October 7, 2008, 10:38 PM CT

Wheezing and asthma in young children

The diagnosis of asthma in a young child may well be more challenging to pediatricians than previously appreciated, as per a review of research and clinical experience literature by Howard Eigen, M.D., of the Indiana University School of Medicine and Riley Hospital for Children appearing in the October 2008 issue of Clinical Pediatrics

"Wheezing can be serious," said Dr. Eigen, the Billie Lou Wood Professor of Pediatrics at the IU School of Medicine and director of pediatric pulmonology and critical care at Riley Hospital. "A comprehensive review of clinical practice and peer evaluated studies show that the difficulty of accurate diagnosis is often underestimated by pediatricians who may link it to a passing cold or other non-serious condition rather than relating it to asthma, a chronic and potentially serious disease".

Dr. Eigen noted in his study that in early childhood asthma is often under recognized and under diagnosed because the symptoms can vary widely and are similar to other common childhood illnesses, including a non-specific cough, flu and bronchitis. Establishing a diagnosis of asthma in young wheezing children also can be challenging for the doctor because the type, severity and frequency of asthma symptoms vary widely among children and, sometimes even with an individual child......... Posted by: JoAnn      Read more         Source

October 7, 2008, 10:23 PM CT

Novel Imaging Approach For Atrial Fibrillation

University of Utah scientists have developed a magnetic resonance imaging (MRI)-based method for detecting and quantifying injury to the wall of the heart's left atrium in patients who have undergone a procedure to treat atrial fibrillation. The results of the study are reported in the Oct. 7, 2008, issue of the Journal of the American College of Cardiology.

Atrial fibrillation (AF) is an arrhythmia, or abnormal heart rhythm, that involves the heart's two upper chambers, or atria. One effective method of treating AF is Radiofrequency (RF) ablation. In RF ablation, mild, painless radiofrequency energy is used to destroy carefully selected heart muscle cells to stop them from conducting extra electrical impulses. Prior research suggested scar formation within the left atrium (LA) after RF ablation helps to predict the success of the procedure in preventing the recurrence of atrial fibrillation.

"Until now, there has not been an accurate, non-invasive way to assess LA scar formation," said lead author Nassir F. Marrouche, M.D., assistant professor of internal medicine in the University of Utah School of Medicine and director of the Atrial-Fibrillation Program. "We have developed a novel MRI-based method to detect and measure the extent of LA wall scarring and, potentially, predict the success of RF ablation in patients with atrial fibrillation"......... Posted by: Daniel      Read more         Source

October 7, 2008, 10:18 PM CT

Novel Lung Cancer Vaccine Trial Launched

Oncologists at the Moores Cancer Center at the University of California, San Diego (UCSD) in La Jolla are hoping to stave off the relentless march of advanced lung cancer by treating patients with a novel kind of cancer vaccine. While a number of vaccines attempt to pump up the immune system to fight off a cancer, the new vaccine, Lucanix, is genetically engineered to also trick the cancer into turning off its immune system-suppressing activities.

The first patients have begun enrolling in a new clinical trial at the Moores UCSD Cancer Center testing the effectiveness of the vaccine. The trial will involve 700 patients at some 90 centers worldwide.

Current therapys for advanced lung cancer have limited effectiveness and new therapies are needed, said Lyudmila Bazhenova, M.D., director of the Lung Cancer Unit at the Moores UCSD Cancer Center and assistant clinical professor of medicine at UC San Diego School of Medicine.

"The future therapys for advanced lung cancer may involve combinations of chemotherapy and targeted agents, and possibly even biologicals such as this," she said.

Roughly 430 patients die of lung cancer every day in the United States, as per Bazhenova, making it the nation's number one killer, despite being the second most common cancer. "While breast cancer mortality has declined about 15 percent, there hasn't been much improvement in mortality in lung cancer in the past several decades," she said. As per the American Cancer Society, an estimated 215,000 new cases of lung cancer will be diagnosed, and 162,000 individuals will die from the disease this year in the United States......... Posted by: Scott      Read more         Source

October 7, 2008, 10:07 PM CT

Compassion meditation to psychological stress

Data from a new study suggests that individuals who engage in compassion meditation may benefit by reductions in inflammatory and behavioral responses to stress that have been associated with depression and many medical illnesses. The study's findings are published online at www.sciencedirect.com and in the medical journal Psychoneuroendocrinology

"While much attention has been paid to meditation practices that emphasize calming the mind, improving focused attention or developing mindfulness, less is known about meditation practices designed to specifically foster compassion," says Geshe Lobsang Tenzin Negi, PhD, who designed and taught the meditation program used in the study. Negi is senior lecturer in the Department of Religion, the co-director of Emory Collaborative for Contemplative Studies and president and spiritual director of Drepung Loseling Monastery, Inc.

This study focused on the effect of compassion meditation on inflammatory, neuroendocrine and behavioral responses to psychosocial stress, and reviewed the degree to which engagement in meditation practice influenced stress reactivity.

"Our findings suggest that meditation practices designed to foster compassion may impact physiological pathways that are modulated by stress and are relevant to disease," explains Charles L. Raison, MD, clinical director of the Mind-Body Program, Emory University's Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, and a lead author on the study......... Posted by: JoAnn      Read more         Source

October 6, 2008, 10:37 PM CT

African-Americans may be at higher risk of stroke

Cerebral microbleeds, which are small bleeds within the brain, appear to be more common in African-Americans than in Caucasians, increasing the likelihood of having a stroke, as per a research studyreported in the October 7, 2008, issue of Neurology, the medical journal of the American Academy of Neurology. These types of brain lesions can be an important indicator for stroke.

For the study, 87 people from the Washington, DC, area who had suffered a certain type of stroke, called an intracerebral hemorrhage, underwent brain scans. This kind of stroke involves bleeding in the brain and makes up 10 to 15 percent of all strokes. Scientists also determined the group's risk factors for stroke such as age, high blood pressure and alcohol use. Forty-two of the people were African-American while 45 were Caucasian.

The study observed that African-Americans had 32 percent more microbleeds than Caucasians. African-Americans were also more likely to have these types of lesions in several different areas of the brain. While African-Americans had more lesions in the lower and middle parts of the brain, Caucasians had them most frequently near the surface of the brain.

"Finding racial differences that could be linked with a higher prevalence for these brain lesions may lead to new methods for testing and treating people to prevent stroke," said study author Chelsea Kidwell, MD, with Georgetown University Medical Center in Washington, DC, and member of the American Academy of Neurology......... Posted by: Daniel      Read more         Source

October 6, 2008, 10:33 PM CT

Occasional memory loss tied to lower brain volume

People who occasionally forget an appointment or a friend's name may have a loss of brain volume, even though they don't have memory deficits on regular tests of memory or dementia, as per a research studyreported in the October 7, 2008, issue of Neurology, the medical journal of the American Academy of Neurology.

The study involved 500 people age 50 to 85 with no dementia who lived in the Netherlands. Participants were asked about occasional memory problems such as having trouble thinking of the right word or forgetting things that happened in the last day or two, or thinking problems such as having trouble concentrating or thinking more slowly than they used to.

Participant's brains were scanned to measure the size of the hippocampus, an area of the brain important for memory and one of the first areas damaged by Alzheimer's disease.

Of the 500 people, 453 reported that they had occasional memory or thinking problems, which are also called subjective memory problems, because they would not show up on regular tests of memory and thinking skills.

The study observed that in people with occasional subjective memory problems, the hippocampus was smaller than in people who had no memory problems. On average, the hippocampus had a volume of 6.7 milliliters in those with occasional subjective memory problems, in comparison to 7.1 milliliters in people with no memory problems......... Posted by: Daniel      Read more         Source

October 6, 2008, 10:28 PM CT

Why current publication practices may distort science

The current system of publishing medical and scientific research provides "a distorted view of the reality of scientific data that are generated in the laboratory and clinic," says a team of scientists in this week's PLoS Medicine

In their Essay, Neal Young (National Institutes of Health, USA), John Ioannidis (Tufts University School of Medicine, USA and University of Ioannina School of Medicine, Greece), and Omar Al-Ubaydli (George Mason University, USA) apply principles from the field of economics to present evidence consistent with a distortion.

There is an "extreme imbalance," they say, between the abundance of supply (the output of basic science laboratories and clinical investigations) and the increasingly limited venues for publication (journals with sufficiently high impact). The result is that only a small proportion of all research results are eventually chosen for publication, and these results are unrepresentative of scientists' repeated samplings of the real world.

The authors argue that there is a moral imperative to reconsider how scientific data are judged and disseminated.

A prior Essay by one of the co-authors, John Ioannidis, which was entitled "Why most published research findings are false" (http://dx.doi.org/10.1371/journal.pmed.0020124) has been the most viewed PLoS Medicine article of all time and was called "an instant cult classic" in a Boston Globe op-ed of July 27 2006 (http://www.boston.com/news/science/articles/2006/07/27/science_and_shams/)......... Posted by: Janet      Read more         Source

October 6, 2008, 10:19 PM CT

Free drug samples carry risks for children

Cambridge, MA.Free prescription drug samples distributed to children may be unsafe, as per a research studyby physicians from Cambridge Health Alliance and Hasbro Children's Hospital. The national study, the first to look at free drug sample use among children, appears in the October 2008 issue of Pediatrics

The authors, who also serve as scientists at Harvard Medical School and the Warren Alpert Medical School of Brown University, observed that children usually receive free drug samples from their doctors. One out of every 20 American children received free drug samples in 2004. Among children who took at least one prescription drug in that year, nearly one in 10 got free samples.

The U.S. Food and Drug Administration identified significant new safety concerns for four of the top 15 most frequently distributed samples in 2004. These four medications acquired new black box warnings or had significant revisions to existing black box warnings issued since 2004. In addition, two of the top 15 sample medications given to children were schedule II controlled substances (drugs controlled and monitored by the Drug Enforcement Agency due to high potential for abuse). Distribution of these medications, Strattera (atomoxetine) and Adderall (amphetamine/dextroamphetamine), carries risk, particularly when drug sample closets in physician's offices (or home medicine cabinets) are not strictly monitored......... Posted by: JoAnn      Read more         Source

October 6, 2008, 10:14 PM CT

Stool DNA testing for colorectal cancer

The first generation of a stool DNA test to identify early colorectal cancer has limitations, as per a Mayo Clinic-led study reported in the Oct. 7, 2008, issue of Annals of Internal Medicine Results did not corroborate findings of an earlier multicenter study that showed stool DNA testing was more accurate than fecal blood testing for colorectal cancer detection. *.

"But the concerns we identified with stool DNA testing are all solvable," says David Ahlquist, M.D., lead researcher in the study that included 4,482 participants and 22 academic medical centers. Scientists have hoped that stool DNA testing could be the user-friendly and accurate screening tool that would increase screening numbers.

More than half of adults in the United States have never been screened for colorectal cancer, the second-leading cause of cancer deaths. While available screening tools work, the most effective tests involve time, effort and costs. For example, colonoscopy requires fasting, bowel cleansing, a doctor visit, sedation, an invasive procedure and lost work time -- factors that contribute to low screening participation.

This blinded study, conducted from 2001 to 2007, compared screening effectiveness of two widely used fecal blood tests (Hemoccult and HemoccultSensa) with a stool DNA test in average-risk patients, ages 50 to 80. The DNA test used was the prototype for PreGenPlus, the first commercially-used stool DNA test, and waccording toformed on samples sent to EXACT Sciences in Marlborough, Mass. All participants underwent a colonoscopy, the gold standard in current screening. Scientists used colonoscopy as the benchmark to detect cancer or premalignant polyps......... Posted by: Sue      Read more         Source

October 6, 2008, 10:12 PM CT

Using a fan during sleep associated with lower risk of SIDS

Fan use appears to be linked to a lower risk of sudden infant death syndrome (SIDS) in rooms with inadequate ventilation, as per a report in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The national occurence rate of SIDS decreased 56 percent from 1992 to 2003, as per background information in the article. This decline is largely attributed to the increased use of the supine sleep position (lying on the back with head facing up) after the introduction of the "Back to Sleep" campaign in 1994. In more recent years, the decrease in SIDS has leveled off. "Eventhough caretakers should continue to be encouraged to place infants on their backs to sleep, other potentially modifiable risk factors in the sleep environment should be examined to promote further decline in the rate of SIDS." The association between room ventilation and SIDS risk is a factor that has not received sufficient attention. Inadequate room ventilation might facilitate the pooling of carbon dioxide around an infant's nose and mouth, increasing the likelihood of rebreathing. The movement of air in the room may potentially reduce the risk of SIDS.

Kimberly Coleman-Phox, M.P.H., and his colleagues at Kaiser Permanente's Division of Research in Oakland, Calif., analyzed information from interviews of mothers of 185 infants who had died from SIDS and mothers of 312 randomly selected infants from the same county, maternal race/ethnicity and age. Mothers were asked about fan use, pacifier use, open window in the room at the infant's last sleep, room location, sleep surface, number and type of covers over the infant, bedding under the infant and room temperature......... Posted by: JoAnn      Read more         Source