Personal Health

 

 

 

Friday, April 23, 2010

 

Omega 3s may help cut colon cancer risk

 

Reuters Health

Friday, April 23, 2010

NEW YORK (Reuters Health) – People who eat plenty of fish oil and other omega-3 fatty acids could cut their risk of colon cancer, new research hints.

Studies in animals and a couple of small trials in people suggest that fish oil supplementation can fight inflammation and may have cancer-fighting properties, Dr. Sangmi Kim of the National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, and colleagues note. But so far studies looking at the diets of larger groups of people have had equivocal results.

To investigate further, Kim and colleagues examined the relationship between polyunsaturated fatty acid intake and bowel cancer risk in 1,503 whites (including 716 colon cancer patients and 787 healthy controls) and 369 African Americans (213 with colon cancer, 156 controls).

Among whites, the researchers found, those in the top fourth based on their omega-3 consumption had half the risk of colon cancer compared to those in the bottom fourth.

When the researchers looked separately at the two main fatty acids contained in fish oil --eicosapentaenoic acids and docosahexaenoic acids -- they found risk also fell with increasing intake.

When the researchers looked at whites and blacks together, they also found a reduced risk of colon cancer with increasing omega 3 intake; separate analysis of the black study participants didn't find this relationship.

They also found that people who consumed more omega-6 fatty acids in relation to omega-3s were more likely to have colon cancer, although omega-6 intake in and of itself didn't affect risk.

In addition to fish oils, omega-3 fatty acid sources include seed oils, such as walnut oil and flax-seed oils, and leafy green vegetables. People in the US typically eat more omega-6 fatty acids than omega-3s; top sources include palm oil, soybean oil, and sunflower oil.

The researchers also found an "unexpected" association between higher omega-3 intake and colon cancer in African-Americans, but urged caution in interpreting this finding, which they say "may have been due to chance." Nevertheless, they conclude, "whether the possible benefit from this dietary modification varies by race warrants further evaluation."

Source: American Journal of Epidemiology, online April 14, 2010.

 

Potential New Test for Early Diagnosis of Osteoarthritis Identified

 

ScienceDaily

Friday, April 23, 2010

 

ScienceDaily (Apr. 23, 2010) — Researchers at King's College London's Department of Twin Research and Genetic Epidemiology, based at St Thomas' Hospital have discovered new ways of measuring biological markers in the blood which could be used to diagnose osteoarthritis earlier.

 

Osteoarthritis is a condition that affects the joints and is the most common type of arthritis in the UK. It mostly occurs in the knees, hips and small joints of the hands, but almost any joint can be affected.

 

The new biochemical test called metabolomics allows the scientists to test for 163 chemical signals at the same time from a single blood sample. These chemical signals are intermediate products of the metabolism of human cells and their 26,000 metabolite ratios represent the rate of the chemical reactions in the human body.

 

The team first studied 123 white women with osteoarthritis of the knee and 299 healthy women from the Twins UK register, comparing the difference in the metabolites and the 26,000 metabolite ratios between the two groups. They found that 14 metabolite ratios were significantly associated with osteoarthritis. The team then tested these signals to see if they were replicated in an independent sample consisting of 76 women with knee arthritis and 100 healthy women. Two ratios -- valine to histidine and xleucine to histidine -- were successfully confirmed in the replication sample.

 

Dr Guangju Zhai, lead author on the paper published in the journal, Annals of Rheumatic Diseases, said: "Osteoarthritis affects an estimated 8.5 million people in the UK and one of its main characteristics is damage to cartilage, the strong smooth muscle that lines the bones and allows joints to move easily and without friction.

 

The search for biomarkers, or traits, which can be used to measure or indicate the effects or progress of a condition is a hugely exciting area of clinical research. The two novel metabolic biomarkers found through our study could indicate increased cartilage breakdown and we now want to study these mechanisms in more detail."

 

Professor Tim Spector, senior author of the paper added: "Ours is the first study using a metabolomics approach to identify novel metabolic biomarkers for osteoarthritis. We hope that further research will lead to these two metabolite ratios being adopted into clinical practice, enabling doctors to diagnose the condition, or identify that osteoarthritis is developing, earlier. Our study also shows the enormous clinical potential of metabolomics, and we hope in future that they could be used to monitor the effectiveness of treatments. At the moment we relay on x-rays and scans -- and our dependence on these methods is a major obstacle to the development of new drugs for osteoarthritis."

 

Research studies such as this underpin King's Health Partners Academic Health Sciences Centre, a pioneering collaboration between King's College London, and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts which aims to deliver medical breakthroughs to patients at the earliest opportunity.

 

The study was funded by the European Community Framework 7 large collaborative project grant Treat-OA, The Wellcome Trust, and Arthritis Research UK. It also received support from the NIHR comprehensive Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London.

Journal Reference:

G. Zhai, R. Wang-Sattler, D. J. Hart, N. K. Arden, A. J. Hakim, T. Illig, T. D. Spector. Serum branched-chain amino acid to histidine ratio: a novel metabolomic biomarker of knee osteoarthritis. Annals of the Rheumatic Diseases, 2010; DOI: 10.1136/ard.2009.120857


Value of B vitamins in cutting heart disease risk challenged

 

By Rachael Myers Lowe

Reuters Health

Friday, April 23, 2010

NEW YORK (Reuters Health) – Two studies released this week reach contradictory conclusions on the value of B vitamins and folic acid (or folate in its naturally occurring form) in reducing the risks of heart disease. What are doctors and their patients to make of this?

"Not much," says Dr. Steven Woloshin of Dartmouth University's Institute for Health Policy and Clinical Practice.

"One study is very weak and the conclusions can't be believed and the other's results don't add much for practitioners or their patients," Woloshin told Reuters Health.

In the first study, Japanese researchers wanted to know if folate and vitamins B6 and B12 in the diet would have any affect on deaths due to heart disease.

Foods that are rich in B vitamins and folate include beans, lentils, potatoes, peanuts, spinach, broccoli, brussel sprouts, and some fruits such as bananas, strawberries, and oranges.

Using data from the large observational Japan Collaborative Cohort Study, Dr. Renzhe Cui and colleagues calculated the nutrients eaten daily by 23,119 men and 35,611 women by analyzing their answers given in food "frequency" questionnaires.

After 14 years of follow-up, 3815 deaths related to heart disease were recorded in the study population of 58,730: 986 from stroke, 424 from coronary heart disease, 318 from heart failure, and 2087 from cardiovascular disease.

In a nutshell, the results suggested that eating a diet high in folate and vitamin B6 was associated with reduced risk of death from heart failure in men and with reduced risk of death from stroke, coronary heart disease, and cardiovascular disease in women.

In the American Heart Association's journal Stroke, the researchers conclude that greater folate and vitamin B6 in the diet may be useful in preventing cardiovascular disease.

Woloshin questions the validity of such a claim, because of the study's design. The researchers can't tell from the data what factors may be responsible for the observed differences, Woloshin said: "There's nothing to hang your hat on."

"For instance, women were more likely to smoke if they ate less folate. Maybe they have other less healthy habits and that's why they are more likely to die of heart failure," Woloshin said. The data gathered in the observational study doesn't say.

A randomized controlled trial, such as the study by the other research group, is needed to make such claims, he said.

Researchers at the University of Bergen in Norway looked at data gathered in the Western Norway B Vitamin Intervention Trial, which included 3,090 patients suspected of having coronary artery disease.

Participants had angiograms to look at restricted blood flow in the coronary arteries. Blood was also collected to measure levels of an enzyme, homocysteine. High blood levels of homocysteine have been associated with increased risk of heart disease.

Study subjects were randomly assigned to take one of three supplement formulations of folic acid, B6 and B12, or a placebo. One hundred eighty-three patients, with a total of 309 lesions in their coronary arteries, were included in this study's analysis. After 10 months, blood was tested, follow-up angiograms were performed and blockages measured again.

Even though homocysteine in the blood was reduced an average of 22 percent in the patients who got a folic acid/B12 supplement, "overall disease progression was not affected," the researchers found.

Writing in the American Journal of Cardiology, Kjetil Loland and colleagues reported detecting "no statistically significant results from treatment." Coronary artery disease had progressed unabated, they note. In fact in one subgroup, CAD appeared to progress more rapidly for those getting the supplement.

"It must be noted that this was in a post-hoc analysis of a subgroup of patient. We felt however obliged to report this finding," Loland told Reuters Health in an email.

Otherwise, "the results support a growing amount of evidence that B-vitamin treatment of cardiovascular disease is ineffective" in patients with established cardiovascular disease," Loland added.

The results also suggest, Loland said, that high homocysteine levels are not a cause of heart disease and treatments aimed at reducing them won't reduce the heart disease risk itself.

Loland said that by using two measurements of arterial blockage, he and his colleagues were, for the first time, able to look at "clinically silent disease progression."

Woloshin believes significant research now has settled the question of whether folic acid and B vitamin supplementation help reduce the risks of heart disease. "It doesn't," he said.

Source: Stroke, April, 2010. American Journal of Cardiology, April 2010

Thursday, April 22, 2010

 

Physics Strategy Tested as Solution for Antibiotic Resistance

 

ScienceDaily

Thursday, April 22, 2010

 

ScienceDaily (Apr. 21, 2010) — A Virginia Tech biologist proposes to use a physics strategy called resonant activation to nudge dormant bacteria cells into a stage where they will be sensitive to antibiotics.

 

In medicine, resonance means the sound the doctor hears when he or she thumps your chest. In physics, resonance is a periodic force or an oscillation whose frequency is close to that of a natural system's frequency. Sound waves are an example of a natural system that can be altered with resonant activation.

 

Jianhua Xing, an assistant professor of biological sciences at Virginia Tech who has studied more than a smattering of physics, was considering the problem of antibiotic resistance when he remembered a physics paper on resonant activation that he had read as a student.

 

One strategy bacterial colonies use to survive antibiotics is to create a few persister cells. Because these cells are dormant or grow very slowly, they can dodge an antibiotic attack that requires active cell wall growth to be effective. Persister cells convert to normally growing cells at a random and slow rate so that there are always a few that remain dormant until the antibiotics are gone. Extending antibiotic treatment can be a dangerous strategy because of severe side effects, such as liver damage.

 

Persister cells have multiple steady states, with fluctuations in the numbers of proteins as they transition to a normal cell. Xing viewed this fluctuation during synthesis and degradation of proteins as a potential target for resonant activation. Instead of a sound wave or electronic signal, the perturbing signal would be repetitive antibiotic treatment.

 

Xing's student, Yan Fu, a second year graduate student in the Interdisciplinary Program of Genetics, Bioinformatics, and Computational Biology at Virginia Tech; and another student, Meng Zhu of the School of Computing at Clemson University, created a computer simulation to compare different strategies of periodic antibiotics cued to protein fluctuations in persister cells. Their finding that resonant activation -- fluctuating antibiotic treatments -- accelerates bacteria colony sterilization was published in the journal Physical Biology.

Xing acknowledges that that the computer simulation simplified the problem by neglecting further complication due to mutation, but said he believes the concept has applications for cancer treatment. "On and off dosing with chemicals could be as effective as or more effective than long-term dosage. You need to stop and let the body recover, then resume," he said.

 

He is particularly interested in conducting experiments to see if resonant activation could increase the efficiency of inducing a normal (somatic) cell into an undifferentiated or stem cell.

"Bacteria mutate quickly, but there could be applications for cancer or stem cell conversion, where mutation is slower or not an issue," Xing said.

Journal Reference:

Fu et al. Resonant activation: a strategy against bacterial persistence. Physical Biology, 2010; 7 (1): 016013 DOI: 10.1088/1478-3975/7/1/016013


Restaurant Sushi May Have More Mercury Than Store-Bought Fare

 

HealthDay News

Thursday, April 22, 2010

THURSDAY, April 22 (HealthDay News) -- The tuna sushi that you order in restaurants may have higher concentrations of mercury than the sushi you buy at your local supermarket, a new study finds.

Supermarkets tend to sell sushi made from yellowfin tuna, which contains less mercury than other tuna species, researchers report.

"We found that mercury levels are linked to specific species," Jacob Lowenstein, a graduate student working with the American Museum of Natural History in New York City, said in a news release from the museum. "So far, the U.S. does not require restaurants and merchants to clarify what species they are selling or trading, but species names and clearer labeling would allow consumers to exercise greater control over the level of mercury they [consume]," he added.

For their study, the researchers combined two efforts: DNA barcoding performed at the museum to identify specific species; and a mercury content analysis from experts at Rutgers University. The report was published online April 21 in Biology Letters.

"People who eat fish frequently have a particular need to know which species may be high in contaminants," said Michael Gochfeld, professor at Robert Wood Johnson Medical School in New Jersey. "Some agencies have been afraid that any mention of contaminants will discourage people from eating any fish."

The team sampled sushi from 54 restaurants and 15 supermarkets in New York, New Jersey and Colorado, and tested them for relative mercury content. Through DNA barcoding, 100 samples were identified as either bigeye tuna, yellowfin tuna or three different bluefin tuna species.

The team reported that all species tested exceeded or approached mercury concentrations permissible by the United States, the European Union, Japan and Canada, plus those set by the World Health Organization.

Higher mercury levels were found in bigeye tuna and bluefin akami, which is a lean, dark red tuna, than in bluefin toro, a fatty tuna, and yellowfin tuna akami, the researchers said. Mercury tends to accumulate in muscle rather than fat, so mercury content is usually -- but not always -- higher in leaner fish. Yellowfin tuna, for example, is lean, but may accumulate less mercury because it is smaller and harvested earlier than other species, they said.

The seafood industry took a critical view of the report.

"This is a study that tests mercury levels in fish, but stops short of any work exploring what -- if anything -- those levels mean for health," said Gavin Gibbons, director of media relations at the National Fisheries Institute, in an institute statement issued Wednesday.

He added that research has shown that "eating fish as a whole food -- omega-3s, selenium, lean protein, traces of mercury and all -- is a boost to heart and brain health."

In addition, Gibbons said, the U.S. Food and Drug Administration's mercury limit for seafood includes a 1,000 percent safety factor, "and approaching that limit or even slightly exceeding it does not equal health risk," he said.

More information

To learn more about mercury in seafood, see the U.S. Environmental Protection Agency.

Does a Man's Estrogen Level Impact His Risk of Prostate Cancer?

 

ScienceDaily

Thursday, April 22, 2010

 

ScienceDaily (Apr. 22, 2010) — A high level of one type of estrogen in a man's body might increase his risk of developing prostate cancer. That is one surprising conclusion from a new study which also offers another novel finding -- that high levels of the estrogen considered fuel for breast cancer might offer a protective benefit against prostate cancer.

 

Details of the research were recently presented at the AACR 101st Annual Meeting 2010.

 

The health of the prostate has long been considered dependent on the level of the male hormones collectively known as androgens however, it is now recognized that estrogens and their metabolites (estrogen broken down by chemical processes in the body) play a role in its normal growth as well as in prostate cancer.

 

"The aim of our study was to evaluate the use of estrogen metabolites, as a marker for prostate cancer risk," says Ourania Kosti, PhD, at Georgetown Lombardi Comprehensive Cancer Center.

 

For the study, the researchers measured estrogens and their metabolites in the urine collected from 77 men with prostate cancer, 77 healthy controls and 37 men that underwent biopsy and but were diagnosed cancer-free.

 

The relative amounts of the 15 estrogens and estrogen metabolites in the urine of prostate cancer cases were similar to that of non-cancer patients with the exception of the estrogen metabolite 4-OHE1.

"This particular estrogen metabolite appeared to be more abundant among men diagnosed with prostate cancer," explains Kosti.

 

Kosti says her team also observed that the estrogen metabolites considered as 'harmful' estrogens in breast cancer (16-KE2 and 17-epiE3) are secreted in higher amounts among those without prostate cancer and in lower amounts in those with prostate cancer.

 

"This suggests that these particular estrogens may have a protective role against prostate cancer development," explains Kosti. "It is possible that different tissues respond to estrogens different ways, therefore the potential role of 16-KE2 and 17-epiE3 in prostate cancer prevention and management should be further explored."

 

Wednesday, April 21, 2010

 

Fish Oil Supplements Provide No Benefit to Brain Power in Elders, Study Shows

 

ScienceDaily

Wednesday, April 21, 2010

 

ScienceDaily (Apr. 21, 2010) — The largest ever trial of fish oil supplements has found no evidence that they offer benefits for cognitive function in older people.

 

The OPAL study investigated the effects of taking omega-3 long-chain polyunsaturated fatty acid supplements over a two year period on the cognitive function of participants aged 70-80 years.

 

The number of people with cognitive impairment is rising and it is estimated that by 2040, more than 81 million people globally will have dementia.

 

Some studies have suggested that high intakes of omega-3 fatty acids, most commonly found in oily fish, are important for the maintenance of good cognitive health in later life.

 

The OPAL (Older People And omega-3 Long-chain polyunsaturated fatty acids) study, published April 21 in the American Journal of Clinical Nutrition, was a randomised controlled trial led by Alan Dangour, Senior Lecturer at the London School of Hygiene & Tropical Medicine and colleagues.

 

The study enrolled 867 participants aged 70-80 years from General Practice clinics in England and Wales. Trial participants who all had good cognitive health at the start of the study were randomly assigned into two groups, one of which received fish oil capsules while the other group received a placebo for two years. Cognitive function was assessed at the start and end of the study by trained research nurses using a series of paper and pencil tests of memory and concentration.

 

After two years, those participants receiving fish oil capsules had significantly higher levels of omega-3 fatty acids in their blood than those participants receiving placebo capsules. However, cognitive function did not change over the course of the study in either group of participants and there was no evidence that the consumption of omega-3 fatty acids had a benefit for cognitive function in older people.

 

Dr. Alan Dangour urges caution in interpreting these results: "From the data we have collected in the OPAL study there is no evidence of an important benefit for memory or concentration of increased omega-3 fatty acid consumption over a two year period among older people with good cognitive health. However, it is important to keep in mind that poor cognitive function can take many years to develop and although this is the longest trial of its kind ever conducted, it may be that it was not long enough for any true beneficial effects to be detected among this healthy cohort of older people."

Journal Reference:

Alan D Dangour, Elizabeth Allen, Diana Elbourne, Nicky Fasey, Astrid E Fletcher, Pollyanna Hardy, Graham E Holder, Rosemary Knight, Louise Letley, Marcus Richards, and Ricardo Uauy. Effect of 2-y n%u20133 long-chain polyunsaturated fatty acid supplementation on cognitive function in older people: a randomized, double-blind, controlled trial. Am. J. Clinical Nutrition, Apr 21, 2010 DOI: 10.3945/ajcn.2009.29121


Studies Confirm Link Between Breast Density and Cancer

 

By Kathleen Doheny
HealthDay Reporter
HealthDay News

Wednesday, April 21, 2010

WEDNESDAY, April 21 (HealthDay News) -- Having dense breasts has long been known to increase a woman's risk for breast cancer, and new research confirms that a decline in breast density over time does, in fact, decrease that risk.

New research also has found that women taking hormone replacement therapy are more likely to experience an increase in breast density, a finding consistent with previous research that found women taking the hormones had a 24 percent increased risk for breast cancer.

Both findings were to be presented Tuesday and Wednesday in Washington, D.C., at the annual meeting of the American Association for Cancer Research.

"Over 50 studies have shown that breast density is a strong risk factor for breast cancer," said Celine M. Vachon, an associate professor of epidemiology in the College of Medicine at the Mayo Clinic, in Minnesota. "Our study is one of the first to examine changes over time," Vachon said.

A very dense breast has less fat than glandular and connective tissue. Mammogram films of high-density breasts are more difficult to read and interpret than those of less dense breasts.

Vachon and her fellow researchers followed 19,924 women older than 35 who had never had breast cancer and looked at breast density changes and cancer diagnoses over time.

From that group, they randomly picked a sample of 219 women who developed breast cancer during the six-year follow-up period and 1,900 who did not. Women with breast cancer were more likely to have extreme breast density -- the highest of four categories -- at the start of the study, with 16 percent in the very dense category, compared with 14 percent of those who remained cancer-free.

Those who developed cancer were somewhat less likely than the other women to have a reduction in density of one category or more, with 37 percent of those with breast cancer and 38.6 percent of the other women seeing that change.

Though density generally declines with age, and the breasts become more fatty, "these changes vary from woman to woman," Vachon said. "And we know the use of postmenopausal hormone therapy can increase density."

In the other study, researchers from Georgetown University and elsewhere found that the increase in density with hormone use predicted breast cancer risk.

Drawing from the Women's Health Initiative study, which looked at hormone therapy and other health concerns, they compared 97 women on hormone replacement who developed breast cancer and 77 who did not take hormones but did develop cancer with 733 cancer-free women, some who took hormones and some who did not.

They found that 57 percent of those who did not take hormones had a decrease in density, compared with just 16 percent of those taking hormone therapy.

Breast cancer risk increased nearly fourfold for the 20 percent of women with the biggest increase in density, compared with the 20 percent of women with the lowest increase or a decrease.

When the researchers took the density information out of the analysis, hormone use was not associated with breast cancer risk, they found, leading them to conclude that the change in density accounted for the increased cancer risk.

Dr. Joanne Mortimer, a medical oncologist and director of the women's cancer programs at the City of Hope Comprehensive Cancer Center in California, said the study results were not surprising.

"We know that breast density probably correlates with the patient's own estrogen levels," she said. "The higher the estrogen, the greater the breast cancer risk."

The new research adds valuable information, she said, about a link that is accepted. Eventually, she said, experts may add density information to established risk models to produce a more precise estimate of an individual woman's risk.

Another study presented at the meeting found that evaluating breast cancer risk in younger women can be done effectively by using DXA (dual energy X-ray absorptiometry), a lower-radiation option to mammography.

More information

The U.S. National Cancer Institute has more about breast density.

Bottled up anger can be deadly for heart patients

 

By Anne Harding

Reuters Health

Wednesday, April 21, 2010

NEW YORK (Reuters Health) – People with heart disease might want to take a careful look at how they handle their feelings of anger. A new study found that heart disease patients who suppressed their anger had nearly triple the risk of having a heart attack or dying over the next 5 to 10 years.

But this doesn't mean that angry outbursts are a better way to handle these feelings, Dr. Johan Denollet of Tilburg University in The Netherlands told Reuters Health. People tend to either vent angry feelings or hold them inside, "but I think it's important for (people) to find a midway solution to resolve these angry feelings -- but in a more constructive way, a more adaptive way," Denollet said.

Anger can strangle blood flow in the heart and lead to abnormal heart rhythms, and has been linked to an increased risk of heart disease. There's also evidence that suppressing anger can be harmful to the heart. In the current study, the researchers investigated the interplay among "Type D" personality, anger, anger suppression, and outcomes in heart disease patients.

People with Type D personalities are prone to suffer from anger and other negative emotions, and find it difficult to express themselves in social situations. "This is the perfect mixture so to speak to render people more liable to chronic forms of stress and tension, which may have a negative impact," Denollet said. Type D's represent about one in five people in the general population, but as many as one in three heart disease patients, the researcher noted.

In the study, 644 patients with coronary artery disease were followed for an average of about six years, during which time 20 percent had a "major adverse cardiac event," meaning they died, had a heart attack, or underwent surgery to restore blood flow to the heart. Ten percent of the entire group died or had a heart attack during the study. Twenty-seven percent of the study participants had Type D personalities.

Anger and anger suppression were related to the risk of a major adverse event, but this relationship disappeared once the researchers took factors like blood pressure and heart disease severity into account. But a significant relationship remained between suppressed anger and the risk of heart attack or death even after the researchers adjusted for these and other factors.

While 4 percent of the patients who didn't have Type D personalities had high levels of suppressed anger, nearly 20 percent of the Type D personality patients did, the researchers found. The personality type also quadrupled the risk of having a heart attack or dying during follow-up.

The findings don't mean that people with Type D personalities or people who have a tough time expressing their anger are doomed to be unhealthy, Denollet noted. "Anger is one of the emotions that (tells) us something is not going the way we would like it to go," the researcher said. People should be aware of their angry feelings and figure out where they're coming from; "it's important to take next steps and try to do something about the situation," Denollet told Reuters Health.

For some people, according to Denollet, finding a way to speak up for themselves and discuss what's angering them with other people in a "sociable, nice way" will be enough; for others, professional help such as assertiveness training and social skills training may be warranted.

Source: American Journal of Cardiology, online April 12, 2010.

New Form of Painkiller May Fight Colon Cancer

HealthDay News

Wednesday, April 21, 2010

WEDNESDAY, April 21 (HealthDay News) -- Adding to previous research suggesting that painkillers can reduce the risk for colon cancer, researchers report that an investigational form of the drug naproxen blocks a molecular process that leads to the disease.

Commonly known by such brand names as Aleve, Anaprox and Naprosyn, the standard form of naproxen is a generic pain medication.

Though the drug has been tested only in the laboratory, not on people, "it appears that the investigational form of naproxen we studied may be more effective than standard naproxen in inhibiting colorectal tumor development," Margie Clapper, co-leader of the Cancer Prevention and Control Program at Fox Chase Cancer Center, said in a news release from the center. "An added benefit would be the reduced gastrointestinal toxicity of this novel type of naproxen."

Researchers found that the new type of naproxen, known as NO-naproxen, appeared to block a signaling pathway that plays a role in the formation of colorectal cancer.

Based on laboratory data, "we think that NO-naproxen is much better than naproxen in nipping this whole process in the bud," Clapper said.

The scientists are testing their finding in mice but do not yet have the results.

The study findings were scheduled to be released at the annual meeting of the American Association for Cancer Research, April 17 to 21 in Washington D.C.

More information

The American Cancer Society has more about colon cancer.

Radiation for prostate cancer lacks data: U.S. panel

 

By Susan Heavey

Reuters

Wednesday, April 21, 2010

WASHINGTON (Reuters) – There is not enough evidence to sort out the effect of various radiation treatments for prostate cancer patients, especially newer, so-called focused radiation, an advisory panel told the U.S. Medicare agency on Wednesday.

The Center for Medicare and Medicaid Services (CMS) panel of outside experts said large gaps in available data make it hard to weigh the impact particular radiation options may have on patients, including possible death or side effects. But it was divided over just how to collect much-needed information.

There is "insufficient evidence across the board," said panel chairman Clifford Goodman, a senior vice president at the Lewin Group.

CMS, which oversees the Medicare insurance program for 45 million elderly and disabled Americas, is taking a closer look at such treatments at a time of great debate over how to treat the cancer that affects roughly more than 2 million men in the United States. About 40 percent of Medicare patients are men.

While the agency has no immediate plans to change its reimbursement rates for such radiation, it will weigh the advice and could use it to later revisit its payment policies. Any changes could impact device makers such as Accuray Inc, Siemens AG, TomoTherapy, and Varian Medical Systems.

Surgery, radiation and simply "watchful waiting" are all possible courses of action. But researchers are increasingly concerned that excessive screening may be leading to over-aggressive treatment when studies show many prostate cancers grow so slowly that most men will die from other causes first.

CMS said reviewing all of the possible therapies would be too big a task for its advisers at one meeting.

In looking just at radiation therapy, the advisers lamented the fact that just a handful of studies have been done and that most don't follow patients long-term for at least five years. Radiologists that use the treatments told the panel more data is being done.

Panelists were split over whether strict, randomized controlled trials, patient registries and other types of informational gathering were most needed.

Many urged various medical groups to band together to compare all types of treatments, not just radiation, to each other -- also known as comparative effectiveness research.

"Given the paucity of evidence ... any evidence that can be gathered will be useful," said panel member Jeffrey Jarvik, a radiologist at the University of Washington.

How that evidence impacts the potential for future payments is a particular concern for newer radiation therapies, such as Accuray's CyberKnife, that are not paid for by Medicare in some U.S. states.

Several prostate cancer patients from Oklahoma and Texas, two states that don't cover it, called on the panel to back such treatments.

Marcel Salive, head of the CMS's division that oversees prostate cancer coverage, said the agency would weigh the panel's advice as it decides whether further action is needed.

But he added that the overall lack of data on radiation would likely cause "a real difficulty in drawing conclusions" and make it tough to make any nation-wide coverage decisions.

Accuray officials did not speak at the meeting but have said they are concerned CMS could later reject payment for use of its device in prostate cancer patients.

(Reporting by Susan Heavey; editing by Carol Bishopric)

Can walking help guard against stroke?

 

By Terri Coles

Reuters Health

Wednesday, April 21, 2010

NEW YORK (Reuters Health) – Walking may be an important weapon for women in the fight against stroke, a new study hints.

The study found that women who walked for two or more hours a week had a lower risk of stroke than those who walked for less than two hours a week.

It's well known that physical activity is good for heart health, including reducing the risk of stroke. "More active people generally demonstrate a 25 to 30 percent lower risk of stroke," Jacob Sattelmair, the study's lead researcher and a doctoral candidate in epidemiology at Harvard School of Public Health in Boston noted in a telephone interview with Reuters Health.

To investigate further, Sattelmair's team studied more than 39,000 healthy women aged 45 or older enrolled in the Women's Health Study. The women reported their leisure-time physical activity at the start of the study (1992-1995) and periodically during the study.

During an average follow-up of nearly 12 years, 579 women suffered a stroke. There were 473 ischemic strokes - the most common type caused by a blockage or blood clot supplying blood to the brain -- and 102 hemorrhagic, or "bleeding," strokes. Four strokes were of an undetermined type.

Overall, the most active women in the study were 17 percent less apt to suffer a stroke during follow up than the least active women, the researchers found.

Compared with women who didn't walk, women who walked two or more hours a week at any pace cut their risk of any type of stroke by 30 percent.

Women who walked at a pace of 3 miles per hour or faster had a 37 percent lower risk of suffering any type of stroke compared to those who walked at a slower pace. Walking appeared to primarily lower the risk of ischemic stroke.

These observations "certainly add to the evidence that even moderate-intensity activity such as brisk walking is beneficial to the reduction of risk of strokes," Dr. Frank Hu, of the Harvard School of Public Health, who was not involved in the study, told Reuters Health by phone.

Hu published a study in 2000 in the Journal of the American Medical Association showing that physical activity, including walking, provided a significant reduction in stroke risk.

The current study is "observational," Hu pointed out, with self-reported data. But the research team controlled well for other risk factors for stroke, he said, such as smoking. A connection between more vigorous forms of physical activity and reduced stroke risk couldn't be properly examined in the study, he added, because there weren't a sufficient number of vigorous exercisers; walking was a more popular activity for the study participants.

Sattelmair and colleagues note that their study primarily looked at well-educated, middle-aged white women, although there is no particular reason to believe that the results can't be generalized across the wider population of American women, according to the researchers.

Men were also not included in the study; exercise has generally been shown to reduce stroke risk in men as well, but there isn't yet clear data on how walking specifically affects risk for them.

Hu said this study is clinically important because of the devastating side effects of stroke, which include reduced mobility, speech difficulties and memory loss. Stroke is the third leading cause of death in the United States, after heart disease and cancer.

"The bottom line," Hu said, "is that this study provides another piece of evidence for why people should move and get off the couch."

Source: Stroke: The Journal of the American Heart Association, online April 6, 2010.

 

How Red Wine May Shield Brain from Stroke Damage: Researchers Discover Pathway in Mice for Resveratrol's Apparent Protective Effect

 

ScienceDaily

Wednesday, April 21, 2010

 

ScienceDaily (Apr. 21, 2010) — Researchers at Johns Hopkins say they have discovered the way in which red wine consumption may protect the brain from damage following a stroke.

 

Two hours after feeding mice a single modest dose of resveratrol, a compound found in the skins and seeds of red grapes, the scientists induced an ischemic stroke by essentially cutting off blood supply to the animals' brains. They found that the animals that had preventively ingested the resveratrol suffered significantly less brain damage than the ones that had not been given the compound.

 

Sylvain Doré, Ph.D., an associate professor of anesthesiology and critical care medicine and pharmacology and molecular sciences at the Johns Hopkins University School of Medicine, says his study suggests that resveratrol increases levels of an enzyme (heme oxygenase) already known to shield nerve cells in the brain from damage. When the stroke hits, the brain is ready to protect itself because of elevated enzyme levels. In mice that lacked the enzyme, the study found, resveratrol had no significant protective effect and their brain cells died after a stroke.

 

"Our study adds to evidence that resveratrol can potentially build brain resistance to ischemic stroke," says Doré, the leader of the study, which appears online in the journal Experimental Neurology.

 

Red wine has gotten a lot of attention lately for its purported health benefits. Along with reducing stroke, moderate wine consumption has been linked to a lowered incidence of cardiovascular disease -- the so-called French paradox. Despite diets high in butter, cheese and other saturated fats, the paradox goes, the French have a relatively low incidence of cardiovascular events, which some have attributed to the regular drinking of red wine.

 

Doré cautions against taking resveratrol supplements, available alongside vitamins and minerals and on websites touting its benefits, because it is unclear whether such supplements could do harm or good. He has not tested resveratrol in clinical trials. And while resveratrol is found in red grapes, it's the alcohol in the wine that may be needed to concentrate the amounts of the beneficial compound. Doré also cautions that drinking alcohol carries risks along with potential benefits.

 

He also notes that even if further research affirms the benefits of red wine, no one yet knows how much would be optimal to protect the brain, or even what kind of red wine might be best, because not all types contain the same amount of resveratrol. More research is needed, he says.

 

Doré says his research suggests that the amount needed could end up being quite small because the suspected beneficial mechanism is indirect. "Resveratrol itself may not be shielding brain cells from free radical damage directly, but instead, resveratrol, and its metabolites, may be prompting the cells to defend themselves," he suggests.

 

"It's not likely that brain cells can have high enough local levels of resveratrol to be protective," he says. The resveratrol is needed to jump-start this protective enzymatic system that is already present within the cells. "Even a small amount may be sufficient," Doré says.

 

Doré says his ongoing research also suggests some therapeutic benefits to giving resveratrol to mice after a stroke to limit further neuronal damage.

 

The research was supported in part by grants from the National Institutes of Health, the Wine Institute and the ABMR Foundation.

 

Other Johns Hopkins authors of the study include Hean Zhuang, M.D.; Herman Kwansa, Ph.D; and Raymond C. Koehler, Ph. D.

Journal Reference:

Yoshihito Sakata, Hean Zhuang, Herman Kwansa, Raymond C. Koehler, Sylvain Dor. Resveratrol protects against experimental stroke: Putative neuroprotective role of heme oxygenase 1. Experimental Neurology, 2010; DOI: 10.1016/j.expneurol.2010.03.032


Bleeding with first baby ups later pregnancy risks

 

Reuters Health

Wednesday, April 21, 2010

NEW YORK (Reuters Health) – Women who bleed early in pregnancy but don't miscarry are at increased risk of pregnancy complications, and this risk carries over to their next pregnancy, according to a large new study from Denmark.

The findings suggest that doctors should keep a closer eye on pregnant women who have experienced first-trimester vaginal bleeding, conclude Dr. Jakob Alexander Lykke of Roskilde Hospital in Roskilde and his colleagues.

It's been shown that about half of women who have first-trimester bleeding will miscarry by 20 weeks of pregnancy, while women who bleed but don't miscarry are known to be more likely to have pregnancy complications. In the current study, the researchers investigated whether this risk might persist into a woman's next pregnancy.

They looked at records for nearly 800,000 Danish women who delivered a first baby between 1978 and 2007, and a subset of nearly 540,000 of these women who also had a second child during that time period.

Around 2 percent of women in both groups had first-trimester bleeding during their pregnancies. Among women who had bleeding in their first pregnancies, 6 percent delivered their babies early between 32 and 36 weeks' gestation, compared to about 4 percent of the women who had no bleeding. (Babies born at 37 weeks of pregnancy or later are considered full-term.)

Earlier preterm delivery, at 28 to 31 weeks, was also more common in women with bleeding (0.3 percent vs. 0.9 percent), as was a pregnancy complication called placental abruption (1.0 percent vs. 1.4 percent), in which the placenta separates from the uterus before delivery.

In addition, premature rupture of membranes, in which water breaks before labor begins in a woman who is at least 37 weeks' pregnant, occurred in 6 percent of women with first-trimester bleeding and 5 percent of women with no bleeding.

According to the researchers, women who bled early in their first pregnancy but not in their second pregnancy were still at increased risk in their subsequent pregnancy for preterm delivery and premature membrane rupture; 8.2 percent of these women delivered their babies at 32 to 36 weeks of pregnancy, compared to 2.2 percent of women with no bleeding; risks for earlier preterm delivery were 4.8 percent and 2.7 percent, respectively.

Four percent of women who had experienced first-trimester bleeding in their first pregnancy had premature rupture of membranes in their second pregnancy, compared to 3 percent of women who did not have bleeding.

The researchers conclude, based on their observations, that early pregnancy bleeding, preterm delivery, placental abruption and premature rupture of membranes may be related to one another, and could provide clues to the underlying causes of these complications.

Source: Obstetrics & Gynecology, May 2010.

 

Heavy Alcohol Use Linked to Cancer

 

HealthDay News

Wednesday, April 21, 2010

WEDNESDAY, April 21 (HealthDay News) -- Researchers say they've gained new insight into a link at the cellular level between alcohol consumption, aging and cancer.

The key appears to lie in telomeres, structures at the end of chromosomes that shorten as people get older. Telomeres are also thought to shorten because of excessive drinking.

Researchers thought that people with shorter telomeres due to heavy drinking would face a higher risk of cancer.

"Heavy alcohol users tend to look haggard, and it is commonly thought heavy drinking leads to premature aging and earlier onset of diseases of aging. In particular, heavy alcohol drinking has been associated with cancer at multiple sites," lead researcher Dr. Andrea Baccarelli, head of a research center at the University of Milan, said in a statement.

In the study, researchers analyzed DNA in 59 people who drank heavily (nearly one in four consumed at least four alcoholic drinks a day) and 197 people who drank at various levels.

Researchers found that telomere lengths were much shorter in those who drank a lot of alcohol.

"The decrease we found in telomere length is very sharp, and we were surprised to find such a strong effect at the cellular level," Baccarelli said.

The study was to be presented Wednesday at the American Association for Cancer Research annual meeting, in Washington, D.C.

More information

For details about alcoholism, see the U.S. National Library of Medicine.

Tuesday, April 20, 2010

 

Weather Might Influence Prostate Cancer

 

HealthDay News

Tuesday, April 20, 2010

TUESDAY, April 20 (HealthDay News) -- A new study links dry, cold weather to higher rates of prostate cancer.

While the findings don't confirm a direct link, researchers suspect that weather may affect pollution and, in turn, boost prostate cancer rates.

"We found that colder weather, and low rainfall, were strongly correlated with prostate cancer," researcher Sophie St-Hilaire, of Idaho State University, said in a news release. "Although we can't say exactly why this correlation exists, the trends are consistent with what we would expect given the effects of climate on the deposition, absorption, and degradation of persistent organic pollutants including pesticides."

St-Hilaire and colleagues studied prostate cancer rates in counties in the United States and looked for links to local weather patterns. They found a link, and suggest it may exist because cold weather slows the degradation of pollutants.

Prostate cancer will strike about one in six men, according to background information in the study. Reports suggest it's more common in the northern hemisphere.

"This study provides an additional hypothesis for the north-south distribution of prostate cancer, which builds on the existing supposition that individuals at northern latitudes may be deficient in vitamin D due to low exposure to UV radiation during the winter months," St-Hilaire said. "Our study suggests that in addition to vitamin D deficiency associated with exposure to UV radiation, other meteorological conditions may also significantly affect the incidence of prostate cancer."

The study was published April 20 in the International Journal of Health Geographics.

More information

The U.S. National Library of Medicine has details on prostate cancer.

Processed meat linked to higher ovarian cancer risk

 

By Howard Wolinsky

Reuters Health

Tuesday, April 20, 2010


NEW YORK
(Reuters Health) – Women who eat a lot of processed meats, such as salami and hot dogs, are at a higher risk of ovarian cancer, according to a new Australian study.


At the same time, those who eat a lot of fish have a lower risk of the deadly tumors, Dr. Penny M. Webb of Gynecological Cancers Group at Queensland Institute of Medical Research in Brisbane, Australia, and colleagues found.


In their report in the American Journal of Clinical Nutrition, the team also found no link between red meat and the cancer, and just a slightly lower risk among women who consumed large amounts of poultry.


"This suggests that by following common dietary guidelines to reduce the intake of processed meats and increase the intake of poultry and fish, women may also reduce their risk of ovarian cancer," Webb and colleagues write.


Researchers re-analyzed data from older studies from more than 2,000 women with ovarian cancer and nearly 2,200 without it who were asked about their diets.


They found that women who ate four or more servings per week of processed meat had an 18 percent higher risk of ovarian cancer than those who ate one or fewer servings per week. Also, women consuming four or more fish meals per week had 24 percent less risk of ovarian cancer than those who ate less than one fish meal per week.


The absolute risk difference, however, was quite small: "In Australia, the risk of developing ovarian cancer before the age of 75 for a woman who eats a lot of processed meat is about 1 percent, compared to about 0.8 percent for those who eat little processed meat," Webb told Reuters Health by email.


Most studies of ovarian cancer risks have focused on lifetime exposure to estrogen, according to Marji McCullough, of the American Cancer Society, meaning women who enter puberty early, and go through menopause late, have a higher risk. "Very few dietary risk factors have been identified for this highly fatal cancer," McCullough told Reuters Health by email.


It's unclear why processed meats and fish would have any effect on ovarian cancer. "There are many theories, but no good evidence as yet," Webb said. "Processed meat contains compounds that could damage cells and thereby cause cancer. Conversely, the omega-3 fatty acids found in fatty fish are thought to be good for health in many ways and may possess anti-cancer properties."


McCullough noted that processed meats preserved with nitrites and nitrates can form nitrosamines, known causes of cancer in animals.


So should women cut out cold cuts? "The association we saw with processed meat is not that strong, so I do not think that women should immediately stop eating all processed meat to reduce their risk of ovarian cancer," Webb said.


"However, we know that there are also other health benefits associated with eating white meat and fish so I think that women should aim for a healthy diet that includes less processed meat and higher levels of poultry and fish," she continued. "This will have a number of health benefits and may also lower their risk of ovarian cancer."


McCullough said the findings are consistent with existing American Cancer Society dietary recommendations: limiting red and processed meats in the diet, and consuming a wide variety of vegetables and fruits.


She noted that there already are good reasons to limit consumption of red meat and processed meat to lower risk for colon cancer and heart disease. "It would be wise to limit processed meats to the occasional event, rather than to consume them as part of one's usual diet," McCullough said.


Source:
http://www.ajcn.org/cgi/content/abstract/ajcn.2009.28415v1 American Journal of Clinical Nutrition, printed online April 14, 2010.


Health Tip: Why Are My Gums Bleeding?


HealthDay
News

Tuesday, April 20, 2010

(HealthDay News) -- Bleeding gums may signal gum disease or a more serious medical problem.

The U.S. National Library of Medicine says bleeding gums may be caused by:

  • Brushing or flossing your teeth too vigorously or incorrectly.
  • Gum disease.
  • A blood disorder.
  • Periodontitis or gingivitis.
  • Hormonal changes during pregnancy.
  • Dentures that don't fit properly.
  • An infection of the teeth or gums.
  • Blood-thinning medications.
  • Vitamin deficiency.


Psychotropic Medications Overprescribed to Children, Study Suggests

 

ScienceDaily

Tuesday, April 20, 2010

ScienceDaily (Apr. 20, 2010) — A new study from the Journal of Marital & Family Therapy warns of the dramatic rise in the use of psychotropic medications for children. One in every fifty Americans is now considered permanently disabled by mental illness, and up to eight million children take one or more psychotropic drugs.

The authors, James P. Morris, Ph.D. and George Stone, LCSW, state that there is little evidence available to warrant the widespread use of psychotropic drugs for children, and little long term data regarding its long term impact on development. According to the authors the mental health field is currently designed to treat adults with psychotropic medications, but they are often misused in the case of children and adolescents, "This presents an ethical challenge to marriage and family therapists, who should be very cautious about these medications as an option for children. The long-term research on their safety for children is uncertain."

As an example, the diagnosis of early onset bipolar disorder and attention deficit hyperactivity disorder has climbed drastically in the past decade. Drugs designed to treat the above two disorders show a fair short term risk-benefit ratio, but a poor long-term benefit. Morris and Stone indicate, "If the psychiatric community has been misled by pharmaceutical companies in thinking that these drugs are safe for their children, the parents of these children have been in turn deluded into putting their children in harm's way."

The authors continue that the pharmaceutical industry is largely influenced by the desire for economic profit, and the marketing muscle behind the industry, and leniency of institutions such as the FDA, tout benefits that are not yet properly evaluated for pediatric use. Between 1994 and 2001, psychotropic prescriptions for adolescents rose more than sixty percent; the rise post-1999 was connected to the development and marketing of several new psychotropic drugs and the rebranding of several older ones.

Morris and Stone claim that family health professionals are put in the line of fire when children begin to experience the negative consequences of long-term use of these medications. They are left with the challenge of evaluating the quality of evidence-based care offered to their pediatric clients by the psychiatric community, and the negative effects of the medications without sufficient empirical evidence or information.

Journal Reference:

James Morris, George Stone. Children and Psychotropic Medication: A Cautionary Note. Journal of Marital and Family Therapy, 2009; DOI: 10.1111/j.1752-0606.2009.00178.x


Added sugar increases heart risks: study

 

By Julie Steenhuysen

Reuters

Tuesday, April 20, 2010


CHICAGO (Reuters) – Eating a lot of sugar not only makes you fat. It may also increase a person's risk for heart disease, U.S. researchers said on Tuesday.


They said people who ate more added sugar were more likely to have higher risk factors for heart disease, such as higher triglycerides and lower levels of protective high-density lipoprotein or HDL cholesterol.


"Just like eating a high-fat diet can increase your levels of triglycerides and high cholesterol, eating sugar can also affect those same lipids," Dr. Miriam Vos of Emory School of Medicine, who worked on the study published in the Journal of the American Medical Association, said in a statement.


The study adds to mounting pressure on U.S. food companies to make their foods healthier as newly passed U.S. health reform legislation shifts the nation's focus on ways to prevent, rather than simply treat disease.

A report by the influential Institute of Medicine released on Tuesday recommended that the U.S. Food and Drug Administration start to regulate sodium intake in foods.


And several states, including New York and California, have weighed a tax on sweetened soft drinks to defray the cost of treating obesity-related diseases.


The addition of sweeteners to prepared foods and beverages in recent decades has sharply increased Americans' daily intake of sugar and overall calories, according to Vos and colleagues.

But no major studies have looked at the impact of too much sugar on levels of fat in the blood.

The researchers asked 6,000 adults what they ate and then grouped them by sugar intake and cholesterol levels.


On average, nearly 16 percent of people's daily calories came from added sugar.

The highest-consuming group ate an average of 46 teaspoons of added sugar per day, while the lowest-consuming group ate an average of only about 3 teaspoons daily.


"It would be important for long-term health for people to start looking at how much added sugar they're getting and finding ways to reduce that," Vos said in a statement.


Too much sugar not only contributes to obesity, but also is a key culprit in diabetes, high blood pressure, heart disease and stroke, according to the American Heart Association.


The association warned last August that Americans need to cut back dramatically on sugar consumption, recommending that women eat no more than 100 calories per day of added processed sugar a day, or six teaspoons (25 grams), while men should keep it to just 150 calories of added processed sugar per said or nine teaspoons (37.5 grams).


Kelly Brownell of Yale University told Reuters last month a penny-per-ounce (penny-per-28 grams) tax on soft drinks could cut the consumption of sugar-sweetened drinks by the average American from 50 gallons (189 liters) annually to 38.5 gallons (146 liters).


He expects such a tax could also cut healthcare costs by about $50 billion over 10 years and raise $150 billion in revenue over the same period.


The American Beverage Association says sugar-sweetened drinks do not pose any particular health risk, and are not a unique risk factor for obesity or heart disease.


(Editing by Sandra Maler)


Depression Medication: Patients Report 20 Times More Side Effects Than Recorded in Charts, Study Finds


ScienceDaily

Tuesday, April 20, 2010


ScienceDaily
(Apr. 20, 2010) — A study from Rhode Island Hospital shows that patients report side effects from medication for the treatment of depression 20 times more than psychiatrists have recorded in the charts. The researchers recommend the use of a self-administered patient questionnaire in clinical practice to improve the recognition of side effects for patients in treatment. The study is published in the Journal of Clinical Psychiatry, Volume 71, No. 4, now available online ahead of print.


One of the most frequent reasons for the discontinuation of medication to treat depression is the side effects that patients may experience. The premature discontinuation of medication is also associated with poorer treatment outcomes. In his recent study, lead researcher Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital, notes that despite the clinical importance of detecting side effects, few studies have examined the adequacy of the detection and documentation methods currently in use among clinicians.

 

Zimmerman and his colleagues asked 300 patients in ongoing treatment for depression to complete a self-administered version of the Toronto Side Effects Scale (TSES). The patients rated the frequency of the 31 side effects and the degree of trouble they experienced. Those patients' charts were then examined to extract side effects information recorded by the treating psychiatrist.

 

The findings indicate that the mean number of side effects reported by the patients on the TSES was 20 times higher than the number recorded by the psychiatrist. When the self-reported side effects were limited to "frequently occurring" or "very bothersome" the rate was still found to be two to three times higher than recorded in their charts.

 

Zimmerman, who is also an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, says, "Despite the importance that side effects have on premature medication discontinuation, there is some evidence that clinicians may not do a thorough job of eliciting information regarding their presence. This study finds that clinicians do not record in their progress notes most side effects reported on a side effects questionnaire.."

 

While there may be several explanations for this, Zimmerman says, "Our research found that the only specific side effect that was regularly inquired about by clinicians was on sexual dysfunction, presumably because of concerns that some patients may be too embarrassed to spontaneously report that without prompting." The researchers also suggest that patients stop reporting to psychiatrists the side effects that they have grown accustomed to, but patients reported these side effects in the self-report scale because there were specific questions about them.

 

The researchers also question whether side effect frequencies reported in industry-sponsored studies may underestimate the prevalence of side effects from medication. As a result, clinicians may not be accurately informing patients of the potential likelihood of such side effects, and that lack of adequate preparation may result in patients prematurely discontinuing their medication.

 

Zimmerman says, "As a result of this study, we believe that ongoing dialogue about side effects during treatment will help to reduce premature medication discontinuation and would help reduce depression relapse rates. Incorporating a self-report questionnaire like the TSES may be helpful to adopt into clinical practice for the treatment of depression."

 

Other researchers involved in the study along with Zimmerman include Janine Galione, BS, Naureen Attiullah, MD, Michael Friedman, MD, Cristina Toba, MD, and Moataz Rahgeb, MD, all of Rhode Island Hospital the Alpert Medical School.

Journal Reference:

Mark Zimmerman et al. Underrecognition of Clinically Significant Side Effects in Depressed Outpatients. Journal of Clinical Psychiatry, 2010;71(4):484%u2013490 DOI: 10.4088/JCP.08m04978blu


Olive Oil May Be Key to Mediterranean Diet's Benefits


HealthDay
News

Tuesday, April 20, 2010

TUESDAY, April 20 (HealthDay News) -- The heart-healthy effects of the famous "Mediterranean diet" may have something to do with components of virgin olive oil that repress genes that promote inflammation, a new study reports.

"These findings strengthen the relationship between inflammation, obesity and diet and provide evidence at the most basic level of healthy effects derived from virgin olive oil consumption in humans," study leader Francisco Perez-Jimenez of the University of Cordoba, Spain, said in a news release from BioMed Central, publisher of BMC Genomics. The study was published online April 19 in the journal.

Perez-Jimenez and his colleagues studied how a diet rich in so-called phenol compounds -- which are found in olive oil, especially extra-virgin types -- affected the workings of genes in 20 people with a common condition called metabolic syndrome. Metabolic syndrome puts people at risk for heart disease and type 2 diabetes.

More information

The American Heart Association has more on the Mediterranean diet.

Children's Cognitive Ability Can Be Affected by Mother's Exposure to Urban Air Pollutants

ScienceDaily

Tuesday, April 20, 2010

ScienceDaily (Apr. 20, 2010) — A study by the Columbia Center for Children's Environmental Health (CCCEH) carried out in Krakow, Poland has found that prenatal exposure to pollutants can adversely affect children's cognitive development at age 5, confirming previous findings in a New York City (NYC) study.

Researchers report that children exposed to high levels of polycyclic aromatic hydrocarbons (PAHs) in Krakow had a significant reduction in scores on a standardized test of reasoning ability and intelligence at age 5. The study findings are published online in Environmental Health Perspectives.

 

PAHs are released into the air from the burning of fossil fuels for transportation, heating, energy production, and from other combustion sources.

 

"The effect on intelligence was comparable to that seen in NYC children exposed prenatally to the same air pollutants," noted Frederica Perera, professor of Environmental Health Sciences and director of the CCCEH at the Mailman School of Public Health, and senior author. "This finding is of concern because IQ is an important predictor of future academic performance, and PAHs are widespread in urban environments and throughout the world."

 

"These results contribute to the cumulative body of published evidence linking ambient air pollution levels and adverse health effects in children and are clearly relevant to public health policy," says Susan Edwards, study lead author.

 

The study included a cohort of 214 children who were born to healthy, non-smoking Caucasian women in Krakow, Poland between 2001 and 2006. During pregnancy, the mothers completed a questionnaire, wore small backpack personal air monitors to estimate their babies' PAH exposure, and provided a blood sample and/or a cord blood sample at the time of delivery. The children were followed through the age of 5 when they were tested using the Raven Coloured Progressive Matrices (RCPM) Test of reasoning ability and intelligence. The researchers accounted for other factors such as second-hand smoke exposure, lead and mother's education. Study participants exposed to air pollution levels below the median (17.96 nanograms per cubic meter) were designated as having "low exposure," while those exposed to pollution levels above the median were identified as "high exposure."

 

The present finding confirms the CCCEH's previous report in 2009 that prenatal exposure to PAHs adversely affected children's IQ at age 5 in a cohort of children of nonsmoking African American and Dominican American women in NYC (Perera et al, 2009).

 

"Air pollution knows no boundaries," said Linda Birnbaum, director of the National Institute of Environmental Health Sciences, which funded the study. "Researchers around the globe are finding that air pollution is harmful to children's development."

 

The authors also included researchers from Columbia University's Mailman School of Public Health, Jagiellonian University and The Southwest Research Institute: Zhigang Li, Shuang Wang, Virginia Rauh, Wieslaw Jedrychowski, Maria Butscher, Agnieszka Keiltyka, Elzbieta Mroz, Elzbieta Flak and David Camann. The research was funded by NIEHS and several private foundations.

Journal Reference:

Edwards SC, Jedrychowski W, Butscher M, Camann D, Kieltyka A, Mroz E, et al. Prenatal Exposure to Airborne Polycyclic Aromatic Hydrocarbons and Children's Intelligence at Age 5 in a Prospective Cohort Study in Poland. Environ Health Perspect, April 20, 2010 DOI: 10.1289/ehp.0901070


Should you use aspirin for a migraine?

 

By Amy Norton

Reuters Health

Tuesday, April 20, 2010


NEW YORK
(Reuters Health) – A single dose of aspirin can bring at least temporary pain relief to about half of people with migraines, a new research review suggests.


Research shows that about half of people with migraines opt to use over-the-counter pain relievers only, with aspirin being a common choice. But it has not been clear exactly how well aspirin performs, or where it fits into the migraine treatment arsenal.


In the new review, UK researchers analyzed 13 clinical trials in which patients were randomly assigned to treat their migraine attacks with either a single dose of 900 to 1,000 milligrams (mg) of aspirin or a comparison treatment -- either a placebo or an active drug, usually the prescription migraine drug sumatriptan.


Overall, the review found, 52 percent of aspirin users got at least some pain relief within two hours -- meaning their pain was reduced from moderate to severe to "no worse than mild." That compared with 32 percent of those using a placebo.


Similarly, one-quarter of aspirin users were pain-free within two hours, versus 11 percent of placebo users.

Aspirin also appeared to reduce some of the other symptoms that can come with migraine attacks, including nausea and sensitivity to light and sound. But a combination of aspirin and the anti-nausea medication metoclopramide - marketed as Reglan - worked even better, the researchers report in the Cochrane Database of Systematic Reviews.


Across two studies, for instance, 46 percent of patients who used aspirin plus 10 mg of metoclopramide got relief from vomiting within two hours, compared with none of those given a placebo.


Still, aspirin -- with or without metoclopramide -- is no magic bullet, said Dr. R. Andrew Moore, one of the researchers on the review.


"For about half of people with migraine, aspirin will help at a level of pain relief that is useful. For half it will not," Moore, of John Radcliffe Hospital in Oxford, told Reuters Health by email.


"No medicine for migraine works in everyone," he added, "and for the individual the key is finding that medicine -- and formulation -- that works for them."


The review also found that the short-term relief from aspirin often did not last. Three studies looked at 24-hour pain relief among patients who partially improved within two hours; 39 percent had sustained pain relief for a full day, compared with 24 percent of placebo users. No study assessed 24-hour relief among people who were pain-free within two hours of taking aspirin.


In addition, while aspirin plus metoclopramide was similarly effective against symptoms as a 50-mg dose of sumatriptan, the prescription drug seemed to work better against pain when taken at a 100-mg dose. Across two studies, 28 percent of sumatriptan users were pain-free at two hours, versus 18 percent of those using aspirin and metoclopramide.


According to Moore, "it's useful to know" that an over-the-counter pain reliever works for some people's migraines. And that's especially true, he noted, for people in developing parts of the world, since aspirin is cheap and readily available.


"But," he added, "no one suffering frequent headaches should just self-medicate -- it's always better to see your primary care physician for a chat."


People should also be aware that aspirin, like any medication, carries a risk of side effects. Used regularly, Moore noted, the drug may lead to problems like ulcers and gastrointestinal bleeding, and older adults -- who are at increased risk of such problems -- should be particularly cautious about frequently using aspirin for pain relief.


Moore
said that parents should also avoid using aspirin for children's migraines. Aspirin, when used by children and teenagers with chickenpox or flu-like symptoms, is associated with Reye's syndrome -- a rare but serious condition marked by brain inflammation. It's generally recommended that parents talk with their doctor before giving aspirin to a child younger than 12.


Source: http://www2.cochrane.org/reviews/en/ab008041.html
Cochrane Database of Systematic Reviews, online April 14, 2010.


Meat Lovers Face Greater Risk of Bladder Cancer

 

HealthDay News

Tuesday, April 20, 2010

TUESDAY, April 20 (HealthDay News) -- Eating meat frequently, especially when it's well-done or cooked at high temperatures, can boost the risk of bladder cancer, a new study suggests.

"It's well-known that meat cooked at high temperatures generates heterocyclic amines that can cause cancer," study presenter Jie Lin, an assistant professor in the University of Texas M. D. Anderson Cancer Center's department of epidemiology, said in a news release from the cancer center. "We wanted to find out if meat consumption increases the risk of developing bladder cancer and how genetic differences may play a part."

This study tracked 884 patients with bladder cancer and 878 who didn't have it. They responded to questionnaires about their diets.

Those who ate the most red meat were almost 1.5 times more likely to develop bladder cancer than those who ate the least. The study linked steak, pork chops and bacon to the highest risk. But even chicken and fish -- when fried -- upped the risk of cancer, the study found.

"This research reinforces the relationship between diet and cancer," study author Dr. Xifeng Wu, a professor in the department of epidemiology, said in the news release. "These results strongly support what we suspected: people who eat a lot of red meat, particularly well-done red meat, such as fried or barbecued, seem to have a higher likelihood of bladder cancer."

Certain people seemed to be at even higher risk because of their genetic makeup, Wu said.

The findings were presented Monday at the American Association for Cancer Research annual meeting, in Washington, D.C.

More information

For more about bladder cancer, see the U.S. National Library of Medicine.

Monday, April 19, 2010

 

Potential Benefit of Dark Chocolate for Liver Disease Patients

 

ScienceDaily

Monday, April 19, 2010

 

ScienceDaily (Apr. 19, 2010) — Doctors could soon be prescribing a dose of dark chocolate to help patients suffering from liver cirrhosis and from dangerously high blood pressure in their abdomen, according to new research presented April 15 at the International Liver CongressTM 2010, the Annual Meeting of the European Association for the Study of Liver in Vienna, Austria.

 

According to the Spanish research, eating dark chocolate reduces damage to the blood vessels of cirrhotic patients and also lowers blood pressure in the liver. Dark chocolate contains potent anti-oxidants which reduce the post-prandial (after-meal) blood pressure in the liver (or portal hypertension) associated with damaged liver blood vessels (endothelial dysfunction). The data also showed that eating dark chocolate may exert additional beneficial effects throughout the whole body. In comparison, white chocolate, which contains no beneficial 'phytochemicals', did not result in the same effects.

 

Professor Mark Thursz, MD FRCP, Vice Secretary of EASL and Professor of Hepatology, at Imperial College London said: "As well as advanced technologies and high science, it is important to explore the potential of alternative sources which can contribute to the overall wellbeing of a patient. This study shows a clear association between eating dark chocolate and portal hypertension and demonstrates the potential importance of improvements in the management of cirrhotic patients, to minimise the onset and impact of end stage liver disease and its associated mortality risks."

 

Cirrhosis is scarring of the liver as a result of long-term, continuous damage to the liver . In cirrhosis, circulation in the liver is damaged by oxidative stress and reduced antioxidant systems. After eating, blood pressure in the abdominal veins usually increases due to increased blood flow to the liver.

 

This is particularly dangerous and damaging to cirrhotic patients as they already have increased blood pressure in the liver (portal hypertension) and elsewhere which, if severe, can cause blood vessel rupture. Thus, eating dark chocolate may ultimately prevent this potential threat to cirrhotic patients.

 

In this study 21 cirrhotic patients with end stage liver disease (child score 6.9±1.8;MELD 11±4; hepatic venous pressure gradient (HPVG*)16.6±3.8mmHg) were randomised to receive a standard liquid meal. Ten patients received the liquid meal containing dark chocolate (containing 85% cocoa, 0.55g of dark chocolate/Kg of body weight) while 11 patients received the liquid meal containing white chocolate which is devoid of cocoa flavonoids (anti-oxidant properties) according to body weight. HVPG, arterial pressure and portal blood flow (PBF)** were measured at baseline and 30 minutes after meal administration, using a US-Doppler.

 

Both meals caused a highly significant but similar increase in portal blood flow with a +24% increase in dark chocolate compared to +34% in those patients who received white chocolate. Interestingly, post-prandial hyperaemia*** was accompanied by an increase in HVPG resulting in a statistically significant increase (17.3±3.6mmHg to 19.1±2.6mmHg, p=0.07) for those patients eating dark chocolate and those receiving white chocolate (16.0±4.7mmHg to 19.7±4.1mmHg, p=0.003). Post-prandial increase in HVPG was markedly reduced in patients receiving dark chocolate (+10.3±16.3% Vs +26.3±12.7%, p=0.02).

 

*HVPG is blood pressure in the liver

 

**PBF refers to blood flow in the liver

 

***Hyperaemia refers to increase blood flow to tissues

Journal Reference:

De Gottardi et al. Dark Chocolate attenuates the post -prandial increase in HVPG in patients with cirrhosis and portal hypertension.. Journal of Hepatology, 2010; 52S9 DOI: 10.1016/S0168-8278(10)60021-9


Breast Cancer Risk Tied to Grandmother's Diet

 

ScienceDaily

Monday, April 19, 2010

ScienceDaily (Apr. 19, 2010) — Eating too much fat in pregnancy may be an indulgence that has a less-than-beneficial effect on generations to come, say researchers at Georgetown Lombardi Comprehensive Cancer Center. Their unique study in rats shows that pregnant females that ate a high fat diet not only increased breast cancer risk in their female daughters but also in that daughter's offspring -- the "granddaughters."

Details of the study were presented at the AACR 101st  Annual Meeting 2010.

 

The researchers say they don't know why this risk is passed on through two generations, but they believe it occurs through as-yet unknown "epigenetic" changes that result in an increase in terminal end buds in the breast tissue -- an increase that apparently can then be passed on through generations. These buds are believed to be the structures where breast cancer can develop, and having more of these structures seems to increase breast cancer risk, says the study's lead investigator, Sonia de Assis, Ph.D., a postdoctoral fellow in Leena Hilakivi-Clarke's laboratory at Lombardi. "That is our theory, but we really don't know how it is happening -- just yet."

 

The researchers add that while the grandmother ate a diet that was 43 percent fat, she didn't eat more calories than a control population of rats, and both her daughters and granddaughters ate a normal chow.

 

The researchers also found that the risk appears to not only extend from mother to daughter and granddaughter, but also from mother to son to granddaughter. For example, the daughters of male and female rats born from mother rats that ate a lot of fat had an 80 percent chance of developing breast cancer, but the risk was about 69 percent if the granddaughter's mother or father was born from a rat that ate normally and the other parent came from a high-fat-consuming parent. By contrast, granddaughters of grandmother rats who ate a normal chow had a 50 percent chance of developing breast cancer.

 

They also studied a different control populations of rats given estradiol- a form of estrogen -- and saw no increase in breast cancer risk in granddaughters. That suggests that the increased estrogen production related to eating more fat is not the source of the problem, they say.

 

"The implications from this study are that pregnant mothers need to eat a well balanced diet because they may be affecting the future health of their daughters and granddaughters," says de Assis.

Email or share this story:

 

Blood Test Identifies People at Risk for Heart Attack That Other Tests Miss

 

ScienceDaily

Monday, April 19, 2010

ScienceDaily (Apr. 19, 2010) — A simple blood test can identify people who are at risk for a heart attack, including thousands who don't have high cholesterol, according to researchers at Oregon Health & Science University.

The new test measures gamma-prime fibrinogen, a component of the blood's clotting mechanism. Elevated levels indicate greater likelihood of a heart attack, even when other signs don't point to cardiovascular trouble, says David H. Farrell, Ph.D., professor of pathology in the OHSU School of Medicine and a member of OHSU's Heart Research Center. The results were recently published in Clinical Chemistry.

"Half a million people suffer fatal heart attacks each year," Farrell says. "About 250,000 of the patients who die have normal cholesterol and some of the patients with normal cholesterol also have elevated levels of gamma-prime fibrinogen. We think this is another risk factor that we should test for."

Farrell and his team confirmed the effectiveness of the gamma-prime fibrinogen test by analyzing 3,400 blood samples from the landmark Framingham Heart Study, the oldest and most prestigious cardiovascular disease study in the world. In addition, OHSU's analysis of the Framingham samples found that patients with well-established heart attack risk factors, including cholesterol, high body mass index, smoking and diabetes also have elevated gamma-prime fibrinogen levels.

"We found that if your gamma-prime fibrinogen levels were in the top 25 percent, you had seven times greater odds of having coronary artery disease," Farrell says.

A small pilot study in 2002 gave OHSU researchers their first inkling that gamma-prime fibrinogen might be linked to heart disease. They obtained the Framingham samples -- which are rarely shared -- and proved the link. The next step is using the test at several hospitals and medical centers to demonstrate it works on a large scale.

"It will take some time to build consensus within the field of cardiology for this test," Farrell says. "The gamma-prime fibrinogen test would be used in conjunction with a cholesterol test to better predict who is likely to suffer a heart attack. Ultimately we are optimistic we can identify people who are at risk who didn't know they are at risk."

OHSU has filed a provisional patent application for a gamma-prime fibrinogen test. Farrell and his colleagues also have formed a company called Gamma Therapeutics, Inc. to mass-produce the assay. OHSU has a process in place to review and manage the individual and institutional conflicts of interest that may arise through its start-up companies.

The gamma-prime fibrinogen research was sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health.

Journal Reference:

R.S. Lovely, S.C. Kazmierczak, J.M. Massaro, R.B. D'Agostino Sr., C.J. O'Donnell, and D.H. Farrell. γ′ Fibrinogen: Evaluation of a New Assay for Study of Associations with Cardiovascular Disease. Clin Chem, 56: 781

New Test May Predict Prostate Cancer's Aggressiveness

By Ed Edelson
HealthDay Reporter

HealthDay Reporter

Monday, April 19, 2010

MONDAY, April 19 (HealthDay News) -- An updated version of the standard prostate cancer test can help improve predictions about which men might not require immediate treatment, researchers report.

The basic test measures blood levels of prostate-specific androgen (PSA), a protein produced by prostate gland cells. But the standard PSA test cannot distinguish between cancers that grow so slowly they can safely be left alone and aggressive life-threatening tumors that call for surgery or radiation therapy.

The new test measures blood levels of three different types of PSA. Combined with annual biopsies, or tissue samples, it was about 70 percent accurate in singling out the aggressive tumors in a small study, John Hopkins University researchers were to report Sunday at the American Association for Cancer Research annual meeting, in Washington, D.C.

"What we have shown is that using the Prostate Health Index and tissue DNA measurement is informative in separating out patients whose cancers are likely to progress vs. those that are not likely to progress," said study leader Robert W. Veltri, an associate professor of urology and oncology at Hopkins.

Prostate Health Index is the name given to the test by Beckman Coulter Inc., which plans to market it.

The study included 71 men originally diagnosed as having small, low-grade and low-stage prostate cancer, the kind whose ultimate aggressiveness is often in doubt.

Currently, identifying the dangerous tumors in that group is no better than "a coin-flip," Veltri said, and, as a result, many men and their doctors choose treatment that might be unnecessary and can cause impotence and other major problems.

Men in the trial had periodic blood tests that measured three different forms of PSA, including pro-PSA, a molecule in which two of the amino acids that make up the protein have been clipped off. It is the pro-PSA level that is most valuable as a predictor, Veltri said, but it is only one part of the study.

The new PSA test is given twice a year, along with a digital rectal exam to determine the size of the tumor, and a yearly biopsy. The regimen found unfavorable indications for 39 of the cancers -- meaning progression of cancer grade or tumor size -- and favorable for the 32 others, Veltri said. "When you combine the DNA reading and the serum Prostate Health Index, it is accurate in about 7 out of 10 cases," he said.

But it was a small study, and "it will take another year or two to get enough cases to nail down the predictive index," Veltri said.

The Hopkins group is trying to identify other biomarkers that would improve the program's predictive value, he said. One hope is that the now-annual biopsies could be done every other year, Veltri said.

The study results have caused "excitement," he said. "Through active surveillance, we can identify a set of prostate cancer patients with low-grade tumors that may be able to have intervention deferred or delayed," Veltri said.

The Hopkins work was described as "outstanding" by Dr. William J. Catalona, director of the prostate cancer program at Northwestern Memorial Hospital's Robert H. Lurie Comprehensive Cancer Center, who pioneered the use of the standard PSA test and helped develop the new version of the test.

The test is awaiting approval by the U.S. Food and Drug Administration and already is approved for use in Europe, Catalona said. In a study of 2,000 men in the Chicago area, "we found it to be more accurate than the tests now available, and it also seems to identify the more aggressive prostate cancers," he said.

Another report at the same meeting described use of a microchip to detect tumor cells in the blood of people with prostate cancer. The presence of circulating cells can indicate spread of the cancer to other parts of the body, but they are so rare that they are invisible to current technology.

The new circulating tumor cell (CTC) chip identified such cells in nearly half of 20 people with early-stage prostate cancer and in two-thirds of people with advanced cancer, providing important prognostic information, researchers at Massachusetts General Hospital reported.

More information

Learn about diagnosis and treatment of prostate cancer from the U.S. National Cancer Institute.

Statins May Slow Progression of Multiple Sclerosis, New Study Suggests

 

ScienceDaily

Monday, April 19, 2010

 

ScienceDaily (Apr. 19, 2010) — A UCSF-led study examining the impact of statins on the progression of multiple sclerosis found a lower incidence of new brain lesions in patients taking the cholesterol-lowering drug in the early stages of the disease as compared to a placebo.

 

Study participants received an 80 milligram daily dose of atorvastatin, marketed by Pfizer Inc. as Lipitor.

Although the study was small with only 81 participants and its primary endpoint, designed to evaluate MS progression in patients following their first attack, was not met, the researchers found over the 12-month course that 55.3 percent of participants did not develop new brain lesions when administered statins compared with 27.6 percent of the placebo group.

 

Study findings were presented April 14, 2010 by University of California, San Francisco researchers during the annual American Academy of Neurology scientific meeting in Toronto.

 

The trial was a phase II, multi-center, randomized, placebo-controlled follow up to a landmark study published by principal investigator Scott S. Zamvil, MD, PhD, associate professor of neurology at UCSF (Youssef, et al., Nature 2002), after his laboratory first observed that statins cause T cell immune modulation that could be beneficial in multiple sclerosis and other autoimmune diseases.

 

Co-led by Zamvil and Emmanuelle Waubant, MD, PhD, associate professor of neurology at the UCSF MS Center, the study tested whether the drug could be used to prevent conversion to definite multiple sclerosis in individuals who have had a first attack.

 

"Our data is preliminary, and we need a larger study to confirm the effects of the drug and its magnitude. It is important that we understand how statins impact the progression of multiple sclerosis in order to better inform physicians and patients of their effect since these drugs are so broadly used throughout the United States and the world, and to learn whether a relatively inexpensive oral therapy can slow the course of disease," said Waubant.

 

MS is considered an autoimmune disease where immune cells attack the central nervous system. Nerves are made up of axons (nerve fibers) surrounded by a myelin sheath. MS occurs when the immune system attacks myelin, leaving scars or lesions in the demyelinated areas of the brain and spinal cord. Damage to myelin disrupts the ability of nerves to transmit information to nerve cells, resulting in neurological disability.

 

The team employed MRI to look at the activity of the medication on the disease course. More than 150 patients were originally intended, but enrollment was stopped due to slow recruitment after 81 patients were randomized. Each subject was asked to come in every three months (five scans over 12 months) for serial brain MRI evaluation. The subject pool was 76.5 percent female, 92.6 percent white, and ranged in age from 24 -- 48 years.

 

Central MRI reading and coordinating was provided by Daniel Pelletier, MD, study author, associate professor of neurology and a member of the Multiple Sclerosis Research Group at UCSF.

 

"The exciting finding in this study is that reducing new brain MRI lesions should be meaningful for patients since new lesions are reliable correlates of future clinical attacks in MS," said Pelletier.

 

In addition to UCSF, the multi-center trial involved Oregon Health & Science University, The Cleveland Clinic, Virginia Mason MS Center, Washington University School of Medicine John L. Trotter MS Center, Montreal Neurological Institute, Barrow Neurological Institute, University of Texas Southwestern Medical Center, University of Rochester, The Multiple Sclerosis Comprehensive Care Center at USC Keck School of Medicine, Yale MS Research Center, Jacobs Neurological Institute, Johns Hopkins University, and Mount Sinai School of Medicine.

 

The research was performed as a project of the Immune Tolerance Network, a clinical research consortium headquartered at UCSF and sponsored by the National Institute of Allergy & Infectious Diseases. Atorvastatin, placebo and additional support were provided by Pfizer. Biogen-Idec provided Avonex, an immune system regulator drug (interferon beta-1a) for study participants who displayed disease activity while on placebo or atorvastatin. Additional funding was provided by the Nancy Davis Foundation and the Maisin Foundation.

 

New Risk Factors for Colon Cancer Studied

 

HealthDay News

Monday, April 19, 2010

MONDAY, April 19 (HealthDay News) -- Researchers report that high levels of a protein measured through blood tests could be a sign that patients are at higher risk of colon cancer.

And another new study finds that in blacks, a common germ boosts the risk of colorectal polyps -- abnormal tissue growths in the colon that often become cancerous.

Both studies are slated to be presented Monday at the American Association for Cancer Research (AACR) annual meeting in Washington, D.C.

One study links high levels of circulating C-reactive protein to a higher risk of colon cancer. Protein levels rise when there's low-grade inflammation in the body.

"Elevated CRP levels may be considered as a risk marker, but not necessarily a cause, for the carcinogenic process of colon cancer," Dr. Gong Yang, research associate professor at Vanderbilt University, said in an AACR news release.

Yang and colleagues studied 338 cases of colorectal cancer among participants in the Shanghai Women's Health Study and compared them to 451 women without the disease.

Women whose protein levels were in the highest quarter had a 2.5-fold higher risk of colon cancer compared to those in the lowest quarter.

In the other study, researchers linked the bacterium Helicobacter pylori to a higher risk of colorectal polyps in blacks. That could make it more likely that they'll develop colon cancer.

"Not everyone gets sick from H. pylori infection, and there is a legitimate concern about overusing antibiotics to treat it," said Dr. Duane T. Smoot, chief of the gastrointestinal division at Howard University, in a statement. "However, the majority of the time these polyps will become cancerous if not removed, so we need to screen for the bacteria and treat it as a possible cancer prevention strategy."

The study authors, who examined the medical records of 1,262 black patients, found that the polyps were 50 percent more prevalent in those who were infected with H. pylori.

More information

Visit the U.S. National Cancer Institute for more on colon and rectal cancer.

 

Lack of Omega-3 Fatty Acid Linked to Male Infertility, Study Suggests

 

ScienceDaily

Monday, April 19, 2010

 

ScienceDaily (Apr. 19, 2010) — According to a University of Illinois study, omega-3 fatty acids may be good for more than heart health. A little-known omega-3 may have implications for treating male infertility.

 

"In our experiment, we used 'knockout' mice that lacked the gene responsible for an enzyme important in making docosahexaenoic acid (DHA). In the absence of DHA, male mice are basically infertile, producing few if any misshaped sperm that can't get where they need to go," said Manabu Nakamura, a U of I associate professor of food science and human nutrition.

 

"We looked at sperm count, shape, and motility and tested the breeding success rate, and the mice lacking DHA simply were not able to breed," said Manuel Roqueta-Rivera, a U of I doctoral student who also worked on the study.

 

In the DHA-deficient knockout mice, sperm counts were extremely low. The sperm that were produced were round instead of elongated and they were unable to move well, he said.

 

But, when DHA was introduced into the diet, fertility was completely restored. "It was very striking. When we fed the mice DHA, all these abnormalities were prevented," he said.

 

This is the first time that the importance of DHA to male fertility has been shown this directly, although some studies have suggested that male fertility patients with low sperm counts and less motile sperm tend to have low levels of this fatty acid.

 

The DHA study is part of the Nakamura team's efforts to understand the function of the omega-3 and -6 fatty acids. As part of that work, they have developed a mouse model to help them understand a particular fat's physiological role. By knocking out genes, they can create deficiencies of the fats they are interested in and learn about their functions.

 

"Knocking out the gene for the delta-6-desaturase enzyme has led to some surprising discoveries, including this one about the importance of DHA in sperm formation and mobility," he said.

 

Nakamura said our body must make DHA from dietary alpha-linolenic acids, the parent compound of the omega-3 fatty acid family. Vegetable oils, including soybean and canola oil, are good sources of alpha-linolenic acid.

 

Nakamura's team plans to continue focusing on this omega-3's effects on fertility. But he cautioned that there are still things they don't understand.

 

"We get hints from looking at sperm in the DHA-deficient animals about what type of pathology we may be looking at and why these polyunsaturated fatty acids are important. But we're still at the starting point in understanding the mechanisms that are involved, and we need to do more research at the cellular level," he said.

 

Funding was provided in part by a CONACyT Mexico fellowship award, grants from the National Institutes of Health, the Foundation Fighting Blindness, and Research to Prevent Blindness.

Journal Reference:

Roqueta-Rivera et al. Docosahexaenoic acid supplementation fully restores fertility and spermatogenesis in male delta-6 desaturase-null mice. The Journal of Lipid Research, 2010; 51 (2): 360 DOI: 10.1194/jlr.M001180


Statins
Won't Lower Colon Cancer Risk

 

By Jenifer Goodwin
HealthDay Reporter

HealthDay News

Monday, April 19, 2010


MONDAY, April 19 (HealthDay News) -- Statins don't lower the risk of colorectal cancer, and may even increase the chances of developing precancerous polyps, new research suggests.

Statins are widely prescribed cholesterol-lowering drugs sold in a variety of generic forms and brand names, including Lipitor, Crestor and Zocor.

Yet, researchers stressed that the results are "not conclusive," and that people taking statins to lower cholesterol and reduce their risk of heart attack should continue taking the drugs.

"We found patients in this study taking statins for more than three years tended to develop more premalignant colon lesions," said study author Dr. Monica Bertagnolli, chief of the division of surgical oncology at Brigham and Women's Hospital and a professor of surgery at Harvard Medical School. "This is an interesting finding that needs to be followed up, but it should not raise alarm. No one should stop taking their statins."

The study is to be presented Monday at the American Association for Cancer Research annual meeting in Washington, D.C., and it is also published online in the journal Cancer Prevention Research.

The data used in the analysis was from an earlier clinical trial to determine if the cox-2 painkiller celecoxib (Celebrex) could be used to prevent colon cancer. That trial included 2,035 people who were at high risk of colon cancer and had already been diagnosed with precancerous polyps, or adenomas.

That study, published in 2006, found the celecoxib reduced the occurrence of adenomas, but it also more than doubled the risk of heart attack and other serious cardiac events.

As a result, celecoxib is not used to prevent colon cancer, though it is still prescribed for its original use, to treat arthritis.

About 36 percent of the people in the trial also happened to be taking statins, enabling researchers to go back and see if statin use had any effect on developing adenomas.

The researchers found that patients who had been in the placebo group and who used statins at any time were no less likely to develop adenomas over a five-year period compared with those patients who never used statins.

For those who took statins for three years or longer, the chances of developing the adenomas were nearly 40 percent higher than those not on statins. Those taking celecoxib and statins did not have an increased chance of developing adenomas, probably because the anti-tumor effects of celecoxib canceled out any tumor-promoting effect of the statins, according to the study.

While statins aren't helpful in preventing colorectal cancer, experts from the American Cancer Society also urged people to continue taking statins for cardiovascular health.

"The suggestion of higher risk of colorectal polyp recurrence among a subgroup of statin users in this study may be due to chance and should not raise concerns," said Eric Jacobs, the American Cancer Society's strategic director of pharmacoepidemiology. "A similar previous study of polyp recurrence did not find higher risk among statin users. Statins are valuable drugs, proven to reduce risk of heart disease. Results of this study should not influence decisions about statin use."

For now, the best way to prevent colon cancer is to make sure you get a colonoscopy screening at age 50, or earlier for those with a family history, Bertagnolli said.

More information

The American Cancer Society has more on colorectal cancer.

 

Eating Disorder Cutoffs Miss Some of Sickest Patients, Study Finds

 

ScienceDaily

Monday, April 19, 2010

 

ScienceDaily (Apr. 19, 2010) — Diagnostic cutoffs for anorexia nervosa and bulimia nervosa may be too strict, a study from the Stanford University School of Medicine and Lucile Packard Children's Hospital has found. Many patients who do not meet full criteria for these diseases are nevertheless quite ill, and the diagnosis they now receive, "Eating Disorder Not Otherwise Specified," may delay their ability to get treatment.

 

"There's mounting evidence that we should reconsider the EDNOS categorization for young people," said Rebecka Peebles, MD, the study's primary author.

 

The EDNOS diagnosis has become a "mosh pit," lumping dissimilar patients into a single category that gets poor recognition from clinicians and health insurers, she said. "It is a bit misleading to patients -- it can make them feel like they don't have a real eating disorder," said Peebles, an instructor in pediatrics at Stanford and an adolescent medicine specialist with the Comprehensive Eating Disorders Program at Packard Children's Hospital.

 

Anorexia and bulimia affect about 1 percent and between 2 and 5 percent of teen girls, respectively, and both diseases are more common among females than males. Their diagnostic criteria were developed by expert consensus, without the benefit of studies to track patients' health. An anorexia diagnosis is now based on being at less than 85 percent of the expected body weight, loss of menstrual periods for at least three months and fear of weight gain despite being dangerously thin. Bulimia patients repeatedly binge on large quantities of food, then "purge" calories by vomiting, abusing laxatives or diuretics, or overexercising. Both diseases can cause serious long-term health problems, and severe cases may lead to death.

 

Peebles' team conducted the first-ever large study to ask whether adolescents with EDNOS are less ill than those who meet the full diagnostic criteria for anorexia or bulimia. The research, which will be published online April 12 in Pediatrics, examined records from all 1,310 female patients treated for eating disorders at Packard Children's between January 1997 and April 2008. They verified patients' diagnoses of anorexia, bulimia or EDNOS, and created categories of "partial anorexia nervosa" and "partial bulimia nervosa" to analyze patients who barely missed cutoffs for these diseases.

 

"Our purpose was to ask if the diagnostic criteria now in use are really separating out the sickest of the sick," Peebles said. Patients' conditions were assessed by noting signs of malnutrition -- such as low heart rate, low blood pressure, low body temperature, low blood levels of potassium and phosphorus -- and long QT interval (an electrocardiogram measurement linked to risk of sudden cardiac death).

 

Nearly two-thirds of the patients studied had EDNOS. As the researchers suspected, the EDNOS category acted as a catchall; patients with partial anorexia were more similar to those with full-blown anorexia than to other EDNOS patients with partial bulimia, for instance. In addition, 60 percent of EDNOS patients met medical criteria for hospitalization and this group was, on average, sicker than patients diagnosed with full-blown bulimia.

 

The sickest EDNOS patients were those who had dropped more than 25 percent of their body weight before diagnosis. These patients had been overweight and had lost weight too quickly and dangerously in order to end up at what is typically considered a normal weight.

 

"People were initially just patting them on the back for their weight loss," Peebles said. "It often took months or years for others to realize that what they were doing didn't seem healthy." Despite their normal body weights, this group was in some ways worse off than underweight patients diagnosed with anorexia, she added. "They manifested criteria of severe malnutrition."

 

In sum, Peebles said, the study suggests that medical criteria for eating disorders should be re-evaluated. Though the current diagnostics cover the right general areas, "we erroneously treat these criteria in a very black-and-white way," she said. "Many practitioners interpret these to believe that menses has to be lost to get an anorexia diagnosis; bulimics have to binge and purge at least two times a week for three months. These findings illustrate the arbitrary nature of those cutoffs."

 

The issue is particularly urgent because many health insurers offer less coverage for EDNOS treatment than for treatment of anorexia or bulimia. And doctors and parents may be falsely reassured if a child is labeled with EDNOS.

 

"I think that when parents walk out of a doctor's office having heard their kid doesn't meet criteria for anorexia, they're relieved," Peebles said. But they shouldn't let their guard down: in many cases, the child's disturbed eating patterns still need treatment.

 

The Stanford collaborators on Peebles' team were Jenny Wilson, MD, a resident in pediatrics, and James Lock, MD, PhD, professor of psychiatry and behavioral sciences and of pediatrics. The study was funded by the Stanford Pediatric Research Fund and the American Heart Association, with additional support from the Stanford Medical Scholars Research Program and the National Institutes of Health.

Journal Reference:

Rebecka Peebles, Kristina K. Hardy, Jenny L. Wilson, and James D. Lock. Are Diagnostic Criteria for Eating Disorders Markers of Medical Severity? Pediatrics, 2010 DOI: 10.1542/peds.2008-1777


Tobacco 'candy' could poison kids: study


By Amy Norton

Reuters Health

Monday, April 19, 2010

NEW YORK (Reuters Health) – Thousands of young children are accidentally poisoned by tobacco products each year in the U.S., and new dissolvable tobacco products that resemble candy might pose an additional risk, according to researchers.

In a study of reports to U.S. poison control centers between 2006 and 2008, investigators found that 13,705 children younger than 6 were accidentally poisoned by tobacco products. Cigarettes were the most common culprit, followed by smokeless tobacco products, and more than 70 percent of the victims were infants younger than one year.

The findings are published in the journal Pediatrics.

In a baby or small child, even a small amount of nicotine, as little as 1 milligram, can cause nausea and vomiting. Larger doses could lead to weakness, convulsions or potentially fatal respiratory arrest.

The new study appears to be the first to bring together the numbers on accidental child tobacco poisonings nationally, according to lead researcher Dr. Gregory N. Connolly, of the Harvard School of Public Health in Boston.

"These numbers are alarming," Connolly told Reuters Health. "Parents need to get the message: Don't leave these products around where children can reach them."

That, he said, includes making sure to clear cigarette butts from ashtrays or anywhere else a baby or child could get a hold of them. In this study, cigarettes or filter tips were responsible for nearly 10,600 of the poisonings the researchers documented. Smokeless tobacco products were behind another 1,768.

But there is now a new concern, according to Connolly's team -- namely, the melt-in-the-mouth tobacco products recently put on the market.

Tobacco companies say the products -- which come in the form of flavored, candy-like pellets, sticks and strips -- are meant to give adults a smoke-free way to get their nicotine fix. But they could also end up as a new route for accidental child poisonings, Connolly and his colleagues say.

"Now we've got something in the marketplace that could be more attractive to kids," Connolly said.

The products are too new to have been behind any of the poisonings in the current study. However, Connolly and his colleagues did do a chemical analysis of one -- Camel Orbs, tobacco pellets with a Tic-Tac-like appearance introduced last year by R.J. Reynolds.

The researchers found that the pellets contained a greater proportion of "free" nicotine than the norm for cigarettes or dipping tobacco.

Free nicotine is more quickly absorbed into the bloodstream, raising the possibility that it could more toxic to a child than other tobacco products are.

The Camel Orb packaging is said to be child-resistant; however, Connolly noted that the packaging is tricky enough that many users might prefer to dispense a number of pellets at a time, leaving some lying around.

He cautioned against doing that in any area where a young child might see them. One pellet contains about 1 mg of nicotine, so might cause nausea, Connolly said. "But if a child gets a few of them," he added, "that could be very serious."

Connolly and other public-health experts had already been critical of the new dissolvable tobacco products -- saying they may only serve to keep smokers addicted to nicotine, and could be especially attractive to teenagers.

David Howard, a Reynolds spokesman, told The New York Times that Camel Orbs were marketed only for adults and come in child-resistant containers. He denied that they look like Tic Tac mints.

"Those packages don't at all look alike to me," Howard told the Times.

In an editorial accompanying the study, officials with the U.S. Food and Drug Administration (FDA) note that while teenagers' smoking rates have slowly declined in recent years, their use of smokeless tobacco products is rising.

Meanwhile, the tobacco industry -- faced with a growing number of indoor smoking bans in the U.S. -- seems to have shifted focus to developing new smokeless products, write Drs. Marisa L. Cruz and Lawrence R. Deyton.

They say that the fact that the nicotine from dissolvable products may be more quickly absorbed raises concerns not only about poisonings in young children, but also about the addiction potential should older kids use them.

The FDA is currently collecting study data from tobacco companies and independent researchers on dissolvable tobacco products and their "potential misuse," according to Cruz and Deyton. They say the agency will use that information to make any future regulatory decisions on the products.

The FDA has already banned cigarettes with added fruit, candy or clove flavorings, but the prohibition does not apply to other tobacco products, including dissolvable ones.

According to the Times, Reynolds' Howard said it was unfair to criticize the flavoring of Camel Orbs because many other products, including the quit-smoking aid Nicogum, come in flavors. Howard also told the Times that many other common products posed risks to infants or children from accidental ingestion.

"Virtually every household has products that could be hazardous to children, like cleaning supplies, medicines, health and beauty products, and you compare that to 20 to 25 percent of households that use tobacco products," he said.

Source:: http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-2835v1 ds.2009-2835v1 Pediatrics, May 2010.

Vitamin K May Protect Against Developing Non-Hodgkin's Lymphoma, Say Mayo Clinic Researchers

 

ScienceDaily

Monday, April 19, 2010

 

ScienceDaily (Apr. 19, 2010) In the first study of vitamin K and Non-Hodgkin lymphoma risk, researchers at the Mayo Clinic campus in Minnesota have found that people who have higher intakes of vitamin K from their diet have a lower risk of developing Non-Hodgkin lymphoma. Non-Hodgkin Lymphoma is a cancer of the immune system and is the most common hematologic malignancy in the United States.

 

At the 101st Annual Meeting of the American Association for Cancer Research (AACR), the researchers report that the risk of developing Non-Hodgkin lymphoma was approximately 45 percent lower for participants who had vitamin K intakes in the top quartile of intake in the study (>108 ug/day), compared to participants who had intakes in the bottom quartile (<39 ug/day). This association remained after accounting for other factors such as age, sex, education, obesity, smoking, alcohol use and intake of foods with high amounts of antioxidants.

 

Vitamin K is a fat-soluble vitamin and is derived from either plants (phylloquinone or vitamin K1) or bacterial synthesis. This study estimated intake of the plant form of vitamin K from diet and supplement use. The most common sources of vitamin K1 in the diet include leaf lettuce and spinach, with smaller amounts found in other vegetables, vegetable oils and some fruits.

 

Researchers at the Mayo Comprehensive Cancer Center are studying the connection between diet and Non-Hodgkin lymphoma risk, and they became interested in a potential role for vitamin K. While vitamin K is best known for its essential function in several proteins involved in blood clotting (the name of the vitamin is derived from the German word "Koagulations"), it also appears to be important in other biological processes, including inhibition of inflammatory cytokines thought to play a role in Non-Hodgkin lymphoma, as well as pathways involved in cell cycle arrest and cell death.

 

"These results are provocative, since they are the first work we have done on the connection between vitamin K and Non-Hodgkin lymphoma, and this is a fairly strong protective effect," says the study's lead investigator, James Cerhan, M.D., Ph.D., a cancer epidemiologist. "However, as with all new findings, this will need to be replicated in other studies."

 

The Mayo study enrolled 603 patients who were newly diagnosed with Non-Hodgkin lymphoma as well as 1,007 matched cancer-free "control" participants. Researchers asked the participants to answer a food questionnaire about their usual intake of over 120 food items two years prior to their cancer diagnosis or enrollment into the study (controls). They also asked about use of a variety of supplements. Vitamin K intake was estimated from this data.

 

While there was a clear trend showing that a greater intake of vitamin K from dietary sources was associated with a lower risk of Non-Hodgkin lymphoma, the use of vitamin K supplements presented a slightly different picture. Increasing intake of vitamin K from supplements did protect against Non-Hodgkin lymphoma, but reached a point where the highest intake offered no reduction in risk. "The significance of this finding is unclear," notes Dr. Cerhan, "but suggests that taking high doses of supplements is unlikely to be helpful." Dr. Cerhan also notes that people taking certain oral anticoagulants or seizure medications should closely follow their physician's dietary recommendations with respect to vitamin K intake, since vitamin K can interfere with these drugs.

 

"Whether the protective effect we observed is due to vitamin K intake, or some other dietary or lifestyle exposure, cannot be definitely assessed in this study," notes Dr. Cerhan. "But these findings add to a lot of other data that support a diet that includes plenty of green leafy vegetables in order to prevent many cancers as well as other diseases."

 

The study was funded by the National Cancer Institute.

 

Sunday, April 18, 2010 

 

Supplements Might Reduce Breast Cancer Risk

 

HealthDay News

Sunday, April 18, 2010

SUNDAY, April 18 (HealthDay News) -- Women who take multivitamin tablets along with calcium supplements seem to have a reduced risk of developing breast cancer, new research suggests.

The authors of the study, which is to be presented Sunday at the American Association for Cancer Research annual conference in Washington, D.C., did not separate out which specific vitamins might be beneficial but suggested that the interactions of different vitamins together might account for the beneficial effect.

"The effect was seen with multivitamins, not with single vitamins," said study co-author Dr. Jaime Matta, a professor of pharmacology, physiology and toxicology at Ponce School of Medicine in Ponce, Puerto Rico. "It's possible that the vitamins work better together than individually."

"We found that taking multivitamins and calcium supplements were strongly protective against breast cancer," said Dr. Manuel Bayona, a professor in the public health program at the Ponce School of Medicine. "Which vitamins exactly? We don't know because they were multivitamins."

The findings, however, do seem to contradict previous reports that the supplement forms of various single vitamins including E and C don't prevent breast cancer in women. Other studies have suggested a protective effect for individual vitamins.

The new study won't do much to settle that confusion, one expert said. "The results are interesting but it's a small study," said Joanne Dorgan, an epidemiologist with Fox Chase Cancer Center in Philadelphia. "At this point in time, most of the big studies don't support an association."

For this study, the authors compared vitamin and calcium intakes of 268 women with breast cancer and 457 women without breast cancer, all in Puerto Rico.

They also measured the ability of the women's DNA to repair itself, a function that is critical to keeping cancer at bay.

"We've known that DNA repair capacity is linked to several other types of cancer," said Matta. "DNA repair capacity is very, very linked to breast cancer risk."

Here, women who were older, had low DNA repair capacity levels, a family history of breast cancer and who had not breast-fed all had a higher risk of breast cancer.

Taking a multivitamin tablet reduced the risk of tumors by about 30 percent, while calcium supplements reduced the risk by 40 percent, the study authors noted.

But when the DNA repair capacity was taken out of the equation, calcium was no longer protective, strongly suggesting that calcium's protective effect came only from its influence on DNA repair.

Vitamins, on the other hand, seemed to have a beneficial effect even beyond contributions to DNA repair, the researchers said.

One drawback of the study is that the authors did not measure women's actual vitamin levels, instead relying on responses to questionnaires. Participants most likely bought widely available brands at chain drug stores. "People here usually don't have access to very sophisticated health food stores or specialty vitamin stores," noted Matta.

The study authors are now looking at ways to use DNA repair capacity function as a marker for breast cancer risk, much like cholesterol is used as a marker for heart disease.

"We're developing new technology that would make measuring DNA repair capacity more inexpensive, faster and easier to do," Matta said.

Still, another expert said the new study was less than convincing.

"The totality of the evidence to date does not support taking vitamins and calcium for breast cancer prevention," said Marji McCullough, strategic director of nutritional epidemiology for the American Cancer Society. "There are other reasons women may wish to take calcium, for example for bone health."

More information

Figure out your breast cancer risk with the help of the U.S. National Cancer Institute. 

Chip may detect spreading cancer cells in blood
 

By Maggie Fox,

Health and Science Editor

Reuters

Sunday, April 18, 2010

WASHINGTON (Reuters) – Researchers have found a way to test blood for the cells that spread cancer and said they might be able to use the method to predict whose cancer will come back after treatment.

The team at Harvard Medical School and Massachusetts General Hospital used a grant from a non-profit group to develop the test, which they tried out on samples from 20 men with prostate cancer.

They found circulating tumor cells in patients with tumors that had not spread, low-grade cancers and in patients who had their prostate glands taken out three months before.

"These are patient groups in whom we would normally not expect to see circulating tumor cells, so it gives us a tremendous amount of information about their risk," said Harvard's Sunitha Nagrath, who led the study.

"Are these patients more prone to come back with recurring disease?" she asked a news conference at a meeting of the American Association for Cancer Research. She said her team would follow the patients to see if the tumors came back in patients who had the circulating cancer cells.

Such a test may also some day serve as a blood test for prostate cancer in addition to PSA or prostate specific antigen tests, which look for a protein made only by prostate cells and which can indicate cancer.

Nagrath said her team's test can detect 200 circulating tumor cells from a teaspoon of blood taken from a cancer patient.

Prostate cancer is the leading cancer killer of men after lung cancer. But it is often a slow-growing disease and doctors are unsure which men have the most deadly types and which men are most likely to have their cancer spread or come back.

The researchers looked for the circulating tumor cells in the blood one day and nine days after the men had their prostates removed, and then again more than three months later.

They found cells in 42 percent of the patients, and in 64 percent of those with advanced prostate cancer.

The cells could not be found right after surgery but reappeared in some of the patients.

Nagrath said it will be important to follow the men to see how well they do and whether those with more of the circulating cells do more poorly.

She also said the test may be useful for monitoring patients on so-called targeted therapies, which affect cancer cells with certain specific genetic mutations.

"With blood tests you can sample the patients every day to see whether the genotype is changing," she said.

The charity Stand Up To Cancer paid for the trial.

(Editing by Bill Trott)

Vaccine Stops Tumor Spread in Mice

 

HealthDay News

Sunday, April 18, 2010

SUNDAY, April 18 (HealthDay News) -- A new study in mice suggests that a transcription factor normally found in male germ cells could become a target for cancer vaccines.

A transcription factor is a protein that controls the transfer (or transcription) of genetic material from the DNA to messenger RNA. This particular factor, known as Brother of the Regulator of Imprinted Sites (BORIS), promotes tumor growth.

Scientists were able to develop a vaccine from BORIS that was effective in helping stop the spread of a breast cancer-like tumor to other parts of the body, a process known as metastasis.

The vaccine "is capable of inducing strong and effective antitumor immunity, but the efficacy of this [strategy] could be even better if one could eliminate immune suppressor cells," lead researcher Michael G. Agadjanyan, head of the department of immunology and professor at the University of California, Irvine's Institute for Molecular Medicine, said in a press release.

Researchers tested the value of a mutated virus using the factor on mice with a form of cancer similar to breast cancer found in humans. They delivered the vaccine into the body by using immune cells known as dendritic cells, whose treelike branches form connections with other cells in the body.

The factor delivered by dendritic cells "elicited strong antitumor cellular immune responses in tumor-free mice," Agadjanyan said. "More importantly, therapeutic vaccination dramatically inhibited both tumor growth and the number of metastases in the lungs of tumor-bearing mice."

He cautioned, however, that the BORIS-based vaccine did not entirely eliminate tumors or stop the spread of cancer. For that reason, it should be combined with other strategies that enlist the immune system to combat cancer, he said.

The study findings were scheduled to be released Sunday at the annual meeting of the American Association for Cancer Research in Washington D.C.

More information

The U.S. National Cancer Institute has an A-to-Z list of cancer types.