June 4, 2009, 3:33 AM CT
Brain irradiation in lung cancer
A national Radiation Therapy Oncology Group (RTOG) study led by a Medical College of Wisconsin Cancer Center doctor at Froedtert Hospital in Milwaukee has observed that a course of radiation treatment to the brain after therapy for locally advanced non-small cell lung cancer reduced the risk of metastases to the brain within the first year after therapy. The study was presented at the American Society of Clinical Oncology annual meeting in Orlando, June 1.
"With improved therapys for non-small cell lung cancer, patients are living longer and we are seeing more brain metastases," says study author Elizabeth Gore, M.D. "This study compared the efficacy of prophylactic (preventive) cranial irradiation (PCI) vs. observation in these patients, and observed that those not receiving cranial irradiation were two and one-half times more likely to develop brain metastasis than those who did".
The study analyzed 356 patients. While the results did not show a statistically significant difference in survival between the two groups, it did show that PCI significantly decreased the occurence rate of brain metastases during the first year post-treatment. Dr. Gore anticipates that additional study of the impact of PCI --on neuro-psychological function and quality of life in these patients-- will help determine if use of PCI should become standard care.........
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June 4, 2009, 3:29 AM CT
Waiting times too long for bariatric surgery
Obesity is now acknowledged as a chronic disease with many related complications, and its prevalence has reached alarming epidemic proportions. While bariatric surgery is effective at treating the disease, access to this procedure is still too limited in Canada. The latest article published by Dr. Nicolas Christou, of the McGill University Health Centre (MUHC), in the recent issue of the Canadian Journal of Surgery
assesses the waiting times for this procedure.
As per the study, the average waiting time for bariatric surgery in Canada is 5 years, a timeframe that is long compared with the 8-week average for cancer surgery or the 18-month average for cosmetic surgery. Yet a number of studies have shown that this type of procedure reduces the risk of death over 5 years from 40% to 85%: bariatric surgery can therefore save lives.
"Waiting times for bariatric surgery in Canada are much too long," Dr. Christou stated. "However, the provincial government's recent announcement of additional money for our speciality is a positive and beneficial step. This funding will help us address our main obstacle, a lack of resources, and therefore represents real hope for our patients".
This investment should also have positive spinoffs in the medium-term for the health care system. Another article recently published by Dr. Christou in the World Journal of Surgery showed that bariatric surgery is the only therapy that ensures major and lasting weight loss. It can also significantly improve the long-term health of these patients by reducing their risk of developing obesity-related complications, such as diabetes, cancer, or heart and respiratory diseases. The costs to the health care system to treat these related pathologies would therefore decrease, and the initial investment would lead to savings within 3 years.........
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June 4, 2009, 3:22 AM CT
Illness, medical bills linked to nearly two-thirds of bankruptcies
Medical problems contributed to nearly two-thirds (62.1 percent) of all bankruptcies in 2007, as per a research studyin the recent issue of the American Journal of Medicine that will be published online Thursday. The data were collected previous to the current economic downturn and hence likely understate the current burden of financial suffering. Between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems rose by 49.6 percent. The authors' prior 2001 findings have been widely cited by policy leaders, including President Obama.
Surprisingly, most of those bankrupted by medical problems had health insurance. More than three-quarters (77.9 percent) were insured at the start of the bankrupting illness, including 60.3 percent who had private coverage. Most of the medically bankrupt were solidly middle class before financial disaster hit. Two-thirds were homeowners and three-fifths had gone to college. In a number of cases, high medical bills coincided with a loss of income as illness forced breadwinners to lose time from work. Often illness led to job loss, and with it the loss of health insurance.
Even apparently well-insured families often faced high out-of-pocket medical costs for co-payments, deductibles and uncovered services. Medically bankrupt families with private insurance reported medical bills that averaged $17,749 vs. $26,971 for the uninsured. High costs - averaging $22,568 - were incurred by those who initially had private coverage but lost it in the course of their illness.........
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June 3, 2009, 5:19 AM CT
Exercising while you have an aching back
People with lower back pain are better off exercising more, not less.
A University of Alberta study of 240 men and women with chronic lower-back pain showed that those who exercised four days a week had a better quality of life, 28 per cent less pain and 36 per cent less disability, while those who hit the gym only two or three days a week did not show the same level of change.
"While it could be assumed that someone with back pain should not be exercising frequently, our findings show that working with weights four days a week provides the greatest amount of pain relief and quality of life," said Robert Kell, main author of the study and an assistant professor of exercise physiology at the University of Alberta, Augustana Campus.
About 80 per cent of North Americans suffer from lower back pain.
Kell presented some of the findings May 30 at the American College of Sports Medicine conference in Seattle, Wash.
In the study, groups of 60 men and women with chronically sore lower backs each exercised with weights in two, three or four-day weekly programs, or not at all. Their progress was measured over 16 weeks. The level of pain decreased by 28 per cent in programs that included exercise four days a week, by 18 per cent three days a week and by 14 per cent two days a week. The quality of life, defined as general physical and mental well-being, rose by 28 per cent, 22 per cent and 16 per cent respectively.........
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June 3, 2009, 5:14 AM CT
How the Brain Processes What the Eye Sees
Scientists at the Center for Molecular and Behavioral Neuroscience (CMBN) at Rutgers University in Newark have identified the need to develop a new framework for understanding "perceptual stability" and how we see the world with their discovery that visual input obtained during eye movements is being processed by the brain but blocked from awareness.
The process of seeing requires the eyes to move so light can hit the photoreceptors at the center of each retina, which then pass that information to the brain. If we were cognizant of the stimulus that passes before the eyes during the two to three times they move every second, however, vision would consist of a series of sensations of rapid motion rather than a stable perception of the world. To achieve perceptual stability, current theory has held that visual information gained during an eye movement is eliminated, as if cut off by a camera's shutter, and removed from processing.
As published in Current Biology (http://www.cell.com/current-biology), significant new research conducted by assistant professor Bart Krekelberg and post-doctoral researcher Tamara L. Watson now shows that theory of saccadic suppression is incorrect and what the brain is doing instead is processing information gained during eye movement but blocking it from being reported.........
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June 3, 2009, 5:11 AM CT
Surgery in patients with RA
A newly released study published by the American Society of Plastic Surgeons reveals that one of the most common conditions caused by Rheumatoid Arthritis (RA) is best treated surgically, sooner rather than later. Patients with RA frequently experience a debilitating condition known as metacarpophalangeal joint disease, which is commonly treated by replacing the knuckle joints with solid silicone joints. However, this therapy (and others like it) has spurred great disagreement between hand surgeons and rheumatologists regarding the indications, timing and perceived outcomes of the procedure; rheumatologists tend to refer late-stage patients for surgery whereas hand surgeons think that earlier intervention can yield more positive outcomes.
In the largest cohort study of its kind, scientists from Michigan, Maryland, and the United Kingdom reviewed the surgical outcomes of 70 RA patients who suffered from varying degrees of hand deformities. Following reconstruction, patients were separated into two groups based on the degree of deformity, and the outcomes of the reconstruction were assessed at 6 months and at years 1, 2 and 3. After reconstruction, both groups had positive self-reported hand outcomes and showed statistically significant improvement from baseline. However, scientists observed that the more severe group still had significant deformities - showing that the more serious the malformation, the more difficult it is to correct.........
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June 3, 2009, 5:08 AM CT
Efforts to quickly develop swine flu vaccine
Researchers around the world are accelerating their efforts to develop a vaccine against the H1N1 influenza virus (Swine flu) as rapidly as possible, reports Genetic Engineering & Biotechnology News
(GEN). The need for such a vaccine received a strong impetus from the World Health Organization, which has issued a Phase 5 pandemic alert, a strong signal that the WHO believes a pandemic is imminent, as per the June 1 issue of GEN (www.genengnews.com/articles/chitem.aspx?aid=2938).
"It can take five or six months to come up with an entirely novel influenza vaccine," says John Sterling, Editor in Chief of GEN. "There is a great deal of hope that biotech and pharma companies might be able to have something ready sooner".
One company, Replikins, actually predicted over a year ago that significant outbreaks of the H1N1 flu virus would occur within 6-12 months. The predictions were based on correlations of flu virus specimens and PubMed documentation of major outbreaks during the past 90 years, focusing on concentrations of, and spacings between, replikinsthe lysine and histidine residues in the hemagglutinin (HA) unit genetic sequences of the eight major genes in the influenza virus. Replikins' officials say the company's PanFLu vaccine is ready for clinical trials.........
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June 3, 2009, 5:06 AM CT
Skin Lesion Leads To More Cancer Types
The study provided up to six years of follow-up to quantify the risk of progression of actinic keratoses to cancer.
Actinic keratoses are sun-damaged rough patches or lesions on the skin - often pink and scaly - that doctors have long believed can turn into a form of skin cancer known as squamous cell carcinoma.
Now scientists at Brown University, the Veterans Administration Medical Centers in Providence and Oklahoma City, and others have determined that actinic keratoses appear responsible for a larger spectrum of skin cancers than previously thought. Their research is highlighted in the current edition of Cancer.
"We found some interesting things," said Dr. Martin Weinstock, the paper's main author. Weinstock, chief of dermatology at the VA Medical Center in Providence, is professor of dermatology and community health at The Warren Alpert Medical School of Brown University. The U.S. Department of Veterans Affairs Office of Research and Development funded the study.
Vincent Criscione, a fourth-year Alpert Medical School student, served as the paper's first author. Beyond Brown and the VA, scientists from Rhode Island Hospital and Henry Ford Hospital in Detroit also contributed.
To conduct the study, Weinstock and the other scientists looked at 169 patients from the VA Medical Center in Oklahoma City who had a high risk for skin cancers. They, in turn, were among 1,131 patients from multiple cites who took part in a chemotherapy prevention trial conducted previously. Most had at least one actinic keratosis on their body. Combined, they had about 7,784 of the lesions on their faces and ears. There were up to six years of follow-up to quantify the risk of progression of actinic keratoses to cancer.........
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June 3, 2009, 5:00 AM CT
Obesity Does Not Worsen Asthma
Being overweight or obese does not make asthma worse in patients with mild and moderate forms of the disease, as per a research studyby National Jewish Health researchers, eventhough it may reduce the response to medications.
"With both asthma and obesity on the rise in recent years, there has been much interest in the possible link between these two conditions," said main author E. Rand Sutherland, Associate Professor of Medicine at National Jewish Health, and main author of the paper appearing in the June 2009 issue of the Journal of Allergy and Clinical Immunology.
"By studying a well characterized group of patients with asthma, we were able to determine that increased weight is not linked to more severe asthma. Eventhough benefits can be obtained with weight loss in other diseases, these findings suggest that an improvement in asthma may not necessarily result from weight loss.
"The findings also suggest that patients and physicians should be aware that obese asthma patients may not respond well to corticosteroids, the most successful controller medicine for asthma, which can affect dosing decisions and choices of possible alternatives to steroids."
Prior studies have suggested that obesity predisposes people to developing asthma, to suffer more severe asthma symptoms, and to respond less to medications. However, the exact mechanism for these links has been unclear, and the studies have generally relied upon patients' reports of their diagnosis and symptoms rather than using more precise tools to characterize patients.........
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June 3, 2009, 4:58 AM CT
Oxygen plus MRI to determine cancer therapy success
Drs. Ralph Mason (left) and Dawen Zhao, both radiologists, have demonstrated that blood oxygen level dependent MRIs might help oncologists determine the best treatment for some cancer patients.
Credit: UT Southwestern Medical Center
A simple magnetic resonance imaging (MRI) test involving breathing oxygen might help oncologists determine the best therapy for some cancer patients, report scientists at UT Southwestern Medical Center.
Previous research has shown that the amount of oxygen present in a tumor can be a predictor of how well a patient will respond to therapy. Tumors with little oxygen tend to grow stronger and resist both radiotherapy and chemotherapy. Until now, however, the only way to gauge the oxygen level in a tumor, and thus determine which therapy might be more effective, was to insert a huge needle directly into the malignant tumor.
The new technique, known as BOLD (blood oxygen level dependent) MRI, can detect oxygen levels in tumors without the need for an invasive procedure. The patient need only be able to breathe in oxygen when undergoing an MRI.
"The patient simply inhales pure oxygen, which then circulates through the bloodstream, including to the tumors," said Dr. Ralph Mason, professor of radiology, director of the UT Southwestern Cancer Imaging Center and senior author of a study appearing online and in a future edition of Magnetic Resonance in Medicine.
"Using MRI, we can then go in and estimate how much oxygen a particular tumor is taking up, providing us some insight into how the tumor is behaving and what sort of therapy might be effective".........
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