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Ovary removals linked to increased risk of kidney failure

Raghu Kshitiz

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Women who have their ovaries removed before menopause may find themselves at higher risk for chronic kidney disease, a new study by the Mayo Clinic has suggested.

Risk can go up more than 7 percent for some women, according to the study that looked specifically at more than 1,600 premenopausal women living in and around Rochester over the span of 14 years.

Researchers believe the reason behind it is the drop in estrogen levels that follows the procedure.

“This is the first study that has shown an important link between estrogen deprivation in younger women and kidney damage,” said study senior author Dr. Walter Rocca, a neurologist and epidemiologist at the Mayo Clinic in Rochester, Minn.

Though the study did not prove cause and effect, women considering having their ovaries removed should be aware of this potentially serious risk, particularly if they aren’t at high risk for ovarian and breast cancer, the researchers added.

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While other studies have already shown removing ovaries at too young of an age can increase a wide variety of chronic diseases and mortality, this study adds chronic kidney failure to that list.

Chronic kidney disease occurs when the kidneys are damaged and can’t filter the blood as well as they should. If the kidneys fail, patients must undergo dialysis and a kidney transplant.

Finding the overall kidney failure risk in women under 50 who had not had their ovaries taken out is 13 percent. That number jumps to 20 percent for those with them removed.

Still, the exact correlation between ovaries producing estrogen and kidney strength remains unknown.

Previous studies have shown that the female hormone estrogen has a protective effect on the kidneys. In this latest study, researchers investigated how the removal of both ovaries affected the kidney function of women who had not yet experienced menopause.

The findings were published Sept 19 in the Clinical Journal of the American Society of Nephrology.

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Suicide can’t be predicted by asking about suicidal thoughts : Study

Gorkha Post

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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