June 9, 2008, 9:25 PM CT
Women worrying about cancer
A significant number of women worrying about cancer may be experiencing sleep disturbances, even without a breast cancer diagnosis, as per a research abstract that will be presented by Amita Dharawat, MD, on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
This collaborative study, from the Brooklyn Health Disparities Center at SUNY Downstate Medical Center and Long Island University in Brooklyn, New York, focused on 1,038 community-based residents, between 50 and 70 years of age; none of whom had a history of a physician-diagnosed cancer. Sleep complaint was defined as a report of either difficulty initiating sleep, maintaining sleep, or early morning awakening.
As per the results, 65 percent of the women reported that they worried about developing breast cancer, and 49 percent reported a sleep complaint. Twenty-seven percent indicated that cancer worry affected their mood, while 25 percent indicated that it affected their daily activity. The odds of reporting sleep complaints for women who worry about cancer were nearly 50 percent greater than odds for women who reported no cancer worry, independent of several confounders.
This is a unique and important finding because sleep-related complaints have never been studied in women who worry about cancer, without a diagnosis, and it provides practitioners with knowledge with regards to identifying and targeting women who report sleep-related complaints with cognitive behavioral treatment, said Dr. Dharawat, who is a second year medical resident, working with Dr. Girardin Jean-Louis on an NIH funded Womens Health Project.........
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June 9, 2008, 8:27 PM CT
Mother's obesity and newborn deaths
Hamisu Salihu, MD, PhD
maternal obesity appears to have no impact on the early survival of infants born to white women, the situation is different for black women, scientists report in the June 2008 issue of the journal Obstetrics & Gynecology.
Infants of obese black mothers had a higher risk of death in the first 27 days following birth than newborns of obese white mothers, the scientists found. Furthermore, this black disadvantage in neonatal infant mortality widened with an increase in the body mass index (BMI).
"Even if the infant of an obese black woman survives pregnancy, labor and delivery, that baby is at greater risk of dying than a baby born to an obese white woman," said the study's lead author Hamisu Salihu, MD, PhD, associate professor of epidemiology at the USF College of Public Health.
The scientists analyzed more than 1.4 million births recorded from Missouri's vital records database, covering the period 1978 through 1997. The database linked black and white mother-infant pairs. Among all women, the likelihood of neonatal death (up to 27 days following death) and early neonatal death (up to six days following death) was 20 percent greater than for nonobese women, the researcher found.
Further analysis revealed that the higher risk of neonatal deaths among newborns of obese mothers was confined to blacks only. The rate of neonatal deaths increased significantly with rising BMIs of black women (ranging from 50 to 100-percent increments). However, the offspring of obese white mothers, regardless of the severity of maternal obesity, had no greater risk of neonatal death than the newborns of nonobese women.........
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June 8, 2008, 8:41 PM CT
New pathogen from pigs' stomach ulcers
Researchers have isolated a new bacterium in pigs' stomachs thanks to a pioneering technique, offering hope of new therapys to people who suffer with stomach ulcers, as per research reported in the recent issue of the International Journal of Systematic and Evolutionary Microbiology.
The bacterium that usually causes stomach ulcers in humans is called Helicobacter pylori. Extensive research has been carried out on this bacterium and the two researchers who discovered it were awarded the Nobel Prize for Physiology and Medicine in 2005. However, in a small percentage of biopsies a similar but previously unidentified bacterium is present. Numerous research papers have described failed attempts to culture this microbe in the laboratory since it was first observed in 1990. Now, researchers from Belgium have succeeded.
"We have developed a new method to cultivate these bacteria and can now study their main characteristics and virulence properties," said Professor Dr Freddy Haesebrouck from Gent University in Belgium. The scientists had to recreate aspects of the bacterium's natural habitat, the stomach. They used acid, which kills other microbes but is needed for these bacteria to grow. Charcoal was used to remove substances that are toxic to the stomach bacterium. Genetic analysis revealed that it is a new species correlation to the common stomach ulcer bacterium Helicobacter pylori. Its name, Helicobacter suis, comes from the Latin for "of the pig".........
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June 8, 2008, 8:26 PM CT
Origins of the brain
One of the great scientific challenges is to understand the design principles and origins of the human brain. New research has shed light on the evolutionary origins of the brain and how it evolved into the remarkably complex structure found in humans.
The research suggests that it is not size alone that gives more brain power, but that, during evolution, increasingly sophisticated molecular processing of nerve impulses allowed development of animals with more complex behaviours.
The study shows that two waves of increased sophistication in the structure of nerve junctions could have been the force that allowed complex brains - including our own - to evolve. The big building blocks evolved before big brains.
Current thinking suggests that the protein components of nerve connections - called synapses - are similar in most animals from humble worms to humans and that it is increase in the number of synapses in larger animals that allows more sophisticated thought.
"Our simple view that 'more nerves' is sufficient to explain 'more brain power' is simply not supported by our study," explained Professor Seth Grant, Head of the Genes to Cognition Programme at the Wellcome Trust Sanger Institute and leader of the project. "Eventhough a number of studies have looked at the number of neurons, none has looked at the molecular composition of neuron connections. We found dramatic differences in the numbers of proteins in the neuron connections between different species".........
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June 5, 2008, 10:28 PM CT
Vitamin D and type 1 diabetes
Food rich in vitamin-D
Sun exposure and vitamin D levels may play a strong role in risk of type 1 diabetes in children, as per new findings by scientists at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine. This association comes on the heels of similar research findings by this same group regarding vitamin D levels and several major cancers.
In this new study, the scientists observed that populations living at or near the equator, where there is abundant sunshine (and ultraviolet B irradiance) have low incidence rates of type 1 diabetes. On the other hand, populations at higher latitudes, where available sunlight is scarcer, have higher incidence rates. These findings add new support to the concept of a role of vitamin D in reducing risk of this disease.
Ultraviolet B (UVB) exposure triggers photosynthesis of vitamin D3 in the skin. This form of vitamin D also is available through diet and supplements.
"This is the first study, to our knowledge, to show that higher serum levels of vitamin D are linked to reduced incidence rates of type 1 diabetes worldwide," said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center.........
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June 5, 2008, 10:23 PM CT
Revision of osteoporosis guidelines
Tufts University researcher Bess Dawson-Hughes, M.D., chaired the committee that recently updated the National Osteoporosis Foundation (NOF) Clinician's Guide to Prevention and Treatment of Osteoporosis. The new Clinician's Guide incorporates the World Health Organization (WHO) absolute fracture prediction algorithm (FRAX), a computer-based tool expected to increase the identification of patients at risk for osteoporosis.
"The introduction of the WHO's fracture prediction algorithm necessitated the revision of the Clinician's Guide," says Dawson-Hughes, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. "The algorithm tells clinicians how likely a patient is to fracture a bone due to osteoporosis or low bone mass in the 10 years following examination, also known as 10-year fracture risk. This can help clinicians decide whether a patient needs to be treated or simply monitored."
Writing in the April 2008 issue of the journal Osteoporosis International, corresponding author Dawson-Hughes and his colleagues describe how to apply FRAX in the United States. Clinicians estimate a patient's 10-year fracture risk using a computer program that considers bone mineral density (BMD) score, or T-score, and nine clinical risk factors including personal fracture history, family fracture history, weight, race and gender. Notably, FRAX and the new Clinician's Guide now apply to men over 50 and post-menopausal non-Caucasian women, including African-Americans, Asians and Latinas. Prior versions applied only to post-menopausal Caucasian women, the group at highest-risk for osteoporosis.........
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June 5, 2008, 10:21 PM CT
Primary care visits reduce hospital utilization
Scientists from Boston University School of Medicine (BUSM) have observed that primary care visits reduce hospital utilization among Medicare beneficiaries at the end of life. The recently published study appears in the Journal of General Internal Medicine.
As per researchers, medical therapys for the six percent of Medicare beneficiaries who die each year comprise almost 30 percent of Medicare expenditures. In addition, the quality of end-of-life care is often poor. Problems include late referrals to hospice, undertreatment of pain, overtreatment with unwanted or ineffective procedures, poor communications regarding prognosis and therapy preferences, and in-hospital deaths that are inconsistent with stated preferences.
Scientists measured hospital utilization during the final six months of life and the number of primary care doctor visits in the 12 preceding months for 78,356 Medicare beneficiaries age 66 +. Hospital days, costs, in-hospital death, and presence of two types of preventable hospital admissions also were studied.
Thirty-eight percent of adults did not have any primary care visits during their final six months of life, 22 percent had one to two primary care visits, 19 percent had three to five visits, 10 percent had six to eight visits and 11 percent had nine or more visits. More primary care visits in the preceding year were linked to fewer hospital days (15.3 days for those with no primary care visits vs. 13.4 days for those with nine or more visits) lower costs ($24,400 vs. $23,400) less in-hospital death (44 percent vs. 40 percent) and fewer preventable hospitalizations for those with congestive heart failure or chronic obstructive pulmonary disease.........
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June 5, 2008, 10:18 PM CT
How to lose weight without losing bone
A higher-protein diet that emphasizes lean meats and low-fat dairy foods as sources of protein and calcium can mean weight loss without bone loss--and the evidence is in bone scans taken throughout a new University of Illinois study.
The research, which compared the results of a high-protein, dairy-intensive diet with a conventional weight-loss diet based on the food-guide pyramid, was published in this month's Journal of Nutrition.
"This is an important finding because a number of people, particularly women in mid-life, are concerned with both obesity and osteoporosis," said Ellen Evans, a U of I associate professor of kinesiology and community health and member of the U of I Division of Nutritional Sciences.
"Furthermore, treating obesity often increases risk for osteoporosis. A number of people lose bone mass when they lose weight," she said.
Co-author of study Donald Layman, a U of I professor of nutrition, has previously reported that protein-rich weight-loss diets preserve muscle mass, help lower blood sugar and lipids, and improve body composition by targeting weight carried in the abdomen.
In the recent study, Layman's diet prescribed approximately 30 percent of all calories from protein, with an emphasis on lean meats and low-fat dairy products.........
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June 5, 2008, 10:15 PM CT
How best to treat chronic pain?
How best to alleviate chronic pain, a leading cause of disability and employee absenteeism, continues to perplex both patients and their doctors.
A review of recent studies on pain medicine appearing in the June 2008 issue of the Journal of General Internal Medicine reports that while various approaches and combinations of therapies to treat pain have advantages and disadvantages, scientists don't yet know how to determine which is best for individual patients.
Among the approaches to pain management studied were those relying on the prescription of opioids (drugs such as morphine, Percocet and Vicodin), surgery, and alternative medicine (acupuncture, herbal remedies).
"We conducted this review of pain management strategies because doctors, particularly primary care doctors who manage the bulk of patients with chronic pain, are frustrated and want to know how to better alleviate what is often debilitating pain. A number of of these physicians have not been well trained in pain management. And while a number of are paying more attention to pain than ever before, particularly given JCAHO (Joint Commission on Accreditation of Healthcare Organizations) and Veteran Affairs mandates that pain be regarded as the --fifth vital sign,-- they don't know what therapy will work for a given patient. They want guidance and we found very limited information," said the paper's senior author, Matthew J. Bair, M.D. Dr. Bair is an assistant professor of medicine at the Indiana University School of Medicine, a research scientist with the Regenstrief Institute, Inc. and an investigator at the Roudebush VA Center of Excellence for Implementing Evidence Based Practice.........
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June 4, 2008, 11:06 PM CT
Symbicort for treatment of asthma in children as young as 6
AstraZeneca today announced that it submitted a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) for approval of a new indication for SYMBICORT® (budesonide/formoterol fumarate dihydrate) Inhalation Aerosol for the long-term maintenance therapy of asthma in pediatric patients ages 6 to 11 years old. SYMBICORT is currently approved for the long-term maintenance therapy of asthma in patients 12 years and older.
"Millions of children in the U.S. are affected by asthma1," said lead investigator Jeffrey Leflein, MD, Allergy & Immunology Associates of Ann Arbor, Michigan. "SYMBICORT could potentially offer another therapy option for the long-term maintenance of asthma in young children whose condition is not adequately controlled with inhaled corticosteroids alone".
The submission package is based on a robust clinical development program consisting of five active or placebo-controlled Phase III trials assessing the efficacy and safety of SYMBICORT pressurized metered-dose inhaler (pMDI) that included 1,446 children ages 6 to 11 years old with asthma.2 The proposed starting dose for children (80/9 mcg twice-daily) was studied in one pivotal randomized, double-blind, active-controlled, 12-week study that reviewed 256 children ages 6 to 11 years old with mild-to-moderate persistent asthma previously treated with inhaled corticosteroid treatment.3 In this study, SYMBICORT was in comparison to budesonide pMDI and formoterol dry powder inhaler.3 A second study evaluating this dose included 351 subjects ages 6 to 11 years old.4 Results from both studies demonstrated that SYMBICORT 80/9 mcg twice daily had a similar safety profile to one of the mono-components, budesonide;4,5 likewise, results from the first study also observed that SYMBICORT 80/9 mcg twice daily had a similar safety profile to its other mono-component, formoterol.5 The most common adverse events reported were headache, pyrexia, upper respiratory tract infection, nasopharyngitis, and pharyngolaryngeal pain.2 .........
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