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February 4, 2008, 8:42 PM CT

2009 Bush budget a disaster for HIV/AIDS

2009 Bush budget a disaster for HIV/AIDS
The Presidents proposed budget for fiscal year 2009, if enacted, would spell disaster for the nations health, and by extension, our national effort to respond to the HIV/AIDS epidemic in the United States.

The Administrations budget flat-funds critical federal support for research at the National Institutes of Health (NIH), public health programs at the Centers for Disease Control and Prevention (CDC), and vital health care safety net programs funded through the Health Resources and Services Administration (HRSA) and the Medicaid program. After accounting for inflation, the budget proposal amounts to a cut in funding for HIV/AIDS research, prevention, care, and therapy.

Adding insult to injury, the budget proposal increases funding for abstinence education programs that have no basis in scientific evidence, an irresponsible policy with potentially deadly consequences. Failure to adequately support evidence-based prevention programs diminishes our capacity to monitor the epidemic, to expand HIV screening to identify those who are already infected but unaware of their status, and to prevent new infections through targeted programs directed to high-risk populations.

Cutting federal Medicaid funding during the current economic downturn when states are struggling to maintain their programs will only result in reductions in eligibility and vital medical services for this essential health care safety net program that provides more financing for HIV care than any other source. The impact of these proposed cuts will undoubtedly fall on the most vulnerable among usthe poor, the elderly, the chronically ill, and those living with disabilities.........

Posted by: Mark      Read more         Source


January 31, 2008, 10:59 PM CT

Survival rates of premature infants

Survival rates of premature infants
Survival rates for the most premature babies at a top London hospital have more than doubled over a 20 year period, as per research reported in the latest edition of the journal Acta Paediatrica.

The study, led by scientists at University College London (UCL) and University College London Hospitals NHS Foundation Trust (UCLH), suggests significant improvements in survival rates can be achieved when maternity and neonatal units have consistent staffing, resources and therapy policies.

The research shows that the overall rates of survival for infants born alive between 22 and 25 weeks of gestation and admitted to the neonatal unit at UCLH increased from 32 per cent to 71 per cent between 1981 and 2000. This includes babies born in other hospitals and transferred to UCH for intensive care.

The scientists also looked at the survival of infants born at the hospital between 1991 and 2000, including those born at 22-25 weeks gestation who died before they reached intensive care. The survival rate for this group at the end of the study period was 69 per cent -- in comparison to 71 per cent for the group that included only babies admitted to the neonatal unit. This suggests that the results were not solely a consequence of selecting infants with a higher chance of survival.........

Posted by: JoAnn      Read more         Source


January 31, 2008, 10:56 PM CT

BRCA1 mutation linked to breast cancer stem cells

BRCA1 mutation linked to breast cancer stem cells
Breast tissue from a woman with breast cancer who had the BRCA1 mutation, with the stem cells represented in red and estrogen receptors in brown. A cluster of expanded stem cells on the left displays decreased estrogen receptor expression compared to the normal lobules on the right.
A new study may explain why women with a mutation in the BRCA1 gene face up to an 85 percent lifetime risk of breast cancer.

Scientists from the University of Michigan Comprehensive Cancer Center observed that BRCA1 plays a role in regulating breast stem cells, the small number of cells that might develop into cancers.

The study, in mice and in human breast cancer cells, observed that BRCA1 is involved in the stem cells differentiating into other breast tissue cells. When BRCA1 is missing, the stem cells accumulate unregulated and develop into cancer.

"Our data suggest that an important reason women with BRCA1 mutations get breast cancer is that BRCA1 is directly involved in the regulation of normal breast stem cells. In these women, loss of BRCA1 function results in the proliferation of breast stem cells. Since we think that breast cancer may originate in these cells, this explains why these women have such a high occurence rate of breast cancer," said senior study author Max S. Wicha, M.D., Distinguished Professor of Oncology and director of the U-M Comprehensive Cancer Center.

The study, published online this week in the Proceedings of the National Academy of Sciences, provides strong support for the hypothesis that a small number of cells, called cancer stem cells, are responsible for fueling a tumor's growth. Wicha's lab was part of the team that first identified stem cells in human breast cancer in 2003.........

Posted by: Janet      Read more         Source


January 31, 2008, 10:53 PM CT

Severe hypertension: 'Silent killer' still on the loose

Severe hypertension: 'Silent killer' still on the loose
Honolulu, HI Hypertension may be one of the top killers in the country, but youd never know it by the way were behaving, say researchers attending the annual congress of the Society for Critical Care Medicine (SCCM).

Research shows that some 73 million people in the U.S. have high blood pressure, yet a number of of them dont even know it. And among those that do, a large number are not taking the medications they need to control it," says Dr. Christopher Granger, a heart specialist at Duke University Medical Center. Weve discovered that these patients are getting highly variable therapy. Moreover, we also found out that we arent doing a very good job following up with these folks once they leave the hospital, he adds.

Granger and his colleagues at nearly two dozen institutions around the country created a special registry to find out what happens to patients with acute, severe high blood pressure those with blood pressure readings above 160/110 when they come to an emergency department or critical care setting for therapy.

They observed that eventhough 90 percent of them already had a diagnosis of high blood pressure, about a quarter of them were not taking the medicines they were supposed to. The scientists also observed that extremely hypertension was correlation to high complication and death rates. A number of of the patients already had major organ damage and over six percent of them died in the hospital. Upon discharge, most of the patients were given prescriptions for at least two medicines, but 41 percent had to be readmitted within three months. What may be most unsettling, however, is the fact that the researchers could not find any evidence in the discharge records of about 60 percent of the patients that there had been any attempt to schedule a follow-up appointment for them.........

Posted by: Daniel      Read more         Source


January 31, 2008, 10:14 PM CT

Sugary soft drinks linked to increased risk of gout

Sugary soft drinks linked to increased risk of gout
Consumption of sugar sweetened soft drinks and fructose is strongly linked to an increased risk of gout in men, finds a study published on bmj.com today.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older. It is caused by excess uric acid in the blood (hyperuricaemia) which leads to uric acid crystals collecting around the joints.

In the United States, levels of gout have doubled over the last few decades, which coincided with a substantial increase in the consumption of soft drinks and fructose (a simple sugar and the only carbohydrate known to increase uric acid levels).

Conventional dietary recommendations for gout have focused on the restriction of purines (found in high levels in meat and meat products, particularly liver and kidney) and alcohol but with no restriction of sugar sweetened soft drinks.

So scientists in the US and Canada examined the relation between intake of sugar sweetened soft drinks and fructose and the risk of gout.

They followed over 46,000 men aged 40 years and over with no history of gout. The men completed regular questionnaires on their intake of more than 130 foods and beverages, including sugar sweetened soft drinks and diet soft drinks, over a period of 12 years. Different types of fruits and fruit juices (high in natural fructose) were also assessed.........

Posted by: Janet      Read more         Source


January 31, 2008, 9:55 PM CT

Parenting program does not prevent toddler behavior problems

Parenting program does not prevent toddler behavior problems
A study of the first universal parenting programme, designed to prevent early child behaviour problems, shows that it has little impact on toddler behaviour.

The study, conducted at the Centre for Community Child Health (CCCH) in Melbourne, Australia, is published on bmj.com today.

Behaviour problems affect up to 20 per cent of children and have major personal, societal and economic ramifications. Left untreated, up to half of behaviour problems in preschool children develop into later mental health problems.

Prevention targeted to high-risk families can be effective, but has limited reach and may stigmatise. Universal programmes offered to all families could address these concerns, but their effectiveness is uncertain.

Scientists from the CCCH and the Parenting Research Centre, with input from maternal and child health nurses, designed a programme suitable for all parents to be delivered by trained health professionals in primary care. The programme aimed to prevent child behaviour problems, such as defiance and aggression, and improve parenting and maternal mental health.

Over 700 mothers of 8 month-old infants took part in the study and were randomised to either the programme (three sessions at age 8-15 months) or usual care from their local Maternal and Child Health centre. Mothers were surveyed throughout the study and their mental health was assessed when their children reached 18 and 24 months.........

Posted by: JoAnn      Read more         Source


January 31, 2008, 9:53 PM CT

Is the obesity epidemic exaggerated?

Is the obesity epidemic exaggerated?
Last week, the UK health secretary declared that we are in a grip of an obesity epidemic, but does the evidence stack up? Scientists in this weeks BMJ debate the issue.

Claims about an obesity epidemic often exceed the scientific evidence and mistakenly suggest an unjustified degree of certainty, argue Patrick Basham and John Luik.

For example, the average population weight gain in the United States in the past 42 years is 10.9kg or 0.26kg a year. Yet, between 1999-2000 and 2001-2002, there were no significant changes in the prevalence of overweight or obesity among US adults or in the prevalence of overweight among children.

Furthermore, they say, the categories of normal, overweight, and obese is entirely arbitrary and at odds with the underlying evidence about the association between body mass index and mortality.

For example, the study on which the bands for overweight and obesity in the US are based observed that the death risks for men with a body mass index of 19-21 were the same as those for men who were overweight and obese (29-31). Other studies have shown negligible differences between body mass index and death rates.

The association of overweight and obesity with higher risks of disease is equally unclear, they write. And, despite supposedly abnormal levels of overweight and obesity, life expectancy continues to increase.........

Posted by: JoAnn      Read more         Source


January 31, 2008, 8:56 PM CT

African-Americans less likely to choose epidurals

African-Americans less likely to choose epidurals
Minority and low-income patients are less likely than those who are white or more well off to agree to post-surgery epidural pain relief, as per new research from physicians at the University of Pennsylvania School of Medicine. The study, published recently in the journal Anesthesia and Analgesia, examined how race, economic and educational status may influence health care choices when access to care isnt a factor. In the overall analysis, education and income were not as important as race in determining epidural acceptance, but the scientists say the costs of improper pain therapy after surgery are large for any patient group.

Epidurals are more effective for relieving postoperative pain, and higher levels of pain have been associated with the development of chronic pain, says E. Andrew Ochroch, MD, an associate professor and director of clinical research in the Department of Anesthesiology and Critical Care. Consequently, if African Americans are either denied or denying themselves epidural for pain relief, then they may be at greater risk for postoperative complications.

Patients who receive perioperative epidural analgesia during major upper abdominal or chest surgery, for instance, have improved lung function, which reduces their risk of pneumonia. And since theyre able to get out of bed to move around sooner, theyre primed to go home sooner than those who have severe pain. Research also shows that patients who have high levels of perioperative pain are more apt to suffer from chronic pain later on.........

Posted by: Emily      Read more         Source


January 31, 2008, 8:39 PM CT

FDA about updating requirements for drug approval

FDA about updating requirements for drug approval
Researchers and the Food and Drug Administration (FDA) are discussing how new technologies in ophthalmology, which make it possible to collect better data about experimental therapys, might affect FDA clinical trials requirements.

Scientists from the National Institutes of Healths National Eye Institute (NEI) and major US universities and research centers met in a roundtable discussion with FDA representatives before an audience of their peers on November 28-29, 2006 in Washington DC.

The discussion among the 30 participants focused on endpoints and clinical trial strategies for evaluating new therapys for age-related macular degeneration (AMD), diabetic retinopathy and other severe retinal disorders.

The exchange is the subject of Report from the NEI/FDA Ophthalmic Clinical Trial Design and Endpoints Symposium, an article in the February 2008 issue of ARVOs peer-evaluated journal, Investigative Ophthalmology and Visual Science (http://www.iovs.org/cgi/content/full/49/2/479). The authors are Karl G. Csaky of Duke University Medical Center, Elaine A. Richman of Richman Associates and Frederick L. Ferris III, of NEI.

The FDA currently recommends that clinical study sponsors compare changes in visual function (measured on a visual acuity chart of letters and numbers) as a primary endpoint in assessing the effect of a new compound for treating a disorder of the eye.........

Posted by: Janet      Read more         Source


January 30, 2008, 9:20 PM CT

Links between prostate cancer, cadmium, and zinc

Links between prostate cancer, cadmium, and zinc
Cadmium exposure is a known risk factor for prostate cancer, and a new University of Rochester study suggests that zinc may offer protection against cadmium.

In an article reported in the February 2008 journal, The Prostate, epidemiologist Edwin van Wijngaarden, Ph.D., reports that PSA levels were 22 percent higher among American men who had zinc levels below the median (less than 12.67 mg/daily) and cadmium levels above the median. (PSA is a protein produced by the cells of the prostate gland. The higher a mans PSA level, the more likely cancer is present.) .

In contrast, among men with a greater than median zinc intake, little evidence of an association between cadmium and PSA was found.

The way zinc and cadmium interact within human organs is significant and provides interesting leads for study, van Wijngaarden said. Zinc stimulates production of a protein that binds cadmium thereby taking it out of circulation and reducing its toxic effects.

However, it is too early to recommend zinc supplements for those whore worried about prostate damage, he added.

Your health is based on the complex interplay of a number of factors, said Van Wijngaarden, an assistant professor in the Department of Community and Preventive Medicine at the University of Rochester Medical Center. Environmental exposures play out differently in people. Its important to identify those subpopulations that may be more sensitive to toxicities.........

Posted by: Mark      Read more         Source



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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.

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