August 3, 2007, 5:24 AM CT

Electric fields as cancer treatment

Low-intensity electric fields can disrupt the division of cancer cells and slow the growth of brain tumors, suggest laboratory experiments and a small human trial, raising hopes that electric fields will become a new weapon for stalling the progression of cancer. The research, performed by an international team led by Yoram Palti of the Technion-Israel Institute of Technology in Haifa, is explained in the recent issue of Physics Today, the flagship magazine of the American Institute of Physics.

In the studies, the research team uses alternating electric fields that jiggle electrically charged particles in cells back and forth hundreds of thousands of times per second. The electric fields have an intensity of only one or two volts per centimeter. Such low-intensity alternating electric fields were once believed to do nothing significant other than heat cells. However, in several years' worth of experiments, the scientists have shown that the fields disrupt cell division in tumor cells placed on a glass dish (in vitro).

After intensively studying this effect in vitro and in laboratory animals, the scientists started a small human clinical trial to test its cancer-fighting ability. The technique was applied to ten human patients with recurrent glioblastoma multiforme (GBM), a form of brain cancer with a very low survival rate. All the patients had their earlier tumors treated by other methods, but the cancer had started to recur in all cases. Fitting the patients with electrodes that applied 200 kHz electric fields to the scalp at regular intervals for up to 18 hours per day, the scientists found that the brain tumors progressed to advanced stages much slower than usual (taking a median time of 26 weeks), and sometimes even regressed. The patients also lived considerably longer, with a median survival time of 62 weeks. While no control group existed, the results compared favorably to historical data for recurrent GBM, in which the time for tumor progression is approximately 10 weeks and the typical survival time is 30 weeks. In addition, 3 of the 10 patients were still alive two years after the electrode treatment started. These results were announced in a recent issue of The Proceedings of the National Academy of Sciences (Kirson et al., PNAS 104, 10152-10157, June 12, 2007)......... Posted by: Janet      Read more         Source

August 3, 2007, 5:13 AM CT

Should patients be paid to take medicines?

Last week, it was announced that drug addicts in England are to be given shopping vouchers for complying with therapy programmes. In this weeks BMJ, two experts debate whether it is acceptable for people to be paid to adhere to medication.

Rewarding patients to cooperate is not new, argues Tom Burns, a senior psychiatry expert at Warneford Hospital in Oxford. Most mental health practitioners reward patients for healthy behaviour and financial incentives are no different.

People who criticise money for medicines emphasise the exploitation of impoverished patients and worries about how patients would spend the money. But whether a payment represents a just reward or immoral exploitation depends on the circumstances not the transaction, he writes.

Far from being unethical and unacceptable, he believes that money for medicine is a refreshingly honest acknowledgement of the different perspectives of the two parties involved.

Rather than a way to manipulate patients to do what we want them to do it provides a model of respectful exchange, he concludes.

But Joanne Shaw, Chairman of Ask About Medicines, believes that payment is not the way to solve the high costs of non-adherence to medication. Paying for adherence, whether in the form of cash or non-financial benefits, creates perverse incentives and undermines the therapeutic alliance between patients and doctors that is needed for long term health care, she writes......... Posted by: Janet      Read more         Source

August 3, 2007, 5:12 AM CT

Screening for stroke risk factors

Actively screening people aged 65 or over in the community improves the detection of atrial fibrillation (irregular heart rhythm), a major risk factor for stroke, finds a study published on bmj.com today.

The prevalence of atrial fibrillation rises with age, from about 1% in the whole population to about 5% in people aged over 65. It can be diagnosed using a simple low cost test (electrocardiography) and the risk of serious problems, such as stroke, can be dramatically reduced by therapy.

There are two types of screening for atrial fibrillation opportunistic and systematic (or total population) screening. In opportunistic screening, a healthcare professional would take a patients pulse during a consultation and, if the pulse was irregular, electrocardiography would be performed to confirm the diagnosis. In systematic screening, the whole target population would be invited for screening by electrocardiography.

So scientists set out to test whether screening was more effective than routine care in detecting atrial fibrillation in the community, and compared opportunistic with total population screening.

They identified 14,802 patients aged 65 or over from 50 general practices in England (split into 25 intervention and 25 control practices)......... Posted by: Daniel      Read more         Source

August 3, 2007, 5:06 AM CT

Heat-related deaths in middle, high school football players

Every year, Fred Mueller compiles a sports list, but unlike popular pre-season picks or a glamorous hot-recruit sheet, nobody envies him this task. Some years the list is longer than others, but, Mueller said, theres no reason any kid should be on it.

Its a list of boys who died playing or practicing football, kids whose body temperatures rose so high and so fast under the summer sun that their brains couldnt keep up, couldnt regulate their cores, and the boys died.

When something is preventable., Mueller said, shaking his head. Those kids could be alive today.

Five young athletes, from 11 to 17 years old, died of heat stroke in 2006. The trend was declining. The last time there were more than five was 1972, when there were seven. In five of the past 16 years there were none. But, Mueller said, there have been 31 since 1995, and all of them could have been avoided.

Seven other players died last year of heart-related deaths that might or night not have been correlation to heat or exertion. And we dont know the number of kids who had heat exhaustion, Mueller said.

With summer practice about to swing into high gear, Mueller said its time to remember these kids, and to keep in mind how heat-related deaths can be prevented.

• Require each athlete to have a physical and know if an athlete has a history of heat-related illness; these kids are more susceptible to heat stroke. Overweight players are also at higher risk.

........ Posted by: Janet      Read more         Source

August 1, 2007, 9:26 PM CT

Coffee drinking reduces risk of liver cancer

After lung and stomach cancer, liver cancer is the third largest cause of cancer deaths in the world. A new study on the relationship between coffee drinking and the risk of hepatocellular carcinoma (HCC) confirmed that there is an inverse association between coffee consumption and HCC, eventhough the reasons for this relationship are still unresolved.

The results of this study appear in the August 2007 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.

At least eleven studies conducted in southern Europe and Japan have examined the relationship between coffee drinking and the risk of primary liver cancer. The current study, led by Francesca Bravi of the Istituto di Ricerche Farmacologiche Mario Negri in Milan, Italy, was a meta-analysis of published studies on HCC that included how much coffee patients had consumed. Scientists combined all published data to obtain an overall quantitative estimate of the association between coffee consumption and HCC.

The results showed a 41 percent reduction of HCC risk among coffee drinkers in comparison to those who never drank coffee. Moreover, the apparent favorable effect of coffee drinking was found both in studies from southern Europe, where coffee is widely consumed, and from Japan, where coffee consumption is less frequent, and in subjects with chronic liver diseases, the scientists state......... Posted by: Janet      Read more         Source

August 1, 2007, 9:20 PM CT

Sleep is the right ingredient for academic success

Returning to the classroom after a three-month break signals that summer is drawing to a close. For children and teens, the end of summer also means an end to the long daylight hours that allows them to stay out later, as well as the long lazy mornings of sleeping in. The American Academy of Sleep Medicine (AASM) advises children and teens that sleep habits adopted over the summer will need to be changed when school starts in order to ensure proper sleep.

Daniel G. Glaze, MD, of Texas Childrens Hospital in Houston, a pediatric sleep expert and a member of the AASM board of directors, notes that, just as one wouldnt start a trip with a half-full tank of gas, children and teens need to obtain a proper amount of sleep during the night to complete the school day successfully.

A number of children, and particularly teens, alter their sleep-wake schedules and maintain a later bedtime, says Dr. Glaze. This works for the summer until the start of the school year. They then need to advance their bedtime to meet early school start times. It is difficult to advance your bedtime and, once a schedule has been established, it may take days or weeks to develop a new schedule. It cant be done overnight. Not unexpectedly, for the first weeks of school, a number of children and teens do not obtain a proper amount of sleep......... Posted by: JoAnn      Read more         Source

August 1, 2007, 9:18 PM CT

New technique for earlier diagnosis of pancreatic cancer

A new optical technology, coupled with routine endoscopy, may enable doctors to detect the subtle tell-tale traces of early pancreas cancer, as per scientists at Northwestern University in Illinois. The optical technology, developed by biomedical engineers at Northwestern exposes cellular changes indicative of cancer in tissue near the pancreas that had previously been detectable only through intensive radiologic scanning or invasive surgery, two techniques that can put pancreas cancer patients at risk.

The results of the pilot study, presented in the August 1 issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, could represent a new approach to detecting pancreas cancer at a very early stage, when therapy is most likely to succeed.

Pancreas cancer is not often detected early because it is a rather inaccessible organ, so this technique holds the potential to be the first reliable, routine screening tool for pancreas cancer, said co-author author Randall Brand, M.D., an associate professor of medicine at Northwestern University and physician at Evanston Northwestern Healthcare. If we could apply this to those at high risk such as people with chronic pancreatitis or who have a family history of pancreas cancer we might see a drastic improvement in pancreas cancer survival......... Posted by: Sue      Read more         Source

August 1, 2007, 9:12 PM CT

New Treatment For Glaucoma

Iowa State University scientists have developed a new technique that successfully treated rats for blindness caused by glaucoma. Their experimental therapy will be used on canine patients in the next year. If proved to be successful, it is expected to move to human trials.

An estimated 3 million people in the U. S. are affected by glaucoma, the second leading cause of blindness in the developed world and the number one cause of vision loss among blacks. People with elevated intraocular pressure are at greatest risk for developing glaucoma.

Iowa State scientists leading the six-year project are Dr. Sinisa Grozdanic, a veterinary ophthalmologist and assistant professor of veterinary clinical sciences; Donald Sakaguchi, neuroscientist and associate professor of genetics, development and cell biology; and Matt Harper, doctoral student in neuroscience. The team also included scientists from the University of Iowa, Yale University, Tulane University and the University of Miami. The work was presented at a recent meeting of the Association for Research in Vision and Ophthalmology Conference.

The scientists previously determined that animals with glaucoma increase production of proteins with neuron-protective capabilities (neurotrophins) in an attempt to shield against blindness. So, they imitated that process in the laboratory, modifying bone marrow-derived stem cells. Then they transplanted the cells into the eyes......... Posted by: Mike      Read more         Source

August 1, 2007, 9:03 PM CT

Vaccine For Metastatic Colorectal Cancer

A therapeutic cancer vaccine has shown effectiveness when given alongside chemotherapy to patients with metastatic colorectal cancer in a phase II trial, as per scientists at Oxford BioMedica (UK) Ltd. The study observed that six of the 17 metastatic colorectal cancer patients in the study showed tumor shrinkage, classified as complete or partial responses following independent expert review.

The study, published in the August 1 issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, was designed to demonstrate the safety and immunogenicity of the vaccine, called modified vaccinia Ankara-encoding 5T4 (TroVax), when used alongside standard chemotherapy. The research was funded by Oxford BioMedica which is developing the vaccine in partnership with Sanofi-Aventis.

Unlike preventative vaccines, such as the human papillomavirus vaccine to prevent cervical cancer, TroVax is a therapeutic vaccine, designed to stimulate the immune systems of patients who already have cancer. The vaccine consists of an attenuated (non-disease causing) version of the vaccinia virus modified to deliver the gene for 5T4, a protein found in a number of tumors.

The idea is that the modified virus enters cells, produces the tumor protein and stimulates the immune system, said lead study author Richard Harrop, Ph.D., vice president of clinical immunology at Oxford BioMedica. To give a vaccine alongside chemotherapy might seem counterintuitive, since chemotherapy can weaken the immune system, but our study shows that TroVax could be complementary to standard chemotherapy, enhancing the immune response to tumors......... Posted by: Sue      Read more         Source

August 1, 2007, 8:49 PM CT

Cholesterol-lowering drugs don't offset healthy choices

Within the medical field, it is often assumed that patients view cholesterol-lowering medications (or statins) as a license to eat whatever they like -- they figure their medicine has them covered, so a steak here and there wont hurt. However, a study published in the recent issue of Mayo Clinic Proceedings finds that such patients dont tend to adopt unhealthy diets when prescribed statins.

Researchers also found that some patients were placed on cholesterol-lowering drugs before theyd made a good faith effort at improving their lifestyle to better their health. And some said they would have preferred starting with lifestyle alterations rather than medication.

Devin Mann, M.D., lead author of the article on statin use, says physicians should reconsider how theyre treating patients who seek preventive care for cardiovascular disease, namely by giving up their long-held assumptions about them.

Physicians arent good at predicting patient behavior, so they should seek to form a partnership of trust with patients based on mutual respect and optimal communication, says.

Dr. Mann from Mount Sinai School of Medicine.

This study involved 71 patients who had been prescribed statins for the primary prevention of cardiovascular disease. Patients were interviewed at the time of prescription and three and six months later, when no significant change in saturated fat intake was noted......... Posted by: Janet      Read more         Source