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"An experimental treatment that involves spinal injections of ozone gas and steroids relieved pain https in over twothirds of people with back problems related to a herniated disc. This condition occurs when the cushions or discs that serve as shock absorbers for the spine become inflamed and bulge or break open. When inflamed discs press against nearby nerves. People with this condition can experience pain numbness and weakness in the back buttocks and legs. None of the people in this study had been helped by other nonsurgical therapies and supporters say the new therapy could become a standard treatment for such patients. But a back pain https specialist who spoke to WebMD says that further research is needed. In the study people reported no pain at six months. About another third reported less frequent episodes of low back pain maybe once a day says researcher Thomas Lehnert MD an assistant professor of radiology at Frankfurt University in Germany. Another reported only a little improvement with pain persisting. And had no improvement or their pain got worse. A few patients resorted to back surgery. Continue Reading Below you might like Still ozone therapy could even help many patients with unrelenting back pain to avoid surgery Lehnert tells WebMD. Before the treatment patients had tried everything without success and were considering an operation he says. Studies suggest that ozone therapy works by reducing inflammation shrinking herniated discs and relieving pressure on the nerves bringing pain signals to the brain https The steroid further reduces inflammation. Lehnert presented the findings here at the annual meeting of the Radiological Society of North America. Pain From Herniated Disc As many as of adults in the U.S. suffer from lower back pain https_assetscontrolled_contenthealthwisemajorLow_Back_PainTopic_Overview.xml at some point in their lives and for many the cause is a herniated disc. About of people with herniated discrelated pain will improve within two months without surgical treatment. Of those who dont improve only will need surgery. The vast majority improve with physical therapy steroid injections chiropractic https_assetscontrolled_contenthealthwisespecialChiropracticTopic_Overview.xml treatment etc. says A. Nick Shamie MD of UCLA Spine Center a spokesman for the American Academy of Orthopaedic Surgeons. Its possible ozone treatment will someday be one of those options Shamie tells WebMD. But because so many people with pain from herniated discs get better on their own it is hard to prove that treatments like ozone therapy actually work he says. And in this study its unknown whether it was ozone the steroids or a combination of the two that helped patients he says. Theres no way to be sure Lehnert says. A headtohead comparison of treatments is planned to answer that question. Ozone Therapy for Back Pain Ozone therapy was developed In Italy. Its been used to treat thousands of lower back pain patients mainly in Europe in recent years. Lehnert says he added the steroid to reduce inflammation because of the pain is due to inflammation in the herniated area. Using computer imaging for guidance the doctor guides the needle used to deliver the ozonesteroid treatment directly into the herniated disc. Patients require no more than a local anesthetic. While patients in the study only got one injection more may be needed he says. Importantly imaging studies showed patients disc volumes shrunk by to in the study. If you reduce the volume it wont be pushing against the nerve causing pain Lehnert says. There were no serious complications and no one had an allergic reaction https_assetscontrolled_contenthealthwisesymptomAllergic_ReactionTopic_Overview.xml. Some people complained of pain around the area in the back where the needle was injected it went away after a few days. In other studies there have been reports of increased pain and bleeding in the eyes Lehnert says. Jeffrey Peterson MD professor of radiology at the Mayo Clinic in Jacksonville Fla. says the technique is promising. Were already using similar procedures for steroid injections says Peterson who moderated the session at which the findings were presented. Whats different here is the medical ozone. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"larry Holzman avid mountainbiker skier and guitarist in a band plays hard. And he didnt want to give it all up due to a spot of pain in his elbow http This wasnt a traumatic injury explains Holzman. It came on gradually and escalated from annoying to excruciating over the course of a couple months. His physical therapist quickly diagnosed it as tennis elbow. Turns out lots of people who develop tennis elbow havent played the game in years. And some have never even picked up a racket. If youre having pain on the elbow on the outside of your elbow when you grip a coffee mug or pick something up with your hands that is almost always tennis elbow says Barton Bishop http a physical therapist at Sport Spine Rehab in Rockville Md. Pain from repetitive overuse of the tendons and muscle that run from the wrist to the elbow can come from all sorts of activities. It usually happens when people grip things too hard or too long. Article continues after this message from our sponsor VIDEO Tennis Elbow Exercise Holzmans injured left elbow muscle strengthens as it lengthens and contracts in this eccentric wrist exercise. Credit Maggie Starbard Marina Dominguez In addition to tennis players Bishop sees the injury in gardeners with their shovels and trowels painters with brushes and golfers with clubs. In Larrys case it was a combination of all his hobbies from squeezing the handlebars on his bike to lifting weights and playing in a band. Gripping guitars and base drums ... can really affect peoples elbows says Bishop. When Holzman came to Sport Spine for help Bishop put him through a series of traditional treatments including ultrasound strengthening and stretching exercises crossfriction massage heat and ice. He also added a series of eccentric wrist exercises using a rubber bar called the TheraBand FlexBar ideal for the injured muscle in tennis elbow. The exercises enable the muscle to lengthen and contract simultaneously. And the FlexBar makes it simple to do this kind of stretch. Hes actually getting his muscle to work says Bishop. Its a perfect exercise. Bishop says the benefit of the FlexBar which costs between and over traditional hand weights is that it helps people strengthen without recreating the symptoms. He says weights can overwork the muscle and sometimes leads to more pain. A study http by researchers at the Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital in New York demonstrated this benefit. They found that adding the eccentric wrist extension exercises using the FlexBar was effective at improving strength and decreasing pain in patients with tennis elbow. Performance Health Brands maker of TheraBand provided the FlexBars for the study but did not fund it. Not all physical therapists are sold on the FlexBar. Theres a variety of methods you can use to achieve the strengthening technique says Jason Grandeo a physical therapist at Body Dynamics Inc. in Arlington Va. But he understands the appeal The FlexBar is easy to use and you can do it at home."

"Just an avocado a day can significantly lower your cholesterol and reduce the risk of heart disease a new study shows. Avocados are rich in socalled healthy fats and other nutrients and the study published in the Journal of the American Heart Association shows the creamy fruit can work within weeks to lower cholesterol. Just like olive oil and nuts avocados have plaquebusting monounsaturated fatty acids and the effects seem similar to all the benefits from a Mediterranean diet the researchers said. And its one more piece of evidence in favor of adding good fats to the diet. In the past we used to substitute carbohydrate for saturated fat and that would result in a lowfat diet said Penny KrisEtherton chair of the American Heart Associations Nutrition Committee and distinguished professor of nutrition at Pennsylvania State University. Now were seeing that its better for people to have good fats in their diet at the expense of saturated fat. And so the current message is to replace saturated fat with unsaturated fat and in so doing consume a moderatefat diet not too much and also not too little KrisEtherton told NBC News. KrisEtherton and colleagues did an intensive study with typical Americans all overweight or obese but with healthy cholesterol and blood pressure levels. Its tough to test diets in real life because people eat so many different things but the team controlled what everyone ate feeding them carefully calibrated diets. One was a lowerfat diet without avocado another was a moderatefat diet without avocado and the third added one avocado per day to the moderatefat diet. The two moderatefat diets looked a lot like the average American diet with about a third of calories coming from fat. The lower fat diet provided percent of calories from fat. Everyone spent five weeks on each diet. No one lost weight but their lowdensity lipoprotein LDL or bad cholesterol levels changed. All diets decreased LDL cholesterol the main lipid risk factor for cardiovascular disease. But the diet with the avocado decreased LDL cholesterol the most KrisEtherton said. Americans are advised to keep total cholesterol below and preferably below http_UCM__Article.jsp. LDL should be below . While they were eating the avocadoaday diet the volunteers saw their LDL go down by more than points compared to their usual levels KrisEthertons team reported in the Journal of the American Heart Association. LDL was . points lower on the moderatefat diet without the avocado and . points less on the lowerfat diet. The volunteers all ate Hass avocados which have bumpy green skin. The Hass Avocado Board helped pay for the research which was also funded by the U.S. government. In addition to monounsaturated fats the avocados contain fiber phytosterols and polyphenols all of which can help lower cholesterol. Avocados also contain natural sugars that may help regulate blood sugar. We need to focus on getting people to eat a hearthealthy diet that includes avocados and other nutrientrich food sources of better fats KrisEtherton said. All the foods were exactly the same except the avocado versus oils that were high in monounsaturated fat on the moderatefat diet. So that was the only difference between the two diets which then tells us that its the avocado that has additional benefits which are beyond the unsaturated fat. The findings are similar to a batch of studies http that showed people who were given olive oil and nuts and told to add them to their diets ended up healthier httpvitals.nbcnews.com_newstastydietcutsheartdiseasestudyfindslite. They were less likely to have strokes or heart attacks and they were less likely to die http a period of years than people who didnt get the extra oils. Saturated fat the kind found in meat and butter has a different chemical structure from the unsaturated fats found in plant products. Repeated studies have shown it raises the risk of heart disease. We studied avocados but maybe a lot of other fruits and vegetables have these bioactive components which have additional cholesterollowering effects KrisEtherton said. And certainly theres an emerging research base showing that some of these bioactive components may affect another lipoprotein particle favorably like highdensity lipoprotein. I think we need to stay tuned for that. Americans may not be used to eating avocado but KrisEtherton says its easy to add. Consumers can include avocados in their diet in salads. They can include avocados on top of a sandwich or in a sandwich. They can make guacamole and use vegetables rather than chips as the dip she said. I love guacamole and with my recipe Ill use avocados cilantro lime juice and garlic... and then sometimes Ill put salsa in or red pepper flakes. But like anything too much of a good thing can be harmful. Avocados are definitely not lowcalorie food. One avocado has around to calories. So I would strongly urge people not to just add an avocado a day to their diet but they have to substitute nutrientpoor calories which are so popular in the U.S. diet. KrisEtherton said. Erika Edwards contributed to this story"

"Research on a bacterial toxin first discovered in Adelaide has led to the development a new blood test for the early diagnosis of ovarian cancer a disease which kills over Australian women and globally each year. The new blood test has the potential to dramatically improve early detection of the disease although it will require further testing before it is available for clinicians. A research team from the University of Adelaide and Griffith University have been studying the interactions between the toxin and an abnormal glycan sugar expressed on the surface of human cancer cells and released into the blood. The team has now engineered a harmless portion of the toxin to enhance its specificity for the cancer glycan and used this to detect it in blood samples from women with ovarian cancer. A paper published this month in Biochemical and Biophysical Research Communications has shown that the new test detected significant levels of the cancer glycan in blood samples from over of women with stage ovarian cancer and in of samples from later stages of the disease but not in any of the samples from healthy controls. Ovarian cancer is notoriously difficult to detect in its early stages when there are more options for treatment and survival rates are better. Our new test is therefore a potential game changer says Professor James Paton Director of the University of Adelaides Research Centre for Infectious Diseases. Professor Michael Jennings Deputy Director of the Institute for Glycomics at Griffith University said Detection of this tumour marker may also play a role in a simple liquid biopsy to monitor disease stage and treatment. The team is currently seeking scientific and commercial partners to further test the technology with larger numbers of patient samples and to adapt it for mass screening."

"Soon you can seek mental health advice on your smartphone as quickly as finding a good restaurant. A novel suite of speedy miniapps called IntelliCare resulted in participants reporting significantly less depression and anxiety by using the apps on their smartphones up to four times a day reports a new Northwestern Medicine study. The apps offer exercises to destress reduce selfcriticism and worrying methods to help your life feel more meaningful mantras to highlight your strengths strategies for a good nights sleep and more. Most apps designed for mental health typically offer a single strategy to feel better or provide too many features that make them difficult to navigate. Users may get bored or overwhelmed and may stop using the apps after a few weeks. But participants robustly used the IntelliCare interactive apps as many as four times daily or an average of times for eight weeks of the study. They spent an average of one minute using each app with longer times for apps with relaxation videos. The participants who completed the research study reported that they experienced about a percent decrease in the severity of depressive and anxiety symptoms. The shortterm studyrelated reductions are comparable to results expected in clinical practice using psychotherapy or with that seen using antidepressant medication. The study will be published Jan. in the Journal of Medical Internet Research. We designed these apps so they fit easily into peoples lives and could be used as simply as apps to find a restaurant or directions said lead study author David Mohr professor of preventive medicine and director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine. Some of the participants kept using them after the study because they felt that the apps helped them feel better Mohr said. There were many apps to try during the study so there was a sense of novelty. Participants had access to the IntelliCare apps from Google Play and received eight weeks of coaching for the use of IntelliCare. Coaching included an initial phone call plus two or more text messages per week over the eight weeks. In the study participants were enrolled and of them completed the study. The preliminary study did not include a control arm so its possible that some people who enrolled in the trial would have improved anyway partly because they may have been motivated to try something new Mohr said. He now has launched a larger trial recruiting participants with a control arm. Some of the IntelliCare apps include Daily Feats designed to motivate you to add worthwhile and rewarding activities into your day to increase your overall satisfaction in life. Purple Chill designed to help you unwind with audio recordings that guide you through exercises to destress and worry less. Slumber Time designed to ease you into a good nights rest. My Mantra designed to help you create motivating mantras to highlight your strengths and values. Using digital tools for mental health is emerging as an important part of our future Mohr said. These are designed to help the millions of people who want support but cant get to a therapists office. More than percent of Americans have significant symptoms of depression or anxiety each year but only around percent of people with a mental health problem get adequate treatment. The IntelliCare algorithm recommends new apps each week to keep the experience fresh provide new opportunities for learning skills and avoid user boredom. Although the apps are not validated each one was designed by Northwestern clinicians and based on validated techniques used by therapists. IntelliCare is a national research study. Individuals can download the apps free with no financial obligation. But Northwestern researchers hope participants will provide confidential feedback via four weekly questions that will be used to further develop the system. The data will help the system make even better recommendations and provide more personalized treatment. People also may enroll in a study in which they will be paid to provide even more feedback. Some also will have access to an IntelliCare coach via text messaging and phone calls who are available to support them in using the apps. We now have evidence these approaches will likely work Mohr said. They are designed to teach many of the same skills therapists teach patients. Different apps are expected to work for different people. The goal is to find whats right for you. Other Northwestern authors include Kate Tomasino Emily Lattie Hannah Palac Mary J Kwasny Kenneth Weingardt Leland R Bardsley Lauren Caccamo Colleen StilesShields and Stephen Schueller. Rebecca Rossom a researcher with HealthPartners Institute also was a study coauthor. The study was supported by grant R MH from the National Institute of Mental Health of the National Institutes of Health."

"Pregnant women may soon be able to have a blood test to predict whether their babies are likely to have Downs Syndrome instead of undergoing risky invasive tests scientists said on Sunday. In a study in the Nature Medicine journal researchers from Cyprus said a trial on pregnancies using the test which involves analyzing the womans blood to detect DNA differences between the mother and the fetus showed it accurately predicted which fetuses were at risk of developing the syndrome. Philippos Patsalis medical director of the Cyprus Institute of Neurology and Genetics who led the study said the results were very exciting and the test now needed to be trialed in a larger study of about pregnancies but could lead to changes in clinical practice within two years. We believe we can modify this test and make it much easier and simple... and then we can have something ready to be introduced into the clinic he told Reuters in Nicosia. Downs Syndrome is the most common genetic cause of mental retardation occurring in out of live births worldwide. The risk of having a baby with Downs which occurs when a child has three copies of chromosome instead of the normal two increases sharply as women get older. The risk for a yearold mother is times that for one who is . Doctors currently use a test known as amniocentesis to check whether a baby is likely to be born with Downs. This test is generally done at about or weeks gestation and involves taking amniotic fluid from the mother by inserting a hollow needle into the uterus. Since amniocentesis carries a small risk of spontaneous miscarriage Patsalis put it at around one or two percent scientists have been looking for new less invasive ways to test for Downs and other potential genetic problems. Patsalis method takes advantage of differences in the DNA methylation patterns which are important to control levels of genes between mother and fetus. It involves taking a small amount of blood from the mother when she is between the th and th week of her pregnancy and detecting extra copies chromosome in the fetus by analyzing the maternal blood. In a small trial Patsalis team were able to correctly diagnose cases where there were extra copies of the chromosome and normal fetuses results they said highlighted its clinical potential. Such a noninvasive approach will avoid the risk of miscarriages of normal pregnancies caused by current more invasive procedures the scientists wrote in their paper. Writing by Kate Kelland editing by Matthew Jones Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"With his smooth fleshy face and twinkly eyes Herbert Auspitz had an air of vigor but he was fading fast. He had a fatal disease with a prognosis worse than that of most cancers severe aortic valve stenosis httphealth.nytimes.comhealthguidesdiseaseaorticstenosisoverview.htmlinlinenytclassifier. It is a narrowing of the valve that controls blood flow from the heart. There is no way to prevent it and there are no drugs to treat it. Until recently his fate would have been sealed. His doctors thought he was too likely to die if they cracked open his ribs and stopped his heart while they cut out his old valve and sewed in a new one. This time they had a new option. They were able to replace his valve using a method recently approved by federal regulators for people who are inoperable or at high risk from openheart surgery. His cardiologists led by Dr. Howard C. Herrmann inserted a new valve made from the lining of a cows heart through a catheter then opened it like an umbrella. Lying on a stretcher after the hourlong procedure at the Hospital of the University of Pennsylvania in Philadelphia a smiling Mr. Auspitz said Im very very very grateful. Advertisement The new valve procedure is part of the changing face of cardiac care in the United States. But even as speedier treatment has helped slash the death toll http from heart attacks over all in the past decade the number of deaths from heart failure httphealth.nytimes.comhealthguidesdiseaseheartfailureoverview.htmlinlinenytclassifier caused by aortic valve disease has risen percent in large part because more people are living long enough to develop it. More than Americans die from the disease annually. It is an illness of aging and an estimated Americans httpcontent.onlinejacc.orgarticle.aspxarticleid are in Mr. Auspitzs position too old or sick for surgery and with a seriously narrowed valve. But recent studies in very sick patients have found the new procedure prolonged lives offering new hope that the death toll from narrowing valves can be reduced. The procedure called TAVR for transcatheter aortic valve replacement httphealth.nytimes.comhealthguidessurgeryheartvalvesurgeryoverview.htmlinlinenytclassifier is now being tested on a much larger pool of generally younger patients at intermediate risk. Some cardiologists say they worry it will be used in such cases before the evidence is in. Others say it will eventually replace surgery for almost everyone who needs an aortic valve not just for the most fragile. The TAVR story is a wonderful example of a transformative technology that began with an idea many dismissed Dr. Patrick T. OGara the immediate past president of the American College of Cardiology wrote httpjama.jamanetwork.comarticle.aspxarticleidampresultClick in JAMA the Journal of the American Medical Association. With the procedure a new valve is folded up and slipped into a catheter a thin flexible tube which is then put into a blood vessel in the groin. When the catheter reaches the base of the aorta the large blood vessel that carries blood from the heart to the rest of the body the doctor opens a balloon that inflates the valve. The old valve remains pushed aside by the new. Patients are awake and only lightly anesthetized. You are putting a valve right above the heart said Dr. Lawrence H. Cohn a Harvard heart surgeon. If you are not careful you could obstruct one of the coronary arteries causing a big heart attack. This is not childs play. It is not for the fainthearted. Dr. Martin Leon of Columbia University Medical Center replaced Mr. Kissingers valve almost a year ago. I am more energetic people tell me I look better and I feel much less tired Mr. Kissinger said. He described the procedure as easier and less debilitating than the openheart bypass surgery he had previously. Theres no comparison. For now evidence of the procedures effectiveness exists only for the sickest patients and there are only five years of data on how long the valves last. Most highrisk patients are older than with a life expectancy of five to seven years but the durability of the valves is more crucial for intermediaterisk patients who are more likely to be in their s with a life expectancy of years. There is some question about whether the process of inserting the new valves loosens debris that can cause strokes. O httpdx.doi.org.S ne large study httpdx.doi.org.S found a higher stroke httphealth.nytimes.comhealthguidesdiseasestrokeoverview.htmlinlinenytclassifier rate in patients receiving valves without surgery compared with those receiving valves with surgery. Another large study httpdx.doi.org.j.jacc... did not find this effect. The valves also tend to leak slightly around the edges. New designs are ameliorating this problem but not solving it. And the procedure is costly. Dr. Reginald Blaber who runs the cardiovascular disease program at Our Lady of Lourdes Medical Center in Camden N.J. said the hospital lost money when it used the valves although it offers the procedure so it can give patients the best treatment. Its a hard proposition when goes right out the door to Edwards the valve manufacturer he said. The hospital gets about from Medicare httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsmedicareindex.htmlinlinenytclassifier which is fine if there are no complications. But older patients in their late s and s often end up with four five or even sevenday hospital stays. We could lose he said. Sign up for Science Times Well bring you stories that capture the wonders of the human body nature and the cosmos. Nonetheless excitement is growing. I think the future is that everyone who needs a valve will get a transcatheter valve said Dr. Catherine M. Otto an echocardiologist at the University of Washington who does not do the procedure. Its going to become the standard. A Struggle for Support It took a brainstorm and years to produce this breakthrough. The idea sprang to life when a Danish cardiologist heard talks on opening arteries with balloons and stents httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsstentsindex.htmlinlinenytclassifier tiny wire cages at a conference in . I thought if you can put a stent httphealth.nytimes.comhealthguidessurgerystentoverview.htmlinlinenytclassifier in a coronary artery you probably can also put a valve in said the cardiologist Henning Rud Andersen of Aarhus University in Jutland. I decided I wanted to be the first in the world to put in a heart valve without surgery. He bought pig hearts from a slaughterhouse and carefully cut out the aortic valve mounting it by hand inside a handmade metal stent. He put a deflated balloon inside the valve and crimped down the valve with his fingers. He made his own catheter and put the compressed valve on the end. Then he inserted it into a pig. I was lucky it worked on the very first pig Dr. Andersen said. After operating on pigs he obtained a patent on his device and tried to get a company to develop it. Nobody was interested he said. Around that time in France Dr. Alain Cribier a cardiologist at Hpital Charles Nicolle in Rouen was thinking along the same lines. He was a highly regarded successful innovator so he thought it would be easy to find a company. I started looking for companies to help me but it was a complete failure he said. All the companies in the United States and Europe and Japan they have experts and the experts are surgeons and they said it is absolutely not possible. We would kill the patients on the table. He joined forces with a former Johnson Johnson executive Stanton Rowe who began making the rounds of venture capitalists. But Mr. Rowe said their response was always the same We will look into it. And who do they call The surgeons. They told them all the reasons why it wont work. Dr. Cohn the Harvard heart surgeon said he and his colleagues had good reasons to look askance. They thought it was strange that the old valve would just remain in the heart. They wondered why the new one would not fly off into the rush of blood being pumped into the aorta after all it was not being sewn in. And pushing a valve into an atherosclerotic artery Pieces of plaque could break off and cause blood clots and strokes. Finally he added it would take patients away from surgeons. We were skeptical he said. Two and a half years later after Dr. Cribier had practiced inserting valves in sheep a yearold man arrived at his hospital needing an aortic valve on the brink of death with almost no heartbeat. He had so many medical problems severe coronary artery disease chronic pancreatitis httphealth.nytimes.comhealthguidesdiseasechronicpancreatitisoverview.htmlinlinenytclassifier that surgery was not an option. Then again no human had ever had a valve put in without surgery. I had to ask the patient his wish Dr. Cribier said. His response was Please please do it. It was the most stressful day for me he said. Sheep he explained do not develop aortic stenosis and their anatomy is very different. We were not sure we could translate it into man he said. Dr. Henning Rud Andersen tested the idea of replacing a heart valve without surgery on pigs. He mounted a pig valve by hand inside a handmade metal stent that he threaded up to the animals heart. As soon as it was implanted I could see blood coming back to his face. Two hours later we were drinking Champagne in his room. French regulators eventually gave Dr. Cribier permission to try the procedure on patients whose life expectancy was just two weeks. He and his colleagues operated on mostly older adult patients and successfully treated . One patient survived as long as six and a half years. But the procedure was risky. It required threading a catheter up through a vein in the groin going across the heart from the right to left side passing the catheter through the mitral valve between the upper and lower left chambers of the heart turning a corner in the lower left chamber and then heading into the aortic valve. It was all too easy to damage the heart with that stiff catheter. Nobody besides Cribier could do it said Dr. Michael Mack a surgeon at Baylor Health Care System. Success in America Nonetheless in Edwards Lifesciences bought PVT the company started by Dr. Cribier and his colleagues for about million most of which went to investors. In the researchers took the method to the United States. Experts at five medical centers tried it on five patients the sickest of the sick. The procedure was so technically difficult and the patients so sick that only two survived. Theres a lot of things in life that you see and say Shoot why didnt I think of this Dr. Mack said. I make no apologies for not thinking of TAVR. I never thought it would work. The researchers began rethinking the procedure. That tortuous route Dr. Cribier had devised going through the groin vein was not working. So Edwards made new catheters that could go straight to the heart through the groin artery. The disadvantage was that by pushing a catheter upstream against the downward rush of blood through an artery there was a greater chance of bleeding or damage to the artery. Before the method could be approved in the United States the Food and Drug Administration httptopics.nytimes.comtopreferencetimestopicsorganizationsffood_and_drug_administrationindex.htmlinlinenytorg required a large clinical trial. It began in sponsored by Edwards and resulted in an approval for patients who could not have surgery. Mr. Auspitz with his son Paul before his valve replacement. Months after the surgery he said he wanted to paint again.CreditJessica Kourkounis for The New York Times The results http published in The New England Journal of Medicine in showed that for these who could have surgery TAVR was at least as good. For those who could not have surgery a valve replacement with TAVR reduced the death rate by percent in the first year. That said Dr. Leon of Columbia who was the trials principal investigator was remarkable. If we treat five patients we would save a life in the first year he said. There are very few treatments in all of cardiovascular medicine that could claim that I can think of heart transplant httphealth.nytimes.comhealthguidessurgeryhearttransplantoverview.htmlinlinenytclassifier and thats it. The results were even more notable he said because the early versions of the devices were clunky stiff and difficult to use. The F.D.A. approved the method with the Edwards device for patients at extremely high risk in . That year Dr. Mack who was then the president of The Society of Thoracic Surgeons and other leaders met with the F.D.A. and Medicare to devise a plan to restrict the devices spread to places where doctors had sufficient skill to implant them safely. The result was a requirement that a hospital should be doing at least surgical aortic valve replacements a year to have access to the technology. It was written into the Medicare coverage decision a first for a medical device. This technology is expensive and high risk Dr. Mack said. The consensus of the group he said was that not every one of the cardiac surgery programs or the cath labs in the U.S. should be able to do it. In June after another company Medtronic did similar studies its device was approved too for highrisk patients. Former skeptics like Dr. Cohn now recommend the procedure for highrisk patients. More recent data from Medtronic indicates that its valve is better than surgery for highrisk patients resulting in fewer deaths at least in the first two years. And new data from another large study httpcontent.onlinejacc.orgarticle.aspxarticleID by Edwards found that patients at intermediate risk did better with the newest version of its valve than would be expected with surgery in the first days when most deaths occur. Truly phenomenal early results Dr. Herrmann said. Last Wednesday the F.D.A. approved the new Edwards valve for highrisk patients it had been available only in clinical trials. Medtronic also has a new version of its valve that cardiologists expect will soon be approved. Dr. Herrmann a clinical trial investigator for both companies said the Edwards valve results were so impressive that cardiologists might change the way they evaluate patients. Instead of asking if a patient is too sick for openheart surgery and thus a candidate for TAVR they should start assuming that most patients with severe aortic valve disease would get TAVR even if they could survive surgery. Now both companies are studying lowerrisk patients in large clinical trials. Mr. Auspitz the yearold man whose valve was replaced in Philadelphia had not heard of the procedure until his doctor suggested it last year. Mr. Auspitz had been in a rehabilitation center for a month recovering from a hospital stay for heart failure. Like many with aortic valve problems he had blamed old age for his fatigue shortness of breath httphealth.nytimes.comhealthguidessymptomsbreathingdifficultyoverview.htmlinlinenytclassifier lack of stamina and the fluid accumulation in his legs and feet. A few days after the procedure Mr. Auspitz was smiling and happy and about to go home. A few months later his son Paul was helping him exercise every day using bands and light weights. And Mr. Auspitz said for the first time in years he wanted to paint again. He plans to start with a portrait of Paul."

"Too few women at high risk for osteoporosis are being tested for the bonedepleting condition while too many women at lowrisk are being screened a new study suggests. A team led by Dr. Anna Lee Amarnath of the University of California Davis examined the medical records of nearly women aged to living in the Sacramento area. The researchers looked at whether or not women were getting a dualenergy Xray absorptiometry DXA test which measures bone mineral density. The result Osteoporosis screening rates jumped sharply at age despite guidelines suggesting that screening only begin at age unless a woman has certain risk factors. However the study also found that those risk factors a small body frame a history of fractures or taking medications that could thin bones had only a slight effect on a womans decision to get her bones tested. Over seven years more than percent of eligible women aged to were not screened Amaraths team found nor were nearly percent of those older than . However nearly percent of lowrisk women aged to were screened as were percent of lowrisk women aged to . The study was published online May in the Journal of General Internal Medicine. DXA screening was underused in women at increased fracture risk including women aged years and older. Meanwhile it was common among women at low fracture risk such as younger women without osteoporosis risk factors Amarnath said in a journal news release. What to do Reminder notes to doctors and patients might help one expert said. Health systems should invest in developing electronic health records systems that prompt providers at the pointofcare when screening is needed and when it can be postponed study senior author Joshua Fenton an associate professor of family and community medicine at UC Davis said in the news release. More information The American Academy of Family Physicians has more about osteoporosis httpfamilydoctor.orgfamilydoctorendiseasesconditionsosteoporosis.printerview.all.html. SOURCE Journal of General Internal Medicine news release May"

"A new form of cataract https surgery using a patients stem cells https has restored vision in babies for the first time and someday the technique may hold promise for millions of older Americans who undergo traditional cataract eye surgery https every year say scientists who developed the new procedure. Eye experts across the country who spoke with CBS News are alternately excited and cautious about the findings published Wednesday in the journal Nature. The procedure developed by researchers at the University of California San Diego and China is less invasive than traditional cataract treatment said the scientists. Cataracts are most common in older adults. As most people age an opaque film slowly forms over the lens the part of the eye that helps with focusing on images at various distances. It clouds vision and can lead to blindness. In cataract https surgery which has been around for several decades eye surgeons make an incision in the front of the eye and remove the lens from its supporting capsule. Then they replace it with an artificial lens. The new procedure described in Nature involves making a slim incision at the side of the lens capsule removing the entire lens yet preserving the empty capsule bag or scaffold. A certain kind of stem cell called endogenous stemprogenitor cells when left intact then begins to repopulate the damaged lens and essentially grow a new healthy lens. Study author Dr. Kang Zhang the chief of ophthalmic genetics at UC San Diegos Shiley Eye Institute told CBS News Unlike the current way of cataract surgery which destroys over half of lens stem cells and requires implantation of a plastic intranet ocular lens https we devised a new surgery to make a very small opening at the side of a cataractous lens bag remove the cataract inside allow the opening to heal and promote dormant lens stem cells to regrow an entirely new lens with vision. Pioneering surgery tested in babies The experimental procedure was done in infants who were born with a congenital cataract condition. By using a less invasive procedure Zhang and his colleagues report that they were able to leave the lens epithelial stem cells also called LECs intact. These LECs regenerated the eyes lens in the children eliminating the need for implants. The same technique was also successfully performed in animals. In little ones with congenital cataracts eye surgeons need to intervene early so that light can get to the brain and allow for normal healthy growth said Suraj Bhat associate professor of ophthalmology and director of the Vision Molecular Biology Laboratory at the UCLA Stein Eye Institute. Bhat was not involved in the new research but said its extremely exciting because it offers an alternative to an extraordinarily invasive procedure. In early childhood cataracts are very bad. We need light to enter into the eyes at a young age to get proper brain function otherwise information does not get transferred to the developing brain said Bhat. Traditional surgery can cause opacity in the line of a childs vision and because the eye is still growing it is difficult to provide good vision with eye glasses explained Julie T. Daniels from University College London Institute of Ophthalmology in an accompanying commentary in Nature. Many children also later go on to suffer from glaucoma. Daniels wrote that to correctly refract light onto the retina at the back of the eye the cornea and lens must remain transparent throughout life. Current treatments for the cornea and lens involve donor transplants or artificial implants but the procedures can be risky. She said the new procedure which coaxes stem cells to regenerate normal tissue in the body offers promise. The studys stem cell engineering has led to the regeneration of transparent lens tissue in children showing that the concept offers a potential therapeutic approach Daniels wrote. She noted a second study in Nature that used transplant tissue grown in the laboratory from stem cells to treat damaged corneas saying it also holds promise. Zhang said their results need to be validated in a large number of patients and with a longer followup period. Will it work in older eyes One major question remains to be answered Can it be applied to agerelated cataracts the leading cause of blindness According to the National Eye Institute about . million Americans suffer from cataracts. Between and the number of cataract cases in the U.S. went up by percent and its expected to continue to grow as the population ages. We are now planning a study to test this approach in this old patient population. In addition we are testing if this approach can be used in treating other leading causes of blindness such as macular degeneration and glaucoma said Zhang. He hopes the surgery will be available to the general population within four to five years. I would anticipate that it may be available after several independent studies with a large number of patients he said. Some other experts in the field saw great promise in the research. Everyones working on this. Stem cells are like the Holy Grail of vision research Dr. James Tsai M.D. president of the New York Eye and Ear Infirmary of Mount Sinai told CBS News. To me its very exciting data. They may be on to something. But he tempered the hope the study offers by noting that the lens regeneration work is also very controversial and could impact a multimilliondollar industry. This is potentially a new surgery. If you think about the implications in the long run lens implants may not be necessary he said. There are a lot of doctors who will want to see more data. He also pointed out that the study involved infants and that adults the most common cataract patients have a different regenerative capacity of lens epithelial stem cells. In the meantime Tsai said its hopeful news for some babies with congenital cataracts like the children who participated in the study. As a glaucoma specialist the way we do congenital cataracts theres a great risk these babies will develop glaucoma for a lifetime and maybe with this new surgery they wont have that glaucoma risk. Dr. Maria Valeria CantoSoler assistant professor of ophthalmology and director of the Retinal Degeneration Research Center at Johns Hopkins Wilmer Eye Institute said she was impressed by the research. The main excitement for me is the ability to regenerate an organ or a tissue within an organ said CantoSoler a retina specialist. From what I know Id say this is the first demonstration where you can use endogenous stem cells for replacing tissue within the eye. Its something we are all looking for. They have actually done it in humans. She said even without answers to the question of whether it will work in aging eyes it creates hope for children with congenital issues. If you can create it in children thats a big thing. You are giving sight back to little kids and that change their lives. Larger studies more eyes needed Dr. Kathryn Hatch an ophthalmologist at Massachusetts Eye and Ear in Boston told CBS News the procedure seems very exciting but more research is needed. Id need to see a larger study with more eyes and we need to see some reproducibility and see how long it would take for the lens if its able to regenerate what are the visual results. Because thats what patients really care about. Their vision. If it takes months to get to an outcome its not superior to the lens technologies we have now. Im not sure what the advantage is. Most patients dont even want to wait. They want to get back to work their life Hatch added. She also had questions about how the procedure was done with such a tiny incision. I dont understand how theyre doing the surgery with such a tiny hole without tearing the capsule. If we make a three millimeter incision in traditional cataract surgery thats really small in an adult. Cataract surgery is traditionally done by hand with a bent needle. Thats one of the most difficult steps to learn as a surgeon. One of most important steps to learn she said and there could be major eye damage if a surgery was compromised by a tear. She also noted that baby eye surgery is different from adults in that the infant cataract is much softer compared to an adults harder cataract. UCLAs Bhat noted another limitation in the study These are all genetic cataracts. This study wasnt long enough. They cataracts may come back he said but its also possible the genetic defect may not reappear. Hes said its unclear if the results will be mirrored in older cataract patients the same concern expressed by others in the field. Cell division is slower in older people Bhat said. The biggest problem as we grow older particularly beyond is cell division which keeps on decreasing. Our ability to make new cells is significantly lost. The process that these people are depending upon is tremendously dependent on cell division. Bhat said he also paused when he read the statement in the paper that claimed a percent success rate three months after surgery. I dont know them. I cant second guess them. Youve got to believe the written word."

"Days after bringing home her newborn twin daughters Alysia Vaccaro could sense Evangelina wasnt as healthy as her sister. I had a baby to compare her to and I just knew something was wrong with her Vaccaro told CBS News. Her mothers intuition was right. Testing revealed Evangelina was born with Severe Combined Immunodeficiency also called SCID or bubble baby https disease. Its a genetic disorder that leaves the body with a weakened immune https system making infants extremely vulnerable to illness. It affects cells that play important roles in helping the immune system battle bacteria viruses and fungi that can cause infections. Even the common cold can be deadly. Symptoms of the disease are frequently first noticed very early in life as was the case with Evangelina. Babies with SCID often come down with recurrent severe respiratory infections that can be life threatening according to the American Academy of Allergy Asthma and Immunology. We wore masks we had hand sanitizer we had raw hands from cleaning so much Vaccaro recalled. The Vaccaros turned to Dr. Donald Kohn at the Broad Stem Cell Research Center at UCLA where Kohn focuses on the development of new methods to treat genetic diseases of blood cells. They enrolled baby Evangelina in a clinical trial there. Dr. Kohn said of an experimental treatment for SCID https Its gone from a one day maybe to a real clinical reality. That means an actual cure for the disease said Kohn who is also director of the Human Gene Medicine Program at UCLA. His treatment involves taking bone marrow from the patient to gather stem cells. A cloned gene is then added to correct what was missing at birth. Those stem cells are given back to the patient where they can go back to the bone marrow and make the blood cells for the rest of the patients life Kohn said. So far the treatment has restored immune systems in all patients in the most recent clinical trials including Evangelina. It is a cure. I know its a cure. Were living the cure said Vaccaro. Now years old doctors say Evangelina is in perfect health. Dr. Kohn is currently working with the FDA to make his treatment available nationwide. Hes also testing the same method as a cure for sickle cell disease. Clinical trials for that treatment are now underway."

"She had taken care of her husband for the last eight years of his life through his blindness through cancer and heart failure. After he died in she sold the Long Island house theyd loved and shared finding it too filled with memories and moved to their country home in upstate New York. Friends thought Anne Schomaker was coping well with her loss she recalled. I volunteered to get myself out and doing things to fill the gaps she said. I had many interests. She traveled and even tried dating again. But I wasnt really doing well said Ms. Schomaker . I had terrible pangs of sadness and despondency. I was missing my husband so badly. Even after seeing a therapist which helped she suffered from nightmares and couldnt bear to hear arias from their favorite operas. The pain just didnt go away she said. The death of someone beloved often brings deep sadness. Usually however the intense grief of early mourning begins to ebb as months pass and people alternate between continuing sorrow and a growing ability to rediscover lifes pleasures. What distinguished Ms. Schomakers suffering was its sheer duration. She had been mired in grief for nine years when she saw an announcement from Columbia University where researchers who had developed a treatment for complicated grief were seeking participants in a study. Maybe this new approach could help Ms. Schomaker thought. Complicated or prolonged grief can assail anyone but it is a particular problem for older adults because they suffer so many losses spouses parents siblings friends. It comes with bereavement said Dr. Katherine Shear httpsocialwork.columbia.edufacultykatherineshear the psychiatrist who led the Columbia University study. And the prevalence of important losses is so much greater in people over . In a review in The New England Journal of Medicine earlier this year Dr. Shear listed several symptoms characteristic of complicated grief http intense longing or yearning preoccupying thoughts and memories and an inability to accept the loss and to imagine a future without the person who died. Often mourners with these symptoms are convinced that had they done something differently they might have prevented the death. Severe and prolonged compared with typical reactions complicated grief impairs the mourners ability to function. Adapting to loss is as much a part of us as grief itself said Dr. Shear who directs the Center for Complicated Grief httpcomplicatedgrief.org at the Columbia University School of Social Work. With complicated grief something gets in the way of that adaptation she said. Something impedes the course of healing. How common is this prolonged grief An epidemiological study of more than people conducted in Germany in put the proportion at nearly percent and at percent among those over age http George A. Bonanno http director of the Loss Trauma and Emotion Lab http at Columbia University Teachers College said the real figure might be closer to to percent. Dr. Bonanno author of The Other Side of Sadness http What the New Science of Bereavement Tells Us About Life After Loss argues that resilience is the typical response to the death of loved ones. Yet he notes we always see a group of people who dont recover. The problem appears more likely when a death is sudden or violent when the person who died was ones spouse romantic partner or child and when the bereaved person has a history of depression anxiety or substance abuse. Defining this sort of grief has engendered some professional disagreement. What criteria distinguish complicated grief from depression or anxiety When does normal grief become prolonged Researchers disagree on even the conditions name. The American Psychiatric Association http in the latest version of its Diagnostic and Statistical Manual http of Mental Disorders declined to classify complicated grief as a mental disorder and instead included persistent complex bereavementrelated disorder in an appendix for further study. The fifth edition published in sets months as the point past which continued symptoms of intense grief may constitute a disorder although Dr. Shear and other researchers had proposed a threshold of six months. Some experts have argued that the available evidence doesnt support a clear distinction between longerthanaverage grieving and mental illness httpjournals.lww.comjonmdAbstractShould_Prolonged_Grief_Be_Reclassified_as_a_Mental..aspx. Does psychiatry need to continually label the range of normal human emotions as disorders Jerome C. Wakefield httpsocialwork.nyu.eduourfacultyfulltimejeromecwakefield.html a professor of social work and psychiatry at New York University said in an interview. By diagnosing complicated grief just six months after a death he said youll get a lot of normal people receiving treatment they dont need including drugs. Dr. Shear also worries about pathologizing normal emotions. But when a woman remains unable to leave her home or answer the phone four years after the death of her adult son as was true of one patient something has clearly gone wrong. If youre worried about what youre experiencing if youre not getting more engaged in life and people around you are saying Honey stop wallowing in it why not get some help Dr. Shear said. Complicated grief therapy developed by her center showed greater effectiveness among older adults than interpersonal psychotherapy in a clinical trial. Subjects including Ms. Schomaker were given a scale with statements measuring responses to loss like I think about this person so much that its hard for me to do the things I normally do and I feel that life is empty without the person who died. Their high scores indicated complicated grief. Close to half of the subjects average age had lost a spouse or partner and more than a quarter had lost a parent. More than three years had elapsed on average since the death. Most subjects reported that they had thought of suicide. They were randomly assigned to undergo weekly sessions of complicated grief therapy which focuses specifically on bereavement symptoms and incorporates memories photographs and recordings or interpersonal psychotherapy. Both treatments helped but in the group receiving complicated grief therapy more than percent were found much improved or very much improved httparchpsyc.jamanetwork.comarticle.aspxarticleidresultClick in the severity of their symptoms and impairment compared with percent in the standard psychotherapy group. A larger foursite study completed but not yet published showed similar effectiveness Dr. Shear said. To make its method more widely available the Center for Complicated Grief has published a manual and offers training workshops for therapists staff members consult with and answer questions from patients and therapists around the country. Darlyn Reardon of Ross Township Pa. for instance sought complicated grief therapy at the University of Pittsburgh Medical Center in . After her husband of years died of cancer it was like I lost my life too she said. Seven years passed and I didnt take care of myself she said. I didnt go to the doctor. I stopped going to church. We had a circle of friends and I stopped seeing them. I stopped everything. Ms. Reardon will always miss her husband John who was a firefighter. But she can take pleasure now in a regular movie and lunch with her cousin in an affectionate pug named Lovey in her teenage grandchildren. Ms. Schomaker too feels substantially recovered. A volunteer and museumgoer with an active social life she is grateful for the complicated grief therapy she received. It gets you thinking about your loss in a different way she said. It encourages you to move on because theres happiness ahead of you."

"Taking a pomegranate pill a day may help slow the progression of prostate cancer https preliminary research suggests. The study is the latest to demonstrate pomegranates promising antitumor effects says study head Michael Carducci MD professor of oncology and urology at Johns Hopkins Medical Institutes. In https other researchers reported that pomegranate juice may also prevent prostate cancer https from getting worse. The new study involved men with cancer https that had not spread beyond the prostate https and rising PSA levels https Rising levels of PSA prostatespecific antigen are a sign that prostate cancer may be getting worse. The men took either one capsule containing gram of pomegranate extract or three pomegranate capsules daily. At the start of the study the mens PSA levels were doubling every months. After six months of taking the capsules it took months for their PSA levels to double. The results were similar regardless of whether the men took one capsule or three Carducci tells WebMD. However men who took three pills daily were more likely to suffer mild to moderate diarrhea https vs. of those who took one pill. Carducci credits antioxidants https in the pomegranate for its anticancer effect. The study was presented at the Genitourinary Cancers Symposium. Pomegranate for Prostate Cancer Opinions Mixed Michael Morris MD of Memorial SloanKettering Medical Center in New York City says the research has some limitations. For starters its never been proven that slowing down the PSA doubling time improves a patients prognosis he tells WebMD. Additionally it would have been useful to have a group of men who only took placebo https to determine if the extract has benefits beyond that of a biologically inert compound Morris says. But Nicholas J. Vogelzang MD chair and medical director of the developmental therapeutics committee at US Oncology in Las Vegas was excited about the data. The change in the PSA doubling time was dramatic. Thats a good result and basically confirms the findings of the juice study he tells WebMD. Improvements in PSA can have a powerful effect on mens anxiety https levels he says. Vogelzang says he recommends pomegranate extract or juice a lot typically for men with rising PSA levels. But I dont usually use it for men whose cancer https has spread beyond the prostate he says. Carducci is an unpaid consultant to POM Wonderful which makes both the pomegranate capsules and the juice used in the earlier study. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"A new study by the CVS Health Research Institute found that home infusion care is safe clinically effective and improves quality of life while reducing health care costs when compared to infusion care delivered in a hospital or clinic. The findings underscore the value of home infusion services where medication is delivered intravenously in a patients home for the health care system including patients and payers. The study http was published in Healthcare The Journal of Delivery Science and Innovation. CVS Health As the U.S. health care payment system shifts from volume to value we are focused on identifying new approaches to health service delivery that provide better care and improve patient outcomes while lowering costs said Troyen A. Brennan MD study author and Chief Medical Officer CVS Health. Our research shows that home infusion care is a promising model that is both cost and clinicallyeffective and is overwhelmingly preferred by patients when intravenous therapy is required. Researchers conducted a systematic review of existing peerreviewed research evaluating infusion care for several conditions including cystic fibrosis antibiotics following orthopedic surgery and several cancers requiring infused chemotherapies. Researchers compared measures of quality safety clinical outcomes quality of life and costs of home infusion services to those provided in medical settings. The research showed that patients receiving intravenous therapy at home had as good or better clinical outcomes as those patients who received the same therapy in a traditional health care setting. In addition patients overwhelmingly preferred receiving their infusion therapies at home reporting fewer disruptions in personal schedules and responsibilities. The costs associated with home infusion were also consistently lower than services provided in a health care facility with savings ranging between and per course of treatment. At CVS Health we provide important home infusion services to patients through Coram which is just one of the ways we are expanding our clinical delivery model and helping to move important health services to lower cost sites of care added Alan Lotvin MD Executive Vice President CVS Specialty. In fact our patients report high satisfaction with our Coram home infusion services citing convenience and comfort as key elements that improved their overall experience. Home infusion services are a rapidly growing delivery model in the health care system with rising rates of chronic and acute conditions that require intravenous therapy. Despite this clinical outcomes and quality of care have not previously been systematically evaluated. While many commercial health plans provide comprehensive coverage for home infusion services Medicare has limited reimbursement for this type of care and Congress is discussing how to implement a comprehensive home infusion benefit for Medicare beneficiaries. Coram https a service provided by CVS Health provides vital infusion care and support to tens of thousands of Americans each month with a range of conditions including immune deficiencies rheumatoid arthritis and serious infections requiring intravenous antibiotic therapy. Care is administered by experienced infusion nurses and pharmacists and in addition patients receive additional disease management education and support throughout their treatment. The CVS Health Research Institute is focused on contributing to the body of scientific knowledge related to pharmacy and health care through research collaborations with external academic institutions participation in federallyfunded research analysis and sharing of CVS Health data sources and coordination of pilot programs and initiatives. CVS Health Research Institute findings support a continuous quality improvement environment which encourages product innovation and development to benefit CVS Health patients clients and their members. About CVS Health CVS Health NYSE CVS httpstudio.financialcontent.comprnewsPageQuoteTickerCVS is a pharmacy innovation company helping people on their path to better health. Through its more than retail pharmacies more than walkin medical clinics a leading pharmacy benefits manager with nearly million plan members a dedicated senior pharmacy care business serving more than one million patients per year and expanding specialty pharmacy services the Company enables people businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at https Logo httpphotos.prnewswire.comprnh SOURCE CVS Health Related Links http"

"Consuming soy foods such as soy milk tofu and edamame and cruciferous vegetables such as cabbages kale collard greens bok choy Brussels sprouts and broccoli may be associated with a reduction in common side effects of breast cancer treatment in breast cancer survivors say a team of scientists led by Georgetown Lombardi Comprehensive Cancer Center. In the study published in Breast Cancer Research and Treatment higher intake of cruciferous vegetables and soy foods were associated with fewer reports of menopausal symptoms. Higher soy intake was also associated with less reported fatigue. The breast cancer survivors studied included nonHispanic white and Chinese Americans including USborn Chinese and Chinese immigrants. Researchers say breast cancer survivors often experience side effects from cancer treatments that can persist months or years after completion of treatment. For example because many treatments designed to prevent breast cancer recurrence inhibit the bodys production or use of estrogen the hormone that can fuel breast cancer growth breast cancer patients often experience hot flashes and night sweats among other side effects. The lead author on the study Sarah Oppeneer Nomura PhD of Georgetown Lombardi said that while further research is needed in larger study populations and with more detailed dietary data this project addresses an important gap in research on the possible role of lifestyle factors such as dietary habits in relation to side effects of treatments. These symptoms can adversely impact survivors quality of life and can lead them to stopping ongoing treatments she says. Understanding the role of life style factors is important because diet can serve as a modifiable target for possibly reducing symptoms among breast cancer survivors. When study participants were evaluated separately by raceethnicity associations were significant among white breast cancer survivors however while a trend was seen in the benefit for Chinese women results were not statically significant. Researchers explain Chinese women typically report fewer menopausal symptoms. Most of them also consume cruciferous vegetables and soy foods making it difficult to see a significant effect in this subgroup. Indeed in this study Chinese breast cancer survivors ate more than twice as much soy and cruciferous vegetables. Whether the reduction in symptoms accounts for longtime use of soy and cruciferous vegetables needs further investigation says the studys senior author Judy Hueiyu Wang PhD of Georgetown Lombardis Cancer Prevention and Control Program. Results obtained in preclinical studies in animals show that biologically active compounds present in both soy and cruciferous vegetables cause breast cancer cells to grow but have opposite effects in animals that consume these compounds well before cancer is diagnosed and continue consuming them during and after cancer treatments. Until more research is conducted breast cancer patients should not suddenly start eating soy if they have not consumed it before says Leena HilakiviClarke PhD a professor of oncology at Georgetown Lombardi and a coauthor of the study. Researchers also found suggestive associations with lower reporting of other symptoms including joint problems hair thinningloss and memory less in women who consumed more soy foods but these associations did not reach statistical significance. Phytochemicals or bioactive food components such as isoflavones in soy foods and glucosinolates in cruciferous vegetables may be the source of the benefit researchers say. Isoflavones bind to estrogen receptors and exert weak estrogenic effects among other effects. Glucosinolates in cruciferous vegetables influence levels of metabolizing enzymes that can modulate inflammation and levels of estrogen possibly attenuating treatmentrelated symptoms. Coauthors of the study include Chiranjeev Dash MBBS MPH PhD Leena HilakiviClarke PhD and YunLing Zhen MPH PhD from Georgetown Lombardi YiTin Hwang PhD from National Taipei University Taiwan Scarlett Lin Gomez MPH PhD from the Cancer Prevention Institute of California Teresa T. Fung MS ScD from Harvard T. H. Chan School of Public Health ShuLan Yeh PhD from Chang Shan Medical University Taiwan and Serena Phillips RN MPH from Milken Institute School of Public Health George Washington University. The study was funded by a Lance Armstrong Foundation Young Investigator Award and the National Cancer Institute CA. The authors report having no personal financial interests related to the study. About Georgetown University Medical Center Georgetown University Medical Center GUMC is an internationally recognized academic medical center with a threepart mission of research teaching and patient care through MedStar Health. GUMCs mission is carried out with a strong emphasis on public service and a dedication to the Catholic Jesuit principle of cura personalis or care of the whole person. The Medical Center includes the School of Medicine and the School of Nursing Health Studies both nationally ranked Georgetown Lombardi Comprehensive Cancer Center designated as a comprehensive cancer center by the National Cancer Institute and the Biomedical Graduate Research Organization which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook Facebook.comGUMCUpdate httpFacebook.comGUMCUpdate Twitter httpstwitter.comgumedcenterlangen gumedcenter and Instagram https gumedcenter. About Georgetown Lombardi Comprehensive Cancer Center Georgetown Lombardi Comprehensive Cancer Center httpslombardi.georgetown.edu is designated by the National Cancer Institute as a comprehensive cancer center the only cancer center of its kind in the Washington DC area. A part of Georgetown University Medical Center and MedStar Georgetown University Hospital Georgetown Lombardi seeks to improve the diagnosis treatment and prevention of cancer through innovative basic and clinical research patient care community education and outreach and the training of cancer specialists of the future. Connect with Georgetown Lombardi on Facebook httpFacebook.comGeorgetownLombardi and Twitter http LombardiCancer."

"Lightly shocking a persons brain just before they learned a new task appeared to strengthen memory in a handful of patients with epilepsy a tantalizing result that could have implications for Alzheimers disease U.S. researchers said on Wednesday. Pacemaker devices known as deep brain stimulators made by Medtronic and St. Jude Medical are already used to calm muscle tremors in patients with Parkinsons disease and other movement disorders and are being tested for a host of other conditions such as treatmentresistant depression. The devices are implanted under the skin in the chest with wires leading up the neck connected to tiny electrodes implanted deep in the brain which produce electrical impulses. The current study was done at the University of California at Los Angeles in seven epileptic patients awaiting surgery who had electrodes implanted deep in their brains to help pinpoint the source of their seizures. The team used this opportunity to see how stimulating the brain affects memory. They focused on an area of the brain called the entorhinal cortex which helps form and store memories. The entorhinal cortex is the golden gate to the brains memory mainframe Dr. Itzhak Fried professor of neurosurgery at the David Geffen School of Medicine at UCLA who worked on the study said in a telephone interview. The research was published in the New England Journal of Medicine. Fried said sensory experiences that eventually become memories pass through this hub before they are stored in the hippocampus the brains chief memory center. For the study patients played a video game in which they had to shuttle people around in taxis to different shops in a virtual city. The team tested whether stimulating the entorhinal cortex or the hippocampus while they were learning their way around the city improved their recall. When we stimulated the hippocampus itself there was not an effect. It was really stimulation in the gateway to the hippocampus the entorhinal cortex where we got the beneficial effect in terms of memory Fried said. Compared to testing before stimulation zapping this part of the brain helped people recognize landmarks and navigate the virtual city more quickly. Fried said the findings suggest stimulating the brain just as memories are forming is key. IMPACT ON ALZHEIMERS In Alzheimers disease this area of the brain is affected early on when signs of dementia begin to appear. Fried said the study might have implications for treatments for patients with early Alzheimers disease but he cautioned that the results are very preliminary. The question would be whether this can help memory in patients with memory impairments he said. Scientists are increasingly focused on ways to treat the memoryrobbing disease which affects more than million Americans. Despite costly efforts no drug has been found that can keep Alzheimers from progressing and policymakers are growing increasingly worried about the swelling ranks of dementia patients as the population ages. Suzanne Haber a neuroscientist at the University of Rochester Medical Center in New York who was not involved in the study said she was very excited about the finding but she cautioned that the treatment is very invasive very expensive and unproven in Alzheimers patients. The Obama administration said on Wednesday it plans to spend an additional million over the next two years to help find an effective treatment for Alzheimers. One team has already tried deep brain stimulation in Alzheimers patients. In a study published in the Annals of Neurology in researchers tested deep brain stimulation in six patients over the course of a year and found the treatment to be relatively safe. They also saw signs the treatment might have an effect on memory. Dr. Sandra Black a brain researcher at the University of Toronto who wrote an editorial on the current study said the findings could have implications for early stage Alzheimers disease if tests were developed to identify this process early through imaging or genomics. Although the current evidence is preliminary is based on small samples and requires replication the potential application of deepbrain stimulation in amnestic disorders is enticing Black wrote."

"The question People treated in the emergency room for a sprain strain or fracture are generally given opioids to help them cope with the pain often leaving with a prescription for opioids too. Might nonopioid painkillers work just as well as these addictive drugs This study The study involved adults average age who had gone to an emergency department with an extremity injury causing moderate to severe pain averaging . on a scale of to . For pain they were randomly assigned to take acetaminophen along with a nonopioid ibuprofen or with one of three commonly prescribed opioids oxycodone hydrocodone or codeine. Within two hours all participants reported essentially identical declines in pain about four points on the scale. Even for people who initially had rated their pain as a for the worst pain possible or had broken a bone there was virtually no difference in pain reduction between those who had and had not taken an opioid. Who may be affected Adults with arm or leg pain caused by a sprain strain or fracture. Research has shown that even shortterm opioid use such as that stemming from an initial prescription for pain from an injury or surgery can make people predisposed to a dependence on the powerful drugs partly from their effectiveness at relieving pain and partly from the euphoria they produce. Abuse of opioids has become an epidemic in the United States with opioids now causing percent of drug overdose deaths. Caveats Data on pain came from the participants ratings no information on side effects was collected. The study did not assess longerterm pain reduction. Find this study Nov. issue of JAMA jama.com httpsurldefense.proofpoint.comvurluhttpsA__jamanetwork.com_journals_jama_fullarticle_dDwQCaQcRAhzPLrCAqeJdrcQiUVEwFYoMRqGDAXQ_puwtYjgrGgivkKNHTVnLjjXizEdTOTAeiQkcgtAvxxZaomBJtwwNDpLLirPUavisiAyNhqVMbIqzsRADsAVgocaGTGmJktuzoWZADscd_AMUSoUqSkDoIe click on Issues Learn more Information on opioids can be found at drugabuse.gov httpsdrugabuse.gov click Drugs of Abuse then Opioids and at familydoctor.org httpsfamilydoctor.org search for opioid addiction. The research described in Quick Study comes from credible peerreviewed journals."

"A treatment that improves the lives of nearly . million people with rheumatoid arthritis might one day originate from scorpion venom. A group of researchers led by Dr. Christine Beeton at Baylor College of Medicine has found that one of the hundreds of components in scorpion venom can reduce the severity of the disease in animal models without inducing side effects associated with similar treatments. The study appears in the Journal of Pharmacology and Experimental Therapeutics. Rheumatoid arthritis is an autoimmune disease one in which the immune system attacks its own body. In this case it affects the joints said Beeton associate professor of molecular physiology and biophysics and member Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine. Cells called fibroblastlike synoviocytes FLS play a major role in the disease. As they grow and move from joint to joint they secrete products that damage the joints and attract immune cells that cause inflammation and pain. As damage progresses the joints become enlarged and are unable to move. Current treatments target the immune cells involved in the disease and none are specific for FLS. Beeton and her colleagues studied FLS looking for an Achilles heel that would allow them to prevent or stop them from damaging the joints. In previous work we identified a potassium channel on FLS of patients with rheumatoid arthritis and found that the channel was very important for the development of the disease Beeton said. We wanted to find a way to block the channel to stop the cells damaging the joints. Potassium channels work by opening gates on the surface of cells that allow potassium ions small charged atoms to flow in and out of the cell. The flow of ions through the channels is necessary for the cells to carry out many of their essential functions. Animals such as scorpions have venoms that block potassium and other ion channels. They use the venoms to paralyze and kill prey. Decades ago scientists discovered this and realized that if handled correctly venoms also might have medicinal applications. Scorpion venom may lead to improved treatments for rheumatoid arthritis Scorpion venom has hundreds of different components. One of the components in the venom of the scorpion called Buthus tamulus specifically blocks the potassium channel of FLS and not the channels in other cells such as those of the nervous system said first author Dr. Mark Tanner a graduate student in the Beeton lab during the development of this project. Here we investigated whether this venom component called iberiotoxin would be able to specifically block the FLS potassium channel and reduce the severity of the rheumatoid arthritis in rat models of the disease. When the researchers treated rat models of the disease with iberiotoxin they stopped the progression of the disease. In some cases they reversed the signs of established disease meaning that the animals had better joint mobility and less inflammation in their joints. In addition treatment with iberiotoxin did not induce side effects such as tremors and incontinence observed when treating with another channel blocker called paxilline. It was very exciting to see that iberiotoxin is very specific for the potassium channel in FLS and that it did not seem to affect the channels in other types of cells which might explain the lack of tremors and incontinence Tanner said. Although these results are promising much more research needs to be conducted before we can use scorpion venom components to treat rheumatoid arthritis Beeton said. We think that this venom component iberiotoxin can become the basis for developing a new treatment for rheumatoid arthritis in the future. Other contributors of this work include Michael W. Pennington Brayden H. Chamberlain Redwan Huq Elizabeth J. Gehrmann Teresina Laragione and Prcio S. Gulko. The contributors are affiliated with one or more of the following institutions Baylor College of Medicine Peptides International Inc. and Icahn School of Medicine at Mount Sinai. This work was supported by the Arthritis Foundation grant and the National Institutes of Health grants GM AI AR HL CA and HG."

"Acupuncture may help ease pain and improve quality of life for people with fibromyalgia a new study suggests. Ten weeks after treatment the pain scores of patients given acupuncture dropped an average of percent compared with an average drop of percent for those given a simulated acupuncture treatment. The benefits were still seen after a year. Individualized acupuncture is a safe and good therapeutic option for the treatment of patients with fibromyalgia said lead researcher Dr. Jorge Vas of the pain treatment unit at Dona Mercedes Primary Health Center in Seville Spain. Fibromyalgia patients have chronic widespread pain which is associated with fatigue poor sleep patterns and depression. The condition affects up to percent of the population Vas said. Between percent and percent of fibromyalgia patients are women. According to the study authors nine out of patients try some form of alternative therapy such as massage or acupuncture in addition to their regular pain medication. Both acupuncture and traditional medicine have a place in treating fibromyalgia said Dr. Alexander Rances an acupuncturist pain management specialist and attending physician at North Shore University Hospital in Manhasset N.Y. A combination of Western as well as traditional Chinese medicine probably offers these patients the best possible therapy he said. With acupuncture extremely thin needles are inserted through the skin at strategic body points to treat pain. Fibromyalgia treatment usually starts with medications such as the nerve pain medication Lyrica pregabalin and if that fails or is only partly effective doctors might add acupuncture to the mix Rances said. For the study Vas and colleagues randomly assigned patients diagnosed with fibromyalgia to individually tailored acupuncture or simulated acupuncture. Patients had nine weekly treatments each session lasting minutes. Although it was allowed for the participants to continue with the pharmacological drug treatment they were taking beforehand when the study was finished the patients who received individualized acupuncture were taking less medication than the group on sham acupuncture Vas said. At weeks six months and months after treatment patients were asked about perceived levels of pain and depression and their physical and mental quality of life. One year after treatment acupuncture patients had an average percent drop in their pain score compared with a little more than percent among those who had simulated therapy the researchers found. Scores on the Fibromyalgia Impact Questionnaire which measures how the condition affects patients lives also differed between groups. Reductions were seen of percent at weeks and just over percent at one year for those given real acupuncture compared with . percent and percent respectively for those given sham acupuncture the researchers said. In addition pressure pain and the number of tender points also improved more in patients given real acupuncture after weeks as did measures of fatigue anxiety and depression Vas said. However although taking less pain medication acupuncture patients were using higher levels of antidepressants after one year which may have artificially boosted the positive results he said. The report was published online Feb. in the journal Acupuncture in Medicine. Dr. Allyson Shrikhande is a physiatrist a doctor who specializes in physical medicine and rehabilitation at Lenox Hill Hospital in New York City. She agreed that antidepressant use could have been a significant contributing factor to their continued improvement. Still Shrikhande said the findings in this study help demonstrate that acupuncture is a safe and effective treatment for chronic pain patients. Many patients with fibromyalgia have a central nervous system that is unregulated meaning an abundance of pain signals are sent to the brain Shrikhande said. Acupuncture can calm or quiet the nervous system and help slow down the pain signals to the brain. Acupuncture can also improve blood flow which can improve oxygenation of tissues she said. Some insurance companies cover acupuncture which costs about a session according to the University of California San Diego Center for Integrative Medicine. More information For more on fibromyalgia visit the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases http_InfoFibromyalgiafibromyalgia_ff.asp. SOURCES Jorge Vas M.D. P.h.D. pain treatment unit Dona Mercedes Primary Health Center Seville Spain Alexander Rances D.O. licensed acupuncturist pain management specialist and attending physician North Shore University Hospital Manhasset and Long Island Jewish Medical Center New Hyde Park N.Y. Allyson Shrikhande M.D. physiatrist Lenox Hill Hospital New York City Feb. Acupuncture in Medicine online"

"Breast cancers in women aged to that are diagnosed by mammograms have a better prognosis than those detected by doctors or the women themselves a new study indicates. They have an earlier diagnosis earlier stage better prognosis said study author Judith Malmgren an affiliated professor of epidemiology at the University of Washington School of Public Health and Community Medicine. She is also president of HealthStat Consulting Inc. in Seattle. The new study like previous ones reignites the ongoing debate about the best age to start routine mammograms and the best screening interval. It appears in the March issue of the journal Radiology. In the U.S. Preventive Services Task Force issued mammogram recommendations. It recommends women aged to who are at average risk for breast cancer have a mammogram done every two years. It also suggests that women aged to at average risk discuss the pros and cons with their doctors and decide on an individual basis if and when to start screening. Meanwhile other organizations including the American Cancer Society recommend women begin mammograms at age and continue to have them annually. Malmgren and her colleagues evaluated nearly women who had breast cancer. All were aged to when they were treated between and . The researchers looked at the method of diagnosis whether by mammogram or if the cancer was found by the doctor or the woman. They also took these into account the cancers stage at diagnosis type of treatment annual followup recurrence and survival. Over the year period the number of breast cancers diagnosed at very early stages increased percent while the number of more advanced cancers stage decreased by percent. Those whose cancers were detected by mammogram rose from percent in to percent in . The number of cancers detected by doctor or patients declined from percent in to percent in . Women whose cancers were detected by mammograms were more likely than the doctor or patientdetected cancers to have lumpectomy or other breastconserving surgery percent vs. percent. The women whose cancers were detected by mammograms were less likely to be given chemotherapy. While percent of women whose cancer was found on mammogram died during a followup period that ranged from one to years percent of those whose cancers were found by the doctor or the women died. When the researchers looked only at invasive cancers percent of the women whose cancer was found on mammogram survived without recurrence at five years percent of the other group did. I dont think the U.S. Preventive Services Task Force is looking at the whole picture Malmgren said. They are concentrating on the harms. Among them according to the guidelines are falsepositives which can lead to anxiety and unnecessary biopsies. Malmgren a breast cancer survivor says more focus should be placed on the benefit of early diagnosis because it often means less treatment is needed. There was a decrease found in cancers being diagnosed at later stages in those whose cancers were found on mammograms. Thats where the money is Malmgren said. Dr. Virginia Moyer chair of the U.S. Preventive Services Task Force and a professor of pediatrics at Baylor College of Medicine reviewed the study. The findings make sense she said. They found that cancers can be detected earlier by mammogram. A screening test if it cant find something earlier than by clinical presentation is a poor test she said. However she said the study does not provide support for all women aged to to have routine mammograms. When considering its recommendation the task force took all available evidence into account including published studies Moyer noted. The data from randomized trials and modeling show there is a very modest improvement in mortality with mammograms from to she said. Because it is so modest and there are risks people need to make their own decision Moyer said. More information To learn more about mammograms go to the U.S. National Cancer Institute. SOURCES Judith A. Malmgren Ph.D. affiliate professor epidemiology Washington University School of Public Health and president of HealthStat Consulting Inc. Seattle Virginia Moyer M.D. chairwoman U.S. Preventive Services Task Force and professor pediatrics Baylor College of Medicine Houston March Radiology"

"As he drove on the New Jersey Turnpike Doug Hikades biggest concern was never the traffic or the tolls but the next rest stop. Id be frantic recalled the Mount Laurel resident . Like most men his age Hikade suffered from the squeeze of an enlarged prostate. Unable to completely empty his bladder he needed to go far more often sometimes half a dozen times a night. Not anymore. Hikade is among thousands who have had a quick office procedure in which a urologist inserts tiny sutures that pull aside the two halves of the enlarged gland almost like curtains on a stage allowing for improved urinary flow. It is total relief he said. The procedure called a prostatic urethral lift does not improve flow as much as surgery in which a physician cuts away some of the inside of the prostate to allow better flow. But the lift procedure and recovery are much quicker with no hospital stay and fewer complications. And patients who get the sutures can always come back for surgery later. Bruce Sloane Hikades urologist said he was doubtful of the sutures at first until he saw the research data and watched another physician demonstrate the technique. He now has implanted the UroLift sutures in several dozen patients and said he likes it because it does not involve destroying any tissue. If I can preserve a guy and keep him whole I like that said Sloane who practices in Center City. Another initial skeptic urologist Steven A. Kaplan of the Icahn School of Medicine at Mount Sinai now performs the procedure as well though he remains unsure how long the improvement will last. In May researchers http said that improvements in peak urinary flow have lasted so far for five years in a study funded by device maker NeoTract Inc. of Pleasanton Calif. But one in patients ended up needing surgery anyway. With the UroLift sutures quick recovery is among the biggest pluses said Kaplan director of the Mens Health Program at the Mount Sinai Health System in New York. They can go to work the next day he said. A common problem Benign prostatic hyperplasia benign meaning no cancer is present strikes up to half of men by age . By age close to percent have symptoms from an enlarged prostate said urologist Sloane. Insurers generally want medication to be tried first but the drugs do not always work and can cause dizziness or other side effects. Both concerns side effects and lack of effectiveness motivated Paul Diamantis to come to Sloanes office for the lift procedure in May. The Haddon Heights resident had no problems with daytime urination but had to get up to use the bathroom several times a night he said. He lay back in a reclining chair in Sloanes office and rolled to one side so Sloane could inject a numbing agent in his prostate going through the rectum. Then Diamantis rolled onto his back and Sloane injected another numbing agent into the urethra. The physician then told Diamantis he would insert a cystoscope into his penis through the urethra until it reached the inside of the prostate. The thin black tube would serve as a sheath for the device that delivered the sutures. Diamantis seemed a bit apprehensive pressing his lips together in response. Now I want you to relax Sloane said. Youll feel it a little bit but not much. In went the scope followed by the delivery device a long silvery rod with a trigger handle on one end. Click Sloane squeezed the trigger to secure the first suture which unfolded into a Tshape on one end hugging the outside of the prostate like a miniature version of those molly bolts that are driven through drywall. The doctor adjusted the device slightly then squeezed the trigger again cutting the other end of the suture to the right length and securing it inside the urethra. The scope was fitted with a small internal camera allowing Sloane to monitor his progress on the screen of a nearby laptop. Diamantis got four sutures two on each side of the walnutsized gland. Some patients get five or six. His entire office visit lasted about an hour but he was back on his feet in minutes. It wasnt bad at all Diamantis said. Taking action before bladder is shot The device got its start more than a decade ago in a biomedical business incubator in California. Three engineers Ted Lamson Joshua Makower and Joseph Catanese III spent months interviewing patients and physicians learning that many were dissatisfied with current treatments for enlarged prostates. They developed UroLift after experimenting in cadavers and founded NeoTract in . The first patients were treated in Australia by the end of . Initial clearance from the U.S. Food and Drug Administration did not come until but now more than half of the patients treated to date are in this country said chief executive officer Dave Amerson. Insurers generally reimburse about for the procedure. Medicare covers it though some private insurers do not. Lamson worked with heart valves for his doctorate in biomedical engineering at Pennsylvania State University a good preparation for his work today. Faulty valves can make the heart work too hard over the long term and the muscle becomes baggy and weak the condition known as heart failure. Ditto for the bladder if it has to strain to force urine through a channel that is surrounded by an enlarged prostate. The bladder has to work a lot harder Lamson said. It is getting worse and worse. Sloane agreed saying it was an argument for not waiting too long to take action. The bladder can regain contractility as long as its not too far gone the urologist said. Once the bladder is shot you cant bring it back. In the days following Diamantis procedure as with most patients he experienced more frequent urination not less as his bladder adjusted to the unrestricted flow. Sloane said a significant improvement after four weeks is common. Hikade who had his procedure in August was so happy that he talked a neighbor into getting it and that man has since recommended it to someone else. And those trips on the turnpike You dont worry about the next rest area Hikade said. Its peace of mind now."

"A new asthma drug being developed by Sanofi and Regeneron Pharmaceuticals may help patients whose condition is not well controlled by existing medicines according to the results of a small clinical trial released Tuesday. In the week study the number of asthma attacks or other outbreaks of symptoms decreased by percent in those getting the drug dupilumab compared with those getting a placebo. Other measures of lung function and disease control also improved according to the study results which were published online Tuesday in The New England Journal of Medicine and presented at the annual meeting of the American Thoracic Society in Philadelphia. Dupilumab blocks the action of interleukin and interleukin two inflammatory chemicals made by the body that are believed to contribute to asthma. Sanofi and Regeneron say there are also preliminary signs dupilumab works against the skin condition atopic dermatitis suggesting it can be blocking a biological pathway that contributes to multiple allergic conditions. Still much larger studies taking at least two or three years are likely to be needed before the drug could reach the market. A commentary on the asthma study also published in The New England Journal of Medicine on Tuesday said it was too early to tell if this therapy will be of clinical value though it was probably on the right path. After two decades of frustration Regeneron which is based in Tarrytown N.Y. has become a major biotechnology company owing to booming sales of Eylea its drug to treat agerelated macular degeneration an eye disease. Regeneron shares have roughly quintupled since the beginning of . In trading Tuesday however they closed down . percent at .. An estimated million Americans have asthma and the disease is not well controlled in to percent of them by the usual therapy which consists of inhaled glucocorticoid steroids and longacting beta agonists. Editors Picks The study involved patients whose disease was not well controlled by existing medications and who had elevated levels of a type of immune system cell associated with problematic asthma. At first the patients continued to take their existing medications while also getting weekly injections of either dupilumab or a placebo. But partway through the trial they stopped taking their usual medications. During the entire weeks three of the patients taking dupilumab experienced a worsening of asthma compared with on the placebo a relative reduction of percent. In the commentary Dr. Michael E. Wechsler of National Jewish Health in Denver said that in actual medical practice patients would not be taken off their existing medications. The real need he wrote is for drugs to help control asthma when used in addition to the existing medications and the study had not demonstrated that dupilumab could fulfill that role. In the first few weeks of the trial when patients were still taking their existing drugs there was no significant difference in the number of worsenings of asthma between dupilumab and the placebo Dr. Wechsler wrote. Dr. George D. Yancopoulos chief scientific officer of Regeneron said the trial was designed to have patients stop taking their existing drugs to get a quick read on whether dupilumab worked. Dr. Yancopoulos and other researchers from Regeneron and Sanofi were among the authors of the study. The lead investigator Dr. Sally Wenzel of the University of Pittsburgh has been a consultant to Regeneron."

"In University of Massachusetts graduate student Tsochen Chang opened a Chinese restaurant in the town of Amherst to support himself. To supply the restaurant he started an organic vegetable farm in Whately in the fertile soil of the Connecticut River Valley. Because he grew a lot of vegetables he started an organic produce trucking and distribution business. Then followed an immense commercial sprout business. By the Chinese entrepreneur was casting about for new commercial crops to grow that would impart both food value and medicinal benefits. In conversations with his friend Dr. Shiu Hu of Harvards Arnold Arboretum Chang became enamored of growing schisandra a berry highly prized in Traditional Chinese Medicine TCM for its purported longevity promoting powers. Hu provided Chang with the fist seeds for this venture which he planted at his Whately farm. Today Pioneer Valley Schisandra cultivates over fifty acres of U.S.D.A. Certified Organic Schisandra berries. The farm has been producing berries since the early s and representatives from a number of giant multinational corporations have driven out to the foothills of the Berkshires to kick tires and contemplate what they might do with a whole lot of schisandra berry. At the farm during harvest a number of Latinos work the berry bushes which are set up on fenced wires like the French espalier method of growing. The berries ripen inconsistently so harvesters will make a few passes through the orchard during harvest season. Chang designed this way of cultivating schisandra and actually went back to China to teach this method to growers there in Chinas northern Liaoning Province. I visited that region in for the harvest and saw that by that time Changs method was commonly used everywhere. At age the clock is ticking for the fulfillment of Changs mission but he seems to be in the right spot for this. Schisandra chinensis has been used in TCM for over years. Schisandra is still relatively unknown in the U.S. market. But due to its ageold use for enhancing vitality and its strong science base the berry and its preparations should get a good market boost in the years ahead. The berry of schisandra owes its name Wu Wei Zi five flavored berry to the fact that it is sweet sour salty bitter and pungent. Schisandra chinensis enjoys millennia of traditional use for prolong life retarding the aging process increasing energy as a fatiguefighter and as a sexual tonic. Schisandra also possesses significant protective antioxidant and antiinflammatory activity. It is considered one of the most highly protective of all medicinal plants and the berry is included in many traditional herbal formulas for improving energy and mental health. The activity of the berry appears due primarily to its concentration of two groups of novel compounds known respectively as schizandrins and gomasins. These agents are lignans and are extensively well studied for internal and topical benefits. Schisandra counters stress by reducing the levels of stress hormones in the blood. Additionally schisandra offers great benefits for athletes. In human studies the berry and its extracts have improved performance among long distance runners skiers and gymnasts. For this reason schisandra berry is often found on the training tables of Chinese athletes. Schisandra also offers special benefits for the mind. Several human studies show that schisandra extract improves concentration coordination and endurance. Schisandra helps to prevent mental fatigue and increases accuracy and quality of work. In various human clinical studies with doctors students soldiers and other groups schisandra demonstrated superior mindsharpening powers. As if all these benefits were insufficient schisandra also offers firstrate liverprotective benefits. Schisandra helps in the treatment of hepatitis as noted in over cases. In fact an antihepatitis drug was developed from Schizadrin C. Standing outside in the early fall sun admiring healthy schisandra bushes its hard not not be impressed by the size and scope of Changs farm and by his longtime commitment to this berry and its future. When Hippocrates advised to let your food be your medicine he could easily have been referring to schisandra whose time in the sun must surely come."

"People who have had Type diabetes for up to years can reverse their condition Keeping weight down means Type diabetes stays reversed A new study from Newcastle University has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes. In addition the team found that even patients who have had Type diabetes for up to years can reverse their condition. The study published today in Diabetes Care is the latest research from worldrenowned Professor Roy Taylor Professor of Medicine and Metabolism at Newcastle University who also works within Newcastle Hospitals. The research is part of a growing body of evidence showing that people with Type diabetes who successfully lose weight can reverse their condition because fat is removed from their pancreas returning insulin production to normal. Reversing diabetes A previous study led by Professor Taylor published in showed that diabetes could be reversed by a very low calorie diet. This caused international interest but the study was very short as it was only eight weeks and the question remained whether the diabetes would stay away. In this new study volunteers with Type diabetes embarked on the same diet of to calories a day. Participants lost on average kilograms just over stone. Over the next months they did not regain any weight. The group included many people with longer duration diabetes defined as more than years and ranging up to years. Overall patients who had had diabetes for less than years reversed their condition. months later they remained diabetes free. In fact after months a thirteenth patient had reversed their diabetes. Though the volunteers lost weight they remained overweight or obese but they had lost enough weight to remove the fat out of the pancreas and allow normal insulin production. Professor Roy Taylor said What we have shown is that it is possible to reverse your diabetes even if you have had the condition for a long time up to around years. If you have had the diagnosis for longer than that then dont give up hope major improvement in blood sugar control is possible. The study also answered the question that people often ask me if I lose the weight and keep the weight off will I stay free of diabetes The simple answer is yes Interestingly even though all our volunteers remained obese or overweight the fat did not drift back to clog up the pancreas. This supports our theory of a Personal Fat Threshold. If a person gains more weight than they personally can tolerate then diabetes is triggered but if they then lose that amount of weight then they go back to normal. Individuals vary in how much weight they can carry without it seeming to affect their metabolism dont forget that of severely obese people do not have diabetes. The bottom line is that if a person really wants to get rid of their Type diabetes they can lose weight keep it off and return to normal. This is good news for people who are very motivated to get rid of their diabetes. But it is too early to regard this as suitable for everyone. That is a separate question and a major study is underway to answer this. The study Participants in this study had Type diabetes for between six months and years. The team showed that Type diabetes could be reversed even in people who had the condition for years. The team were able to identify in advance participants who would not respond to adequate weight loss by reversing their diabetes as at the start they had almost absent insulin production from the pancreas. The study was funded by a National Institute for Health Research Biomedical Research Centre NIHR BRC grant. A larger trial involving patients is already underway. This will examine how successfully people can reverse their diabetes through weight loss simply under the care of their family doctor and nurse. It is being funded by Diabetes UK. The research was possible through Newcastle Academic Health Partners a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University. This partnership harnesses worldclass expertise to ensure patients benefit sooner from new treatments diagnostics and prevention strategies. The diet diet shakes per day and grams of nonstarchy vegetables taking in between and kcal a day for weeks volunteers then gradually returned to eating normal food over the next two weeks with very careful instruction on how much to eat volunteers were seen once a month and supported with an individualized weight maintenance programme over the next months to keep weight steady after the weight loss they were eating around one third less than before the study CASE STUDY Allan Tutty from Sunderland transformed his health by taking part in the study. He said I was diagnosed with Type diabetes around May during routine checks by my GP but my family and I were in disbelief because I had no physical symptoms which led me to consider I had the condition. While I didnt feel fat I was fat on the inside. Ive since seen a scan of my liver and you can see the fat around it. I took part in the research spending eight weeks on an calorie a day diet which was really tough over Christmas and New Year but I was determined to complete it. The payoff for me the possible reversal of my diabetes was more than worth the effort. In the two months I lost two and a half stones and my pancreas was working within normal limits. With my diabetes in remission I havent looked back. I eat normal foods though I eat less than I used to and I enjoy takeaways and chocolate but not on a regular basis so I have maintained my lower weight it has been a total lifestyle change. In fact my life has changed completely thanks to this research. REFERENCE Very low calorie diet and months of weight stability in Type diabetes Pathophysiologic changes in responders and nonresponders. Sarah Steven Keiren G Hollingsworth Ahmad AlMrabeh Leah Avery Benjamin Aribisala Muriel Caslake Roy Taylor. Diabetes Care. Doi .dc Links Previous study http Very low calorie diet the diet http NIHR http"

"The very high levels of vitamin D that are often recommended by doctors and testing laboratories and can be achieved only by taking supplements are unnecessary and could be harmful an expert committee says. It also concludes that calcium supplements are not needed. The group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine the committee says in a report that is to be released on Tuesday http For most people taking extra calcium and vitamin D supplements is not indicated said Dr. Clifford J. Rosen http a member of the panel and an osteoporosis expert at the Maine Medical Center Research Institute. Dr. J. Christopher Gallagher director of the bone metabolism unit at the Creighton University School of Medicine in Omaha Neb. agreed adding The onus is on the people who propose extra calcium and vitamin D to show it is safe before they push it on people. Over the past few years the idea that nearly everyone needs extra calcium and vitamin D especially vitamin D httpwell.blogs.nytimes.comthemiracleofvitamindsoundscienceorhype has swept the nation. With calcium adolescent girls may be the only group that is getting too little the panel found. Older women on the other hand may take too much putting themselves at risk for kidney stones. And there is evidence that excess calcium can increase the risk of heart disease the group wrote. As for vitamin D some prominent doctors have said that most people need supplements or they will be at increased risk for a wide variety of illnesses including heart disease cancer and autoimmune diseases. And these days more and more people know their vitamin D levels because they are being tested for it as part of routine physical exams. The number of vitamin D tests has exploded said Dennis Black a reviewer of the report who is a professor of epidemiology and biostatistics at the University of California San Francisco. At the same time vitamin D sales have soared growing faster than those of any supplement according to The Nutrition Business Journal httpnutritionbusinessjournal.comsupplementsnewsvitamindomegafishoilfocusnewmilliondollarstudy. Sales rose percent from to reaching million. Everyone was hoping vitamin D would be kind of a panacea Dr. Black said. The report he added might quell the craze. I think this will have an impact on a lot of primary care providers he said. The member expert committee was convened by the Institute of Medicine http an independent nonprofit scientific body at the request of the United States and Canadian governments. It was asked to examine the available data nearly publications to determine how much vitamin D and calcium people were getting how much was needed for optimal health and how much was too much. The two nutrients work together for bone health. Bone health though is only one of the benefits that have been attributed to vitamin D and there is not enough good evidence to support most other claims the committee said. Some labs have started reporting levels of less than nanograms of vitamin D per milliliter of blood as a deficiency. With that as a standard percent of the population would be deemed deficient of vitamin D Dr. Rosen said. Most people need to take supplements to reach levels above nanograms per milliliter he added. But the committee concluded a level of to nanograms is all that is needed for bone health and nearly everyone is in that range. Vitamin D is being added to more and more foods said Paul R. Thomas httpods.od.nih.govAboutPaul_Thomas.aspx of the Office of Dietary Supplements at the National Institutes of Health httpods.od.nih.gov. Not only is it in orange juice and milk but more is being added to breakfast cereals and it now can be found in very high doses in supplement pills. Most vitamin D pills he said used to contain no more than international units of it. Now it is easy to find pills even in places like WalMart with international units. The committee though said people need only international units a day. To assess the amounts of vitamin D and calcium people are getting the panel looked at national data on diets. Most people they concluded get enough calcium from the foods they eat about milligrams a day for most adults for women ages to . Vitamin D is more complicated the group said. In general most people are not getting enough vitamin D from their diets but they have enough of the vitamin in their blood probably because they are also making it naturally after being out in the sun and storing it in their bodies. The American Society for Bone and Mineral Research http and other groups applauded the report. It is a very balanced set of recommendations said Dr. Sundeep Khosla a Mayo Clinic endocrinologist and the societys president. But Andrew Shao an executive vice president at the Council for Responsible Nutrition https a trade group said the panel was being overly cautious especially in its recommendations about vitamin D. He said there was no convincing evidence that people were being harmed by taking supplements and he said higher levels of vitamin D in particular could be beneficial. Such claims are not supported by the available evidence the committee wrote. They were based on studies that observed populations and concluded that people with lower levels of the vitamin had more of various diseases. Such studies have been misleading and most scientists agree that they cannot determine cause and effect. It is not clear how or why the claims for high vitamin D levels started medical experts say. First there were two studies which turned out to be incorrect that said people needed nanograms of vitamin D per milliliter of blood the upper end of what the committee says is a normal range. They were followed by articles and claims and books saying much higher levels to nanograms or even higher were needed. After reviewing the data the committee concluded that the evidence for the benefits of high levels of vitamin D was inconsistent andor conflicting and did not demonstrate causality. Evidence also suggests that high levels of vitamin D can increase the risks for fractures and the overall death rate and can raise the risk for other diseases. While those studies are not conclusive any risk looms large when there is no demonstrable benefit. Those hints of risk are challenging the concept that more is better the committee wrote. That is what surprised Dr. Black. We thought that probably higher is better he said. He has changed his mind and expects others will too I think this report will make people more cautious."

"Theres another type of prescription drugs besides opioid painkillers thats involved in thousands of drug overdose deaths in the US every year. The drugs are benzodiazepines which are widely known by their brand names Xanax and Valium and commonly prescribed to help treat anxiety. These drugs were involved in nearly overdose deaths in according to federal data https But theres a catch Such overdoses seem to be very closely tied to the opioid epidemic http with the majority of benzodiazepine overdose deaths involving both benzodiazepines and opioids. A new study http published in BMJ looked at just how much the concurrent use of these two drugs increases the risk of overdose versus the risk of only using opioids. Drawing on a huge sample of nearly patients who were continuously enrolled in private health insurance plans from and researchers compared those who were prescribed just opioids versus those who were prescribed both and what their additional risk of an emergency room visit or inpatient admission was in the period they were prescribed both. The study found that among all opioid users concurrent use of benzodiazepines more than doubled the risk of an emergency room or inpatient visit for a drug overdose. The study also found that eliminating concurrent benzodiazepine and opioid use could reduce the risk for an opioid overdoserelated emergency room or inpatient visit by percent. If that reduced risk applies to overdose deaths as well eliminating concurrent opioid and benzodiazepine use could have prevented up to opioid painkillerrelated overdose deaths in . Keith Humphreys a drug policy expert at Stanford University and one of the authors of the study said this reveals an underappreciated policy lever for reducing drug overdoses making sure patients prescribed to opioids arent also prescribed to benzodiazepines and vice versa. Even if we didnt change opioid prescribing at all the data here suggest that we could cut overdoses dramatically just by getting prescribers to not put people on a benzodiazepine at the same time Humphreys said. Yet the study suggests the opposite has happened. From to coprescriptions to opioids and benzodiazepines among the studied pool of patients increased from percent to percent a nearly percent jump. For some patients eliminating these coprescriptions could involve some tough tradeoffs. If someone genuinely suffers from pain and anxiety doctors and patients will need to work out which condition is more important to treat and which one can be treated with alternatives to avoid a potentially deadly overdose. Hopefully while keeping in mind that theres no httpannals.orgarticle.aspxarticleID good http scientific http evidence http that opioids can treat chronic pain so opioids arent the right treatment for chronic pain in the first place. There are some caveats to the study. For one emergency room visits and inpatient admissions for opioid overdoses likely arent a perfect onetoone proxy for overdoses that didnt involve a trip to a doctor. The study also only looked at legally prescribed opioid painkillers and benzodiazepines missing the effects of concurrent use of illegally obtained pills or drugs. And since the research relied on patients who were continuously insured throughout the study period its possible the findings dont exactly apply to people with spottier coverage. Although sensitivity analyses in the study for people who had lapses in insurance produced similar results. Finally since the study looked at correlation not causation its possible that it missed some other factor driving up overdose deaths among concurrent benzodiazepine and opioid users perhaps for whatever reason these users may be more likely to misuse their drugs. Still its well established https that benzodiazepine and opioids compound each others overdose risk. So its not really controversial to conclude that simultaneously using opioids and benzodiazepines dramatically increases the risk of drug overdose or conversely that stopping the concurrent use of these two drugs could reduce the risk of overdose. Given that the opioid epidemic has quickly turned into the deadliest drug crisis in US history http its important and potentially lifesaving for doctors and policymakers to at least consider the studys findings. For more on the opioid epidemic read Voxs indepth explainer http the abridged explainer http or the maps and charts explainer http"

"If mass mammography screening for breast cancer worked well fewer women would die from the disease. And yet a new study published in JAMA Internal Medicine httparchinte.jamanetwork.comarticle.aspxdoi.jamainternmed.. has found something that may seem counterintuitive More breast cancer screening didnt actually save lives. Screening did however lead to more overdiagnosis detecting cancers that would not have been fatal or even harmful. Related The problem with Taylor Swifts advice about cancer screening http The research led by Richard Wilson of Harvard University revealed that in more than US counties mammography screening programs were linked with more diagnoses of smaller breast cancers but not with fewer deaths or with fewer larger breast cancers which theoretically would be prevented by finding the disease early through screening. You can see this clearly in the chart below The number of diagnosed breast cancers rose with more screening yet the number of deaths from breast cancer years later remained stubbornly stable. Extent of screening breast cancer incidence and mortality in women years and older in US counties. JAMA Internal Medicine httparchinte.jamanetwork.comarticle.aspxdoi.jamainternmed.. To be clear Mass screening is different from using technologies like ultrasounds to diagnose people at risk of a disease or who have symptoms that require investigation. And not all mass screening programs are bad. Colorectal cancer screening for example has been shown to save lives as a result of early detection and the Pap test transformed cervical cancer into a treatable disease. But this isnt the first study to call into question the benefits of mammography and whether women are too often the victims of overdiagnosis. The trouble with overdiagnosis is that while the cancers doctors find wouldnt have harmed their patients the treatment and stress that result from the diagnosis probably will. We have to find a better way to screen women for breast cancer Overdiagnosis in thyroid cancer While the incidence of the disease increased after a screening program was instituted in South Korea the thyroid cancer mortality rate stayed the same. New England Journal of Medicine http The medical community has known http about overdiagnosis and overtreatment for years documenting the problem in a range of cancers in breast prostate lung and thyroid http which you can see in the chart above. This raises a tough question What should the medical community do about overdiagnosis In a related commentary httparchinte.jamanetwork.comarticle.aspxdoi.jamainternmed.. in the journal a pair of doctors from the University of Washington School of Medicine note that the estimates of overdiagnosis of breast cancer are frustratingly broad from less than percent to percent or more of women who get screened. In other words we dont actually know how bad the problem is. Sadly they write we are left in a conundrum. Women will increasingly approach their physicians with questions and concerns about overdiagnosis and we have no clear answers to provide. The authors of the newest study dont advocate no screening. Instead they note that the benefits of screening will probably be more favorable when screening is directed at people with a high risk of the disease such as those with a family history of breast cancer. The US Preventive Services Task Force httpscreeningforbreastcancer.org which analyzes the best available evidence to create guidelines for doctors now recommends biennial mammography screening for the general population in women ages to . For women under and over who arent at a high risk of breast cancer the benefits of mass screening are less clear. There are small things doctors can do that still dont happen often enough. For example most women arent told about the potential downsides of mammography screening even though theyre almost always briefed on the benefits. How to think about the benefits and harms of mammography. Harding Center for Risk Literacy Harding Center for Risk Literacy https For now its up to patients to talk to their doctors about their particular risk profiles and how to screen accordingly. We also need to remember that in medicine more often than not we generally overestimate the benefits and underestimate the harms http"

"Like many autistic children Julian Brown has trouble reading emotions in peoples faces one of the biggest challenges for people with the neurological disorder. Now the yearold San Jose boy is getting help from autism glassan experimental device that records and analyzes faces in real time and alerts him to the emotions theyre expressing. The facial recognition software httpsphys.orgtagsfacialrecognitionsoftware was developed at Stanford University and runs on Google Glass a computerized headset with a frontfacing camera and a tiny display just above the right eye. Julian is one of about autistic children participating in a Stanford study to see if autism glass therapy can improve their ability to interpret facial expressions httpsphys.orgtagsfacialexpressions. Theres not a machine that can read your mind but this helps with the emotions you know recognizing them Julian said. Julian wears the device each day for three minute sessions when he interacts with family members facetofacetalking playing games eating meals. The program runs on a smartphone which records the sessions. When the devices camera detects an emotion such as happiness or sadness Julian sees the word happy or sador a corresponding emojiflash on the glass display. The device also tests his ability to read facial expressions. The autism glass program is meant to teach children with autism how to understand what a face is telling them. And we believe that when that happens they will become more socially engaged said Dennis Wall who directs the Stanford School of Medicines Wall Lab which is running the study. Stanford student Catalin Voss and researcher Nick Haber developed the technology to track faces and detect emotions in a wide range of people and settings. We had the idea of basically creating a behavioral aide that would recognize the expressions and faces for you and then give you social cues according to those said Voss who was partly inspired by a cousin who has autism. Google provided about Google Glass devices to Stanford but otherwise hasnt been involved in the project. The Silicon Valley tech giant stopped producing the headset last year after it failed to gain traction but the device found new life among medical researchers. Brain Power a Cambridge Mass.based startup is also developing Google Glassbased applications to help children with autism improve their facereading abilities and social skills. Autism advocates are excited that researchers are developing technologies to help the estimated one in American children diagnosed with autism spectrum disorder httpsphys.orgtagsautismspectrumdisorder. Glass and wearable technology are the future. Theyre going to play a pivotal role in how we understand manage and diagnose disorders like autism said Robert Ring chief science officer at Autism Speaks. Currently many autistic children httpsphys.orgtagsautisticchildren learn to read facial expressions by working with therapists who use flashcards with faces expressing different emotions. The Stanford team hopes autism glass can provide a convenient affordable therapy that families can do at home. Kids with autism httpsphys.orgtagsautism are not getting enough of the care that they need for as long as they need it and we need to fix the problem Wall said. If the study shows positive results the technology could become commercially available within a couple years Wall said. Anything that can help this population is very welcome and very important but even the best technology will never be enough because we are dealing with a population with often very very profound needs said Jill Escher president of Autism Society San Francisco Bay Area. The study is still in its early stages but Wall said participating children have shown gains in their facereading abilities and family feedback has been encouraging. It has helped our son whos using the Google Glasses connect with the family more said Kristen Brown Julians mother. I think the glasses are a positive way to encourage a kid to look someone else in the face. Julian also gives the device positive reviews I really think it would help autistic people a lot. httpsphys.orgnewsgoogleglassautisticchildren.htmlExplore further Humanoid robot works in therapy for children with autism httpsmedicalxpress.comnewshumanoidrobottherapychildrenautism.html Read more at httpsphys.orgnewsgoogleglassautisticchildren.htmljCp httpsphys.orgnewsgoogleglassautisticchildren.html"

"Women who take bone drugs for several years have a slightly increased chance of suffering an unusual type of thigh fracture according to a large Canadian study. The findings add to earlier concern over the medicines called bisphosphonates whose U.S. labels have been required since October to include a warning about the thighbone fracture risk. However researchers stress the drugs are effective at preventing fractures of the hip or spine which are much more common in elderly people with the bonethinning disease osteoporosis. And the actual risk of having one of the unusual fractures was low said Laura Y. ParkWyllie of St. Michaels Hospital in Toronto who worked on the new study. Women with osteoporosis who are at high risk of fractures should not stop taking their treatment she told Reuters Health. Bone drugs include Mercks Fosamax Roches Boniva Novartiss Reclast and Warner Chilcotts Actonel. Some million Americans currently suffer from bone thinning according to the National Osteoporosis Foundation. The majority are postmenopausal women. ParkWyllie and colleagues tapped into data on more than Ontario women at least years old who had taken the bone drugs. Their findings appear in the Journal of the American Medical Association. Overall women suffered the unusual type of thighbone fracture after starting the bone drugs and nearly had typical hip fractures. The risk of a thighbone fracture differed depending on how long the women had been taking the medicine. After taking bone drugs for five years about one in women went on to suffer a thigh fracture over the next year. That works out to nearly three times the risk of those whod taken the drugs for roughly three months or less after accounting for other risk factors. On the other hand longer treatment was tied to a percent decrease in hip fractures which along with wrist and spine fractures affect about half of all people with osteoporosis. There are several alternative ways to treat osteoporosis including hormone treatment for women. And one preliminary study published along with the Canadian findings in JAMA hints that the common heart medication nitroglycerin might also boost bone health. So far however the cheap and effective bisphosphonate bone drugs remain the most popular treatment option. But some experts worry that negative media coverage might have led to more fractures and possibly deaths by dissuading patients from taking the drugs. The bad news is that overstating the levels of risk of side effects with these drugs which the media have been doing for some time now has led people to stop the drugs when they should be taking them said Dr. Ethel S. Siris who heads the Toni Stabile Osteoporosis Center at Columbia University in New York. Apart from atypical fractures the most serious side effect of the bone drugs is bone death or osteonecrosis of the jaw. But thats a very rare problem experts say which only affects about one in people on bisphosphonates. If youre taking the drugs and youve been on them for a while but arent sure if youre at high risk you should ask your doctor about it ParkWyllie advised. The U.S. Preventive Services Task Force a federal expert panel recommends screening all women over for osteoporosis. SOURCE bit.lyHWZ httpbit.lyHWZ JAMAJournal of the American Medical Association online February . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Among older adults with an unstable ankle fracture the use of a modified casting technique known as close contact casting a molded belowknee cast with minimal padding resulted in similar functional outcomes at months compared with surgery and with fewer wound complications and reduced intervention costs according to a study appearing in the October issue of JAMA. The number of older adults sustaining ankle fractures is increasing. Treatment of unstable fractures is either surgical or nonsurgical using externally applied casts. Neither method yields an entirely satisfactory outcome in older adults. Traditional casting techniques are associated with poor fracture alignment and healing as well as plasterrelated sores. Surgery is often complicated by poor implant fixation bone healing wound problems and infection. A modified casting technique has been developed close contact casting which uses minimal padding compared with traditional casting and achieves fracture reduction by distributing contact pressure by close anatomic fit. Keith Willett M.B.B.S. F.R.C.S. of the University of Oxford United Kingdom and colleagues randomly assigned adults older than years with acute unstable ankle fracture to surgery n or casting n . Casts were applied in the operating room under general or spinal anesthesia by a trained surgeon. Among the adults average age years percent women who were randomized percent completed the study. Nearly all participants percent received assigned treatment of percent who initially received casting later converted to surgery. At months casting resulted in measures of ankle function equivalent to that with surgery. Infection and wound breakdown were more common with surgery percent vs percent as were additional operating room procedures percent vs percent. Radiologic malunion abnormal healing of a fracture was more common in the casting group percent vs percent for surgery. Casting required less operating room time compared with surgery. There were no significant differences in other secondary outcomes quality of life pain ankle motion mobility and patient satisfaction. Close contact casting was delivered successfully for most participants substantially reducing the number of patients requiring invasive surgical procedures at the outset and additional operations during a month period the authors write. The researchers add that close contact casting may be an appropriate treatment for older adults with unstable ankle fracture. doi.jama.. the study is available preembargo to the media at the For the Media website Editors Note Please see the article for additional information including other authors author contributions and affiliations financial disclosures funding and support etc. Editorial Close Contact Casting vs Surgery for Unstable Ankle Fractures The results reported by Willett et al demonstrate that most unstable ankle fractures in older patients can be treated with a cast without the need for surgery writes David W. Sanders M.D. M.Sc. F.R.C.S.C. of Western University London Ontario Canada in an accompanying editorial. However many patients who were initially treated by casting subsequently required repeat casting or surgery. Further studies are needed to help identify which patients will not benefit from casting. Although close contact casting may be unfamiliar to some orthopedic surgeons it can avoid surgery for older patients with ankle fractures yet result in equivalent functional outcomes. This technique is worth considering when treating this challenging clinical problem. doi.jama.. the study is available preembargo to the media at the For the Media website Editors Note The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. To place an electronic embedded link to these articles in your story These links will be live at the embargo time httpjama.jamanetwork.comarticle.aspxdoi.jama.. httpjama.jamanetwork.comarticle.aspxdoi.jama.."

"Aaaaachoo At least a quarter of the U.S. population has allergies. Billions of dollars are spent on treatment and lost workdays. Sufferers often endure agonies of sneezing runny noses itchy eyes coughing and other symptoms. These reactions can be brought on any time of year by dogs cats molds cockroaches dust mites and much much more alas. In summer grasses can be a major culprit. In fall weeds. Right now were in the season of tree pollen. Keep the tissues handy. But there are promising new treatments. Allergy specialist Gurston Nyquist associate professor of otolaryngology and neurological surgery at Thomas Jefferson University recently spoke to us about them. What are the standard treatment options for allergies They consist of a triad. The first is avoidance of what you may be allergic to. The second is medications. Overthecounter antihistamines and nasal steroids are available. There also are prescription medications for allergies. The third is immunotherapy. With that we give small doses of what people are allergic to in order for their bodies to develop tolerance. As a result they develop a less inflammatory reaction to those stimuli. We usually begin by giving smaller doses and then increase the dose slowly until the patient reaches a maintenance phase. They continue getting treatment after that for varying lengths of time but its at the same dose. Generally immunotherapy is recommended for patients who continue to have symptoms despite avoidance and medical therapy or who want to treat the underlying cause of their allergy and change their reactivity. The traditional form of immunotherapy is allergy shots administered in the arm. Whats new We now have the option of sublingual tablets or drops meaning theyre administered under the tongue. The main benefit is the convenience of doing it in the home or elsewhere outside a physicians office. In the U.S. Food and Drug Administration approved the tablets. So far these are only for very specific allergens that include grasses and ragweed. But researchers are developing tablets that would treat for additional allergens including dust mites and trees. Hopefully theyll be available in the near future. Now we also have the option of sublingual drops. We are able to mix patientspecific solutions in the office so these are recommended for patients who have multiple sensitivities to different allergens. People who are allergic to dust mites cats dogs and multiple pollens can have symptoms all year round. This treatment is in a gray area right now where the FDA has not yet formally approved it but has said its OK for practices to be administering it. In general otolaryngology practices including Jefferson have adopted this therapy more than general allergists have. The sublingual drops have been used for decades in Europe Asia and Australia. And the safety profile is excellent. There have been no reported deaths with the drops or tablets and the most common side effect is itching under the tongue. This is in contrast to allergy shots which pose the risk of anaphylaxis rare but it can happen where the patient has a lifethreatening reaction. Thats why theyre administered in a physicians office. One can expect that their symptoms from allergies and their use of medication will be significantly decreased while on immunotherapy. General benefits can continue for two to years after a patient has completed the shots drops or tablets. Who are the best candidates for the newer drops or tablets Heres what I tell patients The best form of immunotherapy is the one they can be most compliant with. Both forms the shots and the sublingual drops or tablets are about equally effective and safe. In general shots are administered weekly for about two years then every other week for another two years. The advantage of the drops or tablets is that if its difficult to get into a physicians office every week because of work or travel the drops or tablets can be administered at home. Is insurance an issue More and more insurance companies are covering treatment with the sublingual tablets. However the sublingual drops are not covered by insurance at this point. Although the cost is dependent on each individual and his or her allergies it ranges between about to a month. Thats similar to what a copay would be. The Obama administrations recent report on the health effects of climate change found that allergies have increased. Why And why do we have allergies in the first place When the weather is warmer theres a longer season of blooming so theres more exposure to allergens. Thats one explanation for why allergies tend to be getting worse. The other is that for tens of thousands of years parasites and other infections unusual in modern society were a major problem in humans. The body developed a defense mechanism inflammation to fight them. Now there arent as many of these infectious diseases for our bodies to deal with but we still have this defense mechanism. It has begun to target other things such as allergens in the environment. Immunotherapy helps teach the body to better tolerate these harmless parts of our environment. People can develop allergies at almost any time of life. Some people have a strong family history of allergies and they are more predisposed. Some people have allergies while theyre young and it continues throughout their lives. Others are able to grow out of allergies with time. And other people develop allergies as adults. So no one is free. The good news is that there are medications and immunotherapy to help."

"UK researchers behind a potential universal liquid biopsy blood test for cancer detection have licensed the technology to an industrial partner to take it to market. The research team believes that the test could be the first screening tool to rule in or rule out cancer in patients under suspicion of the disease alongside other traditional diagnostics methods. The test was developed at the University of Bradford UK. It measures the damage to the DNA of white blood cells when subjected to different intensities of ultraviolet UV light revealing measurable differences in the cells susceptibility to further damage in patients with cancer. The damage forms a comet tail of DNA pieces that are pulled towards the positive end of an electric field. The longer the comet tail the more DNA damage is present which correlates with the presence of cancer. In a proof of concept study the Bradford researchers showed they could identify which samples were from patients with three different types of cancer even those who had yet to be diagnosed with per cent success. However in their two most recent clinical trials of the test involving over blood samples from colorectal and prostate cancer patients and further breast and lung cancer samples that were available they were unable to distinguish those with cancer from healthy patients in cases. To determine whether scoring more cells on the slides would explain this challenging subgroup lead researcher Professor Diana Anderson from the University of Bradford asked IMSTAR to reanalyse the inconclusive slides. The Bradford team had scored cells per slide but the Pathfinder system is able to analyse up to cells per slide and uses Artificial Intelligence concepts in its proprietary software. Scoring a minimum of cells per slide the IMSTAR Pathfinder system was able to separate all individuals of the cancer group from the healthy control group with confirmed statistical significance. These findings are published in FASEB BioAdvances journal httpsonlinelibrary.wiley.comdoiabs.fba.. Professor Anderson said This test is different from other universal cancer tests being developed because it is not looking for a specific biomarker or mutation. This is a generic test for cancer in an individual regardless of the underlying mechanism thats causing their cancer. Im now convinced that if we used the powerful IMSTAR system to look at thousands of cells on all the slide samples in the trials we would see a significant increase in the overall predictability beyond the original per cent of the original study. Parisbased company IMSTAR has now coupled the innovative technology developed at Bradford with their fullyautomated Pathfinder cell readeranalyser to create a powerful and robust test for early detection called TumorScan. Cofirst author Dr Mojgan Najafzadeh from the University of Bradford said We feel that weve taken it as far as we can in proving that the test works with high predictability for cancer outcome and IMSTAR are the right partners to improve it still further. Dr Francoise Soussaline PhD DSc IMSTARs president said To bring a universal liquid biopsy blood test for cancer to market it must achieve a number of criteria including high sensitivity and specificity and be fully automated with high throughput for a medical routine use. In addition test results must be available in hrs and at affordable cost. We believe that the combination of Bradfords innovation and IMSTARs unique expertise has shown that TumorScan can achieve these requisites. IMSTARs vicepresident for medical applications Dr Michel Soussaline confirmed that the company will be working to automate the full test workflow further to take it to market."

"Numerous studies in recent years have suggested that vitamins and supplements have no beneficial effect on your health. Some researchers have gone as far as to warn that popping them may be harmful. But the fact is that most of us cannot get the vitamins and minerals we need from food alone and multivitamins are vital to bridging that gap. According to a study published in the January edition of the Journal of the American College of Nutrition roughly percent of adults are deficient in vitamin A C D E calcium and magnesium. These findings suggest many people may not even have the nutrient levels they need to stave off disease let alone thrive and live in optimal health. As I see it everyone needs a multivitamin for disease prevention and new research agrees. Another study published in the January edition of the journal Postgraduate Medicine suggests that cancers per year would be prevented with daily multivitamin use. The study followed only men but my take is theres no reason to assume this doesnt apply to women as well. In the study multivitamins lowered cancer risk by percent among men with a history of cancer and by percent among men with no history of the disease. This new study used a randomized controlled trial design a method that is considered to be the gold standard for proof in medical science. Ive always recommended targeted vitamin supplementation to my patients because when you boost levels of key nutrients in your body you give yourself the best chances of preventing cancer heart disease dementia and other diseases. While several previous studies failed to prove the benefits of some vitamins the fact is many of those studies have been criticized for poor design and are the reason fewer tangible benefits have been proven. At the very least you should be taking a multivitamin every day. That said not all multivitamins are created equal some contain cheaper and less absorbable forms of nutrients so you wont get their full benefits and others have ingredients you should be wary of. Here are a few tips for selecting a highquality multivitamin that will help you look and feel your best Go for high quality When you look at a typical multivitamin label at the drugstore youll see it has about percent of the daily values recommended for a nutrient. The federal government developed these values during World War II to prevent widespread nutrient deficiency so while that amount should be enough to make sure you have what you need to survive it wont necessarily be enough for optimal health. In some of the higherquality supplements youll see things like Vitamin B at percent of your daily value. That may sound wacky but keep in mind that percent is just the level for basic survival and that percent is going to give you more of what you actually need to feel good. Look for highquality brands with these higher doses. Get one that will be absorbed well by your body Some forms of vitamins are better absorbed in your body. When scanning the label look for B as methylcobalamin as opposed to cyanocobalamin and when it comes to folic acid look for methyltetrahydrofolate MTHF rather than straight folic acid. Both are forms of B but MTHF is the form of B found in nature. For vitamin A look for beta carotene and mixed carotenoids which are derived from plants and are water soluble. And look for vitamin D as opposed to D. Seventy years ago these two forms of vitamin D were seen as equals but recent research has shown that D is a more potent form of D. Avoid toxic fillers Some vitamin companies use colorants and coatings that may be harmful. These include hydrogenated oils artificial colors magnesium stearate and titanium dioxide. Magnesium stearate could even compromise your immunity a study in the journal Immunology found that stearic acid suppresses T cells a key part of your immune system. The vitamins you take should enhance your health so be sure to scan the labels for these cheap additives and steer clear of them."

"Every year many U.S. women get the grim news that they have breast cancer. In alone according to the American Cancer Society more than http were given that diagnosis. Each one very likely came as a devastating blow both to the patient and to her family. But what if some of these cases are preventable What if there was a medication that could at least reduce a womans risk of developing breast cancer Such drugs already exist. The Breast Cancer Prevention Trial published results http in indicating that women who took one of those drugs tamoxifen were half as likely to develop breast cancer as similar women who did not take the drug. Other medications including raloxifene httpen.wikipedia.orgwikiRaloxifene and a class of drugs called aromatese inhibitors httpformularyjournal.modernmedicine.comformularyjournalcontenttagsaromataseinhibitorguidelineaddsaromataseinhibitorbreastcancepagefull do much the same thing though the Food and Drug Administration has not yet approved aromatese inhibitors for this use http Studies estimate httpjnci.oxfordjournals.orgcontent.full that more than million American women at high risk for breast cancer could benefit from taking a preventive drug. But few women are opting for this protection which goes by the name chemoprevention. A study found exceptionally low rates of usage. In part this may be because many doctors are not even discussing this option with their patients. A small study http in the Journal of Womens Health found that only percent of internal medicine family medicine and gynecology physicians reported having recommended or prescribed these medications to women who might benefit from them. The low uptake of these medications is a missed opportunity says Heidi Nelson a professor of medical informatics and clinical epidemiology at the Oregon Health Science University in Portland. Many highrisk women ... could reduce their risks for invasive cancer by approximately to percent. On the other hand these drugs dont suit everyone and they are not without risks of their own. Because some of the side effects are serious such as blood clots in the legs and in the lungs and in the case of tamoxifen uterine cancer only women who are deemed to be at high risk for the disease should consider them. But there are conflicting views on who meets that high risk definition A bit about the drugs Chemoprevention should not be confused with chemotherapy. Although both involve taking drugs chemoprevention medications are taken with the goal of avoiding breast cancer altogether and the subsequent need for chemotherapy later. And they work on the body differently. Chemotherapy kills off cells healthy ones as well as cancercous ones. The chemoprevention drugs by contrast work by blocking estrogen a hormone known to promote the growth of cancer cells in breast tissue. Chemoprevention drugs are called SERMs or selective estrogen receptor modulators and two have been approved specifically for breast cancer prevention tamoxifen which was developed to treat breast cancer after its onset and only later was found to have a preventive benefit and raloxifene which was designed to treat osteoporosis. A study http in the Lancet analyzed data for more than women taking tamoxifen or other SERM drugs. The researchers found an overall percent reduction in new cases of breast cancer years after women took these drugs compared with women who took a placebo. The effect was even larger during the first five years of the study. Investigators working for the U.S. Preventive Services Task Force an independent group of scientists and clinicians funded by the government echoed these results. After looking at multiple trials of tamoxifen and raloxifene the task force noted http that these drugs reduced new cases of breast cancer significantly from cases per women in the control groups to cases per women in the treatment groups. Nelson one of the lead authors of the analysis is confident that these results show a true benefit. Others are more cautious. Kenneth Lin a family physician at Georgetown University who worked on developing the task forces SERM guidelines notes that while SERMs may have reduced new cases they have not been shown to reduce breast cancer mortality in any study or metaanalysis. One possible explanation he says is that these drugs are effective at preventing nonlethal cancers rather than the more serious ones. Not used enough Given that these drugs seem to offer some protection why are they not in widespread use Serious side effects is one reason. Beyond blood clots and uterine cancer other known reactions to the drugs include strokes cataracts bone pain hot flashes nausea and vaginal dryness. For some women the risk of such side effects may be worth taking depending on their particular odds of developing breast cancer. Those odds can be figured by using a commonly used calculator http often called the Gail model that estimates a womans chances of having breast cancer in a fiveyear period and over a lifetime. But this is where it gets more complicated. While many experts agree that women at high risk should consider the medications they do not agree on what Gail score should trigger that consideration. The studies that served as the basis for the FDA approval of the drugs along with recently released guidelines httpjco.ascopubs.orgcontentearlyJCO....full.pdf from the American Society of Clinical Oncology ASCO set the threshold at a fiveyear Gail score of . percent. The Preventive Services Task Force however recommended a threshold of percent. At that point the panel said http women are likely to have more benefit than harm from using tamoxifen or raloxifene. ASCOs lower cutoff worries some experts. At the . percent highrisk threshold Georgetowns Lin says every woman age and older would be considered highrisk. That might lead to a situation in which millions of women would be encouraged unnecessarilyto consider this therapy along with its potential harmful effects. Starting a conversation Kala Visvanathan the lead author of the ASCO recommendations and a faculty member at the Johns Hopkins School of Medicine said the cutoffs provide only a rough estimate of risk. It is important to realize she adds that as the risk increases the benefits tend to be greater. This is an evolving field and our goal is to better discern who is at high and low risk of breast cancer and develop a greater range of prevention strategies. An individual risk analysis should prompt conversation between doctor and patient about the potential benefits and the risk of the therapy. Both the ASCO and the task force guidelines recommend such a conversation. The discussion should include the specific risks and benefits associated with each chemopreventive agent according to ASCO. The task force similarly recommends that clinicians engage in a shared informed decision making with women and said that clinicians should offer to prescribe these drugs. Many risk factors increase a womans chances of having side effects. These factors include older age obesity having a history of a blood clot history of any cancer immobility history of certain autoimmune conditions history of using estrogen or oral contraceptives and history of some form of heart disease. Insured women with a high risk for breast cancer and a low risk for side effects who try this therapy will not incur outofpocket costs because this treatment was included in the Affordable Care Act as mandated nocharge preventive care. So what should a woman do Most important become familiar with your family history know your risk factors and discuss them with your primarycare physician. Age and family history cannot be controlled but lifestyle changes including eating a healthful diet exercising not smoking and not overconsuming alcohol are eminently doable and can reduce your risk. These basic tenets of leading a healthy lifestyle http have been shown to be important factors in breast cancer prevention. Visvanathan and her colleagues are hopeful that more women will be aware of this option. A discussion on the use of preventive agents needs to become part of routine care in women at high risk she says. We should begin to implement preventive strategies based on what we already know. Mishori is an associate professor of family medicine at the Georgetown University School of Medicine and director of the Health Media fellowship. Seliby is a family physician and the Health Media fellow at Georgetown University School of Medicine."

"An intensive text messaging program provides some pregnant women help in fighting the urge to light up a smoke according to a study out today. Our findings show that a text messaging program helped some groups of pregnant women quit smoking during pregnancy says lead author Lorien C. Abroms httpspublichealth.gwu.edudepartmentspreventionandcommunityhealthlorienabroms ScD MA an associate professor of prevention and community health at Milken Institute School of Public Health httppublichealth.gwu.edu Milken Institute SPH at the George Washington University. The studys findings suggest a potential new quitting strategy especially for those later in their pregnancies and older pregnant women. The researchers recruited pregnant women who were already enrolled in an established text messaging program called Textbaby. Textbaby has been found to have a positive health impact on alcohol consumption during pregnancybut not smoking. Abroms and her team wanted to find out if a more intensive mobile phone program called Quitbaby would be more effective. To find out the team recruited nearly pregnant women who smoked an average of cigarettes per day and wanted more help to quit. Quitbaby is targeted to smoking cessation and sends more text messagesbetween and per day aimed at bolstering a pregnant womans resolve to quit. The messages help educate the women about the health risks associated with smoking and they are interactiveallowing a woman to text back for more help if she is experiencing a craving or goes back to smoking. After three months percent of the women who were enrolled in both Textbaby and Quitbaby had quit compared with just percent of women getting just Textbaby. However the difference between the two groups did not reach statistical significance the authors say. The more intensive intervention did seem to help two subgroups quit smoking at least in the short run Abroms says. The combo of Textbaby and Quitbaby helped women age and older and those in the second and third trimester of pregnancy quit through the delivery date and in some cases beyond. However the researchers found that the resolve to quit seemed to disappear postpartum as many of these women started smoking again. Very little help is provided to pregnant smokers who want to quit so the studys findings are important especially if the strategy can be adjusted to be more effective Abroms says. Despite the health risks about percent of women smoke throughout their pregnancy in the United States. Additional studies must be done to find out if Quitbaby can be paired with other smoking cessation tools in order to provide longterm help for pregnant women who want to kick their smoking habit for good she says. The study A Randomized Trial of Text Messaging for Smoking Cessation in Pregnant Women http was published October in the American Journal of Preventive Medicine. The headline of this release was edited for clarity to match the content in the body of the release. The research was supported by the National Institute on Drug Abuse part of the National Institutes of Health. Dr. Abroms has stock in Wellpass Inc. formerly Voxiva Inc. and has licensed Textquit and Quitbaby to Wellpass. About Milken Institute School of Public Health at the George Washington University Established in July as the School of Public Health and Health Services Milken Institute School of Public Health httppublichealth.gwu.edu is the only school of public health in the nations capital. Today more than students from U.S. states and territories and more than countries pursue undergraduate graduate and doctorallevel degrees in public health. The school also offers an online Master of Public Health MPHGW httpspublichealthonline.gwu.edu an online Executive Master of Health Administration MHAGW httpsmha.gwu.edu and an online Master of Science in Management of Health Informatics and Analytics HealthInformaticsGW https_releasesHealthInformaticsGW which allow students to pursue their degree from anywhere in the world."

"A new device meant to help surgeons determine in the operating room if they have removed all cancerous breast cancer tissue may help reduce repeat surgeries after lumpectomy without compromising cosmetic effects according to a new study. The device called MarginProbe emits an electric field and senses a return signal from the tissue examined. Cancerous tissue provides a different electromagnetic signature than normal tissue the researchers explained. This can potentially decrease having to go back to the operating room and with no real effect on your cosmetic outcome said study leader Dr. Susan Boolbol chief of breast surgery at Beth Israel Medical Center in New York City. The study of nearly patients undergoing breastconserving surgery found little difference in the volume of tissue removed when the device was used compared to traditional detection methods. The reality is most of the time we leave the operating room and we dont know if we have a clear margin with all cancer removed or not Boolbol said. Doctors wait for the pathology report to find that out which can take a week or two. With the new device the wait time is about five minutes. Everything still goes through pathology Boolbol said. But the MarginProbe is another tool that might help reduce the odds of needing a subsequent surgery she said. Boolbol is scheduled to present the findings Thursday at the American Society of Clinical Oncologys breast cancer symposium in San Francisco. In June the radiationfree device won the blessing of a U.S. Food and Drug Administration advisory panel. The FDA usually follows the advisory panels recommendations so device approval is anticipated. For the study Boolbol and her colleagues randomly assigned breast cancer patients to receive the MarginProbe after lumpectomy or not receive it. Of those had early cancer known as ductal carcinoma in situ. The others had invasive cancers. Where the device detected cancer cells near the edge or surface of the sample examined surgeons removed additional tissue in the same procedure. Typically about percent of lumpectomy patients need another surgery because of the difficulty distinguishing between healthy and cancerous cells in tissue around the tumor. We looked at whether we could lower the repeat surgery rate by using this device Boolbol said. The patients were followed for two months to see if they needed a repeat surgery. For those with ductal carcinoma in situ percent of the probe group needed a repeat surgery compared to percent of the control group. Among women with invasive breast cancer percent in the device group and percent in the comparison group required more surgery. Looking at the volume of tissue excised the researchers said not much more tissue was removed when the device was used compared to tissue removed in the initial and subsequent surgeries among the controlgroup patients Boolbol said. Dr. Laura Kruper director of the Cooper Finkel Womens Health Center and codirector of the breast cancer program at City of Hope Comprehensive Cancer Center in Duarte Calif. said the device looks promising. However she thinks more research is needed. I would like to see it used in a larger population she said. If the results are repeated in larger studies it could be a welcome addition to doctors techniques she said. The expected cost of the MarginProbe in the United States if approved is not yet known said Michael Graffeo a spokesman for its maker Dune Medical Devices. In Europe where the device is available each probe one per patient sells for about euros or he said. This is much less than the cost of reoperation he noted. The device is also being studied for use with prostate cancer the company said. Data and conclusions presented at meetings should be considered preliminary until published in a peerreviewed medical journal. More information To learn more about breast cancer surgery visit the American Cancer Society. SOURCES Laura Kruper M.D director Cooper Finkel Womens Health Center and codirector breast cancer program City of Hope Comprehensive Cancer Center Duarte Calif. Susan Boolbol M.D. chief breast surgery Beth Israel Medical Center New York City Michael Graffeo spokesman Dune Medical Devices Sept. presentation American Society of Clinical Oncology Breast Cancer Symposium New York City"

"A new blood https test for Alzheimers disease https is accurate at identifying the disease and can perhaps detect it even before symptoms such as memory loss https appear says the tests developer. This is a simple test that has high accuracy and can be run from a single drop of blood https says Robert Nagele PhD a professor of medicine at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine. He is also founder of Durin Technologies Inc. the company that is developing the test. The research results on the new test are published online in PLoS ONE. His test is one of numerous such tests under study says Heather Snyder PhD a spokesperson for the Alzheimers https Association who reviewed the research results. Many labs are looking at this. They are all in the very preliminary very early stages. We all know we need an accurate relatively noninvasive way to diagnose Alzheimers. Last month at the Alzheimers Association International Conference Australian researchers reported good results for another blood test for Alzheimers https under development. It works by determining the amount of amyloid plaque associated with the disease in peoples brains. An estimated . million Americans have Alzheimers disease https the most common form of dementia https according to the Alzheimers Association. Doctors use brain https imaging evaluation of behavior psychiatric tests and other means to diagnose the disease. None are highly accurate and some are costly and not practical to use on a widespread basis experts say. The only definitive way to diagnose the disease is by direct examination of brain https tissue after the patient dies. New Blood Test for Alzheimers How It Works Nageles test looks for antibodies in the blood specific to the disease. Alzheimers is believed to start up to years or so before symptoms are noticeable. Before symptoms occur these brain https changes are under way he tells WebMD. Brain https cells die and when they die they pop they explode like a water balloon breaking. The contents of those dying cells spill partially back into the blood. Your body makes antibodies against the cell debris he says. We believe that happens so it can facilitate the cleanup of the cell debris. The researchers found thousands of these antibodies. Many of these are related to the presence of the disease Nagele says. Nageles team looked at blood samples from people with Alzheimers disease and without. They also looked at blood samples from breast cancer https patients and with Parkinsons disease https to be sure the test could be specific for Alzheimers. Parkinsons and Alzheimers are very close in terms of their pathology Nagele says. Neurons are dying in both cases. He wanted to see if the test could tell Alzheimers and Parkinsons apart. Overall the tests identified of those with Alzheimers correctly. It correctly identified . of those who didnt have Alzheimers. In the process Nagele narrowed down the list of antibody biomarkers needed to detect Alzheimers disease to . The hope is to detect the disease before symptoms appear but Nagele stresses his team has not yet done that. If all goes well he is hopeful the test could be available within a year. Costs are difficult to estimate but it could be about he tells WebMD. New Blood Test for Alzheimers Perspective Snyder calls the report exciting but also had many caveats. I would call it preliminary she says of Nageles research. Its a small study and a small sample. As research on blood and other tests for Alzheimers progresses Snyder says the measures must be standardized so people get the same results regardless of where the test is performed. That has been an issue for instance in some cerebral spinal fluid tests also being studied to detect Alzheimers. What we have seen at least in cerebral spinal fluid tests is that it hasnt held up across different labs she says. She acknowledges some people may not want to know if the disease is in their future but says knowing early has many advantages. They can plan for their financial future as well as their care she says. They can participate in clinical trials https When we do have therapeutic options available the ultimate goal would be intervention."

"Lap band surgery has significant benefits for severely obese teenagers and despite its controversial nature should still be considered as a first option to manage obesity during adolescence a new study has found. Led by University of Adelaide researchers in collaboration with Flinders Medical Centre and published in the journal Obesity Surgery httplink.springer.comarticle.s the study is the first to show medium to longterm followup years of lap band surgery in Australian adolescents. The research followed severely obese teenagers between and years who had Laparoscopic Adjustable Gastric Banding lap band surgery in the South Australian Health Service. Severe obesity is associated with serious physical and psychological conditions affecting quality of life. Australian revised National Health and Medical Research Council guidelines for obesity management say that lap band surgery should be considered in adolescents with severe obesity that is with a body mass index BMI over kgm or over kgm weightheight with the presence of obesityrelated diseases and who dont respond to medical treatment. However there is no data available in Australian adolescents beyond months postsurgery. We are talking about a group of adolescents with severe obesity and significant health and psychological problems related to their increased weight this is not for everyone says corresponding author and Paediatric Endocrinologist Dr Alexia Pea who is a Senior Lecturer with the University of Adelaides Robinson Research Institute. The study found that weight and BMI improved significantly at all followup times following surgery from three months through to months and in some cases as long as five years. BMI loss was between . and . kgm. The median BMI reduction of kgm with the lap band is a good result when compared to BMI reduction using the few medications available or lifestyle measures which is around kgm says Dr Pea. Lap band surgery is reversible and allows time for adolescents to mature to make a more informed decision on a permanent surgical procedure if required later on in life. This is not the case for other surgeries currently offered for obesity management. It is also important that teenagers undergoing this surgery have access to an experienced surgeon as part of a multidisciplinary paediatric team of doctors and Health professionals to ensure there is longterm regular followup. Paediatric surgeon Mr Sanjeev Khurana who did all the lap band surgeries between and says lap band surgery is a reversible surgical procedure that can be safely used in teens with severe obesity. Although gastric banding has been controversial and is currently less used in adults with severe obesity lap band surgery is one of the most studied surgeries for obesity management has a high safety record and can be a temporary option to manage severe obesity during adolescence says Mr Khurana who is also a Senior Lecturer in the University of Adelaides Discipline of Paediatrics. Our findings support lap band surgery as a safe and effective option for management of adolescents with severe obesity provided it is performed by an experienced surgeon and managed afterwards in a paediatric multidisciplinary environment with regular followup until adulthood. Media Contact Dr Alexia Pea Paediatric Endocrinologist and Senior Lecturer Robinson Research Institute University of Adelaide. Mobile alexia.penaadelaide.edu.au mailtoalexia.penaadelaide.edu.ausubjectNewswiseArticleReporterFollowupbccreportersnewswise.com Mr Sanjeev Khurana Consultant Paediatric Surgeon and Senior Lecturer University of Adelaide. Mobile sanjeev.khuranasa.gov.au mailtosanjeev.khuranasa.gov.ausubjectNewswiseArticleReporterFollowupbccreportersnewswise.com Lachlan Parker Deputy Director Media and Corporate Relations Mobile lachlan.parkeradelaide.edu.au mailtolachlan.parkeradelaide.edu.ausubjectNewswiseArticleReporterFollowupbccreportersnewswise.com SEE ORIGINAL STUDY httplink.springer.comarticle.s"

"Toplineresults of the first randomised clinical trial in the world to investigate the effects of a nutritional intervention in very early AD predementia Topline results from the European LipiDiDiet clinical trial were presented today as part of a latebreaking presentation at the Advances in Alzheimers Therapy AAT congress. They showed that in people with very early AD predementia a oncedaily nutritional drink designated a food for special medical purposes can help to reduce brain shrinkage particularly in the hippocampal brain area the part of the brain that helps store shortterm memories for longterm retrieval. And for those who start the intervention early and consumed it regularly it can help to conserve memory and the ability to think and perform everyday tasks. The drink contains Fortasyn Connect a specific combination of fatty acids vitamins and other nutrients. This is the first time a randomised doubleblind clinical trial has shown that a nutritional intervention can help to conserve the ability of patients with very early AD predementia to carry out everyday tasks such as paying bills or finding your way around as measured by the Clinical Dementia RatingSum of Boxes CDRSB a combined measure for the ability to think and perform everyday tasks. This is important because those with very early AD predementia currently have no approved available pharmacological options. The study did not find a significant benefit in broad cognitive function the study primary endpoint. Cognitive decline over the study period was less than originally expected when it was designed ten years ago so differences found between the two groups were too small to be statistically significant. Project coordinator Professor Tobias Hartmann Saarland University Germany explained that this is the most likely reason the primary endpoint was not met. Professor Hilkka Soininen Professor in Neurology MD PhD from the University of Eastern Finland who headed the clinical trial as part of the LipiDiDiet project said Todays results are extremely valuable as they bring us closer to understanding the impact of nutritional interventions on very early AD predementia which we are now better at diagnosing but unable to treat due to a lack of approved pharmaceutical options. The LipiDiDiet study illustrates that this nutritional intervention can help to conserve brain tissue and also memory and patients ability to perform everyday tasks possibly the most troubling aspects of the disease. We look forward to the results of subsequent analyses and the six year extension study which will provide further insights. The clinical trial headed by Professor Hilkka Soininen is part of a large EC project LipiDiDiet to explore the therapeutic and preventative impact of nutrition on neuronal and cognitive performance in ageing AD and vascular dementia. LipiDiDiet is funded by the seventh Framework Programme FP of the European Commission EC and coordinated by Professor Hartmann Saarland University in Germany. Fortasyn Connect was selected by a consortium of leading researchers from European institutes for this month randomised controlled doubleblind multicentre study involving patients on the basis of its results in a previous EU project LipiDiet. Nearly million people have Alzheimers or a related dementia for which there is currently no cure. This number is expected to double every years reaching . million in and . million in . Study details The trial was the first to investigate the impact of Fortasyn Connect on patients with very early AD predementia who were randomised to receive either Fortasyn Connect or an isocaloric control drink once daily. The primary outcome parameter was selected to assess the effect on cognitive function a broad measure of thinking during months intake of Fortasyn Connect compared with a control product. This was a cognitive composite score consisting of the CERAD word immediate recall delayed recall and recognition category fluency and letter digit substitution test. Secondary outcome parameters were brain volumes total hippocampal wholebrain ventricular volumes the Clinical Dementia Rating Sum of Boxes CDRSB Neuropsychological Test Battery composite scores episodic memory executive functionworking memory composite and a complete composite score consisting of subtests progression to AD dementia blood and CSF biomarkers tolerance and safety. No significant difference was observed for the cognitive composite score. Predefined analyses showed significant differences between active and control study groups for hippocampal and wholebrain atrophy and favourable effects for CDR Sum of Boxes and episodic memory both were most pronounced in patients with high baseline cognition with regular intake. Analyses are ongoing for progression to AD dementia and blood and CSF biomarkers. Tobias Hartmann the projects coordinator said We have known for a while that diet can reduce the risk of developing dementia. Indeed certain nutrients have been found to have a neuroprotective effect on the brain. However translating this into an effective intervention hasnt been easy because single nutrients simply arent powerful enough to fight a disease like Alzheimers alone. Todays clinical trial results have shown that the key is combining certain nutrients in order to increase their effect. This is exciting because it shows that in the absence of effective drug options we really have found something that can help slow down some of the most distressing symptoms in very early AD predementia especially in those who started the intervention early. Indeed those patients who have lost the least cognitive function have the most to gain. Notes to editors About LipiDiDiet LipiDiDiet is an innovative project whose remit is dementia prevention related research. The initiative benefits from funding provided by the th Framework Programme FP of the European Commission and follows on from previous projects in the field of dementia. The projects predecessor LipiDiet was incorporated within the th EU research programme in . Since its establishment evidence has been accumulated to support the hypothesis that certain nutritional molecules are beneficial in reducing disease progression in Alzheimers. This stimulated further research which led to the birth of the LipiDiDiet project. For more information about the LipiDiDiet study click here http About Fortasyn Connect Souvenaid is a once a day ml drink containing Fortasyn Connect a combination of nutrients including omega fatty acids choline uridine monophosphate phospholipids antioxidants and B vitamins. It is a Food for Special Medical Purpose FSMP clinically proven for the dietary management of early Alzheimers disease. Souvenaid is backed by years of extensive research based on initial preclinical research by Prof. Kiliaan Radboud University the Netherlands by the LipiDiet project coordinated by Prof. Hartmann Saarland University Germany and funded by the European Union FP research programme and by Prof. Wurtman formerly at the Massachusetts Institute of Technology U.S.A supported principally by the National Institutes of Health. LipiDiDiet Consortium members Saarland University Germany University of Eastern Finland University of Szeged Hungary Tel Aviv University Israel Stichting Katholieke Universiteit Radboud University Nijmegen Medical Center The Netherlands University of Gothenburg Sweden Nutricia Research The Netherlands Karolinska Institutet Sweden Academy of Sciences of the Czech Republic Institute of Physiology VU University Medical Center The Netherlands University of Bonn Germany European Research and Project Office GmbH Germany Heidelberg University Hospital Germany University Hospital of Tbingen Germany Central Institute for Mental Health Germany University Hospital Regensburg Germany For further information on the European LipiDiDiet study and consortium visit http References . A Clinical Trial investigating the effects of Fortasyn Connect Souvenaid in Prodromal Alzheimers Disease Results of the LipiDiDiet study H. Soininen P.J. Visser M. Kivipelto T. Hartmann for the LipiDiDiet study group presentation held at th International AthensSpringfield Symposium on Advances in Alzheimer Therapy March . The World Alzheimer Report The Global Impact of Dementia. Alzheimers Disease International ADI. Accessed March via http Background information for the media on the LipiDiDiet Project and Study Introduction to the LipiDiDiet Project LipiDiDiet is an innovative project which was set up in to address the impact of nutritional lipids on neuronal and cognitive performance in aging Alzheimers disease AD and Vascular Dementia. Its remit is twofold the clinical and epidemiological assessment of the value of nutritional support in people at risk of developing AD and to conduct basic research to better understand and improve the possible therapeutic and preventive effects of nutrition in AD and Vascular Dementia. The projects predecessor LipiDiet was incorporated within the th EU research programme in . During its years of activity preclinical and epidemiological evidence was accumulated to support the hypothesis that certain nutritional molecules could be beneficial in reducing disease progression in Alzheimers. This stimulated further research which led to the birth of the LipiDiDiet project. About the European LipiDiDiet Study As part of the LipiDiDiet project the first randomised clinical trial to investigate the effects of a medical food Fortasyn Connect Souvenaid in patients with very early AD predementia has just been completed. The trial was funded by the seventh Framework Programme FP of the European Commission EC and run by an independent consortium of research partners throughout Europe. Professor Hilkka Soininen Professor in Neurology MD PhD from the University of Eastern Finland headed the clinical trial as part of the LipiDiDiet project. The study coordinator is Tobias Hartmann Professor for Experimental Neurology at the Saarland University Homburg Germany. For more information on the LipiDiDiet research partners please visit http For more information on the European Commission funded research projects please visit httpcordis.europa.eu European LipiDiDiet Study Rationale It is well known that diet has a significant impact on cognitive function and cognitive decline. However whilst clinical trial results on single nutrient based interventions have been largely disappointing epidemiological studies indicate that dietary patterns e.g. Mediterranean or healthy Nordic Diet are more effective in maintaining cognitive function and risk reduction than single nutrients. Extensive preclinical investigation which took place as part the LipiDiDiet project indicated that the nutrient combination in Fortasyn Connect has effects on multiple biological pathways that contribute to an overall neuroprotective effect. In addition earlier randomised controlled trials RCTs with the product have shown an improved memory performance in drugnave mild AD patients along with a good safety profile. LipiDiDiet Consortium members Saarland University University of Eastern Finland University of Szeged Tel Aviv University Stichting Katholieke Universiteit Radboud University Nijmegen Medical Center University of Gothenburg Nutricia Research Karolinska Institutet Academy of Sciences of the Czech Republic Institute of Physiology VU University Medical Center University of Bonn European Research and Project Office GmbH Heidelberg University Hospital University Hospital of Tuebingen Central Institute for Mental Health University Hospital Regensburg For further information on the European LipiDiDiet study and consortium visit http SOURCE LipiDiDiet Consortium"

"When it comes to shedding pounds and improving or eliminating type diabetes gastric bypass surgery may be better than other surgical weightloss procedures two new studies find. But obese patients should be careful to choose surgeons who have performed a high volume of these procedures before committing said Dr. Guilherme M. Campos lead author of one of two papers appearing in the February issue of the Archives of Surgery. Gastric bypass and lapbanding are the two most common surgical weightloss procedures performed in the United States. The former involves stapling the stomach so food has to bypass a section of the small intestine meaning you get full faster and less food gets absorbed into the gut. Lapbanding introduced in involves separating the stomach into two sections with a band so simply speaking eating too much becomes more difficult. Its a diet with a seatbelt said Dr. Mitchell Roslin chief of bariatric surgery at Lenox Hill Hospital in New York City and Northern Westchester Hospital in Mt. Kisco N.Y. In a third type of weightloss procedure known as sleeve gastrectomy surgeons remove part of the stomach. The study led by Campos compared weight loss and diabetes outcomes in patients who underwent gastric bypass surgery with patients who underwent lapbanding. Gastric bypass is considered riskier and more technically demanding than the band. All patients were morbidly obese with a bodymass index higher than and in each group had type diabetes. Although Campos is now an associate professor of surgery at the University of Wisconsin School of Medicine and Public Health in Madison he conducted the study while at the University of California San Francisco. In the bypass group patients lost an average of percent of their excess weight vs. percent for those in the lapbanding group. Threequarters of those undergoing gastric bypass surgery saw their diabetes improve or resolve vs. only half in the other group. The average cost of a bariatric surgery is nearly according to a recent study from Johns Hopkins University. Like all surgeries weightloss surgery carries its own set of possible risks including bleeding blood clots infection and leaks from sites where body tissues are sewn or stapled together according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Later complications may include malnutrition hernias and a tendency in about one in people to regain much of the weight they lost as a result of the procedure. In Campos study roughly equal numbers of patients in each group experienced complications after one year percent in the gastric bypass group compared to percent in the lapbanding group these included infection internal bleeding and blood clots but no deaths. More people in the bypass group had complications right after the surgery. More of those undergoing lapbanding however needed repeat surgeries percent vs. percent. The second study conducted in Taiwan and led by Dr. WeiJei Lee of the MinSheng General Hospital involved randomly assigning obese but not morbidly obese patients with type diabetes to receive gastric bypass surgery or sleeve gastrectomy. Almost all of those undergoing gastric bypass surgery percent had their diabetes resolved vs. only half in the other group these numbers declined to percent and percent after a year. Those in the gastric bypass group also lost more weight and there were no serious complications in either group. There are various theories to explain why gastric bypass may be superior including one that attributes the success to changes in hormones that control the metabolism of blood sugar. And certain procedures may still be preferable for certain patient populations added Roslin such as bands for patients with lower BMI who dont have so many metabolic challenges. Everyone thinks that all weightloss operations are the same even the doctors and the surgeons. But theyre different and they have different resolutions of comorbidities and probably should be used for different indications he said. An editorial accompanying the studies noted the results should be interpreted with caution since longerterm data is not yet available. More information Visit the American Society for Metabolic and Bariatric Surgery for more on weightloss procedures http_fs_surgery.pdf. SOURCES Guilherme M. Campos M.D. Ph.D. associate professor surgery University of Wisconsin School of Medicine and Public Health Madison Mitchell Roslin M.D. chief bariatric surgery Lenox Hill Hospital New York City and Northern Westchester Hospital Mt. KisCo N.Y. February Archives of Surgery"

"Laser pretreatment to soften cataracts https appears to be making cataract surgery safer two new studies suggest. There certainly seems to be a benefit to using the laser says American Academy of Ophthalmology AAO spokesman James Salz MD clinical professor of ophthalmology at the University of Southern California in Los Angeles. He reviewed the findings for WebMD. If you have a technique to soften the cataract there appears to be less chance of damage to the eye https Salz says. The research was presented here at the AAO annual meeting. Standard vs. Laser Cataract Surgery More than . million cataract surgeries are performed annually in the U.S. One in three mostly older Americans will have the surgery at some point in their lives. The surgery is performed to remove the natural lens of the eye https after it has become clouded over time. A permanent artificial lens is then implanted to replace the natural lens and provide appropriate vision https correction for each patient. Currently most aspects of cataract surgery including the initial incision and the breakup and removal of the clouded lens from the lens capsule are performed manually by the surgeon. An ultrasound https instrument with a vibrating needle is used to break up the cataracts https and a vacuum sucks them out. The new studies looked at using the socalled femtosecond laser to deliver nearinfrared light to fragment the cataract into tiny segments prior to removal. The idea is that all the surgeon will have to do is remove the pieces with a vacuum says researcher Mark Packer MD of Oregon Health and Sciences University in Portland. Ideally you wont need ultrasound or at least youll need less ultrasound. Thats important because ultrasound can cause collateral damage to the eye https he says. It can hinder recovery and cause clouding of the cornea https which is the clear outer layer of the eye. Although approved by the FDA the femtosecond laser procedure is not widely used in the U.S. according to the American Academy of Ophthalmology. Laser Cataract Surgery Requires Less Energy One new study led by William Culbertson MD of the Bascom Palmer Eye Institute at the University of Miami involved patients. All had the femtosecond laser procedure in one eye and standard manual cataract surgery in the other. Lens fragmentation involved using the laser to make the incision and split the lens into sections and soften it by etching crosshatch patterns on its surface prior to use of ultrasound and removal. The lasertreated eyes required less ultrasound energy to achieve cataract removal than the conventionally treated eyes. Also surgeons made fewer movements in eyes that received laser pretreatment compared to manual standard surgery. Intuitively if we use less energy and fewer movements inside the eye we will have fewer complications less inflammation and swelling of the eye and faster recovery of vision https Culbertson tells WebMD. Because such problems are relatively rare however we need thousands and thousands of patients to prove this he says. The laser pretreatment adds about five to seven minutes to the usual to minute cataract surgery Culbertson says. The study involved the most common types of cataracts https those graded . Culbertson says that these findings may not apply to higher grade harder cataracts. Laser Cataract Surgery Causes Less Cell Damage Packer and colleagues assessed laser cataract surgery in terms of loss of endothelial cells on the inside surface on the cornea as counted after the procedure. Packer consults for LensAR which makes the laser used in the study. Endothelial cells are a barometer of the health of the eye Packer says. They preserve the corneas clarity and they dont regenerate he says. When laser lens fragmentation was used in eyes there was no loss of endothelial cells the study showed. In contrast there was to cell loss in eyes that received standard treatment. Laser Cataract Surgery Other Advantages Other research has shown other advantages to laser surgery as well Packer says. Incisions are always precisely the same. Thats hard when we use our hands to perform the surgery he says. Also the laser allows doctors to perform more precise standardized capsulotomies which is the opening and removal of part of the lens capsule to make room for the new lens. This reduces the chance that a lens will later become displaced. Laser Cataract Surgery Who Will Pay The big issue is who is going to pay Salz says. The laser costs about on top of the ultrasound probe. The government Medicare https wont pay unless we prove thats the only way to do the surgery and clearly thats not true since standard surgery works he says. Packer says he envisions surgical centers or hospitals that have surgeons doing lots of cases investing in the laser. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"Researchers are hoping that by using a common tool for measuring of brain activity in a new way they may be one step closer to identifying whether a child is a greater risk for autism. We havent diagnosed autism at this point says William Bosl Ph.D. lead author and a research scientist at Childrens Hospital Boston http But he says by using an electroencephalogram httpkidshealth.orgparentgeneralsickeeg.html and new sophisticated computer programs to analyze the EEGs he and his coauthors were able to correctly identify with accuracy which babies were at higher risk for autism and which were not. Scientists have known for quite some time now that the earlier a child with autism gets therapy the easier it is to improve language and behavioral skills. In the American Academy of Pediatrics http that all children be screened for autism at the ages of months and months. Here researchers are trying to find markers for autism before a child begins showing signs of autism. In a new study published Tuesday in the journal BMC Medicine scientists studied infants. babies had a brother or sister with known autism which means they themselves are at an increased risk for the neurodevelopmental disorder that affects about one in children according to the Centers for Disease Control and Prevention http The sibling of a child with a confirmed diagnosis of autism has a in chance of also developing the disorder. These infant siblings were compared with infants with no known family history of autism. The babies were given EEGs at and months of age. Researchers strapped a net of electrodes all over a babys head while it was sitting in its moms lap and a research assistant was blowing bubbles to hold the childs attention. The electrodes measured actual firings of neurons. The EEG technique is much easier to use because the baby can be awake and moving and wiggling around says Dr. Geraldine Dawson chief science officer for the advocacy group Autism Speaks http which partially funded this research. Other brain imaging technologies like magnetic resonance imaging would require a baby to be asleep or sedated because they have to be completely still while the test is being done. Nobody wants to sedate a healthy infant says Dawson. Bosl explains that the new computer algorithms that he developed were able to analyze results of the EEG much better than in the past. He said that judging by the differences in brain activity he and his colleagues could detect which babies were in the highrisk group. They say they were nearly accurate when the boys were months old. They were most accurate with baby girls at age months. Overall the biggest differences in brain activity were seen at months which is much earlier than when a child typically shows behavioral problems associated with autism. The differences in brain activity were smaller as the babies got older. Doctors and scientists not connected to the study are intrigued by the results but caution that this is very early research and not something concerned parents can be looking for as a screening tool for their babies any time soon. Sarah Paterson Ph.D. is the director of the neuroimaging lab at the Center for Autism Research at Childrens Hospital of Philadelphia http She is also looking for early signs of autism as part of the Infant Brain Imaging Study http but her work focuses on differences in brain structure. Paterson says that if the results out of Boston can be confirmed Its very exciting because finding an early sign for autism is really the holy grail. But she cautions that a lot more work needs to be done. This study needs to be replicated by their lab and independent scientists she says. Dr. Max Wiznitzer says the researchers have found a really fascinating technique that offers a different way to look at the brain. Wiznitzer a pediatric neurologist at Rainbow Babies Childrens Hospital http Cleveland Ohio notes that what the study cant tell us is what the differences in brain activity between the two groups of babies actually mean. He too is hopeful that further research will provide more concrete information. Bosl says the first children enrolled in his study are now at and years old which is the age when autism usually is diagnosed. This will now allow the researchers to evaluate them for autism and then look back at the brain activity patterns of the children who do fit the clinical criteria for autism. Bosl acknowledges that if this is very early research but he believes if the results are confirmed it may lead to a safe and inexpensive way to detect autism which would allow intervention before any autistic behaviors appear. Itll change the field if this works says Bosl. He hopes to expand the number of babies in his study to . The only thing slowing us down right now is funding."

"Less than a week after the Food and Drug Administration approved the marketing of LapBand weightloss surgery to million new patients a pair of studies has found that a different older procedure is more effective and no riskier than either the LapBand or another lessdrastic surgery sleeve gastrectomy. In the first headtohead comparison of weightloss surgeries widely used in the United States UC San Francisco researchers found that those who had their stomach capacity reduced by a RouxenY bypass which reduces the stomachs capacity and bypasses a part of the intestine lost more weight required less diabetes medication and were less likely to need further surgery than those who received the LapBand. A second study found that diabetic patients who underwent sleeve gastrectomy which surgically narrows the stomach to reduce food capacity were more likely to continue needing diabetes medications than those who got the gastric bypass. Both studies were published Monday in the Archives of Surgery Last week the FDA broadened approval for the LapBand to people with a Body Mass Index as low as if they also have a weightrelated medical condition a move that is expected to propel millions more obese patients into the offices of bariatric surgeons. The LapBand is an inflatable ring that is surgically implanted around the upper stomach. After surgical wounds have healed saline solution is injected to expand the ring limiting how much food can be consumed. Yet both of the new studies suggest that the RouxenY gastric bypass procedure which is named for the surgeon who invented it and the shape of the altered small intestine remains the standard for patients with severe obesity and serious weightrelated illnesses such as diabetes. The procedure was first performed in . The UC San Francisco study led by surgeon Guilherme M. Campos measured weight loss improvement in metabolic function and quality of life in patients one year after their surgeries. On all those measures gastric bypass produced far better results than LapBand surgery. For instance those who had had gastric bypass lost of their excess weight on average in the year following surgery. Those who got the LapBand lost an average of in the same period. The study also found that although gastric bypass patients had more complications in the first month after surgery those who underwent LapBand surgery had a higher rate of complications later andor more need for surgical adjustments making the overall complication rate similar for both procedures. The authors concluded that gastric bypass has a better riskbenefit profile than LapBand surgery. The second study conducted by researchers in Taiwan compared obese patients who were treated with gastric bypass for their poorly controlled diabetes with similar patients who were treated with a procedure called gastric sleeving which surgically reshapes the stomach to a smaller size but does not close down a portion of the intestine to food. The finding that diabetes improved with gastric bypass but not with gastric sleeving offered an important clue to why gastric bypasses seem to improve the metabolic function of diabetics virtually overnight. Neither sleeve gastrectomy nor the LapBand causes food to bypass any part of the intestine suggesting that hormones in that part of the gut may play a key role in the changes that lead to diabetes. We need to just register that gastric bypass is the gold standard for diabetic control in overweight patients said Beverly Hillsbased weightloss surgeon Ted Khalili director of the Khalili Center for Bariatric Care who was not involved in the study. But Khalili whose practice is roughly split between LapBand and gastricbypass surgery added that the UC San Francisco findings are far less clear for patients whose primary objective is to lose weight. Although more weight loss was seen for the gastric bypass group in the oneyear study patients getting the LapBand continue to lose weight for two to three years after the procedure Khalili said. Comparing the two patient populations three years after surgery would probably have narrowed the weightloss gap considerably Khalili said."

"A new study suggests that continuous movement while sitting may increase metabolic rate more than standing at a desk. Craig Horswill clinical associate professor of kinesiology and nutrition at the University of Illinois at Chicago says the study adds to the growing body of evidence that suggests strategies for increasing nonexercise active thermogenesis defined as spontaneous activity unrelated to a fitness routine are needed to help overcome the detrimental effects of prolonged sitting. Sitting has been identified as a risk factor for early mortality independent of the presence of a disease such as cancer or diabetes. Up to percent of deaths have been attributed to sitting alone. Sitting is bad for our health but it is a big part of daily life for many people said Horswill an expert in exercise and metabolism in UICs College of Applied Health Sciences. Exercise is a good way to counteract the negative effects of sitting but just incorporating physical activity into one part of our day may not be enough to overcome the damage caused by prolonged sitting and an otherwise sedentary lifestyle. Because the workday is a major contributor to sedentary behavior with more than percent of workers in the U.S. reporting more than hours each day tactics that promote workstation activity have emerged in recent years including standing desks as well as dynamic pedal and treadmill workstations. Horswill and his colleagues compared the metabolic rate produced by three workstations seated at a desk seated at a desk equipped with a device that stimulates leg movement and standing at a desk. The device which is commercially available was a movable footrest suspended from the underside of the desk which enabled the feet to swing twist or teeter. Participants in the study familiarized themselves with the workstations during one visit. On a second visit researchers collected metabolic rate and heart rate data during three progressive stages seated seated with the device and standing. Each stage was minutes. The researchers found that modest movement while seated elevated the metabolic rate more than sitting and more than standing by and percent respectively and had no detrimental effect on cognitive function. The findings are published httpscontent.iospress.comarticlesworkwor in WORK a journal affiliated with the Canadian Association of Occupational Therapists and endorsed by the International Ergonomics Association. These results suggest that nonexercise active thermogenesis which we call NEAT can increase movement and calorie burning and may have the potential to impact health said Horswill the senior author on the study. We expected to see the metabolic rate increase with each progressive stage but instead found that metabolic rates from movement while seated were either equal to or higher than rates while standing. Horswill says the study needs to be further validated but that the findings should be especially applicable to individuals poised to benefit from NEAT but unable to access popular standing desks because of injury disability or discomfort. This is more evidence that NEAT something everyone can do throughout the day may be an important strategy for improving health and even reducing early death said Horswill. Haley Scott and Danel Voorhees are coauthors on the paper. Active Ideas LLC which offers the HOVR device used in study funded the research."

"A new study gives depression sufferers much hope if only they can get their doctors to look at this study. Ketamine infusion therapy the controversial treatment for depression has been resisted by many physicians due to concerns about shortlived benefits risks of addiction and the lack of large scale studies. In contrast this retrospective study of over three years of clinical experience shows lasting benefits for many patients with no apparent risk of addiction. Through a handful of ketamine infusions directed by Theodore Henderson MD PhD refractory depression symptoms can be relieved significantly and persistently. Evidence points to the regeneration of brain cells as a critical mechanism for the relief of depression as published in peerreviewed journal Neural Regeneration Research February issue. The study Practical application of the neuroregenerative properties of ketamine real world treatment experience http addresses key points in the controversy surrounding the use of intravenous ketamine for the treatment of depression. Its findings stand in direct contrast to warnings from the American Psychiatric Association APA. While controversial in academic settings Dr. Henderson said his direct experience supports a different strategy for multipleinfusion treatment regimens and his clinical experience shows ketamine can invoke longlasting effects often with less than six infusions. The wealth of clinical experience from treating hundreds of patients with ketamine has supplanted the preliminary data that emerged from the initial openlabel and small doubleblinded studies said Dr. Henderson who is a board certified psychiatrist specializing in diagnosing and treating complex conditions based in Denver Colorado. He is also the cofounder of NeuroLuminance Ketamine Infusion Centers. Patients in the study completed the Quick Inventory of Depressive Symptoms QIDSSR among other scales and showed persistent positive response to the ketamine infusions treatments. What is a Ketamine Infusion Ketamine is a dissociative anesthetic in use since s. Intravenous administration over a prolonged period of time is key to its persistent antidepressant benefit. Depression is associated with neuron loss reduced synapse numbers and dearborization of dendrites. Ketamine appears to potently induce mechanisms which reverse these neurodegenerative processes. Citing over published scientific research studies the new research article also reviews the molecular mechanisms by which ketamine invokes a robust activation of the brains own repair mechanisms. Another conclusion Dr. Henderson highlights is ketamine infusions can relieve refractory depression symptoms persistently perhaps for years. Activation of brainderived neurotrophic factor BDNF appears to have an important role in the antidepressant effects of ketamine. BDNF induces synaptogenesis dendritic arborization improved neuronal health and neurogenesis. These processes likely underlie the persistent benefits of ketamine. Dr. Hendersons findings challenge the oftheld beliefs that ketamine must be given frequently to have any benefit and that ketamine has no longlasting benefit. Dr. Henderson stated Misconceptions about ketamine abound among psychiatrists particularly related to possible chemical dependence problems. However the neurobiological basis of its benefit for depression has nothing to do with causing addictive risk. Our patients get better after a few infusions and from there treatments can be discontinued. The study also challenges concerns about neurotoxicity and a recent hypothesis that patients must experience hallucinations during ketamine infusion in order to have an antidepressant benefit. Please visit NeuroLuminance http or call for more information."

"A daily dose of the antioxidant selenium doesnt appear to elevate bad cholesterol levels and may in fact prompt a very modest boost in good cholesterol a new British study reveals. The finding comes from a sixmonth examination of the impact of various dosages of the supplement on the cholesterol levels of healthy people in England. The issue is that there have been an awful lot of studies about eight that have looked at blood cholesterol both good and bad and have found an association with high blood selenium said study author Margaret P. Rayman a professor of nutritional medicine at the University of Surrey in Guildford England. But an association is only that it doesnt mean one thing causes another. So we looked for whether selenium actually causes cholesterol to rise and we definitively found that there wasnt an adverse effect Rayman said. In fact we can safely and confidently say that if anything selenium had a slightly beneficial effect. However the safety of selenium has not been studied and the authors said the findings werent significant enough to recommend supplementation of the trace mineral. They also noted that the results cant necessarily be applied to Americans because of differences in the food supply and diets of each country. For the study published in the May issue of the Annals of Internal Medicine the authors focused on about healthy British men and women aged to between and . Blood tests determined blood selenium good cholesterol and bad cholesterol levels at the start of the study. For six months some participants were assigned to take daily selenium yeast supplements in either low intermediate or high doses while others were given a dummy pill for the duration. Noting that blood selenium levels were relatively low across the board at the studys launch the authors found that selenium levels did rise as a result of supplementation while those taking selenium also experienced a slight drop in both bad cholesterol LDL and overall cholesterol levels. Good cholesterol HDL levels rose a bit solely among those assigned to the highest selenium dosage. None of the patients experienced any serious side effects as a result of selenium supplementation. Rayman and her associates concluded that selenium supplementation does not appear to have a negative impact on blood cholesterol levels overall and may in fact be modestly beneficial. High cholesterol levels can increase the risk of heart attack. However she cautioned that in general such supplementation has a minor impact and is not advisable as an effective means to combat high cholesterol particularly for people who already have high blood selenium levels. She added that the teams observations were based exclusively on an analysis of British residents and that the findings may not necessarily apply in North America. In the U.K. peoples baseline selenium levels in the blood are considerably lower than they are in the U.S. she noted. There are various reasons for that including the fact that in the U.S. you have a wheat belt that means there is quite a high amount of selenium in the bread staple which is not the case in the U.K. So we cant extrapolate our findings to the U.S. Rayman said. And so I would caution against anybody in the U.S. increasing their selenium intake based on what we found because we also know theres an increased risk for type diabetes when you increase selenium intake if you are already at a high level of blood selenium levels. Dr. Gregg C. Fonarow a professor of cardiology at the University of California Los Angeles said that efforts to gauge the potential health impact of selenium have not yet demonstrated any clear benefit attributable to the trace mineral. Overall the evidence is inadequate to establish a protective role of selenium in cardiovascular disease or to recommend selenium supplementation to improve cardiovascular health he said. More information Theres more on selenium at the U.S. National Institutes of Health httpods.od.nih.govfactsheetsselenium. SOURCES Margaret P. Rayman Ph.D. professor nutritional medicine and director MSc Programme in Nutritional Medicine University of Surrey Guildford England Gregg C. Fonarow M.D. professor cardiology University of California Los Angeles May Annals of Internal Medicine"

"When actress and author Lena Dunham went public about having endometriosis https a disorder of the uterus she wanted to make something clear http The pain it causes can be completely debilitating and women desperately need better treatments. Soon it seems women like Dunham with endometriosis pain will have a new option for relief. An endometriosis pain treatment was just approved by the Food and Drug Administration and its expected to arrive at pharmacies as soon as August https The pill called elagolix brand name Orilissa from the drugmaker AbbVie is the first FDAapproved oral treatment in more than a decade for the moderate to severe pain that comes with endometriosis. This medication could really be transformative said Hugh Taylor httpsmedicine.yale.eduobgynpeoplehugh_taylor.profile an OBGYN at Yale Medical School who led the key trials testing the drug. Endometriosis is one of the most common gynecological conditions https affecting as many as one in women httpendometriosis.orgresourcesarticlesfactsaboutendometriosis of reproductive age. And it can be incredibly painful. The reason is simple Women with the condition are growing excess tissue in their abdomen that they cant shed. Every month a womans uterine lining thickens and sheds during her period if shes not pregnant. With endometriosis that tissue thickens and bleeds but it happens outside of the uterus on the fallopian tubes or even in the nose http or lungs http Because the extra tissue has no way to exit the body it cant go through the vagina since its not growing in the uterus it builds up and becomes trapped leading to pain and in some cases infertility. Theres no cure for endometriosis. To manage symptoms women are usually prescribed birth control or overthecounter painkillers as a firstline approach but they dont always work. In severe cases a doctor may suggest excision surgery https to remove the extra tissue. Dunham had eight surgeries and ended up getting a hysterectomy https which was considered an extreme measure. Enter elagolix. Endometriosis is an estrogendriven disease and the drug works by lowering estrogen levels. Two large doubleblind placebocontrol randomized trials https which women completed tested whether it can help women control endometriosis pain. The results published last year in the New England Journal of Medicine https were impressive. The patients in those trials scored their pain from no pain to severe pain. On average they had pain levels of . out of before starting on the drug and they experienced a point reduction in pain after taking the treatment for three months. Its a major advance said Dr. Louis DePaolo head of the fertility and infertility branch at the National Institute of Child Health and Human Development and another option women have thats effective. Now the less good news The drug wont cure endometriosis itll only tamp down the pain it causes. Many women in the trial experienced the symptoms of menopause hot flashes headache insomnia and researchers have also found the drug causes bone loss. We have no idea about the longterm effects of taking the drug because there are no trials lasting for longer than a year or how it stacks up against other painkillers since the trials only compared it to placebo. Thats not to mention cost The drugs price is listed at per month. But for some the risks and costs may be worth it. Heres why. Endometriosis is incredibly common but it can go undiagnosed for years Endometriosis is a chronic sometimes highly disruptive condition. The three main ways it manifests are through pelvic pain infertility and pelvic masses such as cysts scar tissue and fibroids. According to the American College of Obstetricians and Gynecologists http some important signs of endometriosis include Pain before and during periods Pain during sex Infertility Fatigue Painful urination during periods Painful bowel movements during periods But many women dont know they have endometriosis. Its sometimes mistaken or dismissed for regular period pain. Definitively diagnosing the disorder requires invasive surgery doctors need to peer inside the pelvis through a laparoscopy. Imaging is rarely helpful in getting a clear diagnosis. This involves making a small incision in the belly and inserting a tube with a tiny camera to see if the pelvic organs show signs of tissue scarring and buildup. So its no surprise it takes between three and years http_acognews_roommedianewsroommillionwomanmarchendometriosisfactsheet.pdf after the onset of symptoms to diagnose endometriosis. Doctors arent sure why some women get it Adding to the mystery around endometriosis No one knows exactly what causes it but doctors have some theories https Retrograde menstrual flow During a period when a woman is shedding her uterine lining some of that tissue can flow through her fallopian tubes and into her pelvis which researchers think may cause endometriosis. But doctors have also found that the rate of retrograde menstruation https is about the same in women with and without endometriosis so they think additional factors spur the disorder in some. Genes The disorder runs in families so doctors believe theres a genetic component https If a womans mom or sister had endometriosis the woman is believed to be at a higher risk. Somatic mutations Researchers are also finding that somatic mutations https acquired changes to DNA that happen after a person is born may also be an endometriosis driver. Immune system dysfunction Problems with the immune system can hamper a womans ability to clear her menstrual debris leading to endometriosis. Environmental factors Theres some evidence to suggest environmental exposures to certain chemicals may contribute to ones risk of developing endometriosis. The treatments available dont always help and some have severe side effects When birth control pills or overthecounter painkillers fail to help endometriosis pain httpendometriosis.orgtreatments women are often left choosing between a monthly injection called Lupron Depot https which can put women into a profoundly menopausal state or Danazol httpendometriosis.orgtreatmentsdanazol a male hormone that often causes acne and facial hair growth. In women for whom these drugs arent effective or who dont want to take medications surgery to remove the displaced endometrial tissue can be a highly effective option https_link. But the trouble with surgery is that endometriosis can recur so women may need more surgeries. The success of surgery also depends on finding a skilled and experienced surgeon and theres always the risk of surgical complications. The new drug elagolix is not riskfree either. In the trials women who took the drug had greater bone loss than did those who received placebo and this wasnt entirely surprising. Like other endometriosis treatments the drug works by lowering estrogen levels since endometriosis needs estrogen to grow. When that happens women experience menopausal side effects. The most common in the trials were hot flashes headaches and insomnia. Elagolix is available in two doses mg per day or mg twice daily and the women on the higher dose experienced the side effects more frequently. Mood swings and night sweats were less common and one woman in the trial died by suicide though theres no indication that the medicine was a cause of her death. DePaolo pointed out Elagolix doesnt have the pronounced side effects some of the other compounds have. Thats because he said it doesnt drive down estrogen levels as severely. But for patients who have tried other estrogenlowering medicines elagolix isnt all that appealing. This drug is palliative in nature. It does not cure or shrink the disease Casey Berna director of programs and partnerships for the advocacy group EndoWhat https The drugs side effects also concerned her as did the lack of knowledge about its longterm impact. For other women though the trade offs may be worth it. But in either case women with severe endometriosis are still left choosing between terrible pain surgery or drugs with serious side effects."

"In an early study an experimental stem cell procedure helped teens httpsteens.webmd.comdefault.htm with type diabetes httpsdiabetes.webmd.comguidediabetesoverviewfacts stay off of insulin https injections for about . years on average. The study was very small and the procedure is not ready for widespread use. We now have a unique approach with some positive findings but its still early. We need to better understand the biology behind the treatment and follow patients for longterm side effects Robert E. Ratner MD chief scientific and medical officer of the American Diabetes https Association tells WebMD. This is the latest of several stem cell studies to show promising results for the treatment of type diabetes https Ratner notes. In the new study of teens with type diabetes https who got an experimental treatment using their own stem cells https went into remission and did not need insulin https injections for an average of about . years. The cocktail treatment combines stem cell therapy with drugs that suppress the bodys immune system. In type diabetes https the immune system attacks and destroys insulin https cells within the pancreas https The experimental treatment is called autologous nonmyeloablative hematopoietic stem cell transplantation HSCT. It aims to kill the destructive immune system cells and replace them with immature stem cells https not programmed to destroy insulinproducing cells. First patients are given drugs to stimulate production of blood https stem cells. The blood https stem cells are then removed from the body and frozen. Then patients are hospitalized and given drugs to kill the destructive immune system cells. The harvested blood stem cells are then put back into the patient. Eight teens who took part in the study have remained insulinfree for two years on average. One patient has gone without insulin injections for . years. All our patients considered the treatment to be worthwhile and beneficial though some patients experienced side effects study head Weiqiong Gu MD of Ruijin Hospital in Shanghai tells WebMD. As a result of the immunesystem suppressing drugs most of the patients in Gus study experienced side effects including low white blood cell counts fever nausea https vomiting https hair loss https and suppression of bone marrow. Most of those side effects disappeared within two to four weeks and unlike in previous studies of the experimental therapy none of the patients developed infections pneumonia https low sperm https counts or organ damage. One woman became pregnant https by natural means a year after transplantation and delivered a healthy girl Gu says. Still patients have to be followed for years to ensure they do not develop known longterm complications of immunesuppressing drugs including tumors and infertility https Gu says. The findings were presented here at the annual meeting of the American Diabetes https Association and appear in the July issue of the journal Diabetes Care."

"First marketed in the s as a fertility drug tamoxifen has been hailed as a miracle drug for its ability to prevent and treat breast cancer and despite decades of research scientists have not been able to find anything comparable until now. In a study published in The Lancet http Thursday researchers found that a class of inexpensive existing generic called aromatase inhibitors which suppress hormones reduce recurrence rates by percent as compared with tamoxifen. That confirmed what researchers had believed for several years. But a separate finding about the effect of the drug on death risk was a surprise. The study reported that taking aromatase inhibitors for years reduced the risk of postmenopausal women with breast cancer dying of their disease by percent within years of starting treatment compared with no hormonal treatment. The results were part of the Early Breast Cancer Trialists Collaborative Group a collaboration based at the University of Oxford that collects and analyzes information about randomized clinical trials every few years. Breast cancer and mammograms Study suggests widespread overdiagnosis http Paul Workman professor and chief executive of the Institute of Cancer Research in London said in a statement accompanying the publication of the journal article that the evidence on aromatase inhibitors has been accumulating for well over a decade but it has taken this huge and complex study to make sense of all the data and provide a firm basis for clinical guidelines. It tends to be the discovery of new treatments that grabs the headlines but it is just as important to maximize the benefit patients get from existing treatments through major practicechanging studies like this Workman said. The researchers wrote in the study that a substantial number of the trial participants switched from tamoxifen to aromatase inhibitors after they heard that it could reduce recurrence which affected their results. If this had not happened the benefit of aromatase inhibitors over tamoxifen would probably have been somewhat greater they surmised. A separate analysis by the same group also published in The Lancet http looked at bisphosphonates which are typically used for osteoporosis. Researchers at Sheffield University found that in postmenopausal women during the first years after diagnosis of breast cancer the drug could reduce the risk of death by per cent. Using the two drugs together as a onetwo punch may be even more powerful. Richard Gray a professor at the University of Oxford and who served as the lead statistician for both studies said that half of all women with breast cancer are postmenopausal with hormonesensitive tumors and could potentially benefit from both drugs. The drugs are complementary because the main side effect of aromatase inhibitors is an increase in bone loss and fractures while bisphosphonates reduce bone loss and fractures as well as improving survival he said."

"A few short visits and phone calls with a nurse may be enough to help insomniacs get their zzzs suggests a new study of sleepdeprived older adults. Researchers found that more than half of participants overcame chronic insomnia within a month of starting a brief behavioral treatment. The key ingredient in the therapy according to lead researcher Dr. Daniel Buysse of the University of Pittsburgh School of Medicine was a simple somewhat counterintuitive lesson When you are sleeping poorly the most important thing you can do is spend less time in bed. Insomnia affects about one in every five Americans rising to one in three among the elderly and has been linked to a range of physical problems from accidents to hypertension. Not surprisingly it is also detrimental to mental health. Three decades of research has shown cognitive behavioral therapy to be equally effective to a pill for insomnia with fewer side effects. Yet the time and resourceintense strategy usually involving between six and eight hourlong appointments with a clinical psychologist is not widely available and its cost generally hundreds of dollars is prohibitive for many. Buysse and his colleagues wondered if the pillfree treatment could be shortened and simplified providing more rapid results at a lower cost. To find out they studied adults with chronic insomnia. Participants averaged years of age and were randomly assigned to receive either printed educational material about sleep or the brief behavioral treatment consisting of one to minute inperson session a minute followup session and two minute phone calls. A mental health nurse practitioner in a regular doctors office focused the behavioral instruction on how to restrict time in bed and set regular sleepwake schedules while also discussing the biological rationale behind the strategy including the bodys daily cycles of physical mental and behavioral changes. This therapy has the effect of compressing your sleep into a more solid block Buysse told Reuters Health in an email. More consolidated sleep is more refreshing. Based on questionnaires and sleep diaries the researchers found that two out of every three participants receiving the behavioral intervention responded favorably by the end of weeks while just one out of every four receiving the printed material experienced substantial improvement in their sleep. The gap was similarly wide when the researchers looked at the number of participants who no longer met the criteria for insomnia percent versus percent. On average for every . participants treated one responded favorably and one overcame insomnia report the researchers in the Archives of Internal Medicine. These improvements were sustained for at least months and were backed up by data from a sleep monitor worn on the wrist or ankle. When the researchers looked at information from a different more indepth sleep monitoring system however they failed to find significantly better outcomes with the behavioral therapy. The new results were similar to those previously published on the more intense cognitive behavioral therapy. A lot of insomniacs spend a lot of time lying in bed worrying about their sleep among other things. They expect to have insomnia Dr. Thomas Neylan of the University of California San Francisco who wrote an accompanying commentary in the journal told Reuters Health. Generally the most expedient thing to do is just prescribe a sleeping pill noted Neylan. But the drugs can pose problems ranging from dependence or abuse to cognitive impairment during the day. And the risks may be even more pronounced among older patients added senior author Timothy Monk also of the University of Pittsburgh. Under the influence of the drugs seniors may be more likely to fall and fracture a bone. While brief behavioral treatment for insomnia is not yet generally available Monk told Reuters Health in an email that his team hopes their findings will be an important first step in that process. In the meantime Neylan offers insomniacs some advice If youre not ready to fall asleep dont lie down in bed and try to force yourself to sleep. And if you wake up in the middle of night and dont fall back asleep easily get out of bed. You dont want to have any linkage between the experience of lying in bed and being awake he said. SOURCE bit.lyfOME httpbit.lyfOME Archives of Internal Medicine online January . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A new class of drugs called HIF inhibitors is more effective and better tolerated than the standard of care drug sunitinib in treating kidney cancer researchers with the Kidney Cancer Program at Harold C. Simmons Comprehensive Cancer Center have found. HIF inhibitors which grew out of research begun more than years ago at UT Southwestern Medical Center work by interfering with processes that fuel the growth of cells. Investigators conducted a preclinical trial in mice transplanted with kidney cancer from over patients and showed that the HIF inhibitor PT controlled cancer in half of the tumors according to a study published in the journal Nature. This is a completely new treatment for kidney cancer. We want to make HIF inhibitors available to patients and are currently carrying out clinical trials said Dr. James Brugarolas Director of the Kidney Cancer Program who is leading an million SPORE grant from the National Cancer Institute seeking to translate new discoveries into novel therapies for kidney cancer patients. Part of the SPORE grant one of just two directly related to kidney cancer in the nation is focused on further researching HIF inhibitors. In a previous report Dr. Kevin Courtney Assistant Professor of Internal Medicine and a coauthor of the current study reported at the American Association of Clinical Oncology annual meeting that HIF inhibitors were safe in patients and had activity even in heavily pretreated patients. In the study in Nature investigators show that HIF inhibition was able to control metastatic kidney cancer even after lines of prior therapy. See video. The findings show that HIF is a promising target to combat kidney cancer said Dr. Brugarolas senior author and a Virginia Murchison Linthicum Scholar in Medical Research at UT Southwestern. Nearly Americans are now living with a diagnosis of kidney cancer and more than people are expected to be diagnosed with kidney cancer this year according to the National Cancer Institute. Texas has the fifth highest rate of this cancer in the U.S. What is HIF HIFs or hypoxiainducible factors like HIF allow the bodys cells to adjust to lowoxygen environments. HIFs activate programs that promote the development of blood vessels facilitate oxygen delivery and promote efficient nutrient utilization. Kidney cancer cells hijack the same system to fuel their growth. HIF inhibitors work by suppressing the effects of HIF which include downregulating an important protein called VEGF that promotes the formation of blood vessels needed for tumors to grow. Unlike existing VEGF inhibitors the HIF inhibitor blocks VEGF only in the cancer and therefore does not cause cardiac toxicity or hypertension Dr. Brugarolas explained. New HIF findings In the Nature study researchers compared the two drugs head to head and found that the HIF inhibitor was more active than sunitinib and that it was active against tumors progressing on sunitinib. Furthermore it was also better tolerated. As sometimes happens in patients mice on sunitinib were sickly and lost weight whereas mice on the HIF inhibitor gained weight while on the study he said. Researchers surprisingly found a subset of tumors that do not respond to the drug but were able to identify biomarkers that once verified would help determine which patients are more likely to benefit from HIF therapies. HIF is believed to be the most important driver of kidney cancer. Traditionally proteins like HIF were disregarded as drug targets because their shape made it nearly impossible to design drugs against them Dr. Brugarolas said. The approaches we have taken pave the way for identifying drug candidates for other proteins that have traditionally been considered undruggable. HIF also appears significant in other types of cancer including deadly brain cancers called glioblastomas and nonsmall cell lung cancer the most common type of lung malignancy. How HIF came to be In UT Southwestern researchers Dr. Steven McKnight Chairman of Biochemistry and molecular geneticist Dr. David Russell Vice Provost and Dean of Basic Research led research discovering and describing the protein encoded by the EPAS gene also known as HIFa the main HIF component. Over the course of a decade the laboratories of Dr. Richard Bruick Professor of Biochemistry holder of the Michael L. Rosenberg Scholar in Biomedical Research and a coauthor of the current study and Dr. Kevin Gardner Adjunct Professor of Biochemistry solved the structure of HIFa. By researchers had identified a sweet spot where drugs could bind and shut down HIF activity. Using the Simmons Cancer Centers HighThroughput Screening scientists tested more than chemicals to see which ones could interfere with HIF identifying several potential druglike compounds. The most promising compounds were licensed to Peloton Therapeutics Inc. a biotech firm cofounded by Dr. McKnight and based at UT Southwesterns BioCenter campus. In the first HIF inhibitor an oral drug known as PT entered clinical trials in patients with advanced or metastatic renal clear cell carcinoma. HIF inhibitors also are the target of UTSWs recent million SPORE Specialized Program of Research Excellence award. Investigators will further biomarkers to identify patients most likely to respond to the HIF inhibitor as well as to anticipate ways in which the tumor may evade the drugs impact. UT Southwesterns SPORE program involves four innovative disease and clinical research teams targeting adult and pediatric kidney cancer. Other UTSW SPORE investigators are looking at the function of a gene that identifies a cluster of particularly aggressive tumors in hopes of identifying vulnerabilities that can be targeted with drugs examining kidney cancer metabolism to distinguish aggressive from less active tumors potentially yielding a tailored treatment approach and evaluating novel subtypes of childhood kidney cancer. The HIF research team The Nature research was supported by grants from the National Institutes of Health including the SPORE Peloton Therapeutics Inc. and the Cancer Prevention and Research Institute of Texas the National Center for Advancing Translational Sciences Center for Translational Medicine National Natural Science Foundation of China and philanthropy including the Tom Green Memorial fund. More than researchers contributed to the study including Dr. Payal Kapur Associate Professor of Pathology Dr. Ivan Pedrosa Associate Professor of Radiology in the Advanced Imaging Research Center who holds the Jack Reynolds M.D. Chair in Radiology Dr. Xiankai Sun Associate Professor of Radiology in the Advanced Imaging Research Center who holds the Dr. Jack Krohmer Professorship in Radiation Physics Dr. XianJin Xie Professor of Clinical Sciences Dr. Yang Xie Associate Professor of Clinical Sciences Dr. Tae Hyun Hwang Assistant Professor of Clinical Sciences Dr. Guiyang Hao Assistant Professor of Radiology Dr. Eugene Frenkel Professor of Internal Medicine and Radiology who holds the Raymond D. and Patsy R. Nasher Distinguished Chair in Cancer Research in Honor of Eugene P. Frenkel M.D. the Elaine Dewey Sammons Distinguished Chair in Cancer Research in Honor of Eugene P. Frenkel M.D. and the A. Kenneth Pye Professorship in Cancer Research and Dr. Rene M. McKay Director of Research Administration for the Kidney Cancer Program. Additional UT Southwestern researchers include lead authors Dr. Wenfang Chen Haley Hill Alana Christie and Min Soo Kim as well as Eboni Holloman Andrea PaviaJimenez Farrah Homayoun Dr. Yuanqing Ma Dr. Nirav Patel Dr. Guiyang Hao Qurratulain Yousuf Allison Joyce Dr. He Zhang and Jenny Chang. Disclosures coauthors Tai Wong James P. Rizzi Eli M. Wallace Naseem Zojwalla and John A. Josey are employees and own equity in Peloton Therapeutics Inc. Kevin Gardner and Richard Bruick have licensed IP consult for and own equity Min Soo Kim Tae Hyun Hwang Yang Xie and James Brugarolas are authors on a filed patent pertaining biomarkers of the HIF inhibitor. UT Southwestern Medical Center owns stock in Peloton Therapeutics and has a financial interest in the intellectual property used within the research. The Harold C. Simmons Comprehensive Cancer Center is the only NCIdesignated comprehensive cancer center in North Texas and one of just NCIdesignated comprehensive cancer centers in the nation. Simmons Cancer Center includes major cancer care programs. In addition the Centers education and training programs support and develop the next generation of cancer researchers and clinicians. Simmons Cancer Center is among only U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site. About UT Southwestern Medical Center UT Southwestern one of the premier academic medical centers in the nation integrates pioneering biomedical research with exceptional clinical care and education. The institutions faculty includes many distinguished members including six who have been awarded Nobel Prizes since . The faculty of almost is responsible for groundbreaking medical advances and is committed to translating sciencedriven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in about specialties to more than hospitalized patients and oversee approximately . million outpatient visits a year."

"First results from a human trial of an Ebola vaccine from GlaxoSmithKline show it is safe and generates an immune response scientists said on Wednesday but larger trials are needed to see if it protects and if a booster is needed. The vaccine is being developed by the U.S. National Institutes of Health NIH and GSK against the Zaire strain of Ebola the one circulating in West Africa and the first doses for a larger trial arrived in Liberia last week. That trial is the first of several midstage studies planned for West Africa and aims to test GSKs vaccine and one from Merck and NewLink. Johnson Johnson and Bavarian Nordic have a vaccine in earlystage clinical tests. The earlystage Phase I trial of GSKs vaccine was primarily designed to test safety but Adrian Hill who led the work at Oxfords Jenner Institute said it was encouraging that the shot also prompted responses from the immune system. The safety profile is pretty much as wed hoped and the immune responses are okay but not great he told Reuters. The data published in the New England Journal of Medicine were from healthy volunteers given the vaccine in Britain between Sept. and Nov. last year. The volunteers got one of three doses low medium or high and data from days after vaccination showed the shot was safe at these doses with only mild side effects. People typically experienced mild symptoms that lasted for one or maybe two days such as pain or reddening at the injection site and occasionally people felt feverish Hill said. However the antibody response was weaker than was found in a trial of the same Ebola vaccine in macaque monkeys in which the animals were also found to be protected. Hill said the lower antibody levels together with a lower response detected in the immune systems Tcells suggested to him that a booster may well be needed. Jeremy Farrar director of the Wellcome Trust charity which helped fund the trial said it provided good initial evidence that the GSK vaccine will be safe to use in people. However we still dont know whether it will provide protection against Ebola infection in a realworld situation he said. Thats why trials in West Africa of this and the other vaccines in development must begin as soon possible. Editing by Louise Ireland Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Over the past two decades the number of Americans having total hip replacements has more than doubled to more than a year httporthoinfo.aaos.orgtopic.cfmtopica. Though most patients eventually walk again without pain or the aid of a cane recovery and rehabilitation can be rigorous painful and lengthy. The surgery is extensive As its name suggests it involves removing the joint the damaged bone and cartilage and replacing it with prosthetic parts made of metal plastic or ceramics. Typically surgeons enter the joint from the rear which requires cutting through muscle and cartilage. But with a relatively new procedure surgeons enter from the front and only stretch the muscles aside avoiding the cutting and minimizing pain and recovery time. According to those who use this anterior technique the benefits are substantial. Anthony Unger http medical director at the Institute of Bone and Joint Health at Sibley Memorial Hospital http a clinical professor of orthopedic surgery at George Washington University Hospital says the anterior approach is truly minimally invasive. Unger who has done about hip replacements over years and has used the anterior technique for the past eight years says patients have better overall functionality can sleep on their sides and be confident the new hip wont dislocate. But as with many transitions in medical techniques some surgeons have been reluctant to change. Although agencies and hospitals dont track hip replacements by the type of procedure used Unger says that based on statistics from the American Association of Hip and Knee Surgeons only percent of its members choose the anterior approach. Joshua Jacobs https_jacobs.cfm a vice president of the American Association of Orthopaedic Surgeons and chairman of orthopedic surgery at Rush University in Chicago says the AAOS doesnt endorse or promote one specific technique or procedure over another. Jacobs prefers the posterior approach which he says has been reliable for him. He says that while hes heard about the benefits of the anterior approach hes not aware of a randomized controlled trial comparing the posterior and anterior approach that shows a definite superiority of one over the other. Whats key is that surgeons need to do the approach theyre most comfortable with to get the best outcomes. Teetering like Chaplin A study by Unger in the Journal of Bone and Joint Surgery httpjbjs.orgarticle.aspxarticleidin found that with the anterior procedure there was less muscle damage and inflammation both in the immediate postoperative period and two days later than with the posterior approach. Others surgeons who prefer the anterior procedure say it preserves more of the normal anatomy which also means fewer medications and shorter hospital stays. Michael Bollinger who operates at Palm Drive Hospital in Sebastopol Calif. switched methods a few years ago. With the anterior approach Bollinger says we can take Xrays during the operation to see if the new hip is placed correctly and adjust it when necessary. Many surgeons use a special operating table that makes this possible. Although surgeons can also take Xrays during the posterior procedure it is much more difficult and they wait until patients are in the recovery room where Bollinger says theres not much that can be done. He explains that while the body tolerates an imperfect alignment pretty well if a new hip gets dislocated its often because its not in perfectly. The anterior approach offers other benefits. Robert Saunders a nurse at Alta Bates Summit Medical Center in Berkeley Calif. sees about hip replacement patients a year. He says that nurses love the anterior approach because theres less worry about dislocating the joint. With the posterior approach we have to spread patients legs apart and strap them to a pillow to keep the new joint in place. If they want to move or roll over they cant he says. Saunders says the anterior patients also have an easier time with physical therapy which can start the same day as the surgery. Those whove had the posterior procedure have a lot of pain since when they sit up theyre right on top the incision he explains. Patrick Kennelly a physical therapist with Smartherapy in Chevy Chase http says people who have the anterior procedure dont feel so weak because their hip muscles havent been cut. If theyve had the posterior procedure even if they dont consciously feel weak they tend to shift their weight onto one foot and teeter like Charlie Chaplin. Cautious surgeons Given benefits such as these why havent more surgeons switched methods Unger says that most surgeons have used the posterior approach for years have fine results and see no need to switch. Also he says they work in a very highstress highliability environment. For this reason new techniques are adapted slowly with extreme care and in some cases not at all. Unger adds that surgeons are naturally cautious and typically wait to see results from many studies before they switch methods. Besides his study there have only been a few others. One a prospective randomized study by William Barrett an orthopedic surgeon in the Seattle area compared the two approaches in a peerreviewed paper he presented at the annual AAOS meeting and found benefits with the anterior approach. Another obstacle to the widespread use of the newer approach is that if established surgeons want to switch they face time and cost constraints. They must get training in classes and cadaver labs and the learning curve can be steep. Unger says his was relatively short about cases. Others say it took about cases. And this creates economic issues. If youre a busy surgeon you have a volume to maintain Bollinger says and its hard to go from doing three a day to one during the learning period. Christopher Chen a surgeon who uses the anterior approach at Alta Bates Summit adds that most doctors still use the posterior approach because its the one they were taught. And he says the majority of younger surgeons learn the older approach because established surgeons are typically the ones who staff the residency training programs and demonstrate the method they know best. Most surgeons dont profit from choosing one approach over another Chen says. If there is a financial incentive for promoting the newer technique he says it is that more patients will want the anterior approach so that the surgeon does more surgeries and therefore collects more professional fees for that. William Hamilton who operates at the Anderson Orthopaedic Clinic at Inova Mt. Vernon Hospital http trains young surgeons to do the anterior approach in a yearlong hip and knee replacement fellowship program. Hamilton says that during this time theyre taught both approaches. But he adds that since of the fellows he trained use the anterior procedure as their primary approach in their practices. Hamilton says that a decade ago very few residencies and fellowships taught the anterior approach. Now several institutions around the country have at least one surgeon teaching it. So when students leave and begin their practices its no longer foreign to them. Hamilton who has performed anterior procedures and strongly supports the method says that despite growing interest it will take a generation of new surgeons before use of the anterior approach is widespread. Patients arent informed Many patients arent aware of the option. The case of Daniel Ellsberg who in released the Pentagon Papers a secret study about U.S. involvement in Vietnam is instructive. His hip had been hurting for about a year and when he decided to have surgery his primarycare physician recommended a respected surgeon. Just days before the operation last July a friend told him about the anterior approach. Id never heard of it and neither my doctor nor surgeon mentioned it. I called the surgeons office learned he did the posterior procedure asked for and got a recommendation for one who performs the anterior one and my experience was amazing. The same day as the operation I walked down the hall with a walker. I was home in three days and a week later I walked one or two blocks without pain or a cane. In a month I bodysurfed at the beach says Ellsberg who is . Margot Machol who is two decades younger and lives in Washington had both hips replaced the first with the posterior procedure several years ago the second with the anterior procedure last October. Unger performed both surgeries. After the first I needed pain medicine when I came home from the hospital. Also I had a long list of restrictions of what I could and couldnt do so the hip wouldnt pop out. For six weeks I had to sleep on my back couldnt cross my legs and wasnt able to drive. After the second I didnt take any pain pills once I was home slept on my side soon after the surgery had almost no rules and drove my car in two weeks. I even wanted to ski over Christmas because I felt fine Machol says. Koeppel is a writer based in Washington."

"A wearable device that stimulates the sense of balance with electric noise could help Parkinsons disease patients according to Swedish scientists. Scientists from the University of Gothenburgs Sahlgrenska Academy have developed a portable pocketsized vestibular or balance stimulation device in a bid to improve the lives of Parkinsons sufferers. The research was led by Associate Professor Filip Bergquist who said the simple device was similar to the TENS Transcutaneous Electrical Nerve Stimulation therapy which is used for pain relief for example in child birth. So this is really not a very complicated device. It is a current device which is very similar to the ones that people use for pain relief with electrical stimulation of muscles and nerves whats called TENS. The difference is that we use a particular current profile which you can stimulate the balance organs with without creating a balance disturbance. So you do not get the impression that the world is moving or that you are moving you actually do not feel anything Bergquist explained. The device operates by providing stimulation via patches attached to the patients head behind the ears where the vestibular system is located. Parkinsons disease is characterized by reduced levels in the brain of the hormone dopamine a neurotransmitter that allows different regions of the brain to communicate with one another. Symptoms of advanced Parkinsons disease include an impaired sense of balance as well as tremors poor mobility slowness and stiffness. Nearly all patients diagnosed with the disease are treated with levodopa a drug that stimulates the production of dopamine in the brain. The effectiveness of oral levodopa reduces as Parkinsons disease progresses in the patient and can lead to involuntary movements or dyskinesia. In earlier experiments on rats researchers at Sahlgrenska showed that noisy electric stimulation of the balance organs could be used to change the activity of the brain thereby balancing the effects of dopamine shortage and improving the animals motor skills and balance. The researchers have also tested the method on ten Swedish Parkinsons patients in both medicated and unmedicated states. According to Sahlgrenska on one day the patients received an active noise stimulation and on another day inactive treatment not knowing which day the current was active. According to the research institute the experiments showed that the active noise stimulation improved both the patients balance and the combined symptoms. Parkinsons sufferer Staffan Lindblom said he did not expect any great advances but would be thankful for anything that would make living with the disease easier. I have become hardened in the sense that I do not have too great expectations. But I still believe that something will be found at some point which could be useful. There is extensive research in this field and I hope that it eventually will come up with a result. Not a significant result but a few steps forward would really be appreciated he said. Unfortunately this particular treatment did not work on Lindblom with Bergquist suspecting there could also be other causes to Lindbloms balance problems. Bergquist said he hoped the device could treat patients for whom the Levodopa drug which turns into dopamine in the body and increases levels of the chemical was not enough. He also said they were working on the hypothesis that other diseases which affect the dopamine system such as ADHD Attention Deficit Hyperactivity Disorder could also benefit from this kind of treatment. What we are hoping for with this device is to find a treatment for movement disorders where Levodopa Parkinsons disease where Levodopa is not enough. And in particular in patients with Parkinsons disease where there is problem with gait and balance. But this may not be restricted to Parkinsons disease so there may be other conditions with poor balance where you could use electrical stimulation of the vestibular organs the balance organs to improve balance and gait he said. The plan is now for the device to be tested in a longerterm study where patients will be using it at home. If those trials prove successful the developers hope the device could be available to the public within five years. Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Overweight people could be given help with the discovery that a drug used for sleep disorder could also reduce the impulse for food. There are many factors that cause obesity but there is a growing weight of evidence that shows obesity is not just caused by a behavioural disorder such as a lack of selfcontrol but that many overweight people are physically addicted to foods rich in fat and sugar. When we eat food that tastes good we get a powerful release of dopamine in the pleasurereward section of the brain but food addicts have been found to have a deficiency in a certain type of dopamine so that their sense of reward and pleasure is diminished thus they have to eat more to reach the same level of pleasure as anybody else. Scientists have also found impulsive behaviour is a factor in leading to food addiction and Ivo Vlaev of Warwick Business School plus Myutan Kulendran Laura Wingfield Colin Sugden and Ara Darzi of Imperial College London discovered that a drug called Modafinil usually used for narcolepsy shift work disorder and excessive daytime sleepiness can reduce impulsivity and thus food addiction. We found Modafinil which is already on the market did reduce peoples impulsive behaviour said Professor Vlaev. It has been shown to reduce impulsiveness in a variety of disorders such as alcohol dependence schizophrenia and ADHD. Food addicts suffer from the same neurobiological conditions so we believe it will help food addicts as well and our initial tests have backed up that theory. This could have important implications for people who are obese. There is mounting evidence to show that there is a substantial number of obese people who are food addicts because they have an inability to control their impulsive actions and this drug has shown it can give them more control which will help overweight people lose weight and so improve their health. Food addicts know they need to lose weight but the desire for more food is overwhelming leading to a spiral of depression that can lead to psychological issues as well as health problems. The drug which is sold under a wide variety of brand names around the world was one of two drugs tested by researchers the other being Atomoxetine. Both drugs have been used for impulsive conditions including ADHD. In the paper Pharmacological manipulation of impulsivity A randomized controlled trial published in Personality and Individual Differences the scientists conducted a series of trials on men aged between and with taking a placebo Atomoxetine and Modafinil. The tests revealed that those who had taken Modafinil had a significantly reduced level of impulsiveness whereas Atomoxetine produced no difference compared to the placebo group. Modafinil was found to have an effect on impulsivity in healthy individuals and so would be able to have an even bigger effect on food addicts who are lacking in certain types of dopamine said Professor Vlaev. This drug could be a real help to those people struggling to control their desire for food even though they know they should lose weight. The drug improves selfcontrol which is a key factor in determining obesity so our hypothesis is that this drug should help in treating the disease. For a copy of the paper email Ashley.potterwbs.ac.uk mailtoAshley.potterwbs.ac.uk To interview Ivo Vlaev contact Email Ivo.Vlaevwbs.ac.uk mailtoIvo.Vlaevwbs.ac.uk Warwick Business School is the largest department of the University of Warwick and is triple accredited by the leading global business education associations the first in the UK to attain this accreditation. Offering the full portfolio of business education courses from undergraduate through to MBAs and with a strong Doctoral Programme WBS is the complete business school."

"A treatment is offering hope for millions of patients with sleep apnea https a disorder that causes people to stop breathing when theyre asleep. An estimated million Americans suffer from sleep apnea putting them at greater risk for diabetes heart disease stroke and memory loss. Patients who are older overweight and male are generally most atrisk reports CBS News correspondent David Begnaud. I wasnt breathin. I wasnt getting the correct amount of oxygen. My thought process had gone said Peggy Siravo. Her memory got so bad her family thought she had dementia. Exhausted the yearold could barely do her job as a nurse and she knew something wasnt right. I knew I was in trouble Siravo said. Siravo has severe obstructive sleep apnea where her throat muscles relax blocking her airway and disrupting her sleep. On average she stops breathing times an hour thats nearly once every minute during a nights sleep. She said on a night she could be up four hours and sleep two. She did not find relief from the CPAP machine a common treatment that delivers constant pressurized air. She even needed oxygen on top of that. And then that didnt work. Thats when they introduced me to Inspire and saved my life Siravo said. Inspire is an FDAapproved pacemakerlike device https implanted in the chest. It senses when breathing slows down and sends an electrical pulse to the tongue to stimulate it forward keeping the airway open. This has been revolutionary. Its been a game changer Dr. Maurits Boon said. He is Siravos doctor at Thomas Jefferson University Hospital in Philadelphia. Shed given up. And she had memory issues she was miserable Boon said. This is not a benign disease it actually shortens peoples lives. A few months after having the Inspire device implanted Siravo went to a sleep lab to see how it was working. They ran tests throughout the night. Early the next morning Boon revealed the results. So before we activated the device we have all sorts of problems This is basically your brain saying Im not breathing. And after we activate the device its perfect Boon explained. Look at your oxygen. Nice stable flat line staying around percent. So this is good as it gets. Okay Siravo said. And as far as Im concerned this is a cure. This is awesome Boon said. A study published in the New England Journal of Medicine found that percent of patients experienced less sleep apnea after getting the implant. For years all Siravo and her husband David wanted was a good nights rest and now theyre finally getting it. Every night Siravo turns on the implant before heading to bed. Whats it like to sleep now Begnaud asked. Great. Turn myself on. I go to sleep Siravo said. And then I get up. And I turn myself off. And I have a normal day like you and everybody else. Doesnt work for everybody. But man it worked for you Begnaud said. It sure did. It saved my life Siravo said. Inspire is not for everyone. Its only for moderate to severe cases and like any surgery there is risk of infection. For Siravo she said her memory is back to percent. The device costs around not including the surgery."

"Scientists using brain https scanning technologies say they have been able to predict with accuracy which children with dyslexia https will be able to improve reading skills over a period of a few years. Researchers say their findings reveal activity in specific brain https regions during reading that could eventually lead to new treatments for people with dyslexia. At this time we cannot say which treatment type will each child benefit from study researcher Fumiko Hoeft MD PhD an imaging expert at Stanford University tells WebMD in an email. But with more research and if researchers combine it with intervention studies then we should be able to identify brain https patterns that are predictive of responding to one type of intervention or another. She says in a news release that the study gives us hope that we can identify which children might get better over time and that the findings represent a huge step forward. The discovery of brain https regions involved in the learning disorder may provide a mechanism for enduring improvement that promotes relatively successful reading development according to the study published in the Dec. issue of the Proceedings of the National Academy of Sciences. Study Suggests Interventions to Help Dyslexics Learn to Read Dyslexia is a learning disability https that impairs a persons ability to read and affects to of children in the U.S. About of youths with dyslexia develop adequate reading skills by the time they are adults. But until now what happens in the brain that permits improvement has not been known the researchers say. Brain imaging studies in the past have shown greater activation of specific brain regions in children and adults with dyslexia while they are performing readingrelated tasks. In particular an area known as the interior frontal gyrus seems to be hyperactivated in dyslexic people. Hoeft and colleagues set out to determine whether neuroimaging could predict which children with dyslexia would gain improvement in reading skills using functional magnetic resonance imaging https fMRI which shows oxygen use by areas in the brain and diffusion tensor magnetic resonance imaging DTI which shows connections between brain areas. Study Involves Youths With Dyslexia and Normal Readers For the study the researchers enrolled children with dyslexia and without all between ages and and evaluated their reading skills using standardized tests. They used the two types of brain imaging fMRIs and DTIs observing the brains of the youths while they read. Then . years later they reevaluated reading performance. They found that no behavioral measure including standardized reading and language tests reliably predicted reading gains. But the children with dyslexia who showed greater activation in the right inferior frontal gyrus showed greater improvement over the . years from the studys start. The scientists also examined white matter connected to the right frontal region and children in whom this was better organized also showed improvement. Predicting Learning Improvement May Lead to New Treatments Using these techniques the researchers say they were able to predict with significant accuracy future reading gains in youths with dyslexia. The reason this is exciting is that until now there have been no known measures that predicted who will learn to compensate Hoeft says in a news release. By understanding whats going on in the brains of these children scientists may now be better equipped to develop interventions that focus on brain regions involved and thus help adolescents learn to read faster. Coauthor Bruce McCandliss PhD of Vanderbilt University says in a news release that insights from the brain scans may be crucial for new educational research on how to best meet the individual needs of struggling readers. He tells WebMD in an email that the findings could be used to investigate the possibility that brain activity patterns and structural differences hold clues as to how to match treatment approaches to the particular needs of such children. Alan E. Guttmacher MD director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development says the study creates insights into how certain people with dyslexia learn to compensate for reading difficulties. Understanding the brain activity associated with compensation may lead to ways to help individuals with this capacity draw upon their strengths he says. Similarly learning why other individuals have difficulty compensating may lead to new treatments to help them overcome reading disability. Hoeft says the findings suggest brain imaging can help determine which kinds of treatments are likely to work. She also suggests that the study may show that youths with dyslexia use right brain frontal regions to compensate for reading problems rather than the areas in the left side of the brain as typical readers do."

"People who have narrowed carotid arteries in the neck and show no symptoms may be at risk for stroke and not know it but a simple ultrasound test can identify the problem a new study suggests. This condition known as asymptomatic carotid stenosis is caused by plaque buildup in the arteries that carry blood from the heart to the brain. This can cause less blood to reach the brain and in rare cases may also trigger a stroke if plaque breaks off and becomes lodged in the small vessels in the brain. Only a small minority of patients with carotid stenosis will suffer a stroke said lead researcher Dr. Raffi Topakian from the Academic Teaching Hospital WagnerJauregg in Linz Austria. The problem is identifying the patients at the highest risk for stroke he said. Most patients with carotid stenosis can be managed with medications such as cholesterollowering drugs blood pressurelowering drugs and blood thinners such as aspirin he added. But those at highest risk may need a surgical procedure called an endarterectomy which clears the carotid arteries of plaque. We found with two ultrasound methods we could differentiate the patients who are at very low risk of suffering a stroke lower than percent per year from patients at high risk of stroke higher than percent per year Topakian said. The patients who are at high risk are candidates for surgery he said. Endarterectomy is not recommended for most people with carotid stenosis since the problem can be managed with drugs and there are risks including stroke with the procedure Topakian said. Those who would benefit from the ultrasound test are people with known carotid stenosis who are fit for surgery Topakian said. If they are too sick or frail for surgery it makes no sense to do the ultrasound he said. In addition people at high risk for stroke are also candidates for ultrasound Topakian said. This would include people with high cholesterol high blood pressure or heart disease he said. This test could be a good tool to identify the right patients for surgery Topakian said. Of course anyone with symptomatic carotid stenosis is a candidate for immediate surgery Topakian said. Warning signs include transient ischemic attacks TIAS or ministrokes which cause no permanent damage but are often followed by a stroke within a few days. The report was published in the Aug. online edition of Neurology. For the study a research team led by Topakian followed people with asymptomatic carotid stenosis for two years. Each participant had an ultrasound to see if there were signs that a stroke might occur. These included tiny blood clots which pass into the brain and a type of plaque called echolucent plaque which is fattier than other plaque and linked with an increased risk for stroke. Among those in the study percent had the fattierthannormal plaque percent had signs of blood clots and percent had both the fattier plaque and blood clots the researchers found. In addition over the two years of the study people had TIAs. Moreover people with the fattier plaque were more than six times more likely to have a stroke than those people without the plaque and those with the fattier plaque and clots had a risk that was times higher Topakians team found. Nonetheless some experts said that research suggests that patients with no symptoms are better off without the surgery. Dr. Lars Marquardta professor of surgery at the University of ErlangenNuremberg in Germany and coauthor of an accompanying journal editorial said surgery for people with asymptomatic carotid steno sis is done too frequently. Marquardt noted that the risks associated with the surgery are a lot higher than leaving the stenosis as it is and starting aggressive medical treatment. Patients with symptomatic carotid stenosis dont get the surgical procedure early enough and patients with asymptomatic carotid stenosis have too many surgical interventions Marquardt said. When treating asymptomatic carotid stenosis Marquardt doesnt think the case has been made for distinguishing between high and lowrisk patients. Right now the work done by Topakians group is still experimental he said. Another expert Dr. Larry B. Goldstein director of the Duke University Stroke Center said that what remains uncertain is whether surgical intervention would result in an overall improvement in strokefree survival. It is also unclear how optimal medical management lifestyle changes in addition to antiplatelet medication and statins would affect overall stroke and cardiovascular risk and strokefree survival he said. Both the U.S. Preventive Services Task Force and the American Heart Association currently recommend against general population screening for asymptomatic carotid artery stenosis Goldstein noted. More information For more information on stroke visit the U.S. National Library of Medicine http SOURCES Raffi Topakian M.D. Academic Teaching Hospital WagnerJauregg Linz Austria Lars Marquardt M.D. Ph.D. professor surgery University of ErlangenNuremberg Germany Larry B. Goldstein M.D. director Duke University Stroke Center Durham N.C. Aug. Neurology online"

"The experimental orphan drug teprotumumab significantly reduces the eye bulging associated with Graves disease according to results of a small trial. Among the participants with moderatetosevere disease who were given intravenous infusions of either teprotumumab or a dummy drug every three weeks for eight treatments percent who got the real drug had a reduction of at least millimeters in eye protrusion by the sixth week compared to percent in the placebo group. In virtually all the responders the changes are frequently what anyone would call dramatic said lead study author Dr. Terry Smith of the University of Michigan Medical School in Ann Arbor. The eyes dont have that bulging appearance he said and many of them return to the degree of bulging they had before they got the disease. Thats something that we almost never see in someone whos manifested the degree of disease one needed to have in order to get into the study Smith said. The marked reduction in bulging is similar to that reported after decompression surgery Smith and his colleagues write in the New England Journal of medicine. Graves disease is the most common cause of overactive thyroid in the United States according to the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK. It is an autoimmune disorder in which the immune system attacks the thyroid gland. Certain immunesystem signaling molecules also target other tissues in the body including in the eyes which causes their bulging appearance sometimes known as Graves eyes. About percent of people with Graves disease develop mildly bulging eyes and to percent develop severe bulge. This eye condition usually lasts one to two years and often improves on its own according to NIDDK. Teprotumumab blocks one of these immune signaling molecules so researchers wanted to see what effect it might have on the eyes of Graves patients with moderate to severe bulge. The study included some of the worst cases imaginable and were now wondering whether the drug might find expanded utility in muchlesssevere disease Smith told Reuters Health in a telephone interview. By week the response rate was percent with the drug and percent with placebo. Among those who completed therapy the rates were percent and percent respectively. More people who received the drug had sizeable reductions in disease activity and reductions of mm or more in eye bulge compared to the placebo group the researchers note. However while only percent of patients who received the drug had double vision before the study that rose to percent by weeks. High blood sugar was also a key side effect in participants who already had diabetes the study team notes but adjusting diabetes medications solved that problem. The typical treatment for Graves eyes is glucocorticoids which are not always effective and also have side effects the study team notes. The drug also known as RV or R has been developed by Genmab and Roche. River Vision Development Corporation licensed the drug from Roche. On Monday Horizon Pharma announced that it was acquiring River Vision which paid for the new study. Smith said FDA approval could come sometime in . Enrollment in a followup trial is expected to begin within six weeks. The duration of response to the autoimmune inflammatory disease along with the quick response to initial therapy suggests fewer infusions may be just as effective but future studies will sort that out Smith said. The researchers also cautioned that the study only included volunteers with active disease of recent onset so the potential of teprotumumab in benefiting patients with milder less active or stable disease was not assessed. SOURCE bit.lyqSTjSn httpbit.lyqSTjSn New England Journal of Medicine online May . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Twelve years ago a car wreck took away Nathan Copelands ability to control his hands or sense what his fingers were touching. A few months ago researchers at the University of Pittsburgh and the University of Pittsburgh Medical Center gave Copeland a new way to reach out and feel the world around him. Its a mindcontrolled robotic arm that has pressure sensors in each fingertip that send signals directly to Copelands brain. The scientists published httpstm.sciencemag.orgcontentearlyscitranslmed.aaf details of their work online Thursday in the journal Science Translational Medicine. Its a really weird sensation Copeland now says in a video made shortly after he first tried the system. Sometimes it feels kind of like electrical and sometimes its more of a pressure. But he also describes many of the sensations coming from his robotic hand as natural. When Copeland touches an object with the robotic hand he can tell which finger the sensation is coming from and whether an object feels hard or soft says Robert Gaunt http_.html a bioengineer and assistant professor in the Department of Physical Medicine Rehabilitation at the University of Pittsburgh. But were really not at the point where we could say get him to feel the difference between silk and burlap Gaunt says. The success represents an advance that is absolutely critical in terms of making prosthetics useful says Mike McLoughlin httpjhmvhi.jhu.edupeoplemichaelpmcloughlin an engineer at the Johns Hopkins University Applied Physics Laboratory. McLoughlin is part of a team at Hopkins that developed the Modular Prosthetic Limb http that Copeland is using. The research at both Hopkins and in Pittsburgh is supported by the governments Defense Advanced Research Projects Agency. For several years now people have been able to control robotic arms using thoughts alone. But they have relied entirely on vision to know whether the arm is going in the right direction or grasping an object with the proper amount of force. That makes it very challenging to perform simple tasks like grasping a foam coffee cup without crushing it McLoughlin says. Sensing Touch Watch a blindfolded Nathan Copeland accurately sense which fingers being touched. Credit UPMCPitt Health Sciences Without sensory feedback somebody would have to actually have to look at the prosthetic look at the cup start to close the hand and visually see the cup is starting to deform he says. Restoring Copelands sense of touch was a painstaking process but the Pittsburgh team knew it was possible. His hand has been disconnected from his brain because of his spinal cord injury Gaunt says. But the brain hasnt lost its ability to feel. So the team began looking for a way to send touch sensations directly to Copelands brain. The first step was to monitor his brain activity using a technique called magnetoencephalography httpmegcommunity.orgwhatismeg. We were able to see the parts of his brain that became active when he was watching videos of a hand being touched Gaunt says. Next the researchers placed tiny electrodes in Copelands brain that could stimulate the areas corresponding to each finger. Then they waited for the brain to heal as it adjusted to the presence of the electrodes. It was several weeks before the team was able to send the first tiny pulse of electricity to Copelands brain. When it finally happened he just very calmly said Yep I felt it on my index finger Gaunt recalls. But in the background I was breathing a sigh of relief and other people were cheering. Of course mindcontrolled robots are still years away from consumer applications McLoughlin says. At the moment they are still too expensive too bulky and too finicky to be used outside a laboratory setting. And theres no good way to control them without implanting electrodes in the brain. Still the ability to receive touch sensation from a robotic arm has the potential to help not only thousands of people who are paralyzed but also people with a wide range of physical disabilities McLoughlin says. For example robots that provide sensory feedback could eventually help a disabled person cook a meal or clean up things at home. Were on the verge of something here thats going to transform lives he says."

"A combination of two drugs delays progression of advanced aggressive breast cancer by an average of nine months working in all subsets of the most common type of breast cancer. The combination of a firstinclass targeted drug called palbociclib and the hormone drug fulvestrant slowed cancer growth in around two thirds of women with advanced forms of the most common type of breast cancer. The combination allowed many women with metastatic hormonereceptorpositive HERnegative cancer to delay the start of chemotherapy which is the traditional treatment option in these patients once hormone drugs have stopped working. The international study led in the UK by Dr Nicholas Turner from The Institute of Cancer Research London and The Royal Marsden NHS Foundation Trust updates the results of a major phase III trial published last year. The results confirm the prior benefit observed with palbociclib and show that palbociclib works regardless of how sensitive patients cancer was to earlier hormone therapy. The new research published today Thursday in The Lancet Oncology shows that even women with specific genetic changes conveying resistance to hormone therapy can benefit from the new drug combination. Hormonereceptorpositive HERnegative cancer accounts for around per cent of cases of breast cancer. In the trial researchers from research centres in countries followed women allocated to receive either palbociclib and fulvestrant or a dummy pill and fulvestrant. The trial was funded by Pfizer. Women in the palbociclib plus fulvestrant group took a median of . months to progress as measured by CT and MRI scans compared with . months in the placebo group. Some per cent of the women in the palbociclib plus fulvestrant group showed clinical benefit either a reduction in tumour size or control of disease for at least six months compared with per cent of the women in the placebo plus fulvestrant group. Some per cent in the palbociclib plus fulvestrant group had a decrease in tumour size compared with per cent in the placebo plus fulvestrant group. The study also aimed to assess whether cancers with particular genetic traits responded less well or better to the combination than others. Mutations to the gene PIKCA represent the most common genetic event in breast cancer and mutations in the gene are associated with a shorter response to hormone therapy. The research showed that using liquid biopsies that measure cancer DNA circulating in the blood to detect PIKCA and tests for blood hormone levels the palbociclib combination worked in all types of hormonereceptor positive HER negative breast cancer. Palbociclib is a firstinclass drug with a different mechanism of action to other approved drugs which simultaneously blocks two proteins called CDK and CDK in cancer cells. It causes less severe sideeffects than traditional chemotherapy. In the trial severe sideeffects caused by the combination were rare. Many women per cent on the palbociclib arm had a drop in their white blood cell count but this rarely led to serious symptoms. Study colead author Dr Nicolas Turner Team Leader in Molecular Oncology at The Institute of Cancer Research London and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust said Our research underlines the effectiveness of palbociclib with fulvestrant in metastatic breast cancer and importantly demonstrates its benefit in all types of hormonereceptor positive breast cancer. We hope our results lead to the adoption of this drug combination in breast cancer where it delays the need to start chemotherapy by an average of nine months. Our study also sends a powerful message that in combining new drugs in innovative trials we can find better options for women with advanced breast cancer. Chemotherapy can add several months to life but it comes at a cost of often lifelimiting side effects and we need alternative treatments that are better tolerated to treat patients with advanced breast cancer. Professor Paul Workman Chief Executive of The Institute of Cancer Research London said If were going to drive further improvements in survival from cancer its essential that we find ways of prolonging life in people whose cancers have evolved and become resistant to treatment. This trial is an exciting example of one of the most promising approaches to overcoming drug resistance by combining drugs with different mechanisms of action to block off cancers escape routes. Its very encouraging to see such substantial delays to cancer progression. Notes to editors For more information please contact Henry French on or henry.frenchicr.ac.uk mailtohenry.frenchicr.ac.uk. For enquiries out of hours please call . The Institute of Cancer Research London is one of the worlds most influential cancer research institutes. Scientists and clinicians at The Institute of Cancer Research ICR are working every day to make a real impact on cancer patients lives. Through its unique partnership with The Royal Marsden NHS Foundation Trust and benchtobedside approach the ICR is able to create and deliver results in a way that other institutions cannot. Together the two organisations are rated in the top four cancer centres globally. The ICR has an outstanding record of achievement dating back more than years. It provided the first convincing evidence that DNA damage is the basic cause of cancer laying the foundation for the now universally accepted idea that cancer is a genetic disease. Today it leads the world at isolating cancerrelated genes and discovering new targeted drugs for personalised cancer treatment. As a college of the University of London the ICR provides postgraduate higher education of international distinction. It has charitable status and relies on support from partner organisations charities and the general public. The ICRs mission is to make the discoveries that defeat cancer. For more information visit http"

"Alex Pierce took up distance running with great enthusiasm a couple of years ago. Then she developed knee pain so severe that she could not climb stairs. So Pierce a doctoral student in food science went to see physical therapist Matt Briggs at The Ohio State Wexner Medical Center in Columbus. He performed deep massages suggested changes in her running form and taught her how to exercise her thigh and gluteal muscles to better protect her knees. She believes all of that helped. But Pierce like a growing number of patients had another treatment she is convinced helped even more. Its called dry needling and it involves the insertion of thin nonmedicated solid needles into muscles or connective tissues. Proponents say it can reduce pain and improve movement. Pierce has had the procedure more than half a dozen times and believes it is one reason she will be able to run her fourth marathon in November. This has kind of changed my life she says. Testimonials like that are a big reason dry needling has caught on with some physical therapists athletes and other patients Briggs says. But testimonials are not scientific proof. And there Briggs says is where dry needling is lacking. While some studies have shown promise he says the quality of the evidence is not strong. Thats why Briggs and his colleagues are starting a study looking at dry needling in runners knee the condition that has plagued Pierce. Their goal and the goal of other researchers now looking at dry needling is to produce results rigorous enough to show whether it really works. For now heres what consumers should know Is this acupuncture Physical therapists say it is not though superficially it may look the same says Justin Elliott vice president of government affairs for the American Physical Therapy Association http For one thing he says dry needling as performed by a physical therapist is not rooted in ancient Chinese medicine theres no talk about redirecting the bodys energy flow by placing needles at certain points in the body. Instead needles are placed directly in problem areas. Elliott says dry needling also is practiced by some chiropractors naturopathic physicians and nurses which puts it outside the realm of any one specialty. Acupuncturists beg to differ. What is being called dry needling is clearly a form of acupuncture and should be done only by professionals extensively trained in that discipline says Thomas Burgoon a West Chester Pa. physician who is president of the American Academy of Medical Acupuncture http He says many acupuncturists do exactly what the physical therapists describe with the same kind of needles. Burgoons group has persuaded some states to bar physical therapists from the practice. How might it work One theory is that the needles cause tight muscles to twitch then relax. The needles may also increase blood flow or set off nerve responses that alter pain perception Briggs says. Another possibility Its a placebo effect an improvement triggered by the expectation that a treatment will work rather than by the treatment itself. To look for that possibility the Ohio State study will compare patients who get the real needle treatment to those poked with sham needles that dont pierce the skin. Mark Crislip an infectiousdisease doctor in Portland Ore. who recently wrote about dry needling for ScienceBased Medicine https a website critical of alternative medicine says the version practiced by physical therapists doesnt come with the mystical baggage that accompanies acupuncture. But he says it may well be a theatrical placebo. What do published studies say Its a mixed bag Elliott says. In a review httpfileCUserskpainterDownloadsDryNeedlingResourcePaper.pdf the physical therapy association rated the evidence for dry needling a out of based on the best studies. A formal analysis http_acupunctureanddryneedlingforlowbackpain of trails on acupuncture and dry needling for chronic lower back pain was published by the Cochrane research group in . It found they may be useful additions to standard treatment. But it said higher quality studies were needed. What are the risks Needling can produce minor bleeding and some soreness but in trained hands and with the use of sterile needles and gloves its a very safe procedure Briggs says. In rare cases deep needling can lead to a punctured lung or injuries to nerves and blood vessels and acupuncturists fear nonspecialists will be more likely to make such mistakes Burgoon says. Will insurers pay for this Many will not. Charges for patients can range from to per session says Edo Zylstra CEO of KinetaCore a company that offers intensive threeday weekend courses in dry needling to physical therapists. Do all physical therapists offer this No. The physical therapy association tells members in seven states to steer clear because of recent court or regulatory decisions or language in existing licensing laws. They are California Florida Hawaii Idaho New York South Dakota and Washington. And most of the nations licensed physical therapists are not trained in the technique. About have taken courses in dry needling in the past few years Zylstra says."

"According to a new study women experiencing difficulty with time management attention organization memory and problem solving often referred to as executive functions related to menopause may find improvement with a drug already being used to treat attention deficit hyperactivity disorder ADHD. The study led by researchers at the Perelman School of Medicine at the University of Pennsylvania is the first to show that lisdexamfetamine LDX improved subjective and objective measures of cognitive decline commonly experienced in menopausal women. Results of the study are published online today in the journal Psychopharmacology. Reports of cognitive decline particularly in executive functions are widespread among menopausal women said lead author C. Neill Epperson MD professor of Psychiatry and Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Center for Womens Behavioral Wellness. There are approximately million postmenopausal women living in the US alone and with the average age of onset occurring at the great majority of those women will live in the postmenopausal state for at least onethird of their lives. Therefore promoting healthy cognitive aging among menopausal women should be a major public health goal. The Pennled team administered a oncedaily dose of LDX for four weeks to healthy nonADHDdiagnosed women between the ages of and experiencing difficulties with executive functions as a result of midlife onset menopause and as measured using the Brown Attention Deficit Disorder Scale BADDS. All participants served as their own controls by being randomly assigned to crossover to a placebo for an additional four weeks. The researchers found a percent overall improvement in executive functions for women receiving LDX compared to a percent improvement when taking placebo medication. There were also significant improvements in four out of the five subscales for women taking LDX organization and motivation for work attention and concentration alertness effort and processing speed and working memory and accessing recall. While psychostimulants such as LDX are primarily marketed for the treatment of ADHD they have been successful in treating cognitive complaints in some patients including postmenopausal women. They work by promoting the release of dopamine which is impaired in ADHD and other disorders characterized by executive function problems. Although we observed that shortterm use of LDX was well tolerated and effective in several subjective and objective areas longterm studies of menopausal women receiving LDX are needed similar to those conducted for ADHD patients said Epperson. It is also important for clinicians to confirm that a womans complaints of worsening memory are in the executive function domains are temporally related to the transition to menopause and are not indicative of some other pathological cognitive impairment before prescribing a trial of LDX. In addition to Epperson other Penn coauthors are Sheila Shanmugan Deborah R. Kim Sarah Mathews Kathryn A. Czarkowski Jeanette Bradley Dina H. Appleby Claudia Iannelli and Mary D. Sammel. This project was funded in part by Shire Pharmaceuticals the National Institute of Mental Health the National Institute on Aging and the National Institute on Drug Abuse. Penn Medicine is one of the worlds leading academic medical centers dedicated to the related missions of medical education biomedical research and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania founded in as the nations first medical school and the University of Pennsylvania Health System which together form a . billion enterprise. The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past years according to U.S. News World Reports survey of researchoriented medical schools. The School is consistently among the nations top recipients of funding from the National Institutes of Health with million awarded in the fiscal year. The University of Pennsylvania Health Systems patient care facilities include The Hospital of the University of Pennsylvania recognized as one of the nations top Honor Roll hospitals by U.S. News World Report Penn Presbyterian Medical Center Chester County Hospital Penn Wissahickon Hospice and Pennsylvania Hospital the nations first hospital founded in . Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners a partnership between Good Shepherd Rehabilitation Network and Penn Medicine. Penn Medicine is committed to improving lives and health through a variety of communitybased programs and activities. In fiscal year Penn Medicine provided million to benefit our community. Disclaimer AAAS and EurekAlert are not responsible for the accuracy of news releases posted to EurekAlert by contributing institutions or for the use of any information through the EurekAlert system."

"A comparison between lessexpensive overthecounter hearing assistance devices and a conventional hearing aid found that some of these devices were associated with improvements in hearing similar to the hearing aid according to a study published by JAMA. Presently hearing aids can only be purchased in the United States through a licensed professional with an average cost of for two hearing aids uncovered by Medicare. According to nationally representative estimates less than percent of adults with hearing loss report hearing aid use. Personal sound amplification products PSAPs are lessexpensive overthecounter devices not specifically labeled for hearing loss treatment but some are technologically comparable with hearing aids and may be appropriate for mild to moderate hearing loss. Nicholas S. Reed Au.D. of the Johns Hopkins School of Medicine Baltimore and colleagues compared five of these devices costs approximately to with a conventional hearing aid cost among adults average age years with mild to moderate hearing loss. The researchers found that the change in accuracy in speech understanding from unaided to aided varied by device. Three of the PSAPs were associated with improvements in speech understanding that were similar to results obtained with the hearing aid one demonstrated little improvement and speech understanding was worse with one PSAP. Results lend support to current national initiatives from the National Academies White House and bipartisan legislation requesting that the U.S. Food and Drug Administration create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter the authors write. A limitation of the study was the modest number of participants. For more details and to read the full study please visit the For The Media website. doi.jama.. Editors Note Please see the article for additional information including other authors author contributions and affiliations financial disclosures funding and support etc. To place an electronic embedded link to this study in your story This link will be live at the embargo time httpjamanetwork.comjournalsjamafullarticle.jama.."

"An experimental pill to prevent blood clots exceeded already high expectations as a better therapy for millions of people with atrial fibrillation httphealth.nytimes.comhealthguidesdiseaseatrialfibrillationflutteroverview.htmlinlinenytclassifier according to final results of a worldwide study released Sunday. The study was featured at the European Society of Cardiology in Paris and simultaneously published on the Web site of The New England Journal of Medicine http Its a remarkable achievement said Dr. Valentin Fuster a past president of American and world heart associations who was not involved with the trial. This is one of the most significant advances in cardiovascular medicine in the last five years no question Dr. Fuster chairman of federal and medical panels on atrial fibrillation and director of the heart center at Mount Sinai Medical Center in New York said in an interview. The twicedaily pill to be called Eliquis prevented percent more strokes than the blood thinner warfarin a standard treatment for heart arrhythmia and resulted in percent fewer incidents of major bleeding httphealth.nytimes.comhealthguidesinjurybleedingoverview.htmlinlinenytclassifier over an average of . years in the study. Eliquis also reduced total deaths by percent a mortality benefit its makers BristolMyers Squibb and Pfizer plan to trumpet in a marketing campaign assuming the Food and Drug Administration approves the drug later this year. Barring any problems sales are quickly expected to reach billions of dollars. The new drugs are not without disadvantages. They cost much more than generic warfarin roughly a day instead of or less. And Eliquis and Pradaxa require two pills a day one in the morning and one in the evening instead of the oncedaily warfarin. The study included people in clinical sites in countries and was consistent worldwide the sponsors said. Although the study was financed by the drug makers which raises the issue of bias it met the gold standard for medical research as a randomized doubleblinded trial in which doctors and patients did not know who took which pill until the end. The drug acts on an enzyme that leads to blood clots. Dr. Christopher B. Granger the studys lead author and a professor of medicine at Duke University said I think this is a profound trial result that will have a major impact on the practice and management of patients with atrial fibrillation. It combines both greater efficacy in terms of prevention of stroke httphealth.nytimes.comhealthguidesdiseasestrokeoverview.htmlinlinenytclassifier with a substantial reduction to bleeding risk and that package is one that will be particularly compelling. Wall Street has high expectations too. The companies stock soared after they released a brief statement http about the stroke and bleeding benefits in June. Barclays Capital said the final results on Sunday were perhaps the most anticipated R.D. event of the year. Top of Form Bottom of Form Top of Form If everything checks out Jami Rubin of Goldman Sachs said in an interview that will confirm in our minds that Eliquis has potential to take a majority share of the billion anticoagulation market. More than . million people have atrial fibrillation in the United States according to the Centers for Disease Control and Prevention http_statisticsfact_sheetsfs_atrial_fibrillation.htm. As many as million people will have it by because of an aging population with longer life expectancy. The arrhythmia in the left upper chamber of the heart can cause slow blood flow and clots raising the risk of stroke by four to six times on average the government says http_fibrillation_and_strokeatrial_fibrillation_and_stroke.htm. As many as half of people with the condition however are untreated by varying estimates. Warfarin a cheap yearold drug sold generically under the brand name Coumadin requires frequent blood tests to monitor its active level and interacts with some other drugs and foods including leafy greens. There is great appeal and demand for new drugs that do not vary so much and deliver the same strokepreventing benefits. The first new drug Pradaxa from the German drug maker Boehringer Ingelheim was introduced in the United States http last fall. In the first seven months on market about four in five cardiologists and two in five primary care doctors had prescribed it to more than people Wael Hashad Boehringers vice president for cardiovascular marketing said in an interview last week. Pradaxa inhibits thrombin an enzyme in clot formation. Other emerging drugs block a related enzyme known as Factor Xa. Xarelto from Bayer and Johnson Johnson approved by the F.D.A. in July http to prevent clots in hip and knee replacement httphealth.nytimes.comhealthguidessurgerykneejointreplacementoverview.htmlinlinenytclassifier surgeries goes to an F.D.A. review panel for atrial fibrillation on Sept. . Eliquis is scheduled to be submitted for F.D.A. review later this year. Its New Yorkbased makers are marketing powerhouses with the top two bestselling drugs in the world Lipitor httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicslipitor_drugindex.htmlinlinenytclassifier from Pfizer and Plavix from BristolMyers Squibb. Patents on those drugs expire in the next year making Eliquis even more important to their businesses. Correction August An article on Monday about Eliquis a new strokepreventive drug from Pfizer and BristolMyers Squibb misspelled the brand name of the drug most commonly used now for that purpose. It is Coumadin not Coumidin."

"new method of performing virtual colonoscopy using a CT scan which doesnt involve the dreaded laxative preparation to clear the colon the night before may be about as effective as a standard colonoscopy at identifying the large polyps most likely to become cancerous according to research conducted at Massachusetts General Hospital Brigham and Womens Hospital and elsewhere. If the finding is confirmed by larger studies the technique could eventually serve as a firstline screening tool for colon cancer especially for the many people who avoid screening altogether. The new technique works by using a contrast agent a tiny amount of this dye is ingested two days before the test to highlight fecal matter in the colon which can then be digitally erased from the scan using a computer software program making it easier to see polyps. Advertisement In the study of patients published Monday in the Annals of Internal Medicine the prepfree virtual colonoscopy was able to identify more than percent of suspicious polyps that were millimeters or larger compared with percent identified when the same patients later had a standard colonoscopy. ADVERTISING The research was partially funded by GE Healthcare manufacturer of the CT imaging device. Study participants reported an improved level of comfort with the new technique said study author Dr. Michael Zalis a radiologist at Massachusetts General Hospital primarily because it didnt involve the diarrheainducing prep that keeps most people in close range of a bathroom during the night before a colonoscopy. Of the study participants who expressed a preference percent said they preferred the prepfree CT procedure over the colonoscopy. Only sixty percent of Americans age and over get the American Cancer Societys recommended screening for colon cancer a colonoscopy every years fecal occult blood test every year or a flexible sigmoidoscopy virtual colonoscopy or barium enema imaging every five years. Surveys suggest that patients find the prep required for both colonoscopy and traditional virtual colonoscopy to be the worst part of screening. A number of folks who currently arent being screened because they fear the prep or arent willing to go through it again may be willing to have screening if theyre told they dont need to take laxatives and can still get a potent test said Dr. Durado Brooks director of prostate and colon cancer for the American Cancer Society. Advertisement About Americans die every year from colon cancer added Brooks and at least half of those deaths could be prevented if everyone followed the screening recommendations. Virtual colonoscopy with or without prep has some limitations. About one in five patients must undergo a standard colonoscopy after the imaging procedure to have suspicious looking polyps snipped off and biopsied. The CT scan also delivers a dose of radiation that while only onefifth of the dose of an abdominal CT scan was significant enough to raise the flags of the US Preventive Services Task Force. The government advisory group decided in not to recommend the use of virtual colonoscopy saying that evidence wasnt sufficient enough to prove that the tests benefits outweighed its harms which include a dose of radiation with every screening test. Standard colonoscopy also has rare complications such as an adverse reaction to the sedative perforation to the colon and bleeding from the site where the polyp was taken. Medicare doesnt provide coverage for the imaging test which Zalis said costs about onethird as much as the traditional scope screening. Traditional colonscopy also trumps the virtual test when is comes to detecting smaller polyps less than millimeters in size. The new study found that virtual colonosopy detected only percent of polyps under millimeters in size compared with percent detected by a scope. Whats not clear though is whether missing these smaller polyps will make a difference in terms of catching growths before they turn into cancer. Advertisement Studies are underway right now said Brooks to track these smaller lesions to see what happens to them."

"A fruitbased micronutrient and fiberdense supplement bar the CHORIbar conceived by Drs. Bruce Ames and Mark K. Shigenaga at Childrens Hospital Oakland Research Institute CHORI was shown in clinical trials to improve metabolism in overweightobese OWOB otherwise healthy adults in ways that are consistent with reduced risk of type diabetes and cardiovascular disease. Consumption of the bar for two months also reduced chronic inflammation and initiated a reduction in weight and waist circumference. Decreased inflammation and improved weight and weight distribution can lower the risk of many chronic diseases. These effects occurred without requiring that participants make any change in their current diet or other lifestyle practices other than to eat two CHORIbars each day for two months. The CHORIbar is not just another nutrition bar. It is a serious intervention to improve health. Its composition is therefore complex and required a number of years and a series of clinical trials to develop. The publication describing this work appeared online today April at The FASEB Journal http The bar was developed over the past years by a team of scientists led by Drs. Bruce N. Ames and Joyce C. McCann at CHORI in collaboration with the United States Department of Agriculture USDA. Most people do not eat an optimally nutritious diet particularly the obese. This results in unhealthy metabolism which not only diminishes vigor but increases future risk of many diseases. While poor diets contain much that is not healthy e.g. too much salt sugar they also are missing or deficient in a number of important components e.g. vitaminsminerals omega fatty acids fiber necessary for healthy metabolism. The CHORIbar is intended to fill these gaps with components present in the bar in normal dietary amounts. Considerable evidence in the scientific literature including Drs. Ames and McCanns work on vitamins and minerals supports the idea that simply supplying missing or deficient dietary ingredients will improve metabolism . Development of the CHORIbar has also been guided by Dr. Mark Shigenagas insights into the importance of a healthy gut supported by optimal nutrition for disease prevention. Because of the strong flavors associated with some vitamins and minerals CHORI partnered with the United States Department of Agriculture to produce a tasty bar. Formulation development was guided by over small clinical trials to ensure that beneficial properties of the bar were retained. Most early trials were two weeks in length and involved primarily lean individuals most of whom benefited by increased HDL cholesterol. Results presented in this publication are compiled from twomonth clinical trials that also included a significant number of overweightobese individuals. These trials were conducted over a year period using very similar bar formulations. These trials employed a simple economical design in which participants acted as their own controls i.e. change in metabolic markers was measured before and after eating the bar. Healthy metabolism is like a complex smoothrunning machine. Unhealthy metabolism is like an old machine with many rusted out joints. There is no magic bullet ingredient in nutrition oiling one joint is not going to allow the rusted out machine to run. The CHORIteam thinks the broad scale improvements observed with the CHORIbar may be the result of oiling multiple joints by the complex nutrient mixture. They are currently conducting experiments to better understand which ingredients in the bar are most important in the complex mixture for the observed effects. The increasing prevalence of obesity is taking a huge toll on public health. Conventional approaches that encourage weight loss by improving dietary habits reducing caloric intake and modifying activity can be successful but prove difficult for many to initiate and sustain. The CHORIbar is intended as a nontraditional means to positively impact the obesity epidemic by initiating a healthier metabolism without requiring sudden drastic behavioral changes. It may therefore assist in weight loss programs by beginning a process of favorable metabolic change. Improved metabolism resulting from eating the bar is also associated with a number of reports of feeling better though this observation has not yet been formally tested which the CHORI team predicts will help people transition to improved lifestyle habits. The power of nutrientrich properly formulated foodbased supplements such as the CHORIbar to move dysregulated metabolism in a healthy direction may help reverse obesityassociated conditions and thereby reduce the risk of future chronic diseases. The full potential of foodbased supplements to do the work of some drugs without their negative side effects is just beginning to be seriously investigated. About UCSF Benioff Childrens Hospital Oakland UCSF Benioff Childrens Hospital Oakland formerly Childrens Hospital Research Center Oakland is a premier notforprofit medical center for children in Northern California and is the only hospital in the East Bay devoted to pediatrics. UCSF Benioff Childrens Hospital Oakland affiliated with UCSF Benioff Childrens Hospital San Francisco on January . UCSF Benioff Childrens Hospital Oakland is a national leader in many pediatric specialties including cardiology hematologyoncology neonatology neurosurgery orthopedics pulmonology and sports medicine. The hospital is one of only five ACS Pediatric Level I Trauma Centers in the state and has one of largest pediatric intensive care units in Northern California. UCSF Benioff Childrens Hospital Oakland has licensed beds over physicians in specialties more than employees and a consolidated annual operating budget of more than million. UCSF Benioff Childrens Hospital Oakland is also a leading teaching hospital with an outstanding pediatric residency program and a number of unique pediatric subspecialty fellowship programs. UCSF Benioff Childrens Hospital Oaklands research arm Childrens Hospital Oakland Research Institute CHORI is internationally known for its basic and clinical research. CHORI is at the forefront of translating research into interventions for treating and preventing human diseases. CHORI has members of its investigative staff a budget of about million and is ranked among the nations top ten research centers for National Institutes of Health funding to childrens hospitals. For more information go to http and http References McCann J. C. Shigenaga M. K. MietusSnyder M. L. Lal A. Suh J. H. Krauss R. M. Gildengorin G. L. Goldrich A. M. Block D. S. Shenvi S. V. McHugh T. H. Olson D. A. and Ames B. N. A multicomponent nutrient bar promotes weight loss and improves dyslipidemia and insulin resistance in the overweightobese Chronic inflammation blunts these improvements. The FASEB Journal in press March . MietusSnyder M. L. Shigenaga M. K. Suh J. H. Shenvi S. V. Lal A. McHugh T. Olson D. Lilienstein J. Krauss R. M. Gildengoren G. McCann J. C. and Ames B. N. A nutrientdense highfiber fruitbased supplement bar increases HDL cholesterol particularly large HDL lowers homocysteine and raises glutathione in a wk trial. FASEB J . CHRCOCHORI . Pending United States patent application no. owned by Childrens Hospital Research Center Oakland California. Ames B. N. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. PNAS . Ames B. N. Prevention of mutation cancer and other ageassociated diseases by optimizing micronutrient intake. J Nucleic Acids pli. doi.. McCann J. C. and Ames B. N. Vitamin K an example of triage theory is micronutrient inadequacy linked to diseases of aging Am J Clin Nutr . McCann J. C. and Ames B. N. Adaptive dysfunction of selenoproteins from the perspective of the triage theory why modest selenium deficiency may increase risk of diseases of aging. FASEB J ."

"At some doses the medication lisdexamfetamine dimesylate a drug approved to treat attentiondeficithyperactivity disorder was effective compared with placebo in decreasing bingeeating BE days in patients with bingeeating disorder BED a public health problem associated symptoms of mental illness and obesity and for which there are no approved medications according to a study published online by JAMA Psychiatry. BED is characterized by recurrent episodes of excessive food consumption accompanied by a sense of loss of control and psychological distress. Cognitive behavioral therapy as well as psychotherapy can reduce BE behavior but implementation of these treatments has not been widespread. Consequently many patients with BED are undertreated despite having functional impairments and difficulties in their social and personal lives. The U.S. Food and Drug Administration has not approved pharmacologic treatments for BED according to background information in the study. Susan L. McElroy M.D. of the Research Institute Lindner Center of HOPE Mason Ohio and coauthors compared lisdexamfetamine with placebo in adults with moderate to severe BED in a randomized clinical trial from May through January . The study included and adults with BED in safety and intentiontotreat analyses respectively. The medication was administered in dosages of or mgday or placebo. BE days per week decreased in the mgd and mgd treatment groups but not in the mgd treatment group compared with the placebo group according to the study results. Results also indicate the percentage of patients who achieved fourweek BE cessation was lower with the placebo group . percent compared with the mgd . percent and mgd percent treatment groups. In the primary analysis of this study of adults with moderate to severe BED lisdexamfetamine dimesylate treatment with and mgd but not mgd demonstrated a significant decrease compared with placebo in weekly BE days per week at week . Similarly BE episodes decreased in the and mgd treatment groups. The oneweek BE episode response status was improved in the and mgd treatment groups and a greater proportion of participants achieved fourweek cessation of BE episodes and global improvement of symptom severity with all lisdexamfetamine dosages. ... Confirmation of these findings in ongoing clinical trials may results in improved pharmacologic treatment for moderate to severe BED the study concludes. JAMA Psychiatry. Published online January . doi.jamapsychiatry... Available preembargo to the media at httpmedia.jamanetwork.com. Editors Note Authors made conflict of interest disclosures. This study was supported by Shire Development LLC including funding to Scientific Communications Information and Complete Healthcare Communications Inc. for support in writing and editing the manuscript. Please see the article for additional information including other authors author contributions and affiliations financial disclosures funding and support etc. Media Advisory To contact corresponding author Susan L. McElroy M.D. call Jennifer Pierson at or email jennifer.piersonlindnercenter.org mailtojennifer.piersonlindnercenter.org"

"Lung ultrasound has been shown to be highly effective and safe for diagnosing pneumonia in children and a potential substitute for chest Xray according to a study conducted at the Icahn School of Medicine at Mount Sinai. Results are currently published in the medical journal Chest. To watch study author discuss this research click this link https Pneumonia is the leading cause of death in children worldwide according to the World Health Organization WHO. Symptoms include fever cough and rapid breathing. Chest Xray is considered the test of choice for diagnosing pneumonia in children but the WHO estimates threequarters of the worlds population does not have access to radiography. Investigators conducted a randomized controlled trial in the pediatric Emergency Department at The Mount Sinai Hospital comparing lung ultrasound to chest Xray in children from birth to years of age. The patients were randomly assigned into an investigational arm received a lung ultrasound and if the physician needed additional verification a chest Xray and a control arm received a chest Xray followed by a lung ultrasound. Researchers found a . percent reduction in chest Xrays in the investigational arm compared to no reduction in the control arm with no missed pneumonia cases and no increase in any other adverse events. The research team was led by James Tsung MD MPH Associate Professor in the Department of Emergency Medicine and Department of Pediatrics at the Icahn School of Medicine at Mount Sinai and former clinical fellow Brittany Pardue Jones MD whos currently Assistant Professor in the Department of Pediatrics at Vanderbilt University School of Medicine. Ultrasound is portable costsaving and safer for children than an Xray because it does not expose them to radiation says Dr. Tsung. Our study could have a profound impact in the developing world where access to radiography is limited. Furthermore the reduction in chest Xrays in the investigational arm resulted in an overall cost savings of and length of stay in the Emergency Department was decreased by minutes. In the era of precision medicine lung ultrasound may also be an ideal imaging option in children who are at higher risk for radiationinduced cancers or have received multiple radiographic or CT imaging studies says Dr. Tsung. As more and more handheld ultrasound machines come to market these results suggest that lung ultrasound has the potential to become the preferred choice for the diagnosis of pneumonia in children. Further research is needed to investigate the impact of lung ultrasound on antibiotic use and stewardship. About the Mount Sinai Health System The Mount Sinai Health System is an integrated health system committed to providing distinguished care conducting transformative research and advancing biomedical education. Structured around seven hospital campuses and a single medical school the Health System has an extensive ambulatory network and a range of inpatient and outpatient servicesfrom communitybased facilities to tertiary and quaternary care. The System includes approximately primary and specialty care physicians jointventure ambulatory surgery centers more than ambulatory practices throughout the five boroughs of New York City Westchester Long Island and Florida and affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is ranked as one of the nations top hospitals in Geriatrics CardiologyHeart Surgery and Gastroenterology and is in the top in five other specialties in the Best Hospitals issue of U.S. News World Report. Mount Sinais Kravis Childrens Hospital also is ranked in seven out of ten pediatric specialties by U.S. News World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked th nationally for Ophthalmology while Mount Sinai Beth Israel is ranked regionally. For more information visit http or find Mount Sinai on Facebook Twitter and YouTube."

"The first steps towards developing a vaccine against an insidious sexual transmitted infection STI have been accomplished by researchers at McMaster University. Researchers at the Michael G. DeGroote Institute for Infectious Disease Research at McMaster have developed the first widely protective vaccine against chlamydia a common STI that is mostly asymptomatic but impacts million people around the world each year and can result in infertility. In a study recently published in the journal Vaccine the researchers show that a novel chlamydial antigen known as BD is a potential vaccine candidate for the most common species of chlamydia known as Chlamydia trachomatis. As most C. trachomatis infections are asymptomatic chlamydia can often go untreated and lead to upper genital tract infections pelvic inflammatory disease and infertility. This is why the promise of a vaccine would be extremely beneficial says David Bulir coauthor of the study. Vaccine development efforts in the past three decades have been unproductive and there is no vaccine approved for use in humans said Bulir who just finished his PhD in medical sciences at McMaster. Vaccination would be the best way to way to prevent a chlamydia infection and this study has identified important new antigens which could be used as part of a vaccine to prevent or eliminate the damaging reproductive consequences of untreated infections. In the research teams study BD was able to reduce chlamydial shedding a symptom of C. trachomatis by per cent. The antigen also decreased hydrosalpinx another C. trachomatis symptom which involves fallopian tubes being blocked with serous fluids by . per cent. The results look very promising said senior author James Mahony a professor of Pathology and Molecular Medicine for McMasters Michael G. DeGroote School of Medicine and a researcher at St. Joseph Healthcare Hamiltons Research Institute where the work was performed. Coauthor and McMaster PhD student Steven Liang explains not only is the vaccine effective it also has the potential to be widely protective against all C. trachomatis strains including those that cause trachoma. Trachoma is an eye infection caused by chlamydia and is the leading cause of preventable blindness affecting millions of people in many resourcepoor regions of the world. The vaccine would be administered through the nose. This is easy and painless and does not require highly trained health professionals to administer and that makes it an inexpensive solution for developing nations he said. The next step is more testing for effectiveness against different strains of Chlamydia and in different formulations. The study was funded by the Canadian Institutes for Health Research. Editors Downloadable photos of the researchers are available online David Bulir James Mahony and Steven Liang McMaster provides a high definition broadcast studio that can connect with any television broadcaster around the world. To book an interview please contact Tucker Wilson Media Relations Faculty of Health Sciences McMaster University ext. Wilsotmcmaster.ca mailtoWilsotmcmaster.ca"

"In a bid to increase treatments for the nations million obese adults the Food and Drug Administration has approved U.S. marketing of an implantable device that stimulates weight loss by manipulating key appetite signals passing between the brain and the gut. The new device is the Maestro Rechargeable System manufactured by EnteroMedics of St. Paul Minn. While the FDA has approved four medications for weight loss in the past years the Maestro system is the first weight loss device to be approved since . Using electrical leads implanted just above the stomach and a regulator carried under the skin near the ribcage the device suppresses signals carried by the vagus nerve. The device adopts a variant of a neuromodulation technique long used in the treatment of epilepsy by applying intermittent bursts of electrical current to the vagus nerve it disrupts the signals that prompt the stomach to relax expand and prepare for an influx of food. We think it will be a very important tool in the toolbag of surgeons and physicians treating obesity and its comorbidities said Gregory S. Lea senior vice president and chief financial officer of EnteroMedics. When patients leave the diet counseling and drug world and have nothing more they turn to surgical procedures and only to of patients who might be eligible for bariatric surgery are getting it. The FDA approved the use of the device in adult patients with a body mass index or BMI between and who have at least one other obesityrelated condition such as type diabetes. Delivered by the Maestro device vagal blocking therapy or VBLOC offers obese patients a weight loss therapy that does not permanently alter the digestive system in the way that gastric bypass surgery does and which may be less expensive said Lea. He added it poses no risk of the malabsorption problems that often come with such surgery. In a month clinical trial considered by the FDA . of subjects who received the active Maestro device lost at least a quarter of their excess weight and . of subjects lost at least of their excess weight. On average weight loss in those subjects with an active device was about . greater than that seen in subjects who received a Maestro electrical pulse generator that was not activated. The human bodys longest cranial nerve the vagusor wanderingnerve stretches from the lower abdomen up to the brain stem passing through the heart esophagus and lungs. A key node in the bodys involuntary nervous system it carries signals between body and brain that control heart rate digestive processes and respiration. In a to minute laparoscopic procedure physicians trained to implant the new device will attach its electrical leads to the anterior and posterior trunks of the vagus nerve right at the gastric junction. During a patients waking hours the device is designed to alternate between delivering fiveminute bursts of highfrequency energy and five minutes of inactivity. During sleep the device powers down. By suppressing the exchange of messages that cue hunger and ready the stomach for food the intermittent electrical currents make most feel less hungry feel full sooner and to feel full for longer. Most eat less and lose weight. Researchers testing the device also observed that like bariatric surgery it might have beneficial effects that go beyond weight loss. Suppressing signals between gut and brain on the vagus nerve appeared to improve the metabolic function of obese patients who got the device. You actually see the effect before patients actually have had that much weight loss said Dr. Ken Fujioka a Scripps Institute endocrinologist and weight management expert who conducted some of the studies that led to the EnteroMedics device. That suggests that the device may be especially beneficial for those who have developed obesityrelated type diabetes he said. The onagain offagain nature of the Maestro devices stimulation serves another purpose it prevents the vagus nerves gut signals from going silenta communication loss that would likely prompt the central nervous system to find a compensatory workaround. As a result said Lea the Maestro device appears to be safe and effective for longterm use and unlike surgical alterations to the digestive system reversible. Women who have had the device implanted and became pregnant were able to have it inactivated during their pregnancy and then reactivated afterward he said. While the cost of the device has not yet been set Lea said that getting the device implanted and activated will likely cost somewhere between and an amount that is more than gastric banding but less some of the most complex gastric bypass surgery. The company has begun negotiations with private insurers and the device has been been recognized as exploratory by the board that sets policy for Medicare reimbursements and Lea expressed hope that some might agree to cover the procedure as early as later this year. Watching the nations weight as well as your own Me too. Follow me on Twitter LATMelissaHealy httpstwitter.comLATMelissaHealy and like Los Angeles Times Science Health https on Facebook."

"The decision on whether to give young children antibiotics to treat ear infections has been swinging from one extreme to the other as conflicting clinical trials have pushed pediatricians first toward widespread use of antibiotics then toward a watch and wait approach in which most infections seem to clear up on their own. Two new trials reported Wednesday in the New England Journal of Medicine are nudging the pendulum back toward treatment of the infections known formally as acute otitis media especially for the youngest children. They show that the use of antibiotics in infants under age is only modestly effective and reduces the duration of symptoms by only a small amount but it prevents relapses and progression of the disease. The trials are indicative of a benefit to treatment of acute otitis media in children specifically when the diagnosis is certain said Dr. Wilbert Mason an infectious diseases specialist at Childrens Hospital Los Angeles who was not involved in the study. The reduction of symptoms was marginal he said but they were less likely to have a relapse or to have persistent signs of infection at the end of therapy. The findings confirms the current guidelines for treating children under age said Dr. Al Lieberthal of USCs Keck School of Medicine who is in charge of the American Academy of Pediatrics Committee that prepared the guidelines. The guidelines will be revised in light of the new studies however to tighten the definition of acute otitis media he added. There have been at least a dozen previous clinical trials studying the use of antibiotics in ear infections known formally as acute otitis media. These have given mixed results according to Dr. Anthony S. Fauci director of the National Institute of Allergy and Infectious Diseases because of poor study design and especially because of poor diagnosis of the subjects conditions. In many cases the children had something that looked like otitis media but really wasnt he said. The new studies had really precise criteria to be eligible for enrollment which makes them substantial studies. In one of the studies Dr. Alejandro Hoberman of the University of Pittsburgh School of Medicine and his colleagues studied children age months to months with stringently defined acute otitis media. Half were given the antibiotic amoxicillinclavulanate for days and half a placebo. In the second study Dr. Paula A. Tahtinen of Turku University Hospital in Finland and her colleagues studied children age months to months half of whom were given the antibiotic and half a placebo for seven days. In the Pittsburgh study of the children receiving an antibiotic had a resolution of symptoms by day seven compared with of those receiving a placebo. But of those receiving an antibiotic had a sustained resolution of symptoms compared with of those who got the placebo. The Finnish study looked for continuing symptoms which is known as treatment failure. It found that at the end of seven days treatment failure occurred in . of those who received antibiotic compared with . of those who received a placebo. That sounds like a big improvement said Dr. Richard Rosenfeld chair of otolaryngology at SUNY Downstate Medical Center in Brooklyn who also helped prepare the AAPs guidelines but all it means is that if the eardrum looked nasty the treatment failed. Eardrums sometimes take weeks to months to recover. That finding to me is a bit of a dubious way to say that everybody needs treatment. Experts noted however that certain children should receive immediate antibiotic treatment regardless of age. That includes those who are under months of age those who have a draining ear caused by a ruptured eardrum those with severe symptoms early on and those with infections in both ears. But physicians are reluctant to give antibiotics indiscriminately because of the side effects which include diarrhea yeast infections oral thrush allergic reactions and resistant bacteria. You pay a price for a little bit of improvement Rosenfeld said."

"In the late s the steroid cortisone an antiinflammatory drug was first synthesized and hailed as a landmark. It soon became a safe reliable means to treat the pain and inflammation associated with sports injuries as well as other conditions. Cortisone shots became one of the preferred treatments for overuse injuries of tendons like tennis elbow or an aching Achilles which had been notoriously resistant to treatment. The shots were quite effective providing rapid relief of pain. Then came the earliest clinical trials including one published in that raised incipient doubts about cortisones powers. In that early experiment more than half the patients who received a cortisone shot for tennis elbow or other tendon pain suffered a relapse of the injury within six months. But that cautionary experiment and others didnt slow the ascent of cortisone also known as corticosteroids. It had such a magical immediate effect against pain. Today cortisone shots remain a standard muchrequested treatment for tennis elbow and other tendon problems. But a major new review article https published last Friday in The Lancet should revive and intensify the doubts about cortisones efficacy. The review examined the results of nearly four dozen randomized trials which enrolled thousands of people with tendon injuries particularly tennis elbow but also shoulder and Achillestendon pain. The reviewers determined that for most of those who suffered from tennis elbow cortisone injections did as promised bring fast and significant pain relief compared with doing nothing or following a regimen of physical therapy. The pain relief could last for weeks. But when the patients were reexamined at and months the results were substantially different. Over all people who received cortisone shots had a much lower rate of full recovery than those who did nothing or who underwent physical therapy. They also had a percent higher risk of relapse than people who adopted the timehonored waitandsee approach. The evidence for cortisone as a treatment for other aching tendons like sore shoulders and Achillestendon pain was slight and conflicting the review found. But in terms of tennis elbow the shots seemed to actually be counterproductive. As Bill Vicenzino the chairman of sports physiotherapy at the University of Queensland in Australia and senior author of the review said in an email response to questions There is a tendency among tenniselbow sufferers for the majority percent of those following a waitandsee policy to get better after six months to a year. But this is not the case for those getting cortisone shots he wrote they tend to lag behind significantly at those time frames. In other words in some way the cortisone shots impede full recovery and compared with those adopting a waitandsee policy those getting the shots are worse off. Those people receiving multiple injections may be at particularly high risk for continuing damage. In one study that the researchers reviewed an average of four injections resulted in a percent worse outcome when compared to one injection Dr. Vicenzino said. Why cortisone shots should slow the healing of tennis elbow is a good question. An even better one though is why they help in the first place. For many years it was widely believed that tendonoveruse injuries were caused by inflammation said Dr. Karim Khan a professor at the School of Human Kinetics at the University of British Columbia and the coauthor of a commentary in The Lancet https accompanying the new review article. The injuries were as a group given the name tendinitis since the suffix itis means inflammation. Cortisone is an antiinflammatory medication. Using it against an inflammation injury was logical. But in the decades since numerous studies have shown persuasively that these overuse injuries do not involve inflammation. When animal or human tissues from these types of injuries are examined they do not contain the usual biochemical markers of inflammation. Instead the injury seems to be degenerative. The fibers within the tendons fray. Today the injuries usually are referred to as tendinopathies or diseased tendons. Why then does a cortisone shot an antiinflammatory work in the short term in noninflammatory injuries providing undeniable if ephemeral pain relief The injections seem to have an effect on the neural receptors involved in creating the pain in the sore tendon Dr. Khan said. They change the pain biology in the short term. But he said cortisone shots do not heal the structural damage underlying the pain. Instead they actually impede the structural healing. Still relief of pain might be a sufficient reason to champion the injections if the pain were severe Dr. Khan said. But its not. The pain associated with tendinopathies tends to fall somewhere around a or so on a point scale of pain. Its not insignificant but its not kidney stones. So the question of whether cortisone shots still make sense as a treatment for tendinopathies especially tennis elbow depends Dr. Khan said on how you choose to balance shortterm pain relief versus the likelihood of longerterm negative outcomes. In other words is reducing soreness now worth an increased risk of delayed healing and possible relapse within the year Some people including physicians may decide that the answer remains yes. There will always be a longing for a magical pill the quick fix especially when the other widely accepted and studied alternatives for treating sore tendons are to do nothing or more onerous to some people to rigorously exercise the sore joint during physical therapy. But if he were to dispense advice based on his findings and that of his colleagues systematic review Dr. Vicenzino said he would suggest that athletes with tennis elbow and possibly other tendinopathies think not just once or twice about the wisdom of cortisone shots but three or four times."

"EMBARGOED FOR RELEASE A.M. ET TUESDAY AUGUST Media Advisory To contact Paul D. Miller M.D. call or email millerccbraol.com mailtomillerccbraol.com. To contact editorial coauthor Anne R. Cappola M.D. Sc.M. email Abbey Anderson at Abbey.Andersonuphs.upenn.edu mailtoAbbey.Andersonuphs.upenn.edu. To place an electronic embedded link to this study and editorial in your story These links will be live at the embargo time httpjama.jamanetwork.comarticle.aspxdoi.jama.. httpjama.jamanetwork.comarticle.aspxdoi.jama.. Among postmenopausal women with osteoporosis at risk of fracture daily injection of the drug abaloparatide for months significantly reduced the risk of new vertebral and nonvertebral fractures compared with placebo according to a study appearing in the August issue of JAMA. Osteoporosis is associated with substantial social economic and public health burdens. Based on U.S. Census data a study estimated the prevalence of osteoporosis among women to years of age at . million. It has been estimated that the lifetime risk of osteoporotic fracture for a yearold woman is percent. Additional therapies are needed for prevention of osteoporotic fractures. As a result of its mechanism of action it has been hypothesized that the drug abaloparatide a synthetic peptide would have a more pronounced anabolic i.e. bone growing action on bone compared with the osteoporosis drug teriparatide. Paul D. Miller M.D. of the Colorado Center for Bone Research Lakewood Colo. and colleagues randomly assigned postmenopausal women with osteoporosis to receive daily injections for months of placebo n abaloparatide n or teriparatide n . The trial was conducted at sites in countries. Among women average age years completed the study. New vertebral fractures occurred less frequently in the active treatment groups vs placebo in . percent n of participants in the abaloparatide group in . percent n of participants in the teriparatide group and in . percent n of those in the placebo group. The estimated event rate for nonvertebral fracture was lower with abaloparatide vs placebo . percent in the abaloparatide group . percent in the teriparatide group and . percent in the placebo group. Bone mineral density BMD increases were greater with abaloparatide than placebo. Incidence of hypercalcemia the presence of abnormally high levels of calcium in the blood was lower with abaloparatide . percent vs teriparatide . percent. Overall there were no differences in serious adverse events between the treatment groups. Further research is needed to understand the clinical importance of risk difference the risks and benefits of abaloparatide treatment and the efficacy of abaloparatide vs other osteoporosis treatments the authors write. doi.jama.. the study is available preembargo to the media at the For the Media website httpmedia.jamanetwork.com Editors Note This study was funded by Radius Health. Please see the article for additional information including other authors author contributions and affiliations financial disclosures etc. Editorial Osteoporosis Therapy in Postmenopausal Women With High Risk of Fracture Ultimately which therapy is selected for osteoporosis treatment may be less important than identifying and initiating an approved treatment write Anne R. Cappola M.D. Sc.M. of the Perelman School of Medicine at the University of Pennsylvania Philadelphia and Associate Editor JAMA and Dolores M. Shoback M.D. of the University of California San Francisco in an accompanying editorial. The bar is high for any preventive treatmentin the efforts to prevent a fracture that may or may not ever occur prescribers do not want to prescribe a therapy that causes a new problem. The way forward for fracture prevention involves not only the development of better therapies to prevent fracture and easier delivery systems but also improved adoption of existing osteoporosis therapies for patients with prior fractures and minimization of adverse effects particularly those associated with longterm use. doi.jama.. the editorial is available preembargo to the media at the For the Media website httpmedia.jamanetwork.com Editors Note Both authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported."

"A clinical trial among more than patients has found that the drug ranibizumab Lucentis is highly effective in treating proliferative diabetic retinopathy PDR a complication of diabetes that can severely damage eyesight. The results published by the Journal of the American Medical Association demonstrate the first major therapy advance for the condition in nearly years. Funded by the National Eye Institute NEI and conducted by the Diabetic Retinopathy Clinical Research Network DRCR.net the trial compared Lucentis injections with a type of laser therapy called panretinal photocoagulation which has remained the gold standard for PDR since the mids. Although laser therapy preserves central vision it can damage night and side vision so researchers have sought therapies that lack these side effects. The trial results provide crucial evidence for a safe and effective alternative to laser therapy against PDR said NEI Director Paul A. Sieving M.D. Ph.D. Patients who received Lucentis showed a little bit better central vision much less loss of their side vision and substantially less risk for surgery than patients who received laser treatment said Lloyd Paul Aiello M.D. Ph.D. director of the Beetham Eye Institute at Joslin Diabetes Center and Professor of Ophthalmology at Harvard Medical School. These findings will change the available treatment options for patients with PDR. Diabetic retinopathy damages blood vessels in the lightsensitive retina in the back of the eye. As the disease worsens blood vessels can swell and lose their ability to function properly. Diabetic retinopathy becomes proliferative when lack of blood flow in the retina increases production of a protein called vascular endothelial growth factor VEGF which can stimulate the growth of new abnormal blood vessels. These new vessels are prone to bleeding into the center of the eye sometimes requiring a surgical procedure called a vitrectomy to clear the blood. The abnormal blood vessels can also cause scarring and retinal detachment. Untreated PDR is associated with high risk of visual loss. Lucentis is among several drugs that block the effects of VEGF. Dr. Aiello and George King M.D. Chief Scientific Officer at Joslin Diabetes Center and Professor of Medicine at Harvard Medical School pioneered the study of VEGF in diabetic eye disease beginning in the early s. Their work followed a distinguished Joslin traditionthe basic laser photocoagulation technique was developed in the s by Dr. Aiellos father Lloyd M. Aiello M.D. and grandfather William P. Beetham M.D. About . million U.S. residents have diabetic retinopathy a leading cause of blindness among workingage Americans. Among these about . percent have progressed to PDR. The DRCR.net enrolled participants eyes with PDR in one or both eyes at clinical sites across the country. Eyes were assigned randomly to treatment with Lucentis or laser. About half of the eyes assigned to the laser group required more than one round of laser treatment. In the other group Lucentis was injected into the eye once per month for three consecutive months and then as needed until the disease resolved or stabilized. Because Lucentis is commonly injected to treat diabetic macular edema DMEa buildup of fluid in the center of the retinathe study permitted the use of Lucentis for DME in the laser group if necessary. Slightly more than half percent of eyes in the laser group received Lucentis injections to treat DME. About percent of eyes in the Lucentis group received laser therapy mostly for issues other than DME. At two years vision in the Lucentis group improved by an average of about half a line on an eye chart compared with virtually no change in the laser group. Participants treated with laser generally lost substantial peripheral vision but those given injections did not emphasized Jennifer Sun M.D. M.P.H. Associate Professor of Ophthalmology at Harvard Medical School and physician at the Beetham Eye Institute. This was a clear benefit associated with the antiVEGF medication said Dr. Sun who as the DRCR.net nationwide Protocol Working Investigator was instrumental in the studys development. Many of our patients who have laser treatment notice that they have more tunnel vision which can lead to difficulties as they go about activities of daily life. The use of antiVEGF treatment rather than laser for PDR could help prevent these symptoms. Additionally the need for vitrectomy surgery was lower in the Lucentis group of eyes than in the laser group of eyes. Overall the drugs benefits are particularly clear for people with both PDR and DME. We know that this drug will help treat both conditions at the same time so this is an especially appealing treatment alternative for these patients Dr. Aiello noted. Lucentis should be considered a viable treatment option for people with PDR especially for individuals needing antiVEGF for DME said Jeffrey G. Gross M.D. of the Carolina Retina Center in Columbia South Carolina who chaired the clinical study. The study also suggested that Lucentis may help prevent DME. Among people without this condition at the start of the study only percent of Lucentistreated eyes developed it compared with percent in the laser group. Scientists will follow up on that result as the DRCR.net continues to track patients for a total of five years. A separate clinical trial now getting underway will examine whether antiVEGF injections given at an earlier stage of diabetic eye disease can help prevent people from developing both DME and the sightthreatening PDR stage of the disease at all Dr. Aiello said. The trial reported today is a major study that may substantially change our approach to treatment of PDR summed up Dr. Sun. Laser still has a role in the treatment of PDR for some patients but antiVEGF therapy gives us another tool in our search for better vision outcomes in our patients with diabetes. About Joslin Diabetes Center Founded in Joslin Diabetes Center is worldrenowned for its deep expertise in diabetes treatment and research. Joslin is an independent nonprofit institution affiliated with Harvard Medical School and a federallydesignated Diabetes Research Center. Joslin is dedicated to finding a cure for diabetes and ensuring that people with diabetes live long healthy lives. We develop and disseminate innovative patient therapies and scientific discoveries throughout the world. Our mission is to prevent treat and cure diabetes. Our vision is a world free of diabetes and its complications. For more information visit http About Joslin Research Joslin Research comprises the most comprehensive and productive effort in diabetes research under one roof anywhere in the world. With plus facultylevel investigators Joslin researchers focus on unraveling the biological biochemical and genetic processes that underlie the development of type and type diabetes and related complications. Joslin research is highly innovative and imaginative employing the newest tools in genetics genomics and proteomics to identify abnormalities that may play a role in the development of diabetes and its complications. Joslin Clinic patients and others with diabetes have the option of participating in clinical trials at Joslin to help translate basic research into treatment innovations. Joslin has one of the largest diabetes training programs in the world educating M.D. and Ph.D. researchers each year many of whom go on to head diabetes initiatives at leading institutions all over the globe. For more information visit http"

"Elekta EKTAB.ST today announced new data demonstrating stereotactic body radiation therapy SBRT is a safe treatment option for earlystage lung cancer patients aged or older. The results which were based on data from more than patients across five institutions that comprise the Elekta Lung Research Group are available online and will be published in the July print issue of International Journal of Radiation Oncology Biology Physics http The study evaluated safety and efficacy outcomes of patient reports collected in a multiinstitutional database. Patients were treated with SBRT for earlystage lung cancer between and and followed for a median of . years. The cohort included patients under years of age patients ages to years and patients aged years or more which included patients aged years or more. The median age was years range to . Study results show no significant differences among the three age groups with respect to year local recurrence regional recurrence distant metastases or the incidence of grade or higher toxicity. Causespecific survival was similar among all three age groups . to . percent. Twoyear overall survival was lower in older patients which is likely related to other medical issues. Older patients are often not considered for radiation therapy due to concerns about their ability to tolerate treatment. The results of our study clearly support the use of SBRT for elderly patients especially those who may not be able to tolerate longer courses of radiotherapy or more invasive treatment options says Meredith Giuliani MBBS FRCPC MEd a radiation oncologist in the Cancer Clinical Research Unit at Princess Margaret Cancer Centre University Health Network in Toronto and lead study author. Radiation oncologists need to work closely with our peers in other parts of the medical community to ensure that patients with diagnosed or suspected earlylung cancer are evaluated for potential treatment with SBRT regardless of age. This study is the largest series of its type to evaluate SBRT outcomes in patients aged years and older says Joel Goldwein MD Senior Vice President Medical Affairs for Elekta. In addition to providing important support for using SBRT to treat earlystage lung cancer in elderly patients these findings highlight the value of multiinstitutional collaborations and large data sets that can provide statistically meaningful answers to critical questions about treatment outcome and guide clinical decision making. The Elekta Lung Research Group ELRG is an international collaboration of physicians and physicists that is evaluating clinical outcomes in earlystage nonsmall cell lung cancer patients. To date they have accumulated data on close to such patients and identified medical and technical factors that affect tumor control and toxicity. Their collective experience is among the largest multinational series of patients treated with imageguided SBRT to date. The ELRG includes participants from William Beaumont Hospital in Royal Oak Michigan Princess Margaret Cancer Centre Thomas Jefferson University in Philadelphia Pennsylvania JuliusMaximilians University of Wrzburg in Wrzburg Germany and The Netherlands Cancer InstituteAntoni van Leeuwenhoek hospital in Amsterdam The Netherlands. Disclosure This research was partially supported by Elekta through a research grant with all institutions being members of the Elekta Lung Research Group. This work and these data however are the intellectual property of the individual group members and their sponsoring institutions. The authors declare no other conflicts of interest. The following files are available for download httpmb.cision.comMain.pdfPDF SOURCE Elekta"

"FROM a marketing perspective theres something alluring about being a beauty outsider. Just ask Allison Slater the vice president for retail marketing at Sephora about the new antiaging skin care line Algenist featuring a star ingredient alguronic acid that scientists in San Francisco say they stumbled upon while researching microalgae. Retailing for to Algenist moisturizers serum and eye balm are already available at Sephora.com and will go on sale in the companys stores this week. When we saw it we thought it was so unique such innovation something our clients could really understand Mrs. Slater said of the line. The whole story about this being an unexpected discovery. Mrs. Slater added that it made sense to her that alguronic acid a compound that protects microalgae cells according to Algenists maker Solazyme could also protect middleaged faces from environmental assault. Think about how algae can live anywhere live in the coldest of places or the harshest of places and think about translating that to skin care she said. Dermatologists might not wholeheartedly share Sephoras enthusiasm. But a surprising story about a products genesis can be just as important for generating sales as the products demonstrable efficacy. Consider Crme de la Mer which like Algenist contains sea matter and also involves an enterprising scientist an aerospace physicist trying to heal scars he suffered in a lab accident. Its a slightly different story said Nica Lewis the head consultant of beauty innovation at Mintel a market research firm. But its still brainy scientist comes up with cosmetic product. According to Jonathan Wolfson the chief executive of Solazyme the alternativeenergy company that makes Algenist the product came about after a fortuitous suggestion roughly six years ago by Arthur Grossman a microalgae expert whos now an adviser to the brand. At first Solazyme executives had a good chuckle about the idea of getting into skin care Mr. Wolfson said. I really never thought Id be standing in a store like this he told a gathering of reporters during a preview at Sephora Fifth Avenue amid shiny display cases of primer and volumizing mascara. It may seem novel for a nonbeauty company to get into skin care but these days it really isnt Mrs. Lewis said. There are ingredient suppliers that provide ingredients to health care food and drink industries and cosmetic companies she said. In Japan food and health care companies have found cosmetic applications for their ingredients so they are creating skin care brands. For example Frutarom http a flavoringredient house based in Israel makes Alguard a purified polysaccharide shield from a red microalgae that it says protects skin from daily assaults and reduces roughness as well as the look of fine lines. There are more than algaederived ingredients used in cosmetics worldwide Mrs. Lewis said. The patentpending alguronic acid in Algenist is a single purified highly bioactive compound said Tony Day the vice president for research and development at Solazyme and therefore delivers much higher activity to the skin than products using only a microalgae extract. Studies conducted by an independent lab and commissioned by Algenist none of which have been published in a peerreviewed journal showed alguronic acid increased cell regeneration and the synthesis of elastin which gives skin that snapback youthful quality. This testing also demonstrated that alguronic acid provided protection against cell damage induced by ultraviolet rays and inhibited the enzymes that break down elastin. After reviewing press materials and Solazymes page patent application Dr. David McDaniel a dermatologist and the director of the Institute of AntiAging Research http in Virginia Beach Va. said he was impressed by the invitro testing of alguronic acid. In the petri dish their data seems to show some substantial benefits to their active ingredient he said. But he cautioned that invitro testing does not demonstrate how a final formulation works off the shelf. Dr. Dana Sachs an associate professor of dermatology at the University of Michigan Ann Arbor wrote in an email after looking at Algenists dossier that the claims on cell regeneration and elastin synthesis are based on in vitro models which is hard to extrapolate to in vivo and again no statistical significance is presented so this is a weak claim. Dr. Day who has a doctorate in biochemistry said that statistical significance was found but not included in press materials. And according to the company a study of women showed that after days of using the Algenist serum they had a percent decrease in wrinkles httphealth.nytimes.comhealthguidessymptomswrinklesoverview.htmlinlinenytclassifier as shown by silicone replicas of their faces. Dr. Ellen Marmur the chief of the division of dermatologic and cosmetic surgery httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsplasticsurgeryindex.htmlinlinenytclassifier at Mount Sinai Medical Center in Manhattan did say Algenist could fairly claim that alguronic acid offers protection against ultraviolet damage to cells and that she might use the product as a nice sun protection on top of S.P.F. protection. Algenist literature touts alguronic acids superiority to hyaluronic acid retinol httphealth.nytimes.comhealthguidesnutritionvitaminaoverview.htmlinlinenytclassifier and vitamin C httphealth.nytimes.comhealthguidesnutritionvitamincoverview.htmlinlinenytclassifier among other antiaging ingredients in encouraging elastin synthesis and cell regeneration. But Dr. McDaniel who does research into using plantderived products to lengthen the life of cells says he thinks the comparative data must be viewed with caution because the studies that yielded it are challenging to do accurately hard to interpret and not necessarily predictive of final products. Soon consumers will judge whether Algenist products are a breakthrough. In an unusual move Sephora is introducing the line in locations in countries all at once in a rollout coordinated with QVC. It was a brand nobody has ever heard of said Allen Burke the senior adviser for beauty strategy and development at QVC. We want to give it a lot of visibility all at the same time. But Mr. Burke knows that marketing has its limits. It can be the most interesting story in the world he said. But if it doesnt deliver its not a business that we can do."

"Immunotherapy reduces cardiovascular risk in patients with rheumatoid arthritis according to research presented today at Frontiers in CardioVascular Biology FCVB by Professor Aida Babaeva head of the Department of Internal Medicine Volgograd State Medical University Volgograd Russia. The combination of two extralow dose anticytokine drugs reduced rheumatoid arthritis disease activity and cardiovascular events. Rheumatoid arthritis is an autoimmune disease in which cytokines such as tumour necrosis factor TNF and interferon IFN which normally protect the body attack healthy cells said Professor Babaeva. Patients have painful and inflamed joints. They are also at increased cardiovascular risk particularly if their rheumatoid arthritis is not controlled. Professor Babaevas previous research showed that treatment with anticytokine drugs can decrease the activity of rheumatoid arthritis. Extralow dose antiTNFa reduced levels of inflammatory mediators and cytokines including Creactive protein CRP rheumatoid factor TNF interleukin IL and interleukin IL. The effect was more apparent and developed earlier when patients were treated with a combination of antiTNFa and antiIFN both at extralow doses. The current study investigated the impact of the combination of drugs on cardiovascular events. It included patients who had suffered from active rheumatoid arthritis for at least five years. Patients were randomised to receive the combination of antiTNFa and antiIFN plus standard diseasemodifying therapy patients or placebo plus standard therapy patients. During the three year follow up period the investigators monitored rheumatoid arthritis disease activity and cardiovascular events. Patients taking the combination of anticytokines had a lower rheumatoid arthritis disease activity score as measured by the DAS and more dramatic decreases in IL IL and TNFa than the group on standard therapy alone. The incidence of cardiovascular events unstable angina severe hypertensive crisis and deterioration of chronic heart failure was more than double in the group on conventional diseasemodifying drugs alone compared to those also taking the combination of anticytokines . Professor Babaeva said Our findings suggest that the decreased rheumatoid arthritis disease activity with the combination of anticytokines translates into decreased cardiovascular risk. Rheumatoid arthritis promotes the development of cardiovascular disease in a number of ways. Therefore decreasing disease activity may also reduce cardiovascular risk by slowing down or halting these processes. For example rheumatoid arthritis is associated with dysfunction of the blood vessel lining called endothelium which leads to lipid accumulation in the artery wall plaque formation and atherosclerosis. Increased disease activity is also linked with a procoagulant state in which patients are more prone to blood clots and thrombosis. Patients with active disease have an increase in molecules that promote inflammation which has been associated with an increased risk of cardiovascular disease. In patients with hypertension target blood pressure was reached in of those taking the combination of anticytokines compared to just of patients on standard therapy alone. Professor Babaeva said This doesnt mean that the two drugs directly impact on blood pressure. But the combination can improve endothelial function and it could be that blood pressure is more stable when disease activity is low. We found that the combination of two anticytokines containing extralow doses of antibodies against TNFa and IFN can improve the efficacy of standard rheumatoid arthritis therapy and decrease cardiovascular risk said Professor Babaeva. She concluded We do not think that all patients with rheumatoid arthritis should be treated with this combination. In patients with highly active disease the standard biologics are better at preventing severe complications such as progressive joint destruction andor systemic manifestations vasculitis uveitis involvement of internal organs. We recommend this new approach for preventing cardiovascular events in patients with moderate disease activity who are not receiving the standard biologics and who do not have severe complications."

"Boosting the effect of acupuncture needles with small electric currents may be effective in treating depression a study in Hong Kong has found. Led by Zhang Zhangjin at the School of Chinese Medicine University of Hong Kong the researchers used electroacupuncture to stimulate seven spots on the heads of participants who had suffered several bouts of depression in the last years. The electroacupuncture was given in addition to medication that the patients were already taking and meant to augment their treatment Zhang told a news conference. Half the patients received electroacupuncture nine times over three weeks while the other half the placebo group only had needles inserted superficially into their heads. They were later assessed by experts for their depression levels and the group that received genuine electroacupuncture was found to be a lot happier. The drop in depression scores among the group receiving active treatment was more significant than the placebo group said Roger Ng another researcher in the group which published their findings in the journal PLoS Public Library of Science ONE. When the acupoints are stimulated some brain centres responsible for producing serotonin are stimulated explained Ng a consultant at the department of psychiatry at the Kowloon Hospital in Hong Kong. An imbalance in serotonin levels is believed to be linked to depression. Depression affects about percent of people at some point in their lives. The World Health Organisation predicts that by depression will rival heart disease as the health disorder with the highest disease burden in the world. Zhang said his group may consider moving into another trial using only electroacupuncture on patients suffering milder depression."

"An experimental Alzheimer https treatment slowed memory loss https by about onethird in people with mild Alzheimers https offering hope that the drug can alter the course of the progressive disease. Called solanezumab the drug attaches to a protein called betaamyloid that builds up and clumps together to form sticky plaques that riddle Alzheimers https patients brains. The drug is designed to prevent those clumps from forming. The benefit is small and studies have been inconsistent says researcher Rachelle Doody MD head of Alzheimers disease research at Baylor College of Medicine. But the study offers evidence that targeting betaamyloid can benefit patients she says. Larger studies in many more patients are needed before the drug will be available though she says. The findings were presented here at the American Neurological Association meeting. Encouraging Results Maria Carrillo PhD a neuroscientist and vice president for medical and scientific relations for the Alzheimers Association calls the results encouraging and says she hopes development will continue. While betaamyloid is the leading hypothesis of what causes the disease that has remained unproven. This study may not have hit on everything and it is not the home run we wanted but it is the first time weve seen cognitive benefit with an amyloid treatment she says. The latest results come from a combined analysis of a patient study and a patient study both of which involved people with mild to moderate Alzheimers disease. When the findings of the two studies were looked at individually patients given solanezumab for months didnt do better on either a test used to measure patients symptoms or a measure of how well patients are functioning than patients given a placebo https Combining the two studies to give them more statistical power showed that patients on solanezumab didnt lose their memories as quickly as those on placebo. The results really became clear when the researchers looked only at those patients with mild earlystage disease. In the analysis those given solanezumab had a reduction in memory loss https and other mental symptoms compared with those on placebo. There was even a hint that the drug helped to slow the decline in functioning. Asked if the improvement in cognitive decline is meaningful to a patient Carrillo said I have a family member with AD. I would be happy with a sustained cognitive benefit for my motherinlaw. The only side effect that happened more often in people on solanezumab than patients on placebo was chest pain https . vs. .. Other Alzheimers Drugs in LateStage Testing There are more than million Americans living with Alzheimers disease https which disrupts memory learning and other mental functions. In estimates showed nearly half a million new cases each year and by there will be nearly a million new cases annually according to the Alzheimers Association. Also at the meeting researchers offered an update on another drug called bapineuzumab which targets betaamyloid in the brain https In August researchers reported that patients taking bapineuzumab didnt fare any better in terms of memory loss or daily functioning than those taking placebo. Reisa Sperling MD director of the Center for Alzheimers Research and Treatment at Brigham and Womens Hospital in Boston now reports that imaging studies show bapineuzumab reduces betaamyloid more than placebo. Is the lack of a bigger effect in terms of reducing symptoms because we are giving too little of the drug or giving the drug too late she asks. Hopefully these new results from the bapineuzumab studies together with the clinical results from the solanezumab studies may provide a potential path forward for Alzheimers research Sperling says. No cost has been set for either drug but targeted diseasemodifying drugs used to treat arthritis https generally cost hundreds of dollars a month. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"Chelation therapy is a risky procedure approved to treat rare lifethreatening cases of heavy metal poisoning. A taxpayerfunded study tested whether it could reduce heart attacks Controversial therapy showed small benefit in preventing heart problems Study authors dont advocate the therapy which strips metals from the blood At least people have died from chelation since the s including yearold autistic boy A heart disease study presented Sunday is being called a million waste of time and even a danger to public health by some of the countrys leading health experts. The taxpayerfunded study tested whether a controversial alternative therapy called chelation could reduce heart attacks and other cardiovascular problems in people who had already survived a heart attack. Chelation therapy which can remove metals from the blood is a risky procedure approved to treat rare lifethreatening cases of heavy metal poisoning. Tens of thousands of patients a year undergo the procedure offlabel however paying around outofpocket based on the claims of doctors who say it can cure everything from Alzheimers to autism. National Institutes of Health officials say they launched the study because there has never been any evidence that the practice is effective or safe. In a presentation Sunday doctors said the trial found a small overall benefit to chelation mainly because it prevented heart problems in people with diabetes. Elliott Antman chair of the American Heart Associations Scientific Sessions program committee praised NIH for doing the study. Kudos for funding a trial that says OK if people are lining up to have this done lets let it undergo rigorous clinical trials Antman said in an interview before the results were unveiled. In a statement after the study was presented Antman a cardiologist at Bostons Brigham and Womens Hospital and professor of medicine at Harvard Medical School added Intriguing as the results are they are unexpected and should not be interpreted as an indication to adopt chelation therapy into clinical practice. Yet some doctors say the study was far from rigorously performed and so badly run that its marginally positive results are meaningless. Cardiologist Steven Nissen of the Cleveland Clinic one of the USAs most respected heart experts says hes concerned the study will encourage more patients to get offlabel chelation instead of taking proven medications or making lifestyle changes that clearly have been shown to reduce heart disease. This study has the potential to be extremely dangerous Nissen says. Chelation should not be administered to any patients for the indication of heart disease. ... There are a lot of people including me who believe this was a poor use of taxpayer dollars. At least patients have died from offlabel chelation therapy since the s including an autistic yearold Pennsylvania boy according to a report in The Medscape Journal of Medicine. Even the studys lead author says the research should not be used to recommend chelation therapy and he acknowledges that its findings could have been due to chance. A definitive answer on chelation therapy will take much additional research Gervasio Lamas chief of the Columbia University division of cardiology at Mount Sinai Medical Center in Miami Beach Fla. said in a statement. The most exciting part of this study is that there may be an unexpected signal of benefit. We need to understand whether the signal is true or whether it occurred by chance. The trial known as the Trial to Assess Chelation Therapy or TACT has been dogged by accusations of safety and ethical problems from its beginnings years ago. The study was temporarily halted in because of concerns over ethics and patient safety. An investigation by the federal Office for Human Research Subject Protections which is charged with protecting patients found that patients may not have been properly informed of chelations risks. In response to such concerns researchers revised their consent forms the documents that explain a studys risks and benefits to patients which had failed to mention the risk of death in chelation therapy. Federal officials also ordered researchers to notify patients that the drug they were receiving had never been approved for lead poisoning as implied in the consent form and that the Food and Drug Administration had taken the study drug off of its list of approved medications. Stephen Kopecky a Mayo Clinic cardiologist who participated in the trial says hes also concerned about the reliability of its findings. The overall benefits were very small with . of those randomly assigned to chelation experiencing a cardiovascular problem compared with of those randomly assigned to a placebo infusion. Even more concerning that benefit passed the bar for statistical significance the standard for judging whether a result is real or a fluke by only .. Further analysis showed the benefits were limited to those with diabetes rather than for patients overall. Under the best of circumstances thats not a strong result says anesthesiologist Kimball Atwood of NewtonWellesley Hospital in Massachusetts who has followed the study from its beginning. This studys findings are even more questionable however Kopecky says because patients who got chelation had lower bad cholesterol levels than the placebo group at the start of the trial. That could explain most of their reduced risk for a second heart attack says Kopecky president of the American Society for Preventive Cardiology. In addition of patients stopped getting their assigned treatments and withdrew their consent preventing doctors from including their data or even contacting them to see if they were still alive Kopecky says. That large of a dropout rate which is normally no more than about could skew the studys findings Kopecky says. Thats a big concern any time a study shows a benefit on something thats not highly regulated by the FDA Kopecky says. Kopecky also acknowledges that theres no known biological basis for why removing metals from the blood would help heart disease. That is a milliondollar question he said. More than half the trial sites were led by doctors who practice chelation says Paul Armstrong a professor of cardiology at the University of Alberta chosen to discuss the study on a panel at the heart meeting. That could lead to a bias in favor of chelation Atwood says. All of these factors call into question the results says Michael Carome deputy director of the advocacy group Public Citizens Health Research Group."

"Doctorsintraining face long stressful hours sleepless nights and a high risk of depression http and suicidal thoughts but often are too stoic and timestarved to seek help. A study suggests online selfhelp behavior therapy could be a solution. Suicidal thoughts were much less common in new doctors who had four halfhour online sessions before starting their first year of training compared with those who got no therapy. The research involved about medical interns residents in their first postgraduate year which is often one of the most intense periods of doctor training. It often involves hour weeks and overnight hospital shifts dealing with multiple medical crises. An earlier study of interns found that suicidal thoughts increased almost fourfold during the first three months of residency said Dr. Constance Guille of the Medical University of South Carolina in Charleston. Her research group led both studies. Sarah Dalechek a firstyear psychiatry resident at that university said her program requires two monthlong rotations of hour overnight shifts in an emergency room. She said she became very depressed but had little time to seek help. Its very stressful because youre sleepdeprived youre not eating right ... youre working backtoback shifts and youre trying to catch up on sleep but you cant Dalechek said. She was not involved in the study. Dalechek said she looked into seeing a therapist but would have preferred a webbased program since its confidential and requires no appointment. Luckily her depression subsided when that rotation ended. Guille said offering webbased therapy routinely to medical residents could be beneficial if her research results are confirmed in a broader study. The results were published Wednesday in the journal JAMA Psychiatry. The study involved interns at Yale University and the University of Southern California. It used a free online program developed at the National Institute for Mental Health Research at the Australian National University in Canberra. Interns who got the sessions were percent less likely to have suicidal thoughts during that first year compared to those who received four weekly emails with information about depressions and where to seek help. The online program included sessions about how to put feelings of stress or despair into perspective. For example a poor test grade or bad performance evaluation might lead to feelings of Im not good enough but the lessons encourage more positive thinking about how many exams have you passed to put this failure in a more accurate light Guille said. The training also encourages seeking out activities or thoughts that bring pleasure especially when feeling down. Previous research has shown benefits from similar webbased therapy in other settings. Guille said medical students and residents tend to be highachieving perfectionists but that they need to learn you cant always be perfect in medicine you have to figure out how to deal with failure."

"Merck Cos blockbuster drug Keytruda met the main goal of a latestage trial testing the treatment in patients with cancers of the digestive tract the U.S. drugmaker said on Wednesday. Keytruda among a class of medicines called PD inhibitors is Mercks top selling drug and has already been approved to treat several forms of cancer including skin and lung cancer. PD or PDL inhibitors work by blocking a mechanism of tumors that allows them to evade detection by cancerfighting cells. Keytruda when compared to chemotherapy enabled certain patients with esophageal cancer to live longer helping the drug meet the main goal of the latestage study Merck said. This marks the sixth tumor type where Keytruda has demonstrated a survival benefit and represents the first time an antiPD therapy has achieved overall survival for this patient population said Roy Baynes chief medical officer of Merck Research Laboratories. Esophageal cancer is the seventh most commonly diagnosed cancer in the world the company said. Merck said trial results would be presented at an upcoming medical meeting."

"A multiple sclerosis drug usually reserved for people in the late stages of the disease seems to offer longterm remission in newly diagnosed patients researchers report. Because of serious side effects the drug Lemtrada alemtuzumab is approved in the United States only for patients who have failed other treatments. But the authors of a new study believe giving it early may slow and even reverse some diseaserelated disability. The expectation in MS has always been to try to slow down the progression of the disease. Now we can tell our patients that a significant number can actually improve by reversing their disability said lead researcher Dr. Gavin Giovannoni. He is a neurology professor at Queen Mary University of London in England. The treatment is not without its downsides however. Because of the potential for side effects people who received this treatment have to undergo monthly blood and urine tests for four years after the last dose Giovannoni said. Giovannoni described Lemtrada as an immune system rebooter. First it depletes the immune system then it allows it to recover he explained. During the time when the immune system is depleted there is a risk of infection over eight to weeks including herpes infections he said. Also when the immune system rebuilds itself a significant number of people about percent will develop another autoimmune disease Giovannoni said. These include Graves disease a thyroid disorder and a bleedingbruising disorder called idiopathic thrombocytopenic purpura ITP which occurs in about percent of patients he noted. But these diseases can be treated so its not like MS. Its kind of trading in your MS for another autoimmune disease Giovannoni said. Still one MS specialist who reviewed the new study said patients need to be cautious about taking the drug. Lemtrada is not for every patient with MS and the decision to use it should be carefully considered said Dr. Dhanashri Miskin an attending neurologist at Lenox Hill Hospital in New York City. Although the safety profile is generally manageable for the right patient risks probably outweigh benefits in patients with mild or early stage disease Miskin said. The decision to start Lemtrada should be made in the context of the risks including infusionassociated reactions infections and autoimmune adverse events she said. Although alemtuzumab Lemtrada treatment is associated with safety risks those risks are manageable in most patients Miskin said. The new trial of more than patients with relapsingremitting MS was funded by Sanofi Genzyme and Bayer HealthCare Pharmaceuticals the drugs makers. MS occurs when the immune system mistakenly attacks the protective sheath around nerve fibers in the brain and spinal cord. People can suffer muscle weakness numbness vision problems and difficulty with balance and coordination. Relapsingremitting MS is the most common type with symptoms suddenly worsening and then going into remission. For this study Giovannoni and colleagues treated patients with relapsingremitting MS who had not responded to at least one other MS drug. Lemtrada was given to patients while received another drug interferon betaa. The researchers assessed disability levels at the start of the study and every three months for two years. By the studys end nearly percent of those given Lemtrada had improved by at least one point on a point disability test versus about percent of those receiving interferon the researchers found. Moreover patients receiving Lemtrada were . times more likely to have their thinking skills improve compared to those given interferon. And they were more than twice as likely to see improvement in their ability to move without tremor or clumsiness the findings showed. The findings held after researchers adjusted the results to make sure the gains werent led by those recovering from relapses. Giovannoni believes the drug could offer real relief from MS symptoms. Not only does alemtuzumab improve disability but most patients go into longterm remission of at least five to eight years he said. Some patients have been going years without any evidence of disease activity he said. According to Bruce Bebo executive vice president for research at the National Multiple Sclerosis Society Restoring lost function is a significant unmet need for people living with MS. This study examines previous findings related to the reversal of some disability in those receiving alemtuzumab he said. I am encouraged by these results and urge others to pursue potentially restorative approaches to treatment Bebo said. Giovannoni pointed out that most of the drugs benefits are obtained early in the disease. If you really want this drug to have a big impact you should use it as early as possible. In the European Union its recommended for early use he noted. The report was published online Oct. in the journal Neurology. More information For more about multiple sclerosis visit the National Multiple Sclerosis Society http SOURCES Gavin Giovannoni M.D. Ph.D. professor neurology Queen Mary University of London U.K. Dhanashri Miskin M.D. attending neurologist Lenox Hill Hospital New York City Bruce Bebo Ph.D. executive vice president research National Multiple Sclerosis Society Oct. Neurology online"

"For patients with advanced inoperable stage lung cancer concurrent chemotherapy and the specialized radiation treatment proton therapy offers improved survival compared to historical data for standard of care according to a new study from The University of Texas MD Anderson Cancer Center. The research published in JAMA Oncology reported an overall survival OS of . months. In contrast the historical OS rate with standard of care concurrent chemotherapy and traditional radiation was months at the time when the study was designed. The findings are the final results of the single institution Phase II study and represent the longest followup to date of stage lung cancer patients who have received proton therapy said Joe Y. Chang M.D. professor Radiation Oncology and the studys corresponding author. Lung cancer is the leading cause of cancer death in both men and women in the U.S. According to the American Cancer Society more than people will be diagnosed and will die from the disease in with the majority of patients still being diagnosed when the disease is in an advanced stage. Advanced lung cancer patients with inoperable disease traditionally have been treated with concurrent chemotherapy and conventional photon radiation therapy. However the therapy can be very difficult for patients due to associated toxicities and because many patients are also dealing with comorbidities explained Chang. Proton therapy is an advanced type of radiation treatment that uses a beam of protons to deliver radiation directly to the tumor destroying cancer cells while sparing healthy tissues. Protons enter the body with a low radiation dose and stop at the tumor matching its shape and volume or depth. They deposit the bulk of their cancerfighting energy right at the tumor thereby reducing the dose to cardiopulmonary structures which impacts the toxicity functional status quality of life and even survival for patients explained Chang. With our study we hypothesized that proton therapy would offer a survival benefit to patients and reduce treatmentassociated toxicities which can be very serious he said. The study opened at MD Anderson in in this research Chang and his colleague report on the studys fiveyear results. For the prospective Phase II trial patients with inoperable Stage III nonsmallcell lung cancer were enrolled. The studys primary endpoint was OS. The researchers hypothesized that the median OS would increase from historical data of months on standard therapy to months. Secondary endpoints included distant metastasis and local and regional recurrence rates. Toxic effects of treatment in both the acute and late settings also were analyzed. Median follow up was . months for all patients and . months for alive patients. At five years the median OS was . months and the corresponding fiveyear OS was percent. Median progressionfree survival was . months with a fiveyear progressionfree survival of percent. In sum patients experienced a relapse with distant sites representing percent of all recurrences. Local and regional recurrence rates were low percent and percent respectively. Among the acute and late toxic effects diagnosed in patients were esophagitis pneumonitis and cardiac arrhythmia. Of note said Chang no patients developed the most severe or grade five toxicities as seen in patients who receive standard of care. Chang noted his study is not without limitations. Of greatest significance the study was designed more than a decade ago. While the studys survival recurrence rates and toxic effects are still favorable when compared to rates associated with the most advanced traditional photon radiation therapy intensity modulated radiation therapy IMRT technology to diagnose and stage the disease as well all treatment modalities have significantly improved. When the study opened PET imaging had just been approved for lung cancer staging. The image quality was poor and didnt include a CT component in most facilities across the country said Chang. Obviously the technology has improved dramatically over the last decade and has made a significant impact on diagnosis and staging. Also delivery of both the conventional intensitymodulated radiation therapy IMRT and proton therapy IMPT have improved thereby reducing side effects for both treatment modalities. For example MD Anderson proton therapy patients with advanced lung cancer now can receive IMPT. The technique uses an intricate network of magnets to aim a narrow proton beam at a tumor and paint the radiation dose onto it layer by layer. Healthy tissue surrounding the tumor is spared and side effects are even more reduced than earlier proton delivery said Chang. A Phase II trial studying IMPT and concurrent chemotherapy is underway. Chang also noted the advancements in cancer biology and immunotherapy and that both are important areas of research focus in combination with proton therapy. In addition to Chang other authors on the allMD Anderson study include Stephen Hahn M.D. Ritsuko Komaki M.D. Pamela K. Allen Ph.D. Zhongxing Liao M.D. Steven H. Lin M.D. Ph.D. Daniel Gomez M.D. James Welsh M.D. Melenda Jeter M.D. James Cox M.D. Michael OReilly M.D. Ming Li M.D. and Wencheng Zhang M.D. all of Radiation Oncology John V. Heymach M.D. Ph.D. and Charles Lu M.D. both of ThoracicHead and Neck Medical Oncology Ronald X. Zhu Ph.D. Xiaodong Zhang Ph.D. Heng Li Ph.D. Radhe Mohan Ph.D. all of Radiation Physics and Ara A. Vaporciyan M.D. Thoracic and Cardiovascular Surgery. Vivek Verma M.D. now at the University of Nebraska Medical Center also contributed to the study."

"It was launched decades ago as an anesthetic for animals and people became a potent battlefield pain reliever in Vietnam and morphed into the trippy club drug Special K. Now the chameleon drug ketamine is finding new life as an unapproved treatment for depression and suicidal behavior. Clinics have opened around the United States promising instant relief with their unique doses of ketamine in IVs sprays or pills. And desperate patients are shelling out thousands of dollars for treatment often not covered by health insurance with scant evidence on longterm benefits and risks. Chicago preschool teacher Lauren Pestikas long struggled with depression and anxiety and made several suicide attempts before trying ketamine earlier this year. The price tag so far is about but its worth every dime and penny said the yearold. Pestikas said she feels much better for a few weeks after each treatment but the effects wear off and she scrambles to find a way to pay for another one. For now ketamine has not received approval from the U.S. Food and Drug Administration for treating depression though doctors can use it for that purpose. Ketamine has been around since the s and is widely used as an anesthesia drug during surgery because it doesnt suppress breathing. Compared to opioids such as morphine ketamine isnt as addictive and doesnt cause breathing problems. And some studies have shown that ketamine can ease symptoms within hours for the toughest cases. Its potential effects on depression were discovered in animal experiments in the late s and early s showing that glutamate a brain chemical messenger might play a role in depression and that drugs including ketamine that target the glutamate pathway might work as antidepressants. Conventional antidepressants like Prozac target serotonin a different chemical messenger and typically take weeks to months to kick in a lag that can cause severely depressed patients to sink deeper into despair. Ketamines potential for almost immediate if temporary relief is what makes it so exciting said Dr. Jennifer Vande Voort a Mayo Clinic psychiatrist who has used ketamine to treat depression patients since February. We dont have a lot of things that provide that kind of effect. What I worry about is that it gets so hyped up she said. The strongest studies suggest its most useful and generally safe in providing shortterm help for patients who have not benefited from antidepressants. That amounts to about onethird of the roughly million people with depression worldwide. It truly has revolutionized the field changing scientists views on how depression affects the brain and showing that rapid relief is possible said Yale University psychiatrist Dr. Gerard Sanacora who has done research for or consulted with companies seeking to develop ketaminebased drugs. But to become standard depression treatment he said much more needs to be known. Last year Sanacora coauthored an American Psychiatric Association task force review of ketamine treatment for mood disorders that noted the benefits but said major gaps remain in knowledge about longterm effectiveness and safety. Most studies have been small done in research settings and not in the real world. When delivered through an IV ketamine can cause a rapid increase in heart rate and blood pressure that could be dangerous for some patients. Ketamine also can cause hallucinations that some patients find scary. There are some very real concerns Sanacora said. We do know this drug can be abused so we have to be very careful about how this is developed. Dr. Rahul Khare an emergency medicine specialist in Chicago first learned about ketamines other potential benefits a decade ago from a depressed and anxious patient he was preparing to sedate to fix a repeat dislocated shoulder. He said Doc give me what I got last time. For about three weeks after I got it I felt so much better Khare recalled. Khare became intrigued and earlier this year began offering ketamine for severe depression at an outpatient clinic he opened a few years ago. He also joined the American Society for Ketamine Physicians formed a year ago representing about U.S. doctors nurses psychologists and others using ketamine for depression or other nonapproved uses. There are about U.S. ketamine clinics compared with about three years ago said society cofounder Dr. Megan Oxley. Khare said the burgeoning field is like a new frontier where doctors gather at meetings and compare notes. He has treated about patients with depression including Pestikas. Theyre typically desperate for relief after failing to respond to other antidepressants. Some have lost jobs and relationships because of severe depression and most find that ketamine allows them to function Khare said. Typical treatment at his clinic involves six minute sessions over about two weeks costing each. Some insurers will pay about half of that covering Khares office visit cost. Patients can receive booster treatments. They must sign a fourpage consent form that says benefits may not be longlasting lists potential side effects and in bold letters states that the treatment is not governmentapproved. At a recent session Pestikass seventh she leaned back on a reclining white examiningroom chair as a nurse hooked her up to a heart and blood pressure monitor. She grimaced as a needle was slipped into the top of her left palm. Khare reached up with a syringe to inject a small dose of ketamine into an IV bag hanging above the chair then dimmed the lights pulled the window curtains and asked if she had questions and was feeling OK. No questions just grateful Pestikas replied smiling. Pestikas listened to music on her iPhone and watched psychedelic videos. She said it was like a controlled acid trip with pleasant hallucinations. The trip ends soon after the IV is removed but Pestikas said she feels calm and relaxed the rest of the day and that the mood boost can last weeks. Studies suggest that a single IV dose of ketamine far smaller than used for sedation or partying can help many patients gain relief within about four hours and lasting nearly a week or so. Exactly how ketamine works is unclear but one idea is that by elevating glutamate levels ketamine helps nerve cells reestablish connections that were disabled by depression said ketamine expert Dr. Carlos Zarate chief of experimental therapies at the National Institute of Mental Health. A small Stanford University study published in August suggested that ketamine may help relieve depression by activating the brains opioid receptors. Janssen Pharmaceuticals and Allergan are among drug companies developing ketaminelike drugs for depression. Janssen leads the effort with its nasal spray esketamine. The company filed a new drug application in September. Meanwhile dozens of studies are underway seeking to answer some of the unknowns about ketamine including whether repeat IV treatments work better for depression and if theres a way to zero in on which patients are most likely to benefit. Until there are answers Zarate of the mental health institute said ketamine should be a lastresort treatment for depression after other methods have failed. It was launched decades ago as an anesthetic for animals and people became a potent battlefield pain reliever in Vietnam and morphed into the trippy club drug Special K. Now the chameleon drug ketamine is finding new life as an unapproved treatment for depression and suicidal behavior. Clinics have opened around the United States promising instant relief with their unique doses of ketamine in IVs sprays or pills. And desperate patients are shelling out thousands of dollars for treatment often not covered by health insurance with scant evidence on longterm benefits and risks. Chicago preschool teacher Lauren Pestikas long struggled with depression and anxiety and made several suicide attempts before trying ketamine earlier this year. The price tag so far is about but its worth every dime and penny said the yearold. Pestikas said she feels much better for a few weeks after each treatment but the effects wear off and she scrambles to find a way to pay for another one. For now ketamine has not received approval from the U.S. Food and Drug Administration for treating depression though doctors can use it for that purpose. Ketamine has been around since the s and is widely used as an anesthesia drug during surgery because it doesnt suppress breathing. Compared to opioids such as morphine ketamine isnt as addictive and doesnt cause breathing problems. And some studies have shown that ketamine can ease symptoms within hours for the toughest cases. Its potential effects on depression were discovered in animal experiments in the late s and early s showing that glutamate a brain chemical messenger might play a role in depression and that drugs including ketamine that target the glutamate pathway might work as antidepressants. Conventional antidepressants like Prozac target serotonin a different chemical messenger and typically take weeks to months to kick in a lag that can cause severely depressed patients to sink deeper into despair. Ketamines potential for almost immediate if temporary relief is what makes it so exciting said Dr. Jennifer Vande Voort a Mayo Clinic psychiatrist who has used ketamine to treat depression patients since February. We dont have a lot of things that provide that kind of effect. What I worry about is that it gets so hyped up she said. The strongest studies suggest its most useful and generally safe in providing shortterm help for patients who have not benefited from antidepressants. That amounts to about onethird of the roughly million people with depression worldwide. It truly has revolutionized the field changing scientists views on how depression affects the brain and showing that rapid relief is possible said Yale University psychiatrist Dr. Gerard Sanacora who has done research for or consulted with companies seeking to develop ketaminebased drugs. But to become standard depression treatment he said much more needs to be known. Last year Sanacora coauthored an American Psychiatric Association task force review of ketamine treatment for mood disorders that noted the benefits but said major gaps remain in knowledge about longterm effectiveness and safety. Most studies have been small done in research settings and not in the real world. When delivered through an IV ketamine can cause a rapid increase in heart rate and blood pressure that could be dangerous for some patients. Ketamine also can cause hallucinations that some patients find scary. There are some very real concerns Sanacora said. We do know this drug can be abused so we have to be very careful about how this is developed. Dr. Rahul Khare an emergency medicine specialist in Chicago first learned about ketamines other potential benefits a decade ago from a depressed and anxious patient he was preparing to sedate to fix a repeat dislocated shoulder. He said Doc give me what I got last time. For about three weeks after I got it I felt so much better Khare recalled. Khare became intrigued and earlier this year began offering ketamine for severe depression at an outpatient clinic he opened a few years ago. He also joined the American Society for Ketamine Physicians formed a year ago representing about U.S. doctors nurses psychologists and others using ketamine for depression or other nonapproved uses. There are about U.S. ketamine clinics compared with about three years ago said society cofounder Dr. Megan Oxley. Khare said the burgeoning field is like a new frontier where doctors gather at meetings and compare notes. He has treated about patients with depression including Pestikas. Theyre typically desperate for relief after failing to respond to other antidepressants. Some have lost jobs and relationships because of severe depression and most find that ketamine allows them to function Khare said. Typical treatment at his clinic involves six minute sessions over about two weeks costing each. Some insurers will pay about half of that covering Khares office visit cost. Patients can receive booster treatments. They must sign a fourpage consent form that says benefits may not be longlasting lists potential side effects and in bold letters states that the treatment is not governmentapproved. At a recent session Pestikass seventh she leaned back on a reclining white examiningroom chair as a nurse hooked her up to a heart and blood pressure monitor. She grimaced as a needle was slipped into the top of her left palm. Khare reached up with a syringe to inject a small dose of ketamine into an IV bag hanging above the chair then dimmed the lights pulled the window curtains and asked if she had questions and was feeling OK. No questions just grateful Pestikas replied smiling. Pestikas listened to music on her iPhone and watched psychedelic videos. She said it was like a controlled acid trip with pleasant hallucinations. The trip ends soon after the IV is removed but Pestikas said she feels calm and relaxed the rest of the day and that the mood boost can last weeks. Studies suggest that a single IV dose of ketamine far smaller than used for sedation or partying can help many patients gain relief within about four hours and lasting nearly a week or so. Exactly how ketamine works is unclear but one idea is that by elevating glutamate levels ketamine helps nerve cells reestablish connections that were disabled by depression said ketamine expert Dr. Carlos Zarate chief of experimental therapies at the National Institute of Mental Health. A small Stanford University study published in August suggested that ketamine may help relieve depression by activating the brains opioid receptors. Janssen Pharmaceuticals and Allergan are among drug companies developing ketaminelike drugs for depression. Janssen leads the effort with its nasal spray esketamine. The company filed a new drug application in September. Meanwhile dozens of studies are underway seeking to answer some of the unknowns about ketamine including whether repeat IV treatments work better for depression and if theres a way to zero in on which patients are most likely to benefit. Until there are answers Zarate of the mental health institute said ketamine should be a lastresort treatment for depression after other methods have failed."

"A system of automated twicedaily texts and the ability to use text messaging to receive answers to questions about treatment helps relieve some of the stress of chemotherapy for women with breast cancer researchers at the Fox Chase Cancer Center in Philadelphia reported Monday. The feasibility study was designed to see if texting could relieve some of the anxiety that comes with the fatigue hair loss and other body changes that can accompany anticancer drugs. Compared to women who only received an American Cancer Society pamphlet on chemotherapy the women in the texting group reported an overall lower level of distress and a higher quality of life during their therapy. They also felt they had better communication with their doctors. The text messages were most effective at reducing distress at the and month marks according to the data presented by chief author KuangYi Wen an assistant professor in the Cancer Prevention and Control program at Fox Chase. At the fourth month mark the gap was huge between the texting and control groups she told Reuters Health in a telephone interview. Texting also played a role in helping patients feel like they were in control of their treatment particularly during the first month. Texting did not affect the odds of developing symptoms of depression. Surprisingly the older the patient the greater the likelihood that she would text back seeking more information. One of the patients texted the program times. Thats whats good about this program. Everyone has different informationseeking behavior and the system can respond to that Dr. Wen said. The findings were released at the American Society of Clinical Oncology meeting in Chicago. SOURCE bit.lyMezRw httpbit.lyMezRw American Society of Clinical Oncology June . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"None PHOENIX Oct. PRNewswire Creative Medical Technology Holdings OTCQB CELZ announced today completion of the safety data analysis on patients with pharmacologicallyresistant erectile dysfunction treated with the Companys patented CaverStem procedure. The trial sponsored by Creative Medical Technology Holdings was conducted at the University of California Los Angeles Harbor HospitalLA Biomed under Institutional Review Board IRB approval. An independent medical safety monitor was also appointed to review the patient data for safety and feasibility of administering bone marrow derived stem cells into patients with erectile dysfunction. The goal of this procedure is to regenerate blood vessels and smooth muscle parts of the penis that are not functioning properly in this patient population. Based on establishment of safety of the CaverStem procedure in a formal universitybased clinical trial and independent confirmation of efficacy in an European clinical trial we have launched commercialization for the CaverStem procedure said Timothy Warbington President and Chief Executive Officer of Creative Medical Technology Holdings. Amongst other top urologists we have recruited a worldrenowned urologist as a lead physician to rollout the procedure. We anticipate that the procedure will be available to patients that meet the eligibility criteria within the next days. According to the National Institutes of Health approximately million men in the United States suffer from Erectile Dysfunction of which million do not respond to pharmacological treatments such as Viagra Levitra and Cialis. The CaverStem procedure involves obtaining a small amount of bone marrow from the patient purifying the stem cells using a closed system device that is FDA cleared and then administering these cells in the same procedure into the patients penis said Thomas Ichim Ph.D Chief Scientific Officer and CoFounder of the Company. Having published the first peerreviewed paper on this procedure back in together with internationally renowned urologists and stem cell experts it is very exciting for me to watch this translate from bench to bedside. About Creative Medical Technology Holdings Creative Medical Technology Holdings Inc. is a clinical stage biotechnology company currently trading on the OTCQB under the ticker symbol CELZ. For further information about the company go to creativemedicaltechnology.com. Yiou et al. Intracavernous Injections of Bone Marrow Mononucleated Cells for Postradical Prostatectomy Erectile Dysfunction Final Results of the INSTIN Clinical Trial.Eur Urol Focus. Jun . pii S https https Ichim et al. Intracavernous administration of bone marrow mononuclear cells a new method of treating erectile dysfunction J Transl Med. Jun . https ForwardLooking Statements OTC Markets has not reviewed and does not accept responsibility for the adequacy or accuracy of this release. This news release may contain forwardlooking statements including but not limited to comments regarding the timing and content of upcoming clinical trials marketing efforts funding etc. Forwardlooking statements address future events and conditions and therefore involve inherent risks and uncertainties. Actual results may differ materially from those currently anticipated in such statements. See the periodic and other reports filed by Creative Medical Technology Holdings Inc. with the Securities and Exchange Commission and available on the Commissions website at Related Links httpcreativemedicaltechnology.com httpcaverstem.com SOURCE Creative Medical Technology Holdings Inc. Related Links httpcreativemedicaltechnology.com"

"An international team of researchers has developed a simple laboratory score that is safer and faster at diagnosing patients who visit the emergency department with heart attack symptoms. The score published in CMAJ Canadian Medical Association Journal http can also identify patients at risk of subsequent heart issues after discharge. We have developed a simple lab score that is superior to using cardiac troponin alone for the identification of patients at low and high risk for heart attack or death at emergency department presentation say Dr. Peter Kavsak McMaster University Hamilton Ontario. According to Professor Andrew Worster also from McMaster University This lab score may reduce both the number of blood tests and time spent in the emergency department for chest pain patients. Patients with chest pain symptoms require multiple blood tests over several hours before a diagnosis is reached. Previous studies using highsensitivity cardiac troponin alone to rule out and rule in heart attacks have not consistently demonstrated sufficient safety to use in clinical practice. In this international study researchers from Canada Australia New Zealand and Germany combined common laboratory blood tests available at many hospitals around the world to create a single laboratory score or clinical chemistry score to diagnose heart attack. These blood tests are part of the World Health Organizations list of essential in vitro diagnostics tests for health care facilities with clinical laboratories. The researchers validated the clinical chemistry score as a predictor of heart attack or death within days using data on patients from emergency department studies in the four countries. Within one month of the emergency department visits heart attacks or death in patients occurred. A negative or lowrisk clinical chemistry score at emergency department presentation missed only one of these events compared with up to missed heart attacksdeath when using a highsensitivity cardiac troponin test alone. A positive or highrisk clinical chemistry score also identified about of patients at high risk of heart attack or death when positive compared with a low of detected when the highsensitivity cardiac troponin test alone was positive. The clinical chemistry score worked equally well in men and women. The authors suggest the score can be useful for standardizing diagnoses and improving safety. Adoption of the clinical chemistry score algorithm would standardize reporting of highsensitivity cardiac troponin test results how the tests are interpreted in the normal range and represent an option less susceptible to both analytical and preanalytical errors. This could result in the safest laboratory approach for physicians to use at presentation in the emergency department says Dr. Kavsak. The Canadian Institutes of Health Research funded the study with reagent support from Abbott Laboratories and Roche Diagnostics. Clinical chemistry score versus highsensitivity cardiac troponin I and T tests alone to identify patients at low or high risk for myocardial infarction or death at presentation to the emergency department is published August ."

"For Carlton Davis the always seemed to come out as hte. Frequently having problems in school he once threw a typewriter out of his fourthfloor window at college after making the hte mistake yet again. Abby Schwartz can relate. She would often mix up the letters d and b sounding out certain words to make make sense of them. Things have gotten better but shell still make the occasional bd or flip. Davis now also still mixes up the digits of phone numbers. Reading would be slow. It wouldnt be enjoyable. I would lose my place said Abby of Lexington Massachusetts. There were times when I would yell at myself I cant do this. I cant do this. I cant do this. Abby and Davis like an estimated percent to percent of the population have struggled with dyslexia a condition that broadly speaking hinders a persons ability to interpret language. Scientists have recently made headway in understanding whats going on in the brain of a person with dyslexia which has not been well understood. New research suggests it may be possible to tell from a brain scan whether a dyslexic childs reading ability will improve over a few years. It goes along with the general trend of personalized medicine in which genetic tests brain scans and other tests can increasingly help predict the conditions for which a particular individual is at risk. And a separate recent study found that some dyslexics may have a heightened understanding of space despite an impairment in language. In dyslexia httpedition.cnn.comHEALTHlibrarydyslexiaDS.html also called developmental reading disorder http the brain doesnt properly recognize or process symbols. Children with this condition may find reading comprehension difficult because they dont connect sounds with letters and cant recognize words well. Celebrities http including Whoopi Goldberg Cher and Henry Winkler httpedition.cnn.comLIVINGmf.dyslexia.famous.celebritiesindex.html the Fonz have made their dyslexia publicly known and great artists such as Pablo Picasso are said to have had it. Some children with the disorder can compensate or read fairly normally but perhaps more slowly than their peers by adulthood. It is hard to know who will be able to improve reading skills over time and how much extra help is necessary. A study led by Fumiko Hoeft psychiatry researcher at Stanford University School of Medicine used brain imaging to answer this question. Her study followed children with dyslexia and children without dyslexia over a year period. The researchers found greater activation and connectivity in the brains right hemisphere among dyslexic children who showed greater improvement in reading after the years. They used functional magnetic resonance imaging fMRI to study this phenomenon. In general much of the language comprehension and processing that goes on in the brain happens in the left hemisphere but there is some right hemisphere involvement also. Hoefts study suggests that people with dyslexia who go on to read fairly normally are using a part of the right hemisphere in reading tasks more than the average person would. If made widely available this kind of brain scan could be an important complement to the assessments based on reading and behavior already available for diagnosing dyslexia Hoeft said. As this usage of fMRI becomes more useful and commonplace the high cost per scan would go down she said. Rebecca Branstetter psychologist who blogs at Notes from the School Psychologist httpstudentsgrow.blogspot.com says this dyslexia brain scan could provide useful information but it doesnt highlight environmental factors such as the quality of instruction in the childs classroom that could contribute to reading problems. Abbys father Edward Schwartz fears that this tool would just add to a childs anxiety about the testing process. The potential to alarm a child isnt worth it and he doesnt trust that this method would offer definitive information. The kids are much more likely to feel like theyre broken in some way Schwartz said. Abby he recalls didnt like it to be referred to as a learning disability. She was happy when people offered her alternative ways to think about it. Guillermo Tilley the father of yearold Nate who has dyslexia similarly would not want his son to have the fMRI. It would taint my interpretation of who Nate is and his struggle with dyslexia Tilley said. Of course the results of the study are only preliminary. Participants included children with dyslexia and children without dyslexia which is too small a sample size to prove anything although still respectable when it comes to neuroimaging studies. Another important limitation in the study is that some children in the study did receive tutoring or reading interventions to which they were not randomly assigned. A larger trial that controlled for remediations would offer more conclusive results. But this one found that receiving a remediation did not appear to affect improvement in reading abilities. Heres another insight about dyslexia men with the condition may have enhanced visualspatial abilities http_obArticleURL_udiBWPYXFS_user_coverDate_rdoc_fmthigh_origbrowse_originbrowse_zonerslt_list_item_srchdocinfo according to a study in the journal Learning and Individual Differences. This was another small study dyslexic volunteers and participants without the condition testing how people identify shapes navigate a virtual environment and do other tasks involving spatial reasoning. Davis a noted architect and writer in the Los Angeles area believes he fits that category. He gets thrown off by pure mathematics but hes good at anything involving spatial relationships and design. And those kinds of skills should be taken advantage of in school said Wendy Weiner principal of the artsfocused Conservatory Prep in Davie Florida and mother of a dyslexic child. If they can create projects instead of drawing a picture of a room if they can make a model of a room they will generally do it pretty much to scale because they can visualize things very clearly she said. Because of this Weiner said threedimensional letters and numbers perhaps made out of plastic or clay help a dyslexic child grasp the shapes better. Holding a upright in your hand youre less likely to view it sideways as a V she said. The most important intervention is a direct explicit teaching of phonics or how symbols correspond with sounds Branstetter said. The sooner it can be detected the better. A childs personality can also factor in Some persist despite frustration better than others. Parents should speak to their school psychologists about the best plan of action she said. For Abby a breakthrough moment came at age She started reading voraciously and today reads well above the seventhgrade level. Shed had good tutors and plenty of support from her parents but it also took selfconfidence for her to make herself read on her own she said. As for Davis hed never heard of dyslexia until a friend brought it up when he was and then went through training at a learning development center. Using computers for writing has helped him tremendously especially spellcheck. I know a lot of people who have trouble reading as I did when I was a kid are dyslexic he said. It is an issue that certainly holds back a lot of kids because of their inability to do certain things."

"After a stroke many patients are given the clotbusting intravenous drug alteplase but another drug may be more effective Australian researchers report. Among more than stroke victims TNKase tenecteplase was about twice as effective as alteplase in restoring blood flow to the brain and it also resulted in less disability the scientists found. Tenecteplase is likely to become the preferred medication for clotdissolving in stroke patients said lead researcher Dr. Bruce Campbell head of the stroke department at the Royal Melbourne Hospital in Parkville. It is likely to change stroke treatment guidelines and clinical practice. Campbell said tenecteplase is more effective than alteplase because of differences in the enzymes in each drug. Although both drugs work in the same way tenecteplase is better at attacking and dissolving clots and more resistant to factors that inhibit the breakdown of clots he said. For either drug to be most effective it needs to be given as soon as possible after a stroke occurs. In this study patients were given the drugs within . hours after the onset of a stroke Campbell said. Although tenecteplase appears to be more effective for stroke patients its not approved for that use in the United States according to Dr. Rohan Arora director of stroke at Long Island Jewish Hospital in Forest Hills N.Y. In the U.S. Food and Drug Administration approved tenecteplase for use after a heart attack Arora said. Tenecteplase is being widely used in developing countries such as India he said. One reason is its cheaper than alteplase. In the United States tenecteplase costs about versus alteplase which costs Arora said. In addition tenecteplase is easier to give requiring only a single injection while alteplase requires an injection and an IV drip he added. Arora explained that tenecteplase is not widely used in the United States for heart attack patients because these patients are typically treated with angioplasty or heart bypass surgery. For the new study which did not receive drug company funding Campbell and his colleagues randomly assigned stroke patients to either alteplase or tenecteplase before surgery to remove clots. The researchers specifically looked to see which drug was better at restoring blood flow to clotblocked blood vessels in the brain and which drug resulted in patients having better outcomes. The investigators found that percent of the patients treated with tenecteplase had more than percent of blood flow return to the brain compared with percent of those treated with alteplase. Patients treated with tenecteplase also had better functional outcomes after days than those given alteplase the findings showed. Bleeding into the brain the most serious side effect of either drug occurred in percent of patients regardless of which drug they received Campbell said. The report was published April in the New England Journal of Medicine. More information For more on stroke visit the National Stroke Association http_BwE. SOURCES Bruce Campbell MBBS Ph.D. head stroke department Royal Melbourne Hospital Parkville Australia Rohan Arora MBBS director stroke Long Island Jewish Hospital Forest Hills New York April New England Journal of Medicine"

"Vanda Pharmaceuticals Inc. Vanda NASDAQ VNDA httpstudio.financialcontent.comprnewsPageQuoteTickerVNDA today announced that HETLIOZ a circadian regulator demonstrated significant and clinically meaningful benefits in nighttime and daytime symptoms of jet lag disorder. HETLIOZ is currently approved in the US and Europe for the treatment of Nonhour sleepwake disorder a rare and chronic circadian rhythm sleep disorder. Jet lag disorder is a common circadian disorder frequently observed in millions of travelers who cross multiple time zones. Jet lag disorder is characterized by nighttime sleep disruption a decrease in daytime alertness and impairment to social and occupational functioning. The clinical efficacy results reported today are from the JET PhaseIII clinical study the JET study. In the JET study healthy volunteers were admitted to a sleep unit and were subjected to a circadian challenge of an hours advance to their usual bedtime. The JET study design induced the circadian challenge experienced by travelers who cross times zones which leads to jet lag disorder. This clinical design allowed for the study of HETLIOZ without the confounding effects of sleep deprivation and variable light conditions. Results from the JET study showed significant and clinically meaningful effects of HETLIOZ mg on the primary endpoint of the study as well as multiple secondary endpoints. The prespecified primary endpoint was the amount of sleep time in the first two thirds of the night. Secondary endpoints included measures of sleep parameters TST LPS WASO and next day alertness KSS and VAS. Table . Table Summary of Primary and Key Secondary Endpoint Results Assessment Endpoint HETLIOZ Placebo Difference pvalue Summary pvalue Detail PSG TST . . . p. .E minutes TSTfull . . . p. .E LPS . . . p. .E WASO . . . p. .E KSS average . . . p. .E VAS average . . . p. .E Primary endpoint. The results of the JET study shown above demonstrate the effectiveness of HETLIOZ in treating jet lag disorder. The magnitude of the total sleep time benefit of minutes improvement over placebo is significant and clinically meaningful. The demonstration of benefits in measurements of next day alertness on both KSS and VAS is meaningful and it underscores the ability of HETLIOZ to address both nighttime and daytime symptoms of jet lag disorder. Vanda previously reported on the JET study that examined the effects of HETLIOZ in a circadian challenge of hours advance of the subjects usual bedtime. The results of that study were published in The Lancet in . The observation that HETLIOZ is effective in treating the symptoms caused by an abrupt advance of the circadian cycle of a magnitude of or hours suggests that HETLIOZ will be an effective therapeutic tool in the treatment of individuals that experience symptoms of jet lag. HETLIOZ will be potentially useful under circumstances of rapid eastward transmeridian travel experienced by frequent travelers the rapid deployment of military troops and any circumstances that will necessitate the abrupt phase advance of the sleep wake cycle. Jet lag disorder affects millions of individuals annually who cross multiple time zones during their travel. Jet lag disorder symptoms are more severe during eastward travel. It is reported that more than million US residents make trips abroad each year to overseas destinations. Of these approximately million travel to destinations in Europe Middle East and Asia. It is also reported that approximately . million travel in Business or First class. We are extremely pleased with the outcome of this study which establishes the utility of HETLIOZ in the treatment of jet lag disorder as HETLIOZ was shown to overcome a significant circadian challenge of an hour phase advance. This challenge is equivalent to eastward travel across time zones as experienced for example on travel from Los Angeles to London Washington DC to Moscow Paris to Tokyo or London to Singapore. HETLIOZ improved both nighttime sleep and next day alertness potentially offering significant benefits to millions of travelers said Mihael H. Polymeropoulos MD Vandas President and CEO. Vanda intends to seek marketing approval for the use of HETLIOZ in the treatment of jet lag disorder. Vanda believes that if HETLIOZ is approved by regulatory authorities for the treatment of jet lag disorder it will potentially offer a therapeutic solution to many travelers and will likely represent an important commercial opportunity for the company. For review of the current prescribing information of HETLIOZ please visit http Conference Call The Vanda management team will host a conference call and live webcast today March at AM ET to discuss these updates. Investors can call domestic or international and use passcode . A replay of the call will be available on Monday March beginning at AM ET and will be accessible until Monday March at PM ET. The replay callin number is for domestic callers and for international callers. The passcode number is . The conference call will be broadcast simultaneously on Vandas website. Investors should click on the Investor Relations tab and are advised to go to the website at least minutes early to register download and install any necessary software or presentations. The call will also be archived on Vandas website for a period of days. HETLIOZ IS NOT CURRENTLY APPROVED BY ANY REGULATORY AUTHORITY FOR THE TREATMENT OF JET LAG DISORDER. About HETLIOZ HETLIOZ is a melatonin receptor agonist. HETLIOZ has been granted market authorization by the U.S. Food and Drug Administration and the European Medicines Agency. For full U.S. prescribing information please visit http Important Safety Information The most common adverse reactions incidence and at least twice as high on HETLIOZ tasimelteon than on placebo were headache increased alanine aminotransferase nightmares or unusual dreams and upper respiratory or urinary tract infection. The risk of adverse reactions may be greater in elderly years patients than younger patients because exposure to HETLIOZ is increased by approximately fold compared with younger patients. Indication HETLIOZ is indicated for the treatment of NonHour SleepWake Disorder Non. Important Safety Information HETLIOZ may cause somnolence After taking HETLIOZ patients should limit their activity to preparing for going to bed because HETLIOZ can potentially impair the performance of activities requiring complete mental alertness. The most common adverse reactions incidence and at least twice as high on HETLIOZ than on placebo were headache increased alanine aminotransferase nightmares or unusual dreams and upper respiratory or urinary tract infection. The risk of adverse reactions may be greater in elderly years patients than younger patients because exposure to HETLIOZ is increased by approximately fold compared with younger patients. Use of HETLIOZ should be avoided in combination with fluvoxamine or other strong CYPA inhibitors because of a potentially large increase in exposure of HETLIOZ and a greater risk of adverse reactions. HETLIOZ should be avoided in combination with rifampin or other CYPA inducers because of a potentially large decrease in exposure of HETLIOZ with reduced efficacy. There are no adequate and wellcontrolled studies of HETLIOZ in pregnant women. Based on animal data HETLIOZ may cause fetal harm. HETLIOZ should be used during pregnancy only if the potential benefit justifies the potential risks. Caution should be exercised when HETLIOZ is administered to a nursing woman. HETLIOZ has not been studied in patients with severe hepatic impairment and is not recommended in these patients. Safety and effectiveness of HETLIOZ in pediatric patients have not been established. About Vanda Vanda is a global biopharmaceutical company focused on the development and commercialization of innovative therapies to address high unmet medical needs and improve the lives of patients. For more on Vanda Pharmaceuticals Inc. please visit http Abbreviations PSG Polysomnography TST Total Sleep Time LPS Latency to Persistent Sleep WASO Wake After Sleep Onset KSS Karolinska Sleepiness Scale VAS Visual Analog Scale References . Rajaratnam SM Polymeropoulos MH Fisher DM Roth T Scott C Birznieks G Klerman E. Melatonin agonist tasimelteon VEC for transient insomnia after sleeptime shift two randomized controlled multicenter trials. The Lancet. . . US Department of Commerce International Trade Administration National Travel and Tourism Office. Profile of U.S. Resident Travelers Visiting Overseas Destinations Outbound. httptinet.ita.doc.govoutreachpagesdownload_data_table_Outbound_Profile.pdf FORWARD LOOKING STATEMENTS Various statements in this release and to be made on the conference call are forwardlooking statements under the securities laws. Forwardlooking statements are based upon current expectations that involve risks changes in circumstances assumptions and uncertainties. Important factors that could cause actual results to differ materially from those reflected in Vandas forwardlooking statements include among others the ability of HETIOZ to provide significant benefit in the treatment of the symptoms of jet lag disorder Vandas ability to obtain marketing approval for the use of HETLIOZ in the treatment of jet lag disorder and other factors that are described in the Risk Factors and Managements Discussion and Analysis of Financial Condition and Results of Operations sections of Vandas annual report on Form K for the fiscal year ended December which is on file with the SEC and available on the SECs website at http In addition to the risks described above and in Vandas annual report on Form K other unknown or unpredictable factors also could affect Vandas results. There can be no assurance that the actual results or developments anticipated by Vanda will be realized or even if substantially realized that they will have the expected consequences to or effects on Vanda. Therefore no assurance can be given that the outcomes stated in such forwardlooking statements and estimates will be achieved. All written and verbal forwardlooking statements attributable to Vanda or any person acting on its behalf are expressly qualified in their entirety by the cautionary statements contained or referred to herein. Vanda cautions investors not to rely too heavily on the forwardlooking statements Vanda makes or that are made on its behalf. The information in this release is provided only as of the date of this release and Vanda undertakes no obligation and specifically declines any obligation to update or revise publicly any forwardlooking statements whether as a result of new information future events or otherwise. Corporate Contact Jim Kelly Executive Vice President and Chief Financial Officer Vanda Pharmaceuticals Inc. jim.kellyvandapharma.com mailtojim.kellyvandapharma.com SOURCE Vanda Pharmaceuticals Inc. Related Links http"

"Hundreds of people have caught hellish bacterial infections and turned to Eastern Europe for a centuryold viral therapy. With the world on the cusp of an antibiotics crisis should we all follow suit Rachel George was used to being sick. A genetic condition left her with intellectual disabilities and a weak immune system. By she had endured dozens of bacterial infections kidney ear sinus heart bone and more and taken hundreds of antibiotic pills. But when she entered the Harborview Hospital in Seattle for a foot operation her bodys defenses were pushed to a new limit. Hospitals are hotbeds for nasty and sometimes deadly infections. After her surgery Rachels lungs picked up two methicillinresistant Staphylococcus aureus MRSA and Pseudomonas aeruginosa. Both bugs are part of a growing category of bacterial infections that dont respond to traditional antibiotics. Rachel was supposed to be in the hospital for five days. She stayed nine weeks. She developed pneumonia and acute respiratory distress syndrome and was put on a ventilator with a tube down her throat. When her doctors finally released her they told her mother she had three years to live at most before the bugs won. Three years later in January Rachel was indeed close to death. She was spending half of every month in intensive care the other half at home an IV constantly dripping into her bloodstream. By then she had cycled through more than a dozen powerful antibiotics. Each time the doctors would give her a new drug then watch helplessly as the bacteria overpowered it. Every time we took her back to the hospital it was a question of whether or not this was going to be it her mother Rose George told BuzzFeed News. One day the nurse on duty asked Rose if shed ever considered phage therapy. Rose had never heard of it and thats unsurprising The therapy which uses specialized viruses called bacteriophages to kill bacteria is only available in a handful of former Soviet countries. Rose asked her daughters doctor but shed never heard of phage either. Soon Rose was on the phone with doctors at a small clinic in Tbilisi in the Republic of Georgia ordering glass vials of viruses at a pop. Shes one of at least people desperate enough to try this littleknown viral therapy from Eastern Europe. Its an extreme solution to what may be this centurys biggest medical crisis the death of antibiotics. Since the discovery of penicillin in scientists have amassed a medical arsenal of more than antibiotics. The drugs have prevented soldiers from losing limbs and mothers from dying during childbirth. With access to antibiotics parents no longer worry about losing their kid to an ear infection or bad scrape. But now antibiotics are everywhere not just in orange pill bottles but in the food given to pigs cattle and chicken. And the more the bugs interact with antibiotics the quicker they evolve defense mechanisms. At least strains of bacteria have evolved into superbugs becoming resistant to most of our drugs. And pharmaceutical companies more interested in profitable blockbusters like Viagra and Zoloft havent developed a new class of antibiotics in years. Were dying because of it. More than people in the U.S. die each year from antibioticresistant infections. By an estimated million people worldwide will die by superbug. After two decades of warnings from the scientific community the problem is finally getting serious attention. In his budget proposal released today U.S. President Obama threw . billion at tackling the antibioticresistance crisis nearly double the amount allocated last year. If approved by Congress this money will go toward screening soil samples for new antibiotics reducing the drugs in livestock feed boosting hospital surveillance and perhaps making phage therapy a viable option in the U.S. Phages are bacterias natural enemies. They work by injecting their DNA inside bacterial cells where they replicate wildly produce new phages and eventually cause the bacteria to rupture releasing even more viruses to hunt for bacterial prey. Phages power comes from two places They are the most common and diverse organisms on Earth and each phage harms only specific strains of bacteria. When you turn on the faucet millions of phages flow out with your tap water. That leaves a nearly inexhaustible supply of potential agents to use in the fight against infection. Doctors have been using phages to kill bacteria for nearly a century just not in the U.S. In a Georgian doctor named George Eliava set up the first phage therapy clinic the Eliava Institute in Tbilisi. Antibiotics hadnt been discovered yet so phages were a revolutionary weapon against all kinds of infections Ryland Young head of the Center for Phage Technology at Texas AM University told BuzzFeed News. It was kind of prescientific no one knew what these phages were except that they worked. Five years later penicillin came along. Effective cheap and quick to produce in large quantities doctors in the U.S. U.K. and France quickly seized upon the miracle drug as a key to winning World War II. That also meant keeping this weapon away from the Soviets. With no access to antibiotics scientists behind the Iron Curtain bolstered their use of phages instead. At its very peak when they were supplying the Russian army the Eliava Institute was producing two to three tons of phages per day Zamphira Alavidze a microbiologist in Tbilisi who worked at the Eliava Institute for years told BuzzFeed News. But after the fall of the Soviet Union Eliavas phage production dropped significantly and it downsized into a small research center. Today Georgian doctors frequently use antibiotics to treat infections but often in combination with phages. Every clinic everywhere in Georgia everybody uses the phages Alavidze said. The last decade she added has brought another big change Two small phage clinics in Tbilisi have sprung up to cater specifically to the boom of international patients like Rachel. Ten or fifteen years ago nobody believed the phages would be so popular. They thought we were crazy Alavidze said. Now its not too easy to come to Georgia but we try to help somehow because sometimes nothing else works. Randy Wolcott a wound care doctor in Lubbock Texas first went to Tbilisi in . He was fed up with the lack of options for his patients with drugresistant infections and wanted to investigate phages as a treatment of last resort. Wolcott spent a week at the Eliava Institute. It looked nothing like the gleaming and sterile highrises of most U.S. hospitals the building was small some of the equipment looked ancient and the walls were unpainted. But after observing the Georgian clinicians at work Wolcott was sold. He walked into a city pharmacy and bought hundreds of vials of phages concocted for wound infections. They were very cheap and I bought them by the case Wolcott told BuzzFeed News. The only hiccup came when explaining his viral cargo to U.S. customs officials. It can cause some problems when our government hears that youre bringing viruses back from a former Soviet country Wolcott said chuckling. Its hard to explain. Its a virus but its a virus only for bacteria not for us. Phages arent approved for use in the U.S. So once back in Lubbock Wolcott wrote to the Texas Board of Medicine and asked for permission to use the viruses on his wound patients. The board decided that because these patients had exhausted all other options Wolcott would be allowed to use the experimental treatment in a legal arrangement known as compassionate use. Wolcotts patients saw improvement within days. In of the cases the patients wounds healed enough to save their limbs. He treated hundreds of patients using the original batch of phages he brought over from Tbilisi. Five years ago he went back for more. Wolcott usually uses the phages in combination with traditional antibiotics. But he says he couldnt have offered the same quality of treatment without the viruses. Someone needs to do this in America Wolcott said. To have a bank of stuff that we can turn to for these chronic infections That would be huge. Until that happens though patients are looking abroad. Rose Georges internet search led her to a clinic in Tbilisi called the Phage Therapy Center. It was set up in by Phage International a fledgling medical tourism outfit founded in Danville California by a computer scientist named Chris Smith. The centers doctors asked Rose to send over a bacterial sample from Rachels lungs. Over the course of a month Rose attempted to send several samples but each was rejected by U.S. customs. Roses son tried driving a sample across the border into Canada which led to a sevenhour interrogation by Canadian agents followed by two more hours with the FBI on the U.S. side. Finally Smith suggested that Rose ambiguously label the package as medical records. She did and the shipment slipped through. A few weeks later the Georgian doctors called Rose with good news They would be able to design a concoction of phages to treat Rachels infections. After convincing Rachels doctor to write a prescription for the viruses so they could cross the U.S. border Rose paid the Georgian clinic for a threemonth supply. She was surprised that phages were so inexpensive in contrast her insurance company was forking over roughly a month for Rachels antibiotics. A couple of weeks later boxes filled with vials of phages landed on the Georges doorstep. Rose used a nebulizer to administer the phages twice a day so that Rachel could breathe the liquids into her lungs. Within three weeks Rachels MRSA the same infection shed been fighting with antibiotics for three years disappeared. It hasnt returned in the five years since. Advocates of phage therapy see it as a powerful new weapon in the war were quickly losing against bacterial infection. But phages are certainly not a cureall. Just ask Roger Mintey a yearold retired accountant from the sleepy English town of Reigate. In Mintey caught a severe sinus infection that left him with a nearconstant cold. Hes had it on and off ever since. In the first decade of fighting his illness Mintey sought help at five English hospitals underwent two surgeries and took more than two dozen courses of antibiotics. Nothing worked. In he heard about phage therapy from his cousins wife whod gone to Tbilisi to treat a chronic bladder infection. She pointed Roger to Phage International the same company that helped Rose George get her daughters phages. The Georgian doctors affiliated with the company said they could treat his sinus infection so Mintey cut Phage International a check for and sent a sample of his nasal discharge to Georgia via FedEx. Then accompanied by a friend he boarded his firstever plane to fly to the companys Phage Therapy Center. They landed in Tbilisi at a.m. and were met by someone from the clinic who escorted them to their hotel. Mintey was instructed to drink a phage preparation three times a day from his hotel room. Every couple of days he would go into the clinic for additional phage treatments. The clinic was inside a nondescript building set up something like an indoor mall. You went through a set of double doors passed by a suntanning place and there you were one office two treatment rooms and that was it Mintey told BuzzFeed News. A doctor and two nurses had him sit on a cushioned patients chair. They tipped the chair back so his nostrils faced up and poured the phage liquid into his nose. He was instructed to say the word cuckoo as the phages slowly slid into all of his sinuses seeping out from his nasal passages into his forehead and cheekbones. His nose started bleeding but the clinicians told him it was nothing to worry about. They also gave him a shot of manuka honey extract in his butt telling him it had antimicrobial properties. It was all quite uncomfortable Mintey said. After two weeks Mintey flew back to England. Three days later his infection was back. I realized the entire treatment had done absolutely nothing he said. Mintey claims to have called emailed faxed and sent physical letters to his doctors in Georgia and to Phage Internationals headquarters in California. He heard nothing back. Smith of Phage International claims that emails sent to Roger at the time were bouncing and that he only had Minteys friends phone number. Eventually the clinic sent Mintey more phages in the mail but the infection persisted. He says he has not heard from them since. I was very disappointed Mintey said. By the end of I had given up on phages. Minteys situation highlights many of the difficulties surrounding a therapy only accessible through a small and largely unregulated medical tourism industry. Smith says Phage International has served more than patients to date with some registered on its website. He wants to open a new phage therapy clinic in Trinidad which could be easier for American patients to visit. During the past years youd go to an investor or venture capitalist and theyd never heard of phage and they didnt want to know about it he said. Now thats changed. Nothing about Phage International is decidedly illegal I. Glenn Cohen a law professor at Harvards PetrieFlom Center for Health Law Policy Biotechnology and Bioethics told BuzzFeed News. But there are many ethical issues at play. What happens when something goes wrong Or as in Rogers case when a patient feels like hes not getting what he paid for Who do you go after Where do you do it Cohen said. Thats where things get more tricky. This year two clinical trials are testing phage treatment against several antibioticresistant infections. The first called Phagoburn is big testing burn victims at three European hospitals with a . million investment from the European Union. The second led by a Richmond Virginiabased biotech called AmpliPhi is smaller and privately funded but will include a collaboration with the U.S. Army which has a vested interest in treating wounded soldiers. Both studies will be an important first step in giving phage therapy the credibility it will need to pass muster with the Food and Drug Administration FDA and to gain the support of drug companies needed to fund its eventual commercial development. Big pharmaceutical companies like stuff to appear in bottles and in tablets Jeremy Curnock Cook AmpliPhis CEO told BuzzFeed News. Theyre waiting for people like us to come back with the clinical data. But the biggest obstacle for phage therapy in the U.S. may ultimately have less to do with the science than its implementation into the medical system. Rachel George and Roger Mintey both received personalized phage treatments meaning that the viruses were selected to specifically attack their particular infections. Its uncertain whether the FDA would be able to adopt such a tailormade approach which stands in such stark contrast to the onesizefitsmost approach of antibiotics. Whats more because of the number and diversity of phages and a regulatory system thats been set up to deal with manufactured chemicals rather than the messiness of nature each phage would have to be tested as its own drug even if its used in combination. In a concoction of nine phages designed to treat a mixture of three bacteria that could mean hundreds of trials. Depending on who you ask this is viewed as anything from costly to impossible. Regardless of whether phage therapy reaches widescale use one thing is clear Sticking to the status quo is not an option. With million Americans a year acquiring bacterial infections that are no longer thwarted by antibiotics the era of blissful overdependence on these onetime miracle drugs is drawing to a close. Im quite optimistic about the future of phage says Randy Kincaid senior scientific officer for the arm of the National Institutes of Health that will be overseeing phage therapy development. But I think until and unless people take the more structured approach to understanding and using and developing the treatment well always be asking what if What if wed only done it better what if wed only done it the right way. For Rose George the knotty issues surrounding phage therapy are all beside the point. The Phage Therapy Center gave her access to a treatment she couldnt get in her own country. And that treatment is still ongoing. Though phages cleared one of Rachels infections beautifully the other the Pseudomonas is a stubborn bug. Every three months the Phage Therapy Center asks Rose to send a new sample from Rachels lungs and when the bacteria mutates they send a new mixture of phages. Somehow the infection persists. But Rose is grateful that Rachels infections are finally under control. While the hospital is still their second home because of Rachels numerous other health issues she recently had hip replacement surgery and had her gallbladder removed the infections are no longer what are bringing here there. These people saved my daughters life Rose said. It is crazy that its not part of our arsenal."

"Millions of Americans suffer from pet allergies that prevent them from enjoying the benefits of owning a dog or a cat http Thea Joyce is among them but couldnt bear the thought of having to give up her two cats Kirby and Lennon. It was really bad Joyce told FoxNews.com. I was just itchy all the time and sneezing all the time. I was really uncomfortable and miserable. Joyce tried overthecounter medications but couldnt find relief. She consulted an allergist at Weill Cornell MedicineNew YorkPresbyterian Hospital where a clinical trial involving immunotherapy toothpaste was taking place. The toothpaste called Allerdent works to keep breath fresh and fight cavities while also offering the same benefits as an allergy shot or drops. Researchers found that applying the extracts found in a shot to the lining of a patients mouth worked just as well to alleviate symptoms. The patients who came in were treated for the very things that they were sensitive to and that included indoor allergens like dustmite and pet dander as well as outdoor allergens such as tree pollen grass pollen ragweed pollen Dr. William Reisacher an associate professor of otolaryngology and director of allergy services at Weill Cornell MedicineNew YorkPresbyterian Hospital told FoxNews.com. Joyce who lives in the Bronx New York signed on for the yearlong study that required six of the volunteers to brush their teeth for two minutes using two pumps of the toothpaste in either the morning or night and the other six to use drops under their tongue. Volunteers using the toothpaste were also required to log their usage in a journal. Both groups reported a significant decrease in their symptoms including Joyce who was in the toothpaste group. Allerdent is not covered by insurance meaning Joyce spends about every three months but said the cost is worth it. I used to be so irritable because I was so uncomfortable Joyce said. But now I dont really feel allergy symptoms anymore. To find a prescribing doctor for Allerdent in your area or to find more information visit Allovate.com. httpallovate.com"

"Dolphins are some of the most charming charismatic and entertaining animals in the ocean. Adding to their mystique they have gained a reputation for their supposed healing powers over the last couple of decades. Facilities scattered around the world offer various forms of dolphinassisted therapy for people with mental and physical ailments. Essentially its an expensive opportunity to swim with dolphins. Parents of children with severe autism Down syndrome cerebral palsy or other disabilities spend thousands of dollars on such dolphinbased treatments in hopes that the animals can reach their kids in ways that psychiatrists physical therapists or medications never could. One destination for dolphinbased treatment is Island Dolphin Care in Key Largo Fla. The center has six Atlantic bottlenose dolphins in a pennedin canal connected to the ocean. According to the website the dolphins personalities run the gamut from tomboy to Gucci girl. The center also has a staff that includes a social worker and three special education teachers along with speech therapists and other specialists who visit from time to time. A fiveday program costs and includes about minutes of dolphin time each day. Other time is spent in classrooms or therapy depending on the needs of the child or the wishes of the parents. The dolphins also work with some adults including veterans who have lost limbs. There dont appear to be any dolphin therapy programs in California. You can swim with dolphins at SeaWorld in San Diego but its not offered as therapy. There are several programs in Mexico however including the Living From the Heart Dolphin Experience in Cozumel. The program includes five minute sessions with a single dolphin in a pool over three days. The cost is . The claims The Internet is rife with claims that dolphins can use their natural ultrasound to zap tumors heal muscle injuries and stimulate the brains of disabled children. Through mechanisms that arent completely clear there are also reports that dolphins have relieved chest pain and restored faulty vision. A site for a dolphin therapy center in Ukraine says its dolphins can treat chronic fatigue syndrome headaches depression and autism among many other conditions. The programs closer to this part of the world tend to be more reserved. The website for Island Dolphin Care doesnt claim that the dolphins cure any illness although the dolphins are said to provide unconditional love and support to children with disabilities or terminal illnesses. Deena Hoagland a licensed social worker and executive director of Island Dolphin Care says that dolphins dont have magical powers. Its very irresponsible to give false hope she says. She believes the animals bring joy confidence and selfesteem to children and adults. She adds that dolphin therapy is only a small part of her overall program. We use traditional treatments in an exciting way she says. The website for the Living From the Heart Dolphin Experience says that of autistic children who receive dolphin therapy enjoy benefits that last up to two years. Those benefits are said to include longer attention spans better emotional control and improved communication skills. Macy Jozsef the executive director of Living From the Heart says she has been providing dolphin therapy for more than years. Nobody really knows why dolphins have the impact that they do she says. I speculate that dolphins help synchronize the left side and right side of our brains and nothing else does that. The bottom line If you think your child will enjoy splashing around with a big smart aquatic mammal a dolphin experience might be a fine investment. But if youre looking for a treatment with scientifically proven results you should look past the dolphin tank. Even Hoagland agrees that theres no real research to support dolphin therapy but she sees that shortcoming in a positive light If theres no science behind it how can you say that it doesnt work There are a few dolphin studies out there but they dont add up to much says Lori Marino a neuroscience and behavioral biology researcher at Emory University in Atlanta. Japanese researchers published a small study in suggesting that dolphin therapy can somehow treat eczema but that finding stretches credulity Marino says. Another study that year from Australian researchers concluded that swimming with dolphins could improve feelings of wellbeing while reducing anxiety but the findings were based on questionnaires given to healthy people who had paid for their adventures which predisposed them to see the investment as worthwhile. A more plausible study published in the British Medical Journal in found that dolphin therapy relieved depression symptoms for a group of adults. Marino critiqued these and other studies in a review article published in in the journal Anthrozoos."

"News this summer of a flu vaccine patch sparked a lot of chatter. Could getting vaccinated be as easy as putting on a bandage Could there be fewer or at least smaller needles in our future Some companies and academic labs are working to make those things happen. Theyre refining technologies that involve tiny needles less than a millimeter long and needlefree injectors that can send a dose of vaccine through your skin in a fraction of a second. Some of these technologies are already available on the market while others are still being tested. One hundred very tiny needles A flu vaccine patch is not yet available to the public. But one version developed by Georgia Techs Laboratory for Drug Delivery httpdrugdelivery.chbe.gatech.eduindex.html showed promising results in its first human clinical trial according to a study published http in The Lancet in June. The patch about the size of a small square bandage has tiny dissolvable needles filled with a dose of flu vaccine. Its placed on the arm and activated through pressure. The microneedles dissolve into the skin releasing the vaccine. Article continues after this message from our sponsor In the study participants received either the flu vaccine patch a standard flu shot or a placebo via a patch. Six months later no one involved in the study had gotten the flu. People in the microneedle patch groups reported some redness itching and tenderness but no serious side effects. People who received the flu patch had comparable immune responses to people who had gotten the flu shot. About percent of the patients in the study preferred the patch to the regular shot says Yasmine Gomaa the labs associate director. Now Gomaas lab is looking beyond the flu vaccine. She says the microneedle patch could be particularly helpful in developing countries because it uses a form of vaccines that doesnt need to be kept as cold as regular vaccines. It can be stored at temperatures as high as degrees Fahrenheit for up to a year she says. The microneedles attached to this patch dissolve after being pressed into skin releasing a dose of vaccine. Each microneedle is less than a millimeter in length. Courtesy of Georgia Institute of Technology And the patch can be administered by people who arent trained health professionals. A number of the people in the flu patch study applied it to themselves. In Georgia Tech and the pharmaceutical company Micron Biomedical won . million http in grants from the Bill and Melinda Gates Foundation to develop a patch for polio immunization. Gomaas hope is that vaccine patches will cost less than vaccinations do now. A study https from the Centers for Disease Control and Prevention found that the use of vaccine patches could save on cooling costs and could cut down on waste. Its analysis concluded that a dose of measles vaccine with the patch would cost just under while a typical shot would cost .. But that didnt take into account the costs of getting the patch to market. The potential cost savings wouldnt happen until the patches were in routine use the CDC noted. A twist on Star Trek technology Others in the vaccinedelivery business are taking a different approach using a new twist on a needlefree device called a jet injector that has been around for more than half a century. Star Trek featured such a device calling it a hypospray. Portal Instruments a company that is developing jet injectors uses technology based on work done by Ian Hunter http at the Massachusetts Institute of Technology. Initially we worked on microneedles says the companys CEO Patrick Anquetil https And then Ian realized that why dont we just remove the needle altogether And thats how this project came to be. Needlefree jet injectors were actually used in the s https in mass smallpox vaccination campaigns. As described by the CDC these devices use a highpressure narrow stream of fluid to penetrate the skin. The diameter of the stream is comparable to a mosquito bite. The devices were used to quickly vaccinate large numbers of people including members of the armed forces. Anquetil notes that the older devices sometimes made patients feel as if they had been punched. To create the jet you have to instantaneously create times more pressure than youve got in the tire of a car he says. Patients actually hated them because they were more painful than a needle and syringe. Others echo that sentiment. My yearold neighbor still remembers how painful it was says Ron Lowy httppharmajet.comaboutus CEO of PharmaJet a company that makes an FDAapproved https jet injector that administers a flu vaccine. The older devices had another problem. They used the same nozzle for multiple injections leading to concerns about the transmission of bloodborne pathogens between patients. Todays devices have made a lot of progress Lowy says. Now the syringe is changed for each patient and the injections are gentler. It feels like somebody snapped me with a rubber band he says adding that the injection happens too fast for some patients to register any sensation at all. It lasts about onetenth of a second. He says hundreds of thousands of people in the U.S. have already received the flu vaccine via one of PharmaJets injectors. If you have your choice you want to get poked with a needle or you want to try this Most of the people say Yeah Ill try that he says. Cost remains an issue for some jet injectors. Portal is aiming to get its cost down to or per injection. In vaccines whats really hard is that theres a very very high volume and youre competing with a needle and syringe which is tremendously low cost Anquetil says. PharmaJet says the ability to give precise doses helps to save money. The company says its flu vaccine starter kit which can vaccinate people costs . Nasal spray hits a roadblock FluMist an FDAapproved flu vaccine delivered through a nasal spray https was widely used in the U.S. and at one point was even the preferred method of vaccination for children. Then last year in a sharp turnaround the CDC recommended https that it not be used during the flu season after a study found it had not been very effective in the previous year particularly among kids. The vaccines effectiveness https was just percent so low that no protective benefit could be measured for children ages to the CDC said in a statement. In contrast the effectiveness of the flu shot was about percent for kids in that age group. AstraZeneca the parent company behind FluMist says the CDCs data contradicts https data from several other studies which show the vaccine was about percent effective during the same flu season. And the same vaccine continues to be recommended and used in European Union markets AstraZeneca says. In the U.S. the CDC continues to recommend against the nasal spray vaccine for the upcoming flu season. AstraZeneca hopes to reverse that decision before flu season begins. We continue to pursue a broadbased investigation to identify potential causes of lower effectiveness in recent years the company said in a statement adding that one of the four flu virus strains it used in the vaccine during the past two flu seasons may have been the problem. The company has chosen a new strain of live virus that is similar to other strains that have proven effective in studies and clinical trials."

"FINDINGS Gene expression in specific cells and in specific regions can provide a more precise neuroprotective approach than traditional treatments for neurological diseases. For multiple sclerosis specifically increasing cholesterol synthesis gene expression in astrocytes of the spinal cord can be a pathway to repair nerves that affect walking. BACKGROUND Multiple sclerosis is an autoimmune neurodegenerative disease characterized by distinct disabilities affecting walking vision and cognition to name a few. MS patients differ markedly from each other regarding which disability affects them the most. Inflammation strips the myelin coating from nerve cell extensions called axons and connections at the ends of nerves called synapses are lost together disrupting signaling and eventually causing permanent disability depending on where this occurs. UCLA researchers proposed that molecular mechanisms behind each disability may differ and that neuroprotective treatments tailored for each disability may be more effective than nonspecific treatments aiming to reduce a composite of different disabilities. The team focused on astrocytes a type of brain cell that becomes activated in MS and plays several important roles in disease examining gene expression in astrocytes in different regions. METHOD Working with a mouse model of MS the research team assessed astrocytes in various regions of the brain and spinal cord known to be involved in walking vision or cognition. They compared gene expression changes between regions that correspond to different disabilities. In the spinal cord an area thats critical for walking they found a decrease in the expression of cholesterol synthesis genes. Cholesterol does not leave the blood and enter the brain instead it is made in astrocytes and plays a role in making myelin the nerve coating and synapses the nerve connections. They hypothesized that while inflammation causes loss of myelin and synapses it is the decrease in cholesterol synthesis gene expression in astrocytes that explains why lesions do not repair in MS. They treated MS mice with a drug that increased expression in cholesterol synthesis genes and this resulted in improved walking ability. IMPACT This disabilityspecific discovery approach represents a strategy for finding neuroprotective treatments for neurodegenerative diseases that are tailored to repair damage for each disability one at a time in contrast to a one size fits all treatment approach. AUTHORS In addition to senior author Dr. Rhonda Voskuhl who directs UCLAs Multiple Sclerosis Program and holds the Jack H. Skirball Chair in Multiple Sclerosis Research study cofirst authors were Noriko Itoh Yuichiro Itoh and Alessia Tassoni with other coauthors including Emily Ren Max Kaito Ai Ohno Vista Farkhondeh Hadley Johnsonbaugh Yan Ao Josh Burda and Michael Sofroniew all of UCLA. JOURNAL The study is published in the Proceedings of the National Academy of Sciences. FUNDING The work was supported with funding from the Conrad N. Hilton Foundation the National Institutes of Health the California Community Foundation the Tom Sherak MS Hope Foundation the Rhoda Goetz Foundation for Multiple Sclerosis and other partners of the UCLA Multiple Sclerosis Program."

"Johnson Johnson said on Tuesday its blockbuster drug Stelara was found to be effective in treating a chronic bowel disease in a latestage trial. Two doses of Stelara already approved for psoriasis psoriatic arthritis and Crohns disease was tested in patients with moderatetosevere ulcerative colitis UC who had failed prior therapy. Both mgkg and mg doses of the intravenous treatment showed clinical remission in significantly more patients compared with those on placebo after eight weeks the company said. The treatment and the placebo arms reported similar proportion of side effects with one patient on the mgkg dose dying following excessive bleeding JJ said. Sponsored The patient had no prior history of high blood pressure or cirrhosis the drugmaker said. More than half of UC patients have not experienced remission with currently available treatment options the studys lead investigator Bruce Sands said. Stelara which brought in sales of . billion in the second quarter of is also being tested in autoimmune disease lupus. Ulcerative colitis which affects about people in the United States annually is a chronic condition causing abdominal pain intestinal ulcers bloody diarrhea and weight loss. Current treatments include Pfizer Incs Xelijanz an oral treatment for adults patients with moderatetosevere UC and Merck Cos Renflexis. This story has been refilled to correct the dosage to mg not mgkg in paragraph Reporting by Manogna Maddipatla in Bengaluru Editing by Sriraj Kalluvila Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"In what researchers are calling a breakthrough two preliminary trials have found that either of two tripledrug regimens could potentially benefit percent of people with cystic fibrosis. The trials were shortterm finding that the drug combinations improved adult patients lung function over four weeks. But experts said they were optimistic the results will hold up in the larger longerterm trials already underway. Whats most exciting they said is that the tripledrug approach could open up new options to nearly all cystic fibrosis patients. This is not a cure for cystic fibrosis stressed Dr. Steven Rowe who led one of the trials. But it could be gamechanging. Cystic fibrosis CF is a genetic disorder that causes persistent lung infections. Over time extensive lung damage leads to respiratory failure. At one time children with CF usually died before they reached school age. But with improved treatments the typical life expectancy is now about years according to the Cystic Fibrosis Foundation. Cystic fibrosis is caused by various mutations in a gene called CFTR. In the past several years drugs that target those underlying genetics have become available. Known as CFTR modulators they were heralded as a major advance in treating the disorder. However they work well only for a small number of people with certain CFTR mutations explained Rowe director of the Cystic Fibrosis Research Center at the University of Alabama at Birmingham. The most common mutation that causes cystic fibrosis is called Fdel and it has proven tougher to tackle Rowe said. About half of people with CF carry two copies of the mutation one inherited from each parent. For them a combination of two existing CFTR modulators can ease breathing problems but the overall effects are only modest Rowe said. Then theres the percent of CF patients who carry only one copy of Fdel plus another defect known as a minimalfunction mutation. For them the existing CFTR modulators do not work at all. Both new trials focused on those two groups of patients. The results are published in the Oct. New England Journal of Medicine to coincide with the researchers presentation at a North American Cystic Fibrosis meeting in Denver. Rowes team tested a combination of two available CFTR modulators tezacaftor and ivacaftor plus an experimental one known as VX. The other trial used the same existing drugs along with a similar new drug dubbed VX. Rowes team randomly assigned adults with cystic fibrosis to either take the tripledrug regimen or be in a comparison group. In the comparison group patients with one Fdel mutation took placebo pills while patients with two copies of the mutation took tezacaftor and ivacaftor alone. After four weeks the trial found the tripledrug therapy had improved lung function in patients with both types of mutations. Their performance on a test called FEV rose by as much as percentage points on average what Rowe described as a pronounced improvement. The other trial had nearly identical results. This is the first time Rowe said that CFTR modulator therapy has pushed the needle for patients with one Fdel mutation. An editorial published with the studies said they represent a major breakthrough. Now the questions are whether the improved lung function can be sustained and whether the drugs prevent symptom exacerbations and other complications wrote Dr. Fernando Holguin of the University of Colorado Aurora. Vertex Pharmaceuticals Inc. is developing both experimental drugs. The ability of these potential drugs to treat individuals with a single Fdel mutation means that more people than ever before could benefit said Dr. Michael Boyle senior vice president for therapeutics at the foundation. This is very exciting news for our community. Rowe agreed there are still important questions about the tripledrug regimens. One is how well do they work for younger patients Patients as young as are included in the larger ongoing trials Rowe said. So far the treatments appear safe. Most side effects in the fourweek trials were mild to moderate the researchers said and included cough headache and increased sputum. If the experimental drugs are ultimately approved there will be the realworld issue of price. Vertex currently markets the combination of tezacaftor and ivacaftor as Symdeko at a reported list price of a year. In the United States more than people have cystic fibrosis according to the foundation. More information For an overview of cystic fibrosis visit the Cystic Fibrosis Foundation https SOURCES Steven Rowe M.D. M.S.P.H. director Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham Michael Boyle M.D. senior vice president therapeutics Cystic Fibrosis Foundation Bethesda Md. Oct. New England Journal of Medicine"

"Researchers from the Rowan University School of Osteopathic Medicine are nearing development of a blood test that can accurately detect the presence of Alzheimers disease which would give physicians an opportunity to intervene at the earliest most treatable stage. Robert Nagele PhD presented his teams most recent findings October at OMED in Orlando. Dr. Nageles work focuses on utilizing autoantibodies as bloodbased biomarkers to accurately detect the presence of myriad diseases and pinpoint the stage to which a disease has progressed. By detecting Alzheimers disease long before symptoms emerge Dr. Nagele hopes those with diseaserelated autoantibody biomarkers will be encouraged to make beneficial lifestyle changes that may help to slow development of the disease. There are significant benefits to early disease detection because we now know that many of the same conditions that lead to vascular disease are also significant risk factors for Alzheimers. People found to have preclinical disease can take steps to improve their vascular health including watching their diet exercising and managing any weight and blood pressure issues to help stave off or slow disease progression Nagele said. While the cause of Alzheimers remains elusive it is clear that maintaining a healthy bloodbrain barrier is a critical preventative measure. Diabetes high cholesterol high blood pressure stroke and being overweight jeopardize vascular health. As blood vessels in the brain weaken or become brittle with age they begin to leak which allows plasma components including brainreactive autoantibodies into the brain. There the autoantibodies can bind to neurons and accelerate the accumulation of beta amyloid deposits a hallmark of Alzheimers pathology. The blood test developed by Dr. Nagele has also shown promise in detecting other diseases including Parkinsonss multiple sclerosis and breast cancer. His teams research on the role of autoantibodies explains that All humans possess thousands of autoantibodies in their blood These autoantibodies specifically bind to bloodborne cellular debris generated by organs and tissues all over the body An individuals autoantibody profile is strongly influenced by age gender and the presence of specific diseases or injuries and Diseases cause characteristic changes in autoantibody profiles that when detected can serve as biomarkers that reveal the presence of the disease. In Alzheimers the brain begins to change years before symptoms emerge. Detecting Alzheimers antibodies at the preclinical stage would give patients an opportunity to work with their physician to make lifestyle changes or receive available treatments before they become symptomatic. Potentially this early intervention could help those with preclinical Alzheimers avoid or delay the most devastating symptoms. As osteopathic physicians we constantly tell patients that a healthy lifestyle is the best medicine for preventing disease. We also know that many people tune out messages about nutrition and exercise until a health crisis gets their attention said Jennifer Caudle DO assistant professor of family medicine at Rowan University. I cant think of a single patient who wouldnt take steps to prevent the progression of Alzheimers if they could directly affect their prognosis. Today there is no definitive FDAapproved blood test for Alzheimers which affects an estimated . million Americans. It is among the top causes of death in America. Dr. Nageles research has been supported by grants from the Michael J. Fox Foundation and the Osteopathic Heritage Foundation. About OMED OMED is a fiveday event offering clinical and research updates in specialties with an emphasis on osteopathic principles and practices. The osteopathic philosophy of medicine takes a whole person approach to prevention diagnosis and treatment giving its practitioners a distinct model for clinical problem solving and patient education. OMED welcomes all health care professionals including MDs nurse practitioners and physician assistantsinterested in osteopathic medicines collaborative approach to increasingly complex medical issues. To learn more about DOs and the osteopathic approach to medicine visit http"

"Scientists say they have created a new drug that can attack ovarian and lung cancers https patients for whom other treatments have failed. The U.K.based researchers used a new drug along with chemotherapy medication known as paclitaxel on women with highgrade serous ovarian cancer and participants with squamous nonsmall cell lung cancer. The cancers had spread across the bodies of each participant who did not respond to standard treatment. Over half of patients with ovarian cancer and over a third with lung cancer saw their tumors shrink according to the study which was published in the Annals of Oncology. The cocktail also stopped the cancer growing for almost six months which is unexpected for patients with advancedstage cancers who were unresponsive to currently available treatments including chemotherapy the authors said. Read more Most common childhood cancer is likely caused by lack of exposure to infections major study finds https The research was led by scientists at The Institute of Cancer Research ICR and The Royal Marsden NHS Foundation Trust as well as teams in nine institutions across the U.K. It built on previous research by the ICR that showed ovarian cancer cells resistant to treatment generally have higher levels of a molecule called pSK which aids the growth of the disease. The scientists hypothesized the cancer could use this molecule to render chemotherapy ineffective. Vistusertib attacks proteins called mTOR and which turn on the pSK protein. Combined with paclitaxel chemotherapy the scientists were able to block cancer cells from harnessing pSK. That is why the patients tumors shrunk the study suggests. Dr. Susana Banerjee consultant medical oncologist at The Royal Marsden NHS Foundation Trust and team leader in gynecological cancers at ICR who is leading the phase II trial commented in a statement Effective treatment options for women with relapsed ovarian cancer are limited so these results are very encouraging. Commenting on the next stage of the research she said In the larger phase II trial weve recruited women with relapsed ovarian cancer across the U.K. to standard chemotherapy paclitaxel or paclitaxel in combination with vistusertib. We need to wait for these results expected later this year to see how effective this approach is compared to chemotherapy alone. Professor Udai Banerji author of the study and deputy director of the Drug Development Unit at The ICR and Royal Marsden acknowledged in an interview with Newsweek the cohort of patients was small however anything more than patients usually gives one a rough idea of the effectiveness of a treatment. Dr. Dean A. Fennell professor and consultant in thoracic medical oncology at the University of Leicester who was not involved in the study told Newsweek the study presents an exciting result. He was particularly surprised by the magnitude of the response triggered by vistusertib combined with paclitaxel which is closely related to standard chemotherapy. However Fennell said the study tripped up in that there was no predictive link between mutations and response to treatment. In other words there was no sign of who might benefit the most with treatment he explained. He continued This combination of vistusertib and paclitaxel appears promising in lung cancer. Confirmatory studies will be essential and if positive would broaden our armamentarium for fighting this cancer."