August 13, 2006, 8:52 AM CT

Nurses Have A Larger Role In Smoking Cessation

Some good advice from nurses to patients who smoke significantly increases the likelihood of those smokers quitting, as per several articles in a special issue of the July-August 2006 Nursing Research journal.

"These reports are evidence that nurses are widely recognized as central to global efforts to reduce the detrimental health effects of tobacco use," said Dr. Molly C. Dougherty, Nursing Research editor and professor of nursing at the University of North Carolina at Chapel Hill.

The Nursing Research articles contain tobacco cessation information including original research evaluating methods for treating tobacco dependence. For example, one study observed that smokers who received tobacco cessation information from their nurses were nearly 50 percent more likely to quit than smokers with no nursing intervention. The report also notes that nurses often care for underserved people, who are disproportionately affected by tobacco use.

Summaries in the journal highlight innovative methods for treating tobacco dependence and practical approaches for clinical use, including recommendations from 42 researchers, clinicians, educators and representatives from the Agency for Healthcare Research and Quality and the National Cancer Institute.

"This information represents a call to action for nurses, health care providers and policy-makers. Health care professionals, and especially nurses, have tremendous access to patients and families affected by tobacco use. Nurses are in the unique position to act as agents of change when it comes to preventing and treating tobacco dependence," Dougherty said.........

Posted by: Scott      Permalink         Source

August 12, 2006, 6:34 AM CT

Success Of MRI-guided Breast Biopsy

Radiologists can help confirm that an MRI-guided breast biopsy has successfully removed the lesion by taking an x-ray of the lesion and slices of the lesion, a new study shows.

"Contrast-enhanced MRI of the breast is becoming increasingly useful in patients with lesions that cannot be detected with other techniques," said Basak Erguvan-Dogan, MD, radiologist in Breast Imaging at the University of Texas M.D. Anderson Cancer Center in Houston. "However, it is hard to confirm removal of the targeted lesion because the abnormality does not enhance after being removed from the breast," she said.

Currently, patients who have MRI-guided needle localization and excision of abnormalities may be asked to have follow-up breast MRI; if the lesion has not been successfully removed, another biopsy procedure will need to be done. "By taking x-rays of the lesion specimen, then slicing it up and taking additional x-rays, we can determine if the lesion has been removed or if additional tissue needs to be excised while the patient is still in the operating room," Dr. Erguvan-Dogan said.

Whole specimen and sliced specimen radiography waccording toformed in 10 patients, and X-raying the lesion as a whole and in slices proved to be valuable, said Dr. Erguvan-Dogan. "In all five cancerous cases, sliced specimen radiographs showed the lesion in question, helped the pathologist correctly identify the lesion while the patient was still in the operating room and helped the surgeon obtain negative surgical margins," said Dr. Erguvan-Dogan. In addition, "whole specimen radiography is able to correctly locate fractured biopsy needle localization wires, which may be removed before the patient left the operating room," she said.........

Posted by: Janet      Permalink         Source

August 12, 2006, 6:27 AM CT

Herceptin Effective Even With Low HER-2 Levels

Northwestern University and Evanston Northwestern Healthcare researchers have discovered that the monoclonal antibody Herceptin (trastuzumab) used in combination with certain cancer chemotherapies effectively treats breast cancer tumors that produce low or undetectable amounts of the HER-2 oncogene but overexpress the growth factor heregulin (HRG), an activator of the HER-2 cancer oncoprotein. Increased levels of HER-2 are associated with poor patient prognosis, enhanced metastasis (cancer spread) and resistance to chemotherapy.

Until now it was believed that trastuzumab combined with cytotoxic drug therapy was effective only in HER-2--positive, or HER-2--overexpressing, breast cancer - which represents about 25 percent of all breast cancers, said Dr. Ruth Lupu, director of translational breast cancer research at the Evanston Northwestern Healthcare Research Institute, who led the study, published in the August 10 issue of the Journal of Clinical Oncology.

Lupu is also professor of medicine at Northwestern University Feinberg School of Medicine and a researcher at The Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

The study was conducted as part of the Cancer Center's breast cancer SPORE (Specialized Program of Research Excellence) grant.........

Posted by: Janet      Permalink         Source

August 12, 2006, 6:16 AM CT

Breast Cancer Survivors Change Lifestyle

Breast cancer survivors' beliefs about what may have caused their cancer are connected to whether they make healthy lifestyle changes after a cancer diagnosis. This is the finding of a research study appearing in the August 2006 issue of Psycho-Oncology by researchers at The Miriam Hospital and Brown Medical School.

"We found that breast cancer survivors who believed that an unhealthy behavior - such as consuming an unhealthy diet, contributed to their cancer - were more likely to say that they had changed that behavior since their diagnosis," says lead author Carolyn Rabin, PhD, a psychologist at The Miriam Hospital's Centers for Behavioral and Preventive Medicine. "Likewise, breast cancer survivors who believed that a healthy behavior- such as consuming a healthy diet, could ward off a cancer recurrence - were more likely to say that they had adopted that behavior since their diagnosis".

Due to advances in detection and treatment, there are now more than 10 million Americans who are cancer survivors, according to the American Cancer Society. However, researchers have not yet determined why some cancer survivors are motivated by a cancer diagnosis to make healthy lifestyle changes, while others are not. This question prompted the study by researchers at The Miriam Hospital and Brown Medical School.........

Posted by: Janet      Permalink         Source

August 12, 2006, 6:11 AM CT

"DES Daughters" And Risk Of Breast Cancer

So-called "DES daughters," born to mothers who used the anti-miscarriage drug diethylstilbestrol during pregnancy, are at a substantially greater risk of developing breast cancer compared to women who were not exposed to the drug in utero.

Reporting in the recent issue of the journal Cancer Epidemiology, Biomarkers & Prevention, a nationwide team of researchers found that DES daughters over age 40 had 1.9 times the risk of developing breast cancer, compared to unexposed women of the same age. They also found that the relative risk of developing the cancer was even greater in DES daughters over age 50, but say the number of older women in their study group is, as yet, too small for a firm statistical comparison.

"This is really unwelcome news because so many women worldwide were prenatally exposed to DES, and these women are just now approaching the age at which breast cancer becomes more common," said the study's lead author, Julie Palmer, Sc.D., professor of epidemiology at the Boston University School of Public Health.

She said an estimated one to two million women in the U.S. were exposed to DES, which was frequently prescribed to women from the 1940s through 1960s to prevent miscarriages.

The ongoing study suggests that DES-exposed women are developing the typical range of breast cancers after age 40 at a faster rate than non-exposed women of the same ages. The researchers also found that the highest relative risk of developing breast cancer was observed in study participants from the cohorts with the highest cumulative doses of DES exposure.........

Posted by: Janet      Permalink         Source

August 11, 2006, 6:42 AM CT

The 'Good Life' elusive for middle class

In research to be presented at the American Sociological Association's annual meeting, Phyllis Moen, McKnight Presidential Chair in Sociology at the University of Minnesota, says that middle class couples who both work struggle to compete in job environments designed for single earners with no family responsibilities. As per Moen, couples still are operating under outdated work policies and practices and institutional and organizational rules designed for a one earner, one homemaker model.

"Middle class couples are stretched thin in terms of time by "work-friendly" jobs," said Moen. "In part this reflects the realities of a global information economy with its speed-ups, pressures to increase productivity, 24-7 availability by computer, downsizing insecurities, expectations of long hours and little schedule flexibility."

In her paper, Moen describes evidence that middle class dual-earner couples, who appear advantaged given their education and resources, are nevertheless stretched thin. In fact, fewer than one in six qualify as "super couples" (those where both husband and wife have a high quality of life). And those who fit this category tend to be couples with no children.

In about half of the 1,060 couples she studied, Moen observed that both the husbands and wives reported either low quality of life or only adequate -- what she calls "good enough" -- quality of life. Women working in job environments that are insecure or offer them little scheduling flexibility and control are unlikely to have individual or couple life quality.........

Posted by: Janet      Permalink         Source

August 11, 2006, 0:14 AM CT

Effect Of Parental Cigarette Use In Children

A new study exploring smoking, heavy drinking and marijuana use across three generations indicates that the children of a parent who uses any of these substances are more likely to smoke, binge drink or use marijuana in adolescence and adulthood. Drug transmission across generations, the study found, was for a general tendency to use these substances rather than to use any one specifically, with the exception of tobacco.

The children of cigarette smokers face an particularly murky future, as per the University of Washington study reported in the current issue of the Journal of Abnormal Child Psychology.

"If your parents were smokers it is a double whammy because you are more likely to use drugs in general and even more likely to smoke cigarettes," said Karl Hill, a research associate professor at the UW's Social Development Research Group and co-author of the new study. "There is something about tobacco that if parents smoke, their kids are more likely to smoke. It may be that parents who smoke might leave cigarettes around where their children can see and get to them. Parents may not leave marijuana and alcohol around in the same way".

Data from the paper were drawn from two long-term UW studies, the Seattle Social Development Project and the Intergenerational Project, which are tracing youth development and social and antisocial behavior. Participants were recruited from Seattle elementary schools, and 808 students have been followed since 1985. In addition to the participants, who make up generation 2, data were collected from their parents (generation 1) and their children (generation 3).........

Posted by: JoAnn      Permalink         Source

August 11, 2006, 0:07 AM CT

Bisphosphonates In Treatment Of Multiple Myeloma

Mayo Clinic's multiple myeloma (MM) research team has jointly issued a consensus statement regarding the use of bisphosphonates to prevent or treat bone disease in MM. Their recommendations address several controversial issues, including the type of bisphosphonate to be used and the duration of such treatment, and are available in the recent issue of Mayo Clinic Proceedings.

"It was imperative that we address the issue that has been under recent intense debate due to patient safety concerns," said Martha Lacy, M.D., Mayo Clinic hematologist and lead author of the statement. "These drugs have far-ranging effects that raised concerns in the medical field, so we brought together the relevant specialists to develop a set of best practice recommendations. We published them in Mayo Clinic Proceedings in order to provide other physicians the benefit of our shared knowledge".

The Mayo Clinic team provided recommendations for the myeloma patients for whom bisphosphonates are indicated. They said pamidronate should be the bisphosphonate of choice for patients who are starting treatment, over the newer, more potent drug zoledronic acid, which is more frequently linked to serious damage to jaw bones. Also in the interest of safety, the team recommended that patients without active disease stop bisphosphonate treatment after two years, and patients with active disease reduce the frequency at which the drugs are given.........

Posted by: Janet      Permalink         Source

August 11, 2006, 0:03 AM CT

Advances In Bipolar Disorder Treatment

A new care model for bipolar disorder tested in veterans across the nation reduced their manic episodes and improved their quality of life, as per research led by a psychiatry expert with the Providence Veterans Affairs Medical Center and Brown Medical School.

The randomized, controlled trial also showed that the model did not add to the therapy costs for bipolar disorder, which affects nearly 6 million American adults a year. Results appear in two reports published in Psychiatric Services, a journal of the American Psychiatric Association.

"We applied the same symptom management approaches found in interventions for diabetes and asthma to the therapy of bipolar disorder and observed that people with serious mental illness can help take control of their care," said Mark S. Bauer, M.D., staff psychiatry expert with the Providence V.A. Medical Center and professor of psychiatry and human behavior at Brown Medical School. "This finding should reduce the stigma of helplessness that so often is linked to these disorders, and it will open new avenues for the therapy of bipolar disorder".

Bauer oversaw the clinical trial and is the lead author of both journal articles.

The new model was developed and tested in veterans with bipolar disorder at the Providence V.A. Medical Center. During the trial, 306 veterans were enrolled at 11 V.A. centers located in Arizona, California, Colorado, Georgia, Indiana, Maryland, Ohio, Pennsylvania, Tennessee and Texas. Each veteran was randomly assigned to a study group. One group got usual care through their psychiatry expert. The other group received therapy under the new model.........

Posted by: JoAnn      Permalink         Source

August 10, 2006, 11:55 PM CT

Parental Time And Childhood Obesity

The fight against obesity in children just got a new weapon, thanks to a multi-year study by scientists from Texas A&M University.

The study observed that the amounts and quality of time parents spent with their children has a direct effect on children's rates of obesity, said Dr. Alex McIntosh, lead researcher. McIntosh is professor of sociology with a research appointment from Texas Agricultural Experiment Station.

The U.S. Department of Agriculture study, "Parental Time, Role Strain and Children's Fat Intake and Obesity-Related Outcomes," was published in June.

In general, scientists found the amount of time a mother spent with her child, her work stress and her income level had a larger impact in lowering the child's risk of obesity than the father's time, work stress and income, McIntosh said.

Furthermore, the more time a mother spends with the child, the less likely that child is to be obese; on the other hand, the more time a father spends with a child, the more likely the child will be obese, he said.

"The impacts were greater for 9- to 11-year-old children than for 13- to 15-year-old children," he added.

As a sociologist, McIntosh has long wondered how parents influence their children's nutritional habits, he said.........

Posted by: JoAnn      Permalink         Source