January 4, 2011, 6:59 AM CT
Fertility preservation for oncology patients
A number of young people who've just learned that they have cancer also are told that the therapies that may save their lives could rob them of their ability ever to have children. Infertility caused by chemotherapy and radiation affects a sizable population: Of the 1.5 million people diagnosed with cancer in 2009, nearly 10 percent were still in their reproductive years.
The good news, as per an article in the recent issue of Mayo Clinic Proceedings
(http://www.mayoclinicproceedings.com ), is that techniques to harvest and store reproductive cells have vastly improved in the last several years. "Fertility preservation is still an emerging discipline," says Mayo Clinic reproductive endocrinologist (http://www.mayoclinic.org/reproductive-medicine/) Jani Jensen, M.D. (http://www.mayoclinic.org/bio/13767992.html) , main author of the paper, "but rapid advances in technology in the last several years are now providing new options for patients."
In the review, a team of Mayo scientists look at both long-standing and emerging fertility preservation technologies. Freezing sperm remains a stable and reliable technique, but one approach that has had considerable success in the last five years involves freezing eggs harvested from women. "Cryopreservation of eggs used to be considered the Holy Grail of treatment, not just for cancer patients, but for any woman who wanted to halt the biological clock," says Dr. Jensen. Oocytes are especially fragile cells that rupture easily, and even though research to preserve them dates back to the 1970s, the first successful birth from a stored egg didn't occur until the mid-1980s. "But in the last five years," Dr. Jensen says, "there have been considerable improvements in freezing technology. Since 2004, there have been thousands of babies born worldwide from frozen eggs".........
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January 4, 2011, 6:44 AM CT
Mothers Key To College-age Women Receiving HPV Vaccine
Even after young women reach adulthood, their mothers can play a key role in convincing them to receive the human papillomavirus (HPV) vaccine, new research suggests.
A study observed that college-aged women were more likely to say they had received the HPV vaccine if they had talked to their mother about it.
"Mothers talking to their daughters were an important factor in whether young women were vaccinated," said Janice Krieger, main author of the study and assistant professor of communication at Ohio State University.
"It is an encouraging finding, because it shows that communication between mothers and daughters can be very helpful, even if it appears to be difficult sometimes".
A number of mothers and daughters appears to be uncomfortable talking about the HPV vaccine, because it is designed to prevent the spread of a sexually-transmitted virus, Krieger said.
But regardless of the difficulty in talking about it, the vaccine is important because a persistent HPV infection may cause cancer. HPV is the most common sexually transmitted infection and will infect about half of sexually active people in the United States during their lifetimes.
The study appears in the January 2011 issue of the journal Human Communication Research.........
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January 4, 2011, 6:36 AM CT
Kids frequently exposed to imaging procedures
The rapid growth in use of medical diagnostic imaging, such as Computerized axial tomography scans, has led to widespread concern about radiation exposure in adults and the potential for future cancer risk in patients undergoing these tests.
A newly released study led by University of Michigan scientists now shows that kids also frequently receive these types of imaging procedures during their routine clinical care, and highlights the importance of initiatives to ensure that those tests being performed are necessary and use the lowest possible doses of radiation.
"Our findings indicate that more awareness about the frequent use of these tests appears to be needed among care providers, hospitals and parents," says Adam L. Dorfman, M.D., clinical assistant professor of pediatrics and communicable diseases and of radiology at the U-M Medical School. "Imaging tests are a critical component of good medical care, but the high number of tests raises questions about whether we are being judicious in our use of the technology".
The results of this study were published online today in the Archives of Pediatrics and Adolescent Medicine.
Despite widespread discussions about the health hazards of environmental exposures in children, radiation exposure from the frequent use of imaging procedures has received less attention, possibly due to limited contemporary data in younger patients. As such, this study identified 355,088 children under the age of 18 in five large U.S. health care markets to track how often these imaging procedures are used. The study observed that over 400,000 imaging procedures were performed in just 3 years, with 42.5% of the children receiving at least one of these procedures and a number of undergoing multiple tests. The types of tests the researchers considered included everything from routine x-rays that use very low doses of radiation to more advanced tests, like Computerized axial tomography scans, that require doses that are greater. Based on these data, the average child in this study population would be expected to receive approximately 7 imaging procedures utilizing radiation by age 18.........
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January 4, 2011, 6:24 AM CT
Vitamin D deficiencies and autoimmune lung disease
A newly released study shows that vitamin D deficiency could be associated with the development and severity of certain autoimmune lung diseases.
These findings are being published in the Jan. 4 edition of the journal Chest
Brent Kinder, MD, UC Health pulmonologist, director of the Interstitial Lung Disease Center at the University of Cincinnati and lead investigator on the study, says vitamin D deficiencies have been found to affect the development of other autoimmune diseases, like lupus and type 1 diabetes.
"We wanted to see if lack of sufficient vitamin D would also be seen in patients who are diagnosed with an autoimmune interstitial lung disease (ILD) and whether it was linked to reduced lung function," he says.
Some ILD patients first discover they have an undifferentiated connective tissue disease, a chronic inflammatory autoimmune disease that affects multiple organ systems but is not developed enough for physicians to easily recognize and categorize.
Autoimmune diseases occur when the body produces abnormal cells that turn on the body and attack major organs and tissues. Connective tissue diseases include lupus, scleroderma, polymyositis, vasculitis, rheumatoid arthritis and Sjogren's syndrome.
"ILD is a group of diseases that mainly affect the tissues of the lungs instead of the airways, like asthma and emphysema do," says Kinder. "It causes scarring of the lungs, is more difficult to diagnosis and treat than other kinds of lung diseases and is often fatal.........
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January 4, 2011, 6:21 AM CT
Estrogen may help precancerous cells spread
head and neck cancer is the sixth most common type of cancer and is on the rise in some demographic groups, including young women without any known risk factors. Now, scientists at Fox Chase Cancer Center report that estrogen may increase the movement of premalignant cells in the mouth and thus promote the spread of the disease within the oral cavity.
The new results, reported in the recent issue of Cancer Prevention Research
, a journal of the American Association for Cancer Research, may lead to novel chemoprevention strategies in the future.
Margie Clapper, Ph.D., co-leader of the Cancer Prevention and Control Program at Fox Chase Cancer Center and Cancer Prevention Research editorial board member, and his colleagues had previously reported that estrogen metabolism changes following smoke exposure in the lungs and may contribute to lung cancer. This study on estrogen and lung cancer first appeared in the June 3, 2010, issue of Cancer Prevention Research.
To find out if this female hormone influences development of head and neck cancer, Ekaterina Shatalova, Ph.D., a postdoctoral fellow at Fox Chase Cancer Center and researcher on this study, examined the impact of estrogen on premalignant and malignant cells.
They observed that estrogen induces the expression of an enzyme called cytochrome P450 1B1 (CYP1B1), which is responsible for breaking down toxins and metabolizing estrogen. Interestingly, CYP1B1 induction occurred only in premalignant cells, which are neither totally normal nor malignant. Surprisingly, estrogen did not induce CYP1B1 in cancer cells.........
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January 3, 2011, 6:48 AM CT
Alcoholism and risk for obesity
Addiction scientists at Washington University School of Medicine in St. Louis have observed that a risk for alcoholism also may put individuals at risk for obesity.
The scientists noted that the association between a family history of alcoholism and obesity risk has become more pronounced in recent years. Both men and women with such a family history were more likely to be obese in 2002 than members of that same high-risk group had been in 1992.
"In addiction research, we often look at what we call cross-heritability, which addresses the question of whether the predisposition to one condition also might contribute to other conditions," says first author Richard A. Grucza, PhD. "For example, alcoholism and drug abuse are cross-heritable. This newly released study demonstrates a cross-heritability between alcoholism and obesity, but it also says - and this is very important - that some of the risks must be a function of the environment. The environment is what changed between the 1990s and the 2000s. It wasn't people's genes".
Obesity in the United States has doubled in recent decades from 15 percent of the population in the late 1970s to 33 percent in 2004. Obese people - those with a body mass index (BMI) of 30 or more - have an elevated risk for high blood pressure, diabetes, heart disease, stroke and certain cancers.........
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January 3, 2011, 6:41 AM CT
Angry at God? If so, you're not alone
The notion of being angry with God goes back to ancient days. Such personal struggles are not new, but Case Western Reserve University psychology expert Julie Exline began looking at "anger at God" in a new way.
"A number of people experience anger toward God," Exline explains. "Even people who deeply love and respect God can become angry. Just as people become upset or angry with others, including loved ones, they can also become angry with God."
Exline, an associate professor in Case Western Reserve's College of Arts and Sciences, has researched anger toward God over the past decade, conducting studies with hundreds of people, including college students, cancer survivors and grief-stricken family members.
She and her colleagues report their results in the article, "Anger toward God: Social-Cognitive Predictors, Prevalence, and Links with Adjustment to Bereavement and Cancer" in the new issue of the Journal of Personality and Social Psychology
Anger toward God often coincides with deaths, illnesses, accidents or natural disasters. Yet anger is not limited to traumatic situations. It can also surface when people experience personal disappointments, failures, or interpersonal hurts. Some people see God as ultimately responsible for such events, and they become angry when they see God's intentions as cruel or uncaring. They might believe that God abandoned, betrayed, or mistreated them, Exline says.........
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January 3, 2011, 6:39 AM CT
CPAP therapy reduces fatigue
Patients with obstructive sleep apnea often report that they feel like "a new person" after beginning therapy with continuous positive airway pressure treatment. A newly released study in the Jan. 1 issue of the journal SLEEP
provides objective evidence to support these anecdotal reports, showing that three weeks of CPAP treatment significantly reduced fatigue and increased energy in patients with OSA.
Results of the randomized controlled trial show that CPAP treatment significantly reduced self-reported, mean fatigue scores on two independent measures: from 8.76 at baseline to -0.10 post-treatment on the Multidimensional Fatigue Symptom Inventory � Short Form; and from 7.17 at baseline to 4.03 post-treatment on the fatigue-inertia subscale of the Profile of Mood States � Short Form. These results indicate that participants were no longer suffering from clinically significant levels of fatigue after the three-week intervention period.
Self-reported energy levels also increased after three weeks of CPAP treatment, with the mean score on the vigor-activity subscale of the Profile of Mood States � Short Form increasing significantly from 14.28 at baseline to 16.52 post-treatment. Significant changes in fatigue and energy were not observed in participants who received placebo CPAP.........
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January 3, 2011, 6:20 AM CT
Tonsillectomy in children
A multidisciplinary clinical practice guideline, "Tonsillectomy in Children" would be reported in the recent issue of Otolaryngology�Head and Neck Surgery
(watch for a new cover and publisher in that issue of the journal). The new guideline provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children aged 1 to 18 years under consideration for tonsillectomy. Additionally, this guideline is intended for all clinicians in any setting who care for these patients. This guideline also addresses practice variation in medicine and the significant public health implications of tonsillectomy.
Tonsillectomy is one of the most common surgical procedures in the United States, with over 530,000 procedures performed annually in children under 15 years old. Tonsillectomy is defined as a surgical procedure (performed with or without adenoidectomy) that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Depending on the context in which it is used, the term may indicate tonsillectomy with adenoidectomy, particularly in relation to sleep-disordered breathing.
"Over half a million tonsillectomies are done every year in the United States," said Richard M. Rosenfeld, MD, MPH, journal guideline author and consultant. "The tonsillectomy guideline will empower doctors and parents to make the best decisions, resulting in safer surgery and improved quality of life for children who suffer from large or infected tonsils".........
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December 30, 2010, 6:39 AM CT
New answers for health care design?
Reception area of the Røros Rehabilitation center during the plant intervention.
Credit: Photo by Herman Tandberg, Tandberg Industridesign.
Could a plant "intervention" improve the well-being of patients in a difficult rehab process? Researchers from the Norwegian University of Life Sciences and Sweden's Uppsala University investigated this question in a recent study of 436 coronary and pulmonary patients at a Norwegian rehabilitation center. The results were published in HortScience
Ruth Kj�rsti Raanaas, Grete Grindal Patil, and Terry Hartig studied the effects of an indoor plant intervention during a 2-year study conducted at the R�ros Rehabilitation Center. The experiment showed that patients' overall physical and mental health improved during the program, but the presence of new plants did not increase the degree of improvement. One encouraging finding: pulmonary patients in the "plant intervention group" reported a larger increase in well-being during their rehabilitation program more often than lung patients from the "no-plant" control group.
For the intervention, 28 new plants were placed in common areas at the rehab center, which had previously contained only a few poorly maintained plants. Aside from the introduction of the new plants and removal of some older plants, no other changes were made to the interior decoration during the study period. Coronary and pulmonary patients completed self-evaluations upon arrival at the center, after 2 weeks, and at the end of a 4-week program. The research project, designed to investigate whether the addition of indoor plants in the common areas would improve self-reported physical and mental health, subjective well-being, and emotions among patients over the course of their rehabilitation program, was funded by the Norwegian Foundation for Health and Rehabilitation, the Norwegian Gardener's Union, the Bank of R�ros, Tropisk Design, and Primaflor.........
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