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Friday, December 15, 2006

 

Researchers reverse diabetes in mice

 

By Randall Palmer

Reuters

Friday, December 15, 2006

Nerve cells in the pancreas may be a cause of type-1 diabetes in mice -- a finding that could provide new ways to treat the disease in humans, Canadian and U.S. scientists said on Friday.

Defective nerve endings may attract immune system proteins that mistakenly attack the pancreas, destroying its ability to make insulin, the researchers said. This destruction is what causes diabetes.

Injecting a piece of protein, or peptide, to repair the defect cured diabetic mice "overnight," Dr. Hans Michael Dosch of the University of Toronto said in a telephone interview.

"It is very effective in reversing diabetes," said Dosch, principal investigator for the study.

Writing in the journal Cell, Dosch and colleagues said the faulty nerve endings did not secrete enough of the peptides to keep enough insulin flowing.

Type-1 diabetes, once called juvenile diabetes, affects two million Americans and 200,000 Canadians. There has been no known way of preventing it.

The team will soon begin clinical studies on people whose family history suggests they are at risk of developing type-1 diabetes to see if their sensory nerves work well.

If they do not, Dosch said, that would suggest the bad nerve endings were a cause of diabetes, not only an effect as has been widely assumed.

Trials could then begin injecting peptides into patients with diabetes or those at high risk. It could take a number of years, Dosch said.

He said the findings might also hold promise for type-2 diabetes -- which affects about 10 times as many people as type-1 -- though the results were not as strong.

The researchers found that the peptide injections lowered resistance to insulin, which is used to move blood glucose to the body's cells.

People with type-2 diabetes often are obese. By lowering insulin resistance, it might be possible to prevent further obesity and damage from diabetes.

"Whether we can reverse the process, I don't know. But I think we can certainly impact on the major physiological problem, and that's insulin sensitivity," Dosch said.

"So if these people then have normal insulin, then a little activity, then a little walking would actually help lose weight, and then you stop the vicious circle."

Health Tip: If Your Blood Sugar is Low

 

HealthDay News

Friday, December 15, 2006

(HealthDay News) -- Hypoglycemia, or low blood sugar, occurs when the body's supply of sugar becomes too low. This is very common in diabetics, especially if too much insulin is administered to prevent high blood sugar (sometimes called an insulin reaction).

Here are warning signs of low blood sugar, courtesy of the American Academy of Family Physicians:

Headache. Confusion, nervousness or anxiety. Dizziness and shaking. Sweating. Rapidly beating heart. A powerful feeling of hunger.

 

Advisers suggest restricting antibiotic

 

By Andrew Bridges

Associated Press Writer

The Associated Press

Friday, December 15, 2006

Benefits of an antibiotic linked to rare reports of severe liver problems, including several deaths, outweigh its risks in treating pneumonia but not less serious bacterial infections like bronchitis and sinusitis, federal health advisers said Friday.

The nonbinding recommendations raise the prospect the Food and Drug Administration could modify its approval of the Sanofi-Aventis SA drug, called Ketek, to exclude the treatment of the two lesser infections, which often clear up without drug treatment.

The FDA convened a two-day meeting of outside experts to discuss Ketek in light of concerns about its safety. An agency review found 13 reports of liver failure in patients treated with the drug through September. Reports of blurry vision also have been a concern. Doctors have prescribed the antibiotic more than 5.6 million times in the United States since the FDA approved it in 2004.

On Friday, the FDA panelists voted 16-3 to say Ketek's benefits outweigh its risks in treating pneumonia. In 17-2 votes, the outside advisers said that wasn't the case for bronchitis and sinusitis, which are less serious infections and often spontaneously resolve on their own.

Dr. John Jenkins, director of the FDA's office of new drugs, declined to say what action the agency would take. The FDA isn't bound to follow the advice of its outside experts, but usually does.

"We will be assessing the advice we received from the committee and discussing that very shortly," Jenkins said.

The panel also recommended Sanofi-Aventis develop a medication guide to be given to patients, a move backed by the company.

Dr. John Edwards, of Harbor-UCLA Medical Center in Torrance, Calif., and the panel's acting chairman, called the two-day meeting particularly challenging, since it came amid concern that companies have diminishing interest in developing new antibiotics and increased interest in safety issues linked to the drugs.

Many experts fear overuse of antibiotics is hastening the increasing resistance of many bacteria to older drugs, making the development of novel treatments critical. Some panelists suggested reserving Ketek for second-line use in treating pneumonia.

The label of the drug was changed in June to add a bold-type warning about the rare reports of liver failure and severe injury, some of them fatal. A majority of panel members said that cautionary language should be strengthened and placed in a so-called "black box" to warn doctors and patients of some of the risks associated with the drug.

The FDA's handling of Ketek remains under investigation by a Senate committee. Sen. Charles Grassley (news, bio, voting record), R-Iowa, said this week the FDA intentionally withheld information from FDA advisers when they met in 2003 to consider recommending approval of the drug. FDA officials said they would comment after reviewing his allegations, contained in a 20-page letter sent to the agency.

Sanofi-Aventis said the risks associated with the drug, also known as telithromycin, appear to be comparable to those of other similar drugs and that it represents an important option in treating respiratory tract infections.

Liquid calories add up at mealtime

 

By Amy Norton

Reuters Health

Friday, December 15, 2006

People who want to cut down on calories might be wise to trade in their regular soda for a diet version, a study suggests.

In mealtime tests with 33 adults, researchers at Pennsylvania State University found that diners ate as much food when they were given a sugary soft drink as they did when they drank water or diet soda.

As a result, their calorie count jumped when they had the sugar-sweetened drink. On average, volunteers downed 128 calories from a "small" 12-ounce soda and 151 calories from an 18-ounce portion.

Other studies have found that people fail to "compensate" for calorie-laden drinks by eating less food than they otherwise would have. And sugary soft drinks aren't the only culprits.

"It's not just soda," said Dr. Barbara J. Rolls, a professor of nutritional sciences at Penn State and the senior author on the new study. "A caloric beverage is going to add calories to your meal."

She told Reuters Health that people looking to cut calories should first keep a record of their diet for a few days, then see where they can trim beverage calories. This is a good first step, according to Rolls, because cutting out beverages can be easier than eating less of your favorite foods.

Water and diet soft drinks are some calorie-free options, but people can also reduce calories by adding water to their juice for a "spritzer," or simply having a small soda instead of a large, Rolls noted.

The study findings, published in the American Journal of Clinical Nutrition, are based on experiments with 18 women and 15 men who had lunch in the research lab once a week for six weeks. Julie E. Flood, a doctoral student in nutritional sciences, led the research.

Each week, the researchers gave their lunch guests the same food, but the beverage alternated between water, diet soda and regular soda. Each was served in either a 12-ounce or 18-ounce portion.

In general, Rolls and her colleagues found, the diners ate roughly the same amount at each meal, regardless of which drink was served. And the bigger the beverage, the more they drank.

When men were given the 18-ounce regular soda, they downed 26 percent more liquid calories than they did when they had the smaller soda. For women, the larger drink increased their liquid calories by 10 percent.

According to Rolls, a "big question" right now in nutrition research is how the body's regulation of liquid calories may differ from that of solid food. Hunger and thirst are controlled by separate mechanisms in the body, she noted.

In addition, the mindset people have about eating and drinking -- drinking to quench their thirst, without thinking of it as a source of calories, for example -- may affect their intake.

Source: American Journal of Clinical Nutrition, December 2006.

Multidrug-Resistant TB Growing at Faster Pace

 

HealthDay News

Friday, December 15, 2006

FRIDAY, Dec. 15 (HealthDay News) -- An international epidemic of multidrug-resistant tuberculosis may be more widespread than previously thought, says an article in this week's issue of The Lancet.

Multidrug-resistant TB (MDR-TB) is able to withstand treatment with the two most potent anti-TB drugs, isoniazid and rifampicin.

In this study, World Health Organization researchers identified multidrug-resistant TB in all 79 countries they surveyed. Of the 424,000 new cases of multidrug-resistant TB in 2004, more than half occurred in China, India and Russia.

The overall median prevalence of multidrug-resistant disease in new cases of TB was 1 percent. In eight countries, including Kazakhstan and Latvia, the prevalence was 6.5 percent.

Increasing rates of multidrug-resistant disease were identified in Botswana and Tomsk Oblast in Russia, while decreasing rates were seen in the Cuba, Hong Kong and the United States.

"MDR-TB is a precursor to XDR-TB [extensive drug-resistant tuberculosis], recently reported among HIV-infected people in South Africa," wrote study author Mario Raviglione. He said the study findings "emphasize the importance of implementing sound tuberculosis control activities to prevent further creation of MDR tuberculosis and the necessity of mainstreaming high-quality treatment for MDR tuberculosis into routine tuberculosis control programs. Otherwise, XDR-TB is bound to keep emerging as a fatal variant of TB, especially in high HIV-prevalence settings."

About 8.9 million people around the world develop TB each year. In 2004, TB killed 1.7 million people.

More information

The American Lung Association has more about tuberculosis.

 

Bayer drug can cause kidney damage, FDA warns

 

By Susan Heavey

Reuters

Friday, December 15, 2006

 

Bayer AG's heart-surgery drug Trasylol can increase the risk of kidney damage, U.S. health officials warned on Friday, adding that more precautions may be needed in the future.

The Food and Drug Administration also said the drug will come with a stronger warning about possibly fatal allergic reactions, or anaphylaxis. Patients should not receive Trasylol if they have already been given the drug within the past year, it said.

Use of Trasylol should also be limited to certain patients at an increased risk of blood loss and transfusions during coronary bypass graft surgery, the agency added.

Doctors should consider the "balance of benefits and risks" before giving Trasylol to patients who already have kidney problems or those at risk of them, Bayer said in a statement.

The warning sent Bayer shares down 62 cents, or more than 1 percent, to $52.79 on the New York Stock Exchange.

Trasylol has been at the center of an FDA safety review since two published studies linked the drug's use to kidney problems earlier this year.

The drug, approved in 1993, is also known as aprotinin bovine. It aims to reduce bleeding and the need for blood transfusions in heart surgery patients.

"The purpose of the label change is to inform physicians and patients about the risks associated with Trasylol and to ensure they understand the new warnings and use the product as directed by the label," Dr. Steven Galson, head of FDA's Center for Drug Evaluation and Research, said in a statement.

The agency previously alerted the public to concerns over the drug and held a public meeting in September. Bayer later came forward with additional information from an observational study.

Preliminary analysis of that data showed Trasylol could increase the risk of death, congestive heart failure and strokes, the FDA said. The agency said it would continue its review and that future warnings may be needed.

Bayer spokeswoman Staci Gouveia said the review of the additional data was still under way and the drugmaker was cooperating with the agency.

Other clinical trials showed the drug did not increase the risk of death, heart attack or liver dysfunction, among other issues, the company also said.

Soy-Based Inhibitor Holds Promise as MS Treatment

 

HealthDay News

Friday, December 15, 2006

FRIDAY, Dec. 15 (HealthDay News) -- A natural soy-based substance called Bowmann-Birk Inhibitor Concentrate (BBIC) improved the condition of animals with a disease similar to multiple sclerosis, a U.S. study says.

One group of animals with the MS-like disease called autoimmune encephalomyelitis (EAE) received BBIC, while another group of animals with the same disease received an inert substance.

"Animals that received BBIC were able to walk, while those that didn't get the drug were not," study leader Dr. A.M. Rostami, professor and chair of the department of neurology at Jefferson Medical College in Philadelphia, said in a prepared statement.

The animals that received BBIC weren't cured of their illness and did walk with some limp or weakness. However, the results are promising, the researchers said.

They also found that the central nervous systems of the animals that received BBIC had "significantly less inflammation and demyelination" than animals that didn't receive BBIC.

"It's the first time that BBIC has been used in an EAE model and has shown significant disease suppression, and we hope it can eventually be used in humans," Rostami said.

BBIC inhibits proteases, which are enzymes that play a major role in the inflammation and demyelination associated with multiple sclerosis, in which the myelin coating of nerve fibers become inflamed and scarred.

The study was published Dec. 12 in the journal Multiple Sclerosis.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about multiple sclerosis.

 

Blood sugar control early in pregnancy important

 

By Will Boggs, MD

Reuters Health

Friday, December 15, 2006

 

In women with diabetes, increasing hemoglobin A1C levels early in pregnancy -- an indicator of poor blood sugar control -- are associated with increasing risk of poor pregnancy outcomes, according to a report in the journal Diabetes Care.

Lowering of hemoglobin A1C "seems to be associated with a reduced risk of adverse fetal outcome," Dr. Gunnar L. Nielsen told Reuters Health.

Nielsen and colleagues from Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark investigated the usefulness of first-trimester A1C level in predicting adverse outcomes in 537 pregnancies in women with insulin-dependent diabetes.

Hemoglobin A1C levels averaged 7.4 percent in pregnancies with a good outcome, the team reports, compared with 8.5 percent in the 165 pregnancies that had an adverse outcome, ending in spontaneous or therapeutic abortion, stillbirth, neonatal death, or birth defect.

There was a consistently positive, almost linear association between increasing hemoglobin A1C levels and the risk of adverse pregnancy outcome beginning at an A1C level slightly below 7.0 percent, the results indicate. The American Diabetes Association recommends a target A1C level of 7.0 or lower.

Each 1 percent increase in hemoglobin A1C corresponded to a 5.5 percent increase in risk of having an adverse outcome.

However, A1C was not very helpful in predicting outcome of individual pregnancies. For example, 21 percent of pregnancies with A1C above 10 percent had a good outcome, while 15 percent of pregnancies with A1C less than 6 percent had an adverse outcome.

"Although the association between hemoglobin A1C and outcome intuitively seems to be strong, it is obvious that other factors must be in play," Nielsen said.

Source: Diabetes Care, December 2006.

Study Reveals How Common Painkillers Fight Cancer

 

By E.J. Mundell
HealthDay Reporter

HealthDay News

Friday, December 15, 2006

FRIDAY, Dec. 15 (HealthDay News) -- For years, experts have noted that people who take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief also lower their risk for a variety of cancers.

Now, scientists believe they know why that happens.

New research shows that NSAIDs -- which include aspirin, ibuprofen, Aleve and Celebrex -- boost the level of a cellular molecule that causes malignant cells to die off.

The finding "opens up our understanding of how anti-inflammatory drugs are effective against cancer cells. This could also lead to new drug development and of monitoring drugs' effect on cancer cells," said study senior author Towia Libermann, director of the Genomics Center at Beth Israel Deaconess Medical Center in Boston.

His team published its findings in the Dec. 15 issue of Cancer Research.

The millions of Americans who regularly take a daily NSAID to ease arthritis or other pain have long gotten an added bonus in terms of reduced cancer risk. For example, a study released this spring found that women who took daily aspirin had lower odds of developing a particularly aggressive form of breast cancer. Trials have also been conducted that suggest that Celebrex might reduce risks for precancerous colorectal polyps.

There are other indicators linking chronic inflammation and cancer. "For example, people with inflammatory bowel disease have a significantly higher risk for colon cancer than the regular population," Libermann said, and there's also a highly aggressive breast malignancy -- called inflammatory breast cancer -- that is marked by tissue inflammation.

So, it makes sense that drugs that subdue inflammation might also beat back cancer. But how?

To answer that question, Libermann's team used high-tech gene microarray analyses to examine more than 20,000 genes they knew were activated in the presence of NSAIDs.

They discovered that one gene, in particular, was highly activated to produce a particular cytokine (a protein-signaling molecule) called MDA-7/IL-24.

As the level of this cytokine rose, the ability of cancer cells to avoid programmed cell death declined.

"We showed this in different types of cancer cells and with different types of anti-inflammatory drugs," said Libermann, who is also associate professor of medicine at Harvard Medical School. "In fact, drugs that were not active in killing cancer cells did not induce this cytokine, while drugs that were able to kill cancer cells did induce this cytokine."

Accoring to Libermann, the finding unravels the mystery of how NSAIDs fight malignancy.

Not everyone is convinced, however. Dr. Michael Thun, head of epidemiological research at the American Cancer Society, called the study "interesting" but noted that the work focused on tumor cells -- not the pre-malignant cells, such as those found in colon polyps, that have shown to be most inhibited by NSAIDs. "That's one issue that needs to be looked at further," he said.

Thun also noted that the doses used in Libermann's study far exceed those of everyday NSAID use in the general population.

Both scientists agreed that it is premature to recommend that people at higher risk for cancer take NSAIDs.

"All of the studies done so far were done only in cell cultures and animal models," Libermann stressed. "Nothing's been done in patients yet -- maybe patients would need 100 times more of the drug to get any real effect. And that would have such terrible side effects that it wouldn't work."

Thun agreed. "At this point, there is no health organization that recommends taking aspirin or related drugs to prevent any cancer," he said. The expert added that while aspirin's safety profile remains uncontroversial, "taking aspirin-like drugs [such as Celebrex or Aleve] for prevention has been pretty much ruled out because of heart risk."

But Libermann believes researchers will now start working on refining NSAIDs to provide maximum anti-cancer benefit with minimum risk. "We can take some of these anti-inflammatory drugs and make them more specific to inducing this cytokine in a very potent way -- without some of the side effects that anti-inflammatory drugs can have," he said.

Measuring blood levels of MDA-7/IL-24 might also allow doctors to someday "tailor treatment and monitor how effective a particular drug is," Libermann said. "Because every patient will respond differently."

More information

There's more on NSAIDs and colon cancer at the American Cancer Society.

 

Thursday, December 14, 2006

 

Epidural during labor may hinder breastfeeding

 

By Amy Norton

Reuters Health

Thursday, December 14, 2006

 

Some women who get epidural anesthesia during childbirth may have difficulty with breastfeeding in the short- and long-term, a new study suggests.

Specifically, researchers found, women who received an epidural with the narcotic fentanyl seemed to have more problems with breastfeeding than women who went without an epidural.

They reported more difficulty with breastfeeding in the first week of their babies' lives, and they were twice as likely to have given up breastfeeding by the time the baby was 6 months old.

Though it's not clear that the epidurals were the reason, there is evidence from other research that fentanyl can hinder infants' ability to suckle, Dr. Siranda Torvaldsen, the study's lead author, told Reuters Health.

There's no evidence, however, that other drugs used in epidurals interfere with breastfeeding, according to Torvaldsen, a researcher at the University of Sydney in Australia.

Moreover, the findings, which are published in the International Breastfeeding Journal, do not mean women should feel guilty about wanting an epidural.

"I think the most important message for pregnant women is to get good advice and help with breastfeeding," Torvaldsen said. Lactation consultants, she noted, can help women learn how to best support breastfeeding and overcome any difficulties they may encounter.

"For many women, the benefits of epidural analgesia will outweigh the risks and it is important that women feel supported whatever decision they make," Torvaldsen said.

Of the 1,260 women in the current study, one-third had an epidural during labor. All of the epidurals included fentanyl and an anesthetic called bupivacaine.

Overall, the study found, women who received an epidural were more likely than other mothers to be partially, rather than exclusively, breastfeeding in the week after the birth.

They were also twice as likely to report breastfeeding difficulties in the first week and to give up breastfeeding before the baby was 6 months old.

In general, experts recommend that babies be fed only breast milk for the first 6 months, and then continue breastfeeding after solid foods are introduced, for at least the first year of life.

Although it's not certain that epidural drugs directly cause problems with breastfeeding, Torvaldsen said it's important that women be aware of the possibility, so they can make "informed decisions" about analgesia, and seek advice on successful breastfeeding if they need it.

Source: International Breastfeeding Journal, December 10, 2006.

Health Tip: Understanding Trans Fats

 

HealthDay News

Thursday, December 14, 2006

(HealthDay News) -- Trans fats, also called hydrogenated fats, are man-made compounds that are made from processed liquid oils. These harmful fats will raise bad cholesterol, and could lower a person's good cholesterol levels.

Because these fats are so thick and stiff, they can also clog up arteries and blood vessels, which can lead to heart attack or stroke, says the University of Maryland Medical Center.

Trans fats are commonly found in processed foods such as potato chips, cookies, doughnuts, cakes and many fast foods. You can avoid trans fats by choosing natural, healthy foods such as fruits, vegetables, lean meats, and whole grain breads and cereals. Check ingredient labels for hydrogenated fats, and try to avoid those foods.

Cancer drug helps early lung cancer patients

 

Reuters

Thursday, December 14, 2006

A drug that starves tumors of their blood supply can help patients live longer, without adding to some of the worst effects of chemotherapy, researchers reported on Thursday.

They said Avastin helped patients live a median of two months longer -- a significant time for lung cancer, which usually kills quickly after it is diagnosed.

And more patients were helped by chemotherapy when Avastin was added, they reported in this week's issue of the New England Journal of Medicine.

"This is great news for lung cancer patients -- they live longer, and the side effects from Avastin are unlike those of conventional chemotherapy. For example, Avastin does not cause hair loss, nausea, or vomiting," said Dr. Joan Schiller, chief of hematology/oncology at the University of Texas Southwestern Medical Center, who led the trial.

The researchers added Avastin to standard chemotherapy in a trial of 878 patients with non-small-cell lung cancer.

This is the most common form of lung cancer, which will kill an estimated 162,460 people in the United States alone in 2006.

Lung cancer usually does not cause symptoms until it is far advanced, and only 5 percent of patients survive.

But treatment can help them live longer, and reduce the amount of time they suffer pain and discomfort from the tumors.

Schiller's team tried adding Avastin, known generically as bevacizumab, to the standard chemotherapy regime of paclitaxel and carboplatin, which are infused intravenously.

Avastin, developed by San Francisco-based Genentech and sold by Roche, is an anti-angiogenic drug, which means it stops tumors from growing blood vessels to feed themselves. It is a monoclonal antibody, a human protein that is genetically engineered to interfere with the proteins that cells use to make blood vessels.

"Twenty years ago, we thought no treatment could help patients with advanced lung cancer," Schiller said in a statement.

"Now, we are finding out that this very unique drug called Avastin can also help improve survival even more. Avastin is the first of this very exciting family of drugs to be approved for lung cancer, and there are several other drugs of this type under development which may prove to work even better."

Avastin seems to enhance the chemo, she said.

"In addition to choking off the tumor blood supply, Avastin also makes the remaining blood vessels healthier and enables them to diffuse the chemo drugs into the tumor better," she said.

Unlike the men in the trial, the women did not, as a group, live any longer with Avastin, a finding that could be "a fluke," Schiller said. More study was planned.

Young people who cook at home eat better

 

By Anne Harding

Reuters Health

Thursday, December 14, 2006

 

Young adults who frequently make their own meals have much healthier diets than their peers who never set foot in the kitchen, a new study shows.

"It's really important to be preparing food at home," Nicole I. Larson told Reuters Health. "Those who were preparing foods more often at home had a much higher likelihood of reaching dietary guidelines."

However, relatively few young people regularly shop for, plan, or cook meals for themselves, Larson, of the University of Minnesota, and her colleagues found. Just 21 percent of young men and 36 percent of young women bought fresh vegetables every week, for example, while 44 percent of the men made a dinner with chicken, fish or vegetables at least once a week.

Larson's team surveyed 1,710 18- to 23-year-olds about how they shopped for and prepared food. Young adulthood, when many young people move away from home and fend for themselves for the first time, is a key period for building lifetime eating habits, the researchers note in the Journal of the American Dietetic Association.

Females were more involved with food preparation, the researchers found, with 56 percent making a meal with chicken, fish or vegetables at least weekly and 45 percent making dinner for two or more people at least weekly. While 13 percent of males wrote a grocery list at least once a week, 23 percent of females did.

Study participants with the highest involvement in meal preparation were less likely to eat fast food and more likely to meet Healthy People 2010 dietary goals for intake of calcium, whole grains, fruits and vegetables, and fat, Larson and her colleagues found.

Nevertheless, relatively few met these goals; 31 percent of those with high involvement in meal preparation ate at least five servings of fruits or vegetables daily, compared to 3 percent of those with little involvement in food preparation. Eighteen percent met requirements for eating deep-yellow and green vegetables, while just 2 percent of those with the least involvement in food preparation did.

While most of the study participants felt their cooking skills were adequate, one-quarter said they did not have the money to buy and prepare their own food, and more than one-third said they did not have the time.

"Nutrition intake might be improved by participation in university and community-based courses that teach skills for healthful food preparation," Larson and her team write. They conclude: "Young adults might benefit most from courses that teach skills for preparing quick and economical meals as time constraints and cost were the main barriers to preparation."

Source: Journal of the American Dietetic Association, December 2006.

Fewer breast cancers linked to less hormone therapy

 

By Ed Stoddard

Reuters

Thursday, December 14, 2006

 

A sharp decline in new breast cancer cases in 2003 in the United States have come because millions of older women ceased hormone replacement therapy the previous year, researchers said on Thursday.

But they stressed that because their analysis is based on population statistics, the reasons are not completely certain.

"The investigators report that there was an overall 7 percent relative decline in breast cancer incidence between 2002 and 2003," the University of Texas M. D. Anderson Cancer Center said in a statement.

"The steepest decline -- 12 percent -- occurred in women between ages 50-69 diagnosed with estrogen receptor positive (ER-positive) breast cancer," it said. These types of tumors are fueled by the hormone estrogen.

The study was presented at the 29th annual San Antonio Breast Cancer Symposium.

Researchers said that as many as 14,000 fewer women were diagnosed with the disease in 2003 than in 2002, a year in which there were an estimated 203,500 new U.S. cases.

"It is the largest single drop in breast cancer incidence within a single year I am aware of," said Dr. Peter Ravdin, a research professor in the Department of Biostatistics at M. D. Anderson.

"Something went right in 2003, and it seems that it was the decrease in the use of hormone therapy, but from the data we used we can only indirectly infer that is the case," he said in a statement.

HRT provides the hormone estrogen and sometimes also progestin to women after menopause.

But a big study in 2002 suggested that the combination of estrogen and progestin raised the risk of breast cancer. This brought a premature halt to a Women's Health Initiative study of more than 16,600 women between 50 and 79 who were using HRT, and caused widespread confusion

More analysis of the Women's Health Initiative also showed that HRT could raise the risk of heart disease and especially strokes, and HRT was abandoned except as a way to relieve the most debilitating and stressful symptoms of menopause, such as hot flashes and insomnia.

Ravdin said about 30 percent of American women over the age of 50 had been taking HRT in the early years of this decade but about half of the women stopped in the later part of 2002 after the results of this link were made public.

"Research has shown that ER-positive tumors will stop growing if they are deprived of the hormones, so it is possible that a significant decrease in breast cancer can be seen if so many women stopped using HRT," he said.

"It takes breast cancer a long time to develop, but here we are primarily talking about existing cancers that are fueled by hormones and that slow or stop their growing when a source of fuel is cut," added Donald Berry, an M.D. Anderson professor who helped lead the study.

"Incidence of breast cancer had been increasing in the 20 or so years prior to July 2002, and this increase was over and above the known role of screening mammography. HRT had been proposed as a possible factor, although the magnitude of any HRT effect was not known."

Wednesday, December 13, 2006

 

Compound Boosts Tamoxifen's Cancer-Fighting Power

 

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Wednesday, December 13, 2006

WEDNESDAY, Dec. 13 (HealthDay News) -- Adding a second drug to tamoxifen, the breast cancer drug used successfully for more than 20 years, helps it retain its full strength, scientists at the U.S. National Cancer Institute report.

Over time, tamoxifen can lose its effectiveness. But the new molecule, called disulfide benzamide or DIBA, could provide a way to overcome that acquired resistance and restore tamoxifen's effectiveness.

DIBA "is not a new molecule," noted William Farrar, head of the Cancer Stem Cell Section of the National Cancer Institute's Center for Cancer Research at Frederick, Md., and the study's lead author. "It's been around a while."

Farrar's team gave DIBA to mice engineered to develop tamoxifen-resistant tumors and then to human breast cancer cells in the laboratory. Tumor growth slowed in both cases.

Those findings are published in the December issue of Cancer Cell.

Tamoxifen is the standard of care for women who have what's known as "estrogen-receptor positive breast cancer." When estrogen binds to the estrogen receptor, a series of events that promote rapid cell division ensues. If that cell happens to be a breast cancer cell, the cascade of events can lead to tumor growth.

Tamoxifen acts to block the effects of estrogen on breast tissue. It is routinely used in advanced breast cancer or as additional therapy after primary treatment for early-stage breast cancer.

In Farrar's study, when DIBA was added to the mix, tamoxifen easily inhibited the growth of breast cancer cells.

DIBA "switches off everything, all the molecular machinery of estrogen receptors, which results in breast cancer cell death," Farrar said. And, in the human breast cancer cell lines, "we got a 90 percent reduction in tumors," he added. In the mice studies, DIBA reduced tumor volume almost 50 percent.

DIBA is what is known as a "lead" compound, Farrar said, which means it merely opens the door to suitable drugs. DIBA itself "is probably not appropriate for humans, because of solubility problems." Farrar's team will try to develop or find another compound more suitable for human use, fashioning it after the properties of DIBA.

As research progresses from the laboratory to human clinical trials, "our goal is to develop a molecule that can be orally administered," Farrar said.

V. Craig Jordan, vice president and scientific director of the medical science division of the Fox Chase Cancer Center in Philadelphia, views the new research as promising. Jordan, known as the "father of tamoxifen," notes that tamoxifen is life-saving but also beset with resistance problems.

For example, Jordan said, "if 100 women had advanced breast cancer, 20 would have estrogen-receptor negative [cancer], and tamoxifen would not be indicated. Eight would be estrogen receptor or ER positive, and 40 would get an initial response from tamoxifen while 40 would not. Of the 40 [who got a response], ultimately all would get acquired resistance. It would take two to five years for that to happen."

According to Jordan, the NCI team "have created an opportunity to move from the laboratory to the clinic." Eventually, he said, a DIBA-like compound might boost responses in those who acquired tamoxifen resistance and perhaps in those who initially did not respond to tamoxifen.

The current research, however, focused only on acquired resistance, not initial or intrinsic resistance, he added.

Next, the compound or a similar compound must be tested in humans, Jordan said.

More information

There's more on tamoxifen at the U.S. National Cancer Institute.

 

Low-protein diet might reduce cancer risk

 

Reuters Health

Wednesday, December 13, 2006

Researchers studying a group of vegetarians who'd maintained a diet relatively low in protein and calories found that they had lower blood levels of several hormones and other substances that have been tied to certain cancers.

A comparison group of distance runners also had lower levels of most of these substances compared with sedentary adults who followed a typical American diet -- that is, relatively high in protein from meat and dairy.

However, the low-protein group also had a potential advantage over the runners: lower levels of insulin-like growth factor 1 (IGF-1), a body protein that helps cells grow and multiply. High IGF-1 levels in the blood have been linked to breast, prostate and colon cancers.

It's not clear that this all translates into lower odds of developing cancer, but the findings are a "first step" in showing how lower-protein diets might alter cancer risk, according to the researchers.

"I believe our findings suggest that protein intake may be very important in regulating cancer risk," lead study author Dr. Luigi Fontana, an assistant professor of medicine at Washington University in St. Louis, said in a statement.

He and his colleagues report their findings in the American Journal of Clinical Nutrition.

The findings are based on a small sample of middle-aged adults, including 21 who'd been vegetarians for at least two years; they were recruited through a local vegetarian society and a magazine on "raw" foods.

They were compared with 21 long-time endurance runners the same age, and 21 sedentary adults who ate a typical American diet.

On average, the vegetarians ate just below the recommended daily amount of protein -- 0.8 grams per kilogram of body weight. Both the runners and the sedentary group ate significantly more than the recommended amount.

Fontana's team found that, compared with their sedentary counterparts, the runners and vegetarians had lower levels of several hormones and inflammatory proteins linked to cancer risk.

When it came to IGF-1, specifically, the low-protein group had lower levels than runners did, even though they were equally lean -- suggesting an effect of diet and not just body weight, according to the researchers.

In addition, IGF-1 levels in the sedentary group generally rose in tandem with their protein intake.

"Many people are eating too many animal products," Fontana said, as well as too many processed foods and sugars.

He advised that people try to eat more fruits and vegetables, fiber-rich whole grains, beans and fish, and less red meat. Doing so could bring the amount of calories and protein the average American eats closer to recommended levels -- and possibly lower IGF-I levels, according to Fontana.

"We hope to further clarify what happens to cancer risk when we are chronically eating more protein than we need," he said.

Source: American Journal of Clinical Nutrition, December 2006.

Health Tip: Low Blood Pressure May Be Dangerous, Too

HealthDay News

Wednesday, December 13, 2006

(HealthDay News) -- Low blood pressure (hypotension) occurs when the pressure within the artery walls is too low during and after a heartbeat. If it becomes too low, blood flow to the heart, brain and other organs may be compromised.

The most common symptoms of low blood pressure are dizziness and feeling lightheaded, says the U.S. National Library of Medicine.

The condition can be caused by certain medications, including anti-anxiety drugs, high blood pressure and other cardiovascular medications, antidepressants and narcotics.

Other potential causes include heart attack, dehydration, irregular heartbeat, heart failure, anaphylaxis, shock or diabetes.

If you have low pressure and begin to feel dizzy or lightheaded, have black or maroon stools, chest pain, shortness of breath, an irregular heartbeat, fever higher than 101 degrees, or severe upper back pain, contact your doctor at once.

Study: Fast colonoscopies miss growths

By Marilynn Marchione

AP Medical Writer

The Associated Press

Wednesday, December 13, 2006

Tell your doctor to take his time during your next colonoscopy. Those who spent less than the recommended six minutes on the crucial part of the exam found one-fourth as many precancerous growths than those who lingered longer with the scope, a study found.

It involved thousands of exams done by 12 doctors in a large private gastroenterology practice in Rockford, Ill. Doctors who spent the most time found 10 times more growths than those who zipped fastest through the procedure, said Dr. Robert Barclay, who led the study and published results in Thursday's New England Journal of Medicine.

"We were surprised at the magnitude of the differences among the colonoscopists in our group," he said.

Most doctors are probably not tracking how long they take or how many growths they find, said Dr. Douglas Rex, chief of endoscopy at Indiana University and a spokesman for the American College of Gastroenterology.

"It's a reasonable thing for people to start asking their doctor," he recommended. "Say: 'I want you to be really careful and slow in examining my colon.'"

Colonoscopy is the gold standard test to screen for colon cancer, which will strike nearly 150,000 Americans this year and kill more than 55,000.

While the patient is sedated for the exam — typically less than half an hour — a doctor puts a thin, flexible tube into the bowel. As the lighted scope is slowly withdrawn, the doctor looks for growths called polyps. These can take a decade to form and turn cancerous, so finding them early is one of the best ways to prevent the disease and improve the odds of surviving it.

Barclay and others at the University of Illinois College of Medicine and Rockford Gastroenterology Associates analyzed 7,882 colonoscopies done on their patients over 15 months, including 2,053 first-time screening exams. They clocked how long doctors took to withdraw the scope and compared it to the number, size and type of polyps detected.

Polyps were found in more than 28 percent of patients whose doctors took an average of six minutes or more but in only 12 percent of patients whose doctors went faster. Detection of the most serious types of growths also differed — 6 percent in slower exams versus almost 3 percent.

Previous research suggests that at least 25 percent of men and 15 percent of women ages 50 and older will have one or more polyps, Rex said. Guidelines he helped write for several professional associations recommend that doctors spend at least six minutes on scope withdrawal to help ensure they are not missing a potential cancer.

In an editorial in the journal, Dr. David Lieberman of Oregon Health and Science University in Portland praised the Rockford doctors for examining their own practice to try to improve performance of an important cancer test.

"There is a lesson here for every practitioner in every specialty," he wrote. Research on quality of care should not just be done by big universities, "but also needs to be part of the culture of everyday clinical practice."

Cancer specialists recommend colonoscopies every 10 years for people 50 and older at average risk of colon cancer. Medicare and most insurers cover the exam. Other tests that look for blood in the stool and an exam called flexible sigmoidoscopy also can be used for cancer screening, but must be done more often.

Symptoms of colon cancer can include blood in the stool, changes in bowel habits, or unexplained weight loss or abdominal pain.

On the Net:

New England Journal: http://www.nejm.org

Colonoscopy information: http://www.cancer.gov/cancertopics/factsheet/Detection/colorectal-screening

Researchers Uncover Process Leading to Arterial Plaque Rupture

HealthDay News

Wednesday, December 13, 2006

WEDNESDAY, Dec. 13 (HealthDay News) -- An important molecular process that can cause plaque rupture in people with atherosclerosis has been identified by Columbia University Medical Center researchers.

The findings could lead to therapies to prevent plaque rupture, which can produce clots that may block blood flow and cause heart attacks and strokes.

The Columbia team identified what causes the death of macrophages, which are white blood cells that accumulate in the cholesterol-laden plaques on the inside of arteries. These dead macrophages, which collect into a "macrophage graveyard," are an important cause of plaque rupture.

This study found that macrophages in the plaques die when two receptors on the cell's surface -- TLR4 and SRA -- are activated at the same time. When it's activated alone, TLR4 keeps the macrophage alive. However, when SRA is activated at the same time, it shuts down TLR4, leading to the death of the macrophage.

The findings were published Dec. 11 in the journal Proceedings of the National Academy of Sciences.

Until recently, scientists had hoped that drugs that increase "good" HDL cholesterol, used in combination with statins that reduce "bad" LDL cholesterol ,might help treat atherosclerosis patients. However, the recent failure of an experimental drug designed to increase HDL levels suggests that it may not be possible to rely solely on drugs that raise HDL levels to prevent plaque rupture.

"The recent failure of an HDL boosting therapy means it's particularly important for us to consider alternative strategies and to understand the process behind the rupture of plaques," Dr. Ira Tabas, professor of medicine and anatomy and cell biology, said in a prepared statement.

"Our hope is that this research will lead to alternative therapies to prevent plaque rupture and resulting strokes and heart attacks," said Tabas, who is also Richard J. Stock Professor and vice chairman of research at Columbia University Medical Center.

More information

The U.S. National Heart, Lung, and Blood Institute has more about atherosclerosis.

Panel backs young adult antidepressant warning

By Lisa Richwine

Reuters

Wednesday, December 13, 2006

 

Antidepressant drugs need warnings that they may raise the risk of suicidal thoughts and behavior in adults up to age 25, a U.S. advisory panel said on Wednesday.

The information should be added to current "black box" warnings that say taking the drugs may increase such behavior or thoughts in children and teens shortly after treatment starts, the panel advised the Food and Drug Administration in a 6-2 vote.

Antidepressants include Pfizer Inc.'s Zoloft and Eli Lilly and Co.'s Prozac and Cymbalta. Sales topped $12.5 billion in 2005, according to health information company IMS Health. Some of the drugs come in generic versions.

The panel also endorsed an FDA proposal to note the hazards start declining after age 30 and that the drugs seem to provide protection against suicidal behavior in older patients, particularly after age 65.

Several experts on the advisory panel said the warnings should state that untreated depression also can lead to serious consequences, including suicide.

"We want to extend the age in the black box and at the same time not discourage treatment," said panel member Dr. Andrew Leon, a psychiatrist at Weill Medical College of Cornell University in New York.

The FDA usually follows recommendations from its advisory panels.

The panel deliberations followed testimony from angry and grieving family members who pleaded for strong warnings for all ages. Some said the FDA should have acted when the debate about suicidal behavior first emerged in the early 1990s.

Suzanne Gonzalez said her 40-year-old husband shot himself in the head shortly after he started taking GlaxoSmithKline Plc's Paxil.

"I hold you all responsible for his death, and I always will," Gonzalez shouted at FDA officials and panelists seated around tables in a hotel meeting room.

"I keep asking myself ... what was my husband thinking? How crazy did you make him that morning that he would get up ... and do this to himself?" she said.

Balancing Risks, Benefits

Psychiatrists warned against tough language that may scare patients from treatment. Millions now take antidepressants, but use declined after FDA-ordered warnings in 2004 about suicidal behavior in some youth. Suicide rates have risen slightly even as prescriptions have fallen, some psychiatrists said.

One FDA analysis estimated antidepressants could lead to 14 additional cases of suicidal thoughts or actions among every 1,000 patients treated under the age of 18. For ages 18 to 24, four additional cases could occur.

"A much greater risk of disrupted lives and suicides ... exists with untreated depression," Dr. Darrel Reiger, research director for the American Psychiatric Association, told the panel during public testimony.

Pfizer and Wyeth said they had not seen a link between their drugs and suicidal thoughts or behavior in adult trials. Wyeth, which sells the antidepressant Effexor, would support some type of warning on all antidepressants about possible risks for young adults, said Dr. Philip Ninan, vice president for neuroscience at Wyeth's pharmaceutical unit.

Lilly said any warning should note both the risks of untreated depression and the benefits of treatment.

Glaxo already has added information from a study showing young adults who took the drug in clinical trials were more likely to report suicidal behavior than those with a placebo.

Stocks of antidepressant makers were little changed or mixed in extended trading. The panel's recommendation for an updated warning came after the close of regular trading.

Brain Lesions After Stroke May Predict Future Episodes

 

HealthDay News

Wednesday, December 13, 2006

WEDNESDAY, Dec. 13 (HealthDay News) -- Ischemic stroke patients who have recurrent asymptomatic brain lesions within three months of their initial stroke are at increased risk for subsequent strokes, says a U.S. study in the December issue of the journal Archives of Neurology.

An ischemic stroke occurs as a result of inadequate blood flow to the brain.

Previous research found that asymptomatic (silent) brain lesions -- changes in brain tissue that occur in areas where blood flow is blocked or reduced -- occur more frequently than symptomatic lesions up to three months after a stroke, according to background information in the article.

The authors of this current study investigated whether silent brain lesions detected by MRI scans could help predict stroke patients' risk for subsequent strokes.

Researchers at the National Institute of Neurological Disorders and Stroke studied 120 ischemic stroke patients. Each patient had an MRI brain scan within 24 hours of the stroke and five days after the stroke. Of those patients, 68 had a follow-up MRI after 30 days or up to 90 days after the stroke.

The study found that patients who had silent ischemic lesions on the 30- or 90-day MRI were about 6.5 times more likely than other patients to suffer a subsequent ischemic stroke. Patients with silent lesions on any of the MRI scans (24 hours, five days, 30 days, or 90 days) had an increased risk of death from vascular causes, recurrent ischemic stroke or transient ischemic attack.

"It is a matter of circumstance, rather than tissue pathological features, that determines whether cerebral ischemia is symptomatic or silent," the study authors wrote. "Clinical symptoms depend on the size, location and number of new lesions. Thus, we assume that the pathological process that causes silent lesion recurrence on MRI is the same as the process that causes clinical recurrent strokes. Magnetic resonance imaging may depict pathological changes before the development of clinical stroke symptoms."

More information

The Washington University School of Medicine has more about ischemic stroke.

 

Tuesday, December 12, 2006

 

Younger Siblings May Boost Brain Tumor Risk

 

By Rick Ansorge
HealthDay Reporter

HealthDay News

Tuesday, December 12, 2006

TUESDAY, Dec. 12 (HealthDay News) -- Can the number of brothers and sisters you have affect your risk of developing a brain tumor?

Possibly, German researchers report. They found that children with three or more younger siblings face two to four times the risk of developing a brain tumor by age 15 compared to children with no siblings.

This risk was not seen in children with three or more older siblings or in adults who grew up in large families, however.

"The association with number of younger siblings, and not with number of older siblings, suggests that infections or re-infections in late childhood may play an important role in the development of pediatric nervous system tumors," said lead researcher Dr. Andrea Altieri, of the German Cancer Research Center in Heidelberg, Germany. The findings are published in the Dec. 12 issue of Neurology.

The population-based study, which Altieri called the largest of its kind, analyzed more than 13,600 Swedish brain tumor cases.

It found that children with three or more younger siblings had twice the risk of nervous system tumors known as neuroblastomas, more than twice the risk of brain cancers such as medulloblastoma or ependymoma, and nearly a quadruple risk of meningioma (cancer of the brain's lining, the meninges) compared to children with no siblings.

"The association between the number of siblings and other measures of child overcrowding and the risk of infections is well-documented," Altieri said. "The strongest evidence comes from several studies showing that children attending day-care centers have a two- to fourfold increased risk of infection compared to children cared for at home."

But how would the age of siblings influence brain tumor risk? Altieri has a theory.

"When you have many younger siblings, you have a higher risk of infection during early adolescence and a higher risk of being re-infected from your younger siblings," the researcher pointed out.

On the other hand, the presence of many older siblings increases the risk of infection in infancy and early childhood. "As has been reported for other childhood malignancies, very early infection could even be protective against nervous system tumors," Altieri said, which could explain why no increased risk was seen in children with three or more older siblings.

"There is growing evidence that specific viral infections are associated with several types of cancer," Altieri said, citing links between the Epstein-Barr virus and Hodgkin's lymphoma, human papillomavirus (HPV) and cervical cancer, hepatitis C virus and liver cancer, and HIV and Kaposi's sarcoma.

Although there may be a link between childhood infections and brain tumors, Altieri points out that there's still no proof that infections actually cause them. "Any attempt to show a causal association should selectively consider child nervous system tumors and take into account not only the type of infection but also the individual frequency of childhood infections, the age of infections and the persistency of infections," the researcher said.

"This is a large, well-done study," said Dr. Paul Graham Fisher, of Stanford University in Palo Alto, Calif. "It puts out the idea that maybe there's an issue with birth order and brain tumors, which is interesting. It also points to the fact that we don't have a good understanding of how the immune system, for good or ill, influences the development of brain tumors."

But Fisher said that the study's suggestion that infections may play a role in brain-tumor development has been contradicted by other recent epidemiological research. "A lot of folks have either abandoned or pooh-poohed the idea that brain tumors in kids are virally mediated," he said. "This study should have been put in the context of prior studies that really haven't panned out."

Fisher also faulted the researchers not considering other possible reasons why children with younger siblings are at increased risk. "Maybe it's because Scandinavian people have more children after the first one is diagnosed with a brain tumor," he said. "So, there could be a selection bias here."

Altieri said that several small studies involving fewer than 100 cases have investigated an association between different types of infections -- such as influenza during pregnancy and polyoma virus infection in childhood -- and the subsequent risk of brain tumors. "The results have been inconsistent," the researcher said. However, "this does not mean that infections are not associated with these malignancies."

Altieri allowed that other factors may account for an increased risk of brain tumors. "So far, the association of nervous system tumors with other socioeconomic factors has been very inconsistent. However, we cannot rule out the possibility that other socioeconomic correlates are associated with the disease."

More information

To learn more about primary brain tumors, visit the National Library of Medicine.

 

Exercising may reduce lung cancer risk

 

By Kathy Matheson

Associated Press Writer

The Associated Press

Tuesday, December 12, 2006

Everyone knows smoking is a bad idea, but those who can't give it up may get a little protection from exercise, a study suggests. In a study of older women, researchers found that a physically active smoker had a 35 percent lower risk of lung cancer than a sedentary smoker.

Even so, one expert called that reduction trivial because smoking itself is so risky. And Dr. Kathryn Schmitz, the study's lead author, stressed that exercising does not give women a free pass to smoke.

"The most important thing that smokers can do to reduce the risk of lung cancer is quit smoking," said Schmitz, an assistant professor at the University of Pennsylvania's Center for Clinical Epidemiology and Biostatistics.

Those who quit smoking are 10 to 11 times less likely to develop lung cancer than those who smoke, she said.

The research, published in this month's issue of Cancer Epidemiology Biomarkers & Prevention, was based on information from the Iowa Women's Health Study. That project began in 1986 to follow nearly 42,000 older women. The women filled out health questionnaires over the years, including information about their smoking status and physical activity.

By the end of 2002, the data included 36,410 participants, and 777 had lung cancer.

Of those, 125 were non-smokers, 177 were former smokers, and 475 were current smokers.

Schmitz, who was then at the University of Minnesota's School of Public Health, worked with four colleagues to analyze the data.

Among smokers, the greatest number of cancer cases, 324, came from women who currently smoked and weren't very active. Among physically active smokers, there were 151 cases of lung cancer.

The greatest benefits went to those who had quit smoking and also exercised, with just 82 cancer cases compared to 95 in sedentary former smokers.

Among the exercisers, the lowest risk of lung cancer was found in those who had moderate workouts more than four times a week, or vigorous workouts two or more times a week.

It is still unclear why physical activity might have a preventive effect on lung cancer. Studies over the years have produced conflicting results on that subject. Researchers say it could be that improved pulmonary function reduces both the concentration of carcinogenic particles and the extent to which they are deposited in the lungs.

Also, being more physically active could make smokers more aware of the damage they have caused their lungs — leading them to smoke less or quit, Schmitz said.

Dr. Norman Edelman, chief medical officer for the American Lung Association, echoed Schmitz's comments that the report should not give physically active female smokers "a false sense of security."

"We don't want people to get the wrong message," Edelman said. "A regular smoker has a risk of lung cancer 10 times that of a nonsmoker, and 35 percent reduction in that risk is trivial."

He noted the study does not address the effect of exercise on other smoking-related health problems, such as emphysema and heart disease. He also said that because the active women were less likely to be overweight, it was unclear if the lower lung cancer rate was a result of their exercising or their weight. Some cancers are more common in the obese, Edelman said.

Health Tip: Saturated Fats vs. Unsaturated Fats

 

HealthDay News

Tuesday, December 12, 2006

(HealthDay News) -- While it is necessary and healthy to have some fat in the diet, too much dietary fat can lead to obesity and other conditions like heart disease, stroke and diabetes.

Saturated fats contribute to higher levels of LDL (bad) cholesterol, says the U.S. National Library of Medicine, and should be avoided in large amounts. Foods that are typically high in saturated fat include animal products like butter, cheese, whole milk, ice cream, and fat-laden meats. Some vegetable oils -- such as those from coconut, palm, and palm kernel -- are also high in saturated fats.

Unsaturated fats can actually lower levels of LDL cholesterol, so they are a good alternative to saturated fats. But even unsaturated fats are still high in calories, so excessive amounts in the diet should be avoided. Foods that are a good source of unsaturated fats include olives and olive oil, peanuts, and avocados.

Folic acid won't cut heart, stroke risk, study says

 

By Will Dunham

Reuters

Tuesday, December 12, 2006

 

Taking a folic acid supplement does not cut the risk of heart disease or stroke in people with a history of cardiovascular ailments, according to a study published on Tuesday.

Folic acid, also called folate, is a B vitamin. The body uses it to make new cells. Some doctors have recommended the vitamin to ward off cardiovascular disease, the leading cause of death in the United States.

Researchers led by Dr. Lydia Bazzano of Tulane University School of Public Health and Tropical Medicine in New Orleans analyzed the results of 12 trials conducted since 2002 involving nearly 17,000 people.

Comparing people who had taken folic acid supplements for at least six months with those who had not, the study found virtually identical percentages of cardiovascular disease, coronary heart disease, stroke and all causes of death.

"We found that there was no benefit to using folic acid supplements in terms of cardiovascular disease risk or stroke risk," Bazzano said in an interview.

"We also found that there was no harm in terms of all-cause mortality. Using the supplements didn't seem to make you die any faster, which was good news," Bazzano added.

The findings appear in the Journal of the American Medical Association.

Some previous research had suggested benefits of folic acid in reducing the risk of cardiovascular disease. Studies have shown folic acid supplements drive down blood levels of homocysteine, a sulfur-containing amino acid that has been associated with an increased risk of cardiovascular disease.

Bazzano said folic acid remains extremely important for other reasons, namely for women planning to become pregnant or already pregnant to prevent major birth defects of the baby's brain and spine.

Doctors recommend women take folic acid daily starting before they become pregnant to help prevent so-called neural tube defects such as spina bifida and anencephaly.

"Take it if you're a woman trying to get pregnant, absolutely. But if you're an older person who's already had a heart attack or has any form of vascular disease, this is not what you should be doing," Bazzano said.

"Really, what you should be doing are things like quitting smoking, increasing your exercise if you can, lowering your blood pressure, lowering your cholesterol.

"We know that those things have a major benefit and significantly reduce your risk of having a heart attack or a stroke in the future," she added.

Health Tip: Using Hand Sanitizers

HealthDay News

Tuesday, December 12, 2006

(HealthDay News) -- While the best way to prevent the spread of germs is still good old-fashioned soap and water, antibacterial hand sanitizers are an easy way to practice good hygiene when there's no sink nearby.

For best use of the product, follow its directions carefully, says the Health Services Department at Great Basin College. Apply the product liberally to your entire hand -- front and back -- and rub your hands together until the solution has dried.

If you can see dirt on your hands, however, you should still wash with soap and water, the department says.

Monday, December 11, 2006

 

Two more reasons to exercise, studies find

 

Reuters

Monday, December 11, 2006

Here are two more reasons to exercise: It may help prevent breast cancer and can be a safer way to lose weight than dieting, doctors said on Monday.

One report from the Mayo Clinic College of Medicine in Rochester, Minnesota, said a study of women aged 55 to 69 found that those with the highest physical activity levels when the study began had a 14 percent lower risk of developing breast cancer than those who got low levels of exercise.

The multiyear study, which ended in 2003, involved more than 36,000 women.

While the mechanism involved is not clear it may be that exercise reduces body fat, the major source of estrogen in post-menopausal women, the study said. That could lead to fewer tumors of a type called estrogen receptor positive/progesterone receptor negative, which are typically more aggressive, added the report.

"Further studies are needed to confirm these novel findings, and to evaluate similar relationships among premenopausal women," concluded the report published in the Archives of Internal Medicine.

"If found to be causally related to breast cancer, physical activity would have a substantial public health effect on the prevention of this disease, along with its other positive health benefits," it added.

In another study published in the same journal, doctors at Washington University School of Medicine in St. Louis found that people who slim down by cutting calories may also be losing bone density -- something that does not happen if weight loss comes through exercise.

Loss of bone density can lead to osteoporosis and fractures later in life.

That finding was based on a look at 48 adults involved variously in weight loss by caloric restrictions or exercise.

"A common explanation given for the bone loss induced by weight loss is reduction in mechanical stress on the weight-bearing skeleton (the hip and spine)," the report said.

But when muscles pull on bones during exercise it is thought to produce strains in the skeleton that stimulate new bone production, the researchers said.

"These findings have important implications in designing an appropriate weight-loss therapy program in middle-aged adults, particularly in the subset of patients who may already be at increased risk for bone fracture," the study concluded.

3-Drug Regimen Is New Tool in Leukemia Fight

 

HealthDay News

Monday, December 11, 2006

MONDAY, Dec. 11 (HealthDay News) -- A combination of three chemotherapy drugs -- pentostatin, cyclophosphamide and rituximab -- produced significant clinical response in patients with previously untreated chronic lymphocytic leukemia, according to a study presented Sunday at the American Society of Hematology annual meeting.

Each year, about 10,000 people in the United States are diagnosed with this blood and bone marrow cancer.

"Chronic lymphocytic leukemia is incurable but continues to be made more manageable with the advent of powerful new chemoimmunotherapy tools," lead researcher Dr. Neil E. Kay, a Mayo Clinic hematologist, said in a prepared statement.

"We and our collaborators at Ohio State University... have done previous research on pentostatin that led us to believe there would be success with this (three-drug) regimen, and are pleased with the results," Kay said.

The 64 patients in the study received six cycles of the combined regimen. The patients also received a year of treatment with the anti-infection drug sulfamethoxazole-trimethoprim and the antiviral drug acyclovir.

At the start of the study, the researchers determined that most of the patients had significant disease progression and/or a high expectation of rapid advancement of their disease.

Following treatment, 91 percent of the patients in the study experienced improvement in their condition, including 41 percent who achieved complete response.

"We are very pleased with the results of this study. This is a new, viable option for high-risk patients who might not have had much hope before, and it's especially exciting that it works for patients of all age groups," Kay said.

More information

The U.S. National Cancer Institute has more about chronic lymphocytic leukemia.

Height loss tied to heart disease in men

 

By Carla K. Johnson

Associated Press Writer

The Associated Press

Monday, December 11, 2006

A study of older British men finds that those who shrink in height by about an inch or more over 20 years are more likely to die earlier than other men. Those men also have a greater risk of heart disease.

Scant research had been done previously on the health effects of height loss during aging, except for the extreme bone loss of osteoporosis.

Height loss "may well be another marker of declining health in the elderly," said study co-author Goya Wannamethee, an epidemiologist at Royal Free & University College Medical School in London.

Height loss almost always occurs with other evidence of frailty, she said, such as loss of mobility, weight loss, breathing trouble and musculoskeletal problems, such as arthritis.

Other research has shown similar factors underlie both osteoporosis and heart disease, such as high cholesterol, inflammation and high blood pressure, she said. Inflammation and lipids in the blood may contribute to low bone mineral density, although the exact mechanism is unclear.

The findings, published in Monday's Archives of Internal Medicine, suggest that men should exercise to maintain the muscle strength needed to stand tall, said Dr. Anne Kenny of the University of Connecticut Health Center, who studies osteoporosis and frailty, but was not involved in the new study.

A small study has shown that yoga can increase height in women, Kenny said, and yoga may also help men.

"It points to the need to increase physical activity and try to maintain strength to ward off disability and mortality," Kenny said.

Researchers measured the height of 4,213 British men, first in the late 1970s when the men were between the ages of 40 and 59, then 20 years later, when the men were 60 to 79 years old.

About 15 percent of the men lost more than 3 centimeters in height. That's about 1.2 inches. Osteoporosis is usually associated with much greater height loss.

The men also completed a medical and lifestyle questionnaire, were weighed and gave a blood sample. The researchers followed the men for another six years, during which 760 of the men died.

The men who lost 3 centimeters or more in height were 60 percent more likely to die within six years than the men who retained their height, the researchers found.

When the scientists considered age, smoking, alcohol use and pre-existing health conditions, they still saw a relationship between height loss, earlier death and heart disease.

More research is needed to measure the importance of muscle mass and muscle strength in the aging process, Wannamethee said.

"It is unlikely that just maintaining one's height is the key to longevity," she said.

On the Net:

Archives: http://www.archinternmed.com

 

Health Tip: Getting a Second Opinion

 

HealthDay News

Monday, December 11, 2006

(HealthDay News) -- If you've been diagnosed with a specific disease or health condition, you may be wondering if it's wise to consult another doctor for a second opinion. The Washington University School of Medicine offers these suggestions on when a second opinion is warranted:

If your doctor has recommended surgery. If your doctor's diagnosis or recommendation doesn't sound credible to you, or if you're not comfortable with any treatment prescribed. If your doctor diagnoses you with a condition that's life-threatening. If your doctor recommends a particularly risky or invasive procedure, when a less complicated procedure is available. If you've been prescribed long-term medication or therapy. If your doctor can't make a diagnosis, or if the treatment prescribed isn't making you feel better.

 

Obese men, girls see unusual testosterone levels

 

Reuters

Monday, December 11, 2006

Obese men often experience a sharp decline in testosterone levels while obese girls show much higher levels of the sex hormone than girls of normal weight, according to scientific research released on Monday.

Two separate studies published in the Journal of Clinical Endocrinology and Metabolism could indicate increased health risks for both grown men and teen-age girls who are obese.

Testosterone is the primary sex hormone for men, though it is found in women as well. It helps maintain muscle mass and bone density and keeps sex drive and physical energy at healthy levels.

Testosterone levels naturally decline as men age. But those who put on weight -- as little as 30 pounds (13.6 kg) for a 6-foot man -- lost as much testosterone as if they had aged 10 years, scientists at the New England Research Institutes found.

Those who experienced a traumatic event, such as the loss of a wife, experienced a similar drop in testosterone levels.

The scientists based their findings on a study that tracked 1,667 men.

Obese girls going through puberty had the opposite problem, a separate study found.

Researchers at the University of Virginia and several other universities found that obese girls had two to nine times the levels of testosterone as girls of normal weight.

That could impair reproductive health, lead to undesirable side effects like excess hair growth, and put them at greater risk for diabetes, they said.

That paper was based on a study of 104 girls.

Study shows what helped during 1918 flu

 

By Mike Stobbe

AP Medical Writer

The Associated Press

Monday, December 11, 2006

 

Government health officials tried to build their case for school closings and similar steps during a flu pandemic by showcasing new research Monday that suggests such measures seemed to work during the deadly Spanish flu of 1918.

Researchers found that cities like St. Louis, which instituted "social distancing" at least two weeks before flu cases peaked in their communities, had flu-related death rates less than half that of Philadelphia, which didn't act until later.

The whirlwind historical research project — which started in August — involves a team of researchers from the University of Michigan and the U.S. Centers for Disease Control and Prevention, who combed through health records, newspaper clippings and other documents from 45 cities.

"This is a Manhattan Project of history," said Michigan's Dr. Howard Markel, one of the lead researchers, in a presentation at a pandemic flu planning meeting of health officials in Atlanta.

Another finding: The more social distancing measures were used and the longer they were in place, the less severe was the pandemic's effect on a particular city. Wearing masks in public, restricting door-to-door sales, canceling church and quarantining sick people were among the layers of measures that appeared beneficial.

But the researchers acknowledged they've only just begun their analysis, and haven't teased out which measures were most effective. And they stopped short of saying those steps were the clear-cut reason some cities had lower death rates.

The unpublished research was presented at a meeting designed to help the government refine its advice to states and local governments about how to ready for potential outbreaks of an unusually deadly form of influenza — be it the bird flu circulating in Asia and other parts of the world, or some other strain.

The research by Markel's team is considered some of the first to take a comprehensive look at how a large number of U.S. cities coped with the 1918 Spanish flu pandemic that killed more than 500,000 Americans. They are gathering data for 45 cities with populations of 100,000 or more.

"The conventional wisdom, if you read the standard histories, is that nothing really worked and all cities were devastated," Markel said.

But using statistical modeling, the researchers concluded that cities with multiple measures in place had a smaller peak of illness and lower rates of flu-related deaths.

Several people at Monday's meeting questioned the meaning of the findings.

The 1918 virus hit cities along the East Coast hard and then spread west over the course of several weeks, so cities like St. Louis had more lead time. It's possible the virus mutated to become slightly less deadly in the weeks between when it peaked in Philadelphia and when it peaked in St. Louis, one person suggested.

Also, the nation is now technologically and socially different than it was in 1918, and factors like better transportation and shopping malls might cause a pandemic to play out differently, said Dr. D.A. Henderson, a biosecurity expert at the University of Pittsburgh Medical Center.

(Corrects numbers of deaths to more than 500,000 Americans, sted 1.5 million in 8th graf, The research... )

Probiotic may be helpful for abdominal pain

 

Reuters Health

Monday, December 11, 2006

Treatment with the probiotic Lactobacillus acidophilus, a beneficial type of microbe, produces changes in the intestinal tract that help reduce abdominal pain related to irritable bowel syndrome, findings from an animal study suggest.

In fact, the effect of the treatment in reducing pain is on par with that of morphine.

Probiotics help regularize the population of microbes normally found in the intestines. "Modulation of intestinal flora may be a promising, safe and relatively inexpensive new treatment for abdominal pain, a prominent symptom of irritable bowel syndrome, which affects 20% of the general population," Dr. Pierre Desreumaux, from INSERM in Lille, France, and colleagues note in the research journal Nature Medicine.

Using lab rats with induced abdominal pain, the researchers found that oral administration of Lactobacillus strains led to an increase in the number of receptors for naturally produced pain-killing substances on cells lining the intestine. The result was an analgesic effect similar to that of morphine.

The findings suggest that intestinal microbiology influences the perception of visceral pain, the researchers conclude.

Source: Nature Medicine, online December 10, 2006.

Little-known disease threatening legs

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, December 11, 2006

Gangrene was eating away Frank D. Johnson's toes, the last stage of a little-known disease that slowly chokes off blood flow in millions of people's legs. Dr. Richard Neville made a last-ditch attempt to avoid amputating his leg, implanting a special woven tube to replace a key clogged artery. The artificial blood vessel, coated with a blood-thinning drug to work better, is the latest treatment aimed at saving legs riddled with peripheral artery disease, or PAD.

Far better would be to stop this disease before patients' legs are in such jeopardy, not only to keep the people walking, but because having the leg condition increases sixfold the risk of a heart attack or stroke. If leg arteries are clogged, other blood vessels usually are, too.

Now a major push is on to get more people checked for PAD — with the message that trouble walking isn't a normal part of aging — and to test just which early stage therapy is best at stemming the disease before it imperils a leg.

"PAD has been woefully underdiagnosed and underappreciated," says Neville, vascular surgery chief at Georgetown University Hospital. "Pain in your legs is not something you have to live with, not just a part of getting old."

PAD afflicts up to 12 million Americans as their leg arteries stiffen and narrow. Eventually, the lack of blood flow to muscles causes an aching pain while walking, called claudication.

Worse, if arteries become completely blocked — an emergency called critical limb ischemia — ulcers, infection and gangrene can set in. That leads to 75,000 to 150,000 amputations a year. And when PAD patients lose a leg, their risk of premature death skyrockets as they become even more sedentary, sometimes bedridden.

Anyone can get PAD. But diabetics are particularly vulnerable; one in three over age 50 is likely to have it. So are black Americans, who have twice the risk of whites.

Just getting older increases the risk; about one of five Americans over age 70 has PAD. Other risks include high blood pressure or cholesterol, having ever been a smoker, or having heart disease.

A simple check — feeling the pulse at the ankle and comparing blood pressure in the ankles and arms — is enough to signal the possibility of PAD.

That easy foot check is probably just as important as listening to the heartbeat, says Dr. Alan Hirsch, vascular medicine chief at the Minneapolis Heart Institute. Yet it's not a part of most checkups even for people with obvious risk factors, something a new $2 million campaign by the National Institutes of Health and the PAD Coalition that Hirsch heads are working to change.

"We don't seem to take our legs very seriously," says Hirsch, who laments that between the 15-minute checkup and patient reluctance to complain, leg health — and thus a window into heart health — gets overlooked. "We hope the campaign will create a major paradigm shift."

Among the efforts: NIH-created radio ads that aim to correct the myth that trouble walking is normal as you get older, and efforts to ensure that once the legs are treated, doctors monitor PAD patients' heart health, too.

But how to treat PAD? This month, doctors around the country began recruiting 250 claudication patients for a first-of-its-kind study to determine the best strategy for earlier-stage disease: the drug Pletal; special exercise therapy; artery-widening angioplasty; or some combination.

Some newer technologies, like a tiny razor that shaves clogged arteries and a laser to blast away the sludge, promise help, too.

But thousands of PAD sufferers are like Johnson, with severe disease hastened by high blood pressure and kidney failure at a young age. Last May, the Birmingham, Ala., man danced at his daughter's high school graduation. But by August, he had so little blood flow in his left leg that doctors performed bypass surgery to replace the clogged artery with one of his own clog-free veins.

It failed, and at 49 Johnson was facing amputation.

Cancel that operation, ordered his sister, who happened to work at Georgetown — and drove Johnson up for a second opinion with Neville, who was excited to try the newly approved artificial blood vessel.

Called Propaten, it's not the first manmade blood vessel, but previous ones re-clogged quickly, Neville says. Propaten is coated with the blood thinner heparin, and he cited data from Europe suggesting it may work better for certain hard-to-treat cases.

"My own bias is it's not as good as a vein, but it's the closest thing we've got," says Neville. "I think it will allow us to save legs that might have been lost."

Indeed, a few weeks after Johnson's implant, he's losing a few toes from the gangrene, but Neville expects him to walk again.

"He's back to his fighting self," said his sister, Lucile Harvey.

Editor’s Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

NIH campaign on PAD: http://www.aboutpad.org and http://www.padcoalition.org

Claudication study: http://www.clinicaltrials.gov/ct/show/NCT00132743?order1

U.S. improves rate of blood pressure control: study

 

By Ed Stoddard

Reuters

Monday, December 11, 2006

 

More Americans have their high blood pressure under control, reducing their risk of heart attack, stroke and other diseases, according to a new study released by the American Heart Association on Monday.

More than a third -- 36.8 percent -- now have their blood pressure at healthy levels, compared to 29.2 percent in 1999 and 2000, according to the report.

Nonetheless, that means fewer than half have their blood pressure at a desirable level, according to the report.

Researchers said the improvements could be linked to growing public awareness about the problem, although the proportion of Americans with hypertension or high blood pressure remains little changed.

"It is hard to attribute the improvement to any particular factor ... We have tried to see if the explanation lies in better awareness, detection or treatment," said Dr. Bernard Cheung, an associate professor at Hong Kong University, who wrote the report.

"There is no statistically significant increases in these, so probably all of these contribute in a small way. I think everyone involved in the detection and treatment of high blood pressure can take credit," Cheung said in an e-mail.

He added that the trend did not appear to be related to better drugs, either.

The researchers looked at information on 14,653 people from the National Health and Nutrition Examination Surveys given between 1999 and 2004 for their report.

They found the proportion of Americans with high blood pressure or hypertension remained little changed -- it was 26.8 percent in 1999-2000 and 29.3 percent in 2003-04.

But the numbers who had their blood pressure below the desired level of 140/90 jumped from less that 30 percent to 36.8 percent in 2004.

Diabetics with high blood pressure must keep theirs below 130/80 to have it considered controlled.

"This remarkable jump in the control rate has not been seen previously. The increased control rates may help to decrease the incidence of strokes and heart attacks, which is highly encouraging," Cheung said in a statement.

An estimated 60 million U.S. adults have high blood pressure.

Awareness improved from 68.7 percent to 75.7 percent over the study period while the proportion of people with high blood pressure who were being treated rose from 58.2 percent to 65.1 percent, Cheung's team reports in this week's issue of the journal Hypertension.

"Despite these encouraging findings, a quarter of people with hypertension were unaware they had it and about one-third of people with hypertension were not being treated in 2003-04," Cheung said.

Smoking may worsen knee arthritis

 

Reuters Health

Monday, December 11, 2006

Smokers with knee arthritis suffer quicker joint deterioration than non-smokers with the condition, a new study suggests.

Researchers found that among 159 men with knee arthritis, smokers reported more pain and were more than twice as likely to show significant cartilage loss in the joint.

Cartilage is the elastic tissue that cushions the ends of the bones; in osteoarthritis -- the common "wear-and-tear" form of arthritis -- this cartilage gradually breaks down, leading to inflammation, pain and deformity in the bones.

Some past studies, though not all, have suggested that smokers might be at greater risk of osteoarthritis. The current one, published online by the Annals of the Rheumatic Diseases, suggests that when smokers do develop the condition, it may be more severe.

The findings are "provocative" and should spur further research, write the study authors, led by Dr. Shreyasee Amin of the Mayo Clinic College of Medicine in Rochester, Minnesota.

The 159 men with knee osteoarthritis in the study were followed for 2.5 years. The researchers used MRI scans to measure cartilage loss in the knee at the beginning, midpoint and end of the study. The men also rated their knee pain at each follow-up visit.

In general, Amin's team found, the 12 percent of men who were smoking at the study's outset showed greater cartilage loss over time and reported more pain than their non-smoking counterparts. This was despite the fact that the smokers tended to be younger and weigh less, which might be expected to delay progression of their arthritis.

There are a number of reasons smoking could exacerbate arthritis, according to the researchers. For one, they note, smoking can deprive tissue of oxygen, which might hinder normal cartilage repair. In addition, since cartilage itself has no pain fibers, it's possible that smokers' greater pain comes from damage to other structures in the arthritic joint.

Source: Annals of the Rheumatic Diseases, online December 7, 2006.

Hour of daily exercise cuts bowel cancer risk

 

Reuters

Monday, December 11, 2006

Whether is it jogging around the park, pumping iron or swimming, an hour of vigorous exercise a day can lower the risk of bowel cancer, a study said on Monday.

Even cleaning the house, or two hours of less strenuous activity can make a difference, according to the study of more than 413,000 people in 10 European countries.

"This study is significant because of its very large sample size and the different levels of activity that were observed across the European countries," said Dr Christine Friedenreich, lead author of the research, from the International Agency for Research on Cancer (IARC) in Lyon, France.

"This allowed a more in-depth analysis of how physical activity influences colon cancer risk," she added.

The research was published by scientists working for the European Prospective Investigation into Cancer and Nutrition (EPIC), which was designed to investigate the relationships between diet, nutrition, lifestyle and environmental factors and cancer.

A team of international scientists analyzed the impact of physical activity on the risk of colon cancer and found people with the highest levels of exercise were 22 percent less likely to develop it. The reduced risk was higher, up to 35 percent, for tumors on the right side of the colon.

Although exercise had the biggest impact in cutting cancer risk in people of normal weight, it was also beneficial to a lesser extent in men and women who were overweight or obese.

But exercise did not have a protective effect against rectal cancer.

Colon and rectal are among the most common cancers in developed countries. More than 940,000 cases are diagnosed each year and about 492,000 people die from the illness, according to

IARC.

Health experts estimate about 70 percent of cases could be prevented by changes in diet and exercise.

Professor Elio Riboli, the coordinator of EPIC from Imperial College London, said the large number of people included in the research was important.

"We were particularly interested in the results that we found for different parts of the colon and rectum which were not feasible in previous studies because of the smaller sample sizes and lack of data on the position of the tumors," he said in a statement.

Raising 'Good' Cholesterol Levels Still a Worthy Goal

 

By Amanda Gardner
HealthDay Reporter

HealthDay News

Monday, December 11, 2006

MONDAY, Dec. 11 (HealthDay News) -- Despite the death of Pfizer's new cholesterol drug, researchers say they are not abandoning their quest to find ways to prevent heart disease by raising levels of "good" cholesterol.

Reducing LDL, or "bad" cholesterol, has been the main focus of cardiology in recent years, but boosting its counterpart, HDL, also has a salutary effect.

Indeed, Pfizer was intending to market the new drug with Lipitor, a cholesterol-lowering statin that happens to be the world's best-selling drug. But the development of the drug, torcetrapib, was hurriedly shut down on Dec. 2 because of an unexpected number of deaths and cardiovascular problems in patients participating in clinical trials. Pfizer, the world's largest drug maker, had already poured $800 million into the venture.

Increasing HDL lowers event rates, while lowering LDL cholesterol does the same, explained Dr. Robert Myerburg, a professor of medicine and physiology at the University of Miami's Miller School of Medicine. "That's pretty well-established. There's good supporting data, and the rationale is there."

"It's a valid strategy," added Dr. Daniel Fisher, a clinical assistant professor of medicine at New York University School of Medicine in New York City.

While HDL is not as important as LDL in controlling heart disease, it's still a player, experts say.

"There are six major factors that we've designated that are vastly important in the prevention and control of heart disease, and HDL has never made that cut," explained Dr. Gerald Fletcher, a spokesman for the American Heart Association and a professor of medicine at the Mayo Clinic College of Medicine, in Jacksonville, Fla. "HDL has never been established as that important compared to LDL, but it's certainly important."

Other drugs that are similar to torcetrapib are currently in various stages of development, but it's not clear if the problems that cropped up with torcetrapib will reappear with those medications.

"We don't know the class effect or the potency of the drugs," Myerburg stated. "And we don't know how much added benefit they will provide to the person taking multiple drugs."

In the meantime, doctors and patients already have Niaspan, an extended-release version of niacin. Niaspan is less potent than torcetrapib.

"Niaspan also raises HDL but to a lesser extent," Fisher said. "It's not even in the same ballpark."

And because Niaspan also lowers LDL, it's hard to tease out what's causing the good. "Which is a major player in improving event rates?" Myerburg asked. "We don't know where the benefit is coming from."

And Niaspan, which works by a completely different mechanism than torcetrapib, causes uncomfortable skin flushing that can prompt some patients to discontinue taking their medication. A government-sponsored trial is currently looking at how Niaspan works in combination with statins.

Drugs called fibrates can also boost good cholesterol but, in combination with statins, can have undesirable muscle and liver effects, Fisher said.

Statins themselves raise HDL as well, but to a much lesser extent than either Niaspan or torcetrapib.

There are other things patients can do that don't involve taking another pill, experts added.

"A regular, dedicated exercise program will elevate HDL, but it has to be a long-term thing," Fletcher said.

More information

Visit the American Heart Association for more on cholesterol.

Sunday, December 10, 2006

 

Choose Wisely in the Organic Food Aisle

 

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Sunday, December 10, 2006

SUNDAY, Dec. 10 (HealthDay News) -- Not long ago, buying organic foods meant stopping at your local food co-op or a trek to the farmers' market.

You can still get organic products there, of course, but increasingly, you can also find them at mainstream markets.

"Half of organic foods sold in the U.S. are now sold by chain groceries," said Mark Kastel, co-founder and co-director of the Cornucopia Institute, in Cornucopia, Wis., a think tank and progressive farm-policy research group. "That shift has been happening the last few years."

And that trend is expected to continue. Wal-Mart Stores, for instance, recently announced it plans to double its sales of organic foods, and with its reputation for cost-cutting, the price gap between organic and conventionally grown foods may narrow, although not all experts agree with that prediction.

Costs of organic products are 25 percent to 100 percent higher than non-organic, said Ronnie Cummins, national director of the Organic Consumers Association in Finland, Minn. Typically, he said, "people are willing to pay the extra costs."

With the good news about increased availability comes a caveat: Organic foods advocates say it's getting tougher to choose the best organic offerings. They say some companies are cutting corners in the interest of boosting profits, and that consumers must educate themselves on how to read labels or do research on which companies are producing the best products.

One controversy: The fact that organic milk is produced both by family farms that allow the cows to graze outdoors in pastures, and by "factory farms" that confine cows, give them feed rather than allowing them to graze, and milk them several times a day.

"Confined [milk production] is a quicker, easier way to produce," said Will Fantle, research director of the Cornucopia Institute. But Fantle and other organic advocates frown on the process and the end product.

To help consumers, the Cornucopia Institute has posted a scorecard on its Web site, giving dairy producers a "one-to-five-cow" rating, five being best. The scorecard is the result of a one-year research project in which the research team rated 68 organic dairy producers and private-label products. The institute presented their report in April to the U.S. Department of Agriculture's National Organic Standards Board.

Knowing how to read a label can also help you pick the best organic offerings, experts say. If meat, poultry, eggs or dairy products are labeled organic, they must come from animals given no antibiotics or growth hormones, according to the USDA, which regulates organic standards. And organic produce is grown without using "most conventional pesticides; fertilizers made with synthetic ingredients or sewage sludge; bioengineering; or ionizing radiation," according to the USDA.

If a label says "certified organic," that means the product has been grown and processed according to the USDA national standards and then certified by one of the USDA-accredited certification organizations.

Consumers should also be aware that many companies are importing foods from outside the United States to cut costs, Fantle said. He believes domestically-grown product is better.

"Consumers need to look [at the label]," he said, "to see if the food is coming from foreign sources." If that information is not on the label, he said, "develop some sort of comfort level or relationship with the grocery story providing the foods. Ask, 'Where is this coming from?' "

And a final piece of advice: Don't confuse the word "natural" on a label with "organic."

" 'Natural' is not third party-certified, the way 'organic' is," he said. "It's more a marketing tool."

More information

For more on organic foods, head to the USDA.

 

Saturday, December 9, 2006

 

A Year of Major Advances in Cancer Cited

 

By Steven Reinberg
HealthDay Reporter

HealthDay News

Saturday, December 9, 2006

FRIDAY, Dec. 8 (HealthDay News) -- There were important advances in the detection and treatment of cancer this year -- more people than ever are now surviving the disease -- but cuts in government cancer research dollars could slow progress in the fight.

Those are the conclusions of new research released Friday by the American Society of Clinical Oncology (ASCO).

The report, Clinical Cancer Advances 2006: Major Research Advances in Treatment, Prevention, and Screening, identified six important advances in cancer research for the year, including five new drugs that prolong life.

But, despite such progress, ASCO executives are upset at recent cuts in federal funding for cancer research. To keep pace with inflation, the group is calling for a minimum annual funding increase of at least 5 percent both from and for the U.S. National Institutes of Health (NIH).

"In the last four decades, the investment in clinical cancer research has yielded major progress in prevention, detection and treatment of a wide variety of cancers," Dr. Robert F. Ozols, chairman of ASCO's Cancer Communications Committee, said during a teleconference.

Ozols, a researcher at Fox Chase Cancer Center in Philadelphia, noted that there are now 10 million cancer survivors in the United States, up from 3.5 million in 1970.

"For the first time in 70 years, the number of deaths in the United States due to cancer declined in 2003," he said. "In addition, we are treating cancer better and with less toxicity."

The ASCO report includes only the most important developments in the way cancer is understood or impacts patient care and survival, Ozols said. The most important advances in cancer treatment in the past year, according to the report, are:

The HPV vaccine, Gardasil. As a preventive against human papillomavirus (HPV) infection, the cause of most cervical cancer, the vaccine has the potential to reduce the burden of cervical cancer, which is diagnosed in almost 500,000 women around the world each year. In addition, a 2006 study found the vaccine was also effective in preventing HPV-related vaginal and vulvar precancers.

Targeted therapies that improve survival and response rates for hard-to-treat cancers. These include:

For kidney cancer, the investigational drug temsirolimus (CCI-779), which improved survival when used as a first-line treatment for people with advanced, high-risk kidney cancer, and sunitinib (Sutent), which improved progression-free survival and response rates.

For advanced breast cancer treatment, there is now Lapatinib (Tykerb). For leukemia patients, Dasatinib (Sprycel), which is effective in those who are resistant to imatinib. And last year, cetuximab (Erbitux) arrived, the first new treatment for head-and-neck cancer in 45 years.

Significant advances in genetic tests that predict the outcomes of people with lung cancer.

"These advancers did not happen by accident," ASCO president Dr. Gabriel N. Hortobagyi, from the University of Texas M.D. Anderson Cancer Center, said at the teleconference. "These are the results of the last 30 years of work by investigators and by a major investment this country has made in cancer research."

But cancer research funding itself may well be in crisis, he added. Funding for the NIH had doubled each year up to 2003, but has not been increased since then, he said.

"If you add inflation to that, it is a net cut in funding," Hortobagyi said." We expect next year there will also be a net cut in funding, and that is unfortunate because we are even better prepared today to harvest practical results from the investment in cancer research."

In 2004, the National Cancer Institute, which is part of NIH and funds cancer research, received $4.7 billion, according to NCI. That represents only a 3.2 percent increase over the previous year.

Hortobagyi thinks that rising government deficits and spending in other areas are draining essential dollars from cancer research.

"The decreases in funding are destructive not only because they prevent further progress, but because they result in the dismantling of existing infrastructures for research," he said.

Hortobagyi believes that the National Institutes of Health needs to continue to increase funding just to keep the progress in cancer research at current levels.

"We need a minimum, but consistent, increase of 5 percent per year dedicated to biomedical cancer research," Hortobagyi said. "That will be barely above inflation. It may not ensure growth, but it will ensure maintenance of our current infrastructure and efforts."

More information

The U.S. National Cancer Institute can tell you more about cancer research.

 

College Students Can Pack Stress for Holiday Home Stay

 

HealthDay News

Saturday, December 9, 2006

SATURDAY, Dec. 9 (HealthDay News) -- When college students return home for the holidays, they can bring more than presents with them. They can also cause stress and tension in the home as the entire family makes adjustments, says an expert at Washington University in St. Louis.

"The winter break is the first extended time at home for most freshmen since they left for college in the summer," Karen Levin Coburn, associate vice chancellor for students and dean of the freshman transition at the university, said in a prepared statement.

"The first semester at college may have been their first glimpse of freedom. They wonder if it is possible to go home and still maintain their newfound independence," said Coburn, who is co-author of the book Letting Go: A Parent's Guide to Understanding the College Years.

She offered some advice.

"Parents should not be shocked when students come home with bags under their eyes. Most students have just finished finals, they are exhausted, and they may sleep a lot the first day or two. Parents who have invested money and energy in their children's education may not understand the zombie re-entering their home," Coburn said.

Younger siblings may need support from their parents in order to deal with the changes caused by an older siblings' return home from college for the holidays.

"For example, the middle sibling has been used to being the eldest, and it may be more of a drag than a delight to have big sister home again," Coburn noted.

If the returning student is an only child, parents may realize they've grown accustomed to privacy and a clean home.

"Though parents enjoy the reinvigorated hustle and bustle of family life, they may have moments of longing for the spontaneity and quiet of life on their own. Actually, the ambivalence is not unlike the ambivalence their child feels about being back home versus being on his or her own," Coburn said.

Because money is tight for many parents of college students, finances may become a major issue during the holiday visit. Money issues need to be discussed openly, Coburn said.

"Try to find a time when the student is open to discussion and tactfully try to help him or her understand the necessity of budgeting," she recommended.

Here are some other tips for parents:

Don't try to impose old rules (such as curfews) from the student's high school days. Plan early and consult with your returning college student when making arrangements for family parties, vacations and other activities. Don't do everything for your student. Let him or her take responsibility for the things they've been handling while away at college, such as medical appointments, finances, and car and computer maintenance.

More information

The University of Minnesota has more holiday advice for parents of college students.