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"Weight loss is typically accomplished through changes in diet and exercise. But a new study sheds light on some other factors that can help an individual achieve success. Getting a healthy amount of sleep avoiding stress and complying with specific elements of a weightloss plan such as keeping a food diary seem to boost the odds of success according to a new study. The study conducted by Kaiser Permanente Center for Health Research in Portland Ore. involved nearly adults who had an average body mass index of . or greater is considered obese. The participants whose average age was were instructed to attend group counseling sessions over weeks reduce dietary intake by calories a day by following a lowfat lowsugar diet and increase exercise to at least minutes a week. After six months of the participants had lost at least pounds and were enrolled in a maintenance phase of the study. Researchers found that the people who lost at least pounds had some common characteristics. They were more likely to attend their counseling sessions keep food diaries and exercise. But coming into the study the successful dieters were more likely to report that they slept between six and eight hours each night. People who had lower stress scores coming into the study were also able to lose more weight. People who need to lose weight should consider changes in their sleep patterns and exposure to stress the study authors said. ... if stress becomes chronic and eating is learned to be an effective coping behavior highly palatable food may appear to be addictive they wrote. The study did not find that screen time was linked to weight loss. But TV watching may have a different effect on weight loss than time spent on computers at work the researchers said. The study is published in the International Journal of Obesity http Related Obese and overweight women and children may underestimate how heavy they are. http Return to Booster Shots blog http"

"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."

"More than years after the gene behind cystic fibrosis http_Genomeposterschromosomecftr.shtml was identified a pill that could fix the problem in some people is getting closer to reality. The experimental medicine taken twice a day goes by the code name VX. Now there are some promising results from a study httpclinicaltrials.govctshowNCTtermvxrank in people with a specific genetic mutation that affects about four percent of cystic fibrosis patients. Lung function got percentage points better on average in people who got the drug compared with those taking a placebo. The improvement at six months was still present almost a year after the studys start. That much improvement is a big deal for CF patients Robert Beall http president of the Cystic Fibrosis Foundation told Shots. It is larger than any other clinical intervention weve ever had in cystic fibrosis. Beall said there were no significant side effects. The foundation has championed the development of drugs including VX and has provided million to Vertex http to get the medicine this far. If the drug makes it to market the foundation will receive royalties from sales. This pill for people with the GD mutation http of the cystic fibrosis gene helps a defective protein in cell membranes httpghr.nlm.nih.govgeneCFTR do a better job moving things around. Lisa Jarvis has more details httpcenblog.orgthehaystackvertexunveilsexcitingdataforcysticfibrosisdrug on that at the Haystack blog. But a key takeaway is that the medicine gets at a root cause of cystic fibrosis in some people rather than just relieving their symptoms. Article continues after this message from our sponsor Now to be perfectly clear all we know about the latest data is from press releases. And the drug hasnt been submitted for review by the Food and Drug Administration though Vertex expects to do that later this year. But these results even with plenty of caveats suggest the drug is on the right track. Vertexs shares jumped percent Wednesday as investors figured VX looks even better than theyd expected. Wow wrote Dr. Mark Schoenebaum http a biotech and drug analyst ISI Group in a note to investors. The effectiveness of VX looks best case he wrote. Ultimately the drug might be used by around patients worldwide if approved and Schoenebaum expects it would be command a very high price perhaps a year."

"Vanda Pharmaceuticals Inc said its experimental drug for a rare sleep disorder proved effective in a second latestage trial and the company now plans to apply for a U.S. approval for the drug in mid. The study named Reset was a patient trial designed to test the maintenance effect of a mg dose of the drug tasimelteon. Vanda on December said the drug performed better than a placebo in the first of the four planned latestage trials on the drug. The companys shares rose as much as percent on that day. While the first two are efficacy studies the remaining two are intended to establish the safety profile of the drug. The second trial showed that patients treated by the drug maintained their clinical benefits while placebotreated patients showed significant deterioration in measures of nighttime sleep daytime naps and timing of sleep. The drug is being tested for nonhour disorder that has no approved treatment. The condition in which a persons body clock does not automatically set to the hour day affects a majority of blind people. These results also highlight the importance of chronic therapy in treating Non CEO Mihael Polymeropoulos said in a statement on Wednesday. Tasimelteon received orphan drug status which offers several years of marketing exclusivity for drugs developed for rare conditions from the FDA in and from the European Commission in . An orphan drug if approved can usually fetch a premium pricing in the market. Shares of Vanda which has a market of about million closed at . on Tuesday on the Nasdaq. They have gained nearly percent since December . Reporting by Esha Dey in Bangalore Editing by Maju Samuel Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The benefits for the heart of eating strawberries and blueberries can build up over a lifetime according to the latest research. Brightcolored berries have long been a part of any healthy diet owing mainly to the anthocyanins httphealthland.time.comcanblueberryjuiceboostyourmemory that give them their vibrant color and act as antioxidants to fight off damage to cells. Now a study published in the journal Circulation confirms and quantifies that benefit women who ate three or more servings of blueberries and strawberries per week reduced their risk of heart attack by up to one third. In the study researchers from the Harvard School of Public Health and the University of East Anglia in the U.K. analyzed data from women ages to enrolled in the Nurses Health Study II. For years the women filled out surveys detailing their diets at fouryear intervals. MORE Study Flavonoids May Help Protect Against Parkinsons httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons During the study the women experienced heart attacks httptopics.time.comheartattacks. But women who consumed the most blueberries and strawberries had a reduced risk of heart attack compared with the women who ate berries once a month or less. The women who ate more berries also tended to eat healthier overall consuming more vegetables and fruits than those who didnt eat as many berries but when the scientists broke down the womens diets they found that the highest consumers httptopics.time.comconsumers of berries even had a lower risk of heart attack compared with women who still ate plenty of fruits and vegetables but fewer berries. The effect remained even after the researchers adjusted for other things that can influence heartdisease risk such as obesity high blood pressure smoking httptopics.time.comsmoking low levels of physical activity and a family history of heart disease. These foods can be readily incorporated into diets and simple dietary changes could have an impact in reducing risk of heart disease in younger women says study author Aedin Cassidy from the University of East Anglia. This supports growing lab data showing that these compounds can help keep arteries healthy and flexible. So what is it about berries that help the heart The researchers focused on blueberries httphealthland.time.comcanblueberrieshelpfightfat and strawberries httphealthland.time.comcaneatingstrawberriespreventcancer because these are the most widely consumed varieties in the U.S. Both berries contain high levels of anthocyanins as well as other flavonoids which fight the effects of stress and freeradical damage to cells as they age. They can also keep heart vessels more elastic and flexible which helps combat the growth of plaques that can build up and rupture causing heart attacks. MORE Can Eating Fruits and Veggies Outwit Bad Heart Genes httphealthland.time.comeatingfruitsandveggiesmayoutwitbadheartgenes The results are particularly encouraging because they showed that a change in diet could affect heartdisease risk for relatively young women. That means that regular consumption of berries might be a relatively easy way to lower a womans risk of having a heart attack later in life possibly even insulating her from heart problems. Although we know about the effects of antioxidants httphealthland.time.comstudyveggiesstillreallygoodforyou and flavonoids httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons and their effects in wine httphealthland.time.comcheersladiesadrinkadaymaymeangoodhealthinolderage and chocolate httphealthland.time.comsweetalittlechocolateadaymayhelplowerbloodpressure it is interesting to look at their effects in such a large group of women over a long period of time says Dr. Suzanne Steinbaum director of women and heart disease at Lenox Hill Hospital in New York City who was not involved in the study. The takehome lesson is that even if you are eating these early in life youre getting benefits that last for life. When were making choices in our s we may think that a burger and fries is great but the message is that there are alternatives that make a difference for the rest of your life. It is a powerful message that we can prevent cardiovascular disease by what we eat. Something worth remembering the next time youre in the produce aisle."

"The promise of genetic medicine is beginning to be fulfilled but its been a long hard slog. Take the story of Kalydeco http Its designed to treat people with a lung disease called cystic fibrosis. While not quite a cure the drug is extremely effective for some CF patients. But the success of Kalydeco has been more than two decades in the making. A good starting point for the story is Aug. . Thats the day scientists from the U.S. and Canada announced the discovery of the gene associated with the disease. It was the early days of gene hunting and the CF gene was a big prize. CF is the most common genetic disease in Caucasians. When people inherit a damaged form of the CF gene a critical protein inside cells doesnt work properly. As a result sticky mucus builds up in a patients lungs causing infections and making it hard to breathe. The announcement was supposed to be made in conjunction with three papers http in the Sept. issue of Science but a reporter for Reuters got hold of the story early. Science took the unusual step of allowing the scientists to speak to the media before publication. Article continues after this message from our sponsor At the time scientists predicted that a genetic test for CF was just around the corner. But they also thought a drug to treat the disease was in reach. The first prediction turned out to be right. But it wasnt until years later that we were able to find drugs that directly target the underlying cause of cystic fibrosis says Fred Van Goor who led the team at what is now Vertex Pharmaceuticals http that developed Kalydeco. So it was a long time between the discovery of the gene and the discovery of Kalyedco. It took awhile to find a drug that would help restore the function of the protein the CF gene makes. We tested over chemicals in cells with the defective protein that causes cystic fibrosis says Van Goor. One of those chemicals ultimately became a successful drug but it had to be modified so patients could take it by mouth and so it would last the right length of time in a patients body. From the start Van Goor and his colleagues knew there was a problem with Kalydeco It only works on a small subset of people with CF. They have to have a particular mutation in the CF gene or the drug is of little use. But for people who do have that mutation the drug works remarkably well. Emily Schaller was in one of the early studies of Kalydeco. As part of the study researchers first gave her a placebo then switched her to the active drug. She knew within days that something was different. I was with my brother in Florida and we were walking down the street and I took a deep breath and when I took a deep breath in and I let it out I didnt cough says Schaller. But not only did I not cough but I felt that my lungs were clear and that something huge had happened. It was just something I had never felt in my life before. Schaller isnt cured. She still has a damaged CF gene. The only way to fix that would be gene therapy http where a healthy form of the gene would supplant the damaged one. Although it seems simple in theory in practice gene therapy has been incredibly difficult to accomplish. Schaller isnt particularly bothered by that. Everyone talks about curing a disease cure CF cure these other diseases. But Kalydeco controls CF at the basic defect so Im OK with the other c word control because Im living it and Ive never felt better in my life. The time from gene discovery to successful drug may be shortening but there are only a handful of successful drugs so far and for a while at least the appearance of new ones will be slow. Theyre also likely to be expensive. Kalydeco costs in the neighborhood of per year."

"Researchers at Johns Hopkins Medicine have identified in live human brains new radioactive tracer molecules that bind to and light up tau tangles a protein associated with a number of neurodegenerative diseases including Alzheimers disease and other related dementias. Two studies will be published backtoback in the December issue of Journal of Nuclear Medicineone as featured article of the monthdescribing testing of three candidate molecules in patients with Alzheimers disease as well as the use of one molecule to measure the accumulation of tau proteins. One of the greatest public health challenges is Alzheimers disease for which there currently is no cure and no definitive diagnostic until autopsy says Dean Wong M.D. Ph.D. https professor of radiology and radiological sciences psychiatry and behavioral sciences neurology and neuroscience and director of the Section of High Resolution Brain PET Imaging Division of Nuclear Medicine at the Johns Hopkins University School of Medicine. We have been working hard to identify new radiopharmaceuticals that can help speed the discoveries of diagnostics and treatments for these devastating neurodegenerative disorders. Alzheimers disease is characterized in the brain by the appearance of two abnormal protein structures amyloid plaques and tangled fibers made up of a protein called tau. One of the biggest challenges in studying Alzheimers disease thus far according to Wong is the inability to watch these socalled neurofibrillary tangles develop in real time. As part of a longer term project funded by F. HoffmanLa Roche the team previously tested a collection of approximately potential tracer molecules and identified six promising tracers eventually narrowing them down to three to be made and tested as candidate Tau PET radiopharmaceuticals. These three most promising tracers were previously tested in nonhuman primates and the results looked promising enough to test in people. The researchers recruited a total of patients with Alzheimers disease seven younger healthy controls ages years old and five older healthy controls age or older for brainonly PET scans. An additional six older healthy controls were recruited for fullbody scanning. The study was divided into three parts. In the first part each person was injected with two of the three randomly designated tracers on separate visits prior to receiving a brain PET scan with subsequent evaluation to determine which molecule performed best. In the second part of the study researchers tested the optimal tracer called F RO with additional brain imaging in five patients with Alzheimers and five older controls with followup of previously seen patients to evaluate the potential progression of tau protein tangling after an average span of approximately months. The third part of the study examined six older controls undergoing wholebody scanning. In total the researchers looked at different regions in the brain to evaluate how well the tracers were taken up by the brain how well they penetrated through the tissue and how specifically they bound to the tau protein rather than just sticking indiscriminately to anything. Regions of the brain that typically contain accumulated tau protein include the temporal lobe parietal lobe and occipital lobe among others grey matter in the cerebellum is thought to contain low or no tau in patients with Alzheimers. They found that healthy brains retained little to no tracer whereas the brains of those with Alzheimers showed tau to be in regions of the brain consistent with previously reported postmortem data on filamentous tangles. In the second paper the team examined the detailed quantification of tau binding via F RO in patients with Alzheimers disease five young cognitively normal controls and five older cognitively normal controls. They verified that detailed quantification of the tested and retested tracer in those five patients with Alzheimers and five older controls generated good and reproducible results. According to Wong this body of work reveals that as compared with the currently used Tau tracer F AV the new tracer F RO does not bind randomly to other tissue offering greater clarity into quantification of potential tau burden within the human brain. It really takes a village to make progress in biomedical research and this project was no exception with the involvement of the PET team at Hopkins a CRO who helped recruit healthy subjects colleagues in psychiatry and behavioral sciences colleagues at the National Institute of Aging and neuroscience imaging experts at Roche says Wong. This is a true example of crossdisciplinary collaboration and Im honored to have such great collaborators. This study was made available online in May ahead of peerreview and publication. It was published in the December issue of the journal. Authors of the first Journal of Nuclear Medicine featured paper Characterization of Novel Tau Radiopharmaceuticals CRO CRO and FRO in Healthy Controls and in Alzheimer Subjects httpjnm.snmjournals.orgcontent include Dean F. Wong Hiroto Kuwabara Paul B. Rosenberg Esther Oh Constantine G. Lyketsos Noble George Lorena Gapasin Kelly Kitzmiller Josh Roberts Ayon Nandi James Brasic Chakradhar Mishra Abhay Moghekar Anil Mathur Marilyn Albert and Robert F. Dannals of The Johns Hopkins University Baltimore Maryland Robert A. Comley Susanne Ostrowitzki Cristina Vozzi Frank Boess Michael Honer Luca Gobbi Gregory Klein Jeff Sevigny and Edilio Borroni Pharma Research and Early Development HoffmannLa Roche Basel Switzerland and Susan M. Resnick and Madhav Thambisetty Lab of Behavior and Neuroscience NIHs National Institute on Aging Intramural Research Program Baltimore Maryland. This study was funded by an F. HoffmannLa Roche Ltd. contract to The Johns Hopkins University. Susan Resnick and Madhav Thambisetty are employees of the NIH National Institute on Aging. The authors report no other relevant potential conflict of interest."

"The U.S. Food and Drug Administration took a fresh step on Thursday towards setting a maximum nicotine level for tobacco products in a bid to lower tobaccorelated deaths across the country saying it would collect public comment and scientific research over the next three months. The move was part of a comprehensive plan the agency announced last summer to regulate tobacco and nicotine FDA Commissioner Scott Gottlieb said on a call with reporters. That plan marked a major shift designed to give adult smokers a wider range of alternatives including potentially less harmful ecigarettes. The agency is seeking to determine a level of nicotine in cigarettes and other tobacco products that would be minimally addictive or nonaddictive according to a draft proposal. It hopes setting such a standard would also help prevent teenagers who experiment with tobacco from becoming addicted. The FDA estimates that setting such a standard would help million smokers quit within a year and prevent more than million teens and young adults from becoming regular smokers by the year . There is no other single action our country can take that would prevent more young people from smoking or save more lives said Matthew L. Myers president of Campaign for TobaccoFree Kids. Major tobacco players such as Altria Group and British American Tobacco are grappling with sales declines in the U.S. market and hoping to recoup revenue through novel tobacco and nicotine products such as ecigarettes. Altria Group has partnered with Philip Morris International to sell a novel device called iQOS which heats but does not burn tobacco. The FDA is currently reviewing the iQOS application. The FDA is seeking additional research and data for public review Gottlieb said as it tries to develop a nicotine product standard. Gottlieb said the FDA was also seeking public opinion on whether a product standard should be implemented all at once or gradually. The comment period will be open through midJune said Mitch Zeller director of FDAs Center for Tobacco Products. The FDA will continue to take enforcement actions against companies that inappropriately target children including through the promotion of ecigarettes Gottlieb said. James Figlar executive vice president of research and development for R.J. Reynolds Tobacco Company part of British American Tobacco said the company would work with the agency to create a path for alternative less harmful tobacco products to reach the market. The FDA will seek public input and scientific research on the role that flavors such as menthol play in tobacco addiction and for the regulation of premium cigars Gottlieb said. Well also advance key parts of our tobacco plan very soon he said. Reporting by Yasmeen Abutaleb in Washington and Sharnya G in Bengaluru Editing by Savio DSouza and Bernadette Baum Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The Maryland Proton Treatment Center MPTC is now offering deeptissue external thermal therapy in combination with highprecision protonbeam radiotherapy as a potential way to boost survival chances for certain cancer patients. MPTC is the only center in the world to offer these two treatments at the same facility an advantage to patients because these therapies are typically given within an hour of each other. Research has shown that thermal therapy can be especially useful in difficulttoreach cancers in the abdomen and pelvic region. Studies have found that adding thermal therapy to standard treatments can significantly shrink tumors and can improve survival for some patients. External thermal therapy or hyperthermia in the range of up to F. sensitizes tumor cells to chemotherapy and radiation therapy. In addition heat has been shown to enhance antitumor immune response. We are very pleased to be able to offer deeptissue thermal therapy which can be combined with standard radiation therapy as well as protonbeam therapy to enhance the cancerkilling effects of the radiation says Zeljko Vujaskovic MD PhD a professor of radiation oncology and director of the Division of Translational Radiation Sciences DTRS in the Department of Radiation Oncology at the University of Maryland School of Medicine UMSOM. Early research suggests that adding thermal therapy to protonbeam therapy may be associated with an even greater benefit than when combined with standard radiation therapy and we are excited to be at the forefront of making this combination therapy available to cancer patients says Dr. Vujaskovic an internationally recognized expert in hyperthermic oncology. Proton therapy is a precise form of radiation therapy that deposits all of its energy within the tumor and allows for less irradiation of noncancerous tissue. MPTC which is affiliated with the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center UMGCCC at the University of Maryland Medical Center is the only proton treatment center in Maryland. Radiation oncologists at UMGCCC already use external thermal therapy to treat a range of cancers but do not currently use it for cancers that are deeper in the body. According to Dr. Vujaskovic the new deeptissue thermal therapy equipment which is made by Pyrexar will be used to treat cancers of the abdominal and pelvic region including cancer of the bladder rectum cervix ovaries pancreas and connective tissue which are known as sarcomas. Patients would typically receive the thermal therapy two times a week for an hour before or after they receive standard photon radiation or protonbeam therapy. The system heats the tumor tissue to F. with internal and external probes that enable doctors to continuously monitor the temperature. A waterfilled applicator is placed over the area to be treated and noninvasive radio frequency energy is directed at the tumor. The heat causes the blood vessels in the tumor to dilate bringing more oxygen into the tumor which makes cancer cells more vulnerable to radiation therapy. The acquisition of the deeptissue thermal therapy system was made possible by donations from Jack and Emily Howell and the Middendorf Foundation Inc. Within the Department of Radiation Oncology and throughout our cancer center we strive to make every available tool in the cancerfighting toolbox available to our patients says William F. Regine MD FACR FACRO the Isadore Fannie Schneider Foxman Endowed Chair and Professor of radiation oncology at UMSOM and chair of radiation oncology at UMGCCC. By continuing to develop a comprehensive thermal oncology program we are giving patients more effective treatment options and therefore another reason to hope for better outcomes. The Maryland Proton Treatment Center has achieved another milestone by becoming the first center to offer both deepthermal therapy and proton therapy says E. Albert Reece MD PhD MBA Executive Vice President for Medical Affairs at UM Baltimore and the John Z. and Akiko K. Bowers Distinguished Professor and dean at UMSOM. This achievement is a testament to Dr. Vujaskovics considerable expertise in hyperthermic oncology and leadership in developing an outstanding thermal oncology program at the University of Maryland. Its this type of innovation that sets MPTC apart from other proton treatment centers. About the University of Maryland School of Medicine Commemorating its th Anniversary the University of Maryland School of Medicine was chartered in as the first public medical school in the United States. It continues today as one of the fastest growing toptier biomedical research enterprises in the world with academic departments centers institutes and programs and a faculty of more than physicians scientists and allied health professionals including members of the National Academy of Sciences and a distinguished recipient of the Albert E. Lasker Award in Medical Research. With an operating budget of more than billion the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide researchintensive academic and clinicallybased care for more than . million patients each year. The School has over students residents and fellows and nearly million in extramural funding with more than half of its academic departments ranked in the top among all public medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland Baltimore campus the School of Medicine has a total workforce of nearly individuals. The combined School and Medical System University of Maryland Medicine has a total budget of billion and an economic impact of nearly billion on the state and local community. The School of Medicine faculty which ranks as the thhighest public medical school in research productivity is an innovator in translational medicine with active patents and startup companies. The School works locally nationally and globally with research and treatment facilities in countries around the world. Visit medschool.umaryland.edu httpmedschool.umaryland.edu About the Maryland Proton Treatment Center The Maryland Proton Treatment Center MPTC offers proton therapy a highly advanced and precise form of radiation therapy that can increase radiation dose to tumor while decreasing dose to healthy surrounding tissue to the BaltimoreWashington region and beyond. It is a highly effective treatment for a wide range of localized tumors such as those found in the brain base of the skull head and neck area eye tumors tumors of the esophagus lung prostate liver breast spinal cord as well as gastrointestinal malignancies. It is also an important treatment option for children with cancer. At MPTC each treatment room is equipped with the most advanced form of pencil beam proton therapy which essentially paints the radiation onto the tumor while stopping precisely at the site of the tumor. Proton therapy is performed on an outpatient basis and is a welltolerated noninvasive treatment that can reduce side effects. It can be used in conjunction with other modalities of cancer treatments such as chemotherapy and surgery. MPTC offers a robust clinical trial program to all its patients to further evidencebased medicine. MPTC has been patientcentered from the beginning with a focus on accessibility and affordability. The center was designed to be a regional resource providing the same training privileges and clinical guidelines to physician groups across the region that work sidebyside with MPTC faculty and staff thus improving efficiency and affordability. MPTC offers free concierge services to ensure a seamless patient experience and a successful reconnection back to their referring physician. One of the goals of MPTC is to remain costneutral to insurance providers meaning patients pay the same for proton treatment as they would for other more conventionally available intensitymodulated treatments at the University of Maryland Medical Center. http"

"Drinking beet juice increases blood https flow to the brain https in older people a finding that suggests the dark red vegetable may fight the progression of dementia https a new study shows. Beet roots contain high concentrations of nitrates which are converted into nitrites by bacteria in the mouth https And nitrites help open blood https vessels in the body increasing blood flow and oxygen to places lacking in oxygen. Previous studies have shown that nitrites also found in high concentrations in celery cabbage and other leafy green vegetables like spinach widen blood vessels but researchers say this was the first to find that nitrites also increase blood flow to the brain https Blood Flow to the Brain There have been several very highprofile studies showing that drinking beet juice can lower blood pressure https but we wanted to show that drinking beet juice also increases perfusion or blood flow to the brain https Daniel KimShapiro PhD director of the Translational Science Center at Wake Forest University says in a news release. There are areas in the brain https that become poorly perfused as you age and thats believed to be associated with dementia and poor cognition. Researchers from the Translational Science Center looked at how dietary nitrates affected adults aged and older over a fourday period. On day one subjects reported to a laboratory after a hour fast completed a health status report and had either a high or lownitrate breakfast https The highnitrate breakfast https included ounces of beet juice. Then they were sent home with lunch dinner and snacks that conformed to their assigned diets. On the second day after another hour fast the participants returned to the lab and ate their assigned breakfasts. An hour later an MRI https scan recorded brain flow in each persons brain. And blood tests before and after breakfast confirmed nitrite levels in the body. On the third and fourth days researchers switched diets and repeated the process for each person. MRI scans showed that after eating a highnitrate diet the older adults had increased blood flow to the white matter of the frontal lobes which are the areas of the brain most commonly associated with the degeneration that leads to dementia and other cognitive conditions. Diets Rich in Fruits and Vegetables I think these results are consistent and encouraging that good diet consisting of a lot of fruits and vegetables https can contribute to overall good health says senior investigator Gary Miller PhD an associate professor in Wake Forests Department of Health and Exercise https Science. Because beet juice doesnt exactly taste like a sugary soda Wake Forest has worked with a company to create a new beet juice beverage that is tastier than plain beet juice and a news release says the university is investigating ways to market this beverage. The researchers say that their study and future ones like it may lead to interventions that could improve cognitive and physical functional health in older adults. The findings are published online in Nitric Oxide Biology and Chemistry the peerreviewed journal of the Nitric Oxide Society."

"Exercise can reverse damage to sedentary aging hearts and help prevent risk of future heart failure if its enough exercise and if its begun in time according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit the exercise regimen should begin by late middle age before age when the heart apparently retains some plasticity and ability to remodel itself according to the findings by researchers at the Institute for Exercise and Environmental Medicine IEEM which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas. And the exercise needs to be performed four to five times a week. Two to three times a week was not enough the researchers found in an earlier study. Based on a series of studies performed by our team over the past years this dose of exercise has become my prescription for life said senior author Dr. Benjamin Levine Director of the Institute and Professor of Internal Medicine at UT Southwestern. I think people should be able to do this as part of their personal hygiene just like brushing your teeth and taking a shower. The regimen included exercising four to five times a week generally in minute sessions plus warmup and cooldown One of the weekly sessions included a highintensity minute workout such as aerobic interval sessions in which heart rate tops percent of peak rate for minutes with minutes of recovery repeated four times a socalled x . Each interval session was followed by a recovery session performed at relatively low intensity. One days session lasted an hour and was of moderate intensity. As a prescription for life Levine said this longer session could be a fun activity such as tennis aerobic dancing walking or biking. One or two other sessions were performed each week at a moderate intensity meaning the participant would break a sweat be a little short of breath but still be able to carry on a conversation the talk test. In the study exercise sessions were individually prescribed based on exercise tests and heart rate monitoring. One or two weekly strength training sessions using weights or exercise machines were included on a separate day or after an endurance session. Study participants built up to those levels beginning with three minute moderate exercise sessions for the first months and peaked at months when two highintensity aerobic intervals were added. The more than participants in the study were divided into two groups one of which received two years of supervised exercise training and the other group a control group which participated in yoga and balance training. At the end of the twoyear study those who had exercised showed an percent improvement in their maximum oxygen intake during exercise and a more than percent improvement in compliance or elasticity of the left ventricular muscle of the heart Dr. Levine noted. He compared the change in the heart to a stretchy new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the hearts left ventricle the chamber that pumps oxygenrich blood back out to the body he explained. When the muscle stiffens you get high pressure and the heart chamber doesnt fill as well with blood. In its most severe form blood can back up into the lungs. Thats when heart failure develops said Dr. Levine who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. He also holds the Distinguished Professorship in Exercise Sciences at UT Southwestern which is celebrating its th anniversary this year. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who dont exercise and arent fit leaving them with small stiff chambers that cant pump blood as well. However the researchers also found that the heart chamber in competitive masterslevel athletes remains large and elastic and that even four to five days of committed exercise over decades is enough for noncompetitive athletes to reap most of this benefit. In the current study researchers wanted to know if exercise can restore the hearts elasticity in previously sedentary individuals especially if begun in late middle age. Previous studies from Dr. Levines research program have shown substantial improvements in cardiac compliance in young individuals after a year of training but surprisingly little change if the training was started after age . To start the study researchers recruited participants ages to . Many came from the Dallas Heart Study which includes Dallas residents and is the only singlecenter heart study of its size and multiethnic composition. The Dallas Heart Study is designed to improve the diagnosis prevention and treatment of heart disease. The new study appears in Circulation a journal of the American Heart Association. Collaborators on the study included first author Dr. Erin Howden Research Fellow with UT Southwesterns Graduate School of Biomedical Sciences and the IEEM and now a faculty member at the Baker Heart and Diabetes Institute in Melbourne Australia. Funding came from the National Institutes of Health and the American Heart Association. 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 has received six Nobel Prizes and includes members of the National Academy of Sciences members of the National Academy of Medicine and Howard Hughes Medical Institute Investigators. The faculty of more than is responsible for groundbreaking medical advances and is committed to translating sciencedriven research quickly to new clinical treatments. UT Southwestern physicians provide care in about specialties to more than hospitalized patients emergency room cases and oversee approximately . million outpatient visits a year."

"Acupuncture https may allow people with the lung disease COPD https chronic obstructive pulmonary disease https to breathe a bit easier. COPD https is the umbrella term for chronic lung diseases https including chronic bronchitis https and emphysema https It is often marked by a chronic cough https and shortness of breath. Treatment typically involves the use of inhaled steroids https and bronchodilators https_inhalers_bronchodilators to open airways and make breathing easier. In a new study of people with COPD https some got acupuncture https along with their daily medication https for three months. Others got a sham acupuncture treatment in which the needles did not enter their skin https Those who received acupuncture along with their daily medication for three months were able to walk longer without becoming breathless compared to those who got the sham acupuncture treatment. The study appears online in the Archives of Internal Medicine. People who received real acupuncture also showed improvements in their quality of life and ability to exercise https according to researchers from Kyoto University and Meiji University of Integrative Medicine https in Kyoto Japan. Many people with COPD have problems getting optimal nutrition https because of their condition. The study showed that acupuncture may improve stomach https function making it easier for people with COPD to eat a healthy diet and maintain a normal weight https_assetscontrolled_contenthealthwisespecialweight_managementare_you_at_a_healthy_weight_special_aa.xml. Acupuncture and COPD Symptoms Exactly how acupuncture improves symptoms of COPD is not fully understood. Researchers speculate that needling the acupuncture points on the rib cage area may help relax muscles involved in breathing. This makes perfect sense to TongJoo Gan https_assetscontrolled_contenthealthwisenordgiant_axonal_neuropathy_nord_nord.xml MD. He is a professor of anesthesiology at Duke University Medical Center in Durham N.C. It also may help reduce anxiety https levels he says. When you become breathless your anxiety https goes up so relaxation is another possible explanation for the benefit. Acupuncture has been shown to release chemicals that relax the lungs https and dilate the airways he says. Clearly it looks like a viable alternative to treat chronic COPD Gan says. The downside is so little and the upside is so huge that acupuncture is well worth a try for those who find it difficult to control their COPD despite medications. If you do try it you must choose a licensed and experienced acupuncturist Gan says. If you have COPD or another lung disease acupuncture is worth a shot literally says Len Horovitz MD. He is a pulmonary specialist at Lenox Hill Hospital in New York. Horovitz regularly uses acupuncture to help smokers kick the habit. It also helps people with asthma https and can allow them to use fewer steroids he says. Kim Tsao a licensed acupuncturist in New York and her brother Jianhua Tsoi in Greenwich and Wilton Conn. often use acupuncture to help people with COPD. Most people think it is only for pain but acupuncture can help with lung and other diseases Tsao tells WebMD. But she and her brother are quick to caution that acupuncture should be used with medication and other COPD treatments not in place of it. Most of these patients do see Western doctors already Tsoi says. If they come to us first we tell them to go to Western doctors and get proper medication to stay under control."

"GSK LSENYSE GSK httpstudio.financialcontent.comprnewsPageQuoteTickerGSK today announced the publication of detailed results from a randomised phase III study ZOE of its investigational shingles vaccine Shingrix showing efficacy in adults aged years and older that is maintained for at least four years. The results were published in the New England Journal of Medicine NEJM. The study from which headline results were reported in October showed that the twodose candidate shingles vaccine had efficacy confidence interval compared to placebo in people over years old. Vaccine efficacy was maintained across the various age groups included in the study ranging between in people aged years confidence interval and in those aged years and above confidence interval . The high efficacy is in line with the results of the ZOE trial a study in people over years old which was presented and published last year showing a efficacy confidence interval . A pooled analysis of data from both trials showed the vaccine demonstrated efficacy against shingles confidence interval in adults aged years and older compared to placebo. This efficacy was maintained with an reduction in the risk of shingles confidence interval in the fourth year after vaccination. The risk of serious adverse events potential immunemediated diseases or deaths observed in ZOE was similar in people receiving Shingrix and placebo. The most commonly reported local adverse reaction was pain at the injection site and the most frequently reported systemic adverse reaction was fatigue. The majority of injection site and systemic reactions occurred within seven days of vaccination with most lasting days and generally were mildtomoderate in intensity. In addition a pooled analysis of data from the ZOE and ZOE trials showed that the candidate vaccine effectively reduced the risk of subsequent chronic neuropathic pain also known as postherpetic neuralgia PHN which is the most common and often severe complication of shingles. The candidate vaccine was shown to be confidence interval efficacious in preventing PHN in people aged years and older and efficacious confidence interval in people aged years and over. Dr Emmanuel Hanon Senior Vice President Vaccines Research and Development GSK said This is the first time that such high efficacy has been demonstrated in a vaccine candidate for older people and it is remarkable as we know that these people frequently have an agerelated weakening of their immune system. If approved this candidate vaccine could be an important tool for the prevention of shingles and the pain associated with it which would significantly impact the health and quality of life of so many people. Anthony Cunningham Executive Director of the Westmead Institute for Medical Research in Australia and Principal Investigator of the ZOE study said These data show that this investigational vaccine maintains high efficacy against herpes zoster in people over and years of age the age groups who are most affected by the disease. Importantly it also prevents a common and feared complication of herpes zoster prolonged pain or post herpetic neuralgia in these groups. Based on these and the previously reported ZOE data GSK expects to start submitting regulatory applications for the candidate vaccine for the prevention of shingles in people years and above later this year. About Shingrix Shingrix is a nonlive adjuvanted subunit HZsu candidate vaccine to help prevent herpes zoster and its complications. The candidate vaccine combines glycoprotein E a protein found on the varicella zoster virus VZV that causes shingles with an adjuvant system ASB which is intended to enhance the immunological response to the antigen. Additional trials to evaluate the ability of Shingrix to help prevent shingles are ongoing in healthy people aged and older and in adults with compromised immune systems. These studies will provide additional information with respect to the efficacy and safety profile of the candidate vaccine as well as its ability to stimulate immune responses in other populations and in specific circumstances. Notes to editors The name Shingrix is not yet approved for use by regulatory authorities in most countries including the US Food and Drug Administration FDA. About the ZOE trial The ZOE ZOster Efficacy in adults aged years and over NCT study is a randomised observerblind placebocontrolled saline solution multicentre multinational North America Europe Latin America AsiaPacific phase III trial involving more than adults aged years and older. Two doses were given intramuscularly two months apart. The study which started in August in parallel with the ZOE trial includes subjects in the age ranges and years. The primary objective of ZOE is overall vaccine efficacy against shingles in people years and over compared to placebo. The coprimary objectives of the pooled analysis over both studies are the assessment of overall vaccine efficacy in reducing the risk of developing shingles and PHN in people aged years and over using pooled data from both ZOE and ZOE studies. About the ZOE trial The ZOE ZOster Efficacy in adults aged years and over NCT study is a randomised observerblind placebocontrolled saline solution multicentre multinational North America Europe Latin America AsiaPacific phase III trial involving adults aged years and older. The study started in August . Two doses were given intramuscularly two months apart. The primary objective of this study is the overall vaccine efficacy against shingles in people aged years or older compared to placebo. The study includes subjects in the age ranges and years. About the phase III study programme Involving more than subjects globally the phase III programme for GSKs candidate shingles vaccine evaluates its efficacy safety and immunogenicity. In addition to older adults the candidate vaccine is being evaluated in immunocompromised patient populations including solid and haematological cancer patients haematopoietic stem cell and renal transplant recipients and HIVinfected people. About shingles Shingles typically presents as a painful itchy rash that develops on one side of the body as a result of reactivation of latent chickenpox virus varicella zoster virus VZV. Anyone who has been infected with VZV is at risk of developing shingles with age and altered immune system being recognised as the main risk factors. Complications from shingles can include PHN the most common complication scarring vision complications secondary infection and nerve palsies.PHN is often defined as a localized pain of significant intensity persisting at least days after the appearance of the acute shingles rash. Data from many countries indicate that older adults aged and over are at highest risk for shingles as more than of older adults have been infected with wild type VZV. A persons risk for shingles increases sharply after years of age. Risk of complications including PHN and hospitalisation also increase with age. The individual lifetime risk of developing shingles is approximately one in three for people in the USA however for individuals aged and over this risk increases to one in two people. References . Cunningham et al. N Engl J Med . Efficacy of the herpes zoster subunit vaccine in adults years of age or older. . Lal et al. N Engl J Med Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults . Shingles Herpes Zoster Clinical Overview. US Centers for Disease Control and Prevention. Accessed at http on Sept . . Cohen et al. N Engl J Med Clinical practice Herpes zoster. . The GSK proprietary AS adjuvant system contains QS Stimulon adjuvant licensed from Antigenics Inc a wholly owned subsidiary of Agenus Inc. NASDAQ AGEN httpstudio.financialcontent.comprnewsPageQuoteTickerAGEN MPL and liposomes GSK one of the worlds leading researchbased pharmaceutical and healthcare companies is committed to improving the quality of human life by enabling people to do more feel better and live longer. For further information please visit http"

"U.S. health regulators said on Tuesday they approved a stent by Abbott Laboratories that is the first designed to be absorbed into the bloodstream after it is implanted. The stent called Absorb is made of a plastic similar to dissolving sutures and offers patients an alternative to metal stents currently used to prop open arteries cleared of blockages. Unlike traditional stents that remain in place after implantation Absorb is designed to disappear fully within three years of the procedure. Absorbs appeal is that it allows the blood vessel to return to a natural state free from a permanent metal implant. The approach holds particular promise for patients whose coronary artery disease could require multiple implants over the course of several decades said Mitchell Krucoff a professor at Duke University Medical Center who has advised Abbott on Absorb. This is a game changer he said in an interview. There are no longer going to be permanent metal implants in the artery. Absorb releases the drug everolimus to combat the growth of scar tissue that can form within a stent and cause the artery to narrow again the U.S. Food and Drug Administration which approved the stent said. No metal means the treated artery can pulse and flex naturally as demands on the heart change with everyday activities said Gregg Stone of Columbia University Medical Center who led clinical trials for Absorb. No metal may also reduce the potential of future blockages that occur with permanent metallic stents. Data released in October concluded Absorb was comparable to Abbotts own Xience drugcoated metal stent in safety and effectiveness but showed a higher risk of heart attacks and blood clots. Abbott said it expects the risks to lessen as surgeons gain experience with it. Absorb also will compete with Medtronic Plcs traditional drugcoated Resolute stent and Boston Scientific Corps Synergy and Promus stents. Synergys polymer coating disappears over time after delivering a drug that helps prevent the artery from reclogging leaving a metal stent in place. Abbott plans to roll out the device to about hospitals in the next several months as it trains surgeons on the implant procedure before ramping up sales said spokesman Jonathon Hamilton. Absorb will be priced at a modest premium to Xience he said. Analysts have predicted Absorb will gain a market niche but not surpass drugdispensing metal stents such as Xience in share until longerterm data show more favorable clinical results."

"Almost two million Americans have severe heart failure and for them even mundane tasks can be extraordinarily difficult. With blood flow impeded throughout their bodies patients may become breathless simply walking across a room or up stairs. Some must sleep sitting up to avoid gasping for air. Drugs may help to control the symptoms but the disease takes a relentless course and most people with severe heart failure do not have long to live. Until now there has been little doctors can do. But on Sunday researchers reported that a tiny clip inserted into the heart sharply reduced death rates in patients with severe heart failure http In a large clinical trial doctors found that these patients also avoided additional hospitalizations and described a drastically improved quality of life with fewer symptoms. The results reported at a medical meeting in San Diego and published simultaneously in the New England Journal of Medicine were far more encouraging than heart specialists had expected. Its a huge advance said Dr. Howard Herrmann the director of interventional cardiology at the University of Pennsylvania which enrolled a few patients in the study. It shows we can treat and improve the outcomes of a disease in a way we never thought we could. If the device is approved by the Food and Drug Administration for treatment of severe heart failure as expected then insurers including Medicare most likely will cover it. Like the Science Times page on Facebook. httpon.fb.mepaTQh Sign up for the Science Times newsletter. httpnyti.msMbHaRU In heart failure the organ itself is damaged and flaccid often as a consequence of a heart attack. The muscle pumps inefficiently and in an attempt to compensate the heart enlarges and becomes misshapen. The enlarged organ tugs apart the mitral valve which controls blood flow from the left atrium into the left ventricle. The distorted valve functions poorly its flaps swinging apart. Blood that is supposed to be pumped into the body backs up into the heart and lungs. A vicious cycle ensues The heart enlarges so the mitral valve leaks. The leaky mitral valve makes the heart enlarge even more as it tries to compensate and heart failure worsens. In the new study a device called the MitraClip was used to repair the mitral valve by clipping its two flaps together in the middle. The clip is made by Abbott which funded the study outside experts reviewed the trial data. The result was to convert a valve that barely functioned into one able to regulate blood flow in and out of the heart. Until today researchers were not sure that fixing the mitral valve would do much to help these patients. A smaller study in France with similar patients failed to find a benefit for the MitraClip https But that research included many patients with less severe valve problems the procedure was not performed as adeptly and the patients medications were not as well optimized as in the new study. In the new trial patients with severe heart failure in the United States and Canada were randomly assigned to receive a MitraClip along with standard medical treatment or to continue with standard care alone. Among those who received only medical treatment were hospitalized for heart failure in the ensuing two years. Sixtyone died. In contrast just who got the device were hospitalized for heart failure during the period and died. The results have left leading researchers unexpectedly optimistic. The trial sends a very very powerful message said Dr. Gilbert Tang a heart surgeon at Mount Sinai Medical Center which enrolled a patient in the trial. This is a game changer. This is massive said Dr. Mathew Williams director of the heart valve program at NYU Langone Health which had a few patients in the study. Estimates of how many heart failure patients in the United States are like those in the trial range from . million to . million Dr. Williams said. But he adds the number who might ultimately be treated will be less than the number who could be treated. The device itself costs about not counting the cost of the hospital and doctors a surgeon an interventional cardiologist and an echocardiologist among others all in the operating room. Cardiologists said the study was impeccably executed. The doctors inserting the device first had to demonstrate their expertise doing so. An independent group of experts ascertained that patients medical care was optimal all too often heart failure patients do not receive ideal treatment. Patients with severe heart failure often are gravely ill too sick to have openheart surgery to have mitral valves replaced. Its not worth the risk said Dr. Gregg Stone of Columbia University Medical Center and NewYorkPresbyterian Hospital the studys principal investigator. Dr. Stone reported no relevant conflicts but said that Columbia University gets royalties from the sale of the MitraClip. But the new procedure is much less invasive than openheart surgery. A cardiologist threads the device to the heart through a blood vessel in the groin. Once it reaches the heart the MitraClip is guided to the valve and the device is used to clip the two flaps together. Not every cardiologist is equipped to insert the clip. These are difficult procedures that require training and dedication Dr. Herrmann said. During the procedure for example a tiny echocardiogram camera is placed into the patients esophagus behind the heart to show where the catheter with the clip is going. Doctors must watch an Xray screen and an echocardiogram as they guide the clip to the mitral valve. When the clip arrives you have to see where you are grasping to get a good result Dr. Tang said. The device is already approved by the F.D.A. for patients too frail for surgery but whose hearts are fine except for a mitral valve that does not function properly. Advertisement Cardiologists predicted the F.D.A. would quickly approve the device for patients with severe heart failure as well. It already is used in Europe for these patients but there had been no rigorous studies showing it helped. The new trial promises to alter prospects for many people with severe heart failure who had relatively few options. This will change how we treat these patients Dr. Williams said. Its possible he added that many would fare even better with the valve repair procedure if they were not so frail when they got it. Maybe we need to start intervening earlier he said."

"Theres too little evidence to say definitively whether treating early localized prostate cancer with radiation is a better option than watchful waiting new research finds. In a study funded by the Agency for Healthcare Research and Quality AHRQ researchers from Tufts University reviewed the available literature on radiation and prostate cancer including randomized controlled trials and observational studies. They concluded there was insufficient evidence to say with certainty whether radiation treatment compared to watchful waiting is more likely to save lives. We just dont have sufficient information to say much of anything said Dr. Stanley Ip an assistant professor of medicine at Tufts University Medical Center. In part thats because researchers found no randomized controlled trials considered the gold standard of research that compared radiation therapy with watching waiting Ip said. Though there were observational studies those may be biased because men who opt to hold off on treatment may be those whose tumors are lower risk to begin with he said. The study is published in the June issue of the Annals of Internal Medicine. Watchful waiting which does not involve cancer treatment means having regular exams while keeping an eye on the tumor to see if it grows or spreads. It is usually recommended when doctors feel someones advanced age will allow them to outlive the generally slowmoving cancer or when someone has other conditions that are more likely to prove lethal. Men who are diagnosed with early prostate cancer meaning its confined to the prostate gland and has not spread are confronted with a bewildering array of options for treating it surgery radiation drugs to deprive the tumor of the hormone androgen that may drive its growth or watchful waiting. In AHRQ also commissioned a review of studies on other prostate cancer treatment options but that report could not draw conclusions on the best approach either. What all of these analyses have found is there is very limited data that allows us to determine which of these approaches in the best approach said Dr. Durado Brooks director of prostate cancer for the American Cancer Society. Brooks said more comparative effectiveness research which compares different kinds of treatments is needed. In the meantime what are men diagnosed with early prostate cancer to do Men and their doctors need to consider what the tumor looks like under the microscope which can help gauge how aggressive it may be. They should also consider age and overall health status including whether or not the patient has other conditions more likely to cause death than the prostate cancer. Finally patients and their doctors should weight the potential debilitating side effects of the treatments such as incontinence and erectile dysfunction against how comfortable the man is with holding off on treatment experts say. Men need to learn as much as they can about the possible outcomes and benefits of the various treatments and the potential side effects and choose which direction they are most comfortable with Brooks said. In the current review researchers found several trials that compared different doses of radiation and different types of radiation therapy including external beam radiation therapy in which a radiation is delivered through a beam through the skin or brachytherapy in which radioactive isotopes are delivered via injection into the prostate. For those methods too there was too little research to say with confidence which method was superior in preventing deaths from prostate cancer the researchers said. Retrospective studies however found that radiation treatments were associated with increased urinary or bowel problems compared with no treatment or no initial treatment. There was also moderate strength evidence that a higher external beam radiation was more effective than a lower dose. Taken together the review does point out that based on current evidence doctors should not be telling their patients that this form of radiation is better than that form Brooks said. Some of the distinctions being made are not really supported by the evidence. Proton beam therapy in particular is expensive but according to this report there isnt enough evidence to show its any better than other option. Radiation he noted may be the best option for men whose tumors have spread outside the gland since simply removing the prostate gland surgically is not likely to be as effective he said. The American Cancer Society estimates that in approximately men were diagnosed with prostate cancer and approximately men died of the disease. More information The National Cancer Institute http has more on prostate cancer. SOURCES Stanley Ip M.D. assistant professor medicine Tufts University Medical Center Boston Durado Brooks M.D. director prostate cancer American Cancer Society Atlanta June Annals of Internal Medicine"

"Rupture of an abdominal aortic aneurysm is one of the most dramatic medical emergencies a person can face. It usually strikes without warning killing approximately percent of those who experience it before they reach a hospital. Of those who do get to a health facility alive only about percent survive. When diagnosed through screening aortic aneurysms are carefully monitored for signs of enlargement and surgical intervention often is needed to prevent rupture of the vessel. Now University of Missouri researchers have found that patients who took cholesterollowering medications before endovascular surgery experienced fewer complications and better outcomes. Although this condition usually occurs in men older than with a family history of the disease anyone can have an abdominal aortic aneurysm said Todd Vogel associate professor and chief of the Division of Vascular Surgery at the MU School of Medicine and lead author of the study. Most patients with this disease are older and tend to have other health conditions such as high cholesterol. In an effort to prevent cardiovascular disease they take statin medications. These cholesterollowering medications protect blood vessels from plaque formation and stress and in some cases can even slow the progression of aortic aneurysms. We wanted to understand the impact statin use has on surgical outcomes when repairing this type of aneurysm. Vogels research team reviewed nearly cases where patients either had open surgery or an endovascular repair a minimally invasive procedure that uses a catheter to access the aneurysm. The team then identified patients who took cholesterollowering medication before surgery. Our research showed that patients who took statins before either open or minimally invasive interventions had better outcomes compared to those who did not take statin medications Vogel said. The patients who took statins and had endovascular repairs had a percent decrease in mortality up to one year after surgery. Patients who took statins and had traditional open procedures also did better but the difference was not nearly as significant as with endovascular repair. The bottom line is that patients who used statins were more likely to survive during and after an elective endovascular procedure. Additionally the study showed that statin use also reduced postsurgical complications for patients with other health issues such as peripheral artery disease a condition that causes arterial blockages of blood vessels in the limbs. This information could be beneficial to patients who are about to have elective endovascular abdominal aortic aneurysm repair Vogel said. However further research is needed to assess the benefits of using statins before surgical repair of other types of aneurysms. The study The Impact of Preoperative Statin Therapy on Open and Endovascular Abdominal Aortic Aneurysm Repair Outcomes recently was published in Vascular the official publication of the International Society for Vascular Surgery. About the MU School of Medicine The MU School of Medicine has improved health education and research in Missouri and beyond for more than years. MU physicians treat patients from every county in the state and more Missouri physicians received their medical degrees from MU than from any other university. For more information visit httpmedicine.missouri.edu."

"A North Carolina teen said hes feeling hopeful after getting an infusion of stem cells httpabcnews.go.comtopicslifestylehealthstemcellresearch.htm during an experimental procedure that may help heal his heart and extend his life. Caleb Sizemore was diagnosed with Duchenne muscular dystrophy years ago. The genetic disorder httpabcnews.go.comtopicslifestylehealthgeneticscreening.htm is characterized by progressive muscle degeneration and weakness. The disease can lead to scarring on muscles including the heart. As scarring on the heart worsens it affects the organs ability to function and can be fatal. In February Sizemore became the first patient ever to get an infusion of stem cells into his heart in the hopes of stopping or even reversing some of the scarring related to the disease. Dr. John Jefferies director of advanced heart failure and cardiomyopathy at the Cincinnati Childrens Hospital Medical Center is treating Sizemore. He said a person suffering from Duchenne usually lives into his or her early s because of scarring on the heart. Were going in and trying to reverse the scar tissue and potentially even mitigate the new development of scar tissue Jefferies told ABC News. If we can preserve his cardiac function he has a fantastic outlook. Baby Born Weighing Just Oz Finally Gets to Go Home httpabcnews.go.comHealthmiraclebabybornouncesfinallyhomestoryid Fiancee of NFL Star Dies of Ovarian Cancer at httpabcnews.go.comHealthfianceenflstartonystewarddiesovariancancerstoryid Jefferies explained that the process works by allowing the stem cells to enter the heart thus encouraging the heart to heal itself. The stem cells create a healthy environment in the heart and help the tissue go from abnormal state to normal state Jefferies noted. Jefferies said if the medication works on patients like Sizemore it could then be tested on millions of other Americans who have scarring on their heart due to the disease or past heart attacks. It is very exciting especially because of the impact it has on other kids and how it paves the way so that others can get the treatment and how this will change peoples lives and extend them Sizemore said. The teenager said he also has renewed optimism for his own health. Its made me more hopeful Sizemore said. Especially when I think of how amazing medical treatments and technology is and how far its gotten...especially since I was diagnosed years ago. Sizemore will return to Cincinnati in a few months so doctors can scan his heart and see if the scar tissue has been affected by the infusion."

"For years pregnant women have been warned about eating tuna https because of concerns about mercury exposure. But a federal panel has reignited the debate about the benefits and risks of eating tuna and other seafood during pregnancy. Experts agree that seafood is a rich source of important nutrients and that most of us dont eat enough of it. Fish is rich in omega fatty acids B vitamins iodine selenium and vitamin D. And numerous studies show that the nutrients in fish are particularly important for brain development in fetuses and nursing infants. As part of a sweeping review https of nutrition recommendations the Dietary Guidelines Advisory Committee https recently reiterated the current seafood guidelines Americans should eat a wide variety of seafood. The report also acknowledges the risk of mercury exposure from certain kinds of seafoods and notes that women who are pregnant nursing or may become pregnant should avoid certain kinds tilefish shark swordfish and king mackerel because of their high mercury content. The panel withheld a recommendation about tuna second only to shrimp in popularity in the United States. Current guidelines from the Food and Drug Administration https and the Environmental Protection Agency httpsyosemite.epa.govopaadmpress.nsfbdaceceeaccbedcdcfebcffOpenDocument warn pregnant and nursing women to limit tuna consumption to six ounces per week. The advisory committee has recommended that these agencies reevaluate their stance on tuna for pregnant women. In the report the panel argues that albacore tuna is a special case. They noted that even when women ate double the recommended weekly amount of tuna the benefits far outweighed the risks. All evidence was in favor of net benefits for infant development and cardiovascular disease risk reduction the panel wrote. The suggestion that pregnant women can eat more white albacore tuna the type of tuna typically used in canned tuna has upset advocacy groups that have called for increased warnings about mercury on tuna packaging. Tuna is responsible for nearly seven times more mercury exposure than the four highmercury fish that the Federal Food and Drug Administration advises pregnant women not to eat said Michael Bender director of the mercury policy project in a statement. So why would the proposed dietary guidelines recommend that pregnant women eat more of it But Dr. Steve Abrams a panel member involved in the seafood recommendations and medical director of the Neonatal Nutrition Program at Baylor College of Medicine said that while women need to be aware of the types of fish they are eating the evidence is strong that fish consumption by mothers is good for the brains of their babies. The goal of the dietary guidelines is to give people a healthy way to eat and not to include or exclude certain foods said Dr. Abrams. The benefit of having omega fatty acids in your diet really exceeds the likely risk of contamination. The point is that you should have a variety of types of seafood and not limit yourself to one type and variety includes canned tuna. Alice Lichtenstein senior scientist and director of the Cardiovascular Nutrition Laboratory at Tufts University said the panel hasnt suggested that pregnant women eat more tuna. The issue of fish contamination is a moving target and you need very current data said Dr. Lichtenstein. It may be that the issue is reevaluated and there is no change. Mercury levels in our oceans are on the rise due to an increase in industrial mercury emissions. Plants plankton and tiny fish that have absorbed small amounts of mercury are eaten by larger fish. Over time large fish sharks and swordfish accumulate high levels of mercury. As a result health officials recommend fish like sardines salmon tilapia and trout that are lower on the food chain and have accumulated less mercury in their tissue. The benefits of fish consumption on a developing fetus are clear. In a Harvard study of mothers and infants httpsdash.harvard.edubitstreamhandle.pdfsequence researchers tracked fish consumption during pregnancy and tested the mothers hair to measure her mercury exposure. They found that for each weekly serving of fish the mother ate while pregnant her babys score on visual recognition memory tests increased an average of four points. At the same time a babys score dropped by . points for every one part per million increase in mercury found in the mothers hair sample. The babies who scored highest on the memory tests were those whose mothers had consumed two or more servings of fish each week during their pregnancy but were tested to have very low mercury levels. Health officials have long worried about balancing warnings about mercury against the obvious benefits of consuming more fish. Currently fewer than one in five Americans https eats the recommended two servings a week of fish. About onethird eat one serving of seafood weekly and nearly half of us eats very little seafood or none at all. This fall Consumer Reports issued a lengthy paper https on fish and mercury exposure noting the special concerns about canned tuna due to its popularity. Six ounces of canned tuna contains micrograms of mercury compared to just micrograms of mercury in a sixounce serving of salmon according to Consumer Reports. A sixounce serving of swordfish contains micrograms the magazine said. For people who want to safely eat more seafood the magazine recommended shrimp scallops sardines salmon oysters squid and tilapia as the lowestmercury seafood. Also low are haddock pollock flounder and sole Atlantic croaker crawfish catfish trout Atlantic mackerel crab and mullet. In addition to the usual warnings about high mercury fish Consumer Reports added marlin and orange roughy to the list. They suggested limiting consumption of grouper Chilean sea bass bluefish halibut black cod Spanish mackerel and fresh tuna. To find out more about mercury in seafood go to the Got Mercury calculator created by the Sea Turtle Island Restoration Network at seaturtles.orgprogramsmercury httpsseaturtles.orgprogramsmercury."

"Tiny pellets could treat arthritic knee pain delaying the need for knee replacement surgery a small study has found. Microparticles inserted into small blood vessels around the knee helped reduce the pain and improve function in eight arthritis sufferers according to clinical trial results. The results were presented Monday at the Society of Interventional Radiologys annual meeting in Los Angeles. Patients overall were able to improve their physical function in the knee after the procedure and there were no adverse events related to this treatment said lead researcher Dr. Sandeep Bagla. Bagla is director of interventional radiology at the Vascular Institute of Virginia in Woodbridge. Boston Scientific maker of the microparticles funded the study. Much of the pain that comes from knee arthritis actually stems from inflammation in the lining of the knee joint also called the synovium Bagla said. In fact small blood vessels created by degenerative arthritis feed this inflammation by increasing blood flow to the lining. To treat this Bagla and his colleagues decided to try blocking those tiny blood vessels using microparticles spheres about a tenth of a millimeter in size made from a synthetic gellike material. The microparticles are inserted using a catheter run through a pinholesized incision in a procedure that lasts between and minutes Bagla said. Its an outpatient procedure and no physical therapy is required before or after this procedure he said. The small pilot study the first U.S. clinical trial of this procedure involved patients with moderate to severe arthritis pain. Only had undergone the procedure by the time of Mondays annual meeting and only eight had made it to the onemonth followup Bagla said. Those eight patients averaged a point decrease in pain as measured on a point visual scale used to estimate pain Bagla said. They started with an average baseline of which means their pain was brought down to manageable levels he said. Physical function of their knee also improved based on an index used to judge the effects of osteoarthritis Bagla added. Overall the two scales represented an percent improvement in function the researchers concluded. Bagla said no side effects are expected because the procedure only blocks additional blood flow to the knee rather than cutting it off altogether. You dont normally have this degree of increased blood supply to this lining. Were not blocking normal blood vessels to the knee or leg or bone or cartilage he said. Final results from this clinical trial are expected to be released this summer. Researchers are already kicking off a second larger trial to better understand how the procedure works and which patients it might benefit Bagla said. They think it will be most appropriate for people between ages and who arent ready to go through knee replacement or people who are on chronic pain medication for their knee arthritis Bagla said. Perhaps we can demonstrate and prove patients do not need to be on these medications and can alternatively go through a minimally invasive procedure like this to reduce their knee pain Bagla said. Dr. Suresh Vedantham president of the Society of Interventional Radiology called the new procedure very promising given that it focuses on the inflamed knee lining that causes the pain. This therapy is very welltargeted to that particular mechanism and certainly it should be investigated further said Vedantham who wasnt involved with the study. Hes a professor of radiology and surgery at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. Research presented at medical meetings is typically considered preliminary until it is published in a peerreviewed journal. More information The Arthritis Foundation has more about knee pain https SOURCES Sandeep Bagla M.D. director interventional radiology Vascular Institute of Virginia Woodbridge Suresh Vedantham M.D. professor radiology and surgery Mallinckrodt Institute of Radiology Washington University of St. Louis Society of Interventional Radiology annual meeting March Los Angeles"

"Osteoarthritis OA is one of the leading causes of disability in adults in the United States and knee OA specifically is ranked within the top noncommunicable diseases for global disabilityadjusted life years. The lifetime risk of suffering symptomatic knee OA is estimated to be . and approximately in of the US population is diagnosed with symptomatic knee OA by age . With this knowledge the American Medical Society for Sports Medicine AMSSM has released a new scientific statement that provides guidance for physicians and healthcare professionals who provide care for those patients with knee osteoarthritis. There is a general consensus that the initial management of knee OA treatment should include weight loss and strengthening exercises. However certain aspects of treatment for knee OA are controversial. In light of these issues the AMSSM convened an expert writing group of four sports medicine physicians to review the latest data and provide recommendations for the sports medicine community. We do not treat groups of people we treat individuals said Dr. Thomas Trojian Lead Author and Past AMSSM Board of Director. It is important to look at how a person responds to a medication. Does the person improve if given an injection of viscosupplementation more likely than placebo or intraarticular steroid Using a network metaanalysis we are able to compare the multiple studies done on viscosupplementation and have found that people are more likely to show clinical improvement with viscosupplementation over placebo saline and intraarticular steroids. This is different than studies recently published that say the average response differs. The full report published ahead of print in the Clinical Journal of Sport Medicince CJSM and will appear in the British Journal of Sports Medicine BJSM entitled AMSSM Scientific Statement Concerning Viscosupplementation Injections for Knee Osteoarthritis Importance for Individual Patient Outcomes includes the following notable AMSSM recommendations and one suggestion AMSSM RECOMMENDS viscosupplementation injections for Kellgren and Lawrence KL grade IIIII knee osteoarthritis in those patients above the age of based on HIGH quality evidence demonstrating benefit using OMERACTOARSI Responder Rating but the evidence should be downgraded due to indirectness for those under years of age. AMSSM SUGGESTS viscosupplementation injections for knee osteoarthritis for those under the age of based on MODERATE quality evidence due to response of treatment in those over . AMSSM RECOMMENDS clinicians and researchers collect OMERACTOARSI responder data to track individual response to the viscosupplementation. The full paper will be published in print in the January issues of CJSM and BJSM. Click here httphttp to view statement online. Thanks to members Drs. Thomas Trojian AMSSM Past Board of Director Susan Joy AMSSM Foundation Board Member Andrew Concoff and John Hatzenbuehler along with Whitney Saulsberry PharmD and Craig Coleman PharmD for serving on the expert writing group for this paper. The AMSSM hopes that this information can assist healthcare professionals as they provide care for patients with osteoarthritis. About AMSSM AMSSM is a multidisciplinary organization of sports medicine physicians dedicated to education research advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in nonsurgical sports medicine and serve as team physicians at the youth level NCAA NFL MLB NBA WNBA MLS and NHL as well as with Olympic teams. By nature of their training and experience sports medicine physicians are ideally suited to provide comprehensive medical care for athletes sports teams or active individuals who are simply looking to maintain a healthy lifestyle. http SEE ORIGINAL STUDY httpjournals.lww.comcjsportsmedAbstractpublishaheadAMSSM_Scientific_Statement_Concerning..aspx"

"A study that tracked tens of thousands of midlife and older men for more than years has found that vigorous exercise and other healthy lifestyle habits may cut their chances of developing a lethal type of prostate cancer by up to percent. While most prostate cancers are clinically indolent meaning they do not metastasize and are nonlifethreatening a minority of patients are diagnosed with aggressive disease that invades the bone and other organs and is ultimately fatal. Lead author Stacey Kenfield ScD of UCSF and a team of researchers at UCSF and Harvard focused on this variant of prostate cancer to determine if exercise diet and smokefree status might have lifesaving benefits. In the study published today Nov. in the Journal of the National Cancer Institute the researchers analyzed data from two U.S. studies the Health Professionals FollowUp Study that tracked more than males ages to from to and a second the Physicians Health Study that followed more than males ages to from to . To gage the effects of lifestyle habits the researchers developed a score based on the results of the health professionals survey then applied it to the physicians study. They assigned one point for each affirmative response to questions about regular intense exercise that induced sweating body mass index BMI under tobaccofree status for a minimum of years high intake of fatty fish high intake of tomatoes and low intake of processed meat. To reduce error participants had to be free of diagnosed cancer at the start of the study and a fouryear lag was imposed to rule out those who unknowingly had lethal prostate cancer which was determined by evidence of prostate cancer death or metastasis to the bones or other organs excluding the lymph nodes. Cases were confirmed through medical records and pathology reports and cause of death was determined by death certificate and medical record and secondarily by next of kin. Vigorous activity trumps other lifestyle factors The researchers identified cases of lethal prostate cancer in the health professionals group and cases in the physicians group. Participants with to points in the health professionals group had a percent decreased risk of lethal prostate cancer and a percent decreased risk was observed in the physicians group for the same comparison. For dietary factors alone men with three points versus those with zero points had a percent decreased chance of developing lethal prostate cancer in the health professionals group. In the physicians group this decrease was percent. While there were fewer cases and less detailed data collected in the physicians study the score was similar in both populations indicating the potential benefit of healthy lifestyle habits in warding off lethal prostate cancer said the authors. We estimated that percent of lethal prostate cancer cases would be prevented in the United States if men over had five or more of these healthy habits said Kenfield assistant professor in the Department of Urology at UCSF Medical Center and formerly of the Department of Medicine at Harvard Medical School in Boston where the study was initiated. Its interesting that vigorous activity had the highest potential impact on prevention of lethal prostate cancer. We calculated the populationattributable risk for American men over and estimated that percent of lethal prostate cancer would be reduced if all men exercised to the point of sweating for at least three hours a week Kenfield said. The researchers also calculated that lethal prostate cancer among American men over would be cut by percent if they consumed at least seven servings of tomatoes per week and that percent would be spared this diagnosis if they consumed at least one serving of fatty fish per week. Reducing intake of processed meats would cut the risk by percent they reported. In contrast the populationattributed risk for smoking was percent largely because the majority of older American men are longterm nonsmokers. Lifestyle changes also prevent heart disease diabetes This study underscores the ongoing need for more effective prevention measures and policies to increase exercise improve diet quality and reduce tobacco use in our population said senior author June M. Chan ScD from the departments of Urology and Epidemiology and Biostatistics at UCSF. It takes cooperation and effort from multiple areas like insurance companies employers policy makers and city planners to figure out how to creatively support and encourage more exercise into most busy adults working day. These lifestyle habits align with other recommendations to prevent diabetes and heart disease. About one man in seven will be diagnosed with prostate cancer during his lifetime making it the most frequently diagnosed cancer in the United States excluding nonmelanoma skin cancer. According to the American Cancer Society in there will be approximately cases of prostate cancer and approximately deaths. This study was supported by grants from the Prostate Cancer Foundation and the National Institutes of Health. Coauthors are Erin Van Blarigan ScD of the departments of Urology and Epidemiology and Biostatistics at UCSF Howard Sesso ScD MPH Edward Giovannucci MD ScD Meir Stampfer MD DrPH and Julie Batista ScD all of Harvard T.H. Chan School of Public Health Harvard Medical School and Brigham and Womens Hospital Mary Kathryn Downer and Jaquelyn Jahn both of Harvard T.H. Chan School of Public Health and Brigham and Womens Hospital. About UCSF UCSF is a leading university dedicated to transforming health worldwide through advanced biomedical research graduatelevel education in the life sciences and health professions and excellence in patient care. Founded in as a medical college UCSF now includes topranked graduate schools of dentistry medicine nursing and pharmacy a graduate division with worldrenowned programs in the biological sciences a preeminent biomedical research enterprise and toptier hospitals UCSF Medical Center and UCSF Benioff Childrens Hospitals. Please visit http"

"For infants with congenital malformations of the ear a treatment system called EarWell can gently reshape the earavoiding the pain and cost of later surgery reports a study in the March issue of Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg the official medical journal of the American Society of Plastic Surgeons http ASPS. But treatment must begin earlypreferably within the first three weeks after birth according to the study by ASPS Member Surgeon H. Steve Byrd MD and colleagues of Pediatric Plastic Surgery Institute Dallas. Dr. Byrd comments The EarWell system is effective in eliminating or reducing the need for surgery in all but the most severe congenital ear malformations. Nonsurgical Treatment Avoids Later Consequences of Infant Ear Malformations The researchers review their experience with nonsurgical correction of congenital ear malformations in infants. The EarWell system is a relatively simple technique for molding and reshaping the ear taking advantage of the increased malleability of the ear cartilage in newborns. For best results treatment should start within the first three weeks after birth or correspondingly later in infants born prematurely. The technique and length of EarWell treatment varies according to the type and severity of the infants ear deformity. Dr. Byrd and colleagues present a classification system and technical details for plastic surgeons to follow in evaluating the best treatment for specific types of malformations. For most infants in the study both ears were treated for a total of ears. Ninetyeight percent of infants had relatively mild constrictedtype ear deformities. EarWell treatment started at an average age of days and continued for days including an average of six followup visits to the plastic surgeons office. EarWell treatment was highly successful in correcting or reducing the severity of congenital ear malformations. Results were judged good to excellent in percent of ears with one simple deformity and percent with more complex mixed deformities. About percent of ears with constricted malformations were graded as having no deformity after treatment. Complications consisted mainly of skin injuries that healed without further problems. In eight cases treatment had to be stopped because of an allergic reaction to the adhesive tape used. While the EarWell system is not new the report is the largest study of congenital ear malformations treated with this approachincluding a standardized approach to treatment and assessment of the results. The results strongly support its use especially in infants with deformities and lesssevere malformations. But lack of awareness of this nonsurgical alternative is a key limiting factor. The opportunity for early treatment can be hampered by a failure to convince pediatricians that the majority of misshapen newborn ears do not selfcorrect Dr. Byrd and coauthors write. They also point out that EarWell is highly successful in the treatment of prominent earsa condition that commonly goes unnoticed by parents and pediatricians but is likely to get worse as the child grows. While we can operate on ears later in the patients life waiting not only increases the surgerys difficulty and expense but may expose the child to teasing bullying and loss of selfesteem comments EditorinChief Rod J. Rohrich MD in a featured video on the Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg website. If your baby has any type of ear deformity plastic surgeons can help with or without surgery. Discuss nonsurgical ear molding alternatives with your pediatrician and consult with a boardcertified plastic surgeon...the earlier the better Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg is published by Wolters Kluwer http Click here to read Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System. httpjournals.lww.complasreconsurgFulltextClassification_of_Newborn_Ear_Malformations_and..aspx Article Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System doi .PRS. About Plastic and Reconstructive Surgery For more than years Plastic and Reconstructive Surgery http has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons Plastic and Reconstructive Surgery brings subscribers uptotheminute reports on the latest techniques and followup for all areas of plastic and reconstructive surgery including breast reconstruction experimental studies maxillofacial reconstruction hand and microsurgery burn repair and cosmetic surgery as well as news on medicolegal issues About ASPS The American Society of Plastic Surgeons http is the largest organization of boardcertified plastic surgeons in the world. Representing more than physician members the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than percent of all boardcertified plastic surgeons in the United States. Founded in the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. About Wolters Kluwer Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal business tax accounting finance audit risk compliance and healthcare rely on Wolters Kluwers market leading informationenabled tools and software solutions to manage their business efficiently deliver results to their clients and succeed in an ever more dynamic world. Wolters Kluwer reported annual revenues of . billion. The group serves customers in over countries and employs over people worldwide. The company is headquartered in Alphen aan den Rijn the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam WKL and are included in the AEX and Euronext indices. Wolters Kluwer has a sponsored Level American Depositary Receipt program. The ADRs are traded on the overthecounter market in the U.S. WTKWY. Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization visit http httpwolterskluwer.com follow WKHealth httpstwitter.comwkhealth or Wolters_Kluwer httpstwitter.comWolters_Kluwer on Twitter like us on Facebook https follow us on LinkedIn https or follow WoltersKluwerComms on YouTube. https"

"People with diets short on omega fatty acids the kind found in fish oil were more likely to experience accelerated brain aging a new study found. People with lower levels of omega fatty acids had lower brain volumes that were equivalent to about two years of brain aging said Dr. Zaldy S. Tan http a member of the UCLA Easton Center for Alzheimers Disease Research in the Department of Neurology. The study http published Tuesday in the print edition of the journal Neurology. Tan and his colleagues compared blood levels of two nutrients in omega fatty acids with MRI brain scans and cognitive tests. They found people in the bottom scored lower on such mental tests as problem solving multitasking and abstract thinking. Tan said the MRI images showed those with lower levels of omega fatty acids were also more likely to have minute but significant structural changes in the brain. The MRIs showed higher white matter hyperintensity volume tiny lesions in the brain raising the risk for death stroke and dementia for the low omega fatty acids group. Tan said the results were consistent with signs of damage to the intricate network of blood vessels in the brain. A third of the brain by volume is composed of blood vessels. Tans team studied people with an average age of who were free of dementia. They controlled for such risk factors as age smoking gender body mass index physical activity and APOE httpghr.nlm.nih.govgeneAPOE the one known gene linked to dementia risk. Tan said the next step in the research is to follow these people to see if the risk factors they observed translates into a higher rate of cognitive deterioration. Fatty fish like salmon offer a concentrated source of the omega fatty acid nutrients Tan and his colleagues looked at eicosapentaenoic acid EPA and docosahexaenoic acid DHA. Vegetable and canola oils soybeans flaxseed walnuts and vegetables including spinach kale and salad greens are also a source of omega fatty acids. These contain alphalinolenic acid ALA which the body partially converts to EPA and DHA. Both types are thought to be beneficial. The typical American diet doesnt contain enough of either. Choose My Plate http the governments dietary guidelines recommends eating seafood twice a week. This is an important new finding that supports omega for brain health and brain size said Dr. Majid Fotuhi http chairman of the Neurology Institute for Brain Health and Fitness and assistant professor of neurology at Johns Hopkins University School of Medicine. Fotuhi recommends his patients get mg per day of DHA a nutrient that increases blood flow in the brain reduces inflammation in the brain heart and elsewhere and reduces the toxic aggregation of amyloid in the brain. DHA has the added benefit of improving mood and reducing symptoms of depression he said. The only people who should avoid DHA are patients on a blood thinner like Cumadin he added. Neurology http published weekly is the official journal of the American Academy of Neurology."

"A breath test to detect stomach and esophageal cancers shows promise researchers say. The test measures five chemicals in the breath. It was percent accurate in detecting these cancers in more than patients the new study found. Each year . million cases of cancer of the stomach and esophagus the tube leading from the throat to the stomach are diagnosed worldwide. Both tend to be diagnosed at a late stage and the fiveyear survival rate for the two cancers is percent the researchers said. Findings from the study were presented Monday at the European Cancer Congress ECC. At present the only way to diagnose esophageal cancer or stomach cancer is with endoscopy. This method is expensive invasive and has some risk of complications study author Dr. Sheraz Markar said in an ECC news release. Markar is from Imperial College London in England. With endoscopy a flexible tube is threaded down a sedated patients throat to the stomach to view the digestive tract. A breath test could be used as a noninvasive firstline test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment and better survival Markar said. Because cancer cells are different to healthy ones they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the esophagus and stomach and which do not he explained. Markar added that the test needs to be validated in a bigger group before it could be used on patients. The researchers said they are planning a larger trial of the breath test over the next three years. Study results presented at meetings are generally considered preliminary until theyve been published in a peerreviewed journal. More information The U.S. National Cancer Institute has more on stomach cancer https SOURCE European Cancer Congress news release Jan."

"When patients present with neurologic symptoms such as severe headaches or seizures the symptoms could suggest anything from infection cancer or an autoimmune disease of the brain or spinal cord leaving physicians scrambling to find the cause in a short amount of time. The differences in diagnosis can mean having mere hours to act or being able to take days or weeks to devise a treatment plan. Now researchers at Jefferson https Philadelphia University Thomas Jefferson University have developed a test that could rapidly parse out infections of the brain from other diseases. The diagnostic could prove particularly useful in infants and young children. We have many tests for making diagnoses but the ones that conclusively indicate infection can often take more time than wed like especially in cases of childhood meningitis or encephalitis said Mark Curtis https MD PhD Associate Professor of Pathology Anatomy and Cell Biology who also works as a hospital pathologist. Once confirmed with additional research our test could provide a first rapid and less invasive way to look at whats happening in the brain and guide treatment or further testing. The results were published in the journal PLOS ONE httpsjournals.plos.orgplosonearticleid.journal.pone. on October st. Rather than testing for the presence of bacteria or virus the researchers looked at the first telltale signs of infection the cytokines produced by the patients immune system in response to pathogens and other injury processes. Cytokines are an alarm system in the body said Dr. Curtis. Infectious agents activate a multipronged inflammatory response a key component of which is the release of different combinations of cytokines tailored to combat pathogens. Changes in cytokine levels of cerebrospinal fluid offer a very early measurable sign of infection. Dr. Curtis and colleagues decided to see if they could detect patterns within the cytokines that might differentiate infections from other brain diseases or disorders. In the retrospective analysis the investigators looked at samples collected from patients who had received spinal taps during their hospital stays. The researchers then tested the cerebral spinal fluid CSF for the presence of different cytokines and noticed that patients with confirmed infection of the central nervous system had a different cytokine fingerprint from those confirmed as having tumors or autoimmune disease. This suggested the test could be used to tell the conditions apart. Additionally within the patients identified with central nervous system infections the CSF cytokine fingerprint was different in cases of viral infection compared to those with nonviral pathogens such as bacteria or fungi. With only a small amount of spinal fluid needed CSF cytokine analysis could be used as one of the first diagnostic tests to rapidly triage serious central nervous system disorders and guide immediate intervention said first author Danielle Fortuna MD an Assistant Professor in the Department of Pathology and Laboratory Medicine at the Hospital of the University of Pennsylvania. Worldwide meningitis and encephalitis affect more than four million adults and children each year. Infants and young children have an especially high risk of meningitis and encephalitis and the related often serious sequelae said Dr. Curtis. Being able to rapidly identify a central nervous system disorder as infectious can be crucial in rapid response. In addition the test could distinguish viral from nonviral infections a distinction that could spare a child with a viral infection from an unnecessary course of antibiotics and tailor the care toward antiviral and supportive measures as needed said Dr. Curtis. Moving forward our goal is to formally validate our findings with a larger sample size that includes both adults and children for future use in the clinical arena. Article reference Danielle Fortuna D Craig Hooper Amity L Roberts Larry A Harshyne Michelle Nagurney Mark T Curtis Potential role of CSF cytokine profiles in discriminating infectious from noninfectious CNS disorders PLOS ONE DOI .journal.pone. httpsjournals.plos.orgplosonearticleid.journal.pone. . Media Contact Edyta Zielinska edyta.zielinskajefferson.edu mailtoedyta.zielinskajefferson.edu ."

"Merck Cos approved Keytruda lung cancer treatment provided superior overall survival to chemotherapy in a latestage study of patients with advanced disease whose tumors produce a protein called PDL associated with increased risk of the disease. The U.S. drugmaker on Monday said patients taking the approved milligram dosage of Keytruda and those taking an experimental milligram dose had longer overall survival compared with those taking docetaxel a standard treatment for non small cell lung cancer NSCLC the most common form of lung cancer. Keytruda thereby met its main goal of the study. Patients whose tumors had especially high levels of PDL also went longer without a progression of disease than those taking docetaxel Merck said. Those whose tumors expressed PDL but not at high levels did not show such a statistically significant benefit in progressionfree survival. Safety of Keytruda was consistent with what had been seen in previous trials among lung cancer patients Merck said in a release that included only summary topline information from the results. More detailed data from the study will be provided soon Merck said adding that it will ask the U.S. Food and Drug Administration later this year to add the new data to the drugs package insert label. U.S. regulators in October approved Keytruda on an accelerated basis for patients with advanced nonsmall cell lung cancer whose tumors produce PDL. The approval was contingent on the company providing more detailed data in the future on Keytrudas safety and effectiveness. Keytruda and a similar treatment from BristolMyers Squibb Co called Opdivo are antibodies designed to block the interaction between PDL and another protein PD whose natural function is to put checks on the immune system. By blocking the interaction the drugs aim to enable the patients own immune system to recognize and therefore attack the cancer. Wall Street analysts expect cancer immunotherapies to earn combined annual sales of over billion by ."

"Doctors should consider radiosurgery earlier for patients with severe facial pain according to a new study in the International Journal of Radiation OncologyBiologyPhysics the Red Journal the official journal of the American Society for Radiation Oncology ASTRO. In the research radiosurgery helped improve the quality of life for patients with trigeminal neuralgia and reduced their depression which is often exacerbated by the side effects of other treatments. The authors from Cleveland Clinic in the US say considering radiosurgery earlier on could make a big difference to patients lives. Trigeminal neuralgia TN is a very painful nerve disorder that causes an electrical shock feeling in the face usually in older people. Some things can trigger it like chewing or even the wind blowing but attacks can be random. On a scale of patients often describe the pain as off the scale. TN is commonly treated with antiepileptic medications. While this can reduce the pain it makes patients drowsy and tired and they report feeling drunk. This has an impact on their quality of life and frequently causes depression as it stops them from driving working or even just leaving the house. According to the new study radiosurgery which is normally a second line treatment to be used following the medication helps improve quality of life and reduce depression in patients with TN. By considering it earlier as a treatment option doctors could help improve the lives of patients with TN more quickly. We knew radiosurgery results in pain relief but we didnt know if the patients actually felt better said Dr. Samuel Chao corresponding author of the study. I think people go and see their neurologist and get the pain under control with medication but they dont realize how lousy this can make them feel. Using radiosurgery earlier on allows patients to get off the medications improving their quality of life by allowing them to return to activities they used to do. Radiosurgery is a method for physically treating the nerve using radiation with stereotactic radiosurgery doctors can focus beams of radiation on a single point. It is noninvasive so doesnt require the healing time of traditional surgery. Treatment takes less than an hour and requires no anesthetic. However it is often overlooked or delayed as a treatment because there is a lack of capability and experience with the method. Research has shown that radiosurgery reduces pain for of patients but the broader impact on their lives remained unknown. In the new study Dr. Chao Dr. Kotecha and his colleagues prospectively collected data from patients they treated with radiosurgery using two questionnaires EuroQOL Dimension and Patient Health Questionnaire . They asked questions about the patients pain and facial numbness their health and their ability to take care of themselves. The researchers analyzed patients answers before treatment and at each followup appointment and found that patients reported an improved quality of life and lower rates of depression after radiosurgery. Importantly the benefit of treatment was strongly driven by improvements in pain and discomfort as well as selfcare. Pain and the medication to stop the pain make it difficult for people with TN to go outside and live life explained Dr. Chao. With radiosurgery we can reduce pain improve quality of life and decrease depression people can go out and enjoy life without worrying they will have a random attack. Giving options empowers the patient to be more aware of themselves and manage their own condition. The team plans to analyze the impact of other treatment options and carry out a costbased analysis to establish the best treatment options for TN. Notes for editors The article is Stereotactic Radiosurgery for Trigeminal Neuralgia Improves PatientReported QualityofLife and Reduces Depression httpsdoi.org.j.ijrobp... by Rupesh Kotecha Jacob A. Miller Sujith Modugula Gene H. Barnett Erin S. Murphy Chandana A. Reddy John H. Suh Gennady Neyman Andre Machado and Sean Nagel. It appears in International Journal of Radiation OncologyBiologyPhysics available online April published by Elsevier. Copies of this paper are available to credentialed journalists upon request please contact Name at Email address or Phone number add country code. About International Journal of Radiation OncologyBiologyPhysics International Journal of Radiation Oncology Biology Physics IJROBP known in the field as the Red Journal is the official journal of the American Society for Radiation Oncology ASTRO. It publishes original laboratory and clinical investigations related to radiation oncology radiation biology medical physics and both education and health policy as it relates to the field. This journal has a particular interest in prospective clinical trials outcomes research and large database interrogation as well as reports of highimpact innovations in single or combined modality treatment tumor sensitization normal tissue protection including both precision avoidance and pharmacologic means brachytherapy particle irradiation and cancer imaging. About Elsevier Elsevier is a global information analytics company that helps institutions and professionals progress science advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management RD performance clinical decision support and professional education including ScienceDirect Scopus ClinicalKey and Sherpath. Elsevier publishes over digitized journals including The Lancet and Cell more than ebook titles and many iconic reference works including Grays Anatomy. Elsevier is part of RELX Group a global provider of information and analytics for professionals and business customers across industries. http"

"Johnson Johnsons Stelara helped a significantly higher percentage of Crohns disease sufferers than those who received a placebo according to a study of patients who had not been helped by other commonly used drugs. In addition nearly percent of patients who stayed on Stelara beyond the initial six weeks of the midstage study continued to respond to the drug and there was a significantly higher rate of remission at weeks than in a placebo group. Stelara known chemically as ustekinumab is already approved to treat the skin condition plaque psoriasis and is in latestage testing for psoriatic arthritis. An approval for Crohns would give the drug entry into an estimated . billion U.S. market and . billion market worldwide. The intravenous biotech drug met the primary goal of the study as almost percent of patients who received the milligrams per kilogram of weight dose of Stelara achieved a clinical response defined as a point reduction in the Crohns Disease Activity Index CDAI after six weeks of treatment. That compared with a response rate of . percent of patients who received a placebo. Two lower doses of Stelara were also tested in the study of patients with moderate to severe Crohns disease who were not helped by or could not tolerate treatment with a widely used class of drugs known as TNF antagonists such as Abbott Laboratories Humira. Those who received mgkg had a . percent response rate and the mgkg dose led to a . percent response rate. To see these kind of outcomes where you have high response rates in the short term and then good remission rates out toward five or six months of therapy it shows unequivocally that the drug is effective for treating Crohns disease said Dr. William Sandborn the studys lead investigator who presented the data at the Digestive Disease Week meeting in Chicago on Sunday. Its effective in the patient population that has the greatest unmet need at this point in time Sandborn said of patients who do not respond to antiTNF drugs. He said a point drop in the CDAI was clinically meaningful to patients. Theyll feel measurably better. The patient population was really quite ill and had very high disease activity and despite that we saw nice response rates Sandborn said. In a second phase of the study those who responded to Stelara after six weeks of treatment were given either a mg injection of Stelara at week eight and week or a placebo. After weeks . percent of the Stelara patients maintained a clinical response and . percent were deemed to be in clinical remission. That compared with . percent who maintained a clinical response and a . percent remission rate in the placebo group. Clinical remission was defined as a CDAI score down to . Patients in the study on average started at or on the CDAI scale researchers said. Crohns is a chronic autoimmune disorder of the gastrointestinal tract that affects an estimated Americans. Common symptoms are abdominal pain and diarrhea and it can lead to bowel perforations. Many Crohns patients require surgery when medicines no longer control symptoms. The rate of infections and other serious side effects was similar in the Stelara and placebo groups researchers said. Well need more patients and longerterm data to really fully characterize the safety profile in Crohns disease but so far so good Sandborn said. Reporting by Bill Berkrot Editing by Tim Dobbyn and Dale Hudson Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"If it werent for routine PSA https prostate cancer https screening an extra Americans each year would learn that they had the worst form of the disease a new study suggests. That kind of prostate cancer https metastatic prostate cancer in which the cancer https spreads to the bone or other parts of the body is rapidly fatal usually within two years or less. The new study seems to make a powerful argument in favor of PSA testing. It finds that in the three years before widespread PSA testing men getting their first diagnosis of prostate cancer were three times more likely to learn they had very latestage cancer https than men diagnosed in the most recent three years for which data is available . By not using PSA tests in the vast majority of men you have to accept you are going to increase very serious metastatic disease threefold says study leader Edward Messing MD chief of urology at the University of Rochester Medical Center. In about U.S. men were diagnosed with metastatic prostate https cancer https By projecting data from the prePSA era forward Messing calculates that without routine PSA tests men would have been diagnosed in an extra cases of deadly disease. But its not that simple says Barnett Kramer MD MPH associate director for disease prevention at the National Institutes of Health. Studies looking back at cancer trends in a population are very unreliable when it comes to showing what caused those trends. For example Kramer says what if a man got a PSA test when his prostate cancer was in the very earliest stages of metastatic disease Microscopic cancers already have seeded his body. But he would not yet have symptoms or detectable metastatic disease so hed be diagnosed with earlierstage disease. Hes subtracted forever from the men whose first diagnosis was latestage disease even though screening could not save his life. Messing says this misses the point of his study which appears in the online July issue of the journal Cancer. The reason our study has some meaning is that all a screening test can give you is a shift to lowerstage disease he says. It cant cure the disease and it cant prevent the disease. All it can do is allow you to catch it earlier and give appropriate treatment for the stage of disease you have caught it at. Kramer notes that another study using National Cancer Institute data recently found that latestage prostate cancers declined in men over age after it was recommended that they stop getting PSA tests. Its highly unlikely that not getting screened prevented these cancers. But it does show how easily false results creep into lookback studies. PSA Screening Controversy The U.S. Preventive Services https Task Force recently recommended against routine PSA screening. At best PSA screening may help one man in avoid death from prostate cancer after to years task force cochair Michael LeFevre MD MSPH of the University of Missouri writes in an email to WebMD. We now know that the PSA test harms many more men in the course of testing and treatment after a positive result. But what about Messings study This study is not a randomized trial and the results dont tell us much about whether screening reduces a mans chances of having metastatic prostate cancer LeFevre notes. Since death from prostate cancer will nearly always be preceded by metastatic disease one would expect a significant decline in metastatic disease to be accompanied by a significant reduction in deaths. But that is not what the clinical trials https show. Messing agrees that his study is not a screening study although he argues that the European trial of PSA screening did indeed show the same reduction in metastatic cancer as his study predicted. And this reduction he says argues strongly in favor of routine PSA tests for all men starting at age and older and for higher risk men starting in their s. Kramer says Messing is right when he says screening itself doesnt save lives. Only treatment can do that. And the evidence unfortunately shows that prostate cancer treatment https isnt as good as everyone would like it to be. A recent study in the New England Journal of Medicine looked at men whose earlystage prostate cancer was detected by PSA tests. Those treated with radical prostatectomy https considered the most effective if not the safest treatment were only about more likely to be alive years later than those not treated. And PSA testing carries risks. According to LeFevre Men with suspicious PSA scores get biopsied but up to of these biopsies https find no cancer. Once a biopsy finds cancer theres no way to tell for sure if its going to kill him. Nine out of U.S. men opt for treatment. For every men who get treatment after PSA screening one gets a blood clot https two have a heart attack https or stroke https and up to become incontinent or have urinary incontinence https One in men who gets PSA screening will avoid dying of prostate cancer but one in will die as a result of surgery. PSA Should Men Get the Test So should men get regular PSA tests Many urologists who often treat men suffering terribly from latestage prostate cancer agree with Messing that they should. But many experts on screening tests who often see doctors fail to accept medical evidence that conflicts with their experience agree with LeFevre that they should not. The American Cancer Society has this advice Men should only get the PSA test after having a detailed talk with a doctor about the benefits and risks of PSA screening."

"If you spend all day sitting on your rear end then you might want to schedule some time for a brisk walk just make sure you can spare at least an hour. Scientists analyzing data from more than million people found that it takes about to minutes of moderate intensity exercise to undo the damage of sitting for at least eight hours a day. Not exercising and sitting all day is as dangerous as being obese or smoking they found. And the added risk of parking yourself in front of a television for hours or more a day after sitting at the office is so high even the hour of exercise is not enough to reverse the damage. We cannot stress enough the importance of getting exercise whether its getting out for a walk at lunchtime going for a run in the morning or cycling to work said Ulf Ekelund of the Norwegian School of Sports Sciences in Norway one of the study authors in a statement. It has been long suspected that sitting a lot at work or at home is not healthy. Previous studies have found that prolonged sitting can raise the chances of heart disease various cancers and an earlier death. In the new research experts combed through papers with data on factors including how long people spend sitting their physical activity levels and their televisionwatching habits. The majority of studies included people older than age . All except one were done in the U.S. Western Europe and Australia. Researchers found that people with the highest levels of moderate physical activity to minutes daily erased the higher risk of death linked to being seated for more than eight hours a day. But even that exercise regime was not enough to counter the hazards of also watching more than five hours of television a day. The paper was published online Wednesday in the journal Lancet. Lars Bo Andersen who coauthored an accompanying commentary called the new research very convincing explaining that too much sitting increases the risk of problems including diabetes and heart disease because it can make insulin levels spike and might slow the bodys metabolism. Andersen said that watching lots of television was probably even worse than sitting at the office all day because it likely includes other unhealthy habits. A lot of people dont just watch TV they eat fatty snacks at the same time said Andersen of Sogn and Fjordane University College in Norway. Andersen said that some cultures make it easier than others to squeeze in an hour of exercise every day noting that in Denmark and much of Scandinavia about half of all people either cycle or walk to work. But he said that getting the recommended amount of physical activity shouldnt be overly arduous and doesnt necessarily mean going to the gym for an intense workout. If you are walking and can feel yourself getting a little warm and your breathing is a little heavier thats enough he said. You dont have to be sweaty and out of breath to get the benefits. Copyright The Associated Press http All rights reserved. This material may not be published broadcast rewritten or redistributed."

"Many heart doctor will tell you that one of the best ways to keep your heart healthy is to include more healthy oils httptime.complantssciencehealthierdietbestclimate such as omega fatty acids httptime.comfishoilomegaantidepressants found in fish in your diet. Studies have shown that people in parts of the world who eat more fish have lower rates of heart disease and fewer heart attacks though the same cant necessarily be true of those who take supplementssee this piece Fish Oil Is Hugely PopularBut Should You Take It httpstimeinc.slack.comfilesaliceparkFWFVKZUZcstl____article.pdf for more on that. One thing that has been less clear is what role fish oil plays in people who have already had a heart attack. Can omega fat provide similar benefit Researchers led by Dr. Raymond Kwong at Brigham and Womens Hospital wanted to find out so they took advantage of more sophisticated imaging techniques that can provide detailed pictures of the heart and how its changing in the days and weeks after a heart attack. For the study published in the journal Circulation they studied nearly people who recently had a heart attack who were randomly assigned to take g of omega fatty acids or a placebo pill for six months. Thats a high dose a oz. portion of salmon contains anywhere from half a gram to g of omega. Every two months the volunteers came in for an MRI of their heart to track how much the muscle was changing. Normally after a heart attack part of the heart is starved of oxygen and that portion never recovers. The remaining healthy tissue starts to compensate for the compromised tissue but has to work harder to maintain the hearts normal pumping function. Over time this overworking can lead to scar tissue and start to restrict even the healthy tissues ability to do its job. Kwong and his team found that people taking the high dose of omega fats showed less of this decline in heart function than those taking placebo. Whats more the people who showed the highest blood levels of the omega fats people absorb it at different rates showed the greatest reduction in scarring compared to those with the lowest levels. The effects remained strong even after the researchers accounted for the fact that all of the people were taking standard heart disease treatment drugs including cholesterollowering statins and blood pressure medications. The omega fatty acids seem to be preventing scarring of the otherwise healthy muscle that now has to overwork because of the heart attack says Kwong. Based on analysis of their blood samples the people taking omega supplements also showed lower levels of inflammatory markers httptime.cominflammationhealtheffects which suggests that the fish oil may be working by reducing inflammation following a heart attack. Its the first encouraging strategy for protecting the heart after a heart attack the more remaining healthy tissue that can be saved the stronger the heart will be. Kwong says that the findings are only the first step toward considering whether omega fatty acid supplements should be part of every emergency heart attack response. The g is a high dose previous studies in which people were given g of fish oil were more inconsistent. Most of the people also started taking the supplements two to four weeks after their heart attack. Might they have benefit more if they had started taking the supplements sooner How much omega is needed to start remodeling the heart in a beneficial way These are questions Kwong and others hope to answer with more studies. Kwong collected blood samples from the volunteers and will be studying them for hints about how omega fatty acids are working in the body after a heart attack. To say every heart attack patient should be taking omega fatty acids right away is a bit premature he says. But I do think its logical that our results hold promise and may reduce bad outcomes in patients after a heart attack."

"EPA and DHA omegas reduce the risk of coronary heart disease CHD according to results of a new comprehensive metaanalysis published in the Mayo Clinic Proceedings. Among randomized controlled trials RCTs there was a statistically significant reduction in CHD risk in higher risk populations including percent in those with high triglycerides and percent in those with high LDL cholesterol. A nonstatistically significant percent risk reduction among all populations in RCTs a finding supported by a statistically significant percent reduced risk of CHD among prospective cohort studies. What makes this paper unique is that it looked at the effects of EPA and DHA on coronary heart disease specifically which is an important nuance considering coronary heart disease accounts for half of all cardiovascular deaths in the U.S. said Dr. Dominik Alexander lead author and Principal Epidemiologist for EpidStat. The percent reduced risk among RCTs coupled with an percent risk reduction in prospective cohort studies which tend to include more reallife dietary scenarios over longer periods tell a compelling story about the importance of EPA and DHA omegas for cardiovascular health. Additional study details include The study reviewed randomized controlled trials RCTs and prospective cohort studies with and subjects respectively. The study examined outcomes such as myocardial infarction sudden cardiac death and coronary death. The study compared the results of RCTs which explore interventions under strict clinical conditions to those of prospective cohort studies that are observational and followed larger populations for longer periods of time. There are important public health implications related to reducing the risk of coronary heart disease and therefore we are encouraged by the results of this comprehensive analysis said Dr. Harry Rice Vice President of Regulatory and Scientific Affairs for the Global Organization for EPA and DHA Omegas GOED which funded the study. Its also important that the observed risk reductions were even stronger in patient populations with elevated triglycerides and LDL cholesterol levels two risk factors that affect more than one quarter of the American population. The results confirm that increasing omegas is a healthy lifestyle intervention that can contribute towards reductions in CHD risk added Adam Ismail Executive Director of GOED. Remember that increasing omega intakes is basically just improving the quality of ones diet slightly like reducing the amount of sodium or increasing your dietary fiber. It is a simple inexpensive and achievable change that most consumers need to make to optimize their health. An accompanying editorial in Mayo Clinic Proceedings also acknowledges the importance of the study. The metaanalyses of Alexander and colleagues suggests that omega fatty acid intake may reduce risk of adverse CHD events especially among people with elevated levels of TGs or LDLC....omega fatty acid intake of at least gram of EPADHA per day either from seafood or supplementation as recommended by the American Heart Association continues to be a reasonable strategy said the authors. Study authors did point out that further clinical trials looking specifically at CHD outcomes may continue to provide a better understanding of the promising beneficial relationship between EPADHA and CHD risk. Current RCTs have varying durations different baseline CHD status for study participants and utilize several methods for patient selection and randomization. Future studies should Increase patient populations to account for dropout rates in longer trials. Extensively detail how subjects are diagnosed to create uniform diagnostic criteria. Be appropriately powered to detect an effect in current clinical conditions. Measure baseline omega intake or status of study participants to determine the extent to which it confounds results. The study was supported by a grant from GOED which played no role in study design in the collection analysis and interpretation of data in the writing of the report or in the decision to submit the article for publication."

"An experimental drug appears to reduce the risk of bone fractures in postmenopausal women with osteoporosis better than a placebo and the currently available drug a new study finds. In this phase trial funded by the drugs maker Radius Health fewer women on the injectable drug abaloparatide had spine fractures . percent than women receiving a placebo . percent and slightly fewer than those taking a similar injectable drug teriparatide Forteo . percent. If this gets approved and there is no reason to think it wont this will be the second drug available for the treatment of highrisk osteoporosis said lead researcher Dr. Paul Miller of the Colorado Center for Bone Research. Forteo has been in use for the past years he said. Abaloparatide works differently from Forteo and improves bone density more than Forteo Miller said. Women taking abaloparatide also had fewer other types of fractures . percent than those who got a placebo . percent and slightly fewer than those on Forteo . percent the researchers found. Miller said many spine fractures are painless. Patients are often unaware they have happened until a doctor measures their height and finds they are up to an inch shorter than before he said. Abaloparatide and Forteo are synthetic peptides that help grow and strengthen bone Miller said. Along with building bone density they are the only ones that increase bone quality he said. Bone quality is an important aspect of bone strength the ability to withstand a break Miller said. He predicts that when abaloparatide is on the market it will compete with Forteo driving down the price of both drugs. I am hoping that having a second drug available that it will help reduce the cost he said. Forteo costs about a month if you dont have insurance. Even if a patient is insured monthly copays can range from to . Forteo is covered by Medicare Miller said. The report was published Aug. in the Journal of the American Medical Association. A study based on U.S. Census data estimated that more than million women between the ages of and have osteoporosis. A yearold woman has a percent lifetime risk of fracture due to low bone density. For the study Miller and colleagues randomly assigned nearly postmenopausal women with osteoporosis to receive daily injections of abaloparatide Forteo or a placebo for months. Their average age was . Among the nearly women who completed the trial increases in bone mineral density were greater with abaloparatide than placebo the researchers found. In addition fewer cases of hypercalcemia abnormally high levels of calcium in the blood occurred among women taking abaloparatide percent than Forteo percent. Hypercalcemia can weaken bones cause kidney stones and interfere with heart and brain function. There were no differences among the groups in other serious side effects such as nausea and heart palpations Miller said. Dr. Caroline Messer director of the Center for Pituitary and Neuroendocrine Disorders at Lenox Hill Hospital in New York City is eager for further research. There needs to be a large headtohead trial between Forteo and abaloparatide she said to really see which drug is better. Everybody is going to want to know if this is inferior or superior to Forteo she said adding that this is an early study. It shows more bone building and fewer fractures than Forteo but whether it will replace that drug is still up in the air. An editorial accompanying the study said which drug is selected may be less important than identifying and starting an approved treatment. The bar is high for any preventive treatment in 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 . . . 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 the editorial said. The editorial was cowritten by Dr. Anne Cappola of the Perelman School of Medicine at the University of Pennsylvania Philadelphia associate editor of JAMA and Dr. Dolores Shoback of the University of California San Francisco. More information To learn more about osteoporosis visit the American College of Rheumatology http SOURCES Paul Miller M.D. Colorado Center for Bone Research Lakewood Colo. Caroline Messer M.D. director Center for Pituitary and Neuroendocrine Disorders Lenox Hill Hospital New York City Aug. Journal of the American Medical Association"

"A new type of blood test may help physicians identify which patients with and without evidence of coronary blockages are at risk for heart attacks http and strokes http Even individuals with normal levels of lowdensity lipoprotein LDL known as the socalled bad cholesterol but still at risk seem to be identified according to Mayo Clinic research being presented at the American College of Cardiologys th Annual Scientific Session httpsaccscientificsession.acc.org. The test httpsnewsnetwork.mayoclinic.orgdiscussionmayocliniclaunchesfirstinusbloodtestthatassessesriskofheartattackusingplasmaceramides released commercially by Mayo Medical Laboratories http in August measures blood concentrations of plasma ceramides a class of lipids that are highly linked to cardiovascular disease processes. The study found that individuals with the highest levels of blood ceramides were found to have a to times greater risk of having a cardiovascular event compared with those with the lowest ceramide score regardless of their LDL cholesterol level or the presence of a blockage in the hearts arteries. Our research suggests that evaluating ceramide levels in patients who are not at immediate risk for coronary artery disease events may help cardiologists decide who could benefit from proactive and preventive treatment such as statins or lifestyle changes to prevent a serious cardiac event down the road says Jeff Meeusen Ph.D. http a clinical chemist codirector of Cardiovascular Laboratory Medicine at Mayo Clinic and the studys lead author. According to Dr. Meeusen ceramides are different than cholesterol which gathers and causes a clog in the arteries. Ceramides are more active attracting inflammatory cells and promoting clotting. In the study Mayo Clinic patients who were referred for coronary angiography http to check for possible artery blockages were included and followed prospectively for approximately eighteen years. Patients were similar in age and with regard to blood pressure smoking status and highdensity lipoprotein HDL the good cholesterol excluded were those who had diabetes or a previous heart attack stroke or procedure to open narrowed coronary arteries. Researchers measured four different types of ceramides in the blood at baseline and combined the values into a point scale. Patients were grouped into four risk categories according to their ceramide levels low intermediate moderate and high . Over the eighteen years researchers recorded occurrences of heart attack stroke revascularization and death. Overall . percent of patients had a major cardiovascular event each year. But the risk of having an event became higher as ceramide level increased for each point increase in the ceramide risk score the risk rose by percent. The rate of events was double among people with the highest ceramide score compared with those with the lowest . vs. . percent respectively. In patients without coronary artery disease following angiography the rate of cardiovascular events was only . percent lower than the average overall. But when researchers examined cardiovascular disease in this population by ceramide scores people with the highest levels of ceramides were four times more likely to have an event compared with those with the lowest . vs. . percent respectively. A similar trend was seen among people with low LDL levels mgdL typically considered a good LDL target. In this group the rate of heart attack stroke and revascularization and death was . percent among those with a low ceramide score but . percent in people with the highest ceramide levels. There is a need to identify patients at increased risk for cardiovascular events so that we can test strategies to prevent those events. This test seems to provide such information says Allan S. Jaffe M.D. http senior author of the study cardiologist at Mayo Clinic and chair of the Division of Clinical Core Laboratory Services. The trial was funded by Mayo Clinic. The new test is available to health care providers worldwide through Mayo Medical Laboratories which offers laboratory testing and pathology services to more than health care organizations in more than countries. Mayo Medical Laboratories collaborated with some of the original researchers who established the role of ceramides in cardiovascular disease and Zora Biosciences Oy a diagnostics discovery company based in Finland to develop and refine the test. The present study is also the first to test its clinical utility in a U.S. population. Coauthors are Leslie Donato Ph.D. Sandra Bryant Grant Spears Peter Berger M.D. and Linnea Baudhuin Ph.D. all of Mayo Clinic."

"The makers of POM Wonderful pomegranate juice say that the drink improves blood flow and heart health prevents and treats prostate cancer and works percent as well as Viagra whatever that means. All for about four bucks a bottle. Those impressive claims helped the company rack up million in sales in . They also earned the disapproval of the Federal Trade Commission FTC. Last month the agency sued POM Wonderful for making false and unsubstantiated health claims and is asking the company to remove the claims from its ads. A percent juice drink that contains antioxidants and no added sugar POM is just one of many beverages that bill themselves as promoting better health. VitaminWater kombucha tea coconut water and various brands of juice drinks made from acai goji berry and mangosteen have all used health claims in their marketing and some like POM have been the subject of scrutiny and legal action. The FTC along with the Food and Drug Administration FDA has been cracking down on food and beverage makers for allegedly overselling the health benefits of their products. In alone the FDA warned companies that they were providing misleading nutritional information on their packaging or making overly specific health claims. Health.com dietbusting foods you should never eat http Not all of the products were drinks but the beverage category stands out says Bruce Silverglade director of legal affairs at the Center for Science in the Public Interest a consumer advocacy group based in Washington D.C. At first blush it seems that beverage products are certainly a large proportion of food products that make bogus healthrelated claims. Drinks such as POM have become increasingly popular with consumers in recent years thanks in part to public health campaigns against soda that have been prompted by the obesity epidemic. The trend is away from traditional soda pop toward products claiming to provide magical health benefits Silverglade says. Are the health claims true Yes and no. The federal government doesnt require companies to vet health claims with the agency before plastering them on product packaging as long as the claims are accompanied by a disclaimer about their uncertainty. But that doesnt mean the claims are invented most are based in research. The research is often funded by the manufacturers however and industryfunded research can be prone to bias. A study found that research on health drinks that was funded entirely by beverage companies was between four and eight times more likely to find a favorable result than research with no industry support. If a cell phone company told you they tested all the models and their model came out the best would you believe it Probably not says Dr. Lenard Lesser M.D. one of the coauthors of that study and a researcher at UCLA. The same is true with nutrition research but the stakes are higher because were putting our bodies at risk. Wheres the line between research and marketing httpedition.cnn.comHEALTHcompany.funded.researchindex.html Sounds great hard to believe However farfetched the claims may sound POM is standing behind them. Two weeks before the FTC publicly announced its lawsuit POM preemptively sued the FTC claiming that preapproval of ads featuring health claims violates the companys right to free speech. But are shoppers really convinced that POM can unclog their arteries cure cancer and lead to hotter sex There seem to be more than a few believers out there. I started drinking POM after reading the studies two years ago my triglycerides were almost one of POM Wonderfuls fans breathlessly posted on Facebook after the FTC announced its lawsuit. Working out everyday drinking POM and eating healthy they are now less than . Forget what the Feds say I believe A triglycerides level of is still nearly three times higher than whats considered normal. Most health beverage drinkers arent as enthusiastic as the realtor from Alaska who posted the above testimonial. Quinton Ma a yearold marketing coordinator at Gawker Media in New York City started to drink VitaminWater as a middle schooler because it seemed like a healthy alternative to soda. I figured that if they were selling something that I could get extra vitamins from it couldnt hurt to drink Ma says. Once I learned they were really just cleverly marketed sugar waters I stopped. Health.com You are what you drink httpeating.health.comnewresearchyouarewhatyoudrinkcnnyes But the fact is even when people dont buy the health claims they often still buy the beverage. Thats the paradox of products such as POM Silverglade says The health claims on these products strain the imagination yet studies have repeatedly shown that health claims sell food. Thats because these claims however improbable they may seem distract shoppers from the real nutritional information and hook consumers with buzzwords like antioxidant. This phenomenon is known as a health halo an aura of healthfulness attached to a product based on labels like lowfat allnatural or made with whole grains that seduces consumers into overeating. According to a study by the FTC this halo effect can even lead people to overlook warning statements about the high sodium content of a product for example. A healthy halo develops around products like these says Frances LargemanRoth R.D. Health magazines senior food and nutrition editor. The healthconscious consumer incorporates them into their lifestyle thinking that theyre doing a world of good for themselves. Health.com Food label knowhow mistakes even savvy shoppers make httpeating.health.commistakesshoppersmakecnnyes Ceating a health halo The makers of POM Wonderful have spent million on scientific research on POM products and pomegranates. According to the FTCs complaint the studies POM has funded do not substantiate the companys claims and a closer look at the research seems to bear that out. One of the most prominent claims that POM can decrease arterial plaque by percent was taken from a single pilot study that included just people and was funded by the makers of POM. Another claim that POM drinkers experience a percent improvement in blood flow was taken from another POMfunded study that included just people and only lasted for three months. These days its possible for a food company to pay just about anybody to conduct a study says Silverglade. Michael Aviram Ds.C. a cholesterol researcher at Rambam Medical Center in Haifa Israel defended his studies on pomegranates many of them funded by POM by noting that they were published in very prestigious peer reviewed journals including the American Journal of Clinical Nutrition and Atherosclerosis. Dr. Harley Liker M.D. a physician at UCLA Medical Center who has also led research funded by POM directed all inquiries to a POM spokesman. A grocery store is a designed marketing environment to get people to buy things says Lesser. Lots of products are going to try to use health claims from research often from their own industry just to sell a product. Health.com health products you probably dont need http Iffy health claims dont mean that products like pomegranate juice should be avoided at all costs says Keri Gans R.D. a spokesperson for the American Dietetic Association. As long as consumers limit themselves to ounce servings and products with no added sugar juice can be an excellent source of vitamins and other nutrients Gans says. But its not going to solve any of your health issues she adds. The bottom line is that consumers shouldnt believe everything they read on labels. If they focus on consuming an overall wellbalanced diet they might not need to focus so much on finding a product that makes false promises Gans says."

"An ancient herbal remedy is getting fresh attention this cold and flu season https Some parents and even pediatricians believe elderberry extract or syrup can help kids stay healthy and lessen the symptoms when they do get sick. The Brennan family in Glen Rock New Jersey believes it works.. So we give the kids and we take it ourselves elderberry every morning right after breakfast Kevin Brennan told CBS News. He whips up a homemade concoction using frozen elderberries blueberries and honey. Some medical research suggests elderberry may reduce swelling in the mucous membranes to help relieve congestion. The Brennans pediatrician Dr. Lawrence Rosen explains Elderberry contains chemicals which are flavonoids which are antiinflammatory agents. One small study found an elderberry extract called Sambucol could shorten the duration of flu symptoms https after a person gets sick by about days. That would be similar to prescription antiviral medications https like Tamiflu or Relenza which have been proven effective in much larger studies and approved by the FDA to shorten the duration of the flu. There is not enough research about whether elderberry works in children and there is also isnt enough information about the proper dose in children Dr. Anna Minta of Johns Hopkins Childrens Center told CBS News. Before you start popping elderberries beware eating them raw can make you sick. The University of Maryland Medical Center httpumm.eduhealthmedicalaltmedherbelderberry says European elder also called black elder is the variety most often used for medicinal purposes. Raw or unripe elderberries as well as other parts of the plant contain a toxic compound related to cyanide. If the berries are not cooked thoroughly they can be poisonous. But Kevin Brennan says for his family the natural alternative seems to be working. The duration and the severity of how they get sick is much less and they get healthy quicker he said."

"Breastfeeding is not only good for babies there is growing evidence it may also reduce the risk for stroke in postmenopausal women who reported breastfeeding at least one child according to new research in Journal of the American Heart Association the Open Access Journal of the American Heart AssociationAmerican Stroke Association. Stroke is the fourth leading cause of death among women aged and older and is the third leading cause of death among Hispanic and black women aged and older according to the study. Some studies have reported that breastfeeding may reduce the rates of breast cancer ovarian cancer and risk of developing Type diabetes in mothers. Recent findings point to the benefits of breastfeeding on heart disease and other specific cardiovascular risk factors said Lisette T. Jacobson Ph.D. M.P.A. M.A. lead author of the study and assistant professor in the department of preventive medicine and public health at the University of Kansas School of MedicineWichita. This is among the first studies to examine breastfeeding and a possible relationship to stroke risk for mothers as well as how such a relationship might vary by ethnicity. Researchers analyzed data on participants in the Womens Health Initiative observational study a large ongoing national study that has tracked the medical events and health habits of postmenopausal women who were recruited between and . All women in this analysis had delivered one or more children and percent reported ever having breastfed. Among these women percent breastfed for onesix months percent for seven months and percent for or more months. At the time of recruitment the average age was . years and the followup period was . years. After adjusting for nonmodifiable stroke risk factors such as age and family history researchers found stroke risk among women who breastfed their babies was on average percent lower in all women percent lower in black women percent lower in Hispanic women percent lower in white women and percent lower in women who had breastfed for up to six months. A longer reported length of breastfeeding was associated with a greater reduction in risk. If you are pregnant please consider breastfeeding as part of your birthing plan and continue to breastfeed for at least six months to receive the optimal benefits for you and your infant Jacobson said. Our study did not address whether racialethnic differences in breastfeeding contribute to disparities in stroke risk. Additional research should consider the degree to which breastfeeding might alter racialethnic differences in stroke risk Jacobson said. Because the study was observational it couldnt establish a causeandeffect relationship between breastfeeding and lower stroke risk meaning that it is possible some other characteristic that distinguishes between women who breastfeed and those who dont is the factor changing the stroke risk. However because the Womens Health Initiative is large researchers were able to adjust for many characteristics and the effects of breastfeeding remained strong Jacobson said. Breastfeeding is only one of many factors that could potentially protect against stroke. Others include getting adequate exercise choosing healthy foods not smoking and seeking treatment if needed to keep your blood pressure cholesterol and blood sugar in the normal range Jacobson said. The study was also limited by the relatively small number of strokes that occurred during the followup period just . percent of the women experienced a stroke during the study period and . percent reported having had a stroke prior to the study and by the Womens Health Initiatives exclusion of women who had already had severe strokes at the time of recruitment. Currently the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for six months with continuation of breast feeding for one year or longer. For babies health the American Heart Association recommends breastfeeding for months with transition to other additional sources of nutrients beginning at about four six months of age to ensure sufficient micronutrients in the diet. Frontiers The Heartland Institute for Clinical and Translational Research and the Wichita Center for Graduate Medical EducationKansas Bioscience Authority funded the study. The WHI was supported by the National Health Lung and Blood Institute. Coauthors are Erinn M. Hade Ph.D. Tracie C. Collins M.D. M.P.H. M.H.C.D.S. Karen L. Margolis M.D. M.P.H. Molly E. Waring Ph.D. Linda V. Van Horn Ph.D. R.D. Brian Silver M.D. Maryam Sattari M.D. M.S. Chloe E. Bird Ph.D. Kim Kimminau Ph.D. Karen Wambach Ph.D. and Marcia L. Stefanick Ph.D. Author disclosures are on the manuscript. Additional Resources Available multimedia including photos and an audio interview are on the right column of the release link httpsnewsroom.heart.orgnewsbreastfeedingmayhelpprotectmothersagainststrokepreviewceddcddbff After Aug. view the manuscript online. Story on previous JAHA study June Breastfeeding may reduce a mothers heart attack and stroke risk Follow AHAASA news on Twitter HeartNews httpstwitter.comheartnewslangen For updates and new science from JAHA follow JAHA_AHA httpstwitter.comjaha_ahalangen Follow the researcher on Twitter ltj_ http_ Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the associations policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals. Foundations and corporations including pharmaceutical device manufacturers and other companies also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https About the American Heart Association The American Heart Association is devoted to saving people from heart disease and stroke the two leading causes of death in the world. We team with millions of volunteers to fund innovative research fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallasbased association is the nations oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved call AHAUSA visit heart.org http or call any of our offices around the country. Follow us on Facebook and Twitter."

"Call them brain pacemakers tiny implants that hold promise for fighting tough psychiatric diseases if scientists can figure out just where in all that gray matter to put them. Deep brain stimulation or DBS has proved a powerful way to block the tremors of Parkinsons disease. Blocking mental illness isnt nearly as easy a task. But a push is on to expand research into how well these brain stimulators tackle the most severe cases of depression obsessivecompulsive disorder and Tourettes syndrome to know best how to use them before too many doctors and patients clamor to try. Its not a light switch cautions Dr. Michael Okun of the University of Florida. Unlike with tremor patients the psychiatric patients who respond to DBS tend to improve gradually sometimes to their frustration. And just because the tics of Tourettes fade or depression lightens doesnt mean patients can abandon traditional therapy. They also need help learning to function much as recipients of hip replacements undergo physical therapy says Dr. Helen Mayberg of Emory University. Once your brain is returned to you now you have to learn to use it she told the annual meeting of the American Association for the Advancement of Science. Roughly people around the world have undergone deep brain stimulation for Parkinsons or other movement disorders when standard medications fail says Okun among leading researchers who gathered at that meeting last week to assess the field. How does it work Surgeons implant a wire deep in the brain. Tiny electrical jolts running from a pacemakerlike generator near the collarbone up the neck to that electrode disable overactive nerve cells to curb the shaking. Scientists figured out which spot to target based on surgery that sometimes helps worstcase Parkinsons patients by destroying patches of brain tissue. But with deep brain stimulation the electrodes dont destroy that tissue. The electrical signals can be adjusted or even turned off if they dont help or if they cause neurological side effects. The surgery however does sometimes cause dangerous brain bleeding or infections. Psychiatric illnesses require a similar operation but surgeons must implant the electrode into a different spot in the brain. Theres the rub Its not clear which spot is best for which psychiatric disease. In fact two manufacturers Medtronic and St. Jude Medical have begun major studies of DBS effects on depression. Each places the implant in a different region based on promising pilot studies. And the Food and Drug Administration in approved Medtronics version for a small group of obsessivecompulsive patients who get no relief from todays treatments under a special program that lets devices for rare conditions sell before theres final proof that they work. Dr. Joseph Fins medical ethics chief at New York Presbyterian Hospital worries that may hurt efforts to get such proof. The more available the electrodes are the more people may seek to try the surgeries without enrolling in strict trials. How good is the evidence so far The researchers are pushing for a registry to track DBS recipients to better tell but overall theyre cautiously optimistic. Just over people with intractable obsessivecompulsive disorder have undergone DBS since says Dr. Benjamin Greenberg a Brown University psychiatrist who is heading a major study funded by the National Institute of Mental Health. About threefourths of the first few dozen patients studied significantly improved some as long as eight years. You still have a burden but you have a life is how he describes the improvement. These are people who try to relieve fears or anxiety with obsessive behavior such as washing their hands or checking locks repeatedly many of whom never got out of the house because their daily rituals consumed so much time Greenberg says.Theyd failed behavior therapy designed to teach that whatever they fear doesnt happen if they skip the ritual. But with the brain pacemaker somehow that behavior therapy starts working Greenberg says maybe by enabling their brains to better remember the lessons. One big hurdle The battery tucked near the collarbone tends to last less than two years. Changing it entails outpatient surgery one reason that about a third of studied patients stop getting zapped. So Greenberg just began testing a newer version that patients can recharge every few days. Results on about DBS patients with severe depression have been published so far and roughly half improve regardless of which of the two targeted brain regions is zapped says Emorys Mayberg who shares a patent licensed to St. Jude. Separately shes now studying what the successfully treated brains have in common that might help predict the best candidates hoping to ease a tremendous burden on the patients as they decide whether to try these experiments."

"Many women with severe menopausal symptoms are not being treated for them even though safe effective remedies are available a study from Australia suggests. A woman photographs roses at Regents Park in London July . REUTERSNeil Hall The findings may be applicable to other countries too according to senior author Dr. Susan R. Davis from Monash University in Melbourne. From my interactions with colleagues from across the globe I do not believe that what we have observed is Australianspecific she told Reuters Health by email. The management of menopause has been relatively similar in the UK the USA and in Australia. Up to half of women in menopause experience socalled vasomotor symptoms such as hot flashes and night sweats. Hormone replacement therapy HRT which generally combines estrogen plus progestin is very effective. But after the initial findings of the Womens Health Initiative study showed that HRT can increase the risk of breast cancer stroke and other serious problems many women stopped using it. As reported in the journal Menopause in and Davis and her team analyzed survey responses from nearly women ages to . Seventeen percent were having moderate to severe vasomotor symptoms and percent reported moderate to severe sexual symptoms. But most were not receiving any kind of treatment. Only percent reported use of HRT and less than percent were using any type of therapy that didnt involve hormones. The women who did use hormones were mostly taking pills containing estrogen rather than preparations that are absorbed into the skin and that are potentially safer the researchers found. Extrapolating our findings to . million Australian women aged to years we found that women are likely to have moderate to severe vasomotor symptoms with most women remaining untreated they write. In addition very few women were receiving vaginal estrogen therapy for sexual symptoms. Vaginal dryness is common with menopause and affects sexual functioning. Vaginal estrogen preparations are very safe and effective for this problem but were prescribed to less than percent of the women the authors say. Why are so few women being treated Overall there is the uncertainty of women and of doctors as to what the options are what is and is not safe and of the safe options what and how to prescribe them Davis said. There is also she said a complete lack of understanding that for most women these symptoms are not fleeting. It isnt grin and bear it for a few months and it will all pass as many women suffer severe symptoms for fiveplus years she said. Women and doctors simply are not aware that symptoms can last this long. Finally many women dont realize that non hormonal options can be safe and effective she added. Dr. Wulf H. Utian medical director of the North American Menopause Society agrees that many reasons may underlie the lack of treatment. It is partly fall out from the controversy over hormone therapy he told Reuters Health in an email. But overall he said it is a combination of patients not wanting therapy or not having information about it and also the provider not prescribing it. SOURCE bit.lyhOWOoq httpbit.lyhOWOoq Menopause online July . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A study finds that use of virtual colonoscopy a noninvasive way of scanning the colon for potentially cancerous growths is on the rise. Thats a bit of a surprise given that not all medical experts agree on whether the virtual screen is as reliable as a traditional colonoscopy in which doctors insert a scope with a small camera into the colon. Plus Medicare does not currently reimburse patients for routine screening with virtual colonoscopy but does cover evaluations with colonoscopy. Add to that the aggressive public awareness campaign for colonoscopy screening led by celebrities like Katie Couric who allowed TV cameras in as she got her first test and its clear why more people are familiar with the scope than with its virtual cousin. But in spite of those challenges Megan McHugh at the Health Research and Educational Trust in Chicago and her team report that about of hospitals in the U.S. now offer the screening test up from in . As its name implies virtual colonoscopy is way to survey the colon without actually using a scope. Patients lie in a CT scanner which takes a series of pictures from a variety of different angles and a computer compiles the snapshots in two different ways. The images can be viewed as two dimensional CT scans which display any possible abnormalities protruding from the lining of the colon. Or the images can be combined to generate a D view of the colon allowing the doctors to fly through the organ looking for any suspicious growths or protrusions. The prep for both the virtual and actual colonoscopy is the same the dreaded colon cleanse that many patients find is the worst part of the procedure. The night before the test they start drinking clear liquids and take agents to loosen their stools and empty their colon so any remaining debris isnt mistaken for a tumor during the screen. While the virtual colonoscopy does not require the sedation and insertion of a scope that colonoscopy does it involves exposure to a small amount of radiation. But according to Dr. Marc Gollub director of CT and gastrointestinal radiology at Memorial SloanKettering Cancer Center the radiation is much lower than a regular CT scan and has not been proven to be of any risk. Its similar to the exposure from cosmic radiation you might get on a long airplane flight. While a growing body of data suggest that virtual colonoscopy is as sensitive as colonoscopy in picking up potential tumors not all cancer experts agree that its a good alternative to the goldstandard scope. While the American Cancer Society the American College of Physicians and other gastroenterology experts recommend virtual screening every five years the U.S. Preventive Services Task Force a congressionally mandated but nonfederal independent group of medical experts concluded the evidence wasnt strong enough to justify Medicare coverage of the service. So which one is right for you Virtual colonoscopy is a good option for those who cant be sedated for colonoscopy or who simply cant tolerate the scope. In McHughs survey hospitals reported that these patients make up the bulk of their use. And given the relatively low cost of investing in the software and other equipment required to run a virtual scan more hospitals may be adding the option to their patient services. The virtual scan does involve radiation exposure and if doctors find an abnormality that needs to be removed youll have to undergo a colonoscopy anyway to avoid another colon cleanse consider scheduling a colonoscopy on the same day in case tumors need to be removed. But Gollub notes that only about of healthy adults getting regularly screened actually have tumors. Given the fact that more hospitals are offering virtual colonoscopy its worth discussing with your doctor. In the end its a matter of personal preference its less important how you get screened just that you do get screened."

"Because vertigo can have many causes treating it can be difficult but researchers have identified a new type that may be effectively treated with medication. These conditions can be difficult to diagnose and quite debilitating for people so its exciting to be able to discover this new diagnosis of a condition that may respond to treatment said Dr. JiSoo Kim a researcher at Seoul National University in South Korea. Vertigo episodes of dizziness that can last for minutes or days may be triggered by a number of health issues ranging from an inner ear disorder to tumors. In some cases the cause is unclear. Patients can also experience other uncomfortable symptoms including vomiting headaches and motion sickness. For the study researchers recruited people who had vertigo with an unknown cause. Some had attacks rarely maybe once a year. Others had them two to three times a week. Participants also developed nausea headaches and could not tolerate head movements during the attacks. To diagnose the new vertigo the researchers had patients sit in a dark room. They then moved each patients head forward and shook it from side to side for about seconds. Afterwards a video recorded the patients eye movements. The researchers noticed that uncontrolled eye movements called nystagmus lasted longer in people with this new form of vertigo. The findings were published online May in Neurology. Its possible that the vertigo occurs when this unstable mechanism is disrupted by factors either within the persons body or in their environment Kim said in a journal news release. This new form of the condition is called recurrent spontaneous vertigo with headshaking nystagmus. Thirtyfive study participants had this form of vertigo. They were compared to others whose vertigo is triggered by other conditions including the inner ear disorder Menieres disease. Those with the newly identified form of vertigo experienced uncontrolled eye movements for seconds twice as long as those with Menieres and five seconds longer than those with vestibular migraine and another inner ear disorder called vestibular neuritis. Those with the new form of vertigo were also more likely to have severe motion sickness than those with other forms of the condition the study showed. Preventative medication was given to of the people with the newly detected type of vertigo. Of these onethird saw their symptoms reduced or they recovered completely. The researchers followed the new vertigo patients for an average of years. Five had no more attacks had an improvement in their condition and only one person had a worsening of symptoms. The others outcomes were not revealed. More information The U.S. National Library of Medicine provides more on vertigo httpsmedlineplus.govdizzinessandvertigo.html. SOURCE American Academy of Neurology news release May"

"A modified version of the polio vaccine infused straight into aggressive brain tumors helped some patients live for years longer than they normally would have doctors reported Tuesday. Its no miracle cure only about percent of patients with gliomas were helped but some are alive six years later the team reported in the New England Journal of Medicine. https Its a hopeful enough finding to move forward and test the vaccine in more people the team at the Duke University School of Medicine said. Its very unusual almost unprecedented to get this kind of longterm survival neurologist Dr. Darell Bigner who led the study team told NBC News. The Duke team tested glioma patients over five years. They all had grade IV gliomas a group of brain tumors that includes glioblastoma. These patients have a dismal prognosis the Duke team wrote in the New England Journal of Medicine. There is currently no effective therapy. Standard treatment of brain tumors includes surgery if the tumor is somewhere reachable chemotherapy and radiation. But if the tumor is aggressive its usually fatal. These are people who failed everything Bigner said. Virtually all patients no matter what you treat them with are dead within in two years. About a third of all brain tumors are gliomas according to the National Brain Tumor Society. About people a year are diagnosed with a brain tumor and about of those are malignant. The average survival rate for all malignant brain tumor patients is only . percent the group says. But theres evidence that some viruses can home in on tumors and kill them. Its not clear why but viruses can also make tumors more visible to the immune system. The team at Duke worked with the National Cancer Institute to design and manufacture a modified version of polio vaccine virus. Polio viruses are attracted to nerve cells thats why they cause paralysis. The medical team used polio viruses already weakened and altered for use in polio vaccines and genetically engineered them to carry parts of a common cold virus called a rhinovirus known to be attracted to glioma cells. They infused various doses into the tumors of the glioma patients. We inject the virus directly into brain tumors and it kills all the tumor cells it comes in contact with Bigner said. The most important thing is it sets up a secondary immune response and really destroys the distant tumor cells. Im amazed The very first patient was Stephanie Hopper who was diagnosed with a glioblastoma when she was just . I was throwing up and I had a headache behind my eye. I didnt even know I had cancer until after the surgery to remove the tumor Hopper told NBC News. It was the size of a tennis ball. Hopper was a little wary of being infused with a polio virus but was ready to try. It worked. Shes still alive married and working as a nurse in Greenville South Carolina more than six years later. Im amazed she said. I never really felt like I was going die. I think my life was just put on hold. After three years percent of patients were still alive the team reported. That compares to months or less on average for similar patients. One patient had a hemorrhage and percent had a notable adverse event the team reported. More than half had headaches and half had hemiparesis weakness or paralysis on one side of the body. Another percent had a seizure. More than a quarter had aphasia brain damage that makes speaking and communication difficult. The patient who had the hemorrhage suffered aphasia but was still alive more nearly five years later. Two patients died during the trial. The nature of the treatment causes sideeffects Bigner said. The virus infection causes a very potent inflammation response and that response causes brain swelling. The cancer drug Avastin is used in low doses to control the swelling the team said. Its not clear why just one in five patients benefits said Dr. Annick Desjardins who worked on the study team. vaccine helped halt the growth of malignant brain tumors called gliomas in percent of patientsCourtesy Duke University Duke University Similar to many immunotherapies it appears that some patients dont respond for one reason or another but if they respond they often become longterm survivors Desjardins said. The big question is how can we make sure that everybody responds The Duke team compared their volunteers to similar past patients who did not get the treatment. All but one of those previous patients died after an average of months. Just percent were still alive two years after diagnosis and percent were alive three years later. But the percent or so of patients helped by the vaccine all survived at least three years. As of March of this year eight patients had no evidence of the tumors growing any more and two had no evidence of a brain tumor at all."

"Up to sixteen weeks of intermittent fasting without otherwise having to count calories helps fight obesity and other metabolic disorders. Such fasting already shows benefits after only six weeks. This is according to a study by KyoungHan Kim and Yun Hye Kim in the journal Cell Research which is published by Springer Nature. Intermittent fasting in mice helped to kickstart the animals metabolism and to burn fat by generating body heat. The research team was led by HoonKi Sung of The Hospital for Sick Children in Ontario Canada. Research has shown that our unhealthy eating habits and sedentary lifestyles are playing a major role in the development of lifestylerelated metabolic diseases such as diabetes heart disease and obesity. For this reason dietary interventions like intermittent fasting are gaining popularity to treat conditions such as obesity. The research team in this study wanted to better understand the reactions that interventions such as fasting trigger on a molecular level in the body. They exposed groups of mice to sixteen weeks of intermittent fasting. The recurring regimen saw the animals being fed for two days followed by one day without anything to eat. Their calorie intake was not adjusted otherwise. Four months later the mice in the fasting group weighed less than those in the control group who continued to eat the same volume of food. The lower body weight of the mice in the fasting group was not the only effect. The fasting regime helped lower fat buildup in the white fat by increasing the brownlike fat involved in burning energy and producing body heat of mice on the high fat diet. Their glucose and insulin systems also remained more stable. In a further experiment similar benefits were already seen after only six weeks of intermittent fasting. Through an analysis into the underlying biology involved the researchers found that such intermittent fasting tempers an immune reaction in fat cells. There are changes in certain gene pathways involved in the immune system and the bodys reaction to inflammation. A type of white blood cell known to play a role in fighting inflammation is triggered. Known as antiinflammatory macrophages these cells stimulate the fat cells to burn stored fats or lipids by generating heat. This happens during periods of intermittent fasting because there is an increase in vascular growth factor VEGF that help form blood vessels and activate antiinflammatory macrophage. Intermittent fasting without a reduction in calorie intake can be a preventative and therapeutic approach against obesity and metabolic disorders says KyoungHan Kim. Strikingly these fastingstimulated changes in the growth of vascular cells and subsequent immune alterations occur even after a single cycle of hour fasting and are completely reversed when mice start eating again adds Yun Hye Kim. Reference Kim KH. et al . Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGFmediated alternative activation of macrophage Cell Research DOI .cr.. Note KyoungHan Kims current affiliation is the University of Ottawa Heart Institute Canada"

"Details of a large heart safety study presented on Monday appear to give Merck and Cos diabetes drug Januvia a clean bill of health possibly setting the stage for a return to sales growth for the drugmakers biggest product. A view of the Merck Co. campus in Linden New Jersey March . REUTERSJeff Zelevansky Merck in April said the study called Tecos of patients with type diabetes and a history of heart disease demonstrated that adding Januvia to usual care did not increase major heart problems any more than adding a placebo removing a cloud that has been holding back sales of the medicine and the companys share price. Januvia an oral medication known chemically as sitagliptin that helps lower blood sugar levels had sales of about billion in plus another . billion for the related combination product Janumet On the studys main focus after about three years . percent of Januvia patients had experienced cardiovascular death nonfatal heart attack nonfatal stroke or hospitalization for unstable angina versus . percent in the placebo group. The detailed results also showed no increase in hospitalization for heart failure which had been a particular concern with DPP inhibitors the class to which Januvia belongs. There were such hospitalizations for Januvia and in the placebo group according to data also published in the New England Journal of Medicine. We can be reassured we can use this drug for glucose lowering without affecting the already high cardiovascular risk in people with type diabetes said Professor Rury Holman the studys lead investigator who presented the data at the American Diabetes Association meeting in Boston. For the heart failure concern raised by other agents in the class there is no difference with placebo he added. There was also no significant difference between Januvia and placebo in infections cancer kidney failure or severe hypoglycemia which is dangerously low blood sugar researchers reported. Acute pancreatitis a concern with some diabetes drugs was uncommon but higher with Januvia versus . That was not statistically significant. Numerically this is hardly a major risk just something we need to keep an eye on Holman said. Pancreatic cancers also uncommon were numerically fewer with Januvia versus . Death from any cause occurred in . percent of Januvia patients versus . percent for placebo. The Tecos heart safety study was conducted by an independent academic research collaboration between the University of Oxford Diabetes Trials Unit and the Duke University Clinical Research Institute. It was undertaken after heart safety concerns were raised over other diabetes medicines."

"Researchers have developed a score that predicts an individuals risk of dying within years for people aged between and years old in the UK according to new research published in The Lancet. The score which uses measures that can be obtained by simple questionnaires without any need for physical examination such as selfrated health and usual walking speed could be used by individuals to improve awareness of their health status and by doctors to identify highrisk individuals for further treatment say the authors. Individuals can calculate their personalised year mortality risk and what the study authors call an Ubble age the age where the average mortality risk in the population is most similar to the estimated risk of the individualthrough an online questionnaire using the dedicated interactive website http . The site was developed with Sense About Science a UK charity that that equips people to make sense of scientific and medical claims in public discussion. The Ubble website allows anybody in the UK between forty and seventy years old to calculate their Ubble age and their risk of dying within the next five years compared to the general population using a simple set of a dozen or so questions says study coauthor Professor Erik Ingelsson from Uppsala University Sweden. This is the first study of its kind which is based on a very large study sample and is not limited to specific populations single types of risk or requiring laboratory testing. To create the score Professor Ingelsson and Dr Andrea Ganna from the Karolinska Institutet in Sweden analysed data collected between and from nearly half a million adults aged between and years from the UK Biobank . They used a statistical survival model to assess the probability that specific demographic lifestyle and health measurements could predict death from any cause and six specific causes in men and women separately. The results allow researchers to compare the predictive ability of a large number of healthrelated risk factors which were formerly studied separately and using different populations although the predictive ability of risk factors does not necessarily imply they are causally related to the risk of dying. For example the research shows that selfreported information such as usual walking pace and illness and injuries in the past years is generally a stronger predictor of death and survival than biological measurements such as pulse rate and blood pressure. Surprisingly selfreported walking pace is a stronger predictor of death risk in both men and women than smoking habits and other lifestyle measurements. Selfrated overall health emerged as the single most powerful predictor of death in men and previous cancer diagnosis the strongest predictor in women see figure of the Article. When excluding individuals with serious diseases or disorders smoking habits were the strongest predictors of mortality from any cause figure . Using these findings the researchers then developed an easytocalculate risk score for an individuals risk of dying in the next years based on the most predictive selfreported information including questions for men and for women. The performance of the score was validated in participants enrolled at two Scottish centres which were not used to develop the score and was found to have around accuracy in men and women table . UK life tables and census information were used to calibrate the score for the overall UK population. According to study coauthor Dr Ganna The fact that the score can be measured online in a brief questionnaire without any need for lab tests or physical examination is an exciting development. We hope that our score might eventually enable doctors to quickly and easily identify their highest risk patients although more research will be needed to determine whether it can be used in this way in a clinical setting. Of course the score has a degree of uncertainty and shouldnt be seen as a deterministic prediction. For most people a high risk of dying in the next five years can be reduced by increased physical activity smoking cessation and a healthy diet. Writing in a linked Comment Simon Thompson and Peter Willeit from the University of Cambridge in the UK say One appealing aspect of the website is the representation of an individuals estimated year mortality risk as what the authors call Ubble age the age where the average risk in the population is most similar to the estimated risk of the individual this concept is similar to that of heart age developed for communicating cardiovascular risk. Whether this will help individuals improve selfawareness of their health status however or only lead to socalled cyberchondria is a moot point. Moreover year mortality is easier to predict than longterm morbidity or quality of life and life expectancy all of which are more important to individuals and to society. NOTES TO EDITORS This study was funded by Knut and Alice Wallenberg Foundation and the Swedish Research Council. UbbLE stands for UK Longevity Explorer. For preview login details for the Ubble website please email daisy.bartonlancet.com mailtodaisy.bartonlancet.com. See http for more information. Quotes direct from author and cannot be found in text of Article. UK Biobank http recruited half a million people aged between and years in from across the country. Information on sociodemographics physical measures health and lifestyle factors medical history and blood measurements were taken. All participants agreed to have their health followed. The resource has been open to bona fide health researchers for months. So far more than scientists have registered with UK Biobank to study a wide range of diseases. UK Biobank will only be limited by the imagination of the researchers using it said Professor Rory Collins UK Biobank Principal Investigator. As an open access resource scientists will be able to scrutinise each others work build upon their results or undertake their own novel studies to improve the health of future generations. Assessed using the question In general how would you rate your overall health ExcellentGoodFairPoor."

"Teens who have high levels of folic acid appear to do better in school than those with lower levels Swedish researchers report. Folate intake had a positive association with academic achievement in the students studied the authors wrote in the report published in the July online edition and the August print issue of Pediatrics. Not only should health providers monitor folic acid levels in teens but the findings should influence school meals school teaching and information given to parents according to the researchers. Teens often have high levels of the blood protein homocysteine an amino acid linked to heart disease and low levels of folic acid. In previous studies folic acid levels have been linked to mental ability however until now this had not been linked with improved school performance the study authors said. We know that folate plays a really critical role in brain development and brain function said Dr. Daniel Armstrong associate chair of pediatrics at the University of Miami Miller School of Medicine. We know that in young children folate deficiencies are associated with poorer neurocognitive function and neurocognitive development he noted. In fact folate deficiencies may be involved in the development of autism he added. Armstrong thinks that a diet rich in folate might be important for brain functioning throughout life. Its one of those things thats no harm no foul. Its not going to do us any harm and it might do us some good he said. To find out whether folate might do some good a team led by Dr. Torbjorn K. Nilsson from the department of laboratory medicine at Orebro University Hospital in Sweden collected data on folic acid levels in teens aged years. The researchers also looked at any possible effects of socioeconomic status and genetics. The investigators found that teens who had the highest levels of folic acid also got the best grades. None of the other factors they examined accounted for their finding Nilssons team noted. These results provide new information that points to the importance of keeping a closer watch on folate status in childhood and adolescence. They may also have direct implications for school meal provisions school teaching programs and information to parents the authors concluded. However there is no scientific evidence that taking folate supplements will be beneficial Armstrong noted. Its too early to say that everyone should start taking folate he stressed. Folic acid is one of the B vitamins and is a key component in making DNA and RNA. Insufficient folic acid is a cause of certain birth defects of the spine and brain including spina bifida. Among the elderly folic acid consumption appears to affect mental ability and low levels of this vitamin have been associated with dementia and Alzheimers disease according to several studies. Folic acid is found in leafy green vegetables fruits dried beans peas and nuts. In addition people can obtain folic acid from breads cereals and other grain products enriched with folic acid as well as folic acid supplements. More information For more information on folic acid visit the U.S. National Library of Medicine http SOURCE Daniel Armstrong M.D. professor and associate chair pediatrics University of Miami Miller School of Medicine July Pediatrics online"

"Women who took fish oil during the last three months of pregnancy significantly lowered the risk that their children would develop asthma a study in Denmark has found. Among children whose mothers took fishoil capsules . percent had asthma by age compared with . percent whose mothers were given placebos. The difference nearly percentage points translates to a risk reduction of about percent. But in the study released on Wednesday http the researchers say they are not ready to recommend that pregnant women routinely take fish oil. Although the study found no adverse effects in the mothers or babies the doses were high . grams per day to times what most Americans consume from foods. Before doctors can make any recommendations the study should be replicated and fish oil should be tested earlier in pregnancy and at different doses Dr. Hans Bisgaard the leading author of the study said in an email. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood an independent research unit. Doctors are eager to find ways to prevent asthma a chronic disease that causes wheezing coughing and breathing trouble and that sends many families to the emergency room again and again. The incidence has more than doubled in developed countries in recent decades. More than six million children https_recent_data.htm in the United States have asthma according to the Centers for Disease Control and Prevention as do more than million http children and adults worldwide according to the Global Asthma Network. Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish. The results were published in The New England Journal of Medicine. The scientists bought fish oil from a company that makes it but they said the company had no role in the study. The research was paid for by the Danish government and private foundations. An editorial http in the same journal by an expert who was not part of the study praised the research saying it was well designed and carefully performed. The author of that editorial Dr. Christopher E. Ramsden from the National Institutes of Health said the findings would help doctors develop a precision medicine approach in which fishoil treatment could be tailored to women who are most likely to benefit. But Dr. Ramsden also said it was too soon to put the new findings into practice and he recommended further study. Previous research had suggested that fish oil might help prevent asthma. The idea is plausible because inflammation in the airways and lungs plays a major role in asthma and fatty acids in fish oil are thought to prevent inflammation. The richest sources in food include fish like herring sardines mackerel eel and salmon. Because the earlier studies suggesting a benefit from fish oil were not conclusive the Danish researchers decided to test the idea. They recruited women. Starting in their third trimester half the women took . grams of fish oil a day and half took placebo capsules of olive oil continuing until one week after birth. About a quarter of the mothers and a fifth of the fathers had asthma and they were evenly distributed between the fishoil and placebo groups. The capsules were an overthecounter product called Incromega TG a fish extract made by the British chemical company Croda Health Care. The extract contained the fatty acids eicosapentaenoic acid EPA and docosahexaenoic acid DHA. The researchers tracked the childrens health finding asthma less common in those whose mothers had taken the fish oil with the effect lasting at least through age the longest followup. By age the biggest difference had emerged from data on mothers who before treatment had the lowest levels of EPA and DHA in their blood. In that group only . percent of the children whose mothers took fish oil developed asthma compared with . percent whose mothers took the placebo a difference of . percentage points and a risk reduction of about percent. Low levels of EPA and DHA in the blood can be related to diet but also to genetics. The body normally converts another fatty acid found in plantbased foods to EPA and DHA. But some people about percent in the study carry a genetic variant that impairs their ability to make the conversion. The researchers found that children born to women with little EPA and DHA in their diets and to women with the genetic variant were among those most likely to benefit from exposure to fish oil in pregnancy. Dr. Bisgaard said that pending further study the best way to apply the findings would probably be to test women for the fattyacid levels in their blood and for the genetic variant to determine who might benefit from fish oil. He said that genetics could differ among different populations and that there might be ethnic variations in risk."

"Youve probably heard about it maybe you even remember seeing it once but youre not really sure what it is or even where to find it. The female condom FC or internal condom is a nonhormonal barrier method of birth control. But instead of going on a penis it goes in a vagina which is why its also sometimes referred to as an internal condom. For more information BuzzFeed Health spoke with two experts who could demystify this lesserknown contraceptive Dr. Harry Fisch http clinical professor of urology and reproductive medicine at Weill Cornell Medical College and chief corporate officer of Veru Healthcare which distributes FC Dr. Lauren Streicher httpdrstreicher.com associate clinical professor of obstetrics and gynecology at Northwestern Universitys Feinberg School of Medicine . Its free with a prescription from your doctor. Universal Pictures Up until the past few months the internal condom lived on store shelves usually right next to the male condoms. But it was difficult to get shelf space and secure the product in every outlet Fisch tells BuzzFeed Health. Plus the internal condoms came in threepacks making them more expensive than a big box of male condoms. Recently Veru Healthcare moved FC behind the counter where its available in packs of with a prescription from your provider. Under the Affordable Care Act insurance plans must cover https at least one form of contraception from each FDAapproved method at no cost. And since FC is the only FDAapproved internal condom it will be free httpsfc.us.comwpcontentuploadsBillingFactsheet_.pdf with a prescription from your doctor. There are a few exceptions to this which you can read more about here https_term.bsLxWrPy. . But you dont necessarily need a prescription or insurance to get it. According to Fisch there will soon be a way to order FC directly from their website httpsfc.us.compatient at about . each if youre uninsured or unable to get a prescription. You can also find them for free at many local health centers said Fisch. . It goes inside and outside of the vagina. The internal condom basically looks like an oversized male condom with a ring at each end. The inner ring is made of polyurethane and is there to help you push it back into the vagina so it stays in place during sex. The outer ring actually stays outside of the vagina covering the vulva. The condom itself is longer and looser than a male condom since its designed to feel and function almost like a second skin. So you might be a little shocked at how roomy it looks when you first take it out of the package. Its kind of like a vagina in that a vagina expands Streicher told BuzzFeed Health. A vagina has the capability to accommodate a short penis a long penis a thin penis and a thick penis. This material has the ability to expand to accommodate and because of that you need to have enough there. . Because it reduces skintocontact it might also provide greater protection against herpes and HPV. That outer ring covers more surface area than a male condom meaning theres less skintoskin genital contact during sex. While this hasnt been evaluated in clinical studies Fisch and Streicher said this could reduce the risk of transmitting skintoskin STIs like herpes or HPV which male condoms dont fully protect against. . Internal condoms are latexfree. This is a huge benefit for people with latex allergies or just anyone who hates the feel of latex. The internal condom is made of nitrile which is the same material used for surgical gloves. As a surgeon I can tell you one of the things surgeons require is to be able to feel says Streicher. Surgical gloves have been designed with that in mind. Theyre not going to break but youre going to be able to feel through it. Youre not going to lose the sensation. Another bonus nitrile is known to transfer heat better than latex so it might feel more natural than sex with a latex condom. . It offers about the same pregnancy protection as a male condom. Before we get into the numbers its helpful to understand that birth control effectiveness is measured in terms of failure rates or the percentage of people who get pregnant within the first year of using this method. Internal condoms have a failure rate with perfect use https using it consistently and correctly every single time making them effective. In contrast male condoms have a perfect use failure rate of making them effective. The failure rate for both male and female condoms https goes up when you also include people who used the method inconsistently or incorrectly referred to as typical use. Internal condoms have a typical use failure rate of while male condoms have a typical use failure rate of . The effectiveness of FC httpsfc.us.comwpcontentuploadsinstructions_for_use_english.pdf is actually taken from research on the effectiveness of its predecessor FC the original internal condom approved in . Since the FC is an improved version of FC made of nitrile instead of polyurethane no further FDA studies were required said Fisch. However a study https comparing FC and FC found they had comparable failure rates. . Experts say it takes a few tries to really get the hang of it. This isnt something you should break out for the first time right before you have sex. It takes a little bit of practice and when it comes to pregnancy and STI protection you dont want to just wing it. Streicher recommends inserting it once or twice on your own to get used to it. If youve ever used a menstrual cup or a NuvaRing this should feel pretty familiar. Fortunately if youre getting the internal condom for free you dont have to worry about wasting a few while you figure it out. Heres a stepbystep guide to inserting the internal condom httpsfc.us.comhowtousefcfemalecondomstepbystepinstructionsenglish. . It comes prelubricated with a siliconebased lube but you can also use oilbased lubes with it. As soon as you open the internal condom youll notice that its pretty well lubedup. But if youre someone who likes using coconut oil or another oilbased lube in bed youre free to do that with internal condoms too. Thats a pretty cool bonus since you cant use oilbased lubes with latex condoms as it causes them to break down and become less effective. . When the penis first enters the vagina youll need to hold that outer ring in place. This makes sure that the outer ring doesnt accidentally get pushed into the vagina where it wont be as effective on the first thrust. Streicher suggests gently holding the outer ring in place when the penis first enters the vagina just to make sure its comfortable and in the right spot. After that you can go handsfree. If at any point the internal condom gets pushed into the vagina gets pushed to the side or slips out stop what youre doing and use a new one. Keep in mind that any mishap may reduce its effectiveness in the same way that a male condom that breaksslips offgets lost inside the vagina would be less effective. If theres a chance that any semen got into your vagina you may want to ask your doctor or pharmacist about emergency contraception. . Its possible it could help with sexual functioning for both partners. Unlike the male condom the internal condom is not dictated by an erection. While the penis needs to be erect before you put on a male condom you and your partner can be at any stage of sex when you insert an internal condom. You could even put it in before sex though were not sure why youd want to. This means that if someone has a hard time maintaining an erection when they put on a condom they might not have an issue with the internal condom. Plus theres less pressure on the person with the penis if they do lose their erection at some point because you dont have to worry about the condom slipping off. And remember that outer ring Streicher says that some people might get some added stimulation from the ring rubbing against their clitoris during sex. . It can also be used as a barrier during oral sex. If dental dams https_term.ijjJxBWVj arent your thing again latex you can use the internal condom as a barrier during oral sex says Streicher. This can help protect against STI transmission and it might make the giver or receiver feel a little more comfortable. . And because its made specifically for vaginas it might help someone feel safer and more empowered when it comes to the condom conversation. If you have a vagina youve probably had a condom negotiation at some point in your sex life when for whatever reason someone didnt want to use one. For the record anyone who refuses to do something that will make you feel safe and comfortable during sex probably doesnt deserve to have to sex with you. That said the internal condom might make the whole condom negotiation thing easier. For instance Penis owner I dont have a condom. Lets just do it anyway. Vagina owner I have one It goes in me but whatever its fine. Penis owner I cant have sex with a condom. Ill immediately lose my erection. Vagina owner No worries I have an internal condom. It goes in me not on you so youll probably be fine. Penis owner Im allergic to latex. Vagina owner Interesting I have an internal condom though. Its latexfree. Penis owner Condoms never fit me. Vagina owner attempts to refrain from eye rolling I have an internal condom. Youll fit. Is it a plastic bag Is it an elephant condom Is it one of those bags you stick your wet umbrella in when you go in a department store What is happening Theyre super weird. But its not like the male condom is this glamorous accessory that everyone cant wait to show off. That skintight penis sleeve is just as awkward. Contraception doesnt have to be sexy and sleek it just has to be something that works and that feels good. And in that case the more options the better."

"In a new study of middleaged New Jersey men taking cholesterollowering drugs was linked to a lower chance of dying from prostate cancer. The findings dont prove that the drugs called statins ward off aggressive cancer. But they jibe with previous studies suggesting that getting cholesterol levels under control might help reduce the risk of lifethreatening disease researchers said. People may be on these medications for their heart but it may actually be doing them some good for their prostate said study author Dr. Stephen Marcella from the University of Medicine and Dentistry of New Jersey in New Brunswick. If a persons on the fence about taking a statin medication for their heart this is another potential benefit they may have by taking one of these he told Reuters Health. Marcella and his colleagues collected the medical records of men who had died of prostate cancer and another of the same age and race without prostate cancer or with nonlethal cancer. Most of the men were white and in their mid to lates on average. Close to one in four of the men in both groups combined had ever taken a statin. The researchers found that men who died of prostate cancer were half as likely to have taken a statin at any time and for any duration than men in the control group. When they accounted for whether or not men were overweight and their other health problems and medications it turned out that those with fatal cancers were percent less likely to have ever taken a statin according to findings published in Cancer. But Marcella added I would not tell a person if they dont have a risk of heart disease if they dont have hypertension...to take a statin just to prevent lethal prostate cancer. The evidence thats effective he said just isnt there yet. And even if statins do turn out to help prevent fatal prostate cancer researchers said previous studies have suggested they dont lower a mans risk of getting less aggressive forms of the disease. According to the American Cancer Society about one in every six men will be diagnosed with prostate cancer at some point and one in every men will die of the disease. Marcellas team didnt have the data to figure out if taking a statin for longer or starting one earlier was more beneficial than more limited use of the drugs. VERY TRICKY TO SORT OUT The researchers also couldnt tell whether men started using statins before or after they were diagnosed with aggressive cancer. ADVERTISING But they did find that while highpotency often newer statins were linked to a lower risk of fatal prostate cancer lowerpotency drugs were not. That suggests its something about the drugs themselves that lower mens chances of dying from prostate cancer Marcella said. Statins may protect against fatal prostate cancer through their known cholesterollowering effects said Dr. Stephen Freedland who studies prostate cancer at the Duke University Medical Center in Durham but wasnt involved in the new study. He said that cholesterol is a key nutrient for cancer cells so lower cholesterol levels in the body could prevent more aggressive forms of cancer from developing. But its also possible that statins dont prevent certain cancers at all Freedland said and its something else about men who take statins for example if they also change their diet and start exercising that explains their lower risk of fatal cancer. It gets very very tricky to sort out Freedland told Reuters Health. To prove that statins protect against aggressive cancer would require a large study in which cancerfree men or those with earlystage disease are randomly assigned to take statins or not and then tracked for years to see how many of them die from cancer. That type of study especially involving healthy diseasefree men would be very expensive and time consuming said Dr. Nelly Tan from the University of California Los Angeles who has studied statins and prostate cancer risk. About onequarter of adults age and older in the U.S. take statins to lower cholesterol and protect against heart attacks. The drugs run anywhere from to more than per month and sometimes cause side effects including muscle pain nausea and gas and liver dysfunction. Researchers agreed that until theres clearer evidence for benefit men with healthy hearts shouldnt seek out statin prescriptions for the purpose of lowering their prostate cancer risks. But Freedland said that other strategies for lowering cholesterol such as eating better and exercising regularly are ways almost everyone can lower their disease risks in the meantime. SOURCE bit.lyvAokK httpbit.lyvAokK Cancer online December . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Braeburn Pharmaceuticals and Camurus today announce top line results of a multipledose pivotal Phase study assessing the blockade by CAM of subjective opioid effects of multiple randomized hydromorphone challenges in adults with opioid use disorder. A key objective of medicationassisted treatment for opioid use disorder is to reduce or eliminate the use of illicit opioids. The results from the present Phase study demonstrate that CAM blocks effectively the subjective effects of opioid challenges with hydromorphone including limiting drug liking. This study provides clinical proof of concept that CAM will be an effective treatment for opioid use disorder said Behshad Sheldon President and CEO of Braeburn Pharmaceuticals The current opioid crisis demands innovation and CAMs novel technology is now one step closer to providing physicians and patients with a different approach to treating this deadly chronic disease. The primary endpoint was met for both CAM doses demonstrating blockade of the subjective effects of hydromorphone as measured by the Drug Liking Visual Analog Scale. Furthermore CAM was well tolerated across the course of treatment. The study results show that CAM provides rapid and extended blockade of opioid effects said Fredrik Tiberg President and CEO of Camurus. The results also confirm the dose selection in the current Phase program and the potential of CAM as a future treatment alternative for patients with opioid use disorder from initiation to longterm maintenance. The current study demonstrated that weekly injections of CAM produced significant and robust opioid blockade a critical mechanism of efficacy for medications treating opioid dependence. CAM has the potential to alter the current treatment paradigm for opioid dependence said Sharon Walsh Ph.D Professor of Behavioral Science and Director of the Center on Drug and Alcohol Research University of Kentucky Because of its long acting properties CAM may decrease patient and physician burden improve access to treatment and obviate public health concerns about illicit diversion of buprenorphine. We were pleased to be involved in the development of CAM and are hopeful that it will serve as another safe and effective therapeutic option for patients with opioid use disorder. The ability of CAM to produce a longlasting and robust blockade of hydromorphoneinduced Drug Liking is especially encouraging said Sandra D. Comer Ph.D Professor of Neurobiology Columbia University. Importantly the fact that CAM will be given in the clinic by health providers should address concerns about diversion of buprenorphine for illicit use. We feel that this medication with its ease of administration and flexible dosing capabilities could significantly improve management of patients. About the Phase Trial The Phase study was a threecenter randomized doubleblind inpatient study to evaluate the degree of subjective opioid blocking efficacy of CAM qw in nontreatmentseeking participants with moderatetosevere opioid use disorder. After screening participants were randomized to different CAM qw onceweekly injections for two weeks. During this period four challenge sessions were conducted with a randomized hydromorphone dose to determine subjective liking score based on a visual analogue scale. Additional information on the design of the trial can be found at http . About CAM The investigational CAM buprenorphine subcutaneous injection products for treatment of opioid use disorder are being developed as onceweekly and oncemonthly formulations each with multiple doses to cover all phases of treatment from initiation through maintenance. The CAM products are designed for administration by healthcare personnel to ensure proper delivery that minimizes the risks of diversion abuse misuse and accidental exposure. The CAM products have been evaluated in three Phase clinical trials which evaluated the safety and tolerability as well as pharmacokinetic and pharmacodynamic properties of the products in a total of individuals opioiddependent patients and healthy volunteers under naltrexone blockage. Four more trials including two Phase studies are currently ongoing. CAM is also being developed for treatment of chronic pain. About Braeburn Pharmaceuticals Braeburn Pharmaceuticals an Apple Tree Partners company is a pillfree pharmaceutical company delivering precision medicine in neuroscience. In September the Food and Drug Administration FDA accepted for review Braeburns New Drug Application for its lead candidate Probuphine a sixmonth buprenorphine implant for treatment of opioid addiction. The Agency set May as the target date for action. Longacting therapeutic treatment options can be essential to improving patient outcomes and facilitating recovery in these conditions which are often complicated by stigma and present significant public health challenges. Braeburns investigational product pipeline consists of longacting implantable and injectable therapies for serious neurological and psychiatric disorders including opioid addiction pain and schizophrenia. Candidates include Probuphine a sixmonth buprenorphine implant for treatment of opioid addiction CAM weekly and monthly subcutaneous injection depot formulations of buprenorphine for treatment of opioid addiction and pain a risperidone sixmonth implant for treatment of schizophrenia and a novel molecule ATI for treatment of schizophrenia. More information on Braeburn can be found at http About Camurus Camurus is a Swedish researchbased pharmaceutical company committed to developing and commercialising innovative and differentiated medicines for the treatment of severe and chronic conditions. New drug products with bestinclass potential are conceived based on the proprietary FluidCrystal drug delivery technologies and an extensive RD expertise. Camurus clinical pipeline includes products for treatment of cancer endocrine diseases pain and addiction developed inhouse and in collaboration with international pharmaceutical companies. The companys share is listed on Nasdaq Stockholm under the ticker CAMX. For more information visit http Media contacts Fredrik Tiberg President CEO Tel fredrik.tibergcamurus.com mailtofredrik.tibergcamurus.com http Sherry Feldberg MSLGROUP Boston braeburnpharmamslgroup.com mailtobraeburnpharmamslgroup.com Logo httpphotos.prnewswire.comprnhLOGO Logo httpphotos.prnewswire.comprnhLOGO SOURCE Braeburn Pharmaceuticals Camurus Related Links http"

"The U.S. Food and Drug Administration today approved Rydapt midostaurin for the treatment of adult patients with newly diagnosed acute myeloid leukemia AML who have a specific genetic mutation called FLT in combination with chemotherapy. The drug is approved for use with a companion diagnostic the LeukoStrat CDx FLT Mutation Assay which is used to detect the FLT mutation in patients with AML. AML is a rapidly progressing cancer that forms in the bone marrow and results in an increased number of white blood cells in the bloodstream. The National Cancer Institute estimated that approximately people would be diagnosed with AML in and were projected to die of the disease. Rydapt is the first targeted therapy to treat patients with AML in combination with chemotherapy said Richard Pazdur M.D. acting director of the Office of Hematology and Oncology Products in the FDAs Center for Drug Evaluation and Research and director of the FDAs Oncology Center of Excellence. The ability to detect the gene mutation with a diagnostic test means doctors can identify specific patients who may benefit from this treatment. Rydapt is a kinase inhibitor that works by blocking several enzymes that promote cell growth. If the FLT mutation is detected in blood or bone marrow samples using the LeukoStrat CDx FLT Mutation Assay the patient may be eligible for treatment with Rydapt in combination with chemotherapy. The safety and efficacy of Rydapt for patients with AML were studied in a randomized trial of patients who had not been treated previously for AML. In the trial patients who received Rydapt in combination with chemotherapy lived longer than patients who received chemotherapy alone although a specific median survival rate could not be reliably estimated. In addition patients who received Rydapt in combination with chemotherapy in the trial went longer median . months without certain complications failure to achieve complete remission within days of starting treatment progression of leukemia or death than patients who received chemotherapy alone median three months. Common side effects of Rydapt in patients with AML include low levels of white blood cells with fever febrile neutropenia nausea inflammation of the mucous membranes mucositis vomiting headache spots on the skin due to bleeding petechiae musculoskeletal pain nosebleeds epistaxis devicerelated infection high blood sugar hyperglycemia and upper respiratory tract infection. Rydapt should not be used in patients with hypersensitivity to midostaurin or other ingredients in Rydapt. Women who are pregnant or breastfeeding should not take Rydapt because it may cause harm to a developing fetus or a newborn baby. Patients who experience signs or symptoms of lung damage pulmonary toxicity should stop using Rydapt. Rydapt was also approved today for adults with certain types of rare blood disorders aggressive systemic mastocytosis systemic mastocytosis with associated hematological neoplasm or mast cell leukemia. Common side effects of Rydapt in these patients include nausea vomiting diarrhea swelling edema musculoskeletal pain abdominal pain fatigue upper respiratory tract infection constipation fever headache and shortness of breath. The FDA granted this application Priority Review https Fast Track https for the mastocytosis indication and Breakthrough Therapy https for the AML indication designations. The FDA granted the approval of Rydapt to Novartis Pharmaceuticals Corporation. The FDA granted the approval of the LeukoStrat CDx FLT Mutation Assay to Invivoscribe Technologies Inc. The FDA an agency within the U.S. Department of Health and Human Services protects the public health by assuring the safety effectiveness and security of human and veterinary drugs vaccines and other biological products for human use and medical devices. The agency also is responsible for the safety and security of our nations food supply cosmetics dietary supplements products that give off electronic radiation and for regulating tobacco products. Related Information FDA Office of Hematology and Oncology Products https FDA Approved Drugs Questions and Answers https FDA Fast Track Breakthrough Therapy Accelerated Approval Priority Review https FDA Companion Diagnostics https NCI Adult AML https GARD Systemic mastocytosis httpsrarediseases.info.nih.govdiseasessystemicmastocytosis"

"Weekly sessions of noninvasive repetitive transcranial magnetic stimulation provided sufficient longterm pain relief in percent of patients with central poststroke pain and delivered longterm relief for patients who continued for one year according to a study presented at the International Neuromodulation Society th World Congress by Masahito Kobayashi MD PhD of the Department of Neurosurgery Saitama Medical University Department of Neurology Institute of Brain and Blood Vessels Mihara Memorial Hospital in Saitama Japan. Of patients in the openlabel series patients achieved satisfactorytoexcellent pain relief. Pain relief was sustained in six patients who continued treatment for one year. All patients received repetitive transcranial magnetic stimulation rTMS to their primary motor cortex once a week for at least weeks. Satisfactory relief was considered a percent reduction in pain scores patients and excellent relief pain reduction of percent or more patients. Overall patients who had severe strokecaused dysesthesias such as uncomfortable numbness or prickling experienced less relief than patients without severe dysesthesias suggesting possible neural circuit damage was inhibiting response to treatment. The study participants had all been treated medically after a blood clot or bleed in one side of the brain unilateral ischemic or hemorrhagic stroke. Several weeks into their recovery they had begun to experience severe hand or leg pain as a consequence of brain damage from the stroke. Such central poststroke pain can be extremely disabling and difficult to treat impacting general functioning mood and overall quality of life. Since the s Japan has been an active center of research into the study of electrical motor cortex stimulation EMCS to treat poststroke pain using surgically implanted devices. The study reported at the INS th World Congress builds on observations that electrical motor cortex stimulations effectiveness in relieving central poststroke pain can be predicted by rTMS suggesting the techniques share similar painrelief mechanisms. However Kobayashi and colleagues point out in their peerreviewed online publication of this study Repetitive Transcranial Magnetic Stimulation Once a Week Induces Sustainable LongTerm Relief of Central Poststroke Pain Neuromodulation Technology at the Neural Interface httponlinelibrary.wiley.comdoi.ner.abstract April https that there has still been controversy about the efficacy of rTMS in poststroke pain. Kobayashi said in comparison to EMCS his impression is rTMS efficacy seemed almost the same without requiring surgery. In a review https suggested that there is probable efficacy a level A recommendation for shortterm rTMS treatment of neuropathic pain including central poststroke pain but did not speak to longterm efficacy. Since pain relief from rTMS increases a few days after treatment weekly treatment sessions were selected to try to sustain pain relief at treatment intervals that could be maintained on an outpatient basis. Kobayashi believes neurologists would especially have an interest in this method which is also attractive due to its low sideeffect profile. None of the patients reported any serious side effects from weekly sessions of trains of second Hz rTMS at percent of the active motor threshold. Two patients reported transient slight scalp discomfort after rTMS. In addition to the potential of rTMS in pain relief there has been growing research into noninvasive stimulation to augment progress in physical rehabilitation soon after stroke. It is believed that the stimulation aids in plasticity the ability of the brain to gradually form new neural connections to take on functions previously performed by damaged areas. A first phase of the study assessed whether rTMS had a treatment effect on pain. In it the research team randomly assigned six patients to receive either sham or active rTMS one week and the other treatment the next measuring pain scores before and after each session. Once that phase had shown that rTMS did reduce the patients pain an openlabel treatment phase began. In this second phase the patients underwent weekly rTMS sessions. The patients pain scores were measured just before each weekly session. Data were collected for eight years ending in . Kobayashi said that some patients really hoped to continue rTMS after the study because their pain worsened after rTMS treatment sessions were over and almost all the patients said that after the study ended their pain increased to the level before rTMS. He added that the remaining question to answer is whether the level of the patients severe uncontrollable pain would continue to decrease if rTMS continued for several years. https Kobayashi M. Fujimaki T. Mihara B. and Ohira T. Repetitive Transcranial Magnetic Stimulation Once a Week Induces Sustainable LongTerm Relief of Central Poststroke Pain. Neuromodulation Technology at the Neural Interface. doi .ner. https Lefaucheur JP AndrObadia N Antal A Ayache SS Baeken C Benninger DH Cantello RM Cincotta M de Carvalho M De Ridder D Devanne H Di Lazzaro V Filipovic SR Hummel FC Jskelinen SK Kimiskidis VK Koch G Langguth B Nyffeler T Oliviero A Padberg F Poulet E Rossi S Rossini PM Rothwell JC SchnfeldtLecuona C Siebner HR Slotema CW Stagg CJ VallsSole J Ziemann U Paulus W GarciaLarrea L. Evidencebased guidelines on the therapeutic use of repetitive transcranial magnetic stimulation rTMS. Clin Neurophysiol. Nov. doi .j.clinph.... Epub Jun . Review. PubMed PMID . About the International Neuromodulation SocietyThe International Neuromodulation Society INS is a nonprofit medical society that unites clinicians scientists and engineers to share scientific knowledge about all aspects of neuromodulation in order to encourage best medical practice. Founded in and based in San Francisco CA the INS presents uptodate information about the full breadth of neuromodulation therapies through an interactive website at http chapter scientific meetings the MEDLINEindexed journal Neuromodulation Technology at the Neural Interface httponlinelibrary.wiley.comjournal.ISSN and its biennial world congress."

"A new analysis published today in JAMA Cardiology has found that timely and broad adoption of Entresto sacubitrilvalsartan by all eligible heart failure patients with reduced ejection fraction HFrEF could prevent or postpone more than deaths each year in the US alone. This analysis based on an application of the results of PARADIGMHF to published heart failure statistics is the first to quantify the possible impact of Entrestos potential benefit in reducing death. Heart failure is a chronic condition that contributes to more than deaths in the US every year. About half of people with heart failure have HFrEF. This new analysis estimates that as many as deaths in HFrEF patients annually could be prevented or postponed with optimal use of Entresto with sensitivity analyses demonstrating a range of to . Further the study suggests that delaying routine use of Entresto in clinical practice could have a substantial negative effect on patients given the expected riskbenefit profile as it could result in failure to prevent tens of thousands of deaths. These findings demonstrate the significant survival benefits Entresto could offer to those living with HFrEF if patients in the group defined by the authors were given access to treatment. The study authors stated that nearly of HFrEF patients . million people may be candidates for treatment with Entresto. Heart failure is a lifethreatening condition and despite available medicines about half of patients diagnosed with heart failure die within years. According to the study authors these findings may substantially impact the national health of the HFrEF population offering significant clinical benefit in preventing or postponing death when applied in clinical practice. This expert analysis adds to the already compelling case for the treatment of heart failure patients with reduced ejection fraction with Entresto said Fabrice Chouraqui president of Novartis Pharmaceuticals Corporation. In addition to survival benefits the study also recognizes other treatment effects of Entresto particularly in reducing HF hospitalizations. Coupled with the recent Class I recommendation the strongest endorsement in the focused update to the US HF Guideline these findings underscore the potential of Entresto as a standard therapy for chronic HFrEF patients. In a separate analysis published in the same issue of JAMA Cardiology researchers used data from the PARADIGMHF trial to model the health consequences and costeffectiveness of Entresto over a year time period. They compared Entresto to the ACEinhibitor enalapril and found Entresto was associated with more than a year longer average survival time and that it was costeffective compared to enalapril when these medications were used with other standard of care therapies. For every patients treated with Entresto vs. enalapril potentially . HF hospital admissions could be averted per each year alive in the model. In addition Entresto increased life expectancy at an incremental costeffectiveness ratio consistent with other highvalue widely accepted cardiovascular interventions such as implantable cardioverter defibrillators ICDs and cholesterollowering statins before they became generic. About Heart Failure Heart failure is a debilitating and lifethreatening condition which impacts nearly million Americans and is the leading cause of hospitalization among Americans over the age of . About half of people with heart failure have heart failure with reduced ejection fraction HFrEF. Reduced ejection fraction means the heart does not contract with enough force so less blood is pumped out. Heart failure presents a major and growing healtheconomic burden that currently exceeds billion in the United States which accounts for both direct and indirect costs. About Entresto Entresto is a twiceaday medicine that reduces the strain on the failing heart. It does this by enhancing the protective neurohormonal systems Natriuretic Peptide system while simultaneously inhibiting the harmful effects of the overactive reninangiotensinaldosterone system RAAS. Other heart failure medicines only block the harmful effects of the overactive RAAS. Entresto contains the neprilysin inhibitor sacubitril and the angiotensin receptor blocker ARB valsartan. Entresto is indicated in the US to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure NYHA Class IIIV and reduced ejection fraction. Entresto is usually administered in conjunction with other heart failure therapies in place of an Angiotensin Converting Enzyme ACE inhibitor or an angiotensin II receptor blocker ARB. Entresto filmcoated tablets are available in three dosage strengths mg mg and mg sacubitrilvalsartan. These doses are referred to as mg mg and mg in the clinical trial literature including the New England Journal of Medicine publication of the results of PARADIGMHF. The target treatment dose of Entresto is mg twice daily. Novartis is committed to providing patients with affordable access and resources through Entresto Central. For more information please call ENTRESTO or visit http Please visit http for Entresto full Prescribing Information. IMPORTANT SAFETY INFORMATION Entresto can harm or cause death to an unborn baby. Patients should talk to their doctor about other ways to treat heart failure if they plan to become pregnant. If a patient gets pregnant while taking Entresto she should tell her doctor right away. Patients are not to take Entresto if they are allergic to sacubitril or valsartan or any of the ingredients in Entresto have had an allergic reaction including swelling of the face lips tongue throat or trouble breathing while taking a type of medicine called angiotensinconverting enzyme ACE inhibitor or angiotensin II receptor blocker ARB or take an ACE inhibitor medicine. Patients are not to take Entresto for at least hours before or after they take an ACE inhibitor medicine. Patients should talk with their doctor or pharmacist before taking Entresto if they are not sure if they take an ACE inhibitor medicine. Patients are not to take Entresto if they have diabetes and take a medicine that contains aliskiren. Before they take Entresto patients should tell their doctor about all of their medical conditions including if they have kidney or liver problems are pregnant or plan to become pregnant are breastfeeding or plan to breastfeed. Patients should either take Entresto or breastfeed. They should not do both. Patients should tell their doctor about all the medicines they take including prescription and overthecounter medicines vitamins and herbal supplements. They should especially tell their doctor if they take potassium supplements or a salt substitute nonsteroidal antiinflammatory drugs NSAIDs lithium or other medicines for high blood pressure or heart problems such as an ACE inhibitor ARB or aliskiren. Entresto may cause serious side effects including serious allergic reactions causing swelling of the face lips tongue and throat angioedema that may cause trouble breathing and death. Patients are to get emergency medical help right away if they have symptoms of angioedema or trouble breathing. Patients are not to take Entresto again if they have had angioedema while taking Entresto. People who are black or who have had angioedema may have a higher risk of having angioedema if they take Entresto. Entresto may cause low blood pressure hypotension. Patients are to call their doctor if they become dizzy or lightheaded or they develop extreme fatigue. Entresto may cause kidney problems or an increased amount of potassium in the blood. The most common side effects were low blood pressure high potassium cough dizziness and kidney problems. Please see full Prescribing Information including Boxed WARNING available at http Patients are encouraged to report negative side effects of prescription drugs to the FDA. Visit http or call FDA. Disclaimer The foregoing release contains forwardlooking statements that can be identified by words such as could potential call for accelerate possible suggests expected may compelling endorsement potentially growing committed or similar terms or by express or implied discussions regarding potential new indications or labeling for Entresto or regarding potential future revenues from Entresto. You should not place undue reliance on these statements. Such forwardlooking statements are based on the current beliefs and expectations of management regarding future events and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize or should underlying assumptions prove incorrect actual results may vary materially from those set forth in the forwardlooking statements. There can be no guarantee that Entresto will be submitted or approved for any additional indications or labeling in any market or at any particular time. Nor can there be any guarantee that Entresto will be commercially successful in the future. In particular managements expectations regarding Entresto could be affected by among other things the uncertainties inherent in research and development including unexpected clinical trial results and additional analysis of existing clinical data unexpected regulatory actions or delays or government regulation generally the companys ability to obtain or maintain proprietary intellectual property protection general economic and industry conditions global trends toward health care cost containment including ongoing pricing pressures unexpected safety quality or manufacturing issues and other risks and factors referred to in Novartis AGs current Form F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forwardlooking statements contained in this press release as a result of new information future events or otherwise. About Novartis Novartis Pharmaceuticals Corporation researches develops manufactures and markets innovative medicines aimed at improving patients lives. We offer a broad range of medicines for cancer cardiovascular disease endocrine disease inflammatory disease infectious disease neurological disease organ transplantation respiratory disease eye and ear care and skin conditions. The companys mission is to improve peoples lives by pioneering novel healthcare solutions. Located in East Hanover NJ Novartis Pharmaceuticals Corporation is an affiliate of Novartis AG which provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel Switzerland Novartis offers a diversified portfolio to best meet these needs innovative medicines eye care and costsaving generic pharmaceuticals. Novartis is the only global company with leading positions in these areas. In the Group achieved net sales of USD . billion while RD throughout the Group amounted to approximately USD . billion USD . billion excluding impairment and amortization charges. Novartis Group companies employ approximately fulltimeequivalent associates. Novartis products are available in more than countries around the world. For more information please visit http Novartis is on Twitter. Sign up to follow Novartis at httptwitter.comnovartis. References . Fonarow GC Hernandez AF Solomon SD et al. Potential Mortality Reduction with Optimal Implementation of Angiotensin Receptor Neprilysin Inhibitor Therapy in Heart Failure. JAMA Cardiol. . doi.jamacardio.. . Yancy CW Jessup M Bozkurt B Butler J Casey Jr DE Colvin MM Drazner MH Filippatos G Fonarow GC Givertz MM Hollenberg SM Lindenfeld J Masoudi FA McBride PE Peterson PN Stevenson LW Westlake C ACCAHAHFSA Focused Update on New Pharmacological Therapy for Heart Failure An Update of the ACCFAHA Guideline for the Management of Heart Failure httpscontent.onlinejacc.orgarticle.aspxarticleid Journal of the American College of Cardiology doi .j.jacc.... . Gaziano TA Fonarow GC et al. CostEffectiveness Analysis of SacubitrilValsartan versus Enalapril in Heart Failure Patients with Reduced Ejection Fraction in the United States. JAMA Cardiol. . doi.jamacardio.. . Mozaffarian D Benjamin EJ Go AS et al. Heart Disease and Stroke Statistics Update A report from the American Heart Association. Circulation. ee. doi .CIR.. . Owan TE Hodge DO Herges RM et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. . . Roger VL Weston SA Redfield MM et al. Trends in heart failure incidence and survival communitybased population. JAMA. . Levy D Kenchaiah S Larson MG et al. Long term trends in the incidence and survival with heart failure. N Engl J Med. . . Weir LM Pfuntner A Maeda J et al. HCUP facts and figures statistics on hospitalbased care in the United States . Rockville MD Agency for Healthcare Research and Quality . . Ejection Fraction Heart Failure Measurement. American Heart Association Website.http_UCM__Article.jsp. Published March . Accessed March . . Heidenreich PA Albert NM Allen LA et al. Forecasting the impact of heart failure in the United States a policy statement from the American Heart Association. Circ Heart Fail. . . Entresto Prescribing Information. . Yancy CW Jessup M Bozkurt B et al. ACCFAHA guideline for the management of heart failure A report of the American College of Cardiology FoundationAmerican Heart Association task force on practice guidelines. Circulation. ee. For Novartis multimedia content please visit http For questions about the site or required registration please contact journalisthelpthenewsmarket.com mailtojournalisthelpthenewsmarket.com. SOURCE Novartis Pharmaceuticals Corporation Related Links http"

"Researchers at Mayo Clinics campus in Florida http have conducted the worlds first prospective blinded and placebocontrolled clinical study to test the benefit of using bone marrow stem cells a regenerative medicine therapy to reduce arthritic pain http and disability in knees. The researchers say such testing is needed because there are at least stem cell clinics in the U.S. offering one form of stem cell therapy or another to an estimated plus patients who pay thousands of dollars out of pocket for the treatment which has not undergone demanding clinical study. The findings in The American Journal of Sports Medicine httpajs.sagepub.cominclude an anomalous finding patients not only had a dramatic improvement in the knee that received stem cells but also in their other knee which also had painful arthritis but received only a saline control injection. Each of the patients enrolled in the study had two bad knees but did not know which knee received the stem cells. Given that the stem celltreated knee was no better than the controltreated knee both were significantly better than before the study began the researchers say the stem cells effectiveness remains somewhat uninterpretable. They are only able to conclude the procedure is safe to undergo as an option for knee pain but they cannot yet recommend it for routine arthritis care. Our findings can be interpreted in ways that we now need to test one of which is that bone marrow stem cell injection in one ailing knee can relieve pain in both affected knees in a systemic or wholebody fashion says the studys lead author Shane Shapiro M.D. http a Mayo Clinic orthopedic physician. Journalists sound bites with Dr. Shane Shapiro are available in the downloads below. MEDIA CONTACT Kevin Punsky Mayo Clinic Public Affairs punsky.kevinmayo.edu mailtopunsky.kevinmayo.edu One hypothesis is that the stem cells we tested can home to areas of injury where they are needed which makes sense given that stem cells injected intravenously in cancer treatments end up in the patients bone marrow where they need to go he says. This is just a theory that can explain our results so it needs further testing. Another explanation is that merely injecting any substance into a knee offered relief from pain. That could be but both this idea and the notion that a placebo effect could be involved would be surprising given that some patients are still doing very well years after their study treatment ended says Dr. Shapiro. He adds that these findings are important because while use of a patients own stem cells for regenerative therapy is extraordinarily popular the treatments may be untested and are often poorly regulated. Stem cell clinics often offer expensive treatments for conditions that range from multiple sclerosis lung and heart disease to cosmetic treatments such as facelifts. None of these techniques have been studied because clinics maintain that use of a patients own cells is not a drug. But depending on how they are processed and used stem cells can in fact be regulated by the U.S. Food and Drug Administration as biological products or drugs requiring rigorous safety and efficacy approval processes. In early September the FDA held scientific meetings to clarify how to regulate such practices. Mayo Clinic researchers developed their study with FDA approval. We feel that if we are going to offer any stem cell procedures to our patients the science needs to be worked out Dr. Shapiro says. The study was conducted in Mayos Human Cell Therapy Lab. Researchers extracted to milliliters of bone marrow from each patient then filtered it removed all blood cells and concentrated it down to to milliliters. The solution which contained tens of thousands of stem cells was injected into a patients knee using ultrasoundguided imagery. We actually counted all of the stem cells with markers that are accepted by the FDA and we made sure they would be able to survive inside the patient Dr. Shapiro says. Counting is expensive. Most clinics just draw the cells from bone marrow or fat and inject them back into the patient without checking for stem cells hoping that patients get better he says. Dr. Shapiro and his colleagues are currently designing new studies that will test whether the stem cells home to distant areas of injuries as well as exploring other implications suggested in their findings. Study investigators include Mayo Clinic in Florida senior author Mary L. OConnor M.D. Shari E. Kazmerchak Michael G. Heckman and Abba C. Zubair M.D. Ph.D. http_ga... Dr. OConnor is now at Yale University. Funding for this study was from Mayo Clinics Center for Regenerative Medicine http_ga...."

"Should people at high risk of heart attack https and stroke https eat dark chocolate https every day Maybe according to a new study from Australia. Dark chocolate https may be a pleasant and effective way of delivering important dietary components that can provide health benefits to the ever increasing numbers of people at increased risk of cardiovascular disease https says researcher Christopher M. Reid PhD professor of cardiovascular epidemiology and preventive medicine at Monash University in Australia. Reid and his team constructed a mathematical model to predict the longterm health effects of eating dark chocolate https daily in highrisk people. They did not study actual people eating actual chocolate https The researchers also computed whether it would be costeffective to spend money on a public education campaign about dark chocolates benefits. They found it would be. Several studies have found that dark chocolate with its heart https flavonols can lower blood pressure https and improve cholesterol https However Reid believes theirs is the first study to model the longterm effects of eating dark chocolate in reducing cardiovascular risk. The study is published in the journal BMJ. Chocolate to Prevent Heart Attacks Reids team first looked at the treatment effects linked with dark chocolate by evaluating studies already published. They computed the number of heart attacks https and strokes that would occur with and without the dark chocolate. They also looked at people from the Australian Diabetes https Obesity https and Lifestyle study. All had metabolic syndrome https but none had diagnosed heart disease https or diabetes https at the start. Metabolic syndrome increases the risk of heart disease https and stroke https It is diagnosed when three or more of the following factors are present high blood pressure https high triglycerides https low levels of good HDL cholesterol https high blood sugar https_assetscontrolled_contenthealthwisemedicaltestblood_glucose_medicaltest_hw.xml or a large waist size. Reids team looked at costs associated with the heart and stroke https problems. They used these cost figures to determine how much money could be spent each year to educate highrisk people about dark chocolate and still be costeffective. Their study looked longerterm than most years Reid says. Dark Chocolate to Prevent Heart Disease Stroke First the researchers plugged in the bestcase scenario of the people eating the recommended grams of dark chocolate . ounces or about two bars a day for years. This would prevent nonfatal and fatal heart attacks https and strokes per people over years according to the study model. With an adherence rate there would be fewer nonfatal and fewer fatal heart attacks and strokes per people over years. The estimates may be low Reid says. They found that it would be costeffective to spend per person per year on education. The education might include advertising educational campaigns or subsidies to pay for the chocolate Reid says. Other Experts Not Convinced The new model drew mixed reactions from U.S. chocolate researchers. Its overassuming the benefits says Eric Ding PhD nutritionist and epidemiologist at Harvard Medical School. He reviewed the findings. They are basing their estimates on heart disease https intermediate risk factors blood pressure and cholesterol https and not on actual heart disease events like heart attacks Ding tells WebMD. The researchers are ignoring some downsides he says. They are ignoring the dangers of too many calories and too much fat and sugar from the chocolate bar he says. Those at risk of heart attack and stroke should first focus on lifestyle Ding says. That includes weight loss https if needed exercising https regularly and not smoking https Joe Vinson PhD professor of chemistry at the University of Scranton and a longtime chocolate researcher likes the study even though it has limitations. Its all theoretical based on statistics he says. Even so he says Its wonderful news again on the health effects of dark chocolate for people who have a little higher risk of heart problems than the normal person. With their doctors approval people at risk of heart attacks or strokes could eat a bit of dark chocolate daily and monitor their weight https_assetscontrolled_contenthealthwisespecialweight_managementare_you_at_a_healthy_weight_special_aa.xml and blood pressure Vinson suggests. He recommends eating less than grams used in the model. He suggests about grams or about one chocolate bar daily. Reid suggests that the chocolate should be dark and at least cocoa. The research was supported by an Australian Research Council grant with SanofiAventis Australia."

"Physicians have used the snarelike LARIAT device to close off a sac in the heart that is thought to be the source of harmful clots. But a new University of Pennsylvanialed study finds that this procedure is risky. In older patients with atrial fibrillation cardiologists increasingly are using a snarelike device to close off a small sac in the heart thought to be the source of clots that can cause stroke in those with the abnormal heart rhythm. But the U.S. Food and Drug Administration did not approve the Lariat device for that specific purpose and now a new University of Pennsylvanialed study says this approach though legal too often leads to urgent surgery and even death. Several area hospitals have used the device including one that is part of Penns own health system Pennsylvania Hospital though physicians there have stopped. Others that have tried it include Deborah Heart Lung Center in Browns Mills and Cooper University Health Care in Camden where physicians say it is a reasonable choice for strokeprone patients with limited options. In the study published Monday in JAMA Internal Medicine authors found that the procedure was reported to be successful in . percent of the cases they identified in the medical literature. Success meant physicians were able to close off the left atrial appendage a sac in the wall of the hearts left atrium not that there was any reduction in the rate of strokes. But urgent followup surgery was needed in seven patients or . percent of reported cases and one patient died. The study authors also searched an FDA database of adverse events associated with medical devices finding reports of five patients who died after undergoing a Lariat heart procedure and an additional who required urgent followup surgery. Senior author Jay Giri an assistant professor at Penns Perelman School of Medicine urged a formal study of the device before further use. The Lariat is an absolutely ingenious piece of engineering said Giri an interventional cardiologist. However ingenuity doesnt guarantee its safety and efficacy. Meanwhile the device made by SentreHEART Inc. of Redwood City Calif. is facing competition from a product specifically approved by the FDA to deal with this heart sac. Rather than cinching the sac shut the Watchman device is implanted in the sac to block clots from emerging. The Watchman made by Boston Scientific of Marlborough Mass. was cleared by the FDA in March after rigorous clinical trials. The FDA approved the Lariat in without such trials because its manufacturer told the agency that the product was substantially equivalent to other suturing devices on the market. But those other devices are not used to close off the left atrial appendage and SentreHEART is not allowed to promote the Lariat for that specific purpose either. In fact on the companys website description of the Lariat the only time the word heart appears is in the companys name. The company has filed for a patent to use the device for closing off the heart sac. Giri the study senior author said those facts have left little question that Lariat was designed with the heart in mind even though it was not specifically approved for that purpose. He referred to the process through which it was approved as a regulatory loophole. In a statement the company said that it agreed with the study authors that more research was warranted and that it was in the process of discussing clinical trials with the FDA. However it did not answer questions about whether the Lariat had been used for anything other than cardiac procedures. The way in which the FDA can approve devices as substantially equivalent to those already on the market called the k process has come under fire with other devices recently. Among them are duodenoscopes that have undergone numerous incremental changes and now are thought to pose a higher risk of transmitting bacteria. Physicians who use the Lariat to close off the left atrial appendage are said to be using the product offlabel a practice that is legal and can lead to innovation. It is unclear just how many times the Lariat has been used to close off the heart sac as it is designated with a general billing code that can refer to closing off the appendage with any of several techniques. In Pennsylvania cardiologists closed off a left atrial appendage times between Sept. and Aug. according to the Pennsylvania Health Care Cost Containment Council a state agency that tracks healthcare cost and quality. At Cooper cardiologist Phillip Koren said he and colleagues have used the Lariat on the left atrial appendage of about patients in the last six months. The closure was unsuccessful in a few of those cases but in those there have been no strokes said Koren deputy director of the Cooper Heart Institute. None of the patients suffered adverse events from the device. In patients with afib whose hearts pump blood less efficiently the appendage is thought to be a source of clots because blood can stagnate there. When such clots travel toward the brain that means stroke. Closing off the appendage with the Lariat delivered through catheters not an open incision involves placing magnets inside and outside the heart to serve as a guide for inserting the snare Koren said. It takes two hours and is performed after putting the patient under general anesthesia. At Cooper Koren said the procedure was recommended only in patients who were at high risk of stroke and who had difficulty with anticoagulant medication the usual course of treatment for preventing clots. He said Cooper also planned to start using the Watchman which he said might be easier to use. We are extremely excited that were on the cutting edge of new treatments for patients with atrial fibrillation Koren said. We always have to weigh the benefits and the risks. One of the authors of the new study Daniel McCormick of Pennsylvania Hospital also expressed enthusiasm when he first used the Lariat in January . Its terrific to be able to add another tool to our arsenal of treatments for atrial fibrillation McCormick said in a hospital blog post then. Titled Lasso It Up How a Rodeo Roping Technique Can Help Treat an Ageold Heart Ailment the post was illustrated with a drawing of a ropewielding cowboy on horseback. McCormick was not available to discuss his apparently changed opinion of the procedure but he and study coauthors concluded with the following Highquality randomized clinical trials examining the Lariat as a device for LAA exclusion should be obtained before its widespread use is adopted by the medical community."

"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."

"Research shows a healthy yearold woman has only a percent chance of getting pregnant in any given month but when Pamela Soto turned she never thought she would have a problem conceiving. I was on birth control for a year after we got married and then I thought OK well now Ill start trying to have a baby and for two years nothing happened so then I started going to get tested to find out what was going on Soto told FoxNews.com. Demand for fertility services has surged over the last several years. In fact . million women http ages to have used infertility services in their lifetimes. Pamelas doctors said her fallopian tubes were blocked and that her only options to get pregnant would be with surgery or in vitro fertilization IVF options Pamela did not want to try. I hate needles and I didnt want to go through all the emotions and the hormone shots said Pamela who added that her health insurance would have paid for three IVF cycles. Adhesions which are comprised of internal scar tissue that forms after surgery infection or trauma can cause fallopian tubes to become blocked. And if the mucus that lines the tubes is too thick this can also contribute to blockage. When one or both tubes are blocked the egg cannot travel to the uterus and the sperm cannot reach the egg. After they told me that I would have to do IVF I started looking for natural ways to solve infertility Soto said. By doing a quick Google search Pamela and her husband John Henry Soto found Clear Passage a physical therapy clinic in Gainesville Fla. that treats certain causes of female infertility like blocked fallopian tubes endometriosis and hormonal dysfunction. Clear Passage therapists use their hands to soften and massage away adhesions blocking the tubes. We feel and we check all the organs in the abdomen and the pelvis and wherever we feel that tissues or organs wont move in a certain direction with our hands well stretch them in that direction and well hold that stretch until the tissues and adhesions start to deform and give way Belinda Wurn a physical therapist and codeveloper of the Clear Passage treatment told FoxNews.com. Physical therapists administer the deep massagelike therapy over five days and hours total. It was an uncomfortable pressure Pamela said. I wouldnt describe it as a massage at all. It was like physical therapy it didnt hurt but it wasnt a good feeling either. In a retrospective study httpalternativetherapies.comopenaccessATHM___Rice.pdf of infertile women published in the journal Alternative Therapies in Health and Medicine the treatment showed a percent success rate in opening at least one fallopian tube and a percent pregnancy rate for women whose tubes have opened. We have enough data on enough patients to where we feel were statistically significant in opening blocked tubes treating endometriosis and treating elevated follicle stimulating hormone Dr. Richard King a gynecologist and the medical director for Clear Passage Physical Therapy told FoxNews.com. Eight months after Pamela received therapy at Clear Passage she discovered she was pregnant. She wrapped her positive pregnancy test in a box and surprised her husband with the news on Fathers Day. I cant even imagine not having our daughter Brianna in our lives right now. Shes just brought so much joy to our lives John Henry Soto told FoxNews.com In case the Sotos want to try for a second child King says their therapy has shown longlasting results. We found that this treatment probably lasts a long period of time because weve had a lot of patients with blocked fallopian tubes that weve done this hour protocol to that have had more than one child King said. Although the founders tout the therapys success some fertility experts have expressed skepticism over their findings. When youre talking about a retrospective report youre saying OK we treated these people and these are our results. And thats interesting and their results were good in some sections but its not scientific in the sense of a prospective randomized controlled study Dr. Joel Batzofin http a fertility specialist at New York Fertility Services a part of ARC fertility told FoxNews.com. They the patients were not stratified by disease type by age by duration of infertility by body weight smokers versus nonsmokers ever pregnant versus never pregnant male factors these are all things that have a profound bearing on results. Although Batzofin pointed out the importance of further study he said the therapy may a be useful option for some patients. There are women that produce mucus of a thick viscus quality and it sticks and lodges in there. The fallopian tube at the uterine end is very narrow and it gets blocked in there so its quite easy to imagine that a course of physical therapy is going to soften this up dislodge it and clear the passage Batzofin said. Batzofin added that compared to surgery or IVF the side effects are minimal. I dont think that its going to be harmful he said. But one has to be careful about raising false expectations. The Clear Passage therapy costs around and some insurance plans may cover it. For more information visit ClearPassage.com http"

"Scientists are finding more clues to help determine whether people with mild dementia symptoms are at risk for Alzheimers. A new study suggests that biomarkers found in cerebrospinal fluid fluid that surrounds the spinal cord and brain and acts as a protective cushion could predict who would develop Alzheimers disease of the time among patients with mild cognitive impairment a condition characterized by measurable memory problems. Researchers report these findings in the journal Archives of General Psychiatry httparchpsyc.amaassn.orgcgicontentshort. This is the longest clinical followup ever of patients who begin with mild cognitive impairment researchers reported. Patients were tracked from four to years with a median of . years. The research builds on a Lancet Neurology study http that followed patients for a median of . years beginning with a group of volunteers with mild cognitive impairment.The new study is important because of the long followup period according to Adam Brickman assistant professor of neuropsychology at Columbia University School of Medicine who was not involved in the research. Knowing which patient with mild cognitive impairment patients may go on to develop Alzheimers is vital information for researchers who are looking for treatments for the fatal brain disease. The current thinking is that interventions will be most effective when given to a patient as early as possible http Brickman said. Clinical trials can better focus their efforts if patients are known to be in the early stages of Alzheimers. Generally about to of patients with mild cognitive impairment show evidence of underlying symptoms of Alzheimers so not everyone with this condition is a good candidate for an Alzheimers trial. Researchers focused on two biomarkers previously thought to be involved in Alzheimers disease a kind of protein called betaamyloid and another protein type called tau. Experts believe a decrease in betaamyloid in the fluid of the spinal cord is associated with a toxic buildup of that protein in the brain which causes the formation of plaques linked to Alzheimers disease. Tau has been tied to neurofibrillary tangles http_and_researchers_professionals_and_researchers_alzheimers_disease_pr.aspin the brain researchers find that an increase in tau in cerebrospinal fluid is associated with Alzheimers also. The results from the study suggest that betaamyloid is a much earlier predictor of Alzheimers disease than tau which supports the hypothesis that betaamyloid accumulation in the brain occurs first in the course of the disease. Some of the participants who were originally found to be stable with mild cognitive impairment after about five years went on to develop Alzheimers disease during the longer followup. That suggests that a fiveyear followup period is not long enough to determine how well biomarkers can predict which patients will develop Alzheimers disease researchers say. The association between biomarkers in the fluid and Alzheimers was also described in studies in December httparchneur.amaassn.orgcgicontentextract and August httparchneur.amaassn.orgcgicontentabstract building on the idea that a spinal tap could be useful in predicting Alzheimers. When these sorts of studies get published Brickman and other doctors get phone calls from aging adults wondering whether they should be getting spinal taps to assess their risk. But its too early to use this as a diagnostic tool in clinical settings says Brickman. Down the road the fantasy is that asymptomatic people will be able to get a biomarker test to determine whether theyll one day get Alzheimers but thats not possible right now he adds. What I tell people is If theyre worried about their thinking abilities that they should make an appointment with a neuropsychology or a neurologist to get an evaluation Brinkman says. The way we diagnose Alzheimers disease is by evaluating the behavior and the risk factor medical profile not by looking at biological markers at this point. As scientists gain more insight into predicting Alzheimers aging adults may struggle with the question of whether they want to know their risk http especially since theres still no cure. Some people want to enroll in clinical trials http as soon as they start showing symptoms others would rather be ignorant of their status since there is no cure. In looking for treatments however researchers depend on peoples willingness to contribute to science. The Alzheimers Association runs a system called TrialMatch http_trialsfind_clinical_trials_trialmatch.aspgclidCKTlLelsqCFQLrKgodTlTolg. Check it out if youre interested in finding a trial for yourself or someone you care about."

"How do you convert a simple saline solution into a useful treatment for people with Parkinsons disease Tell them its a drug that costs per dose. And if you want to make it even more effective tell them it costs instead. Thats what researchers from the University of Cincinnati discovered in an unusual clinical trial. Instead of testing a placebo against an actual drug they pitted two placebos against each other. The only difference between the two sham treatments was their purported price. Medical researchers are well aware that the dummy pills used in clinical trials often provide as much relief as the actual drugs being tested. This is whats known as the placebo effect http and its quite common in people with Parkinsons a movement disorder http_diseaseparkinsons_disease.htm that causes tremors stiffness and balance problems. A metaanalysis http found that placebos used in clinical trials of Parkinsons treatments improved symptoms by an average of . The team from the University of Cincinnati and their colleagues had a hunch that patients would be more responsive to a fake drug they thought was real if it came with a heftier price tag. The higher price would be seen as a signal that the treatment was better they figured. So they recruited patients with moderately advanced Parkinsons and asked them to participate in a clinical trial of a medication described as a new injectable dopamine agonist. Patients with Parkinsons lose the brain cells that produce dopamine and a drug like this could pick up the slack. The study volunteers were told that there were two versions of the experimental drug and that both were believed to work equally well. The main difference the story went was the way they were made. As a result one version cost times more than the other. In reality both placebos were composed of the exact same saline solution. And yet the patients perceived the expensive version to be more effective than the cheaper one according to results http published Wednesday in the journal Neurology. Both of the placebos improved motor function compared with a base line test. But when patients got the perdose placebo their improvement was greater than when they got the perdose placebo the researchers reported. In another test of the patients were judged very good or having marked improvement after they took the expensive placebo compared with of patients after they took the purportedly cheap placebo. The researchers also used functional MRI scans to assess the patients brain activity and found that the cheap placebo prompted more action than the expensive one. To the researchers this was a sign that the patients expected less from the placebo they believed cost less so their brains responded by doing more work. Patients expectations have an important role in the efficacy of medical therapies the researchers wrote. Another manifestation of this is the preference many patients have for namebrand drugs instead of their generic counterparts they added. Placebos may be fake but understanding the placebo effect and finding ways to make the most of it is a real priority for researchers. To the extent that doctors can use placebos to improve patients symptoms they can use the real drugs less which may be expensive or toxic. Placebo can be the physicians friend a pair of neurologists wrote an editorial http that accompanied the study. The outcome of this study opens our eyes to another nuance of placebo effect."

"Heres another reason to snack on dried fruit httpshealth.usnews.comhealthnewsblogseatrunhowtoaddsweetnesstoyourmealswithlittleornoaddedsugar. Researchers have announced that people who eat dried plums as part of a regular diet can reduce their risk for developing colon cancer httpshealth.usnews.comhealthnewspatientadviceslideshowsquestionstoaskyourdoctoraboutcoloncancer. This discovery was made by researchers at Texas AM University and the University of North Carolina and presented at the Experimental Biology conference in Boston. Through our research we were able to show that dried plums promote retention of beneficial bacteria throughout the colon and by doing so they may reduce the risk of colon cancer Nancy Turner study author and professor in the nutrition and food science department of Texas AM University said in a press release http_releasestaacrsd.php. Turner and colleagues examined how dried plums antioxidants neutralized the type of changes that occur when cancerous cells damage the DNA. They found that when rats were fed a controlled diet of dried plums two major phyla of bacteria in the gut httpshealth.usnews.comhealthnewspatientadvicearticlesexploringthelinkbetweengutmicrobesanddiabetes Bacteroidetes and Frimicutes increased without negatively impacting other areas of the colon httpshealth.usnews.comhealthnewshealthwellnessarticleslongtermbabyaspirinothernsaidusemaylowercoloncancerrisk. They also observed that those who were on the dried plum diet showed reduced numbers of aberrant crypts which are early signs of precancerous httpshealth.usnews.comhealthnewspatientadvicearticlesevaluatehealthscreeningsbeforeundergoingyournexttest lesions considered to be a red flag for future cancer. From this study we were able to conclude that dried plums did in fact appear to promote retention of beneficial microbiota and microbial metabolism throughout the colon which was associated with a reduced incidence of precancerous lesions Turner said in the release. The researchers plan to conduct additional research in humans."

"Eating tomatoes in your daily salad or regularly enjoying a healthy red sauce on your spaghetti could help reduce your risk of stroke according to research published this week in the journal Neurology. Tomatoes contain a powerful antioxidant that is good for brain health the researchers say and cooked tomatoes seem to offer more protection than raw. This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke says study author Jouni Karppi of the University of Eastern Finland in Kuopio. A diet containing tomatoes... a few times a week would be good for our health. However daily intake of tomatoes may give better protection. Karppi says its the chemical lycopene that gives tomatoes and other fruitsvegetables their rich red color that is helping to protect the brain. Tomatoes are particularly high in the powerful antioxidant that acts like a sponge soaking up rogue molecules called free radicals that if left unchecked can damage cells. The study Researchers tested the level of lycopene in the blood of more than Finnish men aged to starting in . Scientists then followed the men on average for more than a decade to record the number who had strokes. The scientists found that those with the highest levels of lycopene were less likely to have a stroke than those with the lowest amounts in their blood. Caveats Though the study looks promising experts say that we cant necessarily give all of the credit to lycopene. Its a compelling study and it fits with other data that we have about risk of stroke and vegetable and fruit consumption explains Dr. Daniel Labovitz director of the Stern Stroke Center at Montefiore Medical Center in New York. But its not proof that if you eat tomatoes youre going to have less risk of stroke. Labovitz also points out that the group of men who had fewer strokes were younger had lower blood pressure and smoked less than the group more prone to stroke. Though the researchers tried to take these lifestyle factors into account when calculating their findings it may be that these things influenced the outcomes. In other words perhaps better health habits not necessarily just the lycopene lead to fewer strokes. More on lycopene Lycopene has attracted a lot of attention in recent years because its such a powerful antioxidant. If we dont eat enough lycopenepacked foods experts suspect too many free radicals get left in the body damaging blood vessels by helping to form fatty deposits. When these deposits build up a blockage forms. If that vessel is in the brain the blockage can cause a stroke. But the foods we eat are complex and filled with many nutrients making it tough to prove what is really providing benefits. Eating tomatoes is a good thing but we dont know if there is really anything unique about tomatoes apart from other fruits and vegetables that reduce stroke risk explains Dr. Walter Willett chair of the Department of Nutrition at Harvard School of Public Health in Boston Massachusetts. Tomatoes could contribute to reducing stroke in other ways Willett says because they are a good source of potassium which is known to reduce blood pressure. Elevated blood pressure is major risk factor for stroke. Take home message So are lycopene packed tomatoes really the magic fruit It seems the jury is still out but researchers suggest we eat healthy as they continue to search for answers. This is one more reason to consume fruits and vegetables at least a day and its good to include tomatoes in that mix Willett said."

"Antidepressant drugs really do work a major new international study has proven. Pooling data from trials including nearly patients researchers found all drugs analysed were more effective than placebos in the treatment of adults with acute depression. Authors of the studypublished yesterday in the Lancet http many more people could benefit from antidepressant medication. The study results represent the most comprehensive evidence currently available they wrote. In the international study published in the Lancet authors found that fluoxetinecommonly sold under then trade name Prozacwas one of the least effective antidepressants. Stephen CherninGetty Images More than million people worldwide have depression according to the World Health Organization http of which less than half recieve effective treatments. In many countries the rate drops to less than percent. In the U.S. the National Institute of Mental Health estimates https . million adults experienced at least one major depressive episode in . Approximately percent of these people received no treatment. In the U.K where a number of the study authors are based at least one million more people could benefit from drugs or psychotherapy senior author John Geddes said. Some drugs more effective than others The researchers analyzed existing studies of different drugs and found some were much more effective than others. Drugs ranged from more than one third more effective than a placebo to more than twice as effective. The best performers included amitriptyline and escitalopram while the worst included fluoxetinecommonly sold under the trade name Prozacand reboxetine which is not approved for sale in the U.S. A complex treatment picture The results add up to a complex treatment picture for what authors called one of the most common burdensome and costly psychiatric disorders worldwide in adults. Antidepressants do not improve symptoms in about percent of people study author Andrea Cipriani of Oxford University told a press briefing. While these results should reassure many people with depression that antidepressants can be effective this does not necessarily mean antidepressants should always be the first line of treatment he said. Talking therapies are thought to be about as effective as antidepressant medication but these are often much more expensive. Experts not involved in the research agreed the results were significant. Helen StokesLampard chair of the U.K.s Royal College of GPs expressed concern about the stigma surrounding antidepressant use. She said in a statement http Taking antidepressants is frequently portrayed as a negative thing or something done only when other therapies are not available or have failed but this in itself can add to the unfortunate stigma that sometimes exists around people with mental health conditions. But she also urged caution. Although antidepressants are of proven benefitas this study shows she said no doctor wants their patients to become reliant on medication. Putting a longheld controversy to bed Carmine Pariante a professor at the UKs Institute of Psychiatry Psychology and Neuroscience and spokesperson for the Royal College of Psychiatrists said the study finally puts to bed the controversy on antidepressants. James Warner an Imperial College London psychiatrist added Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available."

"A hormone called DHEA and mostly secreted by the adrenal glands may be able to help women who are going through menopause and could also give them better sex lives a study found on Tuesday. Italian researchers writing in the journal of the International Menopause Society Climacteric said they had found the first robust evidence that low doses of DHEA can help sexual function and menopausal symptoms suggesting it may one day become an alternative to hormone replacement therapy HRT. But they stressed that the trial was small so far larger studies are needed to confirm the results. We must bear in mind that this is a pilot study with a small sample Anna Fenton coeditor of Climacteric said in commentary on the work. We cant yet say that this study means that DHEA is a viable alternative to HRT but ... we should be looking to do larger studies to confirm these initial results. DHEA or dehydroepiandrosterone is a natural steroid hormone mostly made in the adrenal glands and has a variety of therapeutic uses. HRT which is a combination of the hormones oestrogen and progesterone is an approved treatment for women going through the menopause who often experience unpleasant symptoms such as hot flushes night sweats loss of sex drive and mood swings. But sales of HRT drugs have fallen sharply since a large study in found higher rates of ovarian cancer breast cancer and strokes in women who took the pills and the search has since been on for alternatives. American researchers said in January that the antidepressant Lexapro made by drugmaker Forest Laboratories significantly cut the number and severity of hot flushes in menopausal women and other antidepressants including GlaxoSmithKlines Paxil and the Pfizer drugs Prozac and Effexor also have been found to be effective. For this trial a team of researchers led by Andrea Genazzani of the University of Pisa followed a group of postmenopausal women with troubling symptoms. Over a year women took vitamin D and calcium took DHEA took standard HRT and took a synthetic steroid called tibolone which is used to alleviate menopausal symptoms. The womens menopausal symptoms sexual interest and activity were measured using a standard questionnaire that explores factors such as satisfaction with frequency of sex vaginal lubrication orgasm and sexual partner. After months all the women on hormone replacements had improvements in menopausal symptoms but those taking vitamin D and calcium did not show any significant improvement. At the start of the trial all groups had similar sexual activity but after the year those taking calcium and vitamin D scored an average of . on the questionnaire scale while those taking DHEA had a score of . showing that those on DHEA had more sexual interest and activity. The results for the HRT group were similar and both the HRT DHEA groups showed a higher level of sexual intercourse in comparison to the control group the researchers said. Genazzani said the results showed DHEA has potential especially for those women who may have problems in taking more conventional HRT. But this is a small study a proof of concept. What we need to do now is to look at a larger study to confirm that these initial results are valid she added. Reporting by Kate Kelland Editing by Jon LoadesCarter Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A rising PSA level isnt such a good predictor of prostate cancer after all and can lead to many unnecessary biopsies says a large new study. Most men over get PSA blood tests but theyre hugely problematic. Too much PSA or prostatespecific antigen only sometimes signals prostate cancer is brewing it also can mean a benign enlarged prostate or an infection. And screening often detects small tumors that will prove too slowgrowing to be deadly. Yet theres no sure way to tell in advance who needs aggressive therapy. On the other hand some men have cancer despite a normal PSA count of or below. So for PSAs that are rising yet still in the normal range some guidelines urge doctors to consider a biopsy. How quickly the PSA number rises is something that patients and doctors worry a lot about said Dr. Andrew Vickers of Memorial SloanKettering Cancer Center. Men show up here with a PSA of and we say Why are you here And they say Well I used to be a and my doctors worried. Am I going to die So SloanKettering researchers studied whether considering PSA velocity adds value to the biopsyornot decision in those otherwise lowrisk men and concluded it doesnt. This is a really important study said Dr. Otis Brawley of the American Cancer Society who wasnt part of the research. A lot of doctors are going to stop looking at a PSA rise of and ordering biopsies. Vickers team tracked men whod taken part in a huge prostate cancer prevention study and whod received a biopsy at the studys end regardless of their PSA level. Just having a rising PSA if nothing else was considered was associated with a slightly higher risk of having cancer although not the more worrisome aggressive kind. But the PSA level alone not its rise was a much better predictor of a tumor reported Vickers a statistician who specializes in prostate cancer. Focusing on PSAs rise instead triggered many more biopsies with close to in men who would get one concluded the study published Thursday in the Journal of the National Cancer Institute. That compares with in men who are biopsied for a high PSA level alone noted Dr. Grace LuYao of the University of Medicine and Dentistry of New Jersey in an accompanying editorial. Theres an important public health message here which is for men not to worry about changes in their PSA if their overall PSA level is low Vickers said."

"Scientists have developed a new HPV human papilloma virus vaccine which protects against nine types of the virus seven of which cause most cases of cervical cancer. The new vaccine offers significantly greater protection than the current vaccine which protects against only two cancer causing types of HPV. A pivotal international clinical trial compared the safety and efficacy of the new vaccine Gardasil with the current vaccine Gardasil in more than women aged between and years old. The findings indicate that if uninfected populations are vaccinated with Gardasil approximately per cent of all cervical cancers worldwide could be prevented. Published in the New England Journal of Medicine the study found that among uninfected women Gardasil was per cent effective at preventing highgrade cervical vulvar and vaginal disease caused by HPV and and was equally effective as the current Gardasil vaccine in preventing diseases caused by HPV and . Professor Jack Cuzick of Queen Mary University of London who coauthored the report and participated in the design and analysis of the study and served on the Trial Advisory Board comments This is a significant achievement. The new vaccine Gardasil is not only safe but will offer greatly improved protection against cervical and other cancers. Eventually this will mean less screening is needed as women will have greater protection from the outset. Gardasil offers the potential to increase overall cervical cancer prevention from to per cent nearly eliminating this cancer among vaccinated women. However its crucial to remember that vaccination must be done before exposure to the virus. Our focus for prevention must be on girls aged as the current UK vaccine programme is doing but the vaccine may also be appropriate for women as part of a screening appointment. Until late last year there were two available vaccines to protect against HPV related disease Cervarix and Gardasil. The UK currently uses Gardasil which protects against four HPV types and offers about per cent protection against cervical cancer and also significantly reduces the risk of other types of cancer and genital warts. However researchers have been trying to find methods to completely eliminate cervical cancer and other HPV related disease and by adding five more cancer related HPV types. The development of the new Gardasil vaccine makes an important step in that direction. HPV is the most common sexually transmitted virus. Many people infected with HPV clear it from their systems with no lasting health concerns and some types of the virus are low risk causing warts or verrucas. However other types are high risk causing cervical cancer and less commonly vulvar vaginal penile anal and throat cancers. Almost all cases of cervical cancer occur as a result of infection with high risk types of HPV. Cervical cancer is still the fourth most common cancer in women with over cases and deaths per year worldwide. In the UK around women a year are diagnosed with cervical cancer and in there were around deaths. In the UK all girls aged to are offered HPV vaccination as part of the NHS childhood vaccination programme. Professor Jack Cuzick concludes Following these important findings this vaccine has been licenced in the USA and approval is currently being sought in the UK and other countries. It is encouraging that the Joint committee on Vaccines and Immunisation is reviewing Gardasil in light of this new evidence. This clinical trial was funded by Merck. For more information contact Charli Scouller PR Manager School of Medicine and Dentistry Queen Mary University of London c.scoullerqmul.ac.uk mailtoc.scoullerqmul.ac.uk Tel Notes to the editor About Queen Mary University of London Queen Mary University of London QMUL is one of the UKs leading universities and one of the largest institutions in the University of London with students from more than countries. A member of the Russell Group we work across the humanities and social sciences medicine and dentistry and science and engineering with inspirational teaching directly informed by our research in the most recent national assessment of the quality of research we were placed ninth in the UK REF . We also offer something no other university can a stunning selfcontained residential campus in Londons East End. As well as our home at Mile End we have campuses at Whitechapel Charterhouse Square and West Smithfield dedicated to the study of medicine and a base for legal studies at Lincolns Inn Fields. We have a rich history in London with roots in Europes first public hospital St Barts Englands first medical school The London one of the first colleges to provide higher education to women Westfield College and the Victorian philanthropic project the Peoples Palace based at Mile End. QMUL has an annual turnover of m a research income worth m and generates employment and output worth m to the UK economy each year."

"Breast cancer is the second most common cancer in women after skin cancer and occurred in women in the United States in . Breast cancer afflicts in women in their lifetime and in die from this disease. Although a number of randomized trials demonstrate the clear benefits of mammography screening in women up to age on reducing mortality data are sparse in women over the age of especially minorities. In percent of breast cancer deaths occurred in the more than million women who are between the ages of to years. In a new study published in the American Journal of Medicine Charles H. Hennekens M.D. senior author and first Sir Richard Doll Professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at Florida Atlantic University indicates that black and white women ages to years who had an annual mammogram had lower year breast cancer mortality than corresponding women who had biennial or noirregular mammograms. Among elder women the American Cancer Society and the United States Preventive Services Task Force recommend regular mammography for ages to . Although many guidelines rely on selfreports Hennekens and his collaborators from Baylor College of Medicine and Meharry Medical College used the Surveillance Epidemiology and End Results SEER program file linked to the Medicare administrative claims file which allowed them to identify screening mammography use from to from nonHispanic women black and white. These linked files also permitted them to explore breast cancer mortality differences between elderly black or white women who selfselected for regular annual or biennial mammography screening. The researchers selected as the lower age limit because Medicare coverage of the general population begins at age and the exposure of interest was regular mammography screening in the four years immediately preceding breast cancer diagnosis. Three mutually exclusive categories were defined no or irregular mammography biennial mammography and annual mammography. They looked at data from nonHispanic white or black women Hispanics were not included because Hispanic white women have substantially lower mortality than nonHispanic whites and the number of Hispanic blacks is small. The researchers also measured socioeconomic status looking at median household income the percentage of individuals living below the poverty level and whether or not they had a high school education. Other significant findings from the study show that White women who had died tended to be older to have a later stage diagnosis to have received chemotherapy and to have a higher socioeconomic status. White women who died were less likely to have undergone surgery and receive radiation therapy. Similar characteristics were seen in black women as in white women. to yearold women receiving regular annual screening mammography during the four years immediately preceding breast cancer diagnosis had consistently lower fiveyear and year risks of breast cancer mortality than women with no or irregular screening regardless of race. year risks were more than three times higher among white and more than two times higher among blacks aged to years with no or irregular screening compared with annual screening. Hennekens notes that further research is needed but that in the future the use of regular claimsbased surveillance for mammography as a source of data may offer some unique advantages over selfreports. From to according to Science Watch Hennekens was the third most widely cited medical researcher in the world and five of the top were his former fellows andor trainees. In Science Heroes ranked Hennekens No. in the history of the world for having saved more than . million lives which placed him two ahead of professor Jonas Salk ranked No. for the development of the polio vaccine. In he received the Fries Prize for Improving Health and in he received the Alton Ochsner Award for his pioneering work on smoking and health. In he was ranked the No. Top Scientist in the World based on his Hindex of . About Florida Atlantic University Florida Atlantic University established in officially opened its doors in as the fifth public university in Florida. Today the University with an annual economic impact of . billion serves more than undergraduate and graduate students at sites throughout its sixcounty service region in southeast Florida. FAUs worldclass teaching and research faculty serves students through colleges the Dorothy F. Schmidt College of Arts and Letters the College of Business the College for Design and Social Inquiry the College of Education the College of Engineering and Computer Science the Graduate College the Harriet L. Wilkes Honors College the Charles E. Schmidt College of Medicine the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan Healthy aging biotech coastal and marine issues neuroscience regenerative medicine informatics lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAUs existing strengths in research and scholarship. For more information visit http"

"The next new acne treatment may be found in the produce section of your food store. Largely due to its antiinflammatory and antibacterial properties the herb thyme which is found with other herbs in the produce section of most food stores may well earn itself a place in the skin https care section of your local drug store. Researchers from Leeds Metropolitan University in the U.K. steeped thyme marigold and myrrh in alcohol to make whats called a tincture and then tested them on the bacteria that cause acne https They all had greater antibacterial effect after five minutes compared to lab specimens exposed to plain alcohol but thyme was the most potent. In fact the thyme tincture was more powerful than standard concentrations of benzoyl peroxide https which is the active ingredient in many acne https products. The new findings were presented at the Society for General Microbiologys Spring Conference in Dublin. If thyme tincture is proven to be as clinically effective as our findings suggest it may be a natural alternative to current treatments researcher Margarita GomezEscalada PhD says in a news release. The problem with treatments containing benzoyl peroxide is the side effects they are associated with namely a burning sensation and skin irritation. Herbal preparations are less harsh on the skin due to their antiinflammatory properties while our results suggest they can be just as if not more effective than chemical treatments she says. But some U.S. dermatologists are quick to caution that while intriguing this research is still preliminary and thymetinged acne treatments https are not yet ready for prime time. Save Thyme for Cooking Alan Shalita MD is the distinguished teaching professor and chairman of the department of dermatology at SUNY Downstate Medical Center in New York. So what does he think about the thyme tincture Its intriguing. But if you have acne https your first stop should be the skin care aisle in your drug store not the produce section of your food store. Choose a cleanser with salicylic acid https followed by a mild benzoyl peroxide leaveon product he says. If that doesnt work see a dermatologist for prescription medications https Joshua Zeichner MD says that time will tell if thyme holds promise as an acne treatment. More research needs to be done to evaluate thyme but it is an exciting prospect and would be a welcome addition. Zeichner is an assistant professor of dermatology at Mount Sinai Medical Center in Manhattan. Dont try thyme at home. How it works in the lab setting is very different than how it works on your skin he says. Amy Forman Taub MD agrees. She is the medical director of Advanced Dermatology and an assistant clinical professor of dermatology at Northwestern University Medical School both in Chicago. We always need more treatments for acne because there are so many people who suffer with it. Is thyme the solution for these people Taub isnt sure. We are far away from developing a preparation that contains thyme but this is interesting she says. Michele Green MD is less cautious. She is ready to call on a compounding pharmacist to develop a thymebased acne treatment right now. Benzoyl peroxide is drying and irritating and an herbal treatment could be fabulous she says. Green is a dermatologist at Lenox Hill Hospital in New York City."

"Administering chemotherapy to AfricanAmerican breast cancer patients prior to surgery could improve their prognosis and survival rates from the disease according to a new study. A research team led by Georgia State University found AfricanAmerican breast cancer patients who receive chemotherapy prior to surgery exhibit trends of reduced regional in lymph nodes recurrence and distant in remote organs such as the liver lungs and brain recurrence of tumors which may help diminish the inequality in breast cancerrelated clinical outcomes between AfricanAmerican and EuropeanAmerican patients. There is a significant disparity in breast cancer mortality between AfricanAmerican and EuropeanAmerican breast cancer patients. Despite a similar number of reported cases of breast cancer among AfricanAmerican and EuropeanAmerican women AfricanAmericans experience a more aggressive clinical course and a percent higher death rate than EuropeanAmericans among premenopausal and menopausal breast cancer patients. Recurrent breast cancer has hindered the successful management of this disease for decades and is one of the primary factors for the racial disparity in prognosis and outcomes. Differences in recurrence rates and patterns between the races following various forms of treatment have not been thoroughly investigated. This is the first clinical study to suggest that neoadjuvant chemotherapy treatment prior to surgery may improve breast cancer recurrence rates and patterns in AfricanAmericans. The results are published in the journal PLOS ONE. Researchers at Georgia State analyzed clinical data from a large cohort of breast cancer patients treated at Northside Hospital in Atlanta from to . The patients selfreported races were primarily AfricanAmerican and EuropeanAmerican. The researchers studied rates and patterns of tumor recurrence after hormone radiation and chemotherapy among AfricanAmerican and EuropeanAmerican breast cancer patients. We found that in general AfricanAmerican breast cancer patients exhibit increased likelihood for tumor recurrence particularly to regional and distant sites after receiving any combination of adjuvant therapy treatment following surgery compared to EuropeanAmerican breast cancer patients. This higher incidence of tumor recurrence can contribute to a poorer prognosis said Nikita Wright first author of the study and a senior Ph.D. student in Dr. Ritu Anejas laboratory in Georgia States Biology Department. When breast cancer recurs it is more challenging to treat regional and distant tumors than local tumors in the breast Wright explained. Interestingly we found that neoadjuvant chemotherapy actually reversed these recurrence trends Wright said. We found that AfricanAmerican breast cancer patients responded better to neoadjuvant chemotherapy than EuropeanAmerican patients. Among patients who received neoadjuvant chemotherapy AfricanAmericans exhibited trends of lower regional and distant tumor recurrence than EuropeanAmericans but higher local recurrence which is easier to manage clinically and is associated with a relatively better prognosis. The researchers also found that among early stage patients noninvasive or minimally invasive breast cancer AfricanAmericans displayed higher tumor recurrence than EuropeanAmerican patients. Coauthors of the study include Jun Xia Sergey Klimov Pranay Neema Dr. Dora Ilyasova Dr. Padmashree C. G. Rida Dr. Remus Osan and Dr. Aneja of Georgia State Dr. Guilherme Cantuaria and Dr. Mildred Jones of the Northside Hospital Cancer Institute Dr. Uma Krishnamurti Dr. Xiaoxian Bill Li and Dr. Michelle D. Reid of Emory University and Dr. Meenakshi Gupta of West Georgia Hospitals. The study was funded by the National Cancer Institute of the National Institutes of Health. To view the study visit httpjournals.plos.orgplosonearticleid.journal.pone.."

"Detailed Results of Phase Trial Presented at the American College of Gastroenterology Annual Scientific Meeting . of Patients Treated Using the Lead Formulation of Novel Prep Achieved a Colonoscopy Rating of Excellent or Good Compared to . of Those Using Standard Prep Products in Colonoscopistblinded Trial Phase Study Planned to Initiate in Early More Patientfriendly Palatable Prep Could Help Increase Patient Acceptance of Colonoscopies for Colorectal Cancer Screening Newton MA October Detailed results from a Phase study of a novel colonoscopy prep ECP under development by ColonaryConcepts LLC show the investigational treatment to be at least as effective and safe as two currently available colonoscopy prep formulations while offering a much higher level of patient satisfaction and preference than standard preps. The investigational prep is designed to be goodtasting with no fasting and lower fluid requirements than standard preps. It consists of nutritionally balanced bars and beverages incorporating the standard purgative active ingredient PEG which a patient consumes during the hours prior to colonoscopy. Results from the randomized singleblind study will be presented today at the American College of Gastroenterology Annual Scientific Meeting being held in Las Vegas NV by principal investigator Douglas K. Rex M.D. Distinguished Professor of Medicine Indiana University School of Medicine. Approximately of those who ought to have a colonoscopy avoid the procedure and the top reason cited for their avoidance is the prep said Dr. Rex. Results from this study show that this innovative investigational product performed as well as or better at colon cleansing than two currently available colonoscopy prep formulations. Moreover the higher levels of patient satisfaction reported by those who used the lead ECP formulation in the trial suggest this new approach to colonoscopy prep may have a positive impact on patient willingness to undergo this potentially lifesaving colorectal cancer screening procedure. The study tested six formulations of ECP using different doses of the active ingredients integrated within different meal kit menus randomized against two U.S. Food and Drug Administrationapproved active comparators. The primary outcome was the proportion of subjects with an endoscopic visibility rating of excellent or good based on the Aronchick scale. Secondary endpoints included segmentbysegment endoscopic visibility based on the Ottawa scale as well as safety tolerability and reports of patient experience. Fiftyone patients were treated with ECP and with active comparators. In the top three most effective formulations of ECP . of of patients had a rating of excellent or good. With ColonaryConcepts lead formulation . of of patients had a rating of excellent or good with of colon segments rated as excellent or good on the Ottawa scale. For the comparator products . of had a rating of excellent or good. There were no serious adverse events across any of the treatment groups. The proportion of patients reporting being satisfied or extremely satisfied with the experience of using the lead ECP formulation was nearly double that for those using the standard preps . versus .. We are very pleased with the efficacy and safety results of this study which clearly support advancing this product to a Phase trial said Corey A. Siegel M.D. M.S. a cofounder of ColonaryConcepts and Director of the Inflammatory Bowel Disease Center at the DartmouthHitchcock Medical Center and Associate Professor of Medicine at The Geisel School of Medicine at Dartmouth. The ECP approach allows patients to eat solid food bars and drink palatable lowvolume beverages a patientfriendly design that participants in the study clearly favored over conventional preps comments Dr. Siegel. Patients participating in the study were nearly four times more likely to recommend ECP to their friends and family as compared to the standard colonoscopy prep. Colonoscopy is still recognized as the gold standard the best way to catch this cancer at an early stage. The medical community has called for an increase in colorectal cancer screening overall both through the recent recommendations of the Cancer Moonshot Blue Ribbon Panel and the National Colorectal Cancer Roundtables call for screening by said Joshua Korzenik M.D. a cofounder of ColonaryConcepts and Faculty Member at Harvard Medical School and the Director of the Brigham and Womens Hospital Crohns and Colitis Center. By making the preparation for the procedure easier we believe ECP can lower patient resistance to colonoscopies and thus can help attain these important public health goals. About ColonaryConcepts LLC ColonaryConcepts LLC is headquartered in Newton MA and is committed to developing patientcentric innovations that improve gastrointestinal health. The company currently has two product candidates in clinical development ECP which is expected to enter Phase clinical trials in early and the Cbar a novel product candidate for chronic constipation which is currently being studied in a Phase b clinical trial. ColonaryConcepts physicianled product development team includes Boardcertified gastroenterologists food scientists pharmaceutical development experts culinary research chefs and product design strategists. For more information about ColonaryConcepts LLC please visit http Media Contact Joan E. Kureczka Bioscribe Inc. Email Joanbioscribe.com mailtoJoanbioscribe.com Ph .. ColonaryConcepts Michael Allio .. michael.alliogmail.com mailtomichael.alliogmail.com Herb Stern .. infocolonaryconcepts.com mailtoinfocolonaryconcepts.com"

"If youre the type of person who needs at least one cup of coffee to get out of the house in the morning and a few more to make it through the day you might think the best thing about java is that it keeps you awake. But new research suggests thats just a bonus. The best thing about your coffee habit might be that it extends your life by reducing your risk of death from heart disease diabetes or even cancer. Two large studies published Monday in the Annals of Internal Medicine found that the more coffee a person drank the lower his or her risk of early death. The results were largely consistent among more than study participants from a variety of racial ethnic and cultural backgrounds. And get this The inverse relationship between coffee consumption and death held up even for people who drank decaf. Previous research had already offered strong hints that coffee isnt bad for you and might actually be good for you. But those studies generally involved fewer people most of whom were of European descent. A team from the National Cancer Institute USC and the University of Hawaii sought to correct that httpannals.orgaimarticleassociationcoffeeconsumptiontotalcausespecificmortalityamongnonwhitepopulations by examining coffeedrinking habits in Americans who were participating in the Multiethnic Cohort Study http which has been tracking volunteers since . On average each volunteer was followed for . years. Compared with the of people who didnt drink coffee at all those who downed two or more cups each day were about less likely to have died during the study period. In addition those who drank just one to six cups of coffee per week were less likely to die. Both of these figures were calculated after taking into account known risk factors for early death such as smoking which is often paired with coffee drinking diet and body mass index. When the researchers examined whites blacks Latinos Japanese Americans and Native Hawaiians separately they found no indication that the associations varied by raceethnicity according to their report. The link between coffee and longevity was statistically significant in all groups except for the Native Hawaiians. The researchers said this was probably because there werent enough of them in the study to rule out the possibility that the link was just a fluke. The study authors also compared coffee drinking with each of the leading causes of death in the U.S. which combined to account for of the deaths that occurred during the study period. The more coffee one drank the less likely he or she was to die of heart disease cancer chronic lower respiratory disease stroke diabetes or kidney disease. Coffee apparently had no effect on the risk of dying of influenza or pneumonia Alzheimers disease accidents or suicide. Until now there hasnt been much data to go on regarding coffee and health risks in people who arent white. Without it researchers couldnt say whether the inverse association observed in people of European descent would apply to people of other backgrounds as well. Now they can see that it does. Not only is this useful information to coffee drinkers it also suggests that theres a biological explanation for the link. More on that later. A second study httpannals.orgaimarticlecoffeedrinkingmortalityeuropeancountriesmultinationalcohortstudy mined data from the European Prospective Investigation into Cancer and Nutrition study httpepic.iarc.fr to see whether there was a link between coffee and early death among people from countries Denmark France Germany Greece Italy the Netherlands Norway Spain Sweden and the United Kingdom. These volunteers were tracked for an average of . years. Once again the researchers most of whom were from Europe found that the top of coffee drinkers in each nation were less likely to die during the study period than their countrymen who shunned coffee altogether. After accounting for smoking diet and other factors the authors calculated that the risk of early death was lower in men and lower in women. As with the American study the European team found no evidence that coffee was linked to better health only for people in certain countries. Both studies found similar results for people who drank decaffeinated coffee as for people who drank the real thing. Though the two studies involved hundreds of thousands of people they werent designed to show that drinking more coffee caused people to live longer that would require a randomized trial. However there are reasons to think that compounds in coffee would reduce the risk of premature death according to an editorial httpannals.orgaimarticlemoderatecoffeeintakecanparthealthydiet that accompanies the studies. For instance the polyphenols found in coffee act as antioxidants helping cells cope with the damaging effects of molecules called free radicals. In addition genes related to caffeine metabolism also influence things like blood pressure and cholesterol. Both groups of researchers also noted that previous studies have linked coffee drinking to improvements in the bodys liver function sensitivity to insulin and inflammation. The editorial concluded that it was still premature to recommend coffee as a way to reduce mortality or prevent chronic disease. But the results should alleviate any fears that theres something dangerous about drinking up to five cups of coffee each day the authors added. Considering that an estimated . billion cups of coffee are consumed somewhere in the world each day thats something to celebrate with an espresso a latte a cappuccino or a regular cuppa joe."

"In the first clinical trial directly comparing three drugs most commonly used to treat diabetic macular edema researchers found all were effective in improving vision and preventing vision loss. However one drug aflibercept provided greater improvement for people with more severe vision loss when treatment was initiated. The trial was conducted by the National Eye Institute Diabetic Retinopathy Clinical Research Network DRCR.net including researchers from Joslin Diabetes Center. The results http appeared in the February online edition of the New England Journal of Medicine. Diabetes is a significant risk factor for developing eye diseases. The most common diabetic eye disease and a leading cause of blindness is diabetic retinopathy which is caused by elevated blood sugar levels damaging the blood vessels of the retina and affects approximately . million Americans. About Americans with diabetic retinopathy have diabetic macular edema DME in which fluid leaks into the macula the area of the retina used when looking straight ahead. The fluid causes the macula to swell blurring vision. DME is the leading cause of moderate vision loss in workingage adults with diabetes. With the rate of diabetes increasing dramatically worldwide many individuals will be at risk for vision loss from diabetic eye complications and DME is a major global health concern says Jennifer K. Sun M.D. M.P.H. http a member of the study research team and writing committee and an Investigator in the Section on Vascular Biology an ophthalmologist in Beetham Eye Institute http_care.html at Joslin and an Assistant Professor at Harvard Medical School. In an earlier study Joslin researchers reported that VEGF a major growth factor for blood vessels is elevated in the eye fluids of patients with proliferative diabetic retinopathy and DME causing leakage and the growth of abnormal blood vessels. Over the past few years drugs that target VEGF have become a standard treatment for DME providing a preferred alternative or adjunct to laser treatment. The standard Medicare perinjection costs of the three antiVEGF drugs evaluated in the study are about for aflibercept Eylea for ranibizumab Lucentis and for bevacizumab Avastin. At the start of the trial adults with DME were enrolled their average age was years and percent had type diabetes. About half of the participants had or vision and the other half had vision of or worse. They were randomized into three treatment groups and received the assigned study drug by injection into the eye until the DME resolved or stabilized. Participants on bevacizumab and ranibizumab received on average injections versus nine for those on aflibercept. One year after starting treatment all participants had improved vision. Those with mild vision loss to at baseline in all three treatment groups gained on average almost two lines on an eye chart. For participants with more severe vision loss or worse aflibercept improved vision on average nearly four lines bevacizumab about . lines and ranibizumab almost three lines. The results clearly remove any doubts about antiVEGF drugs efficacy in treating DME. All three drugs improved vision substantially with aflibercept showing more visual gains in patients with worse vision at the start of the trial. Physicians now have robust data to help them counsel patients and make informed decisions regarding treatment options says study coauthor Lloyd P. Aiello M.D. Ph.D. http_paul_aiello.html Professor of Ophthalmology at Harvard Medical School Director of Joslins Beetham Eye Institute cohead of Joslins Section of Vascular Cell Biology and founding chair of the DRCR Network. In light of these positive results it is more important than ever for patients with diabetes to be evaluated on a regular basis for eye disease and receive treatment promptly once indicated as we now have excellent success in treating patients with DME says Dr. Aiello. The trial was supported through a cooperative agreement from the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health U.S. Department of Health and Human Services. Regeneron Pharmaceutical provided the aflibercept and Genentech provided the ranibizumab for the study. The DRCR.net had complete control over the design of the study data ownership and content of presentations and publications related to this study. About Joslin Diabetes Center Joslin Diabetes Center based in Boston Massachusetts undertakes diabetes research clinical care education and health and wellness programs on a global scale. Joslin is dedicated to ensuring that people with diabetes live long healthy lives and offers real progress in preventing and curing diabetes. Joslin is an independent nonprofit institution affiliated with Harvard Medical School and is recognized worldwide for driving innovative solutions in diabetes prevention research education and care. Our mission is to prevent treat and cure diabetes. Our vision is a world free of diabetes and its complications. For more information visit 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"

"A new study by a Yale researcher may support the use of a device for patients suffering from irregular heart rhythms. The Watchman is a catheterdelivered device that is permanently implanted in the opening of the left atrial appendage LAA a small appendage of tissue that projects off one of the upper chambers of the heart. When patients are in an abnormal irregular heart rhythm called atrial fibrillation blood clots can form in the LAA which can then circulate out through the bloodstream and cause stroke. Once the device is in place in the opening of the LAA a thin layer of tissue grows over it preventing blood clots from forming in the LAA and therefore preventing stroke. It has been suggested that as treatment for atrial fibrillation the Watchman device may be preferable to standard blood thinning medications such as warfarin which raise the risk of bleeding. To assess the costeffectiveness of the device versus medication the researchers developed a statistical model based on data from two key research trials known as PROTECT AF and PREVAIL. The researchers found that while results from the trials varied the device did appear to be more costeffective in the larger longerterm trial. What we know is that the PROTECT AF trial enrolled more patients and has longer followup at this time and this allows greater statistical certainty said Dr. James Freeman assistant professor of cardiology and first author on the paper. Based on that the study may provide more certainty in terms of costeffectiveness. However longerterm results are needed to be completely certain of the devices value in clinical practice he said. The study published online May in Circulation Arrhythmia and Electrophysiology."

"Drinking plenty of water each day may have an unexpected benefit staving off urinary tract infections a new study reports. Young women plagued by UTIs who drank an additional cups of water each day were nearly half percent as likely as a control group to have another infection the study showed. The water group also reduced their use of antibiotics by roughly half or percent. Whats more the amount of time that passed before a womans next UTI and between recurrent infections was longer in the water group than in the control group. Women are more prone to UTIs than men partly due to their anatomy. A shorter urethra makes it easier for bacteria from rectum to enter the vagina and travel to the bladder. Study author Dr. Thomas Hooton said its thought that increasing fluid intake decreases UTI risk in two ways by preventing bacteria from adhering to the bladder and by reducing the overall concentration of bacteria that could cause an infection. Flushing bacteria out of the bladder its been known at least its been thought that it is protective. This study suggests that it is said Hooton clinical director of the division of infectious diseases at the University of Miami School of Medicine. Dr. Hunter Wessells who wasnt involved in the study called the additional fluid intake substantial leading to a corresponding increase in urine output. It is the urine output which is of course the key factor leading to the effect seen in the study said Wessells chair of the department of urology at the University of Washington School of Medicine in Seattle. Dr. Susan Bleasdale medical director of infection control at the University of Illinois at Chicago said the study may be a game changer for antibiotic stewardship programs aimed at reducing inappropriate antibiotic use. She cited a review estimating that million to million women a year will suffer from a UTI accounting for . billion antibiotic prescriptions a year. We might not even need to use antibiotics she said. The study conducted in Bulgaria involved healthy premenopausal women who had at least three UTIs in the past year. All reported low daily fluid intake. They drank roughly four cups of fluid per day including just cups of water a day. Half of the women in the study were asked to consume . liters of water or about cups each day in addition to their usual daily fluid intake. Specifically they were asked to begin drinking a liter water bottle at each meal and finish each bottle before the next meal. The remaining women served as a control group. They continued their usual fluid intake. The women were followed for a year with clinic visits at the beginning of the study as well as and months later. Researchers measured their water and fluid intake urine volume frequency and concentration and symptoms. They also called the women each month to assess compliance and counsel them to return to the clinic for evaluation and possible treatment if they were experiencing UTI symptoms. Overall the water group increased daily water intake by close to cups a day. Their total daily fluid intake including water and other beverages averaged nearly cups. By contrast the control groups total daily fluid intake was less than half of that. Hooton noted that its not clear exactly how much fluid intake must increase to deliver a benefit. Theres no magic in a literandahalf he said. Likewise he believes any increase in fluid not just water may be beneficial since fluids are mostly water. And while the study involved younger women he said older women who experience recurrent UTIs may benefit from increasing their daily fluid intake as well. Whether the advice would benefit women with normal urine output however is unclear Wessells noted. In addition the bother associated with the higher urine output and feasibility of implementing this water intake strategy across a range of occupations and ages requires further study as well he said. Researchers presented the findings Saturday at IDWeek the annual meeting of the Infectious Diseases Society of America the Society for Healthcare Epidemiology of America the HIV Medicine Association and the Pediatric Infectious Diseases Society. Research presented at meetings is generally considered preliminary until published in a peerreviewed publication. More information Visit the U.S. Centers for Disease Control and Prevention for more on UTIs https SOURCES Oct. media briefing with Thomas Hooton M.D. University of Miami clinical director division of infectious diseases University of Miami School of Medicine and Susan Bleasdale M.D. medical director infection control University of Illinois at Chicago Hunter Wessells M.D. professor and chair department of urology University of Washington Seattle Oct. presentation IDWeek San Diego"

"City of Hope patient Susan Young has had a remarkable response to a potentially revolutionary new treatment a combination of the p cancer vaccine and a drug that blocks a specific canceraiding protein. The yearold came to City of Hope in August from UC Davis with advanced triplenegative breast cancer that had metastasized to her bones and skin. She had exhausted all of her chemotherapy options and this experimental treatment was her last hope. The only other option was hospice. At least to percent of her body was covered by lesions inflammation and thickened purplish skin said Yuan Yuan M.D. breast cancer oncologist at City of Hope who treated Young. Six weeks into her treatment the skin lesions were gone her itchiness went away. Its quite a dramatic response. So dramatic in fact that Yuan refers to Young as her miracle patient. This in some ways is pretty unprecedented. This patient is at a late stage of her disease. There are no treatments available that would have done the same thing said Don J. Diamond Ph.D. chair of the Department of Experimental Therapeutics at City of Hope. Young received a combination of the p vaccine and the drug pembrolizumab. Diamond developed the vaccine and has been studying its effectiveness in clinical trials at COH since . He currently is testing it on ovarian cancer and other solid tumors such as pancreatic and gastrointestinal masses. Ive responded great. Im feeling good said Young who has received six of seven pembrolizumab infusions each of which takes about a halfhour and all three p vaccine injections. My skin has cleared up. I think the prognosis is going to be good now. Teaching the immune system to fight The most frequent mutation across all cancers occurs in a gene called p which contributes to cells becoming oncogenic when they produce a mutant form of the p protein p gene mutations are present in about of malignancies. Diamonds vaccine boosts the immune response to many different mutant forms of p. The researchers tested this vaccine known as pMVA in a clinical trial and found it to be safe in patients with advanced gastrointestinal cancers. However patients whose T cells had preexisting high levels of a protein named PD a molecule that instructs immune cells to shut down responded poorly to the antip vaccine. In a subsequent laboratory study the COH researchers showed that these patients immune cells could be reactivated by treatment with a PD inhibitor that is a biosimilar to the clinical drug called pembrolizumab. Together the vaccine and the drug potentially could form a potent team to reactivate the immune system to quickly clear out cancer cells. Before Young the combination had been tried on patients with recurrent solid tumors such as nonsmall cell lung cancer melanoma renal cell carcinoma and many other cancer types. So far while Diamond has noted an immune response in patients given the combination treatment in clinical trials he has not seen a clinical benefit. That is until he met Young. We have treated a number of different types of patients with the combination but nothing is even in the same universe as this he said. A shocking response Young who tested positive for the p mutation has been fighting breast cancer for eight years and has undergone one chemo after another Yuan said. Referred to City of Hope by her physician at Davis she began responding to the experimental treatment right away Yuan said her skin tumors disappearing and the latest biopsies showing no cancer. The purple thickened skin has faded away the skin color has normalized. Shes healed basically she said. Its such a promising early response. Its quite unusual she added. We have two drugs here so its hard to dissect which drug did what but we do think the vaccine played a key role. It was shocking to me said Diamond. What we have noticed is that her immune response to p has been increasing as time goes on. It was of tremendous magnitude in the last blood draw. The next step will be to take bone and CT scans to see if the cancer is disappearing internally as well as externally which Young will receive in a couple of weeks. Even now though Young is extremely happy with the results Yuan said. Her psychological wellbeing has improved. Her appetite is better shes more functional. She went through a lot. It will be very interesting to follow up. I couldnt look at myself. It was really hard Young said of the skin lesions she had endured for five years. They started to go away after the third treatment she said. Even the marks where it was climbing up my neck are all gone.Further study needed What Diamond is hoping for now is funding for a full clinical trial so that he can test the combination in advanced triplenegative breast cancer patients who test positive for p. A couple of major drug companies have already expressed interest in his vaccine he said. What we would like is to have women come here from all over the country and the world to receive this vaccine formula so that we can test this combination Diamond said. If it happened once maybe it will happen twice. But weve got to get these patients in. Following the success in Young the formula has recently been given to two other triple negative breast cancer patients at City of Hope. Its too early to gauge the response although the entire breast team is very excited about this Diamond said. We saw this phenomenal response in this patient. I am very encouraged by the findings so I think theres a story to come. Everything is turning around for me Young said. I was very frightened when I started out. Im not that frightened anymore. I know it still can turn for me but I think Im going to be the miracle that Dr. Yuan wants."

"Dawne GardnerDavis almost skipped the free health screening for her son. The weather was rotten an earlier appointment ran long and yearold Jordan was the picture of health. Jordan Gardner of Cincinnati works on Aug. at a Cincinnati Reds game. Doctors advised him to quit competitive athletics. Today the Cincinnati mother of two is thankful she didnt. Doctors diagnosed Jordan with aortic root dilation a potentially lifethreatening heart defect. They advised the teen who played six sports his favorite being baseball to quit competitive athletics for good. For decades pediatricians and family physicians have sought a more effective way to identify young athletes at risk of dying while playing the sports they love. Now the Heart Institute at Cincinnati Childrens Hospital Medical Center httpcontent.usatoday.comtopicstopicPlacesGeographyCincinnatiChildrensHospitalMedicalCenter is testing a new method. In the most complete test of its kind the institute is using both an electrocardiogram and limited echocardiogram to see the rhythm and structure of the heart. If proved effective it could become the norm for identifying heart conditions that put one in people at risk when doing toplevel physical activities researchers say. Since the study began about a year ago local teens have been screened and diagnosed with heart abnormalities. Twentytwo can continue in athletics though theyll require lifelong monitoring. Four young athletes two girls and two boys have been advised to quit sports altogether. Researchers hope to screen a total of before theyre done. So far their work is turning up a higher rate of heart abnormalities than expected. Jordan was one of the more serious cases. That day at his appointment he his mother and little sister Jaelynne sat astonished as doctors described a dangerously large root in Jordans heart. Because of its size it could rupture if stressed by too much physical activity. The effects could kill him. Jordan took his doctors advice and quit the sports he loved. The saddest day for me had to be the day of baseball tryouts Jordan says. I woke up and I couldnt go to tryouts. After that I just started to cope. Precise diagnoses sought Cases of high school athletes collapsing and dying on sports fields most often result from undiagnosed heart defects says Dr. Jeffrey Towbin codirector and head of clinical care at the Heart Institute. Victims often show no earlier symptoms looking the picture of health. Towbin asked two pediatric cardiologists Dr. Jeff Anderson httpcontent.usatoday.comtopicstopicJeffAnderson and Dr. Michelle Grenier to take on the study that hed wanted to do since joining the Heart Institute and onehalf years ago. One of our goals is to advance the field in areas either untouched or unappreciated as being important Towbin says. These cases are obviously each a tragic event that occur in every city a few times a year. As high school sports begin this year the caution takes on increased urgency. Locally swimmer Jose Cerda Navarro became unconscious during practice with his private swim club in October . He died within the hour at the hospital on this th birthday. Cameron Batson died a few weeks before that while playing a game of pickup soccer. He had graduated that spring from high school in Covington. In the United States a doctor must approve participation in a school or competitive sports league. Approval is generally granted to teens with little to no family history of heart problems and a physical exam devoid of medical red flags. Some years ago Italy instituted a countrywide rule requiring competitive athletes to undergo an electrocardiogram a test that records the electrical activity of the heart. Fewer Italian athletes died after the testing began but the tests also had a relatively high rate of falsely reporting medical problems. That led to unnecessary physical restrictions of athletes. Theres got to be a better way Anderson said. Thats what we set out to answer. Anderson and Grenier now say that adding a limited echocardiogram a twodimensional image of the heart can offer a more precise diagnosis. National estimates are that roughly of people are born with potentially lifethreatening heart defects. But the Childrens Hospital httpcontent.usatoday.comtopicstopicChildrensHospital study is showing more than twice that rate and a higher rate for more minor abnormalities as well perhaps because of better technology Grenier says. I do think theyre real numbers she says of the studys findings so far. Are they normal variations What abnormality is going to contribute to the overall health versus something that just looks funny Thats not entirely known. Grenier and her colleagues at the Heart Institute hope to continue this study turn it into an ongoing program so they may one day be able to answer those questions. In the meantime screenings continue. Making tests affordable accessible A key challenge now is making these tests affordable most medical insurance plans wont cover them. Currently an EKG and echocardiogram would cost parents a minimum of Anderson says. Simons Fund a nonprofit organization donated to honor Cerda Navarro for screenings. Childrens Hospital paid the rest around according to Childrens spokesman Jim Feuer. If an ongoing program of testing happens the hospital would try to tap into thirdparty funding donations and grants Towbin says. The hope would be that with data we could get the entire system interested in participating get funding to run a clinical trial locally and maybe nationally. After Jordans diagnosis his family packed the room to support him for every subsequent appointment. He now takes daily blood pressure medication and is allowed to jog and do other light physical activities. He grew up around athletics so Im sure it was a culture shock for him says his grandfather Lacey Calloway. Whatever he does he knows weve got his back even if its tiddlywinks. Sports teaches discipline GardnerDavis says but her son is finding that in other interests. Jordan plays the drums in a high school concert band is getting into photography and cars now that hes . And he got a summer job at Great American Ballpark httpcontent.usatoday.comtopicstopicGreatAmericanBallpark. GardnerDavis calls the decision to take him for that screening the best decision of my life and suggests other parents take advantage of the free service. Were so thankful she says. Otherwise wed have no idea and Jordan could be standing here one day and gone the next. For more information about reprints permissions http visit our FAQs. To report corrections and clarifications contact Standards Editor Brent Jones. For publication consideration in the newspaper send comments to lettersusatoday.com mailtolettersusatoday.com. Include name phone number city and state for verification. To view our corrections go to corrections.usatoday.com httpsusatoday.usatoday.comnewshealthstoryheartstudyyoungathletes."

"The test has the potential to help curb overtreatment in cancer care. A new genetic test to gauge the aggressiveness of prostate cancer may help tens of thousands of men each year decide whether they need to treat their cancer right away or can safely monitor it. The new test which goes on sale Wednesday joins another one that recently came on the market. Both analyze multiple genes in a biopsy sample and give a score for aggressiveness similar to tests used now for certain breast and colon cancers. Doctors say tests like these have the potential to curb a major problem in cancer care overtreatment. Prostate tumors usually grow so slowly they will never threaten a mans life but some prove fatal and there is no reliable way now to tell which ones will. Treatment with surgery radiation or hormone blockers isnt needed in most cases and can cause impotence or incontinence yet most men are afraid to skip it. Were not giving patients enough information to make their decision said Dr. Peter Carroll chairman of urology at the University of California San Francisco. You can shop for a toaster better than for prostate treatment he said. A study he led of the newest test the Oncotype DX Genomic Prostate Score is set for discussion Wednesday at an American Urological Association meeting in San Diego. The results suggest the test could triple the number of men thought to be at such low risk for aggressive disease that monitoring is a clearly safe option. Conversely the test also suggested some tumors were more aggressive than doctors had believed. Independent experts say such a test is desperately needed but that its unclear how much information this one adds or whether it will be enough to persuade men with lowrisk tumors to forgo treatment and treat it only if it gets worse. Only percent who are candidates for monitoring choose it now. The question is whats the magnitude of difference that would change the patients mind said Dr. Bruce Roth a cancer specialist at Washington University in St. Louis. One man may view a percent chance that his tumor is aggressive as low risk but someone else might say Oh my God lets set the surgery up tomorrow he said. I dont think its a slam dunk. Also unknown Will insurers pay for the expensive test without evidence it leads to better care or saves lives The newest test was developed by Genomic Health Inc. which has sold a similar one for breast cancer since . Doctors at first were leery of it until studies in more groups of women proved its value and the same may happen with the prostate test said Dr. Len Lichtenfeld the American Cancer Societys deputy chief medical officer. The company will charge for the prostate test and says it can save money by avoiding costlier unnecessary treatment. Another test for assessing prostate cancer risk that came out last summer Prolaris by Myriad Genetics Inc. sells for . Both companies can sell the tests without Food and Drug Administration approval under separate rules that govern lab diagnostics. Myriad Genetics has published nine studies on Prolaris involving more than patients. Genomic Health has not published any results on the prostate test another thing that makes doctors wary. Yet it has a track record from its breast cancer test. About men in the U.S. are diagnosed with prostate cancer each year and about half are classified as low risk using current methods. Doctors now base risk estimates on factors such as a mans age and how aggressive cells look from biopsies that give to tissue samples. But tumors often are spread out and vary from one spot to the other. Unless you can be sure your biopsy has hit the most aggressive part thats in the prostate you cant be sure how accurate your risk estimate is explained Dr. Eric Klein chief of urology at the Cleveland Clinic who led early development of the Oncotype prostate cancer test. For one study researchers used prostates removed from men. They measured the activity of hundreds of genes thought to be involved in whether the cancer spread beyond the prostate or proved fatal. A second study of biopsies from patients narrowed it down to genes and researchers picked that seemed to predict aggressiveness no matter the location in the tumor. A third study used single needlebiopsy samples from UCSF patients scheduled to have their prostates removed. The gene test accurately predicted the aggressiveness of their cancer once doctors were able to see the whole prostate after surgery. Using one current method of the men would have been called very low risk and good candidates for monitoring. Adding the gene test put men into that category said another study leader Dr. Matthew Cooperberg of UCSF. The gene test shifted about half of the men into either a lower or a higher risk category. It went both ways that was the remarkable thing. In any category of risk it added independent information compared to the standard criteria we use today Carroll said. More work needs to be done but in my opinion this is a very good start. However Dr. Kevin McVary chairman of urology at Southern Illinois University School of Medicine and a spokesman for the Urological Association said the test must be validated in more men before it can be widely used. Its not there yet he said. UCSF just got a federal grant to see how men choose treatments and whether this test might sway them. We throw all these numbers at them. Are they really going to make a better decision Cooperberg said. Dean Smith a retired marketing executive from Mill Valley Calif. is following his doctors advice to monitor the cancer he was diagnosed with in March. He said a gene test may have made him more comfortable with that decision. At least six of his friends suffered side effects ranging from urinary leakage to inability to have sex after having their prostates removed. I would suspect that having cancer and having to live with it would be very difficult for them but it doesnt bother him Smith said. I will die from something other than prostate cancer I guarantee you."

"Welltimed pulses from electrodes implanted in the brain can enhance memory in some people scientists reported http on Thursday in the most rigorous demonstration to date of how a pacemakerlike approach might help reduce symptoms of dementia head injuries and other conditions. The report is the result of decades of work decoding brain signals helped along in recent years by large Department of Defense grants https intended to develop novel treatments for people with traumatic brain injuries a signature wound of the Iraq and Afghanistan wars. The research led by a team at the University of Pennsylvania is published in the journal Current Biology. Previous attempts to stimulate human memory with implanted electrodes had produced mixed results Some experiments seemed to sharpen memory but others muddled it. The new paper resolves this confusion by demonstrating that the timing of the stimulation is crucial. Zapping memory areas when they are functioning poorly improves the brains encoding of new information. But doing so when those areas are operating well as they do for stretches of the day in most everyone including those with deficits impairs the process. We all have good days and bad days times when were foggy or when were sharp said Michael Kahana who with Youssef Ezzyat led the research team. We found that jostling the system when its in a lowfunctioning state can jump it to a highfunctioning one. Researchers cautioned that implantation is a delicate procedure and that the reported improvements may not apply broadly. The study was of epilepsy patients scientists still have much work to do to determine whether this approach has the same potential in people with other conditions and if so how best to apply it. But in establishing the importance of timing the field seems to have turned a corner experts said. Experts said the new report gives scientists a needed blueprint for socalled closedloop cognitive stimulation implanted electrodes that both monitor the functional state of memory areas moment to moment and deliver pulses only in the very microseconds when theyre helpful. The hope is that such sensitive timed implants could bolster thinking and memory in a range of conditions including Alzheimers and other dementias as well as deficits from brain injury. The cool thing about this paper is that they showed why stimulation works in some conditions and why it doesnt in others said Bradley Voytek an assistant professor of cognitive science and neuroscience at the University of California San Diego who was not involved in the work. It gives us a blueprint for moving forward. Justin Sanchez director of the biotechnologies office at the Pentagons Defense Advanced Research Projects Agency which has doled out some million to advance cognitive stimulation said To me this paper is one of the breakthrough moments on this problem to find locations in the brain to stimulate in this particular way to boost performance. The right hemisphere of a study participants brain. The electrodes are overlaid in blue and the one researchers targeted for stimulation is toward the right highlighted in yellow.CreditJoel Stein and Youssef Ezzyat The new study is the latest chapter in an extraordinary decadeslong collaboration among cognitive scientists brain surgeons and people with severe epilepsy being evaluated for an operation. The preoperative evaluation is a fishing expedition of sorts in which doctors sink an array of electrodes through the top of the skull and wait for a seizure to occur to see whether its operable. Many of the electrodes sit in or near memory areas and the wait can take weeks in the hospital. Cognitive scientists use this opportunity with patients consent to present memory tests and take recordings. This approach called direct neural recording and piggybacking entirely on the clinical placement of the electrodes has become the leading edge of research into the biology of human memory. This study used data from patients and had collaborators from institutions around the country including Emory University the University of Washington the Mayo Clinic and the University of California San Francisco. In a series of experiments the researchers had patients memorize lists of words and later after a distraction asked them to freely recall as many of the words as they could. All the while the scientists monitored a handful of hot spots in the brain which previous work had shown were strongly related to memory encoding. Before the stimulation tests the team determined the precise settings for each patients high and lowfunctioning states. Each participant carried out the wordmemorization tests repeatedly with different words every time some lists were memorized with brain stimulation and other lists with no stimulation which served as a control. The authors then examined memory performance based on whether stimulation arrived during low compared with highfunctioning brain states. The team then statistically analyzed the results and found that people scored slightly higher than usual on words when stimulation arrived during a low or foggy state and worse when the pulse arrived in a high state. The average enhancement effect was about to percent Dr. Kahana said. And when stimulation arrived in a good state the average was about to percent worse than usual. Dr. Doris Greenblatt a psychiatrist who participated in the trial at Emory said she sought the surgery because her epilepsy had long caused memory problems. Each seizure I had tore at the fabric of memory and it was as if my memories werent attached to anything Dr. Greenblatt said. She agreed to the memory testing for the study. It was a little humiliating to be honest she said of the testing. I would remember one or two items from a list of objects in a kitchen for instance then think Oh no what else was there She said she had no idea whether the electrodes in her brain were stimulating or not. All I can say is that it was exhausting and I worried about how I was doing. She had the surgery for her epilepsy a year ago with Dr. Robert Gross and has not had a seizure since her memory is also improved she said. The timed component in this study represented a clear break from previous approaches. In the Defense Department had funded another group testing stimulation in epilepsy patients directly to a brain area near the hippocampus which is crucial to memory formation. That approach did not take into account brain states the high and low function and it was not successful. To me said Dr. Voytek the new approach is a clear demarcation that the era of dumb stimulators is over."

"Merck NYSEMRK known as MSD outside the United States and Canada today announced that the U.S. Food and Drug Administration FDA has approved ZEPATIER elbasvir and grazoprevir for the treatment of adult patients with chronic hepatitis C virus HCV genotype GT or GT infection with or without ribavirin RBV following priority review by the FDA. ZEPATIER pronounced ZEPahteer is a oncedaily fixeddose combination tablet containing the NSA inhibitor elbasvir mg and the NSA protease inhibitor grazoprevir mg. The FDA previously granted two Breakthrough Therapy designations to ZEPATIER for the treatment of chronic HCV GT infection in patients with end stage renal disease on hemodialysis and for the treatment of patients with chronic HCV GT infection. Breakthrough Therapy designation is given to investigational medicines for serious or lifethreatening conditions that may offer substantial improvement over existing therapies. Across multiple clinical studies ZEPATIER achieved high rates of sustained virologic response ranging from to percent in GTinfected patients and to percent in GTinfected patients. Sustained virologic response is defined as HCV RNA levels measuring less than the lower limit of quantification at weeks after the cessation of treatment SVR indicating that a patients HCV infection has been cured. ZEPATIER is not for use in patients with moderate or severe hepatic impairment ChildPugh B or C. ZEPATIER also is not for use with organic anion transporting polypeptides B OATPB inhibitors e.g. atazanavir darunavir lopinavir saquinavir tipranavir cyclosporine strong cytochrome P A CYPA inducers e.g. carbamazepine phenytoin rifampin St. Johns Wort and efavirenz. If ZEPATIER is administered with RBV healthcare professionals should refer to the prescribing information for RBV as the contraindications warnings and precautions adverse reactions and dosing for RBV also apply to this combination regimen. Continued innovation is needed to help address the worldwide epidemic of chronic hepatitis C virus infection said Dr. Roger M. Perlmutter president Merck Research Laboratories. Our clinical program was designed to study a broad range of patients infected with the hepatitis C virus including difficulttotreat patients such as those with stage or chronic kidney disease. The approval of ZEPATIER is a testament to Mercks unwavering commitment to improving therapy for patients with hepatitis C virus infection and we are eager to bring this innovation to patients and physicians in the United States. ZEPATIER was approved with a treatment duration of or weeks depending on HCV genotype prior treatment history and for patients with GTa infection the presence of certain baseline NSA polymorphisms. A week oncedaily regimen is recommended for the vast majority of patients for whom ZEPATIER is indicated. Mercks broad clinical trial program supporting the efficacy of ZEPATIER included six studies in patients with chronic HCV GT or GT infection. These studies assessed the rate of sustained virologic response weeks after the completion of treatment with ZEPATIER SVR. The clinical development program for ZEPATIER enrolled diverse groups of HCV GT and GTinfected patients including treatmentnave patients and those who had failed prior therapy with peginterferon alfa PegIFN and RBV as well as patients suffering with meaningful comorbidities and health complications such as compensated cirrhosis and HIV coinfection. GTinfected patients with severe renal impairment on hemodialysis and those who previously failed therapy with PegIFN and RBV in combination with an HCV NSA protease inhibitor boceprevir simeprevir or telaprevir also were studied. The following table provides a summary of clinical data that contributed to the efficacy assessment of ZEPATIER. The primary endpoint in each study was SVR. Please see section entitled Summary of Study Designs below for additional study design information including treatment arms and baseline characteristics. Clinical Studies Supporting Efficacy of ZEPATIER elbasvir and grazoprevir Clinical Trials Population SVR nN Treatment Regimen and Duration GT CEDGE TN double blind placebo controlled TN cirrhosis ZEPATIER weeks CEDGE COINFXN openlabel single arm TN cirrhosis HIV coinfection CSURFER double blind placebo controlled TNTEa cirrhosis severe renal impairment CEDGE TEd openlabel comparative TEb cirrhosis HIV coinfection ZEPATIER weeks ZEPATIER RBV weeks CSALVAGE openlabel single arm TEc cirrhosis ZEPATIER RBV weeks GT CSCAPE openlabel CEDGE TN CEDGE COINFXN TN without cirrhosis TN cirrhosis TN cirrhosis HIV coinfection ZEPATIER weeks CEDGE TE TEb cirrhosis ZEPATIER RBV weeks TE treatmentexperienced TN treatmentnave. a Failed prior IFN or PegIFN RBV. b Failed prior PegIFN RBV. c Failed prior PegIFN RBV HCV NSA protease inhibitor PI boceprevir simeprevir or telaprevir. d CEDGE TE treatment outcomes for ZEPATIER with RBV for weeks n or without RBV for weeks n not shown because these regimens are not recommended in PegIFN RBVexperienced GT patients. Selected Safety Information about ZEPATIER elbasvir and grazoprevir Elevations of alanine transaminase ALT to greater than times the upper limit of normal ULN occurred in of subjects generally at or after treatment week . These late ALT elevations were typically asymptomatic and most resolved with ongoing or completion of therapy. Healthcare professionals should perform hepatic lab testing on patients prior to therapy at treatment week and as clinically indicated. For patients receiving weeks of therapy additional hepatic lab testing should be performed at treatment week . Patients should be instructed to consult their healthcare professional without delay if they have onset of fatigue weakness lack of appetite nausea and vomiting jaundice or discolored feces. Healthcare providers should consider discontinuing ZEPATIER if ALT levels remain persistently greater than times ULN. ZEPATIER should be discontinued if ALT elevation is accompanied by signs or symptoms of liver inflammation or increasing conjugated bilirubin alkaline phosphatase or international normalized ratio. Recommended Dosage Regimens and Durations for ZEPATIER elbasvir and grazoprevir The dosing regimens and durations for treatment with oncedaily ZEPATIER for chronic HCV GT or GT infection in patients with or without cirrhosis HIV coinfection or renal impairment are as follows Patient Population Treatment Duration GTa Treatmentnave or PegIFNRBVexperienced without baseline NSA polymorphisms ZEPATIER weeks GTa Treatmentnave or PegIFNRBVexperienced with baseline NSA polymorphisms ZEPATIER with RBV weeks GTb Treatmentnave or PegIFNRBVexperienced ZEPATIER weeks GTa or GTb PegIFNRBVPIexperienced ZEPATIER with RBV weeks GT Treatmentnave ZEPATIER weeks GT PegIFNRBVexperienced ZEPATIER with RBV weeks Patients who have failed treatment with PegIFN RBV. NSA resistanceassociated polymorphisms at amino acid positions or . Patients who have failed treatment with PegIFNRBV HCV NSA PI boceprevir simeprevir or telaprevir. For GTainfected PegIFNRBVPIexperienced patients with one or more baseline NSA resistanceassociated polymorphisms positions or the optimal ZEPATIERbased treatment regimen and duration of therapy has not been established. In patients with GTa infection some hepatitis C viruses may contain mutations that can confer resistance to treatment. These are called resistanceassociated polymorphisms also referred to as resistanceassociated variants RAVs. GTa infection accounts for percent of U.S. HCV cases. To help as many patients as possible to achieve SVR testing for NSA resistanceassociated polymorphisms positions or is recommended for GTainfected patients prior to starting treatment with ZEPATIER to determine the optimal dosage regimen and duration. In clinical trials of ZEPATIER percent of GTainfected U.S. study participants had these NSA resistanceassociated polymorphisms at baseline. A week regimen of ZEPATIER with RBV is recommended for GTainfected patients with these baseline NSA polymorphisms as described in the above table. This approval provides patients and physicians with an additional treatment option that has the potential to cure many patients with chronic hepatitis C in the United States said Dr. Ira Jacobson site chair department of medicine Mount Sinai Beth Israel New York. ZEPATIER is a oncedaily singletablet directacting antiviral that has demonstrated high cure rates in genotype and in genotype including treatmentnave and treatmentexperienced patients with or without compensated cirrhosis and those with chronic kidney disease. The company anticipates that ZEPATIER will be available for shipping to wholesalers within seven business days. Chronic hepatitis C is a potentially devastating illness that can cause serious longterm health consequences for patients including reduced liver function liver failure or liver cancer said Michael Ninburg executive director Hepatitis Education Project Seattle. Today chronic hepatitis C is a curable condition for many patients and we are fortunate to have multiple therapeutic tools that can mitigate its impact. Selected Safety Information about ZEPATIER elbasvir and grazoprevir continued The concomitant use of ZEPATIER with certain drugs may lead to possible clinically significant adverse reactions from greater exposure to ZEPATIER or concomitant drugs. Coadministration of ZEPATIER is not recommended with certain strong CYPA inhibitors e.g. ketoconazole or the cobicistatcontaining regimens of elvitegravircobicistatemtricitabinetenofovir disoproxil fumarate or alafenamide. Healthcare professionals should not exceed atorvastatin mgdaily or rosuvastatin mgdaily when given with ZEPATIER. If ZEPATIER is given with fluvastatin lovastatin or simvastatin healthcare professionals should give the lowest statin dose necessary and closely monitor for statinassociated adverse events. If ZEPATIER and tacrolimus are coadministered frequent monitoring of tacrolimus whole blood concentrations changes in renal function and tacrolimusassociated adverse events is recommended. The concomitant use of ZEPATIER and certain drugs may cause significant decrease of elbasvir and grazoprevir plasma concentrations which may lead to reduced therapeutic effect of ZEPATIER and possible development of resistance. Coadministration of ZEPATIER is not recommended with moderate CYPA inducers e.g. nafcillin bosentan etravirine modafinil. In subjects receiving ZEPATIER for weeks the most commonly reported adverse reactions of all intensity greater than or equal to in placebocontrolled trials were fatigue headache and nausea. In subjects receiving ZEPATIER with RBV for weeks the most commonly reported adverse reactions of moderate or severe intensity greater than or equal to were anemia and headache. Pricing Designed to Enable Broad Patient Access to ZEPATIER elbasvir and grazoprevir The latest innovations in chronic HCV treatment that have become available over the past three years now including ZEPATIER provide the U.S. with an unprecedented opportunity to significantly reduce the burden of HCV. The scientific community believes that control of HCV infection may be possible and is actively working to achieve that goal by . A significant medical need remains it is estimated that less than one in five patients with chronic HCV infection are currently treated with thousands of new cases each year. ZEPATIER which received two Breakthrough Therapy designations for GT patients with end stage renal disease on hemodialysis and for GT patients and was thereafter approved by the FDA following priority review offers a highly effective option for a broad range of adult patients with chronic HCV GT or GT infection. Public reports indicate that net prices for the most commonly used directacting antiviral regimens are substantially lower than the list prices. However the majority of patients with chronic HCV have not yet been treated in some cases due to cost constraints. After considering these factors Merck has established a list price of for a week regimen which the company believes to be in the range of net prices for other commonly used HCV directacting antiviral regimens at weeks of therapy. Merck anticipates that this price as well as our comprehensive access strategy to seek broad coverage across commercial and public segments will help broaden and accelerate patient access to treatment and move us closer to our shared goal of reducing the burden of chronic HCV in the U.S. Mercks decadeslong commitment in chronic hepatitis C and infectious diseases overall has been to both scientific innovation and access said Robert McMahon president U.S. Market Global Human Health Merck. We are embracing this opportunity to partner with payers and physicians to enable as many appropriate patients to be treated as possible as quickly as possible. Financial Assistance Programs for Those Who Need Help With the Cost of Their Medicine Merck also anticipates that the list price of ZEPATIER will result in lower outofpocket medication costs for some patients. Lower outofpocket costs alone do not necessarily reflect a cost advantage in the outcome of the condition treated because there are other variables that affect relative costs. The direct outofpocket costs to patients will vary depending on an individuals insurance plan. Privately insured patients who have difficulty affording the copay set by their insurance plan may be eligible for significant copay assistance and may pay as little as for each prescription. Maximum savings are limited and terms and conditions apply. Information is available at http Merck anticipates that the website for ZEPATIER will be accessible within hours of FDA approval. Merck also offers assistance to patients who cannot afford ZEPATIER through Mercks yearold Patient Assistance Program. The Merck PAP provides certain Merck medicines free of charge to eligible patients. The Merck PAP for ZEPATIER is designed primarily for the uninsured who without our assistance could not afford their medication. Additionally for those patients whose insurance plan covers ZEPATIER but who still cannot afford their medication a request for an exception may be made if they meet certain financial medical andor insurance criteria. For more information about the Merck PAP please visit http or call the Merck Patient Assistance Program at . Summary of Study Designs Clinical Trials for GT HCV CEDGE TN was a randomized doubleblind placebocontrolled trial in treatmentnave patients with GT or GT infection with or without cirrhosis. Patients were randomized in a ratio to ZEPATIER for weeks immediate treatment group N or placebo for weeks followed by openlabel treatment with ZEPATIER for weeks deferred treatment group N. Among patients with GT infection randomized to the immediate treatment group the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IU per mL had cirrhosis had nonCC ILB alleles CT or TT and had GTa and had GTb chronic HCV infection. CEDGE COINFECTION COINFXN was an openlabel singlearm trial in treatmentnave HIVHCV coinfected patients with GT or GT infection with or without cirrhosis. Patients received ZEPATIER for weeks N. Among patients with GT infection the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kg per m had baseline HCV RNA levels greater than IU per mL had cirrhosis had nonCC ILB alleles CT or TT and had GTa had GTb and had GTOther chronic HCV infection. CSURFER was a randomized doubleblind placebocontrolled trial in patients with GT infection with or without cirrhosis with chronic kidney disease CKD Stage eGFR mLmin. m or CKD Stage eGFR mLmin. m including patients on hemodialysis who were treatmentnave or who had failed prior therapy with IFN or PegIFN RBV therapy. Patients were randomized in a ratio to one of the following treatment groups elbasvir mg once daily grazoprevir mg once daily for weeks N immediate treatment group or placebo for weeks followed by openlabel treatment with elbasvir grazoprevir for weeks N deferred treatment group. In addition patients received openlabel elbasvir grazoprevir for weeks intensive pharmacokinetic PK group. Patients randomized to the immediate treatment group and intensive PK group had a median age of years range to of the patients were male were white were black or African American were Hispanic or Latino had baseline HCV RNA levels greater than IUmL had cirrhosis and had nonCC ILB alleles CT or TT. CEDGE TE was a randomized openlabel comparative trial in patients with GT or GT infection with or without cirrhosis with or without HCVHIV coinfection who had failed prior therapy with PegIFN RBV therapy. Patients were randomized in a ratio to one of the following treatment groups ZEPATIER for weeks N ZEPATIER RBV for weeks N ZEPATIER for weeks N or ZEPATIER RBV for weeks N. Among patients with GT infection the median age was years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IUmL had cirrhosis had nonCC ILB alleles CT or TT and had GTa had GTb and had GTOther chronic HCV infection. CSALVAGE was an openlabel singlearm trial in patients with GT infection with or without cirrhosis who had failed prior treatment with boceprevir simeprevir or telaprevir in combination with PegIFN RBV. Patients received elbasvir mg once daily grazoprevir mg once daily RBV for weeks N. Patients had a median age of years range to of the patients were male were white were black or African American were Hispanic or Latino mean body mass index was kgm had baseline HCV RNA levels greater than IUmL had cirrhosis and had nonCC ILB alleles CT or TT had baseline NS resistanceassociated substitutions. Clinical Trials for GT HCV The efficacy of ZEPATIER in patients with GT chronic HCV infection was demonstrated in CEDGE TN CEDGE COINFXN CEDGE TE and CSCAPE. CSCAPE was a randomized openlabel trial which included treatmentnave patients with GT infection without cirrhosis. Patients were randomized in a ratio to elbasvir mg once daily grazoprevir mg once daily for weeks N or elbasvir mg once daily grazoprevir mg once daily RBV for weeks N. In these combined studies in patients with GT infection were treatmentnave of the patients were male were white were black or African American had cirrhosis and had HIVHCV coinfection. About Merck Todays Merck is a global health care leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our prescription medicines vaccines biologic therapies and animal health products we work with customers and operate in more than countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through farreaching policies programs and partnerships. For more information visit http and connect with us on Twitter httpstwitter.comMerck Facebook http YouTube http and LinkedIn https ForwardLooking Statement of Merck Co. Inc. Kenilworth NJ USA This news release of Merck Co. Inc. Kenilworth NJ USA the company includes forwardlooking statements within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of . These statements are based upon the current beliefs and expectations of the companys management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline products that the products will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize actual results may differ materially from those set forth in the forwardlooking statements. Risks and uncertainties include but are not limited to general industry conditions and competition general economic factors including interest rate and currency exchange rate fluctuations the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally global trends toward health care cost containment technological advances new products and patents attained by competitors challenges inherent in new product development including obtaining regulatory approval the companys ability to accurately predict future market conditions manufacturing difficulties or delays financial instability of international economies and sovereign risk dependence on the effectiveness of the companys patents and other protections for innovative products and the exposure to litigation including patent litigation andor regulatory actions. The company undertakes no obligation to publicly update any forwardlooking statement whether as a result of new information future events or otherwise. Additional factors that could cause results to differ materially from those described in the forwardlooking statements can be found in the companys Annual Report on Form K and the companys other filings with the Securities and Exchange Commission SEC available at the SECs Internet site http Please see Prescribing Information for ZEPATIER elbasvir and grazoprevir at http_circularszzepatierzepatier_pi.pdf and the Patient Information for ZEPATIER at http_circularszzepatierzepatier_ppi.pdf"

"Actress Marisa Tomei is one of among an estimated million Americans who suffers from chronic dry eye CDE a condition that can cause symptoms such as itchiness stinging difficulty making tears and blurred vision. To raise awareness about CDE and help other people find relief the My Cousin Vinny and The Wrestler star has teamed up with pharmaceutical company Allergan and Guide Dogs for the Blind an organization that trains dogs and pairs them with visually impaired individuals. After toting around eye drops Tomei said she has found a solution with Allergans prescription drug RESTASIS which works by increasing the eyes natural ability to produce tears. CDE causes inflammation that can prevent tear production according to Allergan. Sometimes individuals with CDE have trouble opening their eyes but Tomei said she went to the doctor and reported mild but incessant itchiness and dryness and was diagnosed with CDE. She turned to RESTASIS because she didnt want to keep worrying about constantly using eye drops. It was as simple as going to the doctor getting a prescription and trying RESTASIS Tomei who stars in the upcoming SpiderMan Homecoming movie told FoxNews.com. She decided to partner with Allergan not only because she found the prescription improved her quality of life but also because of the companys relationship with Guide Dogs for the Blind. On Restasis.com you can take the brands dry eye quiz for every quiz taken Allergan has agreed to donate to the organization. When you visit the website youll see a popup window with a portal to take the quiz. Tomei a selfproclaimed animal lover expressed that the effort is close to her heart. A whole world of freedom opens up for these individuals because you can move about a city like this New York City or anywhere much more easily and the dogs can become your eyes she said. The quiz on Restasis.com can help individuals learn whether theyre a candidate for the drug. If you think you may be suffering from CDE Tomei advised visiting your doctor to receive a diagnosis. To learn more visit Restasis.com https"

"Can estrogen preserve brain function and decrease the risk of Alzheimers disease http when given early in menopause http Newly postmenopausal women who received estrogen via a skin patch had reduced betaamyloid deposits the sticky plaques found in the brains of people with Alzheimers disease a Mayo Clinic http study published this month in the Journal of Alzheimers Disease httpcontent.iospress.comjournalsjournalofalzheimersdiseasePreprintPreprint found. Ultimately these deposits harm neurons leading to cognitive problems. In the study women with APOE e http one form of the most common gene associated with lateonset Alzheimers disease had lower levels of amyloid deposits. This study showed for the first time that the brain amyloid deposition a hallmark of Alzheimers disease is reduced in newly postmenopausal women who received betaEstradiol patch form of hormone therapy says lead author Kejal Kantarci M.D. http a Mayo Clinic radiologist http Women with APOE e who have a greater genetic risk for Alzheimers disease particularly benefited from this therapy. MEDIA CONTACT Susan Barber Lindquist Mayo Clinic Public Affairs newsbureaumayo.edu mailtonewsbureaumayo.edu Menopause is defined as occurring months after a womans last menstrual period and marks the end of menstrual cycles. In the U.S. the average age of menopause is . A rapid decline in estrogen with menopause may be associated with an increased risk of Alzheimers disease risk in women. The Womens Health Initiative study by the National Institutes of Health https NIH reported that menopausal hormone therapy started in women or older increased the risk of dementia. In contrast the multicenter Kronos Early Estrogen Prevention Study http the hypothesis that healthy and younger women would respond to menopausal hormone therapy more favorably. The Mayo Clinic study used data from the Kronos study to determine the effects of menopausal hormone therapy shortly after menopause during the critical window of rapid estrogen depletion five to months past menopause. Researchers investigated the brain amyloid deposition in women ages to who participated in the Kronos trial during this critical window. The researchers used positron emission tomography also known as a PET scan to look for the brain amyloid deposits three years after the trial ended. Of the women received estrogen via a skin patch received estrogen orally and received a placebo. Amyloid deposition was lower in women who received the patch compared to the placebo and the effect was most apparent in women with the APOE e genotype. The oral treatment was not associated with lower amyloid deposition. The authors are seeking funding to perform amyloid PET imaging at eight more Kronos Early Estrogen Prevention study sites around the U.S. If our results are confirmed in the larger group of women this finding has the potential to change the concepts for preventive interventions that drive the Alzheimers disease field today Dr. Kantarci says. It also may have a significant impact on women making the decision to use hormone therapy in the early postmenopausal years. Study coauthors are Val Lowe M.D. http Timothy Lesnick M.S. Nirubol Tosakulwong Kent Bailey Ph.D. http Julie Fields Ph.D. http Lynne Shuster M.D. http Samantha Zuk Matthew Senjem M.S. http_ga... Michelle Mielke Ph.D. http Clifford Jack Jr. M.D. http Walter Rocca M.D. http and Virginia Miller Ph.D. http all of Mayo Clinic and Carey Gleason Ph.D. http of University of Wisconsin School of Medicine and Public Health. This study is funded by the Aurora Foundation to the Kronos Longevity Research Institute and NIH. NS AG AG"

"Im driving through a frozen world where the roads are paved in ice. As I swerve left to avoid a miniature iceberg a red fish flashes at the top of my screen. Im supposed to tap all the red fish that pop up but not the green fish or the blue. And I have to do this without crashing the car. An unidentifiable omnipresent gamemeister says Doing one thing at a time is easy but doing them both at the same time is where the magic happens As I get better at the game my brain is being trained to ignore distractions and stay focused or at least thats the hypothesis of the neuroscientists who designed it http The brain networks that control multitasking overlap with networks that control working memory and attention span. So some scientists believe that by playing this game Project Evo you can improve a range of cognitive skills and by extension relieve a range of symptoms associated with cognitive disorders. Weve been through eight or nine completed clinical trials in all cognitive disorders ADHD autism depression says Matt Omernick http executive creative director at Akili http the Northern California startup thats developing the game. Omernick worked at Lucas Arts for years making Star Wars games where players attack their enemies with light sabers. Now hes working on Project Evo. Its a total switch in mission from dreaming up bestsellers for the commercial market to designing games to treat mental health conditions. The qualities of a good video game things that hook you what makes the brain snap engage and go could be a perfect vessel for actually delivering medicine he says. In fact the creators believe their game will be so effective it might one day reduce or replace the drugs kids take for ADHD. But this kind of goal requires a totally different business model before they can deliver their game to players they first have to go through the Food and Drug Administration the FDA. The first time those three letters were uttered in a group setting everyones like Oooo thats scary do we want to do that Omernick recalls. Silicon Valley companies routinely avoid government regulation if at all possible the process for FDA approval can be slow and expensive. If it says FDA approval needed in the business plan I myself scream in fear and run away says Tim Chang http managing director at Mayfield Fund a venture capital firm. He has never backed a company that wanted to go through the FDA. Most startups can bring a new video game to market in six months. Going through the FDA approval process for medical devices could take three or four years and cost millions of dollars. Thats whats been scary about going the regulatory path Chang says. Youre waiting and waiting and waiting for FDA approval going through all these different clinical tests and you could run out of money easily before you get through that. The worst fear is that the technology will become outdated by the time the FDA process is complete. Tech companies are constantly redesigning their software to keep up with competition and consumer habits. Chang says in four years a game could be obsolete. Its really out of sync with the way we think of product iteration he says. Were more on the order of days and realtime changes where youre pushing out app updates every week. On the other hand Chang admits that going the regulatory route could really pay off. If the FDA gives its stamp of approval doctors could prescribe the game. And that opens the door for insurance companies to pay for it. Then youre going into the land of the big big budgets Chang says. Within in the health care field some executives believe the commercial successes of online games like Angry Birds and Candy Crush could translate into the medical world. They see the potential of these games to not only make money but to save money too. When you look at the percentage of individuals that are playing video games percent and overlay that with the percentage of individuals that have chronic conditions or need some assistance from the medical perspective percent the relationship is pretty strong says Willis Gee director of information technology strategy and innovation at health insurer Cigna. On one level its about competition. The Affordable Care Act has made it a lot easier for people to switch health plans. Cigna has to find ways to stand out. People want to do things that are fun says Gee. So we have to be there with them. It might seem like a strange vision for an industry known best for issuing denial letters. But Gee believes reimbursing patients to play games could cut other health costs by promoting exercise and preventing disease for example or even reducing the amount of expensive drugs people take. As an industry were going to have to reorient ourselves around what it is were really trying to do he says. And if at the end of the day the goal is about improving health then we may need to revisit the way we are quantifying outcomes. Drug companies are keeping an eye on these games too. Pfizer partnered with the Project Evo team to see if the game could help improve the diagnosis of Alzheimers disease. The drug manufacturer believes it could alleviate some of the problems with drug trials helping to make them faster cheaper and more efficient. Right now screening for Alzheimers is subjective. Patients and families fill out forms on mood and attention. The results are often inaccurate. Some of the people recruited for drug trials end up not having Alzheimers at all. Dr. Michael Ehlers http Pfizers chief scientific officer for neuroscience says Project Evo could help them identify better candidates more quickly. Id like to think we could cut down standard clinical trials in size and length of time by half or more he says. In terms of the game replacing drugs someday though Ehlers isnt so sure. He has a different analogy. Its just essentially a digital version of otherwise typical kinds of psychological and cognitive behavioral therapy he says. But Ehlers still thinks game designers should go through the same FDA tests and trials as drug manufacturers. Quite important is that we hold them to the same standard of evidence that they actually work he says. Here Ehlers touches on a broader controversy around games like Project Evo. There are several scientists who say this field is so new that its lacking in good evidence that brain changes actually occur. Randall Engle of the Georgia Institute of Technology believes giving the game FDA approval could hinder good science. Because its a proprietary thing at that point and thats a problem. If it becomes proprietary the only people who can do unfettered research on it are the people who own the procedure he says. But then again thats exactly how it works with drugs."

"NIHsupported researchers are reporting additional details about a widelypublicized study that linked a systolic blood pressure target under mm Hg millimeters of mercury with reduced cardiovascular disease and a lower risk of death. The new analysis singles out adults aged and older and confirms that those with high blood pressure also benefit from the lower pressure target similar to the larger group studied in the earlier research nondiabetic adults aged and older. These additional results of the Systolic Blood Pressure Intervention Trial SPRINT appear in the current online issue of the Journal of the American Medical Association JAMA. The study shows that for adults aged years and older with high blood pressure a systolic blood pressure goal of less than mm Hg reduced rates of cardiovascular events such as heart attack and heart failure as well as stroke by percent. This lower blood pressure goal also reduced the risk of death among this group by percent compared to a target systolic pressure of mm Hg. The benefits of a more aggressive blood pressure intervention occurred in both frail individuals with several impairments or disorders and nonfrail older participants the researchers note. About threefourths of the U.S. population aged and older live with hypertension a leading contributor to cardiovascular disease and death. Although the standard blood pressure treatment goal is mm Hg various medical panels have provided inconsistent guidance about what is the optimal blood pressure goal for the senior population. One group has recommended a target blood pressure of mm Hg for persons aged or older while another recommended a target of mm Hg for adults aged or older. Other experts have supported keeping the standard treatment goal at mm Hg. To address this issue the SPRINT study tapped more than volunteers aged and older assigning half to a target blood pressure of less than mm Hg and half to target of less than mm Hg. While study participants with the lower blood pressure goal appeared to have better cardiovascular outcomes overall the researchers caution all other hypertension patients to talk to their doctor to determine whether this lower goal is best for their individual care. In addition to primary sponsorship by the NHLBI SPRINT is cosponsored by the NIHs National Institute of Diabetes and Digestive and Kidney Diseases the National Institute of Neurological Disorders and Stroke and the National Institute on Aging. WHO Lawrence Fine M.D. chief of the Clinical Applications and Prevention Branch at NHLBI and a coauthor of the study is available to comment on the findings and implications of this research. CONTACT For more information or to schedule an interview please contact the NHLBI Office of Science Policy Engagement Education and Communications at or nhlbi_newsnhlbi.nih.gov mailtonhlbi_newsnhlbi.nih.gov link sends email. About the National Heart Lung and Blood Institute NHLBI NHLBI a part of the National Institutes of Health NIH plans conducts and supports research related to the causes prevention diagnosis and treatment of heart blood vessel lung and blood diseases and sleep disorders. The Institute also administers national health education campaigns on women and heart disease healthy weight for children and other topics. NHLBI press releases and other materials are available online at http About the National Institutes of Health NIH NIH the nations medical research agency includes Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic clinical and translational medical research and is investigating the causes treatments and cures for both common and rare diseases. For more information about NIH and its programs visit http NIH...Turning Discovery Into Health"

"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"

"The diet drug Qnexa helps obese people with weightrelated medical conditions to lose more weight than those who take a dummy pill and could allow some to scale back on medications for diabetes high blood pressure or cholesterol according to a new study http published online in the Lancet http Only this study is not so new and its findings may be less weighty than might be concluded with its publication in this respected medical journal. Qnexa an investigational weightloss drug that combines the anticonvulsant topiramate http with the shortterm diet drug phentermine httpvsearch.nlm.nih.govvivisimocgibinquerymetavAprojectmedlineplusqueryphenterminexy was denied FDA approval httparticles.latimes.comoctnewslahebqnexa last October. At that time the FDA asked Vivus the company sponsoring Qnexas application for market approval to conduct further research on the drugs safety. This newly published article details one of two clinical trials that were evaluated by the FDA before the agency decided to deny approval for Qnexa in October . When the FDAs staff scientists combined the results of this study with a second study both funded by Vivus of Mountain View Calif http they concluded that the weightloss difference between those taking Qnexa and those taking a placebo was of nominal statistical significance http In both the Lancet article and the accompanying press release the secondary effects of subjects weight loss with Qnexa were highly touted The findings published Online First in the Lancet ... suggest that this promising new treatment has additional metabolic benefits the press release describing the study says. The authors write Most importantly weight loss achieved with phentermine and topiramate was sustained during weeks with improvements in blood pressure lipids glycaemia and inflammatory markers. In its assessment of those improvements in a June memorandum last year the FDAs scientists were not quite as breathless The groups treated with Qnexa they wrote had the expected improvements in blood pressure lipids and glycemia. The Lancet study does have some additional data not reviewed by the FDA and not entirely typical for such an article comparisons between Qnexas effectiveness for weight loss and that of two other drugs vying for the potentially vast U.S. market httparticles.latimes.comdecnewslahebdietdrug for weightloss drugs. These other weightlossdrug candidates commercially known as Lorcaserin and Contrave havent won FDA approval either but both remain under consideration. In a box labeled research in context the authors offer a comparison that is certainly not apples to apples but which may give Qnexa some competitive edge In studies performed by other researchers using different populations of subjects under different circumstances the authors of the Lancet study note Qnexa promoted greater weightloss than Contrave Lorcaserin or Orlistat http a fatblocking drug long on the market. The study described in the Lancet was funded by Vivus. Three of its seven authors are employees of Vivus a fourth was an employee of the contract research organization that coordinated the study for Vivus. The lead author has served as a consultant to Vivus and the second author acknowledged receiving donations honoraria consulting fees or grants from Vivus as well as several other pharmaceutical firms with interests in weightloss drugs. In denying Vivus approval to market Qnexa in October the FDA asked the company to extend the trial described in the Lancet article and to submit further findings on Qnexas effect on subjects heart function as well as on its safety for use in women who might become pregnant."

"As a young girl Rachel Brathen lived with crippling back pain httpabcnews.go.comtopicslifestylehealthbackpain.htm. Born with scoliosis httpabcnews.go.comtopicslifestylehealthscoliosis.htm a curvature of the spine she was later in a car accident then a whitewater rafting accident that made her back problems worse. I had so much pain that I would wake up and reach my arm out to touch my alarm and something would just snap the yearold who now lives in Aruba httpabcnews.go.comtopicsnewsaruba.htm said. Why Even Vaccinated People Can Catch the Measles httpabcnews.go.comHealthvaccinatedpeoplecatchmeaslesstoryid Scientists Crack the Code on How to UnBoil a HardBoiled Egg httpabcnews.go.comHealthscientistscrackcodeboilhardboiledeggstoryid Join the Yoga and Health Tweet Chat Today at PM ET httpabcnews.go.comHealthWellnessdrbesserslivetwitterchatjoinstoryid When she was a teen doctors recommended surgery to straighten her spine. Both her aunt and grandmother also were diagnosed with scoliosis. Her aunt opted for the back surgery which helped alleviate pain but also left her with very limited movement in her spine. Then a friend suggested Brathen try yoga httpabcnews.go.comtopicslifestylehealthyoga.htm. She decided to try a few classes before undergoing the knife. More than million people practice yoga in the United States according to the Sporting Goods Manufacturers Association. Many of them practice to improve flexibility and find pain relief according to the Yoga Journal. But as Dr. Richard Besser ABC News chief health and medical editor noted its difficult to pin down whether yoga is effective at easing symptoms of those who have back pain. There are many types of yoga and so many different causes of back pain he said. Despite the lack of conclusive research Besser said there is some recent evidence to suggest that people with chronic lowback pain who do a carefully adapted set of yoga poses may experience less pain and improve their ability to walk and move. In one randomized controlled trial published in the Annals of Internal Medicine back pain patients who learned yoga had better back function and were better able to manage their pain. Another study in the same journal showed that yoga improved disability from chronic back pain more than exercise httpabcnews.go.comtopicslifestylehealthcardiovascularexercise.htm or selfcare instructions. There is also a close relationship between yoga and stress so taking yoga might reduce stress and in turn provide some relief to someone with a tense achy back noted Dr. Amit Sood professor of medicine at the Mayo Clinic httpabcnews.go.comtopicslifestylehealthmayoclinic.htm in Rochester Minnesota httpabcnews.go.comtopicsnewsminnesota.htm. But as good as yoga may be for soothing stress and a sore back Sood recommended getting medical clearance first and taking it slow and easy to start. Thats exactly what Brathen did. She started with gentle restorative classes that focused on improving the core strength of her middle muscles. Little by little she noticed the pain was less intense and less frequent. She said it took years to move from a slow meditative practice to more rigorous poses. Today she is not only nearly pain free she is able to do advanced moves like handstands and acrobatic arm balances. Brathen said she is so grateful for her yoga practice she became an instructor. Now she travels the world teaching yoga and sharing her story. She started a social media challenge with the hashtag yogaeverydamnday that has . million fans on Instagram httpabcnews.go.comtopicsbusinesstechnologyinstagram.htm. But she said yoga has done more for her than just heal her lower back. Yoga helps with a feeling of wellbeing on so many levels she said. The world could benefit more from people with flexible hearts than flexible bodies. Tweet Chat on the health benefits of yoga today at PM ET httpabcnews.go.comHealthWellnessdrbesserslivetwitterchatjoinstoryid Has your mind body and spirit been helped in some way by yoga Join our tweet chat today on the health benefits of yoga at p.m. ET and share your story. Dr. Richard Besser ABC News chief health and medical editor will moderate. Joining is easy. Heres how httpabcnews.go.comHealthWellnessdrbesserslivetwitterchatjoinstoryid. Additional reporting by ABC News Liz Neporent."

"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"

"A new insomnia drug helped people get a bit more shuteye in a lab study researchers report. The drug known as suvorexant is being developed by Merck Research Laboratories which funded and conducted the study. The medication is not available yet but the U.S. Food and Drug Administration is reviewing it for possible approval the researchers said. In the United States about percent of people say they have chronic insomnia according to the U.S. Centers for Disease Control and Prevention. There are sleep aids on the market but they do not work for everyone and they can have side effects that include sleepwalking daytime drowsiness and confusion. Suvorexant works differently from those drugs zeroing in on specific brain chemicals involved in the ability to sleep explained study author Dr. William Herring executive director of clinical research at Merck. The study published online Nov. and in the Dec. print issue of the journal Neurology included healthy adults with primary insomnia which means it wasnt caused by an underlying physical or mental health problem. All of the patients spent four weeks on one of four doses of suvorexant and another four weeks on placebo pills. They had their sleep monitored in a sleep lab on their first night with each treatment and then came back again after four weeks. Overall Herrings team found people slept better with the drug although the improvement was not dramatic. At the outset when patients spent eight hours in bed they were typically asleep for percent of that time. One day on suvorexant boosted that by anywhere from percent to percent relative to the placebo. Between and fewer minutes were spent awake during those sleep periods. There was still a benefit four weeks later. One expert pointed out however that the benefit was small. The amount of additional sleep was not tremendous said Dr. Carl Bazil director of the division of epilepsy and sleep at New YorkPresbyterian HospitalColumbia University Medical Center. The effect was essentially comparable to what has been seen with other sleep medications said Bazil who was not involved in the research. But he said suvorexant is seen as a potentially important development in the world of sleep medicine because the drug blocks specific brain chemicals called orexins which help keep people awake. Standard sleep medications work more widely throughout the brain Bazil explained which is why they can have a host of side effects. The way suvorexant works makes a lot of sense Bazil said. The hope is that it will help some people who havent responded to other drugs and have fewer side effects. Its promising news Bazil added that there were no serious side effects in this study. The most common side effects were sleepiness reported by about percent of patients on the two higher doses of suvorexant headache reported by about percent dizziness and abnormal dreams percent. There are still many questions including whether the drug would benefit people with insomnia due to a health condition which doctors call secondary insomnia. The study also excluded adults aged or older an age group commonly affected by insomnia. But Herring said seniors were part of a larger month trial and Merck has submitted those results to the FDA. Another sleep specialist said the findings show some potential benefit from suvorexant but he cautioned insomnia sufferers against relying completely on any drug. Medication can be important said Dr. William Kohler who directs the Florida Sleep Institute in Spring Hill. But in the long run the best methods for treating insomnia are behavioral techniques. Kohler said cognitive behavioral therapy where people learn to change the thoughts and habits that affect their sleep quality is a proven way to manage insomnia. For most people he said medication should be a temporary treatment behavior change is the longterm fix. Bazil agreed I look at most people with insomnia as someone who developed bad sleep habits. A drug ideally used for a short time may help encourage sleep and get people on the right track Bazil said. But those bad sleep habits youve got to address them too he added. The problem Kohler noted is that we dont want to make behavior changes. We want to pop a pill. More information Learn more about insomnia and good sleep habits from the National Sleep Foundation http SOURCES Carl Bazil M.D. Ph.D. director division of epilepsy and sleep New YorkPresbyterian HospitalColumbia University Medical Center New York City William Kohler M.D. medical director Florida Sleep Institute Spring Hill Fla. William Herring M.D. Ph.D. Merck Sharp Dohme Corp. Whitehouse Station N.J. Dec. Neurology"

"A computerized brain training program cut the risk of dementia among healthy people by percent U.S. researchers said on Sunday in reporting an analysis of the results of a year study. The preliminary findings presented at the Alzheimers Association International Conference in Toronto are the first to show that any kind of intervention could delay the development of dementia in normal healthy adults. To date cognitive psychologists and neuroscientists have largely rejected evidence that computerbased cognitivetraining software or brain games have any effect on cognitive function. The new findings would be quite promising if they hold up through peer review and publication in a scientific journal said Dr. John King an expert in social research at the National Institute of Aging. The institute is part of the National Institutes of Health which funded the study. King worked on the original clinical trial on which the new analysis is based. The study known as Active examined the effects of cognitive training programs on healthy older adults. Participants were divided into three groups. One got training for memory improvement one for reasoning and one with computerized training in speedofprocessing. In the speed training which emphasized visual perception individuals were asked to identify objects on a screen quickly. The program got harder with each correct answer. Participants had onehour training sessions conducted in a classroom setting over five weeks. Some received four additional booster sessions one year after the original training and four more two years after that. Scientists measured cognitive and functional changes immediately and at one two three five and years after the training to see if it affected how participants performed daily tasks. Results of that study published in found modest benefits in the reasoning and speedofprocessing groups but not memory. Sponsored The new analysis was by Dr. Jerri Edwards of the University of South Florida whose mentor Dr. Karlene Ball of the University of Alabama at Birmingham sold her rights to the program to Posit Science. Edwards also was a paid consultant for the company for part of . The program is now incorporated in Posit Sciences BrainHQ.com brain training program. Edwards did a secondary analysis of the year data looking at the time it took individuals to develop dementia. She found that the group that did speed training showed percent less risk of dementia relative to the control group while the memory and the reasoning interventions offered no such benefit. People who completed or more speed training sessions were at percent less risk for developing dementia over the years of the study Edwards said. At first blush thats kind of a big deal Mayo Clinic Alzheimers expert Dr. Ronald Petersen said. This may even be clinically relevant. In a group of nearly neuroscientists and cognitive psychologists led by researchers at Stanford Universitys Center on Longevity and the Berlin Max Planck Institute for Human Development signed a letter saying there was little evidence of such results from brain games. The letter was in response to heavy marketing by companies touting the benefits of their programs based on scant scientific data. Edwards said she was frustrated with the scientific debate which is one reason she agreed to present her findings before they were published. Im sick of our studies being ignored she said. King said the training offered in the program was slightly different from the current Posit Science offering and that it was unclear whether speed training would help people who are already at risk for dementia. Its a promising result from an interesting data set he said. I do think we will know more after the paper is reviewed."

"A onetime treatment with Luxturna the first US Food and Drug Administrationapproved gene therapy for an inherited disorder will cost per eye. Spark Therapeutics Inc. the Philadelphiabased maker of voretigene neparvovec announced Wednesday in a statement httpir.sparktx.comnewsreleasesnewsreleasedetailssparktherapeuticsannouncesfirsttheirkindprogramsimprove that it reached an agreement in principle with Harvard Pilgrim and affiliates of Express Scripts to make the onetime treatment available to patients with a rare genetic defect that often leads to blindness. The mutation affects both eyes usually at the same pace so most patients would need treatment for both eyes a Spark Therapeutics spokeswoman said. In some cases the gene therapy will be available under an outcomesbased rebate arrangement. The company also stated that its proposal to the Centers for Medicare and Medicaid Services the government program that covers about million Americans would allow installment payments for the drug. For a onetime therapy like Luxturna a nontraditional payment and distribution model is necessary to ensure needs of all parties patients payers and providers are addressed said Jennifer Luddy a spokeswoman for Express Scripts. At least one patient advocate disagrees. The new payment models announced today are merely a way to disguise a price that is simply too high David Mitchell president and founder of Patients For Affordable Drugs said in a statement https Spark Therapeutics is charging as much for Luxturna as they think they can get away with. Spark Therapeutics CEO Jeff Marrazzo coauthored a recent blog post in the journal Health Affairs https that said the current payment system accustomed to ongoing treatment of chronic diseases creates significant challenges for gene therapies and other treatments. Onetimeonly treatments for rare genetic disorders are still unique he noted. The drug is intended for patients with retinal dystrophy due to a mutation of the RPE gene. This rare genetic defect causes severe visual impairment beginning in infancy and can eventually lead to blindness. The company believes the total population in the US Europe and select additional markets in the Americas and AsiaPacific is up to approximately individuals who have the mutation targeted by Luxturna explained Monique da Silva a spokeswoman for Spark Therapeutics. The drug will be available in the United States in early spring with an estimated to people in the US standing to benefit from this treatment according to Spark. Luxturna is only the third gene therapy approved for use in the United States two others were also approved in . This is the first to correct an inherited genetic mutation. Luxturna is a liquid that is injected directly into the eye with a microscopic needle during a surgical procedure. The drug supplies a third gene a normal RPE gene to cells in the retina a layer of tissue lining the back of the eye. This third version of the gene does not remove or replace the two mutated genes causing the disease which remain inside the cells. However the normal gene delivered by the treatment is able to function within the retinal cells and correct vision problems. In the phase clinical trial out of participants who received the gene therapy demonstrated a gain in functional vision as assessed by a mobility test performed in a maze according to the company. Risks of the treatment include cataracts elevated eye pressure retinal tears and holes and inflammation. The companys offer of unusual payer models including rebates and installment payments will help ensure patients individual financial situation does not hinder access to treatment da Silva said. New technologies such as gene and cell therapies hold out the potential to transform medicine FDA Commissioner Dr. Scott Gottlieb said in a statement https announcing the August approval of Kymriah considered to be the first gene therapy to be approved for the US market. Follow CNN Health on Facebook and Twitter See the latest news and share your comments with CNN Health on Facebook https and Twitter httpstwitter.comcnnhealth. Kymriah is a leukemia treatment made by pharmaceutical giant Novartis. Similar to Luxturna Kymriah is a onetime treatment and its price tag is . However Novartis said this price will not be charged to patients who do not respond within a month of treatment."

"The question Millions of people take a lowdose aspirin daily in hopes of reducing their chances of having a heart attack. For women might aspirin also help prevent breast cancer This study The researchers analyzed data on women most in their early s who had no history of breast cancer. About percent of the women reported taking a lowdose aspirin milligrams percent took ibuprofen percent took fullstrength aspirin mg and about percent took a COX inhibitor or another nonsteroidal antiinflammatory drug NSAID. All were taking the medication at least three times a week. Over seven years women got a breastcancer diagnosis. Those taking lowdose aspirin were percent less likely to have developed any type of breast cancer compared with women who took no NSAID. They were percent less likely to have developed the most common type breast cancer that is hormonereceptorpositive and HERnegative. The study did not find similar links between regulardose aspirin or other NSAIDs and the risk for breast cancer. Certain adults should take a daily baby aspirin expert panel says https_term.fdd Who may be affected Women. About of every women in the United States will develop breast cancer at some point. Those who take a daily lowdose aspirin also called a baby aspirin usually do so to prevent cardiovascular disease the leading cause of death for women older than . Aspirin has been shown to help keep blood from clotting which can help prevent heart attacks and ischemic stroke the type caused by a blocked blood vessel in the brain. However aspirin can increase the risk for internal bleeding so women should talk with their doctors before starting a lowdose aspirin regimen for any reason. Caveats The researchers suggested that the difference in results between low and regulardose aspirin may have been attributable to most women taking lowdose aspirin more often than three times a week even daily for cardiovascular protection as opposed to moresporadic use of regulardose aspirin for pain relief. Hormone therapy and alcohol use were more prevalent among the participants than normal both are considered risk factors for breast cancer and may have affected the results. Data on aspirin and other NSAID usage came from the womens responses on questionnaires. Most of the participants were white. Find this study May in Breast Cancer Research breastcancerresearch.biomedcentral.com httpsurldefense.proofpoint.comvurluhttpA__breastDcancerDresearch.biomedcentral.com_articles_._sDDDdDwQFAgcRAhzPLrCAqeJdrcQiUVEwFYoMRqGDAXQ_puwtYjgrGgivkKNHTVnLjjXizEdTOTAeiQkcgtAvxxZaomsqDhoDQuZ_NPBOAolYDwpIqzPwmGdAwhNNsIEuxJYwQGZEtz_vYCsFwIADLCvjDQXFNUUge. Learn more about Information on breast cancer is available at cancer.gov httpcancer.gov. Learn more about the benefits and risks of aspirin at heart.org httpheart.org search for aspirin. The research described in Quick Study comes from credible peerreviewed journals."

"A new study suggests a way to help men with early lowrisk prostate cancer avoid being overtreated for a disease that in most cases will never threaten their lives. It found that a drug can slow the growth of these tumors in men who opt to be monitored instead of having treatment right away. This is the first time that a drug for treating enlarged prostates also has been shown to help treat prostate cancer in a rigorous study. It may persuade more men to choose active surveillance or watchful waiting instead of rushing to have treatments that can leave them with urinary or sexual problems httpsmedicalxpress.comtagssexualproblems doctors say. However the results also show that most of these men do very well with no treatment at all. Were identifying men who are not likely to need even a pill said Dr. Maha Hussain a University of Michigan cancer specialist. But Americans fear cancer so much that they want some kind of treatment and underestimate the financial and medical risks of treating lowrisk cases she added. She is program chair of a cancer conference in Florida where the study will be presented later this week. Results were released Tuesday in a telephone news conference sponsored by the American Society for Clinical Oncology. Roughly half of the men diagnosed each year in the United States with prostate cancer have lowrisk disease PSA blood levels under and low tumor aggressiveness scores. The American view of cancer is that its always best to treat so about percent of these men choose to have that right away said Dr. Otis Brawley a prostate cancer expert who is chief medical officer of the American Cancer Society. In Europe though most choose watchful waiting close monitoring and treatment only if the cancer progresses or causes pain or other problems. Doctors know that drugs that shrink the prostate GlaxoSmithKline httpsmedicalxpress.comtagsglaxosmithkline PLCs Avodart and Merck Co.s Proscar can help prevent prostate cancer. But federal health advisers recently recommended against taking them for this purpose because of potential risks. The new study tested Avodart not to prevent cancer but to prevent the progression of it in men who already have the disease which may be a much better use of such drugs said the studys leader Dr. Neil Fleshner of University Health Network and Princess Margaret Hospital in Toronto. We know the vast majority of these men are not destined to die from that cancer and wanted to see if Avodart could make watchful waiting safer Fleshner said. The study enrolled about men in the United States and Canada with lowrisk cancer that was confirmed by a biopsy. They were given daily Avodart or dummy pills and new biopsies and three years later. Prostate cancer got worse in percent of men taking Avodart and percent of those on dummy pills. Final biopsies showed no signs of cancer in percent of men on Avodart versus percent of those on dummy pills. Doctors say this last result shows how tiny many of these cancers were to start with that they couldnt even be found when new biopsies were done. Doctors dont think Avodart can cure cancers but it seems to suppress it said Dr. Howard Sandler a prostate cancer httpsmedicalxpress.comtagsprostatecancer specialist at CedarsSinai Medical Center in Los Angeles. He had no role in the study but is involved with the cancer conference. Researchers gave no details on Avodarts side effects but said no new ones appeared in the study. Avodart and Proscar are known to cause sexual problems for some men but many men httpsmedicalxpress.comtagsmen over have this anyway and only about percent more do when taking these drugs said Brawley who helped test Avodart for cancer prevention. The new study was sponsored by Avodarts maker GlaxoSmithKline. Avodart and Proscar cost about a pill generic versions of Proscar are available for about . Proscar is similar to Avodart but has not been tested for treating early cancer as this study did. Sandler said Avodart might relieve some mens anxiety about monitoring their disease and may make them more comfortable not having immediate treatment. If it was me Id choose active surveillance he said. Avodart has the potential to be an important help. More information Prostate cancer info http and tinyurl.comASCOanswers httptinyurl.comASCOanswers Risk calculator tinyurl.comriskcalculator httptinyurl.comriskcalculator"

"People with stage III colon cancer who regularly eat nuts are at significantly lower risk of cancer recurrence and mortality than those who dont according to a new large study led by researchers at Yale Cancer Center. The findings were published today in the Journal of Clinical Oncology. The study followed participants in a clinical trial for a median of . years after they were treated with surgery and chemotherapy. Those who regularly consumed at least two oneounce servings of nuts each week demonstrated a improvement in diseasefree survival and a improvement in overall survival. Further analysis of this cohort revealed that diseasefree survival increased by among the subgroup of nut consumers who ate tree nuts rather than peanuts said Charles S. Fuchs M.D. director of Yale Cancer Center and senior author of the study. Tree nuts include almonds walnuts hazelnuts cashews and pecans among others. In contrast peanuts are actually in the legume family of foods. These findings are in keeping with several other observational studies that indicate that a slew of healthy behaviors including increased physical activity keeping a healthy weight and lower intake of sugar and sweetened beverages improve colon cancer outcomes said Temidayo Fadelu M.D. a postdoctoral fellow at DanaFarber Cancer Institute and lead author of the paper. The results highlight the importance of emphasizing dietary and lifestyle factors in colon cancer survivorship. Additionally the researchers emphasized the study highlighted connections between biological mechanisms that worsen disease not just in colon cancer but in certain chronic illnesses such as type diabetes. Many previous studies have reported that nuts among other health benefits may help to reduce insulin resistance a condition in which the body has difficulty processing the insulin hormone. Insulin resistance leads to unhealthy levels of sugar in the blood and is often a predecessor to type diabetes and related illnesses. Earlier research among patients with colon cancer has revealed worse outcomes among those with lifestyle factors such as obesity lack of exercise and a diet with high levels of carbohydrates that heighten insulin resistance and quickly raise levels of blood sugar. These studies support the hypothesis that behaviors that make you less insulinresistant including eating nuts seem to improve outcomes in colon cancer Fuchs said. However we dont know yet what exactly about nuts is beneficial. Nuts also might play a positive role by satisfying hunger with less intake of carbohydrates or other foods associated with poor outcomes Fuchs noted. Patients may not be eating nuts due to concerns about the high fat content said Fuchs. For example a oneounce serving of about almonds holds about calories including grams of fat. People ask me if increasing nut consumption will lead to obesity which leads to worse outcomes he said. But whats really interesting is that in our studies and across the scientific literature in general regular consumers of nuts tend to be leaner. Dietary changes can make a difference. An earlier analysis of diets in the same patient cohort by Fuchs and his colleagues found a significant link between coffee consumption and reduced recurrence and mortality in colon cancer. When Fuchs advises his patients about lifestyle choices first and foremost I talk about avoiding obesity exercising regularly and staying away from a highcarbohydrate diet he said. Then we talk about things like coffee and nuts. If you like coffee or nuts enjoy them and if you dont there are many other helpful steps you can take. Overall we are working to apply the same rigorous science to the understanding of diet and lifestyles in the colon cancer patient population that we apply to defining new drugs Fuchs said. Cocorresponding authors on the paper are Jeffrey Meyerhardt M.D. of DanaFarber and Ying Bao M.D. of Brigham and Womens Hospital. Lead funding for the research was provided by the National Cancer Institute. Support also came from private sponsors including Pfizer Oncology and the International Tree Nut Council Nutrition Research Education Foundation. The private sponsors did not participate in the design conduct or analysis of the study or in review or approval of the paper."

"For the millions of Americans with chronic low back pain a silver bullet to alleviate the condition has yet to be identified a new study suggests. Reviewing studies comparing spinal manipulative therapy SMT to other treatments such as medication exercise or physical therapy researchers from the Netherlands found that SMT appears to be no better or worse than other options at relieving back pain longterm. The analyses indicated that SMT which involves manual manipulation of the spine and surrounding muscles has only a shortterm impact on pain relief although it eases pain faster than other treatments. In short no single therapy is better than another although some individuals are likely to have more success with one therapy than another said study author Sidney Rubinstein a research fellow at VU University Medical Center in Amsterdam. Current studies are focusing on which subjects are more likely to benefit from spinal manipulation exercise or other therapies he added. Spinal manipulation should be considered a viable treatment option for those with nonspecific chronic low back pain. The study was recently published in the journal Spine. More than patients were included in the compilation of results which the study authors said were sparse in data indicating participants overall recovery quality of life and ability to return to work. The studies also varied in quality with only nine of considered low in bias according to background information accompanying the study. In all evaluations patients were randomly assigned to SMT or another comparison treatment including active treatments such as exercise or inactive placebo treatments. About twothirds of the studies were not included in a previous review published in and all patients had suffered from lower back pain for weeks or longer. While chiropractors often perform SMT on patients it is also administered by physical therapists and osteopaths. But which treatment is right for any patient depends not only on their specific pain but their doctors recommendations and their own comfort level with various options said Stephen Perle a spokesman for the American Chiropractic Association. The cost of SMT sessions varies widely depending on the region Perle said. Nobody has the answer at this time Perle said. I guess people in almost every profession like to say We have a compelling treatment and it will work almost every time but thats just not the case. With low back pain there are many reasons people dont get better added Perle also a professor of clinical sciences in the College of Chiropractic at the University of Bridgeport in Connecticut. So the finding was not unexpected. An unrelated study of patients with low back pain published July in Annals of Internal Medicine suggested that massage may be better than medication or exercise for shortterm pain relief. Seattle researchers found that those who received either relaxation massage or structural massage which involved manipulation of muscles and ligaments had less pain and better functioning for up to a year compared to those getting usual medical care which included medication and physical therapy. More information The U.S. National Institute of Neurological Disorders and Stroke has more information about low back pain. SOURCES Sidney Rubinstein D.C. Ph.D. research fellow Institute for Research in Extramural Medicine VU University Medical Center Amsterdam the Netherlands Stephen M. Perle D.C. spokesman American Chiropractic Association and professor clinical sciences College of Chiropractic University of Bridgeport Conn. June Spine"

"Amsterdam The Netherlands A test that measures the levels of five chemicals in the breath has shown promising results for the detection of cancers of the oesophagus and stomach in a large patient trial presented at the European Cancer Congress . Together stomach and oesophageal cancer account for around . million new cancer diagnoses each year worldwide . Both tend to be diagnosed late because the symptoms are ambiguous meaning the fiveyear survival rate for these two types of cancer is only . The new research involving more than patients showed that the test could diagnose cancer with an overall accuracy of . Dr Sheraz Markar an NIHR Clinical Trials Fellow from Imperial College London under the supervision of Professor George Hanna told the Congress At present the only way to diagnose oesophageal cancer or stomach cancer is with endoscopy. This method is expensive invasive and has some risk of complications. A breath test could be used as a noninvasive firstline test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment and better survival. The trial was based on the results of previous research that suggested differences in the levels of specific chemicals butyric pentanoic and hexanoic acids butanal and decanal between patients with stomach or oesophageal cancer and patients with upper gastrointestinal symptoms without cancer. The new research aimed to test whether this chemical signature that seemed to typify cancer could be the basis of a diagnostic test. In the new study the research team collected breath samples from people at St Marys Hospital Imperial College Healthcare NHS Trust University College London Hospital and the Royal Marsden Hospital London. Of these had been diagnosed with stomach or oesophageal cancer and showed no evidence of cancer when they had an endoscopy. All the samples were analysed with a technique called selected ion flowtube mass spectrometry which is able to accurately measure small amounts of different chemicals in mixtures of gases such as breath. Researchers measured the levels of the five chemicals in each sample to see which ones matched to the chemical signature that indicated cancer. The results showed that the test was accurate overall with a sensitivity of and a specificity of . This means that not only was the breath test good at picking up those who had cancer sensitivity it was also good at correctly identifying who did not have cancer specificity. Dr Markar said Because cancer cells are different to healthy ones they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the oesophagus and stomach and which do not. However these findings must be validated in a larger sample of patients before the test could be used in the clinic. Over the next three years the researchers will continue with a larger trial using the test with patients who are being given an endoscopy for gastrointestinal symptoms but not yet diagnosed with cancer. This will assess the ability of the test to pick up cases within a group that is likely to contain only a small percentage of cancers. The team is also working on breath tests for other types of cancer such as colorectal and pancreatic which could be used as firstline tests in general practice surgeries."

"A new animal study from Beth Israel Deaconess Medical Center Harvard Medical School led by Dr. Christos Mantzoros indicates that a diet containing walnuts may slow colorectal tumor growth by causing beneficial changes in cancer genes. This is the first study that evaluates whether walnut consumption can cause changes to microribonucleic acids miRNA the nucleotides that are involved in altering gene expression. miRNA are the focus of much research in the growing field of epigenetics or the study of how genes may be changed by environmental factors. Our research demonstrates that a walnut diet causes significant changes in the expression profile of miRNAs in localized colorectal cancer tissue and that a walnut diet incorporates protective fatty acids in the colonic tumor either through its direct effects or through additive or synergistic effects of multiple other compounds present in walnuts said Dr. Mantzoros. While future studies are needed were optimistic of the role of miRNAs as biomarkers of disease and prognosis and may demonstrate a potential therapeutic target for colorectal cancer treatment. Researchers conducted the randomized study with two groups of mice. One group was fed the equivalent of two servings ounces per day of walnuts for humans while the second group received a similar control diet with no walnuts. After days researchers found that in walnutfed mice key miRNA that may affect cancer cell inflammation vascularization blood supply and proliferation were positively engaged. The tumors of mice fed the walnutcontaining diet were found to have times the amount of total omega fatty acids including plantbased alphalinolenic acid ALA in the tissue compared to the mice fed the control diet. The study results found that a smaller tumor size was associated with greater percentage of omegas in tumor tissues suggesting that ALA may provide a protective benefit. Tumor growth rate was also significantly slower in the walnut group compared to the control group. As this study was conducted on animals results cannot yet be implied for humans. ALA is an essential fatty acid critical to various body processes and is known to reduce inflammation. Walnuts are the only nut that contain a significant source of alphalinolenic acid ALA . grams per ounce. Walnuts also contain a variety of antioxidants . mmolounce and numerous vitamins and minerals. Colorectal cancer is the third most common type of cancer worldwide and is second to only lung cancer as the leading cause of death in Western Countries. Diet has been shown to be a modifiable risk factor in preventing many types of cancer including colorectal cancer. It is estimated that percent of colorectal cancer in men and percent in women can be prevented by diet and other lifestyle changes. An article detailing these findings Dietary Walnut Suppression of Colorectal Cancer in mice mediation by miRNA patterns and fatty acid incorporation has been published in the Journal of Nutritional Biochemistry. This study was supported from a grant by the American Institute for Cancer Research and the California Walnut Commission. About California Walnut Commission The California Walnut Commission established in is funded by mandatory assessments of the growers. The Commission is an agency of the State of California that works in concurrence with the Secretary of the California Department of Food and Agriculture CDFA. The CWC is mainly involved in health research and export market development activities. For more industry information health research and recipe ideas visit . NonDiscrimination Statement The California Walnut Commission CWC prohibits discrimination in all programs and activities on the basis of race color national origin age disability sex marital status familial status parental status religion sexual orientation genetic information political beliefs reprisal or because all or part of an individuals income is derived from any public assistance programs. Persons with disabilities who require alternative means for communication of program information Braille large print audiotape etc. should contact the CWC offices at . To file a complaint of discrimination write to USDA Director Office of Civil Rights Independence Avenue S.W. Washington D.C. or call voice or TDD. CWC is an equal opportunity employer and provider. The California Walnut Commission offices are located at Parkshore Dr. Ste. Folsom CA Resources . World cancer research fundamerican institute for cancer research. Food nutrition physical activity and the prevention of cancer A globalperspective. AICR . . Platz EA Willett WC Colditz GA et al. Proportion of colon cancer risk that might be preventable in a cohort of middleaged us men. Cancer Causes Control. . . Tsoukas MA Ko BJ Witte TR Dincer F Hardman WE Mantzoros CS. Dietary walnut suppression of colorectal cancer in mice Mediation by miRNA patterns and fatty acid incorporation. J Nutr Biochem. Apr . Epub ahead of print"

"Dermira Inc said its experimental topical therapy for excessive underarm sweating was successful in two latestage studies bringing it one step closer to providing an easytouse therapy for the often embarrassing condition. While the function of sweating is to prevent overheating those affected sweat even when the body does not need cooling. Existing therapies for excessive underarm sweating also called axillary hyperhidrosis offer limited effectiveness and can be expensive. The first line of defense are antiperspirants. Next patients can try costlier alternatives such as botox injections a device called miraDry that delivers electromagnetic energy to decompose sweat glands or laser therapy to destroy them. Sufferers can also opt for localized surgery like liposuction to remove or injure sweat glands. Oral medicines can be used to systemically limit sweating. For instance a class of drugs called anticholinergics are commonly used offlabel for this purpose but they are linked with the risk of dementia. Based on the most recent estimates about . million Americans have some form of excessive sweating including palms feet underarms or head and about half of this population suffer from the underarm form said Dermira spokeswoman Erica Jefferson in an interview ahead of the data readout. The Menlo Park Californiabased companys shares were up percent at . in extended trading on Wednesday. About twothirds of the total enrolled in the two trials for the companys topical treatment DRM were treated with wipes containing DRM while the rest were not. In the first trial a significant improvement in the severity of sweating was seen in . percent of the patients treated with the drug compared with . percent patients in the control group on a scale designed by the company. In the second trial a significant improvement was seen in . percent of the drugtreated patients compared with . percent in the control group. Dermira said it had expected to apply for marketing approval for the drug in the second half of subject to completion of the drugs longterm safety trial. Reporting by Natalie Grover and Shailesh Kuber in Bengaluru Editing by Maju Samuel Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Researchers hope a new treatment developed in the United Kingdom will prove vital in controlling future flu pandemics such as HN swine flu bird flu as well as ending the need for annual flu jabs. Developed by scientists at Oxford University the new vaccine works by targeting protein cells inside the influenza A virus instead of current vaccines that attack proteins on the outside of the flu virus. According to Sarah Gilbert head of the project at Oxfords Jenner Institute this method is effective because proteins inside the virus are far more similar across all the influenza strains and are less likely to mutate. In the first successful trial on humans healthy people were vaccinated and infected with the seasonal flu strain along with nonvaccinated volunteers. Flu kills every year. Its not just swine flu. Normally its the very old or very young that die from flu but every year there are deaths from influenza A. Sarah Gilbert from Oxford Universitys Jenner Institute. The results say Gilbert are important in developing a new form of protection that researchers hope could spell the end of flu vaccination supply problems. The most recent global pandemic was the HN flu pandemic in which the estimates of deaths ranged as high as in the U.S. alone according to the Centers for Disease Control and Prevention. Gilbert explained With the swine flu pandemic it took four months before the first doses of the vaccine were available and there was only a small amount available Gilbert explained. It took a further six months before it was possible to vaccinate a large number of people. With this type of vaccine you would at least be able to start using the vaccine as soon as you knew a new pandemic was starting. You could stockpile the vaccine and wouldnt have this wait to make a new pandemicspecific vaccine she said. The vaccine would be an important step in treating seasonal flu not just pandemics. Flu kills every year. Its not just swine flu. Normally its the very old or very young that die from flu but every year there are deaths from influenza A said Gilbert. In the U.S alone its believed about people die from seasonal flurelated causes in an average year according to the CDC. The initial results are positive says Peter Palese professor and chair of microbiology at Mount Sinai School of Medicine New York but more research is needed before the new treatment is approved. I think its a very interesting and very elegant approach and the data so far looks very very good he said. But although the vaccine has been give to humans unfortunately there is no evidence presented to say if it really results in protection against infection. Gilbert agrees more work is required before the vaccine becomes available estimating a wait of at least five year but says the results are a fundamental next step in the treatment of flu. Its fairly certain flu vaccines are going to change a lot in the next few years she said. Whether its this vaccine or another one someone else develops I dont think well be continuing with the type of flu vaccines that we have at the moment."

"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."