February 13, 2006, 11:27 PM CT

Stopping Antidepressant Use While Pregnant

Pregnant women who discontinue antidepressant medications may significantly increase their risk of relapse during pregnancy, a new study funded by the National Institute of Health's National Institute of Mental Health found.

Women in the study who stopped taking antidepressants while pregnant were five times more likely than those who continued use of these medications to experience episodes of depression during pregnancy, reported Lee Cohen, M.D. of Massachusetts General Hospital and his colleagues in the February 1 issue of the Journal of the American Medical Association.

Depression is a disabling disorder that has been estimated to affect approximately 10 percent of pregnant women in the United States. Recently there has been concern about the use of antidepressants during pregnancy; however what has not been addressed is the risk of depression recurrence should someone discontinue antidepressant use. This study sheds light on the risk of relapse associated with discontinuing antidepressant treatment during pregnancy.

In the study, Cohen and his colleagues enrolled pregnant women already taking antidepressants and then noted how a number of of the women decided to stop taking their medications. They then assessed the risk of relapse for the women who stopped versus maintained antidepressant treatment.........

Posted by: JoAnn      Permalink     

February 13, 2006, 10:50 PM CT

Revolutionary New Heart Valve For Children

Children with congenital heart defects may soon have an alternative to invasive open-heart surgery that will mean less time in the hospital, a quicker recovery and no need to break open the breastbone, thanks to a new collaboration between scientists at the UCLA Henry Samueli School of Engineering and Applied Science and pediatric cardiologists at Mattel Children's Hospital at UCLA.

Using a super-elastic, shape-memory metal alloy called "thin film nitinol," UCLA engineers are developing a collapsible heart valve for children that can be loaded into a catheter, inserted into a vein in the groin area, guided into place and then deployed in a precise location within the heart. As the valve is released from the catheter, it springs back to its original shape and begins to function.

"What is really novel about the valve UCLA Engineering has created is the memory-retaining alloy and butterfly design that opens or hinges from the middle of the valve rather than the edges," said UCLA mechanical and aerospace engineering professor Gregory Carman, who, along with UCLA researcher Lenka Stepan, crafted the valve. "The unobtrusive leaflets within the valve mean there is no obstruction to blood flow. This smaller, low-profile design is well suited for children and, over time, will potentially allow children born with heart valve defects to experience less pain and live much fuller lives".........

Posted by: JoAnn      Permalink         Source

February 13, 2006, 10:45 PM CT

Heart Disease-glucose Connection

Men with cardiovascular disease may be at considerably increased risk for death even when their blood sugar level remains in the "normal" range, suggests a new study by a team of researchers at UCLA and Cedars-Sinai Medical Center in Los Angeles. The study, a statistical analysis examining the correlation between glucose (blood sugar) levels and death in patients with cardiovascular disease, will be published Feb. 15 in the American Journal of Epidemiology, the leading scientific journal in its field.

Cardiovascular disease includes coronary heart disease, stroke, angina and peripheral vascular disease. Currently, doctors consider a glucose level of 100 or less to be normal, 101-126 to be impaired and above 126 to be diabetic.

"Our findings suggest that for men with cardiovascular disease, there is apparently no 'normal' blood sugar level," said Sidney Port, UCLA professor emeritus of mathematics and statistics, and lead author of the study. "For these men, across the normal range, the lower their blood sugar, the better. Their death rate over a two-year period soars from slightly more than 4 percent at a glucose level of 70 (mg/dl) to more than 12 percent at 100 (mg/dl) -- an enormous increase."

Surprisingly, however, and contrary to conventional belief, above 100 (mg/dl), their risk does not seem to change -- it stays at the same high level -- no matter how high above the normal range, Port said. Their death rate at 100 and 150 is the same. Eventhough these data suggest that blood sugar for men with cardiovascular disease should be as low as possible, co-author Mark Goodarzi, assistant professor-in-residence at Cedars-Sinai Medical Center's Division of Endocrinology, cautions that their study by no means proves that deliberately lowering glucose would reduce mortality.........

Posted by: JoAnn      Permalink         Source

February 13, 2006, 7:30 AM CT

Non-brca Breast Cancer And New Cancers

The risk for a new cancer in the unaffected breast substantially increases in women diagnosed with unilateral, hereditary (non-BRCA) breast cancer, as per a new study. Reported in the March 15, 2006 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society, the study reveals women under 50 diagnosed with hereditary (non-BRCA) breast cancer are at significantly greater risk for developing cancer in the other breast, also known as contralateral breast cancer (CBC). Adjuvant hormonal treatment, however, reduces CBC risk.

Women with hereditary (non-BRCA) breast cancer are estimated to be at up to six times greater risk of developing a second primary malignancy in the other breast than the general population is of developing primary breast cancer. Young age at first diagnosis, family history of breast cancer, and confirmed BRCA1 or BRCA2 gene mutations are the primary risk factors for CBC. However, the contribution of non-BRCA hereditary cancers to the risk of CBCs is poorly understood.

Led by Katarina Shahedi, M.D. of the Umeå University and his colleagues at the Karolinska Institute in Stockholm, Sweden, scientists reviewed data from 120 families and 204 women with unilateral breast cancer and a family history of breast cancer but no BRCA mutations to better characterize the CBC risk for these women.........

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February 13, 2006, 7:25 AM CT

How Accurate Are The Medical Tests?

Anyone who visits a doctor is familiar with diagnostic tests. The results are either negative (no disease), or they indicate an underlying disease and are used to guide therapy decisions. But how reliable is the evidence from studies evaluating the accuracy of medical tests?.

To determine a test's accuracy, scientists compare its results with those of a "gold standard" -- commonly a more definitive test but one that is too costly, time-consuming or risky. However, shortcomings in study design and methodology are known to affect estimations of accuracy.

In this issue, Anne Rutjes and his colleagues report on their analysis of 487 primary studies of test evaluations to determine if the published results were accurate. Surprisingly, they found that only one of the studies had no design deficiencies. Studies that included patients with severe disease and healthy control subjects were most likely to overestimate accuracy. Thus, the test would perform well among patients with obvious and severe disease, but it would be much less accurate when used to detect mild or early disease.

In an accompanying commentary, Toshi Furukawa and Gordon Guyatt underscore the importance of the study by Rutjes and his colleagues. They see diagnosis and test performance as proceeding in a stepwise fashion, starting with a set of symptoms and signs. Knowing the accuracy of a test in a real clinical setting is critical, as is knowledge of the accuracy of the gold standard.........

Posted by: Sue      Permalink         Read more....

February 11, 2006, 3:04 PM CT

People React Differently To Pain

A Rochester-based study has observed more than 20 percent of people with chronic pain did not seek doctor help for their pain. The study supports the opinion of a number of physicians that a large segment of patients has an unmet need for pain care.

Increased media attention and doctor education are recommended to decrease the number of "silent sufferers," as per the study. Reported in the recent issue of Mayo Clinic Proceedings, the study looked at 3,575 people. Of the 2,211 respondents who reported pain of more than three months' duration, 22.4 percent (497) stated that they had not informed their doctor about their pain. The survey covered a cross-section of residents of Olmsted County, Minn., from March through June 2004.

It is unclear whether the reasons for not seeking therapy are limited to minor impact of pain on the person, or for other reasons such as poor prior experiences with pain care, perceived lack of effective therapys, and barriers to health care; lack of medical insurance, for example.

The importance of pain management has gained increasing recognition in the last decade. In 1995, the American Pain Society declared pain to be the fifth vital sign, a designation to increase pain awareness among health care professionals.

The rapid increases in pain medicine prescription hint at a population of patients with unmet pain needs, as per the study.........

Posted by: JoAnn      Permalink         Source

February 11, 2006, 2:50 PM CT

DNA Breaks Associated With Leukemia

When otherwise normal DNA adopts an unusual shape called Z-DNA, it can lead to the kind of genetic instability associated with cancers such as leukemia and lymphoma, as per a research studyby scientists at The University of Texas M. D. Anderson Cancer Center.

The study, issued in advance of the Feb. 21 edition of the Proceedings of the National Academy of Sciences, demonstrates for the first time that the oddly shaped DNA can cause DNA breaks in mammalian cells. Interestingly, these sequences prone to forming Z-DNA are often found in genetic "hot spots," areas of DNA known to be prone to the genetic rearrangements associated with cancer. About 90 percent of patients with Burkitt's lymphoma, for example, have DNA breaks that map to regions with the potential to form these odd DNA structures.

"Our study shows that DNA itself can act as a mutagen, resulting in genetic instability," says Karen Vasquez, Ph.D., lead author of the study and assistant professor of carcinogenesis at.

M. D. Anderson's Science Park Research Division, Smithville, Texas. "The discovery opens up a new field of inquiry into the role of DNA shape in genomic instability and cancer".

Imagine untwisting the DNA ladder and then winding it up the other way. The result is a twisted mess with segments jutting out left and right, and the all important base pairs that hold the DNA code zigzagging in a jagged zipper shape. Researchers call this left-hand twist Z-DNA. This is a far cry from the graceful right-hand twisted helix that has become an iconic symbol of biology. It just doesn't look right, and it doesn't act right either, as per Vasquez. This awkward shape puts strain on the DNA, and as Vasquez and her colleagues show, can cause the DNA molecule to break completely apart.........

Posted by: Janet      Permalink


February 10, 2006, 7:39 PM CT

Explaining Alzheimer's Memory Loss

Based on laboratory research, researchers at Georgetown University Medical Center have a new theory as to why people with Alzheimer's disease have trouble performing even the simplest memory tasks, such as remembering a family member's name.

That's because they discovered a physical link between apolipoprotein E (APOE), the transport molecules known to play a role in development of the disease, and glutamate, a brain chemical necessary for establishing human memory.

As per a research findings reported in the Journal of Biological Chemistry, the research team specifically found that receptors on the outside of brain nerve cells (neurons) that bind on to APOE and glutamate are connected on the surface of neurons, separated from each other by only a small protein.

While the scientists don't know why these receptors are linked together, they say inefficient or higher-than-average levels of APOE in the brain could possibly be clogging these binding sites, preventing glutamate from activating the processes necessary to form memories.

"We have found out that two receptors previously thought to have nothing to do with each other do, in fact, interact, leading us to conclude that APOE affects the NMDA glutamate channel that is important in memory," says the study's senior author, G. William Rebeck, PhD, associate professor of neuroscience in Georgetown's Biomedical Graduate Research Organization.........

Posted by: Daniel      Permalink    Source


February 10, 2006, 7:27 PM CT

veggies may protect you from cancer

Need another reason to eat your vegetables? New research shows that some of them contain chemicals that appear to enhance DNA repair in cells, which could lead to protection against cancer development, say Georgetown University Medical Center researchers.

As per a research findings reported in the British Journal of Cancer (published by the research journal Nature) the scientists show that in laboratory tests, a compound called indole-3-carinol (I3C), found in broccoli, cauliflower and cabbage, and a chemical called genistein, found in soy beans, can increase the levels of BRCA1 and BRCA2 proteins that repair damaged DNA.

Eventhough the health benefits of eating your vegetables-particularly cruciferous ones, such as broccoli-aren't especially new, this study is one of the first to provide a molecular explanation as to how eating vegetables could cut a person's risk of developing cancer, an association that some population studies have observed, says the study's senior author, Eliot M. Rosen, MD, PhD, professor of oncology, cell biology, and radiation medicine at Georgetown's Lombardi Comprehensive Cancer Center.

"It is now clear that the function of crucial cancer genes can be influenced by compounds in the things we eat," Rosen says. "Our findings suggest a clear molecular process that would explain the correlation between diet and cancer prevention."........

Posted by: Janet      Permalink    Source


February 10, 2006, 6:53 PM CT

Diabetes Control For Chinese-speaking Immigrants

Health providers helping Chinese-speaking Asian American immigrants with diabetes better control their disease to avoid complications need to do more than just have translators and bilingual staff in hospitals or doctors' offices. While that's a start, these patients also need comprehensive patient education materials written in Chinese and a medical staff thoroughly versed in the customs and cultural issues that may impede their diabetes care, as per a new study by scientists at Joslin Diabetes Center.

The Chinese-speaking immigrants who were surveyed at community health centers in Boston, New York City and Oakland, Calif., were found to have less knowledge of how to manage their diabetes - and generally had a trend toward poor blood glucose control - compared with Asian American immigrants who preferred to speak English, as per William C. Hsu, M.D., who led the pilot study along with his colleagues in Joslin's Asian American Diabetes Initiative (AADI). But after being given a bilingual diabetes education book, the participants showed improved understanding of their disease and a trend toward improved blood glucose control in laboratory tests.

The study, which appears in the recent issue of the American Diabetes Association's journal, Diabetes Care, is among the first of its kind to explore language barriers to diabetes management among Chinese-speaking immigrant populations.........

Posted by: JoAnn      Permalink    Source