October 15, 2008, 5:45 PM CT

Genetic analysis predicts whether liver cancer likely to recur

Scientists are poised to unlock the genetic secrets stored in hundreds of thousands of cancer biopsy samples locked in long-term storage and previously believed to be useless for modern genetic research. With the aid of a new technique developed by Howard Hughes Medical Institute researchers, researchers can now reconstruct thousands of genes that are "shredded" into tiny pieces when tissue samples are treated with a chemical fixative and stored in wax a protocol that is usually used to preserve the samples.

The researchers tested their new technique on liver tissue samples from 307 patients enrolled in clinical studies in four different countries. Using sophisticated microarray technology, the researchers studied RNA from stored liver tissue samples and identified a tell-tale genetic profile that indicates whether liver cancer will recur. Since the testing was done on tissue samples of patients whose clinical outcome was known, the scientists were able to associate specific "gene expression signatures" with particular outcomes.

The scientists are optimistic that oncologists will be able to use this information to determine which liver cancer patients would likely suffer recurrence and treat them to help prevent it.

"It is now possible to scan the entire genome for gene expression profiles in tissues that have been fixed for a very long timein our study as long as twenty-four years," said Howard Hughes Medical Institute investigator Todd R. Golub, who led the study. "There are lots of those tissues available compared with frozen ones, and tissue availability has been a real bottleneck in cancer genomic research"......... Posted by: Janet      Read more         Source

October 14, 2008, 10:04 PM CT

Why do women get more cavities than men?

Reproduction pressures and rising fertility explain why women suffered a more rapid decline in dental health than did men as humans transitioned from hunter-and-gatherers to farmers and more sedentary pursuits, says a University of Oregon anthropologist.

The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.

His conclusions are outlined in the recent issue of Current Anthropology The study examined the frequency of dental caries (cavities) by sex to show that women typically experience poorer dental health than men. Among research evaluated were studies previously done by Lukacs. Two clinical dental studies published this year (one done in the Philippines, the other in Guatemala) and cited in the paper, Lukacs said, point to the same conclusions and "may provide the mechanism through which the biological differences are mediated".

A change in food production by agrarian societies has been linked to an increase in cavities. Anthropologists have attributed men-women differences to behavioral factors, including a sexual division of labor and dietary preferences. However, Lukacs said, clinical and epidemiological literature from varied ecological and cultural settings reveals a clear picture of the impacts on women's oral health......... Posted by: Janet      Read more         Source

October 14, 2008, 9:47 PM CT

Vitamin B does not slow cognitive decline in Alzheimer's

A clinical trial led by Paul S. Aisen, M.D., professor of neurosciences at the University of California, San Diego School of Medicine, showed that high-dose vitamin B supplements did not slow the rate of cognitive decline in patients with mild to moderate Alzheimer disease. The study would be reported in the October 15 issue of the Journal of the American Medical Association (JAMA).

Aisen is director of the Alzheimer's Disease Cooperative Study (ADCS), a multi-center network spanning the United States and Canada, which conducted the clinical trial to determine if reduction of an amino acid called homocysteine would reduce the risk of Alzheimer's disease or slow its progression. Homocysteine is known to be involved in neurological disease, including Alzheimer's, and its metabolism is affected by B vitamins. Therefore, it was thought that B vitamin supplements might offer a new therapeutic approach in treating Alzheimer' disease.

"Previous studies using B vitamin supplementation to reduce homocysteine levels in patients with Alzheimer's weren't large enough, or of long enough duration to effectively assess their impact on cognitive decline," said Aisen. "This study of several hundred individuals over the course of 18 months showed no impact on cognition, eventhough it resulted in lower levels of homocysteine in these patients."........ Posted by: Janet      Read more         Source

October 9, 2008, 10:39 PM CT

A low-cholesterol diet leaves a bitter taste in the gut

One role for the proteins on the tongue that sense bitter tasting substances, type 2 taste receptors (T2Rs), is to limit ingestion of these substances, as a large number of natural bitter compounds are known to be toxic. T2Rs are also found in the gut, and it has been suggested that there they have a similar role to their function in the mouth (i.e., they might limit intestinal toxin absorption). Data to support this idea has now been generated in mice by Timothy Osborne and his colleagues, at the University of California, Irvine.

By supplementing the food that mice eat with the drugs lovastatin and ezetimibe (L/E), it is possible to reduce the amount of cholesterol that they take up, and they are therefore considered to be consuming a low-cholesterol diet. Such a diet increases the activity of the protein SREBP-2 in the gut. In this study, SREBP-2 was shown to directly induce the expression of T2Rs in cultured mouse intestinal cells as well as in the intestine of mice consuming food supplemented with L/E. In addition, SREBP-2 was shown to directly enhance T2R-induced secretion of the intestinal peptide cholecystokinin in both the cultured mouse intestinal cells and mice consuming food supplemented with L/E. As low-cholesterol diets are naturally composed of high amounts of plant matter that is likely to contain dietary toxins, and one function of cholecystokinin is to decrease food intake, the authors suggest that SREBP-2induced expression of T2Rs might provide a mechanism both to inform the gut that food-borne toxins could be present and to initiate a response that limits their absorption......... Posted by: JoAnn      Read more         Source

October 8, 2008, 9:43 PM CT

Women, the elderly and weekend admissions

Women, the elderly, and patients admitted to the emergency department on weekends are all less likely to receive same-day coronary angioplasty for a life-threatening heart attack in Florida, University of South Florida scientists found. Their study was published this month in the American Journal of Cardiology.

Angioplasty, also known according tocutaneous coronary intervention (PCI), uses a catheter-guided balloon to open a blocked artery and restore blood and oxygen to the heart. A stent is commonly placed to hold open the artery. The procedure is the recommended therapy for the most serious and deadly of heart attacks known as ST-elevation myocardial infarctions or STEMIs, as per guidelines published by the American College of Cardiology and the American Heart Association. Studies show that rapid access to PCI can reduce heart muscle damage, hasten recovery, improve survival and prevent long-term disability better than clot-busting drugs alone.

Elizabeth Pathak, PhD, and Joel Strom, MD, both of USF, examined same-day PCI rates in over 58,000 acute heart attack patients who were admitted to emergency rooms in more than 200 Florida hospitals from 2001 to 2005.

The study included men and women ages 18 and older from the three largest ethnic groups in Florida: whites, blacks, and Hispanics. The scientists observed that the use of same-day PCI for heart attack patients more than doubled -- from 20 percent to 40 percent -- during the study period......... Posted by: Janet      Read more         Source

October 8, 2008, 9:34 PM CT

The pepperoni pizza hypothesis

What's the worst that could happen after eating a slice of pepperoni pizza? A little heartburn, for most people.

But for up to a million women in the U.S., enjoying that piece of pizza has painful consequences. They have a chronic bladder condition that causes pelvic pain. Spicy food -- as well as citrus, caffeine, tomatoes and alcohol-- can cause a flare in their symptoms and intensify the pain. It was thought that the spike in their symptoms was triggered when digesting the foods produced chemicals in the urine that irritated the bladder.

However, scientists from Northwestern University's Feinberg School of Medicine believe the symptoms -- pain and an urgent need to frequently urinate -- are actually being provoked by a surprise perpetrator. Applying their recent animal study to humans, the researchers believe the colon, irritated by the spicy food, is to blame.

Their idea opens up new therapy possibilities for "painful bladder syndrome," or interstitial cystitis, a condition that primarily affects women (only 10 percent of sufferers are men.) During a flare up, the pelvic pain is so intense some women administer anesthetic lidocaine directly into their bladders via a catheter to get relief. Patients typically also feel an urgent need to urinate up to 50 times a day and are afraid to leave their homes in case they can't find a bathroom......... Posted by: Janet      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 3, 2008, 5:27 AM CT

Brain pathway responsible for obesity

University of Wisconsin-Madison researchers, for the first time, have found a messaging system in the brain that directly affects food intake and body weight.

Published in the Oct. 3, 2008 issue of Cell, the findings--from a study in mice--point to a entirely new approach to treating and preventing obesity in humans. The discovery also offers hope for new ways to treat related disorders, such as type 2 diabetes and cardiovascular diseases--the most prevalent health problems in the United States and the rest of the developed world.

Led by Dongsheng Cai, an assistant professor of physiology at the UW School of Medicine and Public Health, the scientists looked specifically at the hypothalamus--the brain structure responsible for maintaining a steady state in the body--and for the first time observed that a cell-signaling pathway primarily linked to inflammation also influences the regulation of food intake. Stimulating the pathway led the animals to increase their energy consumption, while suppressing it helped them maintain normal food intake and body weight.

The research stems from recent explorations into the problem called metabolic inflammation, a by-product of too much food or energy consumption. Unlike the classical inflammation typically observed in infections, injuries and diseases such as cancer, the metabolic inflammation seen in obesity-related diseases is much milder, doesn't lead to overt symptoms or cause tissues damage......... Posted by: JoAnn      Read more         Source

October 3, 2008, 5:11 AM CT

Study examines how doctors discuss medical errors

We can learn from our mistakes, but how willing are we to talk about them? And what happens when those making mistakes are physicians, who are often expected to be infallible?

A new University of Iowa study shows that most general practice doctors in teaching hospitals are willing to discuss their own patient care errors with colleagues, but about one in four do not. At the same time, nearly nine of 10 doctors said that if they wanted to talk about a mistake, they knew a colleague who would be a supportive listener. The findings are published in the Oct. 1 issue of the Journal of Medical Ethics

The results suggest that it is important to ensure that learning occurs not just in the person who made the mistake but also among their peers, said the study's lead author, Lauris Kaldjian, M.D., Ph.D., associate professor of internal medicine at the University of Iowa Carver College of Medicine.

"Discussing medical errors can be a form of professional learning for doctors. Mistakes should be considered shared commodities and used for all they're worth," said Kaldjian, who also is director of the college's Program in Bioethics and Humanities. "The findings also point to some challenges for physicians seeking emotional support after making an error"......... Posted by: Janet      Read more         Source

October 2, 2008, 5:04 AM CT

Acupressure calms children before surgery

An acupressure therapy applied to children undergoing anesthesia noticeably lowers their anxiety levels and makes the stress of surgery more calming for them and their families, UC Irvine anesthesiologists have learned.

As per Dr. Zeev Kain, anesthesiology and perioperative care chair, and his Yale University collaborator Dr. Shu-Ming Wang, this noninvasive, drug-free method is an effective, complementary anxiety-relief treatment for children during surgical preparation. Sedatives currently used before anesthesia can cause nausea and prolong sedation.

"Anxiety in children before surgery is bad because of the emotional toll on the child and parents, and this anxiety can lead to prolonged recovery and the increased use of analgesics for postoperative pain," said Kain, who led the acupressure study. "What's great about the use of acupressure is that it costs very little and has no side effects".

In this study, Kain and his Yale colleagues applied adhesive acupressure beads to 52 children between the ages of 8 and 17 who were to undergo endoscopic stomach surgery. In half the children, a bead was applied to the Extra-1 acupoint, which is located in the midpoint between the eyebrows. In the other half, the bead was applied to a spot above the left eyebrow that has no reported clinical effects......... Posted by: JoAnn      Read more         Source

October 2, 2008, 4:59 AM CT

Culture's role on alcohol and violence

Countries with strict social rules and behavioral etiquette such as the United Kingdom may foster drinking cultures characterized by unruly or bad behavior, as per a new report on alcohol and violence released recently by International Center for Alcohol Policies (ICAP). The report lists 11 cultural features that may predict levels of violence such as homicide and spousal abuse.

The report, "Alcohol and Violence: Exploring Patterns and Responses," examines the association between alcohol and violence through the disciplines of anthropology, clinical psychology, human rights law, gender, and public health.

"We need to look more closely at the meaning attached to both drinking and violence in different.

cultures, without assuming that the one causes the other," writes Anne Fox, PhD, a contributor to the report and founding director of Galahad SMS Ltd. in England.

Dr. Fox writes that the presence of certain cultural features can largely predict levels of homicide, spousal abuse and other forms of violence. Violence-reinforcing cultures tend to share the following features:

• Cultural support (in media, norms, icons, myths, and so on) for aggression and aggressive.
  
  solutions;.
• Militaristic readiness and participation in warssocieties that are frequently at war have.........
  
  
  Posted by: Janet      Read more         Source
  
  

October 1, 2008, 8:40 AM CT

Genes influence effectiveness of weight-loss drug

Obese patients with a specific genetic make-up lose more weight when taking the weight loss drug sibutramine and undergoing behavioral treatment in comparison to those without this genetic make-up, reports a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.

The obesity epidemic continues to be an increasingly global problem: an estimated 1.6 billion adults worldwide are overweight (body mass index [BMI]>25) and 400 million are obese (BMI>30). In addition, the incidences of diabetes and other debilitating diseases attributable to obesity continue to rise.

While there are numerous options for the therapy of obesity, this study examined sibutramine, a medicine approved for the long-term therapy of obesity. The drug creates a feeling of fullness, prevents decline in metabolic rate linked to low calorie diets and causes weight loss, particularly when combined with behavioral treatment. However, weight loss with the drug is highly variable. Therefore, a research team at the Mayo Clinic assessed the influence of specific markers of candidate genes controlling serotonergic and adrenergic mechanisms (α2A-receptor, 5-HTTLPR and GNβ3) on weight loss/body composition in response to sibutramine or placebo......... Posted by: JoAnn      Read more         Source

September 29, 2008, 10:31 PM CT

Second-hand smoke may trigger nicotine dependence

Montreal, September 29, 2008 Parents who smoke cigarettes around their kids in cars and homes beware second-hand smoke may trigger symptoms of nicotine dependence in children. The findings appear in the September edition of the journal Addictive Behaviors in a joint study from nine Canadian institutions.

"Increased exposure to second-hand smoke, both in cars and homes, was linked to an increased likelihood of children reporting nicotine dependence symptoms, even though these children had never smoked," says Dr. Jennifer O'Loughlin, senior author of the study, a professor at the Universit de Montral's Department of Social and Preventive Medicine and a researcher at the Centre Hospitalier de l'Universit de Montral.

"These findings support the need for public health interventions that promote non-smoking in the presence of children, and uphold policies to restrict smoking in vehicles when children are present," adds Dr. O'Loughlin, who collaborated with scientists from the Universit de Sherbrooke, the Universit de Moncton, the University of British Columbia, McGill University, Concordia University and the Institut national de sant publique du Qubec.

Study participants were recruited from 29 Quebec schools as part of AdoQuest, a cohort investigation that measures tobacco use and other health-compromising behaviours. Some 1,800 children aged 10 to 12 years old, from all socioeconomic levels, were asked to complete questionnaires on their health and behaviours. Scientists also asked questions about symptoms of nicotine dependence and exposure to second-hand smoke......... Posted by: Janet      Read more         Source

September 25, 2008, 11:04 PM CT

English health care system failing to encourage breastfeeding

The English healthcare system is failing to encourage breast feeding and a national strategy to promote breast feeding is urgently needed, say experts on bmj.com today.

In the UK, the women most likely to use formula milk are young, white and from low socioeconomic backgrounds, and this has created a major public health and inequalities challenge, write Professor Mary Renfrew from the University of York and Professor David Hall from the University of Sheffield.

It is well known that breast feeding improves infant health, and it has been shown to be the single most important preventive approach to saving children's lives.

In spite of national and international policy initiatives, 40% of women in the UK who start to breast feed discontinue by the time their baby is 6 weeks old, and only 20% of infants are exclusively breast fed at six weeks.

Yet evidence has shown that the main reasons cited for discontinuing breastfeeding could be easily remedied. For example, problems getting the baby to feed, or women reporting that breast feeding is painful.

In addition, recent data show that health professionals, particularly doctors, are not adequately trained in giving advice on breast feeding, and often do not know how to position the baby so that feeding is effective and pain free......... Posted by: Emily      Read more         Source

September 25, 2008, 11:03 PM CT

Are we spending too much on health?

In this poor economic climate and period of lower growth is it time to consider limiting spending on healthcare budgets? Two experts debate the issue on bmj.com today.

The key challenge is to get more value for money from the already vast sums of money spent on health services rather than increasing spending, argues Professor Nick Bosanquet from Imperial College, London.

In the UK, health care spending is growing 2% points faster than GDP and this is unsustainable in an era of lower growth when the government says it has reached the limits of taxable capacity, he writes.

"There will be no incentive to invest in a new kind of health service while the easy option of continued growth in high spending in the old one remains", he warns.

Bosanquet suggests that capping spending to current percentages of GDP (8𔃇%) would encourage more efficiency and better financial management by creating pressure to redesign more effective health systems.

Decisions on health spending should be made on the basis of value, and priority must be given to raising value from the pound or Euro, he writes. From 1990𔃆 the return on health expenditure was 148% in the UKfor every pound spent, we got 2.48 worth of health gain back, and the USA has had similar gains......... Posted by: Janet      Read more         Source

September 24, 2008, 9:37 PM CT

Call for warning labels for energy drinks

Johns Hopkins researchers who have spent decades researching the effects of caffeine report that a slew of caffeinated energy drinks now on the market should carry prominent labels that note caffeine doses and warn of potential health risks for consumers.

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication," says Roland Griffiths, Ph.D., one of the authors of the article that appears in the journal Drug and Alcohol Dependence this month.

The market for these drinks stands at an estimated $5.4 billion in the United States and is expanding at a rate of 55 percent annually. Advertising campaigns, which principally target teens and young adults, promote the performance-enhancing and stimulant effects of energy drinks and appear to glorify drug use.

Without adequate, prominent labeling; consumers most likely won't realize whether they are getting a little or a lot of caffeine. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch," says Griffiths.

Caffeine intoxication, a recognized clinical syndrome included in the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing) and in rare cases, death......... Posted by: Janet      Read more         Source

September 24, 2008, 6:56 PM CT

American kids most medicated

American children are approximately three times more likely to be prescribed psychotropic medicine than children in Europe. A new study published recently in BioMed Central's open access journal Child and Adolescent Psychiatry and Mental Health claims that the differences may be accounted for by regulatory practices and cultural beliefs about the role of medicine in emotional and behavioural problems.

Julie Zito led a team of scientists from the USA, Gera number of and the Netherlands who investigated prescription levels in the three countries. She said, "Antidepressant and stimulant prevalence were three or more times greater in the US than in the Netherlands and Gera number of, while antipsychotic prevalence was 1.5 to 2.2 times greater".

The use of antidepressants, like Prozac, and stimulants, like Ritalin, in children has been the subject of a great deal of controversy and this study quantifies the differences in practice between the US and Western Europe. The authors claim that the differences may be partly due to different diagnostic classification systems, "The US trend of increasing bipolar diagnosis in children and adolescents does not reflect European practice". The authors also mention government cost restrictions in Europe, the larger number of child psychiatry experts per capita in the US and the use of two or more different psychotropic drugs in a single year in US children as possible explanations......... Posted by: JoAnn      Read more         Source

September 22, 2008, 10:29 PM CT

Acupuncture reduces side effects of breast cancer treatment

Boston Acupuncture is as effective and longer-lasting in managing the common debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms) linked to breast cancer therapy and has no therapy side effects in comparison to conventional drug treatment, as per a first-of-its-kind study presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.

Findings also show there were additional benefits to acupuncture therapy for patients with breast cancer, such as an increased sense of well being, more energy, and in some cases, a higher sex drive, that were not experienced in those patients who underwent drug therapy for their hot flashes.

"Our study shows that physicians and patients have an additional treatment for something that affects the majority of breast cancer survivors and actually has benefits, as opposed to more side effects. The effect is more durable than a drug usually used to treat these vasomotor symptoms and, ultimately, is more cost-effective for insurance companies," Eleanor Walker, M.D., lead author of the study and a radiation oncologist at the Henry Ford Hospital Department of Radiation Oncology in Detroit, said.

The reduction in hot flashes lasted longer for those patients with breast cancer after completing their acupuncture therapy, in comparison to patients after stopping their drug treatment plan......... Posted by: Janet      Read more         Source

September 22, 2008, 10:26 PM CT

Women and South Asians with angina

Women and South Asian people with typical pain were more likely than those with atypical pain to receive a diagnosis of angina pectoris and to have increased mortality rates or acute coronary complications, a study by UK scientists found. Despite this, in women and South Asians, both those with typical and atypical pain had lower rates of angiography and coronary interventions compared with men and white people respectively.

In this study of 7784 South Asian and white people in the United Kingdom, it was also observed that more women than men and more South Asians compared with white people reported atypical chest pain and were less likely to receive a diagnosis of angina.

"Women and South Asian people with typical chest pain were at increased risk of adverse coronary outcomes compared with those who presented with atypical pain," state Dr. Justin Zaman of University College London and UK-based colleagues.

Differences in the description of symptoms did not account for the lower rates of intervention. "Further study should examine why South Asians and white women with potentially the same adverse prognosis as men received poorer care," state the researchers.

In a related commentary, Dr. Deborah Diercks from the University of California and coauthor Dr. Chadwick Miller of Wake Forest University ask whether misdiagnoses occur because of the way patients report symptoms or physician misinterpretation or bias. They point out that "patients with atypical chest pain are still at significant risk for cardiac disease.and patients with typical symptoms, regardless of ethnic background or sex, should receive further cardiac evaluation to minimize the impact of cardiac disease"......... Posted by: Daniel      Read more         Source

September 22, 2008, 10:20 PM CT

Physicians may miss opportunities to respond with empathy

In a small study of 20 audiorecorded interactions, physicians seldom responded empathetically to concerns raised by lung cancer patients, as per a report in the September 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Empathy is an important element of effective communication between patients and physicians and is linked to improved patient satisfaction and compliance with recommended therapy," the authors write as background information in the article. "Patients who are more satisfied with the communication in their medical encounters have improved understanding of their condition, with less anxiety and improved mental functioning." However, responding to patients' emotional needs can be challenging for physicians; they may begin medical school with empathy for their patients but gradually learn detachment, perhaps in order to cope with time constraints or sadness.

Diane S. Morse, M.D., of the University of Rochester Medical Center, Rochester, N.Y, and his colleagues conducted an analysis of 20 recorded and transcribed consultations between patients with lung cancer (average age 65, all male) and nine physicians (three oncologists and six thoracic surgeons). Each visit contained an average of 326 statements, and those made by patients were coded into three themes: statements about the impact of lung cancer, statements about diagnosis or therapy and statements about health system issues affecting care......... Posted by: Scott      Read more         Source

September 18, 2008, 10:44 PM CT

Probiotic intervention and lipid profile change?

The new global metabolic profiling techniques, like lipidomics as a branch of metabolomics, have made it possible to measure large numbers of different metabolites, and are currently being applied to increase our understanding of the health and disease continuum.

A Finland research group investigated the effect of a three weeks intervention of a probiotic LGG intervention on serum global lipidomics profiles in healthy adults. This will be published on 28 May 2008, in the World Journal of Gastroenterology The result showed that there were decreases in the levels of lysophosphatidylcholines (LysoGPCho), sphingomyelins (SM) and several glycerophosphatidylcholines (GPCho), and increases in triacylglycerols (TAG) in the probiotic LGG group. These changes may contribute, for example, to the metabolic events behind the beneficial effects of LGG on gut barrier function seen in prior studies.

This study, done in collaboration with research groups of Associate Professor Riitta Korpela and Professor Matej Oreič, was the first to characterise the effect of probiotics on global lipidomics profiles. There were indications that probiotic LGG intervention may lead to changes in global lipidomics profiles reflected in decreased LysoGPCho and SM, mainly decreased GPCho and mainly elevated TAG. In addition, among the inflammatory variables, IL-6 was moderately associated by changes in global lipidomics profiles, while there was only a weak association between the lipidomics profiles and the two other inflammatory markers, TNF-αand CRP......... Posted by: Daniel      Read more         Source

September 18, 2008, 9:03 PM CT

Work together or face 'disastrous consequences'

Faced with the prospect of more variable and changing climates increasing Africa's already intolerable disease burden, researchers must begin to reach out to colleagues in other fields and to the people they want to help if they hope to avert an expected "continental disaster," as per leading climate, health, and information technology experts, who met in Nairobi last week.

Climate change will further increase the already high variability of Africa's climate, fostering the emergence, resurgence and spread of infectious diseases. "A warmer world will generally be a sicker world," said Prof. Onesmo ole-MoiYoi, a Tanzania medical, veterinary and vector expert. "We researchers need to adopt a new way of working, one that makes African communities bearing the burden of disease part of the solution rather than part of the problem." The separate fields of human health, animal health, climate, vectors and environment must come together to avert a "continental disaster," as per leading experts who attended the meeting.

Patti Kristjanson of the International Livestock Research Institute (ILRI), which hosted the meeting, agreed. "We need to do things differently than we have in the past. The impact of disease will increase if we continue to operate in silos. Our only chance at reducing the impact of deadly diseases in Africa is to increase collaboration across the disciplines of environment and health, and in a way that involves local communities. Failure to do so could lead to disastrous consequences"......... Posted by: Janet      Read more         Source

September 17, 2008, 5:08 PM CT

Pelvic disorders affect large number of women

Nearly one-quarter of all women suffer from pelvic-floor disorders, such as incontinence, at some point in their lives, a national study, including scientists from UT Southwestern Medical Center, has found.

The study of nearly 2,000 women in seven U.S. cities observed that 23.7 percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.

"This study is the first nationwide study to confirm what we consider a high prevalence of pelvic-floor disorders in the U.S.," said Dr. Joseph Schaffer, professor of obstetrics and gynecology at UT Southwestern and an author of the study, which appears in today's issue of the Journal of the American Medical Association.

"Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent," he said.

The national rate of pelvic-floor disorders has not been well-studied, eventhough several regional studies have observed that almost 10 percent of women go through surgery for such conditions at some point in their lives, while one-third of those women have two or more surgeries.

The current study was designed to assess the national rate of such disorders. The participating women were interviewed in 2005 and 2006 at their homes or at a mobile interview center and did not undergo physical examination. The questions were part of the National Health and Nutrition Examination Survey......... Posted by: Emily      Read more         Source

September 16, 2008, 10:26 PM CT

Emotions are key in the study of face recognition

Recognizing the faces of family and friends is commonly an effortless process. However, a minority of people have difficulties identifying the person they are meeting or remembering people they have met before. These problems can be quite dramatic, to the point where those affected fail to recognize the face of their spouse or child or even their own face. New research on face blindness demonstrates the importance of using naturalistic emotional faces and bodies for a better understanding of developmental face disorders.

The study, which is reported in the open-access journal PLoS ONE this week, by scientists in the Netherlands and at Massachusetts General Hospital, led by Beatrice de Gelder, shows that the presence of emotional information in the face increases neural activity in the area of the brain linked to face recognition (the fusiform face area, or FFA), a finding that could be used to design novel assessment and training programs. The study also provides evidence that body and face sensitive processes are less categorically segregated in people with face blindness and points to a possible cause of face blindness in cortical specialisation.

Recent research has shown that as much as 2% of the population suffers from face recognition difficulties. On analogy with developmental dyslexia, these cases are usually referred to as developmental prosopagnosia, referring to the possible origin of the adult face recognition deficit in anomalous development of the full face recognition skills......... Posted by: JoAnn      Read more         Source

September 16, 2008, 10:22 PM CT

Colds and flu cut by one-third in vaccinated seniors

A winter free from colds and flu? Not yet. But a new study offers new evidence that Canada's top cold and flu-fighting product provides significant help. The three-year study showed that trial participants who took COLD-FX were about one-third less likely to get a "Jackson" cold or flu. The very sensitive Jackson scoring method is a well-accepted scientific approach for judging clinical symptoms, which include coughing, sneezing, runny noses and others. COLD-FX is a unique extract of North American ginseng discovered by 25 Canadian scientists. The multi-center study also revealed that COLD-FX gave trial participants added protection on top of the flu shot's benefit.

The multi-centre study confirmed the results of prior clinical trials evaluated by Health Canada, the federal government's regulatory body. One study reported in the Canadian Medical Association Journal showed that for trial participants who regularly suffer two colds a year, COLD-FX reduced their chance of getting a second one by 56%. Health Canada approved strong claims for the product last year.

The multi-centre trial involved 780 healthy seniors in four major Canadian cities who took the flu shot just previous to their six-month therapy phase as part of the study. Participants were given either the standard dose of two capsules a day or double the standard dose or a placebo. The study was led by Dr. Gerald Predy, Medical Officer of Health for Alberta Health Services, in collaboration with various leading Canadian researchers. Neither the participants nor the researchers were aware of who was receiving what in this double-blind, placebo controlled trial......... Posted by: Mark      Read more         Source

September 16, 2008, 10:04 PM CT

A healthy lifestyle halves the risk of premature death in women

Over half of deaths in women from chronic diseases such as cancer and heart disease could be avoided if they never smoke, keep their weight in check, take exercise and eat a healthy diet low in red meat and trans-fats, as per a research studypublished on bmj.com today.

It is well known that diet, lack of physical activity, being overweight, alcohol consumption and smoking increase the risk of disease including cancer and diabetes, but little research has examined combinations of lifestyle factors in younger populations and women.

Dr Rob van Dam and his team from the Harvard School of Public Health and Brigham and Women's Hospital, recruited nearly 80 000 women aged 34 to 59 years in 1980 who were part of the Nurses' Health Study in the US. They analysed the data of over 1.5 million person-years follow up over a 24 year period.

Participants completed detailed follow-up questionnaires every two years about their diet, frequency of physical activity, alcohol intake, weight, how much they smoked, and disease history. Deaths were confirmed by next of kin and the National Death Index.

Over the follow-up period the authors documented 8 882 deaths including 1 790 from heart disease and 4 527 from cancer.

The authors estimated that 28% of these deaths could have been avoided if women had never smoked and that 55% could have been avoided if women had combined never smoking, regular physical activity, a healthy diet and maintaining a healthy weight. Alcohol intake did not substantially change this estimate, eventhough heavy alcohol consumption is associated with an increased risk of dying from cancer......... Posted by: JoAnn      Read more         Source

September 15, 2008, 10:20 PM CT

Vaccine against HER2-positive breast cance

Scientists at Wayne State University have tested a breast cancer vaccine they say completely eliminated HER2-positive tumors in mice - even cancers resistant to current anti-HER2 treatment - without any toxicity.

The study, published in the September 15 issue of Cancer Research, a journal of the American Association for Cancer Research, suggests the vaccine could treat women with HER2-positive, therapy-resistant cancer or help prevent cancer recurrence. The scientists also say it might potentially be used in cancer-free women to prevent initial development of these tumors.

HER2 receptors promote normal cell growth, and are found in low amounts on normal breast cells. But HER2-positive breast cells can contain a number of more receptors than is typical, promoting a especially aggressive type of tumor that affects 20 to 30 percent of all patients with breast cancer. Therapies such as trastuzumab and lapatinib, designed to latch on to these receptors and destroy them, are a mainstay of therapy for this cancer, but a significant proportion of patients develop a resistance to them or cancer metastasis that is hard to treat.

This therapy relied on activated, own-immunity to wipe out the cancer, says the study's lead investigator, Wei-Zen Wei, Ph.D., a professor of immunology and microbiology at the Karmanos Cancer Institute......... Posted by: Janet      Read more         Source

September 15, 2008, 10:18 PM CT

Massage therapy may have immediate positive effect

A new study from the National Institutes of Health finds that massage treatment may have immediate benefits on pain and mood among patients with advanced cancer. The study appears in the September 16, 2008 issue of Annals of Internal Medicine

In a randomized trial of 380 advanced cancer patients at 15 U.S. hospices, improvement in pain and mood immediately following therapy was greater with massage than with simple touch.

"When patients near the end of life, the goals of medical care change from trying to cure disease to making the patient as comfortable as possible," said Jean S. Kutner, MD, MSPH, Associate Professor of Medicine, Division of General Internal Medicine at the University of Colorado Denver School of Medicine. "This study is important because it shows massage is a safe and effective way to provide immediate relief to patients with advanced cancer".

Pain and depressed mood are common problems for patients with advanced cancer. While drug therapies can reduce symptoms, they don't always work and often have troublesome side effects. Scientists believe that massage may interrupt the cycle of distress, offering brief physical and psychological benefits. Physically, massage may decrease inflammation and edema, increase blood and lymphatic circulation, and relax muscle spasms. Psychologically, massage may promote relaxation, release endorphins, and create a positive experience that distracts temporarily from pain and depression......... Posted by: Janet      Read more         Source

September 15, 2008, 10:08 PM CT

Migraine linked to blood clots in veins

People with migraines may also be more likely to develop blood clots in their veins, as per a research studyreported in the September 16, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.

In the condition, called venous thrombosis or thromboembolism, blood clots form in a vein, which can limit blood flow and cause swelling and pain. Those clots can then dislodge from the vein and travel to the heart and the lungs, which can be fatal.

For the study, 574 people in Italy age 55 and up were interviewed to determine whether they had a history of migraine or migraine at the time of the evaluation and their medical records were evaluated for cases of venous thrombosis. The arteries in their necks and thighs were scanned with ultrasounds to check for atherosclerosis, or hardening of the arteries.

Of the participants, 111 people had migraine. A total of 21 people with migraine also had one or more instances of venous thrombosis, or 19 percent. In comparison, 35 people without migraine had the condition, or 8 percent.

Scientists do not know why migraine and venous thrombosis are linked. One theory is that the blood of people with migraine may be more prone to clotting.

The study also observed that people with migraine are not more likely to have hardening or narrowing of the arteries, which is contrary to a current theory......... Posted by: Daniel      Read more         Source

September 15, 2008, 9:43 PM CT

Steady work and mental health - is there a connection?

Despite low overall unemployment, Canada's manufacturing industry has cut 88,000 jobs this year, with nearly all the losses occurring in Ontario. Also, part-time employment has grown by 3.5 per cent in 12 months, much faster than the 0.9 per cent growth in full time work. A new report from the World Health Organization (WHO) on the social determinants of health demonstrates that these kind of employment changes can affect more than your wallet. Research from the Centre for Addiction and Mental Health (CAMH)'s Dr. Carles Muntaner in the WHO report highlights the profound impact of employment conditions on health.

Dr. Muntaner and his research team observed that poor mental health outcomes are linked to precarious employment (e.g. temporary contracts or part-time work with low wages and no benefits). When compared with those with full-time work with benefits, workers who report employment insecurity experience significant adverse effects on their physical and mental health.

The research team have also observed that stress at work is linked to a 50 per cent excess risk of coronary heart disease, and there is consistent evidence that jobs with high demands, low control, and effort-reward imbalance are risk factors for mental and physical health problems (major depression, anxiety disorders, and substance use disorders). Canada and many other wealthy countries such as the U.K., the United States, Australia and New Zealand all face similar challenges, Dr. Muntaner notes, because there's a greater tolerance for inequities than in some other countries such as Sweden and Denmark......... Posted by: JoAnn      Read more         Source