December 3, 2008, 5:25 AM CT

Exposure to secondhand smoke reduced

As the correlation between second-hand smoke and coronary heart disease (CHD) became clearer and legislation was passed to reduce such passive smoking, exposures have been reduced. In an article reported in the January 2009 issue of the American Journal of Preventive Medicine, scientists from the University of California, San Francisco, Partners Healthcare, Boston and Columbia University have recalibrated the CHD Policy Model to better predict future trends in CHD.

At 1999჻� levels, passive smoking caused between 21,800 and 75,100 CHD deaths and between 38,100 and 128,900 myocardial infarctions annually. Treatment costs ranged from $1.8 to $6.0 billion per year. If recent trends in the reduction in the prevalence of passive smoking continue from 2000 to 2008, scientists predict that the burden would be reduced by approximately 25%󈞊%.

The CHD Policy Model is a computer simulation of CHD incidence, prevalence, mortality and costs in the US population aged >35 years. Using data from a variety of sources, such as the US Census, the Framingham Heart Study (FHS), the Framingham Offspring Study (FOS), the National Health and Nutrition Evaluation Survey (NHANES), the National Hospital Discharge Survey (NHDS) and the Year 2000 National Health Interview Survey (NHIS), the scientists updated the Model to better predict how reduced second-hand smoke may reduce CHD......... Posted by: Daniel      Read more         Source

December 3, 2008, 5:23 AM CT

New breast imaging technology targets hard-to-detect cancers

Breast-specific gamma imaging (BSGI) is effective in the detection of cancers not found on mammograms or by clinical exam, as per a research studypresented today at the annual meeting of the Radiological Society of North America (RSNA).

"BSGI can identify the most difficult to detect breast cancerinvasive lobular carcinoma," said lead author Rachel F. Brem, M.D., professor of radiology and director of the Breast Imaging and Interventional Center at The George Washington University Medical Center in Washington, D.C. "It also can help us detect additional lesions of all types of breast cancer in women whose mammograms show only one suspicious lesion."

Breast cancer affects more women than any other non-skin cancer and, as per the American Cancer Society, accounts for more than 40,000 deaths annually in the U.S. Most experts agree that the best way to decrease breast cancer mortality is through early detection using mammography and clinical breast exam. However, some cancers are difficult to detect with mammography and clinical exam, especially in the earliest stage when therapy is most effective.

Typically while mammography findings are characterized by the difference in appearance between normal and suspicious breast tissue, BSGI findings are based on how malignant cells function......... Posted by: Janet      Read more         Source

December 3, 2008, 5:21 AM CT

Stress-related disorders affect brains processing of memory

Scientists using functional MRI (fMRI) have determined that the circuitry in the area of the brain responsible for suppressing memory is dysfunctional in patients suffering from stress-related psychiatric disorders. Results of the study will be presented today at the annual meeting of the Radiological Society of North America (RSNA).

"For patients with major depression and other stress-related disorders, traumatic memories are a source of anxiety," said Nivedita Agarwal, M.D., radiology resident at the University of Udine in Italy, where the study is being conducted, and research fellow at the Brain Imaging Center of McLean Hospital, Department of Psychiatry at Harvard Medical School in Boston. "Because traumatic memories are not adequately suppressed by the brain, they continue to interfere with the patient's life".

Dr. Agarwal and his colleagues used brain fMRI to explore alterations in the neural circuitry that links the prefrontal cortex to the hippocampus, while study participants performed a memory task. Participants included 11 patients with major depression, 13 with generalized anxiety disorder, nine with panic attack disorders, five with borderline personality disorder and 21 healthy individuals. All patients reported suffering varying degrees of stressful traumatic events, such as sexual or physical abuse, difficult relationships or "mobbing" a type of bullying or harassment at some point in their lives......... Posted by: JoAnn      Read more         Source

December 1, 2008, 6:22 PM CT

Eating eggs when pregnant affects breast cancer in offspring

A stunning discovery based on epigenetics (the inheritance of propensities acquired in the womb) reveals that consuming choline-a nutrient found in eggs and other foods-during pregnancy may significantly affect breast cancer outcomes for a mother's offspring. This finding by a team of biologists at Boston University is the first to link choline consumption during pregnancy to breast cancer. It also is the first to identify possible choline-related genetic changes that affect breast cancer survival rates.

"We've known for a long time that some agents taken by pregnant women, such as diethylstibesterol, have adverse consequences for their daughters," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "But there's an upside. The emerging science of epigenetics has yielded a breakthrough. For the first time, we've learned that we might be able to prevent breast cancer as early as a mother's pregnancy".

The scientists made the discovery in rats by studying females whose mothers were fed varying amounts of choline during pregnancy. Different groups of pregnant rats received diets containing standard amounts of choline, no choline at all, or extra choline. Then the scientists treated the female offspring with a chemical that causes cancer of the mammary gland (breast cancer). Eventhough animals in all groups developed mammary cancer, the daughters of mothers that had received extra choline during pregnancy had slow growing tumors while daughters of mothers that had no choline during pregnancy had fast growing tumors......... Posted by: Janet      Read more         Source

December 1, 2008, 6:14 PM CT

Some 'good cholesterol' isn't good enough

If you think your levels of "good cholesterol" are good enough, a new study reported in the December 2008 issue of The FASEB Journal suggests that you may want to think again. In the report, scientists from the University of Chicago challenge the conventional wisdom that simply having high levels of good cholesterol (HDL) and low levels of bad cholesterol (LDL) is necessary for good heath. Instead, they show that the good cholesterol has varying degrees of quality and that poor quality HDL is actually bad for you.

"For a number of years, HDL has been viewed as good cholesterol and has generated a false perception that the more HDL in the blood, the better," said Angelo Scanu, M.D., a pioneer in blood lipid chemistry from University of Chicago and first author of the study. "It is now apparent that subjects with high HDL are not necessarily protected from heart problems and should ask their doctor to find out whether their HDL is good or bad".

The scientists came to this conclusion after reviewing published research on this subject. In their review, they observed that the HDL from people with chronic diseases such as rheumatoid arthritis, kidney disease, and diabetes is different from the HDL in healthy individuals, even when blood levels of HDL are comparable. They found that normal, "good," HDL reduces inflammation, while the dysfunctional, "bad," HDL does not......... Posted by: Daniel      Read more         Source

December 1, 2008, 6:06 PM CT

Maternal exposure to folic acid antagonists

Exposure to folic acid antagonists during pregnancy is linked to a higher risk of placenta-mediated adverse outcomes such as preeclampsia, placental abruption, fetal growth restriction or fetal death reports a retrospective cohort study published in CMAJ http://www.cmaj.ca/press/pg1263.pdf.

Folic acid antagonists include a broad range of drugs used to treat epilepsy, mood disorders, high blood pressure and infections. As approximately 50% of pregnancies in industrialized countries like Canada are unplanned, there is a risk of unintended exposure to these medications.

The study, conducted by scientists from Ottawa, Montreal, Saskatoon and Hunan, China looked at 14 982 women who had taken folic acid antagonists one year previous to delivery and 59 825 women who did not. Dr. Shi Wu Wen and co- scientists observed that maternal exposure to folic acid antagonists was linked to a slightly higher risk of adverse pregnancy outcomes. They suggest re-classifying some folic acid antagonists and recommend increased folic acid supplements for women requiring folic acid antagonists during pregnancy.

In a related commentary http://www.cmaj.ca/press/pg1243.pdf, Dr. Joel Ray suggests the research study presents some "thought-provoking findings, but the results may not be ready for adoption by clinical practitioners or drug policy makers." He cites some real concerns with the study design and the need for clinically relevant finding as cautions about translating findings into practice......... Posted by: Emily      Read more         Source

December 1, 2008, 6:00 PM CT

Childhood vaccines cause financial burden

The costs that health care providers are charged and reimbursed for childhood vaccines vary widely, and the high cost of some immunizations is leading to significant financial strain for some physicians, as per a pair of new studies from the University of Michigan Health System.

The findings suggest that a number of physicians appear to be paying too much and receiving too little reimbursement, but they can use this new data to help improve both areas, the scientists say.

"Physicians need to be better business people, and negotiate better prices and payments," says lead author Gary L. Freed, M.D., MPH, chief of the Division of General Pediatrics and director of the Child Health Evaluation and Research (CHEAR) Unit at the U-M Health System's Mott Children's Hospital. Freed is the immediate past chair of the U.S. Department of Health and Human Services' National Vaccine Advisory Committee.

With vaccines for children enrolled in Medicaid funded by the public sector through the federal Vaccines for Children Program, prices are negotiated annually with vaccine manufacturers by the Centers for Disease Control and Prevention. But the data from the new studies support the belief that costs and reimbursements are widely variable in private practices.

"Until now, nobody knew what anyone was paying," Freed notes. "This information will change the way in which physicians negotiate prices." The studies appear in the recent issue of the journal Pediatrics........ Posted by: JoAnn      Read more         Source

December 1, 2008, 5:55 PM CT

Exercise helps prevent age-related brain changes

Elderly adults who exercise regularly show increased cerebral blood flow and a greater number of small blood vessels in the brain, as per findings presented today at the annual meeting of the Radiological Society of North America (RSNA).

The study, conducted at the University of North Carolina (UNC) Chapel Hill, is the first to compare brain scans of elderly adults who exercise to brain scans of those who do not.

"Our results show that exercise may reduce age-related changes in brain vasculature and blood flow," said presenter Feraz Rahman, M.S., currently a medical student at Jefferson Medical College in Philadelphia. "Other studies have shown that exercise prevents cognitive decline in the elderly. The blood vessel and flow differences may be one reason".

The scientists recruited 12 healthy adults, age 60 to 76. Six of the adults had participated in aerobic exercise for three or more hours per week over the last 10 years, and six exercised less than one hour per week. All of the volunteers underwent MRI to determine cerebral blood flow and MR angiography to depict blood vessels in the brain.

Using a novel method of three-dimensional (3-D) computer reconstruction developed in their lab, the scientists were able to make 3-D models of the blood vessels and examine them for shape and size. They then compared the blood vessel characteristics and how they correlation to blood flow in both the active and inactive groups......... Posted by: JoAnn      Read more         Source

December 1, 2008, 5:54 PM CT

Curbing hormones' effects in obese patients

Once-promising drugs that were abandoned in the fight against breast cancer still could be effective in obese patients, new research suggests.

In laboratory tests, hormones produced by fat cells stimulate breast cancer cells to migrate and invade surrounding tissues, researchers at Emory University School of Medicine found. A class of drugs called epithelial growth factor receptor (EGFR) inhibitors could block the stimulatory effects of the hormones.

The researchers' results are published online and are scheduled for publication in the recent issue of the journal Cancer Research

"This group of compounds was basically written off as far as breast cancer goes," says senior author Dipali Sharma, PhD, assistant professor of oncology/hematology at Emory University School of Medicine and Emory Winship Cancer Institute.

Sharma and her colleagues have been studying the effects of leptin, a hormone produced by adipocytes (fat cells), on breast cancer cells. One of leptin's functions is to send "had enough" signals to the hypothalamus, part of the brain that controls appetite, and it also regulates bone formation, reproductive functions and the growth of blood vessels.

Most obese people appear to produce an abundance of leptin but for them, leptin"s appetite-controlling effects are muted in ways that are poorly understood. In addition to leptin, obese people also have high levels of insulin-like growth factor-1 (IGF-1), which is produced primarily by the liver......... Posted by: JoAnn      Read more         Source

December 1, 2008, 5:53 PM CT

Antibiotics: Single largest class of drugs causing liver injury

Antibiotics are the single largest class of agents that cause idiosyncratic drug-induced liver injury (DILI), reports a new study in Gastroenterology, an official journal of the American Gastroenterological Association (AGA) Institute. DILI is the most common cause of death from acute liver failure and accounts for approximately 13 percent of cases of acute liver failure in the U.S. It is caused by a wide variety of prescription and nonprescription medications, nutritional supplements and herbals.

"DILI is a serious health problem that impacts patients, physicians, government regulators and the pharmaceutical industry," said Naga P. Chalasani, MD, of the Indiana University School of Medicine and lead author of the study. "Further efforts are needed in defining its pathogenesis and developing means for the early detection, accurate diagnosis, prevention and therapy of DILI".

In this prospective, ongoing, multi-center observational study the largest of its kind patients with suspected DILI were enrolled based upon predefined criteria and followed for at least six months. Those with acetaminophen liver injury were excluded.

Scientists observed that DILI was caused by a single prescription medicine in 73 percent of the cases, by dietary supplements in 9 percent and by multiple agents in 18 percent. More than 100 different agents were linked to DILI; antimicrobials (45.5 percent) and central nervous system agents (15 percent) were the most common. Of the dietary supplements causing DILI, compounds that claim to promote weight loss and muscle building accounted for nearly 60 percent of the cases. The study observed that at least 20 percent of patients with DILI ingest more than one potentially hepatotoxic agent......... Posted by: Mark      Read more         Source