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June 25, 2009, 5:54 PM CT

MRI for imaging breast cancer?

MRI for imaging breast cancer?
Reviewing the records of 577 patients with breast cancer, Fox Chase Cancer Center scientists observed that women with newly diagnosed breast cancer who receive a breast MRI are more likely to receive a mastectomy after their diagnosis and may face delays in starting therapy. The study demonstrates that, despite the lack of evidence of their benefit, routine use of MRI scans in women newly diagnosed with breast cancer increased significantly between 2004 and 2005, and again in 2006.

The study is online now and will be appearing in the August edition of the Journal of the American College of Surgeons

"We have yet to see any evidence that MRI improves outcomes when used routinely to evaluate breast cancer, and yet more and more women are getting these scans with almost no discernable pattern," said Richard J. Bleicher, M.D., F.A.C.S., a specialist in breast cancer surgery at Fox Chase. "For most women, a breast MRI previous to therapy is unnecessary. MRI can be of benefit because it's more sensitive, but with the high number of false positives and costs linked to the test, more research is needed to determine whether MRI can improve outcomes in women who have already been diagnosed with breast cancer".

Bleicher and colleagues evaluated the records of 577 patients with breast cancer seen in a multidisciplinary breast clinic where they were reviewed by a radiologist, pathologist, and a surgical, radiation, and medical oncologist. Of these patients, 130 had MRIs previous to therapy.........

Posted by: Janet      Read more         Source


June 23, 2009, 5:13 PM CT

Underweight and extremely obese die earlier

Underweight and extremely obese die earlier
Underweight people and those who are extremely obese die earlier than people of normal weightbut those who are overweight actually live longer than people of normal weight. Those are the findings of a newly released study published online in Obesity by scientists at Statistics Canada, Kaiser Permanente Center for Health Research, Portland State University, Oregon Health & Science University, and McGill University.

"It's not surprising that extreme underweight and extreme obesity increase the risk of dying, but it is surprising that carrying a little extra weight may give people a longevity advantage," said David Feeny, PhD, coauthor of the study and senior investigator for the Kaiser Permanente Center for Health Research.

"It appears to be that a few extra pounds actually protect older people as their health declines, but that doesn't mean that people in the normal weight range should try to put on a few pounds," said Mark Kaplan, DrPH, coauthor and Professor of Community Health at Portland State University. "Our study only looked at mortality, not at quality of life, and there are a number of negative health consequences linked to obesity, including high blood pressure, high cholesterol, and diabetes".

"Good health is more than a BMI or a number on a scale. We know that people who choose a healthy lifestyle enjoy better health: good food choices, being physically active everyday, managing stress, and keeping blood pressure, cholesterol, and blood sugar levels in check," said Keith Bachman MD, a weight management specialist with Kaiser Permanente's Care Management Institute.........

Posted by: JoAnn      Read more         Source


June 23, 2009, 5:11 PM CT

New therapy to prevent heart failure

New therapy to prevent heart failure
A landmark study has successfully demonstrated a 29 percent reduction in heart failure or death in patients with heart disease who received an implanted cardiac resynchronization treatment device with defibrillator (CRT-D) versus patients who received only an implanted cardiac defibrillator (ICD-only).

MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy) is a clinical trial that enrolled more than 1,800 patients in the United States, Canada and Europe and followed the patients for up to 4 years. The results of the trial were released recently by the University of Rochester Medical Center and Boston Scientific, the study's sponsor. The MADIT-CRT Executive Committee stopped the trial on June 22, 2009, when the trial achieved its primary end point significant reduction in heart failure or death with CRT-D versus ICD-only. Heart specialist Arthur Moss, M.D., professor of Medicine at the University of Rochester Medical Center, led the MADIT-CRT trial.

A previous study (MADIT-II) by Moss and associates in 2002 showed the ICD was effective in reducing mortality. The current MADIT-CRT study sought to determine if CRT-D could reduce the risk of mortality and heart failure, which affects 5.7 million Americans, and the results are very positive.........

Posted by: Daniel      Read more         Source


June 23, 2009, 5:09 PM CT

Morning people and night owls

Morning people and night owls
Are you a "morning person" or a "night owl?".

Researchers at the University of Alberta have observed that there are significant differences in the way our brains function depending on whether we're early risers or night owls.

Neuroresearchers in the Faculty of Physical Education and Recreation looked at two groups of people: those who wake up early and feel most productive in the morning, and those who were identified as evening people, those who typically felt livelier at night. Study participants were initially grouped after completing a standardized questionnaire about their habits.

Using magnetic resonance imaging-guided brain stimulation, researchers tested muscle torque and the excitability of pathways through the spinal cord and brain. They observed that morning people's brains were most excitable at 9 a.m. This slowly decreased through the day. It was the polar opposite for evening people, whose brains were most excitable at 9 p.m.

Other major findings:
  • Evening people became physically stronger throughout the day, but the maximum amount of force morning people could produce remained the same.
  • The excitability of reflex pathways that travel through the spinal cord increased over the day for each of these two groups.
........

Posted by: Daniel      Read more         Source


June 21, 2009, 9:28 PM CT

Dramatic outcomes in prostate cancer study

Dramatic outcomes in prostate cancer study
Two Mayo Clinic patients whose prostate cancer had been considered inoperable are now cancer free thanks in part to an experimental drug treatment that was used in combination with standardized hormone therapy and radiation treatment. The men were participating in a clinical trial of an immunotherapeutic agent called MDX-010 or ipilimumab. In these two cases, physicians say the approach initiated the death of a majority of cancer cells and caused the tumors to shrink dramatically, allowing surgery. In both cases, the aggressive tumors had grown well beyond the prostate into the abdominal areas.

"The goal of the study was to see if we could modestly improve upon current therapys for advanced prostate cancer," says Eugene Kwon, M.D., Mayo Clinic urologist and leader of the clinical trial. "The candidates for this study were people who didn't have a lot of other options. However, we were startled to see responses that far exceeded any of our expectations".

The patients first received a type of hormone treatment called androgen ablation, which removes testosterone and commonly causes some initial reduction in tumor size. Scientists then introduced a single dose of ipilimumab, an antibody, which builds on the anti-tumor action of the hormone and causes a much larger immune response, resulting in massive death of the tumor cells. Both men experienced consistent drops in their prostate specific antigen (PSA) counts over the following weeks until both were deemed eligible for surgery. Then, during surgery, came a greater surprise.........

Posted by: Mark      Read more         Source


June 21, 2009, 8:44 PM CT

Combined antiviral and targeted chemotherapy

Combined antiviral and targeted chemotherapy
A discovery by a team of Canadian and American scientists could provide new ways to fight HIV-AIDS. As per a newly released study published in Nature Medicine, HIV-AIDS could be treated through a combination of targeted chemotherapy and current Highly Active Retroviral (HAART) therapys. This radical new treatment would make it possible to destroy both the viruses circulating in the body as well as those playing hide-and-seek in immune system cells.

The study was led by Dr. Rafick-Pierre Skaly, of the Universit de Montral. Dr. Jean-Pierre Routy of the Research Institute of the McGill University Health Centre (RI-MUHC) and researchers from the National Institutes of Health (NIH) and the University of Minnesota in the United States also collaborated on the investigation.

To date, anti-AIDS therapys have been stymied by "HIV reservoirs" immune system cells where the virus hides and where existing HAART therapys cannot reach. The scientists successfully identified the cells where HIV hides and the "stealth" mechanisms that allow the virus to escape existing therapys. This breakthrough opens the way towards innovative therapies that are completely different from current approaches.

"Our results argue in favour of a strategy similar to the one used against leukemia, which is targeted chemotherapy, linked to a targeted immune therapy. This would make it possible to destroy the cells containing a virus, while giving the immune system time to regenerate with healthy cells," says Dr. Rafick-Pierre Skaly, a professor at the Universit de Montral, researcher at the Centre Hospitalier de Universit de Montral (CHUM), director of INSERM 743 and scientific director of the Vaccine and Gene Therapy Institute of Florida.........

Posted by: Mark      Read more         Source


June 21, 2009, 8:42 PM CT

How obesity increases the risk for diabetes

How obesity increases the risk for diabetes
Marc Montminy (left) and Yiguo Wang are researchers with the Salk Institute for Biological Studies.

Credit: Courtesy of the Salk Institute for Biological Studies
Obesity is probably the most important factor in the development of insulin resistance, but science's understanding of the chain of events is still spotty. Now, scientists at the Salk Institute for Biological Studies have filled in the gap and identified the missing link between the two. Their findings, to be reported in the June 21, 2009 advance online edition of the journal Nature, explain how obesity sets the stage for diabetes and why thin people can become insulin-resistant.

The Salk team, led by Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, discovered how a condition known as ER (endoplasmic reticulum) stress, which is induced by a high fat diet and is overly activated in obese people, triggers aberrant glucose production in the liver, an important step on the path to insulin resistance.

In healthy people, a "fasting switch" only flips on glucose production when blood glucose levels run low during fasting. "The existence of a second cellular signaling cascadelike an alternate route from A to Bthat can modulate glucose production, presents the potential to identify new classes of drugs that might help to lower blood sugar by disrupting this alternative pathway," says Montminy.

It had been well established that obesity promotes insulin resistance through the inappropriate inactivation of a process called gluconeogenesis, where the liver creates glucose for fuel and which ordinarily occurs only in times of fasting. Yet, not all obese people become insulin resistant, and insulin resistance occurs in non-obese individuals, leading Montminy and colleagues to suspect that fasting-induced glucose production was only half the story.........

Posted by: JoAnn      Read more         Source


June 16, 2009, 9:38 PM CT

Statins don't lower risk of pneumonia

Statins don't lower risk of pneumonia
Taking popular cholesterol-lowering statin drugs, such as Lipitor (atorvastatin), does not lower the risk of pneumonia. That's the new finding from a study of more than 3,000 Group Health patients published online on June 16 in advance of the British Medical Journal's June 20 print issue.

"Previous research based on automated claims data had raised some hopeand maybe some hypefor statins as a way to prevent and treat infections including pneumonia," said Sascha Dublin, MD, PhD, a doctor at Group Health and assistant investigator at Group Health Center for Health Studies. "But when we used medical records to get more detailed information about patients, our findings didn't support that approach".

In fact, Dublin's population-based case-control study observed that pneumonia risk was, if anything, slightly higher (26%) in people using a statin than in those not using any; and this extra risk was even higher (61%) for pneumonia severe enough to require being hospitalized.

"As a doctor, I'm a fan of statins for what they've been proven to do: lowering cholesterol and risk of heart disease and stroke in people who've had either disease or are at risk for them," said Dublin. Statins are HMG coenzyme A reductase inhibitors, which also include Zocor (simvastatin) and Mevacor (lovastatin). This class of medications lessens inflammation, which plays a role in infections.........

Posted by: Mark      Read more         Source


June 16, 2009, 5:06 AM CT

Predicting Fatal Fungal Infections

Predicting Fatal Fungal Infections
This image shows two human

neutrophils. The circular object

about to be engulfed by the

upper neutrophil is a

Cryptococcus neoformans cell.
As per a research findings published in The Journal of Infectious Diseases, scientists from Albert Einstein College of Medicine of Yeshiva University have identified cells in blood that predict which HIV-positive individuals are most likely to develop deadly fungal meningitis, a major cause of HIV-related death. This form of meningitis affects more than 900,000 HIV-infected people globally-most of them in sub-Saharan Africa and other areas of the world where antiretroviral treatment for HIV is not available.

A major cause of fungal meningitis is Cryptococcus neoformans, a yeast-like fungus usually found in soil and in bird droppings. Virtually everyone has been infected with Cryptococcus neoformans, but a healthy immune system keeps the infection from ever causing disease.

The risk of developing fungal meningitis from Cryptococcus neoformans rises dramatically when people have weakened immunity, due to HIV infection or other reasons including the use of immunosuppressive drugs after organ transplantation, or for treating autoimmune diseases or cancer. Knowing which patients are most likely to develop fungal meningitis would allow costly drugs for preventing fungal disease to be targeted to those most in need. (In the U.S., the widespread use of antiretroviral treatment by HIV-infected people, and their preventive use of anti-fungal drugs, has dramatically reduced their rate of fungal meningitis from Cryptococcus neoformans to about 2%.).........

Posted by: Mark      Read more         Source


June 16, 2009, 5:03 AM CT

RNA snippet suppresses spread of aggressive breast cancer

RNA snippet suppresses spread of aggressive breast cancer
Image courtesy of University of Illinois
A low cellular level of a tiny fragment of RNA appears to increase the spread of breast cancer in mouse models of the disease, as per scientists at Whitehead Institute for Biomedical Research.

Measuring levels of this so-called microRNA, which is also linked to metastatic breast cancer in humans, may more accurately predict the likelihood of metastasis (which accounts for 90% of cancer-related deaths) and ultimately help determine patient prognoses.

In the study, whose results are published in the June 12 issue of Cell, Scott Valastyan, a graduate student in Whitehead Member Robert Weinberg's laboratory, screened patient breast cancer samples for microRNAs with potential roles in metastasis. MicroRNAs are single strands of RNA about 21-23 nucleotides long. Within a cell, a single microRNA can fine-tune the expression of dozens of genes simultaneously. This capability could be especially important in metastasis, a multi-step process that could be influenced by a single microRNA at several points.

The screened samples were classified as either metastatic cancer or non-metastatic cancer. After analysis, the microRNA miR-31 stood out because of its inverse correlation with metastasis. In samples where a patient's original tumor had not metastasized, the cancer cells retained high levels of the microRNA. But where the tumor had metastasized, the cancer cells came to possess lower levels of miR-31.........

Posted by: Janet      Read more         Source



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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.

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