April 18, 2006, 11:39 PM CT

Using PSA Endpoints For Prostate Cancer Research

A new study from Columbia University Medical Center scientists at NewYork-Presbyterian Hospital/Columbia, who are members of the Southwest Oncology Group (SWOG), suggests that certain changes in prostate-specific antigen (PSA) levels may serve as surrogate endpoints for prostate cancer survival. Scientists looking to speed up the process of clinical trials have suggested that these biomarkers could be used to measure therapy efficacy.

Currently, the U.S. Food and Drug Administration accepts only survival as an endpoint of measure. Survival as a primary endpoint was used in phase III studies of novel chemotherapeutic drugs for men with androgen-independent prostate.

Daniel P. Petrylak, M.D., associate professor of medicine at Columbia University College of Physicians & Surgeons and director of the genitourinary oncology program at NewYork-Presbyterian/Columbia, together with his research team, retrospectively analyzed results of 551 men with prostate cancer treated in the Southwest Oncology Group Protocol S9916. By reviewing the clinical trial, it was noted that there were several different changes in PSA levels, which could possibly serve as surrogate endpoints for survival.

The authors observed that the risk of death, in men whose serum PSA levels declined by at least 30 percent in the first three months of therapy, was reduced more than 50 percent. Findings are reported in the Journal of the National Cancer Institute (April 19, 2006 issue).........

Posted by: Mark      Permalink         Source

April 18, 2006, 11:03 PM CT

Care Of Women During Pregnancy And Labor

The recent issue of Journal of Obstetric Gynecologic and Neonatal Nursing is challenging nurses who care for pregnant and laboring women to reconsider family centered maternity care.

In four articles in the Clinical Issues section of the journal, guest editor Merry-K Moos, brings together experts who explore new innovations in caring for pregnant women and their families to improve the birthing experience for not only the mother, but also the healthcare provider and the institution. ".....these articles were written to promote reflection on current efforts to alter the care dynamics for pregnant women in this country" writes guest editor Moos. "I am hopeful that they will stimulate you to examine the current and potential energy in your practice setting to encourage family-centered maternity care".

In the first article Prenatal Care: Limitations and Opportunities, Moos, explores the limitations of the way pregnant women are currently cared for and presents three promising alternatives to the dominant medical model: the comprehensive prenatal care approach illustrated by a number of publicly funded prenatal clinics; the prenatal empowerment model as exemplified by midwifery care; and the prenatal group model as illustrated by Centering Pregnancy.

The second article, Zohar Massey, Sharon Schindler Rising, and Jeannette Ickovics take a closer look at the model of Centering Pregnancy. In Centering Pregnancy: Relationship-Centered Care the authors explain the philosophy behind this innovation of prenatal care provided in a group setting which is changing the fundamental nature of how health care professionals and women interact during gestation. It is suggested that in group prenatal care, women come together for support and empowerment, with positive effects on babies and families.........

Posted by: Emily      Permalink         Source

April 18, 2006, 10:53 PM CT

Quality Standards Issued For Testing Herbal Products

The National Institute of Standards and Technology (NIST) has issued the first suite of Standard Reference Materials (SRMs) in a planned series of reference materials for botanical dietary supplements.

The dietary supplement industry has exploded in the past decade to about 29,000 products, with about 1,000 new products introduced each year, as per the Food and Drug Administration (FDA). In 2001 NIST began working with the FDA and the National Institutes of Health's Office of Dietary Supplements (NIH/ODS) on a series of SRMs of popular botanical dietary supplements. Manufacturers can use these materials for quality control, and scientists can use them to ensure that their laboratory analyses of supplements are accurate. Products such as botanical supplements, that have been derived from extracts of plant materials are challenging to analyze accurately because of their complex sample matrices.

The new NIST reference materials were designed primarily for quality control of supplements containing ephedra, a plant once widely used in herbal weight-loss products. Ephedra products were pulled from the market by the FDA in 2004 after being linked to cardiovascular problems, but the new test materials remain valuable both to assure that new products are not adulterated with ephedra and because they also can be used to improve several other key measurements in other botanical supplements, including concentrations of potentially toxic heavy metals.........

Posted by: Janet      Permalink         Source

April 18, 2006, 7:03 AM CT

New Drug For Breast Cancer Prevention

One more breakthrough and one more addition to the armamentarium to fight against breast cancer. National Cancer Institute reports that one of the largest breast cancer studies ever done showed that the osteoporosis drug Raloxifene (Evista andreg;) is as effective as tamoxifen in the prevention of breast cancer.

Raloxifene (Evista andreg;) has a lower side effort profile compared to tamoxifen and has 36 percent fewer uterine cancer risk and about 30 percent fewer risk of blood compared to Tamoxifen.

Tamoxifen is indicated for women who are at high risk of developing breast cancer for example those women who carry BRCA mutations. Since Raloxifene is as effective as tamoxifen with lesser side effects, this drug may soon replace Tamoxifen for prevention of breast cancer in high-risk women. Raloxifene needs approval from FDA as a breast cancer prevention drug before it could be used for this purpose.

Currently an estimate 500,000 women use Raloxifene to reduce the risk of osteoporosis, so it is expected that a number of women will be comfortable using it for breast cancer prevention.

"There is something proactive you can do if you're at higher than average risk of getting breast cancer," said Dr. James Stewart who is the director of the breast cancer program at the UW Comprehensive Cancer Center. "The sticky part of it will be sitting down with your doctor to talk about are the expected benefits worth it".........

Posted by: Janet      Permalink

April 17, 2006, 10:54 PM CT

Contro Blood Sugar Prior To Surgery

Patients with diabetes who have good control of blood glucose levels before having surgery may be less likely to have infections after their procedures, as per a research studyin the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Postoperative infections, including pneumonia, wound infection, urinary tract infection and sepsis (systemic blood infection), can lead to poor outcomes and high health care costs, as per background information in the article. The risk of infection is higher in patients with diabetes. Controlling blood sugar has been shown to reduce a number of of the complications associated with diabetes, including kidney, nerve and eye diseases. However, prior studies have not examined whether controlling blood sugar before surgery can affect outcomes afterward.

Annika S. Dronge, M.D., Yale University School of Medicine, West Haven, Conn., and his colleagues examined the relationship between glycemic (blood sugar) control and postoperative infections in 490 diabetic patients. All of the participants underwent major noncardiac surgery in the Veterans Affairs Connecticut Healthcare System between Jan. 1, 2000, and Sept. 30, 2003, and had their hemoglobin (Hb A1c) levels measured within 180 days previous to surgery. Hb A1c reflects the patient's control of blood glucose levels over the prior two to three months. Good glycemic control was defined as meeting the American Diabetes Association target, an Hb A1c level of less than 7 percent.........

Posted by: JoAnn      Permalink         Source

April 17, 2006, 10:51 PM CT

Perceptions Of Male Culture In Surgical Profession

Even though men and women are similar in factors they consider important in deciding on a career in surgery, the perception of surgery as an "old boys' club" and negative perceptions of the surgical personality may deter women from choosing the field, as per results of a small survey reported in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Recent analyses have suggested that more general surgeons will be needed in the future, but fewer medical students are entering surgery residencies, as per background information in the article. About half of all entering medical students are women, who have historically been less likely to choose surgery as a career.

Debra A. Gargiulo, M.D., and his colleagues at the University of Vermont, Burlington surveyed 298 Vermont physicians and medical students. Of the 141 who completed the survey, there were 90 women and 60 men, including 31 attending physicians (16 general surgeons and 15 obstetrician/gynecologists), 16 residents and 94 medical students. Sixty-four percent of men and 53 percent of women indicated that were interested in a surgery career before their surgical rotation. Respondents were asked to select their top three deterrents to a surgical career. Findings included.

• 46.7 percent of female medical students vs. 20.4 percent of males perceived sex discrimination in surgery
........

Posted by: Janet      Permalink         Source




April 17, 2006, 10:46 PM CT


Recurrent Melanoma May Be More Common


Approximately 8 percent of patients with melanoma skin cancer may develop an additional melanoma within two years of their initial diagnosis, and those with atypical moles appear to be at higher risk, as per an article in the recent issue of Archives of Dermatology, one of the JAMA/Archives journals.

Cutaneous (skin) melanoma begins in cells known as melanocytes, which produce the pigment that gives skin its color. Prior studies have evaluated the recurrence of melanoma among patients already diagnosed with the disease; most have estimated that less than 4 percent of them will develop additional tumors in the year following diagnosis, as per background information in the article.

Linda Titus-Ernstoff, Ph.D., Dartmouth Medical School, Lebanon, N.H., and his colleagues assessed the frequency of and risk factors for recurring cancer among 354 New Hampshire residents with a first diagnosis of cutaneous melanoma. Participants completed a 40-minute telephone interview, during which they answered questions about medical history, demographics, eye and hair color, sun exposure and whether their skin tanned, burned or freckled in the sun. They then underwent a skin examination, during which a doctor identified and catalogued non-malignant and atypical moles. Atypical moles have at least three of the following features: a diameter larger than 5 millimeters, redness, an irregular or ill-defined border, a variety of colors or a portion that is flat.........

Posted by: George      Permalink         Source




April 17, 2006, 10:43 PM CT


Tanning Ads In High School Newspapers

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A small study found that nearly half of high schools in the Denver area contained tanning advertisements in their newspapers, as per an article in the recent issue of Archives of Dermatology, one of the JAMA/Archives journals.

The ultraviolet (UV) radiation used in tanning parlors is a classified carcinogen, as per background information in the article. As tanning has become more popular among teen girls, the incidence of skin cancer has increased among young women. The World Health Organization recommends that individuals younger than age 18 not use UV tanning devices, but there is no restriction on advertising such devices to youth in the United States.

Scott Freeman, M.D., University of Colorado at Denver and Health Sciences Center, Aurora, and his colleagues examined the frequency of tanning advertisements in 131 newspapers from 23 public high schools in three Colorado counties. All of the papers were published between 2001 and 2005, most usually in 2004.

Tanning advertisements were found in newspapers from 11 (48 percent) of the 23 schools. Eighteen separate establishments placed the 40 tanning advertisements, 15 of which offered unlimited tanning for periods of up to four months. Nearly half (19) of the ads mentioned discounts requiring student identification or labeled as "prom specials," while two ads (5 percent) mentioned parental consent or accompaniment.........

Posted by: George      Permalink         Source




April 17, 2006, 10:34 PM CT


Genetic Switch That Links Animal Growth And Cancer


Laboratory discoveries by researchers at two universities may lead to new directions in cancer treatment drugs. The scientists have discovered that a genetic switch involved in growth and development of an animal is the same one used to prevent normal cells from becoming malignant.

The findings are published in the April 18 issue of Current Biology. Experiments were carried out by first author Masamitsu Fukuyama, a postdoctoral scientist working in the laboratories of Joel H. Rothman, a professor in the Department of Molecular, Cellular and Developmental Biology at the University of California, Santa Barbara, and Ann Rougvie, a professor in the Department of Genetics, Cell Biology, and Development at the University of Minnesota. Fukuyama is now an assistant professor at the University of Tokyo.

"The parallels between the control of development during the normal process of maturation and the control of cancer growth are striking," said Rothman. "We recognize that cancer cells in a number of ways simply mimic what normal cells do in a developing animal, only at an unfortunate time and place."

In life, there is a time to wait and a time to grow, Rothman explained. "A number of creatures remain in a waiting state until conditions are right for growth. A tiny redwood, for example, can remain persistently arrested for years inside a seed. Only when the seed senses water will it sprout and initiate development into a mature tree. A number of animals similarly halt their development until the environment is right for growth and development."........

Posted by: Janet      Permalink         Source




April 17, 2006, 10:28 PM CT


Smoking May Cause Far More Cancer Deaths In Asian Americans


Korean, Chinese, Japanese, and Vietnamese American males living in California die of cancer at three times the rate of South Asian females in California, whose cancer mortality rate is one of the lowest in the world.

As per a new study by UC Davis Cancer Center researchers, such disparities between genders and Asian and Pacific Islander ethnic groups can be explained almost entirely by tobacco smoke exposure - suggesting that if smoking were eliminated, Asian and Pacific Islander Americans all would have very low cancer mortality rates, with minimal variation from group to group.

"Among Asian Americans and Pacific Islanders, non-lung cancer death rates, like lung cancer death rates, correlate very closely with their smoke exposures," said Bruce N. Leistikow, associate professor of public health sciences at UC Davis and a leading expert on the epidemiology of smoking-related illnesses. "If all Asian and Pacific Islander Americans had as little smoke exposure as South Asian females in California, our work suggests that their cancer mortality rates across the board could be as low as that of the South Asian females."

South Asian females in California had a cancer mortality rate of 58 deaths per 100,000 people per year. The cancer mortality for the United States as a whole was 193.5.........

Posted by: Janet      Permalink         Source