Supreme Court to hear “pay-for-delay” drug case

(Reuters) – The Supreme Court on Friday agreed to decide whether brand-name drug companies may pay money to generic drug rivals to keep their lower-priced products off the market, a practice estimated to cost consumers and the government billions of dollars each year.

The arrangements, known as “pay-for-delay” or “reverse payments,” have for more than a decade vexed antitrust enforcers including the Federal Trade Commission, which have been stung until recently by a series of court decisions allowing such practices.

In a typical case, a generic rival challenges the patent of a brand-name competitor, which then pays the rival a sum of money to drop its challenge. Defenders of the practice call it a legitimate means to resolve patent litigation.

The court accepted an appeal by the FTC, which had challenged annual payments of $ 31 million to $ 42 million by Solvay Pharmaceuticals Inc, now owned by Abbott Laboratories Inc, to stop generic versions of AndroGel, a treatment for the underproduction of testosterone, until 2015.

These payments went to such rivals as Watson Pharmaceuticals Inc, Paddock Laboratories Inc and Par Pharmaceutical Cos, and were intended to help Solvay preserve annual profits estimated at $ 125 million. The 11th U.S. Circuit Court of Appeals in Atlanta upheld the arrangement in April.

(Reporting by Jonathan Stempel in New York; Editing by Kevin Drawbaugh)

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High court to hear key gay-marriage cases

A same sex marriage supporter waves a gay pride flag outside the Supreme Court (Chip Somodevilla/Getty Images)

The Supreme Court announced Friday that it will decide two major gay marriage cases next year that could have a sweeping effect on the rights of same-sex couples to wed. The cases, which likely won't be decided until June, mark the first time the justices will consider arguments for and against same-sex marriage.

The court will review California's gay marriage ban, which passed in a 2008 ballot initiative months after the California's high court had legalized same sex unions and thousands of gay Californians had already tied the knot. Two federal courts have struck down Prop. 8 as discriminatory, leaving the Supreme Court to render a final judgment.

The justices will also hear a challenge to the federal Defense of Marriage Act, a law passed under President Bill Clinton that prevents the federal government from recognizing gay marriages. Windsor v. United States was brought by Edith Windsor, a resident of New York who paid $363,000 in estate taxes after her wife died because the federal government did not recognize their marriage. New York is one of nine states (and the District of Columbia) where gay marriage is legal, so Windsor argues that the federal government is discriminating against her by not recognizing her state-sanctioned marriage.

The Obama administration decided last year to no longer defend the Defense of Marriage Act, so Congress has hired outside counsel to argue on behalf of the law. Recently, two federal appeals courts had struck down the law as unconstitutional, virtually requiring the Supreme Court to take the case to settle the dispute between the courts and Congress.

Legal experts are skeptical that the court would deliver a sweeping ruling deciding whether or not all Americans, regardless of sexual orientation, have a fundamental right to marry. In the DOMA case, it's more likely they will narrowly decide whether the federal government has a legitimate interest in refusing to recognize same-sex married couples who wed in states where gay marriage is legal. (Marriage has traditionally been regulated by the states.) In the Prop 8 case, justices may decide whether a ban on gay marriage is legal in the specific case of California, where gay couples were allowed to marry for several months before the ban passed. Such a narrow decision would not necessarily affect gay marriage bans that have passed in dozens of other states where same-sex marriage was never legal in the first place.

But Ted Olson, a former U.S. solicitor general under George W. Bush  and one of the lead attorneys in the battle against Prop 8, told reporters on Friday that he planned to argue that there's a "fundamental constitutional right to marry for all citizens." His co-counsel, David Boies, called same-sex marriage the civil rights issue of this era. John Eastman, the chair for the anti-gay marriage National Organization for Marriage, said in a statement that he thinks the Supreme Court will uphold Prop 8 and DOMA. "We believe the U.S. Supreme Court will overturn this exercise in judicial activism and stop federal judges from legislating from the  bench on the definition of marriage," Eastman said.

For both cases, court-watchers will have their eyes trained firmly on swing justice Anthony Kennedy, who has a record of ruling in favor of gay rights. In 2003, Kennedy wrote the Court's opinion in Lawrence v Texas, a landmark decision that said the government cannot outlaw anal sex between consenting adults, whatever their sexual orientation. ("The liberty protected by the Constitution allows homosexual persons the right to choose to enter upon relationships in the confines of their homes and their own private lives and still retain their dignity as free persons," he wrote.) Kennedy also cast the deciding vote striking down a Colorado law that would have prevented local governments from passing laws specifically protecting gay and lesbian civil rights.

Because of Kennedy's history on the issue, many legal experts think there's a good chance the court will strike down DOMA, with Kennedy joining the court's four liberals for the decision. But the workings of the Supreme Court are notoriously hard to predict, and it's still a complete mystery what the nine justices will decide next June.

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Protesters surge around Egypt’s presidential palace

CAIRO (Reuters) – Tens of thousands of Egyptian protesters surged around the presidential palace on Friday and the opposition rejected President Mohamed Mursi‘s call for dialogue to end a crisis that has polarized the nation and sparked deadly clashes.

The Islamist leader’s deputy said he could delay a December 15 referendum on a constitution that liberals opposed, although the concession only partly meets a list of opposition demands that include scrapping a decree that expanded Mursi‘s powers.

“The people want the downfall of the regime” and “Leave, leave,” crowds chanted after bursting through barbed wire barricades and climbing on tanks guarding the palace of Egypt‘s first freely elected president.

Their slogans echoed those used in a popular revolt that toppled Mursi’s predecessor Hosni Mubarak in February 2011.

Vice President Mahmoud Mekky said in a statement sent to local media that the president was prepared to postpone the referendum if that could be done without legal challenge.

The dialogue meeting was expected to go ahead on Saturday in the absence of most opposition factions. “Tomorrow everything will be on the table,” a presidential source said of the talks.

The opposition has demanded that Mursi rescind a November 22 decree giving himself wide powers and delay the vote set for December 15 on a constitution drafted by an Islamist-led assembly which they say fails to meet the aspirations of all Egyptians.

The state news agency reported that the election committee had postponed the start of voting for Egyptians abroad until Wednesday, instead of Saturday as planned. It did not say whether this would affect the timing of voting in Egypt.

Ahmed Said, leader of the liberal Free Egyptians Party, told Reuters that delaying expatriate voting was made to seem like a concession but would not change the opposition’s stance.

He said the core opposition demand was to freeze Mursi’s decree and “to reconsider the formation and structure of the constituent assembly”, not simply to postpone the referendum.

The opposition organized marches converging on the palace which elite Republican Guard units had ringed with tanks and barbed wire on Thursday after violence between supporters and opponents of Mursi killed seven people and wounded 350.

Islamists, who had obeyed a military order for demonstrators to leave the palace environs, held funerals on Friday at Cairo’s al-Azhar mosque for six Mursi partisans who were among the dead. “With our blood and souls, we sacrifice to Islam,” they chanted.

“ARM-TWISTING”

In a speech late on Thursday, Mursi had refused to retract his November 22 decree or cancel the referendum on the constitution, but offered talks on the way forward after the referendum.

The National Salvation Front, the main opposition coalition, said it would not join the dialogue. The Front’s coordinator, Mohamed ElBaradei, a Nobel peace laureate, dismissed the offer as “arm-twisting and imposition of a fait accompli”.

Murad Ali, spokesman of the Brotherhood’s Freedom and Justice Party (FJP), said opposition reactions were sad: “What exit to this crisis do they have other than dialogue?” he asked.

Mursi’s decree giving himself extra powers sparked the worst political crisis since he took office in June and set off renewed unrest that is dimming Egypt’s hopes of stability and economic recovery after nearly two years of turmoil following the overthrow of Mubarak, a military-backed strongman.

The turmoil has exposed contrasting visions for Egypt, one held by Islamists, who were suppressed for decades by the army, and another by their rivals, who fear religious conservatives want to squeeze out other voices and restrict social freedoms.

Caught in the middle are many of Egypt’s 83 million people who are desperate for an end to political turbulence threatening their precarious livelihoods in an economy under severe strain.

“We are so tired, by God,” said Mohamed Ali, a laborer. “I did not vote for Mursi nor anyone else. I only care about bringing food to my family, but I haven’t had work for a week.”

ECONOMIC PAIN

A long political standoff will make it harder for Mursi’s government to tackle the crushing budget deficit and stave off a balance of payments crisis. Austerity measures, especially cuts in costly fuel subsidies, seem inevitable to meet the terms of a $ 4.8-billion IMF loan that Egypt hopes to clinch this month.

U.S. President Barack Obama told Mursi on Thursday of his “deep concern” about casualties in this week’s clashes and said “dialogue should occur without preconditions”.

The upheaval in the most populous Arab nation worries the United States, which has given billions of dollars in military and other aid since Egypt made peace with Israel in 1979.

The conflict between Islamists and opponents who each believe the other is twisting the democratic rules to thwart them has poisoned the political atmosphere in Egypt.

The Muslim Brotherhood’s spokesman, Mahmoud Ghozlan, told Reuters that if the opposition shunned the dialogue “it shows that their intention is to remove Mursi from the presidency and not to cancel the decree or the constitution as they claim”.

Ayman Mohamed, 29, a protester at the palace, said Mursi should scrap the draft constitution and heed popular demands.

“He is the president of the republic. He can’t just work for the Muslim Brotherhood,” Mohamed said of the eight-decade-old Islamist movement that propelled Mursi from obscurity to power.

(Additional reporting by Omar Fahmy; Writing by Edmund Blair and Alistair Lyon; Editing by Giles Elgood)

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‘Post-PC’ is more than just marketing buzz for Apple CEO Tim Cook

Apple (AAPL) is no stranger to ditching technologies when it deems them to no longer be useful. The company dropped the floppy disk for a CD-ROM drive on the first iMac and most recently has shifted to building MacBooks and iMacs without any physical disc drives. In his first televised interview on NBC’s Rockcenter with Brian Williams, Apple CEO Tim Cook revealed that he has “ditched physical keyboards” now that he spends 80% of his time using his iPad “authoring email” and “working on things.” Cook says he’s gotten quite good at typing on the screen and advises people to trust auto-correction as it’s “quite good” — though it’s a feature we still blast iOS for some five years after the first iPhone launched. But what does it mean when the boss of the country’s most valuable company and the most revered technology company in the world doesn’t even use physical keyboards anymore? Perhaps the “post-PC” era will become mainstream sooner than we thought.

For years, Apple has touted the idea that we’re entering the “post-PC” era – a period when touchscreen-equipped smartphones and tablets will eclipse desktops, notebooks and complex operating systems as they slowly fade away into a niche reserved for professionals.

While there will still be a need for notebooks, Windows PCs and Macs, the increasing numbers of smartphones and tablets sold and continued decline of worldwide PC sales support Apple’s claim that mobile is where the next tech battleground is, even if Microsoft (MSFT) thinks otherwise.

The term “dogfooding” is often thrown around between tech blogs and Cook is doing exactly that — using his “own product to demonstrate the quality and capabilities of the product.”

As Steve Jobs once said, Apple only builds products its own engineers and designers would use themselves.

Cook’s not saying, “iPads are great” for some people and some tasks. The fact that Cook uses his iPad for 80% of his work and an iPhone all the time suggests he and Apple are serious about this post-PC era. Apple wants iPads and iPhones to be great for all of your computing needs.

Apple is serious enough about it that the big boss has shifted his habits from old-school typing on actual keyboards to using virtual keyboards. And for all we know, Cook could be using even more natural human interfaces such as more voice recognition (ex: Siri in iOS and built-in dictation in OS X Mountain Lion).

Will physical keyboards go the way of the dodo in the next handful of years? It’s doubtful, but don’t be surprised if you see fewer and fewer offices with QWERTY keyboards attached to PCs and more desks and execs just carrying tablets and a smartphone on the side.

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Kristen Wiig may join “Anchorman: The Legend Continues”

LOS ANGELES (TheWrap.com) – Kristen Wiig is being eyed for a role in “Anchorman: The Legend Continues” for Paramount Pictures, a person familiar with the negotiations has told TheWrap.

Wiig would play opposite Steve Carell, as a love interest in the sequel. The script is still being written, and no cast beyond the principals has been set.

Adam McKay is directing the feature, which is being produced by Judd Apatow through his Apatow Productions banner. The film is a sequel to the 2004 hit, “Anchorman: The Legend of Ron Burgundy” and is due to be released in October 2013.

Best known for her work on “Saturday Night Live,” Wiig is one of the most in-demand actresses in Hollywood, since appearing in the film “Bridesmaids.” She could recently be seen at the Toronto International Film Festival in the indie feature “Imogene,” and has been busy filming a number of titles, including “The Secret Life of Walter Mitty,” and “Hateship Friendship,” with Guy Pearce.

“Anchorman: The Legend Continues” will see the original film’s cast return, including Will Ferrell, Christina Applegate, Paul Rudd and Carell. The story follows the on-set adventures of San Diego’s top newsman who is played by Ferrell. “Anchorman: The Legend of Ron Burgundy” made around $ 85 million at the box office.

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Why are People so Interested in the DSM-5?

There is a lot of internet buzz about the approval by the American Psychiatric Association‘s (APA) board of trustees of its fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5.)

The APA press release notes “the trustees’ action marks the end of the manual’s comprehensive revision process, which has spanned over a decade and included contributions from more than 1,500 experts in psychiatry, psychology, social work, psychiatric nursing, pediatrics, neurology, and other related fields from 39 countries.”The approval was announced on Saturday, December 1 (was the APA trying to keep it quiet?) with publication of the DSM-5 scheduled spring 2013. For a book that has no plot or characters, its pending publication has caused great excitement. True, it is a sequel, but it is not the latest installment of Harry Potter or the Twilight Saga.Though the DSMs have not reached the volume of sales of a Harry Potter (so far), the paperback edition of the last version of the DSM had a sales rank of 261 on Amazon.com. This is remarkable for a book that is over 900 pages in length and written for professionals.Besides being bestsellers, the DSMs have inspired games and even music awards. DSM-IV the Game is available for free online. It is described as “beautiful way to engage and learn about yourself, family, and friends and as an ice breaker at your next holiday gathering.”Several years ago, Dr. Jill Squyres, a clinical psychologist in San Antonio, created the DSM-IV Music Awards for her professional society’s fall social. The DSM-IV Music Awards are modeled on the Academy Awards. She chooses categories based on a DSM diagnosis and then nominates songs that are reflective of disorders such as Major Depression (Jagged Little Pill by Alanis Morisette, King of Pain by the Police), Mania (Wake Me Up Before You Go Go by Wham, Life in the Fast Lane by the Eagles), Obsessive-Compulsive Disorder (I’m In Love With My Car by Queen, Pinball Wizard by the Who), and Borderline Personality Disorder (Isn’t life Strange by Jim Morrison, Addicted to Love by Robert Palmer).How does a medical book about psychiatric disorders inspire games and awards let alone become a bestseller? There are not enough medical professionals or people with vested interests, such as the pharmaceutical or insurance industries, to account for these sales figures. What is behind the fascination with the DSM among the general public? I believe it is because our mental state goes to the core of who we are as human beings and our fascination with the link between mental illness and creativity.Mental illness went “public” long before cancer and AIDS. Although mental illness is still considered a stigma by the general public, writers and artists have been talking publicly about their bouts of depression and struggles with alcohol and drugs for hundreds of years. Ernest Hemingway, Virginia Woolf, Sylvia Path and Vincent van Gogh committed suicide. The poets T.S. Eliot and Ezra Pound were committed to mental institutions. The 27 club is comprised of musicians who died at age 27; Janis Joplin, Jimi Hendrix, Brian Jones, Kurt Cobain, and Amy Winehouse. The public breakdowns and rants of Mel Gibson, Alec Baldwin, Lindsay Lohan, Charlie Sheen and Mel Gibson have been televised and viewed by millions on YouTube.The style and language of the DSM is another reason for its popularity. Unlike most medical textbooks , there is relatively little medical terminology and diagnoses are described in terms that are easily understandable to the nonmedical reader. Each diagnosis includes a list of symptoms, referred to as criteria, that typify the disorder. The list of symptoms is exhaustive, but not all symptoms necessarily occur in the disorder. The format and clear non-technical language invite the reader to examine and apply this new knowledge to themselves and others. A parent who worries that his child might have Attention Deficit Hyperactivity Disorder (ADHD) or a spouse concerned that their loved one is displaying symptoms of Alzheimer’s disease can easily look up these disorders and review the symptom check list.Psychiatric disorders consist of behaviors that are extreme. The same behaviors occur with less intensity or frequency in everyday living. A key symptom of Major Depression Disorder is anhedonia, a failure to find pleasure in everyday life. Anhedonia was the working title of Woody Allen’s movie Annie Hall, which won four Academy Awards including Best Picture. In mild or moderate degrees, most of us have experienced “mild anhedonia” (a.k.a being in a funk) at some point in our lives.Obsessive-compulsive disorder (OCD) is an anxiety disorder marked by obsessions, which consist of unwanted and repeated thoughts, or behaviors, and compulsions that make those with OCD feel compelled to perform a behavior to lessen their anxiety. Although most of us are not paralyzed by OCD, we all have some traits. We go back and check to see if we locked our doors or left the tea kettle on. And although we might wish to have the detective skills of Adrian Monk or the writing skills of Jack Nicholson in As Good As It Gets , these fictional characters inability to cope with OCD causes them great anguish and the inability to have significant relationships.I believe that today’s films and TV shows that portray mental illness are popular because they present characters we can relate to, unlike earlier films such as Psycho, a film that scared people so much they stopped taking showers. We laugh at the neurotic mother-son relationships portrayed in Everyone Loves Raymond and Seinfeld because we can relate to them. And we worry about our children. Are we pushing them so hard that they will end up like Natalie Portman’s crazed ballerina in the Black Swan?Brain scans have shown that that creativity and “madness” light up similar pathways in the brain. However, the overwhelming majority of mentally ill people are not artists and most artists are not mentally ill. Edgar Allen Poe, Vincent Van Gogh and Ernest Hemingway were gifted artists who happened to be mentally ill. Their mental illness did not make them artists. In fact, mental illness interferes with the artistic process. William Styron was not able to write in the throes of his depression. The mathematician John Nash did his greatest work before he was diagnosed with schizophrenia.I have no doubt that some gifted people are able to function by “throwing themselves into their art.” However, their legacy is their work, not their mental illness. People may fantasize about being able to play guitar like Jimi Hendrix, write like Hemingway, and sing and dance like Michael Jackson. But they don’t fantasize about being clinically depressed, overdosing on drugs, being homeless, or being institutionalized.To answer to my question of why we are so fascinated by the DSM, I believe it is because it presents and explains extremes of behavior, related to and connected with the more normal levels of behavior we experience. We read the DSM to find ourselves in its pages.Images: Vincent Van Gogh; Janis Joplin; MONK cover by author.

Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.
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Pelosi slams House GOP for taking break amid debt talks

House Minority Leader Nancy Pelosi today ripped House Republicans for scheduling a five-day break amid the " fiscal cliff" debate, asking why the chamber is not in session "trying to build confidence" and "find common ground" with only 26 days left until a mix of steep tax hikes and spending cuts take effect.

"Here we are, Thursday in December. The talk around here is what's going on at the negotiating table. Is anything going on at the negotiating table?" Pelosi, D-Calif., wondered at her weekly news conference. "I can't even explain to my constituents why Congress isn't in session now trying to at least build bridges of understanding and representing."

The GOP-controlled House concluded legislative business Wednesday afternoon after a light floor schedule this week. House Majority Leader Eric Cantor cancelled one day of legislative business previously scheduled for today, and also cut next Friday from the calendar. Cantor, however, announced Wednesday that he has added an unspecified number of days to the legislative calendar the week of Dec. 17.

"I'm really surprised that the Republicans would leave," Pelosi said. "With all that needs to be done, [are House Republicans] avoiding the conversation? Sounds like people don't want to be in town for some reason."

At least one top House Republican, however, stayed at the Capitol: House Speaker John Boehner.

President Obama and Boehner spoke on the phone Wednesday afternoon, but no details were released about the conversation. An aide to the speaker said that "the lines of communication are open" today.

Pelosi, who said she remains in close contact with the president, has repeatedly described a Republican counter-proposal this week as "an assault" on the middle class, seniors and the country's future. She also criticized the proposal for failing to detail how Republicans would specifically achieve savings if they refused to raise tax rates on the wealthiest taxpayers.

"Why are we not here getting information?" Pelosi said. "What are we talking about here? What are we talking about when we say restructure entitlements? What does restructure mean? Destroy? Wither on the vine? Voucherize? Or does it mean let's work together to make these stronger and improve benefits for the beneficiaries?"

But with a stalemate on tax rates, even negotiations between White House and congressional staffs seem to have ground to a halt.

"It's hard to explain to anyone why there's even a mystery in the conversation that we shouldn't be having the upper 2 percent of our population paying its fair share," she said. "How do you start by saying we want to know what you're going to do to seniors before we will do what we know we have to do, which is make the wealthy pay their fair share?"

Pelosi also doubted whether the GOP proposal, which called for $600 billion in health-care savings through changes such as increasing the eligibility age for Medicare, would create adequate savings.

"Show me the money. I don't even know why that is something that people think is going to produce money. What are we going to do with people between 65 and 67?" she said. "It's not even the right thing to do, first and foremost, but is it a trophy that the Republicans want … to raise the rates for the wealthiest people in our country?"

Lawmakers return to the House for legislative business Tuesday, three weeks before the "fiscal cliff" kicks in.

The Senate is in session today.

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Kathie Lee Gifford’s “Scandalous” musical to close after three weeks

LOS ANGELES (TheWrap.com) – So much for Kathie Lee Gifford‘s career as a playwright. The former “Live!” co-host’s Broadway musical “Scandalous: The Life and Times of Aimee Semple McPherson,” is shuttering a little after three weeks after it opened.

The musical, which opened November 15, will have its final performance December 9 at the Neil Simon Theatre in New York.

Gifford wrote the book and lyrics for “Scandalous,” which chronicled the life of evangelist and proto-celebrity Aimee Semple McPherson, who rose to prominence in the 1920s, only to fall from public grace amid scandalous love affairs and other controversies.

In all, “Scandalous” will have played 29 regular performances before it goes dark and 31 previews. The musical stars Carolee Carmello (left) and George Hearn, among others, and is directed by David Armstrong (“A Christmas Story the Musical,” “Catch Me if You Can”).

Though Gifford had ample opportunity to plug the production via her “Today” co-hosting duties – and she certainly took advantage of the opportunity – critics were generally unkind in their appraisal of the show.

“‘Scandalous’ isn’t so much scandalously bad as it is generic and dull,” wrote the New York Times’ Charles Isherwood.

Newsday’s Linda Winer took specific aim at Gifford’s “bombardment of nursery-rhyme lyrics.”

Talkin’ Broadway’s Matthew Murray, meanwhile, scoffed that the play “is not distinctive in one positive way.”

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Asthma symptoms may vary during menstrual cycle

NEW YORK (Reuters Health) – Some women may have more or fewer asthma symptoms, such as coughing and wheezing, depending on their time of the month, a new study suggests.

Researchers said spikes and dips in estrogen and other hormones likely affect the lungs and other physiological responses involved in breathing. However, it’s still unclear whether the findings could improve doctors’ treatment of women with asthma.

The menstrual cycle “is a very important cycle… with all the biological changes and physiological things that happen,” said Dr. Samar Farha from the Cleveland Clinic, who studies asthma and other respiratory diseases but wasn’t involved in the new research.

“(Some) asthmatics describe that just before their menses, they get a worsening of their symptoms,” she told Reuters Health – but more scientific assessments of what’s going on have come to conflicting conclusions.

For the new study, researchers surveyed close to 4,000 women in Northern Europe who had normal periods and weren’t taking birth control pills.

Along with other health and lifestyle questions, they asked women to report when their last period started, as well as whether they’d had any breathing-related problems in the past three days – such as wheezing or waking up with a coughing attack.

Just under eight percent of women in the study had been diagnosed with asthma. Between two and six percent reported recent wheezing, coughing and/or shortness of breath.

Dr. Ferenc Macsali of Haukeland University Hospital in Bergen, Norway, and colleagues found the number of women with of each of those symptoms changed depending on where they were in their menstrual cycle.

For example, wheezing spiked just before and just after mid-cycle (ovulation). The dip in between corresponds to peaks in estrogen, follicle stimulating hormone and luteinizing hormone, the researchers write in the American Journal of Respiratory and Critical Care Medicine.

Complaints of shortness of breath and coughing both declined just after women got their periods, and shortness of breath was also more rare right before menses started.

Macsali’s team saw cyclical patterns in breathing symptoms in women with and without asthma.

What explains those patterns is still up for debate. Estrogen may affect the lungs directly, the researchers said. Insulin resistance and markers of general inflammation are known to vary during the menstrual cycle, which could also play a role in when breathing symptoms get better or worse.

“The observed patterns in our study are most likely a result of… complex hormonal processes,” the researchers wrote, “and it does not seem plausible that one sex hormone should explain the variation in respiratory symptoms during the menstrual cycle.”

Women with asthma should “be aware of a possibility that their symptoms are influenced by day in cycle,” Macsali told Reuters Health in an email.

Not all asthmatics will notice those changes, Farha pointed out.

For women whose symptoms do get a little worse at certain times of the month, it’s also unclear whether that ever puts them in serious danger, she added. But Farha said it may still be worth bringing up the issue with their doctor.

“It could lead to more personalized therapy, based on where their symptoms are getting worse, in which phases of their menstrual cycle,” Farha said. “You could change therapy and escalate therapy based on (those) phases.”

SOURCE: http://bit.ly/SGe7b0 American Journal of Respiratory and Critical Care Medicine, online November 29, 2012.

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