April 28, 2009, 5:21 AM CT
Pregnancy safe with epilepsy, avoid valproate
New guidelines developed by the American Academy of Neurology and the American Epilepsy Society show it's relatively safe for women with epilepsy to become pregnant, but caution must be taken, including avoiding one particular epilepsy drug that can cause birth defects. The guidelines are reported in the April 27, 2009, print issue of Neurology
, the medical journal of the American Academy of Neurology, and will be presented April 27, 2009, at the Academy's Annual Meeting in Seattle.
The guidelines recommend women with epilepsy avoid taking the drug valproate during pregnancy.
"Strong evidence shows that valproate is associated with an increased risk for fetal malformations and decreased thinking skills in children, whether used by itself or with other medications," said lead guideline author Cynthia Harden, MD, Director of the Epilepsy Division at the University of Miami's Miller School of Medicine and member of the American Academy of Neurology.
The guidelines also suggest, if possible, women with epilepsy should not take more than one epilepsy drug at a time during pregnancy since taking more than one seizure drug has also been found to increase the risk of birth defects in comparison to taking only one medication.
"Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant," said Harden. "These guidelines show that women with epilepsy are not at a substantially increased risk of having a Cesarean section, late pregnancy bleeding, or premature contractions or premature labor and delivery. Also, if a woman is seizure free nine months before she becomes pregnant, it's likely that she will not have any seizures during the pregnancy".........
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April 28, 2009, 5:17 AM CT
Psychological effects of inadequate sleep
A recent Finnish study suggests that children's short sleep duration even without sleeping difficulties increases the risk for behavioral symptoms of ADHD.
During the recent decades, sleep duration has decreased in a number of countries; in the United States a third of children are estimated to suffer from inadequate sleep. It has been hypothesised that sleep deprivation may manifest in children as behavioral symptoms rather than as tiredness, but only few studies have investigated this hypothesis.
The scientists at the University of Helsinki and National Institute of Health and Welfare, Finland, examined whether decreased sleep leads to behavioral problems similar to those exhibited by children with attention-deficit/hyperactivity disorder (ADHD).
280 healthy children (146 girls and 134 boys) took part in the study.
The scientists tracked the children's sleep using parental reporting as well as actigraphs, or devices worn on the wrist to monitor sleep.
The children whose average sleep duration as measured by actigraphs was shorter than 7.7 hours had a higher hyperactivity and impulsivity score and a higher ADHD total score, but similar inattention score than those sleeping for a longer time. In multivariate statistical models, short sleep duration remained a statistically significant predictor of hyperactivity and impulsivity, and sleeping difficulties were linked to hyperactivity, impulsivity and inattention. There were no significant interactions between short sleep and sleeping difficulties.........
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April 28, 2009, 5:15 AM CT
Smoking, high blood pressure and being overweight
Smoking, hypertension and being overweight are the leading preventable risk factors for premature mortality in the United States, as per a newly released study led by scientists at the Harvard School of Public Health (HSPH), with collaborators from the University of Toronto and the Institute for Health Metrics and Assessment at the University of Washington. The scientists observed that smoking is responsible for 467,000 premature deaths each year, hypertension for 395,000, and being overweight for 216,000. The effects of smoking work out to be about one in five deaths in American adults, while hypertension is responsible for one in six deaths.
It is the most comprehensive study yet to look at how diet, lifestyle and metabolic risk factors for chronic disease contribute to mortality in the U.S. The study appears in the April 28, 2009 edition of the open-access journal PLoS Medicine
"The large magnitude of the numbers for a number of of these risks made us pause," said Goodarz Danaei, a doctoral student at HSPH and the main author of the study. "To have hundreds of thousands of premature deaths caused by these modifiable risk factors is shocking and should motivate a serious look at whether our public health system has sufficient capacity to implement interventions and whether it is currently focusing on the right set of interventions." Majid Ezzati, associate professor of international health at HSPH, is the study's senior author.........
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April 28, 2009, 5:13 AM CT
A pandemic flu in making?
New research published recently (Monday April 27) from the University of Leicester and University Hospitals of Leicester NHS Trust warns of a six-month time lag before effective vaccines can be manufactured in the event of a pandemic flu outbreak.
By that time, the first wave of pandemic flu appears to be over before people are vaccinated, says Dr Iain Stephenson, Consultant in Infectious Diseases at the Leicester Royal Infirmary and a Clinical Senior Lecturer at the University of Leicester.
In his paper published in PNAS- Proceedings of the National Academy of Sciences
of the USA- Dr Stephenson makes the first case for a pre-pandemic vaccine to mitigate the worst effects of pandemic flu.
He said: "This study is the first to show an effective pre-pandemic vaccine approach. This means that we could vaccinate people potentially a number of years before a pandemic, to generate memory cells that are long lasting and can be rapidly boosted by a single dose of vaccine when needed".
Dr Stephenson, of the Department of Infection, Immunity and Inflammation at the University of Leicester, said: "If an influenza pandemic occurs, vaccination will to be the main way to protect the population. The major current threat seems to be from avian influenza H5N1 (bird flu) which has spread rapidly around the world and causes human infections and deaths.........
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April 28, 2009, 5:10 AM CT
Dietary fats trigger long-term memory formation
Having strong memories of that rich, delicious dessert you ate last night? If so, you shouldn't feel like a glutton. It's only natural.
UC Irvine scientists have observed that eating fat-rich foods triggers the formation of long-term memories of that activity. The study adds to their recent work linking dietary fats to appetite control and may herald new approaches for treating obesity and other eating disorders.
Study results appear this week in the early online edition of the Proceedings of the National Academy of Sciences
Daniele Piomelli, the Louise Turner Arnold Chair in Neurosciences, teamed with UCI's James McGaugh, one of the world's leading learning and memory researchers, to examine how dietary fats facilitate memory retention.
Piomelli's prior studies identified how oleic acids from fats are transformed into a compound called oleoylethanolamide (OEA) in the upper region of the small intestine. OEA sends hunger-curbing messages to the brain to increase feelings of fullness. In elevated levels, OEA can reduce appetite, produce weight loss and lower blood cholesterol and triglyceride levels.
Piomelli and McGaugh discovered that OEA also causes memory consolidation, the process by which superficial, short-term memories are transformed into meaningful, long-term ones. It does this, Piomelli said, by activating memory-enhancing signals in the amygdala, part of the brain involved in the consolidation of memories of emotional events.........
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April 27, 2009, 5:31 AM CT
Diet soda may reduce kidney stones
Patients with stone disease could benefit from drinking diet soda. New research from the University of California, San Francisco suggests that the citrate and malate content in usually consumed sodas appears to be sufficient to inhibit the development of calcium stones. The study was presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA).
Increased alkalinity is proven to augment citraturia, a known factor for calcium stones. Malate increases the amount of alkali delivered. Scientists measured the citrate and malate content of 15 popular diet sodas. The scientists observed that Diet Sunkist Orange contained the greatest amount of total alkali and Diet 7-Up had the greatest amount of citrate as alkali.
"This study by no means suggests that patients with recurrent kidney stones should trade in their water bottles for soda cans," said Anthony Y. Smith, MD, an AUA spokesman. "However, this study suggests instead that patients with stone disease who do not drink soda appears to benefit from moderate consumption".........
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April 27, 2009, 5:27 AM CT
Statins may reduce the risk of prostate cancer
Cholesterol-lowering drugs called statins may reduce inflammation in prostate tumors, possibly hindering cancer growth, as per a research studyled by researchers in the Duke Prostate Center.
"Prior studies have shown that men taking statins seem to have a lower occurence rate of advanced prostate cancer, but the mechanisms by which statins might be affecting the prostate remained largely unknown," said Lionel Baez, M.D., a researcher in the Duke Prostate Center and lead investigator on this study. "We looked at tumor samples and observed that men who were on statins had a 72 percent reduction in risk for tumor inflammation, and we believe this might play a role in the correlation between prostate cancer and statin use".
The scientists presented their finding at the American Urological Association's annual meeting on April 26, 2009, and the study was selected to be part of the meeting's press program on April 27, 2009. The study was funded by the United States Department of Defense and the American Urological Association Foundation.
The scientists looked at pathological information from the tumors of 254 men who underwent radical prostatectomy or surgery to remove the entire prostate as a therapy for prostate cancer at the Durham Veterans Affairs Medical Center between 1993 and 2004. The tissue was graded by a pathologist for inflammation on a scale of 0 to 2: 0 for no inflammation, 1 for mild inflammation (less than 10 percent of the tumor) and 2 for marked inflammation (greater than 10 percent of the tumor).........
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April 27, 2009, 5:08 AM CT
Simple household bleach to treat kids' eczema
It's best known for whitening a load of laundry. But now simple household bleach has a surprising new role: an effective therapy for kids' chronic eczema.
Chronic, severe eczema can mar a childhood. The skin disorder starts with red, itchy, inflamed skin that often becomes crusty and raw from scratching. The eczema disturbs kids' sleep, alters their appearance and affects their concentration in school. The itching is so bad kids may break the skin from scratching and get chronic skin infections that are difficult to treat, particularly from methicillin-resistant Staphylococcus aureus
Scientists from the Northwestern University Feinberg School of Medicine have discovered powerful relief in the form of diluted beach baths. It's a cheap, simple and safe therapy that drastically improves the rash as well as reduces flare-ups of eczema, which affects 17 percent of school-age children.
The study found giving pediatric patients with moderate or severe eczema (atopic dermatitis) diluted bleach baths decreased signs of infection and improved the severity and extent of the eczema on their bodies. That translates into less scratching, fewer infections and a higher quality of life for these children.
The typical therapy of oral and topical antibiotics increases the risk of bacterial resistance, something doctors try to avoid, particularly in children. Bleach kills the bacteria but doesn't have the same risk of creating bacterial resistance.........
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April 27, 2009, 5:03 AM CT
Improving treatment of lung cancer
Prevention, personalized therapies and closer collaborations between surgeons, medical oncologists and radiation oncologists will result in better outcomes for patients with lung cancer and those at risk, a leading European expert says.
"Lung cancer is a complex disease. It is one of the most complex cancers, and the more we learn about the biology of the disease, the more we realize that improved cancer care will result from multidisciplinary therapy," said Prof Robert Pirker, from the Medical University of Vienna, Austria.
Prof Pirker is co-chair of the scientific committee of a new medical conference, the European Multidisciplinary Conference in Thoracic Oncology (EMCTO), being held for the first time this year, 1-3 May, in Lugano, Switzerland. The conference aims to further clinical and scientific cooperation between disciplines to help in the fight against lung cancer.
Over the past 5 years, scientists have established that for patients with operable cancer, surgery followed by chemotherapy can result in good outcomes. Now, large clinical trials are beginning to evaluate that adding molecular targeted therapies can further improve the chance of a successful outcome for some patients. In addition, doctors are now attempting to refine their therapys based on the clinical characteristics of individual patients, and based on the molecular profile of their tumour.........
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April 27, 2009, 5:01 AM CT
Who should get PSA testing?
LINTHICUM, MD, April 27, 2009The American Urological Association (AUA) today issued new clinical guidance which directly contrasts recent recommendations issued by other major groups about prostate cancer screening, asserting that the prostate-specific antigen (PSA) test should be offered to well-informed, men aged 40 years or older who have a life expectancy of at least 10 years. The PSA test, as well as how it is used to guide patient care (e.g., at what age men should begin regular testing, intervals at which the test should be repeated, at what point a biopsy is necessary) is highly controversial; however, the AUA believes that, when offered and interpreted appropriately the PSA test may provide essential information for the diagnosis, pre-treatment staging or risk evaluation and post-treatment monitoring of prostate cancer.
The new Best Practice Statement updates the AUA's prior guidance, which was issued in 2000. Major changes to the AUA statement include new recommendations about who should be considered for PSA testing, as well as when a biopsy is indicated following an abnormal PSA reading. As per the AUA, early detection and risk evaluation of prostate cancer should be offered to well-informed men 40 years of age or older who have a life expectancy of at least 10 years. The future risk of prostate cancer is closely correlation to a man's PSA score; a baseline PSA level above the median for age 40 is a strong predictor of prostate cancer. Such testing may not only allow for earlier detection of more curable cancers, but may also allow for more efficient, less frequent testing. Men who wish to be screened for prostate cancer should have both a PSA test and a digital rectal exam (DRE). The Statement also notes that other factors such as family history, age, overall health and ethnicity should be combined with the results of PSA testing and physical examination in order to better determine the risk of prostate cancer. The Statement recommends that the benefits and risks of screening of prostate cancer should be discussed including the risk of over-detection, detecting some cancers which may not need immediate therapy.........
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