July 15, 2008, 10:40 PM CT
Caesarean section: no consensus on best technique
Despite the routine delivery of babies by caesarean section, there is no consensus among medical practitioners on which is the best operating method to use. In a systematic review published in The Cochrane Library
, scientists call for further studies to establish the safest method for both mother and infant.
"Caesarean section is a very common operation, yet there is a lack of high quality information available to inform best practice," says researcher Simon Gates of the Clinical Trials Unit at the University of Warwick.
Techniques used during caesarean section operations depend largely on the preferences of individual surgeons. Their personal preference can affect the length of the operation, amount of blood lost, risk of infection and the level of pain experienced by a woman following surgery.
The review includes 15 trials that together involved 3,972 women. Eventhough results from several of these trials suggest that single layer closure of the uterus after delivery reduces blood loss and operation times in comparison to double layer closure, there was no information on other important outcomes such as infection and subsequent complications. The scientists found only very limited data on incision techniques and instruments, as well as methods used to close the uterus. They were therefore unable to make recommendations as to the most appropriate surgical procedure.........
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July 15, 2008, 10:29 PM CT
Peers important for nutrition education
A systematic literature review conducted by a team of scientists from the University of Connecticut, the Hispanic Health Council (Hartford), and the Connecticut Center for Eliminating Health Disparities among Latinos assessed the impact of peer education/counseling on nutrition and health outcomes among Latinos living in the United States. The results, reported in the July/recent issue of the Journal of Nutrition Education and Behavior,
provide evidence that peer nutrition education has a positive influence on diabetes self-management and breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviors, among Latinos in the US.
"Overall, these nutrition education demonstration studies suggest that peer education has the potential to change dietary behaviors among Latinos," commented lead investigator Rafael Prez-Escamilla, PhD. "There is a need to better understand how nutrition peer educators can be formally incorporated into the health care system within the Chronic Care Model community health worker (CHW) framework." Latinos are the largest minority group in the United States, accounting for more than 12% of the population, and they are expected to be nearly 25% of the population by 2050. Latinos also have less access to nutritionally adequate and safe foodin comparison to 7.8% of non-Latino white individuals, almost 20% of Latinos are food insecure.........
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July 15, 2008, 10:19 PM CT
Men and women are wired differently
Temptation may be everywhere, but it's how the different sexes react to flirtation that determines the effect it will have on their relationships. In a new study, psychology experts determined men tend to look at their partners in a more negative light after meeting a single, attractive woman. Conversely, women are likelier to work to strengthen their current relationships after meeting an available, attractive man.
Men may not see their flirtations with an attractive woman as threatening to the relationship while women do, as per findings from a study in the recent issue of the Journal of Personality and Social Psychology,
published by the American Psychological Association. Scientists observed that women protect their relationship more when an attractive man enters the picture but men look more negatively at their partner after they've met an available, attractive woman. Men can learn to resist temptation when trained to believe that flirting with an attractive woman could destroy their relationship, said lead author John E. Lydon, PhD, of McGill University in Montreal.
Scientists conducted seven laboratory experiments using 724 heterosexual men and women to see how college-aged men and women in serious relationships react when another attractive person enters the mix.........
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July 15, 2008, 9:40 PM CT
Regular walking nearly halves elderly disability risk
Elderly adults can decrease their risk of disability and increase their likelihood of maintaining independence by 41 percent by participating in a walking exercise program, as per a new University of Georgia study.
The study, which appears in the current issue of the Journal of Geriatric Physical Therapy, also observed that walking program participants increased their peak aerobic capacity by 19 percent when in comparison to a control group and increased their physical function by 25 percent.
"In the past decade, scientists have focused on the benefits of strength training in maintaining independence, but until now we didn't have strong evidence using an objective performance measure that a walking program would improve physical functioning," said co-author of study M. Elaine Cress, professor of kinesiology and researcher in the UGA Institute of Gerontology. "Our study observed that walking offers tremendous health benefits that can help elderly adults stay independent."
The scientists randomly assigned 26 low-income adults aged 60 and older to either a walking exercise group, which met three times a week for four months, or a nutrition education control group. Initially, the group would walk for 10 minutes continually. As the weeks progressed, they increased their walking time to 40 continuous minutes. Each session began with a 10-minute warm-up and ended with a 10-minute cool-down that included balance and flexibility exercises.........
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July 15, 2008, 9:22 PM CT
Gene signatures for scleroderma
Distinct genetic profiles can discern different groups of patients with scleroderma, a vexing autoimmune disease in which the body turns against itself, Dartmouth Medical School scientists report. Their discovery of distinguishing molecular subtypes within the disease offers new insight into the complexity of a poorly understood and hard to treat illness and opens a window for better diagnosis and targeted therapies.
Scleroderma is a chronic connective tissue disorder that can cause skin hardening and internal organ dysfunction and affects four times as a number of women as men. It captures a range of related conditions, from mild, localized to the skin, to systemic and life threatening.
Patient complications are variable and hard to predict, explains Dr. Michael Whitfield, assistant professor of genetics at DMS, who headed the research team. "We show that we can divide the patients even more finely than what is currently done clinically, and found a clear association between disease severity and gene expression. " The results were published online, July 16 in PLoS ONE
, an open-access journal of the Public Library of Science.
"We show for the first time that we can classify patients with a systemic autoimmune disease into different groups by gene expression patterns alone," says Whitfield "Now that we have discovered new subsets at the molecular level, we can begin to map the genetic pathways to see if we can we use these signatures to predict who will progress to different clinical endpoints." The scientists hope to begin to understand which patients should be treated aggressively, for example, and which drugs benefit which patients.........
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July 15, 2008, 9:20 PM CT
Pinpointing Achilles Heel of HIV
Scientists in UT Houston laboratory of Sudhir Paul, Ph.D., may have uncovered a chink the armor of the deadly HIV virus. Pictured from left to right are: Paul, Yasuhiro Nishiyama, Ph.D., and Stephanie Planque.
Human Immunodeficiency Virus (HIV) scientists at The University of Texas Medical School at Houston believe they have uncovered the Achilles heel in the armor of the virus that continues to kill millions.
The weak spot is hidden in the HIV envelope protein gp120. This protein is essential for HIV attachment to host cells, which initiate infection and eventually lead to Acquired Immunodeficiency Syndrome or AIDS. Normally the body's immune defenses can ward off viruses by making proteins called antibodies that bind the virus. However, HIV is a constantly changing and mutating virus, and the antibodies produced after infection do not control disease progression to AIDS. For the same reason, no HIV preventative vaccine that stimulates production of protective antibodies is available.
The Achilles heel, a tiny stretch of amino acids numbered 421-433 on gp120, is now under study as a target for therapeutic intervention. Sudhir Paul, Ph.D., pathology professor in the UT Medical School, said, "Unlike the changeable regions of its envelope, HIV needs at least one region that must remain constant to attach to cells. If this region changes, HIV cannot infect cells. Equally important, HIV does not want this constant region to provoke the body's defense system. So, HIV uses the same constant cellular attachment site to silence B lymphocytes - the antibody producing cells. The result is that the body is fooled into making abundant antibodies to the changeable regions of HIV but not to its cellular attachment site. Immunologists call such regions superantigens. HIV's cleverness is unmatched. No other virus uses this trick to evade the body's defenses".........
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July 15, 2008, 9:18 PM CT
Vitamin A pushes breast cancer to form blood vessel cells
Scientists at Georgetown University Medical Center have discovered that vitamin A, when applied to breast cancer cells, turns on genes that can push stem cells embedded in a tumor to morph into endothelial cells. These cells can then build blood vessels to link up to the body's blood supply, promoting further tumor growth.
They say their findings, reported in the July 16 online issue of PLoS ONE
, is a proof of principle of the new and controversial "vasculogenic mimicry" theory, proposing that, as needed, tumors build their own blood pipelines. This is very different from the well-accepted role of tumor angiogenesis, when tumors send signals to blood vessels to grow toward the cancer.
The study's senior author, Stephen W. Byers, Ph.D., a professor of oncology and cell biology at Georgetown's Lombardi Comprehensive Cancer Center, also says that this study helps explain why retinoids-- natural or synthetic vitamin A agents--have had mixed results in treating cancer. "Finding that vitamin A may cause some breast cancer cells to form blood vessels brings up the rather disturbing notion that therapy with these drugs may actually stimulate tumor growth," says Byers.
For example, use of beta-carotene, the most important dietary precursor of vitamin A and the chemical that makes carrots orange, has been found to increase lung cancer progression in a large clinical trial. Additionally, fenretinide, a synthetic retinoid, appears to reduce the risk of second breast cancers in premenopausal women, but increase the risk in postmenopausal women, Byers says.........
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July 14, 2008, 9:50 PM CT
Exercise may prevent brain shrinkage in early
Mild Alzheimer's disease patients with higher physical fitness had larger brains in comparison to mild Alzheimer's patients with lower physical fitness, as per a research studyreported in the July 15, 2008, issue of Neurology
, the medical journal of the American Academy of Neurology.
For the study, 121 people age 60 and older underwent fitness tests using a treadmill as well as brain scans to measure the white matter, gray matter and total volume of their brains. Of the group, 57 were in the early stages of Alzheimer's disease while the rest of the group did not have dementia.
"People with early Alzheimer's disease who were less physically fit had four times more brain shrinkage when in comparison to normal elderly adults than those who were more physically fit, suggesting less brain shrinkage correlation to the Alzheimer's disease process in those with higher fitness levels," said study author Jeffrey M. Burns, MD, of the University of Kansas School of Medicine in Kansas City and member of the American Academy of Neurology.
The results remained the same regardless of age, gender, severity of dementia, physical activity and frailty. There was no relationship between higher fitness levels and brain changes in the group of people without dementia.........
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July 14, 2008, 9:48 PM CT
Colorectal cancer screening rates still too low
Eventhough colorectal cancer screening tests are proven to reduce colorectal cancer mortality, only about half of U.S. men and women 50 and older receive the recommended tests, as per a report in the July 2008 issue of Cancer Epidemiology, Biomarkers and Prevention
, a journal of the American Association for Cancer Research.
The Centers for Disease Control and Prevention conducted a National Health Interview Survey and found only 50 percent of men and women 50 and older had received screening in 2005. Eventhough this was an improvement over the 43 percent of screened individuals reported in 2000, it is still far from optimal, researchers say.
"Colorectal cancer is one of the leading cancer killers in the United States, behind only lung cancer. Screening has been shown to significantly reduce mortality from colorectal cancer, but a lot of people are not yet getting screened," said Jean A. Shapiro, Ph.D., an epidemiologist at the Centers for Disease Control and Prevention (CDC).
Shapiro says a major problem appears to be insurance coverage. Among people without health insurance, scientists found the rate of colorectal cancer screening was 24.1 percent in comparison to over 50 percent of insured Americans, depending on the type of insurance. Among patients without a usual source of health care, the screening rate was 24.7 percent in comparison to 51.9 percent of patients with a usual source of health care.........
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July 14, 2008, 9:43 PM CT
Coronary heart disease patients live longer, but not always happier
Better therapys have improved survival in people with coronary heart disease, but the quality of those extra years may be less than ideal, as per research reported in Circulation: Journal of the American Heart Association.
Compared with adults without coronary heart disease (CHD), adults with CHD scored up to 9 percent lower on four scales measuring "quality of life." Patients with coronary heart disease were more likely to say they had poorer quality of life, or describe themselves as sick, said lead author Jipan Xie, M.D., Ph.D., former health scientist in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention in Atlanta, Ga.
Quality of life, which includes physical functioning, psychological functioning, social functioning, overall life satisfaction, and perceptions of health status, can be used to measure effectiveness of therapy and predict the long-term mortality after a cardiac event.
Those most likely to report poorer quality of life in this study were:
- age 18 to 49;
- women; and
- black or Hispanic.
The age-related difference, Xie said, probably reflects a difference in age-related expectations.
"Younger people may feel more pressure - particularly younger men - in the workplace and may be more threatened by limitations imposed by their disease," she said.........
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