jessica F.

 

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