August 23, 2010, 7:12 AM CT
Cost of prostate cancer care
A new analysis has observed that short-term and long-term costs of prostate cancer care vary considerably based on which therapy strategy a man initially receives. Published early online in Cancer
, a peer-evaluated journal of the American Cancer Society, the study finds that therapys that appears to be less expensive in the short-term may have higher long-term costs.
For men with early stage prostate cancer, various therapys are available, including surgery, radiation treatment, hormonal therapy, watchful waiting, or combinations of the above. A variety of factors determines which therapy is appropriate for a given man, and in some cases, a man appears to be able to choose among several options. Cost is one of a number of factors to consider when choosing among these options.
To determine how the initial therapy received by men with early stage prostate cancer affects costs of medical care both in the short-term (first year following diagnosis) and long-term (across five years of follow-up), Claire Snyder, PhD, of the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health in Baltimore led a team that evaluated early stage prostate-cancer cases from the Surveillance, Epidemiology and End Results (SEER)-Medicare database. (This database combines cancer incidence and survival data from US population-based cancer registries with Medicare administrative claims.) Patients included 13,769 men aged 66 years or older who were diagnosed in 2000 and were followed for 5 years. They were divided into groups based on the therapy they received during the first 9 months after diagnosis: watchful waiting, radiation, hormonal treatment, hormonal treatment plus radiation, and surgery (men in this latter group may have received hormones and/or radiation as well). Treatment costs were divided into initial (months -1 to 12), long-term (each 12 months thereafter), and total (months -1 to 60) costs. The incremental costs of care were calculated as the difference in medical costs for patients versus a group of similar men without cancer.........
Posted by: Mark Read more Source
August 23, 2010, 7:11 AM CT
Rectal cancer rates are rising
A new analysis has observed that while colon cancer rates have remained steady over the past several decades among people under the age of 40, rectal cancer rates are increasing in this population across races and in both sexes. Published early online in Cancer
, a peer-evaluated journal of the American Cancer Society, the study indicates that greater efforts are needed to diagnose rectal cancer in young individuals who show potential signs of the disease.
Rectal cancer is considered to be rare among young individuals in the United States. Because underestimating rectal cancer's incidence may lead to missed or delayed diagnoses in younger people, Joshua Meyer, MD, a radiation oncologist currently at Fox Chase Cancer Center, led a team that analyzed trends in rectal cancer incidence in the United States compared with colon cancer trends. Dr. Meyer worked on this research while at the New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City.
By conducting a retrospective study using data from the Surveillance Epidemiology and End Results (SEER) cancer registry, the researchers identified 7,661 colon and rectal cancer patients under age 40 years between 1973 and 2005. The scientists then calculated the change in incidence over time for colon and rectal cancers.........
Posted by: Janet Read more Source
August 19, 2010, 7:10 AM CT
Brain connections break down as we age
The circled portion of the older adult' brain on the left indicates the cross-talk
between the two hemispheres that is not apparent in the younger brain on the right.
Provided by Rachael Seidler
It's unavoidable: breakdowns in brain connections slow down our physical response times as we age, a newly released study suggests.
This slower reactivity is linked to an age-related breakdown in the corpus callosum, a part of the brain that acts as a dam during one-sided motor activities to prevent unwanted connectivity, or cross-talk, between the two halves of the brain, said Rachael Seidler, associate professor in the University of Michigan School of Kinesiology and Department of Psychology, and lead study author.
At other times the corpus callosum acts at a bridge and cross-talk is helpful, such as in certain cognitive functions or two-sided motor skills.
The U-M study is the first known to show that this cross-talk happens even while elderly adults are at rest, said Seidler, who also has appointments in the Institute of Gerontology and the Neuroscience Graduate Program. This resting cross-talk suggests that it is not helpful or compensatory for the two halves of the brain to communicate during one-sided motor movements because the opposite side of the brain controls the part of the body that is moving. So, when both sides of the brain talk simultaneously while one side of the body tries to move, confusion and slower responses result, Seidler said.........
Posted by: Daniel Read more Source
August 11, 2010, 7:46 PM CT
Natural vaccine against malaria
A study reported in the journal Science Translation Medicine proposes that preventative therapy with affordable and safe antibiotics in people living in areas with intense malaria transmission has the potential to act as a 'needle-free' natural vaccine against malaria and may likely provide an additional valuable tool for controlling and/or eliminating malaria in resource-poor settings.
This research, which was conducted by a multinational team of scientists from the London School of Tropical Medicine and Hygiene (LSHTM), Heidelberg University School of Medicine, the Max Planck Institute for Infection Biology, Gera number of, and the KEMRI-Wellcome Trust Research Programme, Kenya, observed that infection with malaria parasites during administration of preventative antibiotics developed a vaccine-like immunity against re-infection.
Approximately half the world's population is at risk of malaria and about one million people (mainly children living in sub-Saharan Africa) die each year from malaria, a mosquito-borne parasitic disease. Malaria parasites are transmitted to people through the bite of an infected Anopheles mosquito. Only an estimated 10 to 100 parasites per mosquito bite invade the liver where they replicate. About a week after infection, tens of thousands of parasites are released into the bloodstream where they are responsible for malaria's recurring fevers and cause life-threatening complications.........
Posted by: Mark Read more Source
August 11, 2010, 7:35 PM CT
New Ovarian Cancer Tests Have High Accuracy
Researchers at the Georgia Institute of Technology have attained very promising results on their initial investigations of a new test for ovary cancer. Using a new technique involving mass spectrometry of a single drop of blood serum, the test correctly identified women with ovary cancer in 100 percent of the patients tested. The results can be found online in the journal Cancer Epidemiology, Biomarkers, & Prevention Research.
"Because ovary cancer is a disease of relatively low prevalence, it's essential that tests for it be extremely accurate. We believe we may have developed such a test," said John McDonald, chief research scientist at the Ovarian Cancer Institute (Atlanta) and professor of biology at Georgia Tech.
The measurement step in the test, developed by the research group of Facundo Fernandez, associate professor in the School of Chemistry and Biochemistry at Tech, uses a single drop of blood serum, which is vaporized by hot helium plasma. As the molecules from the serum become electrically charged, a mass spectrometer is used to measure their relative abundance. The test looks at the small molecules involved in metabolism that are in the serum, known as metabolites. Machine learning techniques developed by Alex Gray, assistant professor in the College of Computing and the Center for the Study of Systems Biology, were then used to sort the sets of metabolites that were found in malignant plasma from the ones found in healthy samples. Then, McDonald's lab mapped the results between the metabolites found in both sets of tissue to discover the biological meaning of these metabolic changes.........
Posted by: Emily Read more Source
August 11, 2010, 7:27 PM CT
More heart attacks in cooler weather
Lower outdoor temperatures are associated with an increase in the risk of heart attacks, as per a newly released study by researchers at the London School of Hygiene & Tropical Medicine (LSHTM).
For the study (reported in the British Medical Journal and released online today at bmj.com), the researcher, led by Krishnan Bhaskaran of LSHTM observed that each 1 degree C reduction in temperature on a single day is linked to around 200 extra heart attacks.
Bhaskaran and his colleagues analysed data on 84,010 patients admitted to hospital with a heart attack between 2003 and 2006 and compared this with daily temperatures in England and Wales. The results were adjusted to take into account factors such as air pollution, influenza activity, seasonality and long term trends.
He observed that a 1 degree C reduction in average daily temperature was linked to a cumulative 2% increase in risk of heart attack for 28 days. The highest risk was within two weeks of exposure. The heightened risk may seem small but in the UK there are an estimated 146,000 heart attacks every year, so even a small increase in risk translates to around 200 extra heart attacks for each 1 degree C reduction in temperature on a single day.
"Older people between the ages of 75 and 84 and those with prior coronary heart disease seemed to be more vulnerable to the effects of temperature reductions," comments Krishnan Bhaskaran, "while people who had been taking aspirin long-term were less vulnerable." He continues, "We found no increased risk of heart attacks during higher temperatures, possibly because the temperature in the UK is rarely very high in global terms. Our results suggest that even in the summer, the risk is increased by temperature reductions." In conclusion, he says "our study shows a convincing short term increase in the risk of myocardial infarction (heart attacks) linked to lower ambient temperature, predominantly in the two weeks after exposure."........
Posted by: Daniel Read more Source
August 11, 2010, 7:19 PM CT
Earlier detection of melanoma
This skin tumor is shown after treatment with a new contrast agent that can improve the visualization of skin cancer cells using an advanced medical imaging device.
Credit: American Chemical Society
Researchers are reporting development of a substance to enhance the visibility of skin cancer cells during scans with an advanced medical imaging system that combines ultrasound and light. The hybrid scanner could enable doctors to detect melanoma, the most serious form of skin cancer, in its earliest and most curable stages, the report in the monthly journal ACS Nano
Lihong Wang, Younan Xia, and his colleagues point out that early diagnosis is key to improving survival in patients with melanoma. The five-year survival rate for melanoma is about 98 percent if detected early but can be as low as 15 percent when detected at an advanced stage. Existing imaging techniques for early detection of melanoma produce low-quality images, can "see" only a fraction of an inch below the skin, and use potentially harmful radioactive materials. A promising new technique called photoacoustic tomography (PAT) can overcome these problems. The system shoots light into tumors, which slightly heats up the cancer cells and produces high frequency sound waves that provide images of the tumor. But the PAT system lacks an optimal contrast agent that can easily enter skin cancer cells and make them visible.
The researchers developed such an agent by attaching a peptide (one of the building blocks of proteins) that targets skin cancer cells to gold "nanocages." These hollow gold nanoparticles have a box-like shape and are barely 1/50,000th the width of a human hair. When injected into mice with skin cancer, the nanocages improved the image quality of the cancer cells by three-fold in comparison to nanoparticles lacking the peptide. The gold nanocages also show promise as a way to kill skin cancer cells using heat or anti-cancer drugs, they add.........
Posted by: George Read more Source
August 11, 2010, 7:07 PM CT
Bone marrow stem cells to treat respiratory failure
Xiaohui Fang is the lead author of the new Journal of Biological Chemistry paper providing further evidence of the therapeutic potential of stem cells derived from bone marrow for patients suffering from acute lung injury, one of the most common causes of respiratory failure in intensive care units.
Credit: Cardiovascular Research Institute of the University of California, San Francisco
Scientists are reporting this week newly released study results they say provide further evidence of the therapeutic potential of stem cells derived from bone marrow for patients suffering from acute lung injury, one of the most common causes of respiratory failure in intensive care units.
Led by Drs. Michael A. Matthay and Jae W. Lee at the Cardiovascular Research Institute of the University of California, San Francisco, the team writes in a Journal of Biological Chemistry
"Paper of the Week" that its experiments have revealed how a type of bone marrow stem cell bolsters damaged lung cells.
"We observed that these stem cells secreted a significant quantity of a protein that restored the barrier that keeps fluid and other elements out of the lungs," said Lee, an associate professor of anesthesia at UCSF. "We're optimistic about the promise that future clinical trials may hold".
Researchers for decades have harnessed the natural regenerative properties of bone marrow to treat patients with blood-related diseases. And, of late, investigations into the potential of using bone marrow stem cells to treat damaged tissues have intensified.
There are two types of stem cells in bone marrow. One kind, hematopoietic stem cells, is tasked with producing red and white blood cells, depending upon the immune system's needs. The other, mesenchymal stem cells, is the focus of Matthay and Lee's work. While mesenchymal stem cells also support the production of blood cells, researchers today are quite interested in their ability to differentiate into cells that, when mature, develop into tissues throughout the body.........
Posted by: Scott Read more Source
August 11, 2010, 7:16 AM CT
Drug coverage leads to increased use of antibiotics
Improved drug coverage under Medicare Part D has led to an increase in the use of antibiotics by seniors, especially of brand-name and more expensive drugs, as per a University of Pittsburgh Graduate School of Public Health study. Reported in the Aug. 23 issue of Archives of Internal Medicine
and the first to explore spending on antibiotics under Medicare Part D, the study suggests recent changes in drug coverage improved the use of antibiotics for pneumonia, but could lead to unnecessary spending on expensive broad-spectrum antibiotics and the overuse of inappropriate antibiotics.
"Overuse of antibiotics is a common and important problem that can lead to medical complications and drug resistance," said the study's main author, Yuting Zhang, Ph.D., assistant professor of health economics at the University of Pittsburgh Graduate School of Public Health. "One of the key questions we sought to answer with our study is how improved prescription drug coverage under Part D affects the usage of these drugs."
The study included more than 35,000 Medicare beneficiaries and compared their use of antibiotics two years before and after the implementation of Medicare Part D, which reduced out-of-pocket drug spending between 13 and 23 percent. They observed that antibiotic use increased most among beneficiaries who lacked drug coverage previous to enrolling in Medicare Part D. Beneficiaries who previously had limited drug coverage also were more likely to fill prescriptions for antibiotics after enrolling in Part D. The largest increases were found in the use of broad-spectrum, newer and more expensive antibiotics.........
Posted by: Janet Read more Source
August 11, 2010, 7:05 AM CT
Hear sounds in cardiac failure
For emergency department patients with shortness of breath and a risk of heart failure, physicians usually grab one thing first: a stethoscope.
It allows them to hear the S3, an abnormal third sound in the heart's rhythm strongly associated with cardiac disease and heart failure. However, the low-frequency, low-pitch sound is notoriously very difficult to hear with a stethoscope alone.
In a study available online in the American Journal of Emergency Medicine,
a UC emergency medicine doctor concludes that acoustic cardiography, a new technology combining a 12-leed ECG with cardiac acoustic data, can aid physicians in detecting the S3ultimately increasing the accurate diagnosis of acute heart failure in certain subsets of patients.
The study involved analyzing data from one of the largest emergency department-based trials in acute heart failure, the HEart failure and Audicor technology for Rapid Diagnosis and Initial Treatment (HEARD-IT) multinational trial. The trial, conducted at nine sites from March to October 2006, measured the diagnostic accuracy provided by adding acoustic cardiography to an emergency medicine physician's tools.
"The S3 is highly associated with heart failure," says Sean Collins, MD, UC emergency medicine associate professor and lead author of the study. "So we studied how measuring the presence of the S3 changed physicians' impressions of what was going on, how it potentially changed their workup and treatment for patients".........
Posted by: Daniel Read more Source