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"Scientists have developed a blood test that could identify which people with depression will respond to treatment so that patients can avoid spending months taking antidepressants that do not help them. The experts involved believe the breakthrough could lead to depressed patients receiving personalised treatments that are more likely to relieve their symptoms. The Royal College of Psychiatrists said that if it worked the test could prove to be a key moment in the quest for the holy grail of biological psychiatry. The scientists at Kings College London behind the development claim that their test accurately and reliably predicts whether depressed patients will respond to common antidepressants which could herald a new era of personalised treatment for people with depression. If the test proves effective it is hoped that by measuring patients level of blood inflammation it would identify which of them would benefit from receiving antidepressants soon after their diagnosis to stop their condition worsening. What does depression feel like Trust me you really dont want to know Tim Lott About half of all patients with depression get no benefit from antidepressants the first time they take them and they never work for one in three people. Currently it is impossible to establish who should or should not be given antidepressants or combinations of them. That means that patients are tried on a succession of different drugs for weeks or more and experience prolonged periods of ineffective treatment because their medication does not benefit them. One in six Britons will suffer depression at some point in their life. Last year .m prescriptions for antidepressants were issued in England. Researchers focused on two independent clinical groups of depressed patients on two biological markers that measure inflammation of the blood as heightened levels are associated with poor response to antidepressants. They found that blood test results above certain levels reliably predicted how well patients would respond to commonly prescribed antidepressants. Their findings have been reported in the International Journal of Neuropsychopharmacology. The identification of biomarkers that predict treatment response is crucial in reducing the social and economic burden of depression and improving quality of life for patients said Prof Carmine Pariante from KCLs institute of psychiatry psychology and neuroscience. This study provides a clinically suitable approach for personalising antidepressants therapy. Patients who have blood inflammation above a certain threshold could be directed towards earlier access to more assertive antidepressant strategies including the addition of other antidepressants or antiinflammatory drugs Pariante added. Dr Cosmo Hallstrom a spokesman for the Royal College of Psychiatrists said Finding biological markers for depression and other mental illnesses has been the holy grail of biological psychiatry. Such a finding and a test to back it up would be critical to advancing our understanding of the biological causes of depression. It would accelerate our therapeutic interventions and make them more tailored to the needs of the patient. But further clinical research is needed to see if the findings can be applied in a clinical setting Hallstrom added. Stephen Buckley head of information at the mental health charity Mind said We welcome research which adds to our understanding of treatments and medications that may work for people experiencing mental health problems. These initial findings are interesting but as with all areas of mental health there is still more research to be done. Mental health https problems including depression are estimated to cost bn a year in England. The World Health Organisation has predicted that by depression will be the second biggest cause of health problems in the world."

"Small doses of aspirin can lower the risk of heart attack in people who never had heart disease a new look at the medical evidence shows. But the bloodthinning drug doesnt appear to cut the chances of dying from the disease at least not enough that researchers can say for certain. And experts warn people to consult their doctor before taking the medication which increases the risk of bleeding ulcers. I like to say you have to make the recommendation about aspirin one patient at a time Dr. Michael L. LeFevre who was not linked to the study told Reuters Health. LeFevre worked on the aspirin recommendations from the U.S. Preventive Services Task Force USPSTF a federally supported expert panel. The task force advises that men age to take aspirin to stave off heart attacks as long as the benefit outweighs the risk of bleeding. For women age to aspirin is recommended to prevent strokes with the same caveat. The new work by Alfred Bartolucci of the University of Alabama at Birmingham and colleagues was supported by aspirinmaker Bayer AG. The research team pooled the results of the nine trials that have tested the drug in the prevention of heart disease so far including three that werent part of the USPSTF review. About men and women age and up took part in the studies. Some were healthy and some had diabetes but none had chest pain or other symptoms of an ailing heart. The researchers found a percent reduction in nonfatal heart attacks among participants who took aspirin compared to those who did not. They dont mention how many people actually suffered such a heart attack but an earlier analysis of six of the trials showed that out of every people individuals taking aspirin had heart attacks every year compared to individuals taking placebo pills. On the other hand that analysis also found aspirin increased the rate of bleeding from . to per people per year making the authors conclude the drug was of uncertain net value. Heart disease is the leading killer worldwide and accounts for more than a third of deaths in the U.S. according to the American Heart Association. Every year heart attacks alone kill some Americans. In the current study published in the American Journal of Cardiology the researchers also report small decreases in stroke and death risks with aspirin although those changes might have been due to chance. It refines our knowledge of how beneficial aspirin is Dr. Graham Nichol an expert in emergency care at the University of Washington in Seattle said about the study. I dont think this paper is inconsistent with previous work. Nichols who was not involved in the study said aspirin is clearly beneficial for people whove already had heart disease and that it also seems to help those at high risk. There is not universal agreement on what is high risk he told Reuters Health. In my mind if you have diabetes or multiple risk factors for heart disease such as smoking or obesity it is reasonable to take aspirin. In addition working to eliminate those risk factors by other means will not only slash the risk of heart disease but also a host of other health problems. LeFevre added that while the new study did add extra evidence compared with earlier work it failed to analyze the effects on men and women separately. That muddies the picture because men may see a benefit in the form of fewer heart attacks whereas aspirin appears to lower the risk of stroke in women. We cant tell from the existing study if that is going to hold up or not he said. One recent study has suggested that despite the increase in bleeding ulcers from aspirin the reduction in heart attacks might make the cheap drug costeffective for men over . The question then becomes finding out what your risk of heart attack is in the first place which your doctor can help with. The number of events that you prevent depends on your baseline risk LeFevre concluded. A blanket recommendation that everybody should take an aspirin is not a good idea. SOURCE bit.lyhkVBee httpbit.lyhkVBee American Journal of Cardiology online April . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"When a suspicious lesion shows up in the lungs on a CT scan the first thing your doctor wants to know is whether its cancerous. A specialist will pass a long thin bronchoscope http into your airway in the hope of grabbing a few cells of the growth so they can be examined under a microscope. But some of these lesions or nodules are deep in the small branches of the lungs out of reach of the bronchoscope which is about the diameter of a pen. Other times the results are inconclusive. That has left only two ways to determine whether the abnormality is cancerous inserting a needle through the chest wall and into the tumor or surgically opening a patients chest to find it and remove it if necessary. The first procedure carries a percent risk of collapsing a lung pneumothorax as well as infection. The second is serious surgery that requires general anesthesia and results in the loss of lung tissue. Both are inpatient procedures that carry the cost and other risks of hospitalizations. In about a third of the surgeries the growth turns out to be benign meaning the surgery was unnecessary. But now according to a study published Sunday in the New England Journal of Medicine http_home there appears to be a new much less invasive way of determining whether a growth is malignant. Researchers at Boston University have discovered that the thin epithelial cells that line the entire airway show changes that indicate whether a growth is malignant. With small brushes on the bronchoscope they can take some of those cells and using genomic testing that has been available only in recent years reach a conclusion. Breast cancers predicted to rise by percent by http The study released Sunday showed that the tests were about percent accurate on subjects. A private company has purchased the technology and is making it available to hospitals across the country. Even though lung cancer tends to develop deep in your lung all the cells that line your airway are exposed said Avrum Spira a professor of medicine at Boston University who led the research. They have changes in their genome. Spiras test focuses on messenger RNA the molecules that express genes instructions to cells. He called the technology a canary in the coal mine for lung cancer which kills about people in the United States each year. If the test is negative its accuracy will allow doctors to wait and watch a lesion. If it shows a malignancy a biopsy still would be needed to confirm the cancer. There will still be a small number of biopsies Spira said. But were going to reduce them significantly. Other research is being conducted to find markers for lung cancer though much of it focuses on substances that can be found in the blood Spira said. With the vast majority of lung cancer victims being smokers the epithelial cells show changes that could be tracked once the technology became available he said. The next logical question is whether those changes might be detected early enough to predict and prevent lung cancer. Spira said his team already is working on research to determine whether thats possible. Woman denied bank transaction after chemotherapy erases her fingerprints http The current advance was a long time in coming and shows the difficulty of bringing research from the lab to the consumer. Spira said the initial discovery was made years ago but he couldnt find any private group willing to put up the millions of dollars needed to conduct studies work through the government and academic regulatory process and bring his idea to market. Seven years ago he formed his own company raised venture capital and eventually proved that his idea worked. Now his company has been purchased by Veracyte which will take over the production and marketing of the Bronchial Genomic Classifier. We were adding seconds to a minute to the length of a bronchoscopy Spira said. . . . Even then the regulatory hurdles were significant. We got over them all but they were significant. Correction The original version of this post incorrectly named the company that is distributing the Bronchial Genomic Classifier. This version has been corrected."

"Normally used in dentists offices and hospitals nitrous oxide yes laughing gas https is starting to turn up again in ambulances in some rural areas where medical workers with clearance to provide more traditional painkillers https often arent on board. It gives advanced emergency medical technicians who are a step down from higherlevel paramedics a way to help relieve patients pain and anxiety on what can sometimes be long trips to a hospital. For someone to be in pain for that extended period of time you know we want to try to ease that said Scott Brinkman chief of emergency medical services in Stowe a ski resort town that sees many related injuries and started using nitrous a year ago. Nitrous oxide https equipment has been sold to ambulance crews in at least states in the past three years including Maine New York North Dakota Oregon Texas and Wisconsin according to Henry Schein Medical the sole distributor of the version for ambulances. Nitrous has been more commonly used in ambulances in Europe and Australia. It is also not an opioid a bonus as the country grapples with a drug crisis. Experts have blamed prescription opioids https for spikes in overdoses and some patients simply might not want to be given an opioid or their injury doesnt require something so strong. In Stowe for example a woman who dislocated her shoulder asked not to be given narcotics because she was recovering from addiction Brinkman said. The drug also bridges the gap between a cold pack and narcotics said Michael Chiarella director of operations at Richmond Rescue in Richmond Vermont which also handles many injuries suffered at a nearby ski resort. The drug is delivered by breathing through a mask or tube that the patient holds so they can regulate how much they are getting. Its fastacting and it wears off said Jeremy Oleson an advanced EMT and chief of the fire department in Twin Mountain New Hampshire. Nitrous was used on some ambulances in the s and s until the product line was sold. The portable product is now back on the market with another manufacturer. The renewed use of nitrous on ambulances https comes as some states have begun to allow advanced EMTs which have less training than paramedics to administer it in line with national guidelines. Stowe a largely volunteer squad is adding a unit to a second ambulance this fall at a cost of about plus costs for disposable supplies and some cleaning agents as well as the nitrous cylinders which cost about to refill. Brinkman estimates the drug costs less than per use once the equipment is purchased. Not all is rosy. Nitrous oxide in and of itself has the potential to be used as a recreational drug and can be misused by providers and patients or can be stolen for personal use or sale on the street according to the American Ambulance Association. And while it has its advantages nitrous oxide also can cause nausea vomiting and lightheadedness which could cause complications with some patients said Dr. Edward Yaghmour chairman of the American Society of Anesthesiologists Committee on Obstetric Anesthesia. The gas cannot be used in patients with head injuries or who have abdominal pain or pulmonary concerns. Nitrous helped Nick Chegwidden an EMT himself after he fell while skiing at Stowe Mountain Resort in March and the edge of his ski cut his leg. His adrenaline kicked in he said but by the time the ambulance arrived to minutes later he was in pain. He couldnt move his foot so he was also having anxiety. The advanced EMT crew gave him nitrous. So for the transport he said I was calm and comfortable."

"When it comes to supernutritious foods the blueberry has long had a health halo floating over it. Going back to Colonial times when Native Americans and English settlers ground up blueberries and added them to porridge in both dried and fresh forms httpusda.govdocumentsResultsResearch.pdf there have been hints of healthpromoting effects. In recent years regular consumption of berries has been linked to better brain health httpnaldc.nal.usda.govdownloadPDF and a decreased risk of Type diabetes http Now a new study httpnewsroom.heart.orgnewsstrawberriesblueberriesmaycutheartattackriskinwomenpreviewdd published in the American Heart Associations journal Circulation suggests eating three servings per week of blueberries and strawberries helps cut the risk of heart attacks among some women. We showed for the first time that a regular intake of substances that are naturally present in red bluecolored fruits and vegetables can reduce the risk of a heart attack by about percent in young and middleaged women ages mids to compared with women who ate berries once a month or less says study author Aedin Cassidy http of the University of East Anglia. The researchers found other fruits such as apples and pears were not associated with a decreased risk. Article continues after this message from our sponsor To study the relationship between berry consumption and heart disease Cassidy and her collaborators at the Harvard School of Public Health analyzed findings from the Nurses Health Study http which includes more than nurses in the U.S. Periodically over the past years the nurses have reported details about their diets and lifestyles to researchers. At the same time researchers have monitored the nurses health to see which diseases they go on to develop or not. Its certainly not a perfect way to detect how certain foods may influence health but it identifies important associations. Cassidy says the association between berry consumption and heart disease was strengthened when she and her collaborators controlled for other reasons that could have explained the finding. Even when we adjusted for things like fat intake fiber intake medication use or body size and for example exercise we still got these strong reductions in risk Cassidy says. So whats in blueberries that makes them so good for us Researchers have pinpointed a class of plant compounds known as anthocyanins http_anthocyanins.pdf. These compounds give the red and blue color to everything from berries to eggplants to cherries. And when you eat a steady diet of them they seem to have a number of positive health effects. They have effects on blood pressure in animal models says Cassidy. And in lab experiments theyre shown to exert antiinflammatory effects as well as help modulate nitric oxide http in the body which could help arteries stay more elastic and flexible. All of these effects could be beneficial explains Robert Eckel http_staffPagesEckel.aspx a preventive cardiologist at the University of Colorado. But he says its important to point out that the women in this study werent prime candidates for heart attacks anyway. Having a heart attack when youre a woman between ages of and is distinctly unusual says Eckel. Would the protective effect hold up for older women Eckel says its not clear. But nonetheless for the first time I think we have some evidence that the intake of theses anthocyanins may have a protective effect. So go ahead. Load up on berries. And if theyre out of season like now studies show frozen berries have similar levels of beneficial compounds."

"The Food and Drug Administration on Monday approved the first drug derived from marijuana which will be used to treat two rare and severe forms of childhood epilepsy. The drug called Epidiolex https_term.dafefa is an oral solution containing highly purified cannabidiol CBD which is one of scores of chemicals in the cannabis sativa plant commonly known as marijuana. The drug contains only trace amounts of the psychoactive element THC and does not induce euphoria. Epidiolex was approved for patients age and older who suffer from LennoxGastaut and Dravet syndromes. Both cause uncontrolled daily seizures and put patients at high risk for other physical and intellectual disabilities injury and early death. The disorders afflict fewer than people in the United States but experts expect Epidiolex to be prescribed for other types of epilepsy as well. The drug is the first treatment approved for Dravet syndrome. FDA Commissioner Scott Gottlieb said the approval was a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies. The medication tested in three randomized placebocontrolled trials with more than patients was effective in reducing seizures the FDA said. Gottlieb noted that the action was not an approval of marijuana or all of its components but rather of one specific CBD medication for a particular use. The agency he added remains concerned about the proliferation and illegal marketing of unapproved CBDcontaining products with unproven medical claims. In April an advisory committee unanimously recommended https_term.eadb approval of the drug for the two types of epilepsy. The FDA previously cleared medications containing synthetic versions of THC for nausea for patients getting chemotherapy and for other uses but it had not approved any drug derived from the plant itself. Marijuana and its components including CBD are Schedule controlled substances meaning they are banned because they are thought to have a high abuse potential no medical value and serious safety implications. Now that Epidiolex is approved by the FDA cannabidiol is expected to be reclassified by the Drug Enforcement Administration within days. However it isnt clear whether such a reclassification would involve CBD products in general the CBD formulation used specifically in Epidiolex or something else. For those who have long argued that cannabis offers medical benefits the FDA approval represents a milestone a recognition that the plant is a rich source of compounds which have potential therapeutic activity Justin Gover chief executive of GW Pharmaceuticals the Londonbased company that developed the drug said in an interview last week. We are just scratching the surface of what could be a range of cannabisbased medications. The medication which will continue to be manufactured in Britain will be marketed by Greenwich Biosciences the U.S. subsidiary of GW Pharmaceuticals. The drugmaker is testing other CBD treatments for glioblastoma and schizophrenia. Shlomo Shinnar president of the American Epilepsy Society and a neurologist at Montefiore Medical Center in New York has said the drug will be a very valuable addition to the limited options for treating severe childhoodonset epilepsy. Shinnar said he will welcome approval of a medicine that had undergone stringent FDA review for safety and effectiveness. Many parents already are giving children unregulated CBD formulations that are available in medical marijuana dispensaries in the many states where such operations are legal. Some have said that they have no intention of switching to the new prescription CBD drug because the products theyre using are helping their children. Others said they are anxious to try an FDAapproved product."

"Queensland University of Technology QUT researchers have identified a drug that could potentially help our brains reboot and reverse the damaging impacts of heavy alcohol consumption on regeneration of brain cells. Their studies in adult mice show that two weeks of daily treatment with the drug tandospirone reversed the effects of weeks of bingelike alcohol consumption on neurogenesis the ability of the brain to grow and replace neurons brain cells. The findings have been published in Scientific Reports https This is the first time tandospirone has be shown to reverse the deficit in brain neurogenesis induced by heavy alcohol consumption Tandospirone acts selectively on a serotonin receptor HTA The researchers also showed in mice that the drug was effective in stopping anxietylike behaviours associated with alcohol withdrawal and this was accompanied by a significant decrease in bingelike alcohol intake This is a novel discovery that tandospirone can reverse the deficit in neurogenesis caused by alcohol said study leader neuroscientist Professor Selena Bartlett from QUTs Institute of Health and Biomedical Innovation https We know that with heavy drinking you are inhibiting your ability to grow new neurons brain cells. Alcohol is specifically very damaging for neurons. Other studies in mice have shown that tandospirone improves brain neurogenesis but this is the first time it has been shown that it can totally reverse the neurogenic deficits induced by alcohol. This opens the way to look at if neurogenesis is associated with other substanceabuse deficits such as in memory and learning and whether this compound can reverse these. Professor Bartlett who is based at the Translational Research Institute said the discovery by study coauthors QUT postdoctoral research fellows Dr Arnauld Belmer and Dr Omkar Patkar came about serendipitously after research started in a different direction. It was surprising and exciting Dr Belmer said. This drug is relatively new and available only in China and Japan. It is commonly used there and shown to be highly effective in treating general anxiety and well tolerated with limited adverse effects. Professor Bartlett said researchers are constantly looking at new treatment strategies for alcohol abuse and addiction which is characterised by extended periods of heavy alcohol use binges and abstinence and anxiety and depression which contribute to relapse. This is not just another drug that shows promise in helping to reduce binge drinking she said. While it could possibly have that effect it might be able to help reboot the brain and reverse the deficits the alcohol abuse causes both the inhibition to the brains ability to regenerate and the behavioural consequences that come from what alcohol is doing to the brain like increases in anxiety and depression. The study by Professor Bartlett Dr Belmer Dr Patkar and Dr Vanessa Lanoue Queensland Brain Institute can be accessed here https"

"Tenyearold Mallory Oakes loves to read in fact she has been doing it since before she was years old. Her mother knew she had a gifted child but those gifts would not come without challenges. I think I knew from very early on that she was different but she was my first child so I figured anything that I saw there was a chance that she would grow out of it Amy Oakes told FoxNews.com. She would wake up in the middle of the night with night terrors at a very young age she stopped napping around months any type of change in our schedule could set off an epic tantrum. Oakes didnt know it then but her daughter Mallory was one of more than percent of American children living with attention deficit hyperactivity disorder ADHD She was diagnosed in first grade after there were some difficulties in the classroom Amy said. But there were other components to it there was oppositional defiant disorder there were some autism spectrumlike behaviors and difficulty later on socializing with other children. Oppositional defiant disorder is one of the most common conditions linked to ADHD in children and is characterized by anger tantrums opposition to authority and sometimes aggressive behavior. For Mallory the disorder led to a pattern of epic meltdowns which left Amy reeling and willing to try anything to control them. Initially I tried a number of different things different kinds of therapies art therapies. I took her to somebody who supposedly could heal through touch she said. We tried some medication therapies that ended up being really a nightmare for us and making matters worse. Medication is often the first line of defense in conventional medicine for kids with ADD and ADHD with doctors prescribing everything from stimulants to antipsychotics and even antidepressants to help control the symptoms. The spectrum of ADHD and related disorders is broad and there is no onesizefitsall treatment. There were times I remember saying to my husband that her behaviors are holding our family hostage because it could be one meltdown a day it could be five meltdowns a day Amy said. She couldnt do anything to stop it and I really began to realize that her brain wouldnt let her even if she wanted to be good her brain wasnt allowing her to. Mallorys oppositional behavior reached a fever pitch when the family moved from their home in Hoboken N.J. to the suburb of Glen Rock N.J. in . She wasnt able to attend mainstream school anymore and the school that we ended up putting her in was an endoftheroad school in my mind it was not a place where she belonged Amy said. Desperate for a solution Amy started searching for success stories about kids like Mallory who had been helped by different therapies. Thats when she found the Brain Balance Achievement Center in Allendale N.J. We went in for the assessment and her behaviors at the assessment were really terrible Amy said. I thought we werent going to get accepted to the program and they told us they could help us and we never looked back. The specialized learning centers of which there are now throughout the country were developed by Dr. Robert Melillo a neurology researcher and author of the book Disconnected Kids to help balance the brains of kids with learning disorders like Mallory. What thinking really is is really coordinating different networks in the brain so that we can bring all of those networks together at one time Melillo told FoxNews.com. And if kids have poor coordination in their body they often have poor coordination in their brain poor coordination between their networks so they cant bring all these networks together to learn in the most optimal way. The program uses a combination of sensory motor physical exercises and academic learning to help stimulate and strengthen the parts of the brain responsible for certain disorders. If you get a child who has really strong left brain and delayed right brain those are kids that may be labeled with attentional problems or behavioral problems or social issues Melillo said. The easiest way to get their brain to become coordinated is by making their body coordinated so a large part of what were doing is this sensory motor interaction building their muscle tone building their strength building their body spatial awareness. The program also incorporates what Melillo calls bionutritional guidelines to make sure children are getting the proper nutrition for optimal learning. Parents are a big part of the learning experience and are tasked with athome exercises to do with their kids. Mallory attended the Brain Balance Achievement Center three times a week after school for three months at a time starting in November . She has since gone on to complete two more cycles of Brain Balance learning and no longer takes medication to manage her condition. Shes playing on the basketball team now shes involved in theatre things that she wasnt able to do because her behaviors prohibited her from doing them Amy said. I really felt very hopeless before we found Brain Balance so the fact that I just have hopes for her now is a beautiful thing and I think she can do anything she wants to do. For more information visit BrainBalanceCenters.com http"

"A new study finds that individuals struggling with obesity who are not candidates for weightloss surgery can benefit substantially from nonsurgical endoscopic sleeve gastroplasty according to research presented at Digestive Disease Week DDW http the largest international gathering of physicians researchers and academics in the fields of gastroenterology hepatology endoscopy and gastrointestinal surgery. Patients who underwent ESG a procedure performed through the mouth with an endoscope to accordion the stomach by suturing pleats to reduce its size achieved greater weight loss than laparoscopic banding but less weight loss than laparoscopic sleeve gastrectomy surgery. Patients who received treatment endoscopically had shorter hospital stays and lower costs than those who had laparoscopic surgery. Obesity continues to be a problem in America and it is an epidemic rapidly spreading around the world said Reem Z. Sharaiha MD MSc assistant professor of medicine at Weill Cornell Medicine and attending physician at New YorkPresbyterianWeill Cornell Medical Center the studys lead author. Our research the first to compare these treatments demonstrates that endoscopic sleeve gastroplasty is safe and effective in helping patients lead healthier lives. It should be considered as another tool available to clinicians and patients in the fight against obesity. Dr. Sharaiha followed patients who underwent ESG patients laparoscopic sleeve gastrectomy patients or laparoscopic banding . During the oneyear followup period patients went to an academic bariatric center of excellence as part of their treatment. At oneyear followup patients who chose laparoscopic sleeve gastrectomy surgery achieved the greatest percent total body weight loss at . percent compared to . percent for endoscopic sleeve gastroplasty patients and . percent for laparoscopic banding patients. Researchers found that patients who received endoscopic treatment had lower complications percent than those who received surgical treatment percent for laparoscopic sleeve gastrectomy and percent for laparoscopic banding. Dr. Sharaiha noted that these findings do not suggest that endoscopic sleeve gastroplasty will replace the two surgical treatments as weightloss interventions. Instead these results show that endoscopic sleeve gastroplasty is another possibility that patients and healthcare providers should consider when discussing options. While endoscopic sleeve gastroplasty is performed with an endoscopic device through the mouth laparoscopic sleeve gastrectomy involves a small surgical incision in the belly to place a tube in the abdomen allowing doctors to reduce the stomachs volume. With laparoscopic banding doctors insert a tube through an incision in the belly to place a band around the stomach restricting food intake. The team also reported that endoscopic sleeve gastroplasty patients customarily left the hospital on the same day of treatment while laparoscopic sleeve gastrectomy patients stayed for about three days and laparoscopic banding patients for a day and a half. When examining cost researchers reported endoscopic sleeve gastroplasty resulted in the lowestcost with an average institutional procedure cost of compared to for laparoscopic sleeve gastrectomy and for laparoscopic banding. For years patients seeking weightloss interventions had limited options because they could not tolerate or did not want surgery or it was not even an option for them added Dr. Sharaiha. Our research shows that endoscopic sleeve gastroplasty can be the treatment theyve been looking for. Its less invasive than surgery and helps them reach their health goals. Obesity is associated with heart disease stroke diabetes and some cancers and researchers estimate that it is the secondleading cause of preventable death after tobacco use. The Centers for Disease Control and Prevention CDC estimates that more than one in three U.S. adults is obese having a body mass index of or more. The CDC estimated the medical cost of obesity in the U.S. at approximately billion in . Globally the World Health Organization estimates that more than million people were obese in . Dr. Reem Z. Sharaiha will present data from the study Endoscopic Sleeve Gastroplasty Laparoscopic Sleeve Gastrectomy and Laparoscopic Band for Weight Loss How Do They Compare abstract on Saturday May at a.m. CT in S of McCormick Place. For more information about featured studies as well as a schedule of availability for featured researchers please visit http Dr. Sharaiha did not have any disclosures for DDW research. Digestive Disease Week DDW is the largest international gathering of physicians researchers and academics in the fields of gastroenterology hepatology endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases AASLD the American Gastroenterological Association AGA Institute the American Society for Gastrointestinal Endoscopy ASGE and the Society for Surgery of the Alimentary Tract SSAT DDW takes place May at McCormick Place Chicago. The meeting showcases more than abstracts and hundreds of lectures on the latest advances in GI research medicine and technology. More information can be found at http"

"Researchers at the Childrens Hospital of Eastern Ontario CHEO looked at the incidence of and risk factors associated with sedationrelated adverse events in pediatric emergency departments as part of a multicentre observational study published today in JAMA Pediatrics. When children and youth present at an emergency department and require an immediate painful procedure it is standard to sedate the patient so they can tolerate the treatment. Procedural sedation is commonly used for painful or uncomfortable procedures like setting fractures repairing lacerations and draining abscesses in emergency departments worldwide. Although sedationrelated serious adverse events occur infrequently recognition and early intervention is necessary to ensure patient safety said Dr. Maala Bhatt lead author director of pediatric emergency research at CHEO and assistant professor at the University of Ottawa. Weve been able to identify sedation medications and practices associated with the best clinical outcomes which is practicechanging. According to the authors this study represents the largest and most robust prospective emergency department procedural sedation cohort to date. It includes children from six emergency departments across Canada sedated with six different medication combinations. The results of the study show that choice of sedation medication had the biggest impact on the incidence of adverse events and need for significant interventions in response to those events. The incidence of serious adverse events was lowest among patients sedated with ketaminealone and highest among patients sedated with combination drugs ketamine plus propofol or fentanyl. The overall incidence of adverse events in the study population was .. The most common events were a decrease in oxygen saturation . and vomiting .. Significant interventions in response to an adverse event were rare occurring in only . of children. Two other practices receiving an opioid prior to sedation and having a laceration repair were associated with the occurrence of vomiting oxygen desaturation and need for significant interventions. The low rate of serious adverse events and significant interventions supports the safety of procedural sedation in the hands of emergency department physicians said Dr. Bhatt. While all sedation medications and combination of medications are effective and safe in the hands of experienced providers ketaminealone is associated with the fewest serious adverse events and significant interventions making it a logical choice for providing procedural sedation for children in emergency departments. Coauthors include Drs. Maala Bhatt David W. Johnson Jason Chan Monica Taljaard Nick Barrowman Ken J. Farion Samina Ali Suzanne Beno Andrew Dixon C. Michelle McTimoney Alexander Sasha Dubrovsky Nadia Sourial and Mark G. Roback for the Sedation Safety Study Group of Pediatric Emergency Research Canada PERC. This study was funded by a Canadian Institutes of Health Research CIHR team grant in Pediatric Emergency Medicine. About the CHEO Research Institute The CHEO Research Institute coordinates the research activities of the Childrens Hospital of Eastern Ontario CHEO and is affiliated with the University of Ottawa. Its three programs of research include molecular biomedicine health information technology and evidence to practice research. Key themes include cancer diabetes obesity mental health emergency medicine musculoskeletal health electronic health information and privacy and genetics of rare disease. The CHEO Research Institute makes discoveries today for healthier kids tomorrow. For more information visit http"

"A new study from The University of Texas Medical Branch at Galveston has revealed that a treatment taken daily by people who have had organ transplants to prevent organ rejection protects against Alzheimers disease. An early online version of this paper detailing the findings has been published and is scheduled for publication in the July issue of the Journal of Alzheimers Disease. Alzheimers disease is the most common ageassociated neurodegenerative disorder that has no cure. Compelling evidence shows that toxic protein aggregates called A oligomers selectively target and disrupt the points of communication between brain cells impairing memory in people suffering from the disease. Because of this there is a large consensus that preventing this kind of toxicity would be an effective treatment strategy. Calcineurin is an enzyme that regulates communication between brain cells and memory formation. The UTMB research team and others have shown previously that this enzyme plays a central role in the harmful effects of the A oligomers and that elevated calcineurin is found in the nervous system of Alzheimers patients. Using a mouse model of Alzheimers the researchers earlier showed that blocking calcineurin restored memory function. However the question of whether such a strategy would prevent the onset and progression of Alzheimers in people is challenging because treatment with a calcineurinblocking agent suppresses the immune system. To bypass this issue the UTMB team analyzed data from the medical records of patients who received organ transplants and must take calcineurin inhibitorbased medications such as Tacrolimus or cyclosporine for the rest of their lives to prevent rejection of the transplanted organ. As part of the medical care for transplant recipients any evidence of memory impairment or dementia is immediately noted and monitored as it can limit treatment compliance among these patients. The participants were separated into groups by age at the time of last visit or death gender and ethnicity. Eight participants showed evidence of dementia two were younger than five were in the years old group and one was in the years old group. The UTMB study data was compared with national data obtained from the Alzheimers Association Facts and Figures dataset on agematched patients to compare the prevalence of Alzheimers. These data clearly show that the prevalence of dementia and Alzheimers in our transplant patient group is significantly lower in fact almost absent when compared to national data from the general population said senior author Luca Cicalese professor in the department of surgery. In patients over years percent of the general population had dementia compared with . percent of the study subjects. In Americans over years . percent of the population had dementia compared with . percent of the study subjects. Among Americans over years percent had dementia although we did not have any patients in this age group with dementia. Since the people involved in the study mostly come from Texas the researchers further compared their over years old group with the prevalence of Alzheimers in the general population of the state and got similar results. Taken together our findings from these people confirm the data obtained with animal models and support for the first time in human subjects our notion that calcineurin inhibition has a protective effect on the development and possible progression and even reversal of Alzheimers disease said senior author Giulio Taglialatela Professor and Vice Chair for Research in the department of neurology and director of UTMBs Mitchell Center for Neurodegenerative Diseases. Therefore we are currently working on devising treatment strategies to obtain the same beneficial effects in AD humans using low doses of calcineurin inhibitors that result in minimal or no immunosuppression thus limiting possible undesired side effects. UTMBs Cristiana Rastellini Professor in the departments of Surgery and Microbiology Immunology also was an author on this paper. This research was supported by the National Institutes of Health and the Mitchell Center for Neurodegenerative Diseases. Disclaimer AAAS and EurekAlert"

"Among a group of older women selfreported caffeine consumption of more than mg per day was associated with a percent reduction in the risk of incident dementia over years of followup. This level is equivalent to two to three oz cups of coffee per day five to six oz cups of black tea or seven to eight ounce cans of cola. The mounting evidence of caffeine consumption as a potentially protective factor against cognitive impairment is exciting given that caffeine is also an easily modifiable dietary factor with very few contraindications said Ira Driscoll PhD the studys lead author and a professor of psychology at the University of WisconsinMilwaukee. What is unique about this study is that we had an unprecedented opportunity to examine the relationships between caffeine intake and dementia incidence in a large and welldefined prospectivelystudied cohort of women. The findings come from participants in the Womens Health Initiative Memory Study which is funded by the National Heart Lung and Blood Institute. Driscoll and her research colleagues used data from communitydwelling postmenopausal women aged and older who reported some level of caffeine consumption. Intake was estimated from questions about coffee tea and cola beverage intake including frequency and serving size. In years or less of followup with annual assessments of cognitive function of these women received a diagnosis of probable dementia or some form of global cognitive impairment. Those who consumed above the median amount of caffeine for this group with an average intake of mg per day were diagnosed at a lower rate than those who fell below the median with an average intake of mg per day. The researchers adjusted for risk factors such as hormone therapy age race education body mass index sleep quality depression hypertension prior cardiovascular disease diabetes smoking and alcohol consumption. The paper Relationships Between Caffeine Intake and Risk for Probable Dementia or Global Cognitive Impairment The Womens Health Initiative Memory Study is available at httpbiomedgerontology.oxfordjournals.orgcontentearlygerona.glw Direct correspondence to Ira Driscoll PhD Department of Psychology University of WisconsinMilwaukee Garland Hall East Hartford Avenue Milwaukee WI Email driscoliuwm.edu mailtodriscoliuwm.edu Sharing on social media Find Oxford Journals online at OxfordJournals httpstwitter.comOxfordJournals"

"Can acupressure achieve a sustained reduction in menstrual pain Is an appbased selfcare program particularly attractive to young women These questions addressed in a new study by researchers from Charit Universittsmedizin Berlin the results of which have been published in the American Journal of Obstetrics and Gynecology. Approximately to percent of young women experience pain during their periods. While this pain primarily manifests itself as lower abdominal cramping other symptoms include headache backache nausea and diarrhea. Acupressure is a technique derived from traditional Chinese medicine TCM. In contrast to acupuncture this technique can be used as a form of selfcare and is suitable for use at home. Rather than using needles this technique involves massage or pressure being applied to specific points on the body. The researchers wanted to evaluate whether in a group of women suffering from severe menstrual pain aged between and selfacupressure would be more effective at achieving a sustained reduction in menstrual pain than usual care alone e.g. pain medication and hormonal contraceptives. A total of participants were randomly assigned to one of two treatment groups both of which received a study app and short introduction. Acupressurebased features with instructions on how to administer selfacupressure shortly before and during menstruation were only made available to the intervention group. One advantage of an appbased intervention is its ability to provide visual descriptions of the pressure points users need to target in order to achieve the desired effect. It can also send regular reminders. Additionally the app was used to collect all studyrelated data. Initially we simply wanted to conduct a study on the use of selfcare techniques for menstrual pain. However the women who were involved during the planning stages all of whom were affected by menstrual pain wanted an app reports the studys principal investigator Prof. Dr. Claudia Witt of the Institute of Social Medicine Epidemiology and Health Economics. The app helped participants to apply simple selfacupressure techniques to three different acupressure points. After three months percent of participants in the acupressure group reported a percent reduction in pain intensity. After six months this proportion had increased to more than half of the women in this group percent. Only percent of women in the control group reported a similar reduction in pain intensity at both the month and month marks. Women in the acupressure group also used less pain medication than women in the control group and reported lower levels of pain overall. We were surprised to see that after six months two thirds of participants continued to use selfacupressure. So far research into the clinical effectiveness of apps has been limited and only a few have been tested using randomized controlled trials says Dr. Daniel Pach of the Institute of Social Medicine Epidemiology and Health Economics. He adds We were able to show that apps can be evaluated in a clinical trial setting. However despite our experience with conventional clinical trials there was a lot for us to learn something we found both exciting and eyeopening. The app Luna httpsitunes.apple.comdeapplunaselbsthilfeidmt has recently been updated and optimized for use with iOS. Susanne Bldt Daniel Pach Sanna von EisenhartRothe Fabian Lotz Stephanie Roll Katja Icke Claudia M. Witt Effectiveness of appbased selfacupressure for women with menstrual pain compared to usual care a randomized pragmatic trial. In American Journal of Obstetrics and Gynecology Volume Issue February Pages .e.e. DOI .j.ajog.... Contact Prof. Dr. Claudia Witt Institute of Social Medicine Epidemiology and Health Economics Charit Universittsmedizin Berlin t Email claudia.wittcharite.de mailtoclaudia.wittcharite.de Links httpsepidemiologie.charite.deen httpsepidemiologie.charite.demetasmeldungartikeldetailluna german"

"When I was a kid my parents refused to let me drink coffee because they believed it would stunt my growth. It turns out of course that this is a myth http_rmoduleinline. Studies have failed again and again to show that coffee or caffeine consumption are related to reduced bone mass or how tall people are. Coffee has long had a reputation http as being unhealthy. But in almost every single respect that reputation is backward. The potential health benefits are surprisingly large. When I set out to look at the research on coffee and health I thought Id see it being associated with some good outcomes and some bad ones mirroring the contradictory reports you can often find in the news media. This didnt turn out to be the case. Just last year a systematic review and metaanalysis of studies looking at longterm consumption of coffee and the risk of cardiovascular disease was published httpcirc.ahajournals.orgcontent.long. The researchers found studies involving more than participants. The combined data showed that those who consumed a moderate amount of coffee about three to five cups a day were at the lowest risk for problems. Those who consumed five or more cups a day had no higher risk than those who consumed none. Of course everything Im saying here concerns coffee black coffee. I am not talking about the mostly milk and sugar coffeebased beverages that lots of people consume. These could include http_healthtworstcoffeedrinksamerica but arent limited to things like a McDonalds large mocha http_nutrition.mccafe..mccafemochalarge.html calories grams of fat grams of carbohydrates a Starbucks Venti White Chocolate Mocha http calories grams of fat grams of carbs and a Large Dunkin Donuts frozen caramel coffee Coolatta http_caramel.htmlDRP_DAIRYWholeMilkDRP_SIZELargeDRP_FLAVORCaramelDRP_BLENDFrozenCoffee calories grams of fat grams of carbs. I wont even mention the Cold Stone Creamery GottaHaveItSized Lotta Caramel Latte https calories grams of fat grams of carbs. Regular brewed coffee http has or fewer calories and no fat or carbohydrates. Back to the studies. Years earlier a metaanalysis a study of studies in which data are pooled and analyzed together was published looking at how coffee consumption might be associated with stroke httpaje.oxfordjournals.orgcontent.long. Eleven studies were found including almost participants. As with the prior studies consumption of two to six cups of coffee a day was associated with a lower risk of disease compared with those who drank none. Another metaanalysis published a year later http confirmed these findings. Rounding out concerns about the effect of coffee on your heart another metaanalysis examined how drinking coffee might be associated with heart failure httpcircheartfailure.ahajournals.orgcontent.long. Again moderate consumption was associated with a lower risk with the lowest risk among those who consumed four servings a day. Consumption had to get up to about cups a day before any bad associations were seen. No one is suggesting you drink more coffee for your health. But drinking moderate amounts of coffee is linked to lower rates of pretty much all cardiovascular disease contrary to what many might have heard about the dangers of coffee or caffeine. Even consumers on the very high end of the spectrum appear to have minimal if any ill effects. But lets not cherrypick. There are outcomes outside of heart health that matter. Many believe that coffee might be associated with an increased risk of cancer. Certainly individual studies httptheincidentaleconomist.comwordpresstheresareasoniusesystematicreviewsandmetaanalyses have found that to be the case and these are sometimes highlighted by the news media. But in the aggregate most of these negative outcomes disappear. A metaanalysis published in found that increasing coffee consumption by two cups a day was associated with a lower relative risk of liver cancer http by more than percent. Two more http recent studies http confirmed these findings. Results from metaanalyses looking at prostate cancer httponlinelibrary.wiley.comdoi.j.X...xabstract found that in the higherquality studies coffee consumption was not associated with negative outcomes httpannonc.oxfordjournals.orgcontent.long. The same http holds true httpjournals.plos.orgplosonearticleid.journal.pone. for breast cancer http where associations were statistically not significant. Its true that the data on lung cancer http shows an increased risk for more coffee consumed but thats only among people who smoke. Drinking coffee may be protective in those who dont. Regardless the authors of that study hedge their results and warn that they should be interpreted with caution because of the confounding and most likely overwhelming effects of smoking. A study looking at all cancers http suggested that it might be associated with reduced overall cancer incidence and that the more you drank the more protection was seen. Drinking coffee is associated with better laboratory values in those at risk for liver disease httponlinelibrary.wiley.comdoi.liv.abstract. In patients who already have liver disease its associated with a decreased progression to cirrhosis. In patients who already have cirrhosis its associated with a lower risk of death and a lower risk of developing liver cancer. Its associated with improved responses to antiviral therapy in patients with hepatitis C and better outcomes in patients with nonalcoholic fatty liver disease. The authors of the systematic review argue that daily coffee consumption should be encouraged httponlinelibrary.wiley.comdoi.liv.abstract in patients with chronic liver disease. The most recent metaanalyses on neurological disorders found that coffee intake was associated with lower risks of Parkinsons disease httponlinelibrary.wiley.comdoi.ggi.abstract lower cognitive decline httpadvances.nutrition.orgcontent.long and a potential protective effect against Alzheimers disease httpweb.a.ebscohost.comehostdetaildetailsiddfdffdaffebdaebsessionmgrvidhidbdataJnNpdGUZWhvcQtbGlZQdd but certainly no harm. A systematic review published in httpjama.jamanetwork.comarticle.aspxarticleid found that regular coffee consumption was associated with a significantly reduced risk of developing Type diabetes with the lowest relative risks about a third reduction seen in those who drank at least six or seven cups a day. The latest study published in httpcare.diabetesjournals.orgcontent.abstract used updated data and included studies and more than . million participants. Again the more coffee you drank the less likely you were to have diabetes. This included both caffeinated and decaffeinated coffee."

"Dermatologists will soon get some hightech help deciding which suspiciouslooking moles should be removed and checked for melanoma the deadliest form of skin cancer http The Food and Drug Administration http on Wednesday approved a firstofitskind device called MelaFind that makes detailed digital images of skin growths and uses a computer to analyze them for signs of cancer offering a sort of second opinion to doctors. The device is approved only for dermatologists and only for use on growths that dont have obvious signs of cancer but still have one or two worrisome traits. The hope is to find more melanomas sooner. Nearly all patients diagnosed with earlystage melanoma can be treated and cured but percent of patients with latestage melanoma die from it within five years. More than people in the U.S. will be diagnosed with melanoma this year and percent are diagnosed only after the disease has spread to other parts of the body according to estimates from the National Institutes of Health http To diagnose the disease doctors decide which moles to remove and biopsy using an entirely visual set of guidelines involving size shape and color. Most dermatologists easily spot latestage lesions that have obvious signs of cancer including irregular edges uneven color and a width greater than millimeters. But many others are tough calls. Every day patients come in with moles on their back and the dilemma is which ones are suspicious and need to be biopsied said Dr. David Pariser former president of the American Academy of Dermatology. The diagnosis of melanoma is the most serious one a dermatologist makes and we have sleepless nights worrying about it said Pariser who consulted for the devices maker Mela Sciences Inc. of Irvington N.Y. on its presentation to FDA. The devices handheld attachment about the size of a blow dryer emits light that penetrates below the surface of the skin taking multicolored images that reflect the depth and shape of skin growths. A computer compares these to a database of archived images and recommends whether a biopsy should be done. In a companysponsored study published last year involving around patients some with multiple growths doctors reported that MelaFind correctly suggested biopsies on of melanomas that doctors had removed. MelaFind correctly identified about percent of noncancerous growths which was better than doctors in the study who were correct less than percent of the time on average. The study was published in the Archives of Dermatology. The companys study was not intended to show that screening with the device saves lives only that it can help improve a doctors ability to spot melanoma. For now experts say MelaFind will help dermatologists make better decisions on which moles to remove. There is no such thing as percent certainty in medicine said Dr. George Elias a melanoma expert at Georgetowns Lombardi Comprehensive Cancer Center who had no ties to the company or the device. Ultimately its the responsibility of the dermatologist to use his clinical judgment to make the best decision. This machine is there to help him not replace him. Elias voted with the majority of an FDA panel that narrowly endorsed the device last year. Dermatologists say its too early to tell whether MelaFind will lead to fewer unnecessary biopsies. A biopsy takes a few minutes in my hands so if theres an issue with any lesion we will always biopsy whether we have a MelaFind picture or not said Dr. Leonard Goldberg a dermatologist at the Texas Medical Center and vice president of the Skin Cancer Foundation a disease awareness group that accepts donations from makers of sunscreen. MelaFind underwent a contentious yearslong review by the Food and Drug Administration which initially rejected the device and concluded it could potentially cause more harm than good. Regulators worried that the device could give physicians a false sense of certainty leading to fewer biopsies. Another concern was that doctors could misinterpret the devices feedback particularly error messages when a mole cannot be scanned. About percent of growths scanned in the company study came back as unevaluable. At a meeting last fall FDA scientists said Mela Sciences had not shown how its device would influence daytoday decisions by doctors. The agency also worried about its use by general doctors not accustomed to identifying suspicious skin moles. Despite these concerns the panel of advisers narrowly backed the overall safety and efficacy of the device in a vote. Regulators said this week that they ultimately approved the device after Mela Sciences agreed to limit its use to boardcertified dermatologists who undergo a specialized training course. The device is only good for certain lesions and thats why you have to be a dermatologist to be able to classify and categorize those lesions appropriately said Christy Foreman director of FDAs Office of Device Evaluation. Foreman said an FDArequired followup study would help determine how much of a benefit MelaFind represents for patients. This device represents new technology. At the end of the day I dont know that this will be the best technology out there but it is a step forward to allow continued innovation in this area Foreman said. Dont expect to see a MelaFind machine at your next doctors appointment. The company plans to bring them next year to just dermatologists on the East coast all of whom must undergo company training before they can begin using the device. Doctors will pay a onetime fee of to lease and receive training on the device. Patients will pay out of pocket for a MelaFind scan which analysts say may limit use to more affluent patients who are willing to pay extra for the latest medical care. Mela Sciences does not plan to ask insurers to cover the device until several years from now after it is more widely used."

"Worcester Mass. When the standard malaria medications failed to help critically ill patients the attending physician in a Congo clinic acted under the compassionate use doctrine and prescribed a notyetapproved malaria therapy made only from the dried leaves of the Artemisia annua plant. In just five days all people fully recovered. This small but stunningly successful trial offers hope to address the growing problem of drugresistant malaria. Details of the cases are documented in the paper Artemisia annua dried leaf tablets treated malaria resistant to ACT and i.v. artesunate case reports by an international team lead by Pamela Weathers PhD professor of biology and biotechnology at Worcester Polytechnic Institute WPI who has pioneered the use of dried leaves of Artemisia annua DLA as a malaria therapy. To our knowledge this is the first report of driedleaf Artemisia annua controlling ACTresistant malaria in humans the authors of the Phytomedicine http paper note adding that more comprehensive clinical trials on patients with drugresistant malaria are warranted. Successful treatment of all ACTresistant cases suggests that DLA should be rapidly incorporated into the antimalarial regimen for Africa they added and possibly wherever else ACT resistance has emerged. Watch a video https_cfeatureyoutu.be about research at WPI related to this study. The report documents the experiences of patients in the North Kivu province of the Democratic Republic of Congo who showed symptoms of malaria and were originally treated with the recommended medication artemisininbased combination therapy ACT which blends artemisinin a chemical extract from Artemisia annua with one or more other drugs that attack the malaria parasite in different ways. The patients ranging in age from months to years did not respond to the standard ACT treatment and all lapsed into severe malaria defined by symptoms that can include loss of consciousness respiratory distress convulsions and pulmonary edema. One patient a fiveyearold child became comatose. All were then treated with intravenously administered artesunate the frontline medication for severe malaria but again they showed no improvement. As a last resort doctors turned to driedleaf Artemisia DLA a therapy developed and extensively studied by Weathers and her team at WPI. After five days of treatment with tablets made from only the dried and powered leaves of Artemisia which has been prepared and analyzed using methods developed by Weathers and postdoctoral fellow Melissa Towler all patients fully recovered. Laboratory tests showed they had no parasites remaining in their blood. Weathers noted more than other drugresistant patients also have been successfully treated with DLA tablets. These patients were dying Weathers said. So to see percent recover even the child who had lapsed into a coma was just amazing. Its a small study but the results are powerful. According to the World Health Organization WHO more than million people contracted malaria in and some died with young children and pregnant women being particularly vulnerable. Caused by a mosquitoborne parasite the illness is reported in nearly countries and threatens nearly half of the worlds population. ACT the current recommended therapy is expensive to produce and is in short supply in areas hit hardest by the disease. In addition while the combination therapy is designed to be less prone to the drug resistance that has rendered previous antimalarial agents ineffective increasingly the malaria parasite is showing signs of resistance to ACT particularly in Southeast Asia. Weathers began her research on artemisinin and Artemesia annua also known as sweet wormwood more than years ago. In recent years she has turned her attention to the use of DLA as an alternative to conventional antimalarial drugs. Noting that Artemisia annua which is classified as a generally regarded as safe GRAS herb has been consumed by humans and used as an herbal therapy for thousands of years often in the form of a tea she became intrigued by the potential for using the dried plant rather than just a chemical extract as a malaria treatment. A study she published in Photochemistry Reviews in was the first to demonstrate that dried leaves of the Artemisia annua plant delivers times more artemisinin to the blood than does the drug based on the chemical extract of the plant. In a paper published in PLOS ONE the following year Weathers and her team showed that not only does DLA have antimalarial properties it is more effective in knocking out the parasite and reduced the level of parasite infection more completely in mice. In a study in the Proceedings of the National Academy of Sciences the WPI researchers with colleagues at the University of Massachusetts Amherst showed that dried Artemisia leaves cured rodents infected with malaria strains that were known to be resistant to artemisinin. And in an experiment that accelerated the evolution of the malaria parasite by passing it through up to generations of mice the parasite showed no signs of resistance to DLA. Weathers says the superior performance of DLA in comparison to ACT as well as its ability to kill drugresistant parasites and avoid the resistance trap itself is likely due to the synergistic effects of a complex array of phytochemicals contained in the plants leaves several of which are also known to have antimalarial properties and others of which may act both to enhance the absorption of artemisinin into the bloodstream and bolster its effectiveness against malaria. In effect the dried leaves constitute a robust natural combination therapy one whose benefits far surpass those of ACT and other combination drugs. We have done a lot of work to understand the biochemistry of these compounds which include a number of flavonoids and terpenes so we can better understand the role they play in the pharmacological activity of the dried leaves Weathers said. The more we learn the more excited we become about the potential for DLA to be the medication of choice for combatting malaria worldwide. Artemisia annua is known to be efficacious against a range of other diseases including other tropical maladies and certain cancers so in our lab we are already at work investigating the effectiveness of DLA with other diseases. Another advantage of DLA over conventional malaria treatments is its low cost and the relative simplicity of its manufacture Weathers said. While the processes for manufacturing ACT is costlier and requires a higher degree of expertise producing DLA tablets can be accomplished with simpler equipment and a modest amount of training. Growing Artemisia annua and producing and testing the tablets Weathers noted are ideal local business that can provide jobs in impoverished areas and greatly expand access to antimalarial therapy. In fact she has already established a supply chain in Africa that includes growing and harvesting highproducing cultivars in East Africa along with GMP Good Manufacturing Practice processing operations in Uganda where the leaves are dried pulverized and homogenized where the powder is compacted into tablets and where the tablets are tested to verify their dosage. This supply chain helped produce the tablets used to treat the patients in the Democratic Republic of Congo. This simple technology can be owned operated and distributed by Africans for Africans Weathers said. About Worcester Polytechnic Institute Founded in in Worcester Mass. WPI is one of the nations first engineering and technology universities. Its academic departments offer more than undergraduate and graduate degree programs in science engineering technology business the social sciences and the humanities and arts leading to bachelors masters and doctoral degrees. WPIs talented faculty work with students on interdisciplinary research that seeks solutions to important and socially relevant problems in fields as diverse as the life sciences and bioengineering energy information security materials processing and robotics. Students also have the opportunity to make a difference to communities and organizations around the world through the universitys innovative Global Projects Program. There are more than WPI project centers throughout the Americas Africa AsiaPacific and Europe."

"By now youve probably heard all the buzz about the Mediterranean diet httparticles.cnn.comkeywordmediterraneandiet or perhaps youve tried it. Aside from helping to prevent the metabolic syndrome http_.pdf a cluster of risk factors for heart disease and diabetes a new study httpcontent.onlinejacc.orgcgicontentabstract.in the Journal of the American College of Cardiology says the diet can have positive global effects on the individual risk factors low HDL good cholesterol high triglycerides high blood pressure and a high blood sugar rate as seen by your doctor through a blood test. In addition waist size is a risk factor a waist more than inches for women and inches for men is of concern. The syndrome is present when someone has three of those five risk factors. The study is one of the first studies that evaluated the role of Mediterranean diet on metabolic syndrome and revealed a beneficial association quite a big influence taking into account that the Mediterranean diet is a nonpharmacological mean said study author Demosthenes Panagiotakos from the Department of Science of DieteticsNutrition at Harokopio University of Athens in Greece. Take this test to see how well youre managing your diabetes httpinhealth.cnn.comassessmentsmanagingdiabetes The researchers looked at over half a million people from previous studies on the Mediterranean diet http which included people in Spain Greece the U.S. France Sweden Italy and Australia among other countries. They found the beneficial effects from diets rich in fruits and vegetables olives and olive oil lowfat dairy products and whole grain cereals. Other components included a moderate daily intake of alcohol with meals mostly from red wine eating fish poultry or tree nuts like walnuts or cashews weekly and limiting eating red meat to about twice a month. The researchers say whats responsible are the antioxidant and antiinflammatory effects. Panagiotakos added that the diet includes all main food groups but in a balanced way. The study notes physical activity is also an important part in preventing the risk factors for the metabolic syndrome. Tips for managing your diabetes httpinhealth.cnn.comtipstomanagingdiabetes The Mediterranean diet isnt just a little extra olive oil noted Dr. Robert Eckel an endocrinologist and past president of the American Heart Association. Its all these other components Eckel said. I think the health professional needs to recognize that people that meet the criteria for the metabolic syndrome are at higher risk for heart disease and diabetes and we strongly recommend that lifestyle intervention is used to prevent the syndrome and also to modify its prevalence he said. According to the American Heart Association data from shows a third of adults age and older met that criteria. And just a few years earlier over percent of adolescents ages were classified as having the syndrome. That translates into . million young people. But its not only in the U.S. This is a global epidemic Eckel emphasized. This is not simply America. Its occurring throughout Mexico Central and South America Southeast Asia Australia and around the world. Eckel said obesity is by far the largest issue responsible for the metabolic syndrome. According to the World Health Organizations http figures at least one in three of the worlds adult population is overweight and almost one in people is obese. For children the numbers are also sobering million kids under age are overweight. Panagiotakos concludes that this pattern of eating can be easily adopted by people of various cultures and populations. The macroenvironment we are living promotes obesity in all age groups of people... the choice of a healthy diet like the Mediterranean diet is on our hands. Better eating from childhood to older life contributes to better quality of life he said."

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

"Results from a new prospective clinical trial indicate that highdoserate HDR brachytherapy administered in a single Gray Gy treatment may be a safe and effective alternative to longer courses of HDR treatment for men with localized prostate cancer. The study http is available online in the International Journal of Radiation Oncology Biology Physics http the flagship journal of the American Society for Radiation Oncology ASTRO. With brachytherapy also known as internal radiation therapy RT implants are surgically inserted in or near cancerous tissue to deliver a curative radiation dose directly to the tumor while limiting exposure for surrounding healthy tissue. Reducing this exposure is of particular concern for treating tumors in the prostate which is surrounded by multiple critical structures. In contrast to lowdoserate LDR brachytherapy where radioactive seed implants are placed permanently in the body and gradually deposit low levels of radiation over a period of months HDR treatments deposit the dose in one treatment after which the radioactive implant is removed from the patient. Typically HDR brachytherapy is administered in four to as many as nine treatment sessions which generally requires multiple invasive procedures to insert the implants. While the number of sessions can be streamlined by increasing the dose given in each session data on the safety and tolerability of highly escalated brachytherapy doses are still relatively new and therefore limited. In this study researchers found that patients who received a single fraction of Gy HDR brachytherapy experienced similar clinical outcomes as with LDR brachytherapy but with the convenience of a single visit. It is becoming apparent that patients may be treated definitively for their prostate cancer in as little as a single day with a minimally invasive outpatient procedure said lead study author Daniel J. Krauss MD a radiation oncologist at Oakland Universitys William Beaumont School of Medicine in Royal Oak Michigan. We found that patients generally can resume normal activities the following day with typical side effects. The study which appeared in the Red Journals January issue http presented the results of a nonrandomized prospective clinical trial of patients with low or intermediaterisk nonmetastatic prostate cancer with a median followup period of . years. All patients received a single Gy fraction of HDR brachytherapy. The median patient age was years range and percent of the patients presented with stage T disease. At an average of nearly three years following treatment cancer control rates were favorable and the toxicity profile was highly favorable. Three patients experienced recurrence or progression yielding an estimated threeyear cumulative biochemical control rate of percent. Within the six months following HDR therapy seven patients . experienced grade urinary side effects most commonly frequencyurgency .. No patients experienced shortterm grade urinary toxicity or grade gastrointestinal GI toxicity. Rates were similarly modest for longterm side effects. Six patients . experienced chronic grade urinary toxicity and one patient . experienced grade chronic GI toxicity that subsequently resolved. No patients experienced longterm grade urinary toxicity or grade GI toxicity. This study illustrates that a potentially curative dose of radiation may be delivered safely to the prostate entirely in a single administration said Dr. Krauss. Giving the entire dose in a single treatment theoretically could have had a greater negative impact on the normal tissues in close proximity to the prostatemeaning the bladder urethra and rectumbut this was not found to be the case. Toxicity rates were extremely low with essentially no major complications encountered in this initial group of patients. While findings highlight the potential tolerability of a single fraction of HDR brachytherapy for localized prostate cancer the article also emphasizes the need for additional followup to compare longterm cancer control rates with conventional treatment approaches which generally administer larger cumulative doses than the Gy dose used in this trial. As the followup interval lengthens Gy dosing in a single fraction may or may not be sufficient to result in cure rates comparable to historical standards. One thing that this study has made clear however is that the extremely low toxicity and complication rates leave room to escalate the single fraction dose in subsequent trials said Dr. Krauss. While additional study and longer followup are necessary to confirm the optimal dose for singlefraction HDR brachytherapy we are optimistic that the singletreatment approach can eventually become a standard practice for prostate cancer treatment. For more information or a copy of the full study contact ASTROs media relations team at pressastro.org mailtopressastro.org. For the study abstract visit http For more information about Red Journal visit http ABOUT ASTROASTRO is the premier radiation oncology society in the world with more than members who are physicians nurses biologists physicists radiation therapists dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology the Society is dedicated to improving patient care through professional education and training support for clinical practice and health policy standards advancement of science and research and advocacy. ASTRO publishes three medical journals International Journal of Radiation Oncology Biology Physics http Practical Radiation Oncology http and Advances in Radiation Oncology http developed and maintains an extensive patient website RT Answers http and created the Radiation Oncology Institute http a nonprofit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO visit https"

"A team of researchers from the University of Miami Miller School of Medicine has shown that the IPortal Neuro Otologic Test which uses the headmounted goggle that gauged eye movement through video cameras and computers can successfully diagnose concussion with percent specificity and percent sensitivity. These findings illustrate how use of the IPortal goggle can better identify oculomotor vestibular and reaction time OVRT differences between those with mild traumatic brain injury mTBI and nonaffected individuals. Mild traumatic brain injury is typically diagnosed through physical exam findings. However to best manage mTBI researchers have felt it critical to develop objective tests to substantiate the diagnosis. With these findings it appears the IPortal goggle may be a solution. Michael Hoffer M.D. an otolaryngologist and concussion expert at UHealth the University of Miami Health System and lead investigator has been using the goggle for two years recruiting study participants from the emergency rooms of University of Miami Hospital and two military hospitals. Control subjects were recruited from volunteers at the locations where the study was being conducted. Another benefit for this research was that this next generation test has the considerable advantage of not requiring baseline testing said study coauthor Carey Balaban Ph.D. of the University of Pittsburgh. The goal was to identify OVRT performance metrics that differentiated between mTBI and control groups and to create a model that could accurately evaluate mTBI neurologic status in patients. The results of the trial met the expectations of Hoffer and his team of researchers. This is the first paper demonstrating an objective method of diagnosing mTBI that relies on physiologic parameters said Hoffer who is professor of otolaryngology at the University of Miami Miller School of Medicine. This work opens the door for site of injury testing and access to physiologic tests for athletes of all ages. Mild traumatic brain injury is a public health issue. Since the development of the goggle researchers have hoped that the technology used by the goggle in a research setting could be translated to the sidelines of all sports from professional leagues to amateur and little leagues. The research findings published by PLOS ONE help support their objective. It is not inconceivable that in the near future you will see the IPortal goggle used on every sideline in America Hoffer said. With accurate and timely diagnosis which is possible through this technology patients could receive better treatment faster. Its one of many developments that are needed to begin to curb the concussion epidemic."

"New research from the University of Michigan Life Sciences Institute has determined how a common holiday spicecinnamonmight be enlisted in the fight against obesity. Scientists had previously observed that cinnamaldehyde an essential oil that gives cinnamon its flavor appeared to protect mice against obesity and hyperglycemia. But the mechanisms underlying the effect were not well understood. Researchers in the lab of Jun Wu research assistant professor at the LSI wanted to better understand cinnamaldehydes action and determine whether it might be protective in humans too. Scientists were finding that this compound affected metabolism said Wu who also is an assistant professor of molecular and integrative physiology at the UM Medical School. So we wanted to figure out howwhat pathway might be involved what it looked like in mice and what it looked like in human cells. Their findings which appear in the December issue of the journal Metabolism indicated that cinnamaldehyde improves metabolic health by acting directly on fat cells or adipocytes inducing them to start burning energy through a process called thermogenesis. Wu and her colleagues tested human adipocytes from volunteers representing a range of ages ethnicities and body mass indices. When the cells were treated with cinnamaldehyde the researchers noticed increased expression of several genes and enzymes that enhance lipid metabolism. They also observed an increase in Ucp and Fgf which are important metabolic regulatory proteins involved in thermogenesis. Adipocytes normally store energy in the form of lipids. This longterm storage was beneficial to our distant ancestors who had much less access to highfat foods and thus a much greater need to store fat. That fat could then be used by the body in times of scarcity or in cold temperatures which induce adipocytes to convert stored energy into heat. Its only been relatively recently that energy surplus has become a problem Wu said. Throughout evolution the oppositeenergy deficiencyhas been the problem. So any energyconsuming process usually turns off the moment the body doesnt need it. With the rising obesity epidemic researchers like Wu have been looking for ways to prompt fat cells to activate thermogenesis turning those fatburning processes back on. Wu believes that cinnamaldehyde may offer one such activation method. And because it is already used widely in the food industry it might be easier to convince patients to stick to a cinnamonbased treatment than to a traditional drug regimen. Cinnamon has been part of our diets for thousands of years and people generally enjoy it Wu said. So if it can help protect against obesity too it may offer an approach to metabolic health that is easier for patients to adhere to. Now before anyone goes dumping tons of extra cinnamon in their egg nog in hopes of keeping holidayseason pounds at bay Wu cautioned that further study is needed to determine how best to harness cinnamaldehydes metabolic benefits without causing adverse side effects. The research was supported by the Human Frontier Science Program Edward Mallinckrodt Jr. Foundation National Institutes of Health and American Heart Association. Other study authors were Juan Jiang Margo Emont Heejin Jun Xiaona Qiao Jiling Liao and Dongil Kim all of UM. The study is titled Cinnamaldehyde induces fat cellautonomous thermogenesis and metabolic reprogramming DOI .j.metabol...."

"The breast surgery and reconstructive team at The Valley Hospital http in Ridgewood NJ is taking the lead in providing new and progressive advances in breast cancer surgery. Valley was the first hospital in northern New Jersey where an innovative technique called prepectoral placement of a tissue expander was utilized during breast reconstruction surgery following a mastectomy. The procedure results in diminished postoperative pain quicker recovery time improved mobility and an excellent aesthetic outcome for patients. The technique has the potential to be a gamechanger says Tzvi Small M.D. Director of the Department of Plastic and Reconstructive Surgery at The Valley Hospital who performed the breast reconstruction procedure on Hasbrouck Heights resident Vanessa Burt . This variation of a standard technique used during breast reconstruction will revolutionize the postoperative recovery in patients who meet certain criteria for the procedure notes Dr. Small. Here at Valley we are proud to offer this option for our patients and are excited about its potential for vastly improving patient care for women with breast cancer. The technique involves placing tissue expanders interim implants under the skin on top of a womans pectoralis muscles after her breast tissue has been removed. After a recovery period of approximately two months during which the womans chest skin heals blood supply replenishes and the expanders are gradually inflated to stretch the skin the patient returns for an outpatient surgical procedure to replace the tissue expanders with permanent breast implants. In addition to exceptional cosmetic results the technique is likely to improve clinical outcomes as evidenced by ongoing research that shows women who undergo this procedure experience less pain and a shorter recovery period. Over the past decade there have been dramatic improvements in breast reconstruction that utilize various types of surgical innovations implants and biologic tissue notes Dr. Small. It is very rewarding as a reconstructive surgeon to continuously refine these procedures for our patients. Ms. Burt chose the Valley breast surgery team after carefully researching her treatment options for DCIS ductal carcinoma in situ a diagnosis that is often debated among clinicians as to whether it should be classified as breast cancer at all. In DCIS abnormal cells have not spread beyond the milk ducts into adjacent breast tissue or lymph nodes. After consulting with several breast surgeons and reconstructive surgeons Ms. Burt opted for a nipplesparing mastectomy performed by breast surgeon Tihesha Wilson M.D. Assistant Medical Director of Valleys Breast Center http Immediately following in the operating room Dr. Small performed the breast reconstruction. This was a long journey says Ms. Burt a publicist for the San Franciscobased Fat Wreck Chords music company. Dr. Wilson was more than patient with me as I first chose active surveillance for one year and then decided to undergo a double mastectomy when another area of DCIS was identified in November . I am also grateful for Dr. Smalls willingness to look outside the box and for his determination to perform my reconstruction in a way that would give me the best results with the least amount of recovery time. I want to also commend the pathologists at Valley who were exceptional in their diagnostic results. Dr. Wilson and Laura Klein M.D. Medical Director of the Breast Center have extensive experience in performing nipplesparing mastectomy a technically demanding surgery that is performed within aesthetically appealing minimally invasive incisions. With expertise in minimally invasive oncoplastic breast surgery Dr. Wilson has also studied complementary medicine and provides her patients with a holistic integrative approach to breast care. Its important to listen to each womans needs and then to decide together what is the best approach to treatment so that in the end the cancer will be gone and the woman can move on with her life says Dr. Wilson. The Valley Breast Center http provides comprehensive diagnostic surgical and support services using a multidisciplinary approach. The Breast Center is designated by the National Accreditation Program of Breast Centers a program of the American Cancer Society. Valleys Breast Imaging Center has been named a Breast Imaging Center of Excellence by the American College of Radiology."

"Alzheimers disease can be heartbreaking to watch and frustrating to treat. Most medicines on the market do little more than delay the inevitable mental decline. But a new drug called Dimebon appears to stop and perhaps even reverse the symptoms of the cruel and degenerative disease according to a new study published in the journal Lancet today. I was pleasantly surprised to see the effect on cognitive function on memory on activities of daily living that not only were clearly significant but seemed to increase over time said Dr. Sam Gandy former chairman of the Alzheimers Association Medical and Scientific Advisory Council. Dimebon wasnt designed to treat Alzheimers disease. Far from it. Its an antihistamine that was supposed to treat allergies. But a study that tracked mild to moderate Alzheimers patients for a year and found that at six months those taking Dimebon three times a day showed significant improvement in mental tests and cognitive functioning while those placed on the placebo kept deteriorating. A year into the study the Dimebon group was still improving while those without the drug were declining rapidly. Whats most encouraging for researchers is that current Alzheimers drugs lose their effectiveness after three or six months. But Dimebon still worked after at least a year and seemed to be improving with time. For those five million Americans living with Alzheimers disease memories tend to be lost first and then its victims lose the ability to care for themselves. Currently there is no cure for Alzheimers so eventually they lose their lives. Those with Alzheimers in the moderate to severe stages often lose the ability to complete daily tasks such as dressing themselves walking and eating. Karen Henes of CrotononHudson N.Y. was diagnosed with Alzheimers just a year ago and already complains of some such symptoms. I would like to just go see my grandchildren. I cant Henes said. Im not responsible enough just to drive. I cant always remember what to do. Its really sad. Her husband Michael expressed equal frustration with the disease. Life with Karen is so frustrating. It has already changed he said. She writes down all her appointments and she still doesnt remember them. On a daytoday basis its a struggle. Dimebon has been shown to improve patient memory and skills and to help on small daily tasks like using the telephone shopping and remembering the grocery list. Doctors havent yet figured out exactly how the drug works. Researchers think that the drug affects the mitochondria or the energy powerhouses of the brain cells. There are two major classes of Alzheimers drugs and researchers think that Dimebon performs both functions. Alzheimers patients families and doctors tend to be skeptical of new drugs because so many have fallen short over the years. Dr. Gandy cautioned that the new study was small. Dimebon must go through more clinical tests. And even if theyre a success it will be at least two years before Dimebon is approved for treatment by the Federal Drug Administration. This is promising but its not marketed anywhere in the world right now and it hasnt been approved in any country said Dr. Rachelle Doody the studys principal investigator and Effie Marie Cain chair in Alzheimers disease research at Baylor College of Medicine. This is coming along she told ABC News. Its coming along pretty quickly relative to other agents but this drug and all the others are not cures for the disease. Alzheimers patients like Henes are optimistic. I cant wait. I am so excited about the possibility Henes said. If I can stay the way I am now until a drug that comes along I will be a lucky person. To learn more about participating in the Phase III clinical trials of Dimebon visit this site http or call ...."

"A new report highlights a novel way for doctors to replace thinning hairlines transplanting leg hair. The report a study of two cases published in The Archives of Dermatology describes a new procedure in which receding hairlines were restored by taking hair follicles from patients legs and grafting them to the head. Mens leg hair had successfully been transplanted before to the back of the head but these are believed to be the first documented cases of leg hair being used to restore the hairline. The procedure has the potential to restore the hairlines of millions of men with male pattern baldness the most common cause of hair loss and often an enormous source of stress https The condition also called androgenic alopecia typically begins at the hairline and eventually creates a horseshoeshaped pattern of hair around the ears. It stems from a sensitivity largely genetic to the effects of hormones on hair follicles. In traditional transplants hair follicles are taken from an area that runs an inch or two above the ears and temples to the back of the head. Dermatologists can transplant follicles from this area called the safe donor zone because hair follicles there are impervious to the hormones that cause hair loss to the front of the head without worrying that the hair that grows from them will fall out. But hair that comes from the back of the head is typically much coarser than the fine hair that grows in front. If you look at a natural hairline its very soft like baby hair said Dr. Sanusi Umar an associate instructor of dermatology at the medical school of the University of California Los Angeles and author of the new report. The back of the head is where you find the thickest hair on the head. If you take that hair and use it in the hairline it can end up looking harsh and pluggy because the hair is too thick. Dr. Umar was inspired to develop the procedure in part from personal experience. In as a medical internist with thinning hair he underwent a traditional hair transplant procedure but was unhappy with the results. That inspired me to go into dermatology he said. After reading a report showing it was possible for transplanted leg hair to survive and grow naturally on the back of a mans head https Dr. Umar realized its potential to create softer more naturallooking hairlines. If you transplant leg hair on the head its not going to start acting like head hair. It will still grow shorter and slower than scalp hair he said. At his clinic in Redondo Beach Calif. Dr. Umar tried the technique on two patients one a yearold man who was embarrassed by the results of a traditional hair transplant to restore his hairline. He was selfconscious about the problem and resorted to styling his hair forward to obscure the hairline Dr. Umar wrote in his report. The other patient a yearold man who had also undergone a traditional transplant was likewise unhappy about his hairline which he felt was too harsh and straight Dr. Umar wrote. He had resorted to cropping his hair short to obscure the problem. With the patients under local anesthesia Dr. Umar used a device that creates microscopic wounds around hair follicles in the back of the leg the follicles were then removed and transplanted to the hairline. The hairs were removed in a diffuse pattern so there were no bald spots on the legs after the procedure. Because these are very tiny wounds they heal and close up with minimal scarring he said. In each case Dr. Umar and his team extracted about leg hair follicles and grafted them one by one to the patients hairlines. About to percent of the transplanted leg hair grew successfully on the patients heads after the operations and both men were happy with the results Dr. Umar said. The hairline was fully grown and softlooking by nine months in the yearold he wrote at which time the patient started combing his hair backward and sporting a ponytail exposing his hairline comfortably. Since then Dr. Umar has done eight more of the procedures including one in a woman. On average a procedure involves to follicles and takes about eight hours with breaks. A lot of these patients have no other options or alternatives he added. Theyve been told to forget about it by many other clinics. Its lifealtering for them when they realize that this is possible."

"Labor is an intensely strenuous activity with the uterine muscle contracting every few minutes to reposition a baby through the pelvis and down the birth canal. Even low levels of dehydration can seriously compromise normal physiological function yet recent studies looking at hydration in laboring women via the rates of intravenous IV fluid showed conflicting results. By pooling the data of several studies Thomas Jefferson University http researchers showed that a higher rate of IV fluids not only decreased csection rates but also shortened the overall length of labor by one hour as well as shortened the pushing phase. The results were published online as an accepted article https in Acta Obstetricia et Gynecologica Scandinavica. The results are compelling and strongly argue for a change in practice says Vincenzo Berghella M.D. the Director of Maternal Fetal Medicine and Professor in the Department of Obstetrics and Gynecology at the Sidney Kimmel Medical College at Thomas Jefferson University. We have already begun changing practice at Jefferson http to give women more fluids in labor to allow them to have the best chance of delivering vaginally. Dr. Berghella and colleagues compiled data from seven small clinical trials that collectively included a total of women. Of those about half or women received IV fluids at a rate of milliliters per hour and the other half women received fluids at the lower rate of milliliters per hour. General practice in the United States is to administer IV fluids at milliliters per hour during labor. With the data pooled the researchers could see a clear difference in outcomes for women in the two groups. Women getting the faster fluid rate milliliters per hour were less likely to get a cesarean section. The higher fluid rate also reduced the overall time of labor by an average of minutes and shortened the pushing phase by nearly minutes on average. Weve known that its important for women to stay well hydrated during pregnancy and labor. This study suggests that IV fluids could help women maintain hydration at appropriate levels reduce the likelihood of csection and decrease length of labor says Dr. Berghella. Recently we also showed that letting women eat more liberally in labor httpblogs.jefferson.eduatjeffinthenewsnewstudyshowseatingduringlaborcanbesafeforwomen especially in early labor has benefits including shorter labor and no identifiable risks. Today approximately one in three births in the United States occurs via csection despite an increased attention by national and international obstetric societies on safely reducing the practice. This study and others are providing evidence for changes in obstetric practice that could help safely reduce csection rates. Drs. Ehsanipoor Saccone Seligman PierceWilliams and Ciardulli were the coinvestigators with Dr Berghella. The authors report no conflicts of interest. Article reference R.M. Ehsanipoor. et al. Intravenous Fluid Rate for Reduction of Cesarean Delivery Rate in Nulliparous Women A Systematic Review and Metaanalysis. Acta Obstetricia et Gynecologica Scandinavica. doi .aogs.. . About Jefferson http Jefferson through its academic and clinical entities of Thomas Jefferson University and Jefferson Health including Abington Health and Aria Health is reimagining health care for the greater Philadelphia region and southern New Jersey. Jefferson has people dedicated to providing the highestquality compassionate clinical care for patients educating the health professionals of tomorrow and discovering new treatments and therapies to define the future of care. With a university and hospital that date back to today Jefferson is comprised of six colleges nine hospitals outpatient and urgent care locations and a multitude of physician practices throughout the region serving more than inpatients emergency patients and . million outpatients annually."

"The U.S. Food and Drug Administration today approved Nuplazid pimavanserin tablets the first drug approved to treat hallucinations and delusions associated with psychosis experienced by some people with Parkinsons disease. Hallucinations or delusions can occur in as many as percent of patients with Parkinsons disease at some time during the course of their illness. People who experience them see or hear things that are not there hallucinations andor have false beliefs delusions. The hallucinations and delusions experienced with Parkinsons disease are serious symptoms and can lead to thinking and emotions that are so impaired that the people experiencing them may not relate to loved ones well or take appropriate care of themselves. Hallucinations and delusions can be profoundly disturbing and disabling said Mitchell Mathis M.D. director of the Division of Psychiatry Products in the FDAs Center for Drug Evaluation and Research. Nuplazid represents an important treatment for people with Parkinsons disease who experience these symptoms. An estimated Americans are diagnosed with Parkinsons disease each year according to the National Institutes of Health and about one million Americans have the condition. The neurological disorder typically occurs in people over age when cells in the brain that produce a chemical called dopamine become impaired or die. Dopamine helps transmit signals between the areas of the brain that produce smooth purposeful movement like eating writing and shaving. Early symptoms of the disease are subtle and occur gradually. In some people Parkinsons disease progresses more quickly than in others. As the disease progresses the shaking or tremor which affects the majority of people with Parkinsons disease may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes hallucinations and delusions difficulty in swallowing chewing and speaking urinary problems or constipation skin problems and sleep disruptions. The effectiveness of Nuplazid was shown in a sixweek clinical trial of participants. Nuplazid was shown to be superior to placebo in decreasing the frequency andor severity of hallucinations and delusions without worsening the primary motor symptoms of Parkinsons disease. As with other atypical antipsychotic drugs Nuplazid has a Boxed Warning alerting health care professionals about an increased risk of death associated with the use of these drugs to treat older people with dementiarelated psychosis. No drug in this class is approved to treat patients with dementiarelated psychosis. In clinical trials the most common side effects reported by participants taking Nuplazid were swelling usually of the ankles legs and feet due to the accumulation of excessive fluid in the tissue peripheral edema nausea and abnormal state of mind confused state. Nuplazid was granted breakthrough therapy designation http for the treatment of hallucinations and delusions associated with Parkinsons disease. Breakthrough therapy designation is a program designed to expedite the development and review of drugs that are intended to treat a serious condition and where preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy on a clinically significant endpoint. The drug was also granted a priority review. The FDAs priority review http program provides for an expedited review of drugs that offer a significant improvement in the safety or effectiveness for the treatment prevention or diagnosis of a serious condition. Nuplazid is marketed by Acadia Pharmaceuticals Inc. of San Diego California. 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."

"Nearly every American who has become a parent in the last decade has heard the slogan breast milk is best and has likely been encouraged to offer breast milk to newborns. Among other things breast milk contains natural sources of prebiotics small indigestible fiber molecules that promote the growth of good bacteria in the babys gut. Yet for many families breastfeeding is difficult or impossible. Fortunately modern infant formulas are getting closer to the real thing with the help of University of Illinois researchers. In a recent study from the Piglet Nutrition and Cognition Lab at U of I scientists worked with piglets to show prebiotics included in infant formula can enhance memory and exploratory behavior. When we provide prebiotics in formula our results confirm that we can not only benefit gut health which is known but we can also influence brain development says Ryan Dilger associate professor in the Department of Animal Sciences Division of Nutritional Sciences and Neuroscience Program at U of I. We can actually change the way piglets learn and remember by influencing bacteria in the colon. Piglets are widely considered a more informative model for human infants than mice and rats their digestive systems behavioral responses and brain development are remarkably similar to human infants. Therefore researchers are increasingly turning to piglets to test hypotheses in preclinical trials related to human health especially in the context of gut microbes and brain development. There hasnt been a lot of work looking at the gutbrain axis in humans but a lot of rodent work is showing those connections. This is taking it to an animal model that is a lot closer to human infants and asking if that connection still exists and if we can tease out possible mechanisms says Stephen Fleming lead author of the study and a doctoral student in the Neuroscience Program at U of I. In early Dilger and his colleagues worked with piglets to show that a combination of innovative formula components including prebiotics may play a role in brain development and behavior. In their new study the team concentrated solely on the effects of prebiotics. Starting on the second day of life piglets were given a cows milkbased infant formula supplemented with polydextrose PDX a synthetic carbohydrate with prebiotic activity and galactooligosaccharide GOS a naturally occurring prebiotic. When the piglets were days old Fleming took them through several learning memory and stress tests. After days blood brain and intestinal tissues were collected for analysis. The test for learning and memory gave piglets a chance to play with dog toys one theyd seen before and one brandnew toy. If they spent more time with the new toy that was an indication that the piglet recognized it as new and preferred it. This novel object recognition test improves on classic maze tests commonly used in rodent studies. If youre trying to test for memory this test is closer to what wed do with an infant. After all we dont generally train infants on mazes Fleming says. We know from previous research this test works for pigs but this is the first published example of using it in a nutrition context. Pigs fed PDX and GOS spent more time playing with new objects than pigs who didnt receive the prebiotic supplements. The preference for novel objects an indication of natural curiosity is a sign of healthy brain development and points towards positive development of learning and memory. When prebiotics are working the way they should good bacteria increase in abundance. One way to tell is by looking at metabolic endproducts volatile fatty acids VFAs excreted by bacteria during digestion of prebiotic fibers. Volatile fatty acids are a global indicator for whether prebiotics had an effect on the overall population of bacteria. For example we might want to see an increase in Lactobacillus and other beneficial bacteria that produce butyrate Dilger explains. Volatile fatty acid VFA concentrations in the colon blood and brain were changed in pigs receiving PDX and GOS compared with control pigs. Recent evidence suggests that bacterial VFAs could be getting into the blood and traveling to the brain where they could potentially affect mood and behavior. We found that yes VFAs are absorbed in the blood of pigs that were fed PDXGOS. And yes they do get into the brain Fleming explains. But when we looked at the relationship between these VFAs and the results of our behavior tests there did not appear to be a clear connection. Another surprise was a decrease in serotonin in brains of pigs fed the prebiotic. When you hear less serotonin theres an immediate reaction to say Well thats bad Fleming says. Not necessarily those pigs didnt show greater anxiety than control pigs during a stress test or poorer performance when given a learning and memory test. The researchers hypothesize that the prebiotics may alter levels of tryptophan serotonins amino acid precursor but its too early to say. Although more work is needed to tackle remaining questions the study adds to the growing body of research suggesting a strong and potentially modifiable link between the gut and the brain a link that makers of infant formula should strongly consider. There are so many ways we can alter the composition of the microbiota and they can have very strong benefits. Promoting good gut health remains a strong focus in the field of nutrition Dilger says. The article Dietary polydextrose and galactooligosaccharide increase exploratory behavior improve recognition memory and alter neurochemistry in the young pig is published in Nutritional Neuroscience. Fleming and Dilgers coauthors include Supida Monaikul Alexander Patsavas Rosaline Waworuntu and Brian Berg. The work was supported by Mead Johnson Nutrition."

"In I was shocked to learn that new guidelines issued by the The American College of Obstetricians and Gynecologists http stated that women should wait three to five years between pap smears which are the primary method of screening for cervical cancer. Thanks to that recommendation which has influenced insurance company policies annual pap tests are no longer the standard of care today and I see that as a huge problem. For one the three to fiveyear interval between screening tests for women ages to doesnt take into account the several risk factors that boost a womans chance of developing cervical cancer such as multiple sexual partners a weakened immune system that occurs with smoking and even oral contraceptive use for more than five year http For these women there is a still a serious need for more frequent cervical cancer screening but nowhere in the guidelines are these risk factors addressed. Unfortunately the only risk factor that changes the recommended frequency of screening is an abnormal pap result in the past. I watched a yearold woman die of cervical cancer during my OBGYN residency and it was horrible. I dont see why major medical organizations have made a recommendation that puts women at risk of a cancer that can be so easily prevented and frankly I see it as more of an economic decision than anything else. Lets take a closer look at what this means Lets say you have multiple sexual partners and during a visit to your gynecologist this information flies under the radar for whatever reason. A woman with multiple sexual partners has a greater chance of acquiring HPV the virus that causes most cervical cancers. By the same token no one brings up the issue of your partners number of partners. And by the way you can never be percent positive that your partner is monogamous no one can The greater the number of partners he has the greater his risk of contracting HPV and passing it to you. So you arent given cervical cancer screening that day when in fact many doctors would agree that you need it. Another problem I have with the current guidelines is this New recommendations published last summer in the Annals of Internal Medicine httpannals.orgarticle.aspxarticleid advised physicians to stop offering routine pelvic exams to asymptomatic averagerisk women. I find this outrageous. Pelvic exams allow your physician to inspect the vulva for changes and even feel around the ovaries uterus and fallopian tubes for any masses. The delay to diagnosis of vulvar cancer specifically is about months. A gynecologist is trained to detect early changes and then do a biopsy for anything suspicious. As a diagnostic and screening tool the pelvic exam is vital. What makes all of this even worse No more pelvic exams and infrequent paps mean women wont see their gynecologist as regularly and they may miss opportunities to voice concerns related to their reproductive health. An annual wellwoman visit with your gynecologist allows you to discuss your health status sexual practices contraception needs and get a breast exam among other things so its still important for you to go even if you dont end up having a pap or pelvic exam. Ultimately when it comes to gynecological cancer screening tests every woman has individual risk factors so you should talk to your doctor about yours. If you fall into any of the high risk categories you have multiple partners you smoke or are otherwise immunocompromised and youve been on birth control pills for five years or more you really should be screened at least every other year. If youre insurance denies to cover this you should fight them on the basis of being at a higher risk. And always be sure to visit your gyno if youre having any sort of symptom such as pelvic pain irregular discharge or sexual dysfunction all of which can point to a more serious problem. In these cases you should be given a pelvic exam at the very least."

"A cure for Alzheimers disease AD a condition marked by progressive debilitating cognitive decline that affects more than . million Americans is the holy grail in disease research. One expert Dr. Dale Bredesen a professor at the Buck Institute for Research on Aging and a professor at the Easton Laboratories for Neurodegenerative Disease Research at UCLA thinks he might have found a way to reverse memory loss a hallmark of the disease. In a study published in the journal Aging Bredesen and colleagues showed how patients who were experiencing agerelated memory decline showed brain scan improvements after following an approach called metabolic enhancement for neurodegeneration MEND a point individualized regimen of diet exercise brain stimulation sleep improvements medication and vitamins and other specific protocols for five to months. For example an MRI of one patient showed hippocampal volume at the th percentile for his age range prior to MEND. The hippocampus is a brain area critical for learning and memory that shrinks in Alzheimers patients. After months of following the prescribed protocol his hippocampal volume increased to the th percentile. The study noted that some of the patients who had to quit working as a result of their memory decline were able to return to work after adopting MEND and participants who were struggling at their jobs reported an improvement in job performance. Lives have been dramatically impacted Bredesen told CBS News. Im enthusiastic about that and continue to evolve the protocol. James E. Galvin M.D. M.P.H. a professor of clinical biomedical science at FAUs Charles E. Schmidt College of Medicine and a professor in the Christine E. Lynn College of Nursing who was not involved in the study agreed that personalized approaches such as the MEND protocol are the types of approaches needed for this disease going forward. Its important to be excited about this approach he told CBS News. However Galvin cautioned Im not sure about the method. The MEND protocol outlined in a study in the journal Aging calls for interventions to treat conditions that could be associated with Alzheimers such as inflammation stress and diabetes. However MEND also requires the use of supplements which are not well studied and do not require FDA approval. Not all things from the approach have a lot of scientific support behind them Galvin told CBS News. But Bredesen believes that the only way to treat Alzheimers is to treat all of the underlying problems which may require intervention with supplements. Nutrition exercise sleep stress reduction these are all critical pieces of this he told CBS News. Its about optimizing biochemistry for your genetics whatever it takes. But even if MEND is effective the program is complex and difficult to follow. A Buck Institute press release on the study stated None of the patients were able to stick to the entire protocol. The significant diet and lifestyle changes and multiple pills required each day were the two most common complaints. Bredesen said that to simplify the program they are connecting patients with health coaches. Were trying to make it simpler but we dont want to lose the efficacy he said. Bredesen noted too that the MEND protocol was suitable for patients in the early stages of Alzheimers. One participant from the study who had been diagnosed with latestage Alzheimers did not show improvements with the protocol. If you told me that your mother is and living in a home I would say that Id want to treat you he said. Its about prevention. Bredesen said that his team has a couple of larger trials planned to confirm or refute the results in the current study and to address key questions about how long results can be maintained and how late in the course of cognitive decline reversal is possible. Galvin agrees that more research is necessary before any conclusive results can be reported. This is moving in the right direction he told CBS News. These anecdotal case reports provide a nice point to start a discussion."

"It can be an all too common scenario for certain stroke https survivors. They cant see or recognize anything on one side of their body. This condition often occurs after a stroke https on the right side of the brain https and is typically treated with a combination of physical therapy https and brain https retraining or mental tasks using a pen and paper or computer. This is often not enough to make a meaningful improvement. Now new research in Neurology suggests that stimulating the nerve cells in the brain https with magnet therapy may aid recovery. During transcranial magnetic stimulation TMS a doctor places a large magnetic coil against the patients scalp which creates electric currents to stimulate nerve cells. After a stroke https one side of the brain https can become overactive and its circuits can get overloaded. Enter TMS. This therapy may restore balance between the two sides of the brain. And according to the new study it helps. Ten out of people who faced this problem following a stroke received the magnet therapy daily for two weeks. The other received a fake treatment. All participants also did standard brain retraining. Everyone took tests that measured their abilities after the study and then again two weeks later. The tests measured line crossing and figure and shapecopying ability. The tests also measured activities of daily living affected by neglect such as dialing numbers on a phone reading a menu and sorting coins. Overall participants who received the magnet therapy improved by . immediately following treatment and by . two weeks later. There were no improvements seen in test scores of those who got the other treatment. The overactive brain circuits also improved among people who got the TMS treatment the study showed. Researcher Giacomo Koch MD PhD of the Santa Lucia Foundation in Rome Italy and colleagues point out that the changes could be the combined effects of the mental tasks and the TMS. Cautious Optimism About Magnet Therapy Stroke specialists and others who are familiar with TMS are cautiously optimistic about the role this treatment may one day play in stroke rehabilitation. This is an intriguing and important study says Ralph L. Sacco MD. He is chairman of the neurology department at the University of Miami Miller School of Medicine. This work is preliminary he says. TMS is not ready for prime time but this is an important step in the right direction. Patrick Lyden MD says that rehab alone could and should be enough to treat this kind of stroke. He is chairman of the department of neurology at CedarsSinai Medical Center in Los Angeles. If we could get more patients into a good rehab program we wouldnt need fancy stimulation techniques he says. Unfortunately we do. And this is a very novel treatment and very exciting information. Alan Manevitz MD is a psychiatrist https at New York Citys Lenox Hill Hospital. He uses TMS to treat people with depression https including depression https that can follow a stroke. The new study suggests that TMS has tremendous potential in treating stroke https disability he says. It is premature to know whether the transcranial magnetic stimulation will have an impact on clinical treatment says Randolph Marshall MD MS. He is chief of the stroke division of the department of neurology at Columbia University Medical Center and he wrote an editorial to the study. The TMS units are expensive and require specialized training. Nonetheless if it is proven effective in a larger clinical trial https the use of TMS may burgeon he says."

"Janet Jay is a cyborg. No shes not RoboCop or Darth Vader. But she shares a similarity with those characters Her alltoohuman body has been upgraded with a machine. A nextgeneration implant deep in Jays back stimulates her spinal cord overriding her bodys pain signals to give her some relief from the back pain that has plagued her for years. In an article https on Popular Sciences website Jay writes about her experience with pain and the nextgeneration way shes finding relief. She is hardly alone in her suffering. According to the National Center for Health Statistics httpsnccih.nih.govnewspress an estimated . million Americans or . percent of U.S. adults experience chronic pain. It can interfere with work and home life and leave patients debilitated disabled and depressed. So it makes sense that Jay jumped at the chance to experience longterm pain relief with the help of a spinalcord stimulator. Jay lays out the hows and whys of spinal stimulation and she paints a vivid picture of a life in agony a journey that has included skeptical doctors plenty of painkillers and unanswered questions about the future. She also describes her path to spinal stimulation how the device works with the body to shortcircuit pain and the many roadblocks to relief that patients face. Even for me the battle is not over Jay writes. Since this surgery Ive actually had another disc herniate complicating everything. My spine isnt cured and I still hurt all the time. But the pain is far more controlled and I can function much better at my current level of discomfort. As the human and financial costs of the opioid crisis rise spinal stimulation may become more popular even though its expensive. Jay says she was lucky Her insurance covered much of the sixfigure bill for the procedure."

"Using electrical pulses to stimulate nerve centers deep within the brain https may reduce high blood pressure https that cant be controlled with medication a case report shows. Doctors in the U.K. made the discovery after implanting a device that works as an electric stimulator of a region of the brain https in a yearold man who had developed chronic pain https on the left side of his body following a stroke https Though his pain eventually returned after four months his doctors report that their patients previously uncontrolled blood pressure https has remained normal for nearly three years. That was a surprise because experts had long thought that pain had to be reduced to see a reduction in blood pressure. Pain creates stress and that can have an effect on ones blood pressure says Nikunj J. Patel MD a neurosurgeon at Frenchay Hospital in Bristol U.K. and an author of the case study. Patel says that makes the impact of the case study startling and exciting because if studies bear the findings out deep brain https stimulation may one day help people with hypertension https whose blood pressure remains uncontrolled on multiple medications https The case study is published in the Jan. issue of Neurology. While the case study is only an example of the phenomenon occurring in a single person previous reports have observed the same kinds of reductions in blood https pressure in people getting deep brain https stimulation for pain though researchers had believed that the blood https pressure benefit was directly tied to the degree of pain relief the person experienced. What their case report shows is that blood pressure can be reduced in a sustained fashion in a patient with unsuccessful deep brain stimulation for pain says Erlick Pereira MD a neurosurgeon at the University of Oxford. Pereira wrote about blood pressure reductions in a patient getting deep brain stimulation in the January issue of the Journal of Clinical Neuroscience. I think thats important because it paves the way for potentially studying patients without chronic pain https and offering the treatment sometime in the future to reduce blood pressure he says. Blood Pressure Control The doctors report that their patient immediately following his stroke https had spiking blood pressure that ranged from to . Normal blood pressure is or lower. Even after taking a combination of four different hypertension https medications the man was unable to get his blood pressure down and eventually though he regained movement after being partially paralyzed by his stroke https he developed a chronic pain. Doctors tried for three years to control their patients pain without success. So they agreed that he might be a candidate for deep brain stimulation which can sometimes be helpful for people who cant find relief any other way. At first the neurostimulator seemed to help the pain and when doctors measured their patients blood pressure they were surprised to find that it had dropped significantly to as low as . They took the patient off all his hypertension https medications and his blood pressure normalized to an average of in the first eight weeks after surgery. Within weeks his blood pressure had inched back up only slightly to . After four months the pain relief from the electrical stimulation wore off but his blood pressure stayed down. After more than two years with blood pressure still near normal his doctors tested his response by switching the neurostimulator on and off. When the device was off his blood pressure increased by about points. When it was turned back on his blood pressure dropped by points. DrugResistant High Blood Pressure According to the National Center for Health Statistics about one in three Americans has high blood pressure. Studies suggest that about one in eight people being treated for hypertension cant get their blood pressure under control even on three or more medications. Uncontrolled high blood pressure can lead to myriad health problems including heart https and kidney failure https eye https damage and blindness strokes and heart attacks https dementia https and erectile dysfunction https When medication fails newer surgical interventions including renal nerve ablation where nerves in the major arteries https of the kidneys https are zapped and deactivated with radiofrequency energy and carotid baroreceptor stimulation where electrodes stimulate nerves near major arteries that supply blood to the brain may be options that can help reduce the risks of major complications from very high blood pressure. These treatments are not a panacea Patel says. Onethird of the people who get these interventions are still not helped. With further testing experts think deep brain stimulation could become a third interventional option for patients. Its a procedure with tiny but important risks says Pereira. Those risks include bleeding in the brain https infection and reactions to the surgical anesthesia. Additionally the electrodes may be placed too closely to other brain areas and affect things like speech and movement and the wires may break or malfunction. But if we can follow a group of patients over three years or more and show that the blood pressure reductions are sustained this could become an important third option. Deep Brain Stimulation and Blood Pressure The region of the brain being stimulated in these procedures which is called the periaqueductal gray PAGperiventricular gray PVG region acts like a switchboard for pain signals throughout the body. It also controls the bodys response to stress the fightorflight response. In response to a perceived threat the body prepares for action by increasing the heart rate https and blood pressure. Some researchers think that stimulating the PAGPVG region can help shut down an overactive stress response letting blood pressure and heart rate return to normal levels. In deep brain stimulation electrodes are implanted into areas of the brain. Wires attach the electrodes to small metal electrical impulse generators that are implanted under the skin https on the chest. Deep brain stimulation is FDA approved to treat movement disorders including Parkinsons disease and essential tremor https It is also has an FDA humanitarian device exemption for treatment of dystonia https and severe cases of obsessivecompulsive disorder."

"The U.S. Food and Drug Administration today approved Trulance plecanatide for the treatment of Chronic Idiopathic Constipation CIC in adult patients. No one medication works for all patients suffering from chronic gastrointestinal disorders said Julie Beitz M.D. director of the Office of Drug Evaluation III in the FDAs Center for Drug Evaluation and Research. With the availability of new therapies patients and their doctors can select the most appropriate treatment for their condition. According to the National Institutes of Health an estimated million people are affected by constipation. Chronic idiopathic constipation is a diagnosis given to those who experience persistent constipation and for whom there is no structural or biochemical explanation. Trulance taken orally once daily works locally in the upper GI tract to stimulate secretion of intestinal fluid and support regular bowel function. The safety and efficacy of Trulance were established in two week placebocontrolled trials including adult participants. Participants were randomly assigned to receive a placebo or Trulance once daily. Participants in the trials were required to have been diagnosed with constipation at least six months prior to the study onset and to have less than three defecations per week in the previous three months as well as other symptoms associated with constipation. Participants receiving Trulance were more likely to experience improvement in the frequency of complete spontaneous bowel movements than those receiving placebo and also had improvements in stool frequency and consistency and straining. Trulance should not be used in children less than six years of age due to the risk of serious dehydration. Trulance should be avoided in patients six years of age to years of age. The safety and effectiveness of Trulance have not been established in patients less than years of age. Trulance should not be used in patients with known or suspected mechanical gastrointestinal obstruction. The most common and serious side effects of Trulance was diarrhea. Patients may experience severe diarrhea. If severe diarrhea occurs patients should stop taking Trulance and contact their health care provider. Trulance is manufactured by New York New Yorkbased Synergy Pharmaceuticals 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."

"In a remarkably rapid translation of laboratory research findings into a treatment with the potential to benefit patients UC San Francisco scientists have successfully completed a Phase II clinical trial showing that an FDAapproved antihistamine restores nervous system function in patients with chronic multiple sclerosis MS. In light of previous laboratory studies of the antihistamine compound at UCSF the researchers said the drug most likely exerted its effect by repairing damage MS had inflicted on myelin an insulating membrane that speeds transmission of electrical signals in the nervous system. The drug tested in the trial clemastine fumarate was first identified as a candidate treatment for MS in by UCSFs Jonah R. Chan PhD Debbie and Andy Rachleff Distinguished Professor of Neurology vice chief of the Division of Neuroinflammation and Glial Biology and senior author of the new study. First approved by the U.S. Food and Drug Administration FDA in for allergies the drug has been available over the counter in generic form since . The researchers said that the Phase II results published online on October in The Lancet are the first in which a drug has been shown to reliably restore any brain function damaged by a neurological disease in human patients. To the best of our knowledge this is the first time a therapy has been able to reverse deficits caused by MS. Its not a cure but its a first step towards restoring brain function to the millions who are affected by this chronic debilitating disease said the trials principal investigator Ari Green MD also Debbie and Andy Rachleff Distinguished Professor of Neurology chief of the Division of Neuroinflammation and Glial Biology and medical director of the UCSF Multiple Sclerosis and Neuroinflammation Center. Chan and Green are codirectors of the UCSF SmallMolecule Program for Remyelination and both are members of the UCSF Weill Institute for Neurosciences. The new results are particularly notable Chan said because patients in the trial had suffered from MS symptoms caused by injury to myelin for years. People thought we were absolutely crazy to launch this trial because they thought that only in newly diagnosed cases could a drug like this be effective intuitively if myelin damage is new the chance of repair is strong. In the patients in our trial the disease had gone on for years but we still saw strong evidence of repair. MS is an autoimmune neurodegenerative disorder that affects nearly . million people worldwide. The disease strikes when the immune system attacks myelin layers of fatty insulating membrane that surround nerve fibers. Unlike the rubber insulation around wires however myelin helps electrical signals in neurons move faster and more efficiently. As myelin damage continues over the course of the disease neurons progressively lose their ability to reliably transmit electrical signals resulting in progressive loss of vision weakness walking difficulties and problems with coordination and balance. Current MS treatments aim to prevent the immune system from doing further harm but none have been shown to repair damaged myelin. In both his research and in subsequent studies with a mouse model of MS however Chan and colleagues had demonstrated that clemastine fumarate promotes myelin regeneration and restores neural function promising preclinical results that inspired the new study known as the ReBUILD trial. Because the visual system is often one of the first and most prominent parts of the brain to be affected in MS and because there are wellestablished tools to measure the speed of neural transmission in the areas of the brain devoted to vision the research team used a method known as visual evoked potentials or VEPs to assess clemastines therapeutic effects in the trial. The fivemonth Phase II trial enrolled patients with relapsing but generally longstanding MS whose VEPs reflected preexisting deficits in neural transmission. The researchers showed flickering patterns on a screen to participants and used electrodes placed over the brains visual areas at the back of the head to gauge how long it took for the flickering signal presented to the eye to generate an electrical response that could be detected by the electrodes. The time from presentation of the pattern to the detection of the VEP is a measurement of how long it took for the signal to travel via nerve fibers from the retina at the back of the eye to the visual areas at the back of the brain. To enhance the power of their study the researchers used a crossover design they divided the patient population in two and gave the drug blinded to both participant and researcher to one group and a placebo to the other for days then they switched between the two groups giving a placebo to the first group and the drug to the other for the next days. This flipflop technique gave the researchers the ability to compare patients to themselves a form of control that increased the statistical power of the study by nearly an order of magnitude Green said. During the periods when each group was taking the drug the neural signal from the eye to the back of the brain was significantly accelerated over the baseline measurements taken before the patients began the study. The effect persisted in the group that had switched to placebo suggesting that durable repair of myelin had been induced by the drug. Although the research team could not directly observe evidence of rebuilding of myelin in trial participants using magnetic resonance imaging MRI Chan and Green said that this reflects a weakness of current MRI techniques as a tool for this purpose rather than evidence that myelin regeneration did not take place. We still dont have imaging methods that have been proven to be able to detect remyelination in humans said Chan. That myelin increases the speed of neural transmission is one of the most wellestablished concepts in neurobiology and combined with the clear evidence from Chans preclinical research showing that clemastine fumarate promotes myelin formation myelin regeneration is the only plausible explanation for the VEP results the authors said. This is the first step in a long process Green said. By no means do we want to suggest that this is a cureall. We want to groundtruth myelination metrics were designing the crucible thats going to be used to test any future method for detecting remyelination. The work was funded through generous support from the Rachleff Family. In addition to Green and Chan authors all at UCSF include Jeffrey M Gelfand MD MAS Bruce A Cree MD PhD MAS Carolyn Bevan MD W. John Boscardin PhD Feng Mei PhD Justin Inman Sam Arnow Michael Devereux Aya Abounasr Hiroko Nobuta PhD Alyssa Zhu Matt Friessen PhD Roy Gerona PhD Hans Christian von Bdingen MD PhD Roland G Henry PhD and Stephen L Hauser MD. UC San Francisco UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research graduatelevel education in the life sciences and health professions and excellence in patient care. It includes topranked graduate schools of dentistry medicine nursing and pharmacy a graduate division with nationally renowned programs in basic biomedical translational and population sciences and a preeminent biomedical research enterprise. It also includes UCSF Health which comprises three topranked hospitals UCSF Medical Center and UCSF Benioff Childrens Hospitals in San Francisco and Oakland and other partner and affiliated hospitals and healthcare providers throughout the Bay Area."

"It sounds almost too good to be true a twostep cream that tightens up baggy eyes and can keep dry legs from flaking. A team at the Massachusetts Institute of Technology has developed the cream and licensed it to two companies with close ties to the lab one called Living Proof best known for spinning out MIT inventions to the hair care market and a second one called Olivo Labs which will develop it for medical uses perhaps to deliver drugs to the skin. The creams effects are detailed in a scientific report in the journal Nature Materials but as part of the schools close association with the companies its being patented and produced at almost the same time. First the science. The research was led by Robert Langer a prolific inventor who heads a biological engineering lab at MIT. Writing in the journal Nature Materials the team said they searched databases for materials that were already on the market and recognized as safe that could take a whole new approach to skin care. Betty Yu the companys principal scientist earned her PhD in biochemistry and toxicology. She has studied how to deliver drugs into the skin and led efforts to develop hair care products. She wanted to move on to skin products. They wanted something stretchy and strong that wouldnt pucker up when it dried on the skin and that would be breathable. You put on a primer layer just kind of rub it in. Then you put on a second layer and rub that one in. It has to have the right optical properties otherwise it wont look good and it has to have the right mechanical properties otherwise it wont have the right strength and it wont perform correctly Langer said. Creating a material that behaves like skin is very difficult added Dr. Barbara Gilchrest a dermatologist at the Massachusetts General Hospital who worked on the study. Many people have tried to do this and the materials that have been available up until this have not had the properties of being flexible comfortable nonirritating and able to conform to the movement of the skin and return to its original shape. They screened about compounds before settling on polysiloxane a siliconebased gel. They call it a crosslinked polymer layer or XPL for short. It works in two parts Langer told NBC News. You put on a primer layer just kind of rub it in. Then you put on a second layer and rub that one in. Theres crosslinking and it tightens it up. Crosslinking is a wellunderstood process. Separate strands of material become stronger when they link up. Vulcanization used to make tires is a crosslinking process Langer said. Rubber alone would not be that strong. In this case the catalyst is platinumbased and it turns the gel into a thin stretchy sheet. There are hundreds of skin products that do this now but this one sticks better and doesnt pucker the skin the team reports. Lightscattering particles are added to the second layer and they reflect light off the skin making it look clearer and smoother. Langer tried it on his arm. It was almost like you couldnt see it. After a minute I didnt know it was there he said. They ran four experiments on the product. In one they applied it to the skin under the eyes of volunteers. It lasted for hours before it started peeling off and smoothed out the eye bags that become so common as people age they wrote. Such a result has been previously achieved only by a lower lid blepharoplasty an invasive surgical procedure they wrote. They demonstrate it in this video. https They also put tested at against petroleum jelly and regular moisturizer on people with dry flaky legs. The XPL lasted longer and helped keep the skin from losing moisture better than the petroleum jelly which lasted better than moisturizer. For now there is no magical cream that can make you look younger. The results confirmed the XPL as a second skin barrier that protects the skin from excessive moisture loss to the environment they wrote. Repeated daily wear resulted in no report of irritation or other adverse events resulting from the XPL use. Furthermore the XPL remained intact following activities such as swimming running and exposure to rain they added. The stuff can just be peeled off or taken off with makeup remover the researchers said. Dermatologist Dr. Jennifer Lucas of the Cleveland Clinic who was not involved in the study said shed have to see longterm results to make a judgment. Conceptually its a great and novel idea she said. For now there is no magical cream that can make you look younger. Olivo will work first to develop the product to deliver drugs to the skin perhaps allergy or eczema medication or longlasting sunscreen MIT said. Langer said it might also be used to help burn patients."

"Shoulder instability is most common in the young athletic population bringing a focus to how these injuries are best treated. Research presented today at the American Orthopaedic Society for Sports Medicines AOSSM http Annual Meeting in Colorado Springs CO demonstrated that surgery after a firsttime shoulder dislocation lowered the reinjury risks and need for followup surgery when compared to those who were initially treated nonoperatively and experienced a repeat dislocation prior to surgery. The study examined patients at an average of months postsurgery. Of this group patients had experienced their first dislocation while had recurrent dislocations after being initially treated nonoperatively. After treatment with an arthroscopic bankart repair the postoperative dislocation rate in the firsttime injury group was compared to in those who did not have surgery after their initial injury. The average age of patients was years old. Deciding between a nonoperative program or going forward with surgery can be a challenging decision for medical professionals treating shoulder injuries in young athletes noted the studys lead author Tyler J. Marshall MD from Alabama Ortho Spine and Sports in Birmingham AL. However this study shows a substantial benefit for athletes undergoing surgery to prevent recurrent instability down the road. The research data was collected between and from eight fellowship trained surgical practices with patient ages ranging from to years old. Surveys given to patients during followups asked for information such as test for shoulder functionality whether patients returned to sport postoperative instability events and if further surgery was required on the shoulder. While young athletes and parents may be wary of surgery our study shows the advantages of this treatment approach commented Marshall. Physicians should counsel those with first time injuries on these benefits moving forward. The American Orthopaedic Society for Sports Medicine AOSSM is a global leader in orthopaedic sports medicine education research communication and fellowship and includes national and international sports medicine leaders. The Society works closely with many other sports medicine specialists including athletic trainers physical therapists family physicians and others to improve the identification prevention treatment and rehabilitation of sports injuries. AOSSM is also a founding partner of the STOP Sports Injuries http campaign to prevent overuse and traumatic injuries in kids"

"Pungent steam rises from a boiling pot of a mugwort tea blended with wormwood and a variety of other herbs. Above it sits a nude woman on an openseated stool partaking in a centuriesold Korean remedy that is gaining a toehold in the West. Vaginal steam baths called chaiyok are said to reduce stress fight infections clear hemorrhoids regulate menstrual cycles and aid infertility among many other health benefits. In Korea many women steam regularly after their monthly periods. There is folk wisdom and even some logic to support the idea that the carefully targeted steam may provide some physiological benefits for women. But there are no studies to document its effectiveness and few American doctors have even heard of it. It sounds like voodoo medicine that sometimes works said Dr. Vicken Sahakian medical director of Pacific Fertility Center in Los Angeles. Niki Han Schwarz believes it worked for her. After five steams she found she had fewer body aches and more energy. She also became pregnant eight months ago at the age of after attempting to conceive for three years. Han Schwarz and her husband orthopedic surgeon Charles Schwarz are determined to introduce vaginal steam baths to Southern California women. Their Santa Monica spa Tikkun Holistic Spa offers a minute VSteam treatment for . The identical treatment is available for men to steam the perineal area. At Daengki Spa in Koreatown a minute VHerbal Therapy treatment can be had for a squat. The steam includes a mixture of herbs imported from Korea by spa manager Jin Young. The spas website claims the treatment will rid the body of toxins and help women with menstrual cramps bladder infections kidney problems and fertility issues. It is a traditional Korean health remedy according to the website. Across the country chaiyok treatments are not easy to find. They are available in a scattering of alternative holistic health centers. The flashy Juvenex Spa in Manhattan offers its minute Gyno Spa Cure for . A complete setup for a doityourself steam openseated stool boiler and herbs can be purchased online at http for . The two predominant herbs in the steam bath mixture are mugwort and wormwood. Mugwort Artemisia vulgaris has been used in Eastern medicine for hundreds of years to balance female hormones. It contains natural antibiotics and antifungal agents according to herbalists and alternative medicine journals. It is also said to stimulate the production of hormones to maintain uterine health protect the uterus from ulcers and tumors stimulate menstrual discharge and ease fatigue headaches abdominal discomfort and nausea among other claims. Wormwood Artemisia herba an antimicrobial cooling herb is also popular in Eastern medicine. It has been used historically to induce uterine contractions and treat bladder infections fevers open sores constipation diarrhea hepatitis jaundice eczema and parasitic infections. The leaves and young shoots are antibacterial and antiviral and they also relax the blood vessels and promote the discharge of bile according to historical tradition. Neither herb has been subjected to the rigorous analysis used to vet Western medicines. But Han Schwarz says she and her husband became persuaded by the herbs healing abilities after conducting a factfinding mission in South Korea. They discovered that people there used the herbs to aid digestive disorders and immune system strength for reduction of headaches and pain from inflammatory conditions to improve energy to regulate the menstrual cycle and hormones and to detoxify the uterus. One of their clients Sherman Oaksbased writer Lanee Neil said she prefers the VSteam to the harshness of a douche and thinks of it as a facial for her private area. Its a simple relaxing treatment says Neil who hopes it will help her become pregnant. You can imagine people doing this in the forest somewhere. TaeCheong Choo who teaches at Samra University of Oriental Medicine in Los Angeles strongly endorses chaiyok treatment especially for gynecological problems and infertility. He says he used to administer it to his patients in Korea but he doesnt have the time to prepare the formula here. Many infertility problems are related to coldness and stagnation Choo says. The chaiyok treatment is effective for coldness or poor circulation in the lower part of the body because it increases the blood circulation and blood supplies nutrition so the more blood supply the faster the healing process. Dr. Suzanne GilbergLenz an obstetrician and gynecologist at Womens Care of Beverly Hills Medical Group says the idea of steaming the pelvic area is not insane. The heat boosts circulation and the increased blood flow brings more oxygen and immune factors to the region she says. However she notes its impossible to say whether the herbal steam does any good. Most of these kinds of treatments are not put through intensive clinical trials so it becomes challenging to evaluate the actual impact they have she says. In addition traditional practices like chaiyok have been cut off from the larger system they grew out of including factors of cultural and family life diet environment etc. Theres a bigger picture that were really missing."

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

"The first year of free lung cancer screening in the Augusta Georgia area found more than double the rate seen in a previous large national study as well as a Massachusettsbased screening for this number one cancer killer. The higher rates coupled with the majority of cases being found in early treatable stages point toward the need for ongoing accessible free screening in highrisk populations and underserved regions say researchers at the Georgia Cancer Center at Augusta University. High risk includes those who have smoked a pack of cigarettes daily for two or three decades and if theyve quit smoking did so less than years ago. The screening of highrisk individuals within a mile radius of Augusta found percent had lung cancer and percent of those were caught early said Dr. Carsten Schroeder thoracic oncology surgeon at the Georgia Cancer Center and Medical College of Georgia at AU. The researchers note that a percentage of the patients presenting at screening had early symptoms like a persistent cough so the rate of cancer detection in patients who showed no indication of disease was . percent still double the rates of previous studies. Lung cancer is still the number one cancer killer in the United States and in our world Schroeder said. If we catch it in the early stages ideally before symptoms surface we can operate and patients can have an overall survival rate of percent. Fiveyear survival rates are closer to percent in more advanced disease. The pioneering National Lung Screening Trial which began in and included largely urban centers found cases of lung cancer among the highrisk individuals screened in the first year for a rate of . percent. That study also provided the first broad evidence that lowdose computed tomography or LDCT was a more effective screening tool than the traditional chest Xray. A decade later the Massachusettsbased Lahey Hospital Medical Center on which the Augusta screening was modeled found a . percent prevalence in the first months of screening. Like the previous experiences the Augusta area screening that started in also reiterated the ability of LDCT to find lung cancer early said Schroeder corresponding author of the study in Southern Medical Journal. Six of the eight cases found in the screening were considered potentially curable with surgery. Positive results were communicated directly to the participants primary care provider negative results were communicated to primary care docs and participants along with a reminder for another screening in a year. Participants particularly from surrounding more rural communities have limited access to health care Schroeder said. The areas median household income is percent lower than the national average and the poverty level is percent higher according to the U.S. Census Bureau. The Augustaarea experience found generally younger patients who started smoking earlier in life and had multiple risk factors. Augusta area participants were an average of years old about half male and female more than percent were white and nearly percent were black. It doesnt matter how old you are if you have smoked years you might want to consider a lungcancer screening Schroeder said referencing the reality that some adults started smoking as children. Part of his drive to start a screening program in the Augusta area was that when he relocated here three years ago from the Cleveland area he found patients were often referred to him with later lesstreatable disease. In the Cleveland area where Schroeder previously practiced as a faculty member at Case Western Reserve University and where access to health care andor health insurance was more widely available early lung cancers might even be detected incidentally when patients had CT scans for a variety of other reasons. Augusta researchers were able to offer free screening by utilizing natural downtime of the combined positive emission tomography or PET and computed tomography or CT scanner said Dr. Norman B. Thomson III chief of generalcardiothoracic radiology in the MCG Department of Radiology and Imaging and study coauthor. The combination technology is often used to visualize other tumor types throughout the body and many patients require an injection of sugar dye which will be taken up by the tumor but must first circulate for about an hour before the scan is done. That means the machine is staffed at times when it is not able to be fully used for other diagnostic procedures time that provides a natural window for lung screening using just the CT imaging capability in under five minutes from arrival to exit Thomson said. More typically a scan could cost between . In the last decade CT technology has gotten increasingly adept at picking up early small nodules Thomson said. Low radiation doses work well in the lungs which are mostly filled with air that provides a blank background for nodule surveillance. Thomson notes that means LDCT is also adept at finding things like scar tissue and small inflammatory nodules that also are more common in the lungs of smokers. Nodules a third of an inch or smaller tend not to be cancer and more solid masses tend to be Thomson said. They may follow up on smaller nodules in six months then if the nodule is stable go back to annual reviews. And while some lung cancers are super aggressive screening also may uncover some slowgrowing versions that like some prostate cancers will not threaten life but need to be treated andor closely followed once found. Thats why the acid test for screening is not how many cancers you find or what stage the cancer is Thomson said rather what screening does to lung cancer death rates. Current evidence definitely supports screening he said. Also like lung cancer has been coincidently found in CT scans for other reasons physicians like Thomson and Schroeder are now incidentally finding cardiovascular disease in their lung cancer screening. To date about individuals have been screened in the Augusta area and Schroeder is working to expand statewide hoping to use the state public medical schools extensive campus network that has students learning from physicians at practices and hospitals across Georgia as a natural base. We want to reach as many people as we can as early as we can he said. Also about half of patients screened continue to smoke so screening might also be a logical point for smoking intervention Schroeder said. The original National Lung Screening Trial orchestrated by the National Cancer Institute and the American College of Radiology was launched in and enrolled nearly patients nationally. Fiveyear survival rates were about percent for early cancers and about percent for lung cancer found late. Following the trial the National Comprehensive Cancer Network a nonprofit organization of cancer centers that develop guidelines for cancer diagnosis and treatment along with the United States Preventive Services Task Force which makes recommendations for preventive medicine recommended screening highrisk individuals on a slightly broader scale which the Lahey and Augusta area screening used. The group recommends screening for those age with a pack year or greater history who have stopped smoking for years or less and those age or older with a pack year smoking history and an additional risk factor other than secondhand smoke such as family history of lung cancer or a personal cancer history. A pack year means smoking one pack a day for years or a variation like two packs daily for years. After years of not smoking the lung cancer risk tends to diminish but never vanishes. Schroeder would prefer the screening still not stop there. A total of individuals signed up for the Augusta area screening qualified and actually had LDCT. More than patients were not screened in the first year primarily because of socioeconomic and travel limitations that created a sixweek backlog. Ninety percent of lung cancer is related to cigarette smoking the leading cause of preventable disease and death in the United States according to the Centers for Disease Control and Prevention. Symptoms of lung cancer include persistent intense coughing shortness of breath pain in the chest shoulder or back and changes in the color andor volume of phlegm or mucus hoarseness and coughing up blood. A survey of smoking by adults by the Centers for Disease Control and Prevention found about percent of adults in the country smoked rates for Georgia and adjacent South Carolina were between percent. Rates in Massachusetts where the Lahey screening occurred are . to . percent. Rates were highest in certain demographics. As examples smoking rates were highest among those without a graduate education degree certificate and lowest among those with a graduate degree higher among those living below the poverty level versus above it and higher among some minorities such as American Indians and Alaska Natives multiple race individuals and blacks. For more information about free lung cancer screening at the Georgia Cancer Center and MCG call or email lungaugusta.edu mailtolungaugusta.edu."

"A small study suggests that deep brain stimulation which is currently being investigated as a treatment for general depression may also help patients with bipolar disorder. There are some caveats. The surgery necessary to allow deep brain stimulation is extremely expensive. And for now the research is preliminary so its too early to know for sure if the treatment is appropriate to be used for any kind of depression. Still the study suggests that brain stimulation not only just helps patients who havent been able to recover from depression but it seems to be associated with the absence of relapses. Theyre not only getting better theyre staying better said study coauthor Dr. Helen Mayberg a professor in both the departments of psychiatry and behavioral sciences and neurology at Emory University School of Medicine in Atlanta. In deep brain stimulation surgeons insert wires into the brain that allows a specific region to be continuously hit with an electronic pulse. The level of stimulation is controlled by a pacemakerlike device implanted in the chest. Deep brain stimulation has been around for more than years Mayberg said and is commonly used to treat Parkinsons disease. The cost of the surgery is about she said. Previous research by Mayberg and others suggested that deep brain stimulation had potential as a treatment for depression. The St. Jude Medical Neuromodulation company which has provided consulting fees to Mayberg and some of the other study authors is currently recruiting patients for a study that could pave the way for its approval as a treatment for depression Mayberg said. The new study which appears online Jan. in the Archives of General Psychiatry began with patients with depression and seven with bipolar disorder a condition that causes severe mood swings and is also known as manic depression. They all received deep brain stimulation for weeks after going through four weeks either with or without stimulation. Most of the patients continued to receive the treatment over two years although researchers temporarily turned it off in three of them as part of the study before realizing that doing so caused their depression to return. The researchers found that percent of patients went into remission after weeks percent of patients after one year. After two years of the patients still in the study seven patients percent were in remission. The number of patients who got better increased over time but its not quite clear as to why Mayberg said. The workings of deep brain stimulation as a whole are a mystery although Mayberg said it may work by changing the brains rhythms. Patients didnt suffer from side effects she noted. So whats next Dr. Samuel James Collier an assistant professor of psychiatry at the University of Texas Southwestern Medical Center at Austin predicted that even if deep brain stimulation turns out to be an effective treatment for depression itll be far from the first line of defense. Medications and ECT electroconvulsive therapy are clearly safer better tolerated and do not embody a large surgical risk Collier said. I cant think of a scenario where deep brain stimulation would be considered even remotely before medications and ECT were exhausted. Still he said its important to note that we seem to be making progress and hopefully those who are suffering the most can find solace in that and not give up hope. For now research continues. If patients are interested in deep brain stimulation treatment they should try to get into the study thats ongoing Mayberg said. More information For more about deep brain stimulation http visit the U.S. National Library of Medicine. SOURCES Helen S. Mayberg M.D. professor departments of psychiatry and behavioral sciences and neurology Emory University School of Medicine Atlanta Samuel James Collier M.D. assistant professor of psychiatry University of Texas Southwestern Medical Center at Austin Jan. Archives of General Psychiatry online"

"Amgen Inc said its potent cholesterol fighter Repatha significantly reduced the risk of heart attacks strokes and death in patients with heart disease according to initial results of a large eagerlyanticipated trial released on Thursday. The data should pave the way for greater acceptance by health insurers and pharmacy benefit managers who have been rejecting about percent of prescriptions written for the expensive medicine despite multiple appeals by physicians. An Amgen sign is seen at the companys office in South San Francisco California in this October file photo. REUTERSRobert GalbraithFiles No new safety problems cropped up in the patient study called Fourier Amgen said. It also said Repathas effect on mental function was similar to placebo likely alleviating concerns that it might impair cognition in some patients. The trial was widely expected to be positive especially after a smaller study presented in November showed Repatha therapy led to regression of arteryclogging plaque an underlying cause of heart disease. These results show unequivocally the connection between lowering LDL cholesterol with Repatha and cardiovascular risk reduction even in a population already treated with optimized statin therapy Amgen research chief Sean Harper said in a statement. Details on the magnitude of benefit will be revealed in midMarch at the American College of Cardiology meeting in Washington D.C. Industry analysts have been looking for a percent to percent reduction of major adverse heart events. Repatha with a list price of more than a year was approved based on its ability to dramatically lower bad LDL cholesterol in patients who require more intensive therapy on top of widelyused statins such as Lipitor or who are unable to tolerate statins. But those who control budgets wanted concrete proof that the drug could actually reduce the risk of heart attacks and death before making it easier for patients to get the medicine. Repatha and a rival drug from Regeneron Corp and Sanofi have had endured anemic sales as a result. Amgen reported just million in thirdquarter sales. The company said Repatha would be well on its way to becoming a billion seller if all prescriptions written had been filled. The primary and secondary goals of the study are composites of several adverse outcomes. At the heart meeting in March researchers will also provide details on risk reduction for each of the components such as nonfatal heart attack nonfatal stroke and heartrelated death. The primary goal also included need for a new arteryclearing procedure and hospitalization for angina. Reporting by Bill Berkrot Editing by Alan Crosby Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The definition of Alzheimers disease just got wider and deeper but the expansion wont change how the vast majority of people are diagnosed. It also doesnt change the very limited treatment choices. But the new criteria which were developed by the National Institute on Aging and the Alzheimers Association are almost guaranteed to prompt confusion even in people who are thinking quite clearly. For research theres a lot of value. For everyday clinical use very very little. David Knopman a professor of neurology at the Mayo Clinic The guidelines say for instance that newly developed biomarker tests such as assays for proteins in spinal fluid and some specialized brain scans can be used for early diagnosis of Alzheimers. But the guidelines say the tests are to be used only for research and not for diagnosing Alzheimers in the general public. The distinction is nothing to worry about for patients and their families. You dont need a biomarker test for everyday clinical practice says David Knopman httpmayoresearch.mayo.edumayoresearchstaffknopman_d.cfm a professor of neurology at the Mayo Clinic who was cochairman of the group that revised the dementia diagnosis. The existing tests for Alzheimers are adequate he says. And those biomarkers Its in the fine print but it definitely says in multiple places that the biomarkers are for research purposes. Why Well the biomarker tests and PET scans httparchneur.amaassn.orgcgicontentfull arent yet accurate enough to reliably diagnose Alzheimers and havent been approved by the Food and Drug Administration. And its also because there are no treatments that can prevent slow or stop early signs of Alzheimers. For research theres a lot of value Knopman says. For everyday clinical use very very little. About million Americans have Alzheimers. The hallmark signs are problems with thinking learning and memory. The current definition created in describes Alzheimers that way. But over the past few years theres been solid evidence that Alzheimers starts damaging the brain years before a person starts having noticeable problems thinking. Scientists have been putting a lot of effort into trying to identify what starts the disease process but have so far come up empty. The new definitions which were just published online http by the journal Alzheimers Dementia acknowledge this dimly understood early phase of Alzheimers. Now there are two new predementia phases mild cognitive impairment and preclinical Alzheimers. In mild cognitive impairment a persons changes in thinking are noticeable to himself friends or family. They would show up on tests of memory and recall but dont interfere with everyday activities. Alzheimers is just one possible cause. Because there are no treatments http to prevent or stop Alzheimers many people may not consider this diagnosis a blessing. The second new phase preclinical Alzheimers is much squishier. Theres no list of symptoms that a doctor can whip out to say youve got it. Rather the goal in creating this category is to see if scientists can define when the disease starts and track it through biomarker tests brain imaging or other yettobeinvented tests. If that happens it might someday lead to ways to prevent Alzheimers. But for now this category is useful only to researchers. The goal in all this according to the Alzheimers Association is to increase opportunities for earlier diagnosis http and treatment. The problem is that there arent yet any reliable tools for earlier diagnosis and treatment. The new criteria are really a call for more research and the money to fund it. That would be good for the Alzheimers Association https and the National Institute on Aging http which sponsored the work on the new criteria. And it does leave one wondering if a lot more worry will be generated by the notion of preclinical Alzheimers when science and medicine cant offer anything to ease those fears."

"Using high doses of cholesterollowering drugs called statins appears to reduce the risk of heart attack stroke or the need for additional cardiac procedures more than regular doses of statins in people who have had a stroke or suffer from heart disease two new studies find. This benefit was seen even among those whose cholesterol levels were already low researchers say. Statins include widely used medications such as Crestor Lipitor and Zocor. For highrisk people those with heart disease or who have had a stroke who are taking a standard dose of a statin further reduction in LDL cholesterol will give them extra benefit said Dr. Colin Baigent of the Clinical Trial Service Unit and Epidemiological Studies Unit at University of Oxford in the United Kingdom who was involved in both studies. This applied even if the patients already had low levels of lowdensity lipoprotein LDL or bad cholesterol he noted. The reports are published in the Nov. online edition of The Lancet. In the first study researchers at Oxford and the University of Sydney in Australia collected data from studies on patients who took part in trials. This type of review called a metaanalysis gathers data from various studies to see if a pattern emerges. Among these trials five compared high doses of statins with regular doses and the other studies compared people taking statins with people not taking the drugs. The researchers found that in trials comparing statin doses taking highdose statins reduced the odds of having a stroke by an additional percent compared to the usual doses of statins. Specifically there was a percent reduction in heartrelated death or heart attack a percent reduction in the need for a new heart operation and a percent reduction in stroke the researchers found. When they did an updated analysis of the trials first major cardiovascular events such as heart attack and stroke were lowered by a highly significant percent for a . millimole per liter mmolL reduction of LDL cholesterol. Taking all trials together deaths were reduced by percent for mmolL in reduction of LDL cholesterol with no significant effect on deaths from stroke or other vascular causes. In addition there were no significant effects of statins on deaths due to cancer or other nonvascular causes and no excess risk of cancer even at low LDL cholesterol concentrations. The second study is a randomized trial called the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine SEARCH led by professor Jane Armitage also a scientist at the CTSU in Oxford. This trial looked at the benefits of statin therapy with milligrams mg versus mg simvastatin Zocor among heart attack survivors. The study was supported by a grant from Merck manufacturer of the simvastatin. Over almost seven years of followup those taking the higher dose statin had greater reductions in LDL cholesterol compared with those taking the lower dose. The reduction in LDL cholesterol from the higher dose ended up decreasing the risk of a major cardiac event by percent the researchers found although the statistic in itself was not clinically significant. The researchers noted that the higher dose of Zocor simvastatin did result in a risk of a muscle disease times higher than that associated with the lower dose. The muscle disease known as myopathy can cause pain weakness and in its rare but most severe form destruction of the muscle tissue leading to kidney failure. Researchers found that two cases of myopathy occurred with the low dose and cases with the higher dose. Researchers also found that rhabdomyolysis the most severe form of the muscle disease associated with statins was diagnosed in seven participants given mg of Zocor simvastatin compared to none who were given mg of simvastatin. Two died within a few weeks of developing the disorder with one cause of death mentioning the muscle disorder as a contributing factor. Researchers also found that seven participants had creatine kinase levels higher than times the upper limit of normal a possible indicator of kidney damage. For this reason they noted that the incidence of severe muscle disease on mg of Zocor might be an underestimate. Baigent noted this side effect is one associated with Zocor but taking lower doses of other more powerful statins may alleviate the problem. There are newer ways of increasing LDL cholesterol reduction by using the newer more potent statins such a Lipitor or Crestor he said. All statins carry the risk of myopathy but lower dosages are associated with a reduced risk. Bernard M.Y. Cheung from the University of Hong Kong and coauthor of an accompanying journal editorial said that people who are at risk from heart attacks and strokes should have their LDLcholesterol lowered intensively. Their doctors should consider prescribing a statin either at a high dose or using a more powerful statin he said. If you are at risk from a heart attack or stroke either because you have had these conditions before or because you have the risk factors for them you should be considered for intensive treatment to lower the LDL cholesterol Cheung said. If your blood cholesterol is raised but you do not have other risk factors for heart disease and stroke then your doctor may well decide that you do not need to take any drugs to lower cholesterol he said. But if you are at risk from those diseases you would need intensive treatment to lower LDL cholesterol even if your LDL cholesterol level is not very high he added. Commenting on the studies Dr. Gregg Fonarow American Heart Association spokesman and professor of cardiology at the University of California Los Angeles said that despite the proven benefits of LDL cholesterollowering with statin therapy many physicians have been reluctant to prescribe and patients reluctant to take higher doses of more potent statin medications due to concerns about side effects or safety. Lowering LDL cholesterol by to percent with potent statins such as atorvastatin at mg or rosuvastatin at to mg lowers the risk of major cardiovascular events by to percent he said. Most patients tolerate higher doses of more potent statins equally well as lower doses of less potent statins Fonarow said. Millions of patients with or at high risk of cardiovascular disease who would derive additional cardiovascular protection from higher doses of more potent statins are not currently treated with these agents. But they should be. More information For more information on statins visit the U.S. National Library of Medicine http SOURCES Colin Baigent M.D. Clinical Trial Service Unit and Epidemiological Studies Unit University of Oxford U.K. Bernard M.Y. Cheung Ph.D. University of Hong Kong Gregg Fonarow M.D. American Heart Association spokesman and professor cardiology University of California Los Angeles Nov. The Lancet online"

"For concussion sufferers even those who never lost consciousness physicians may now be able to predict early on who is more likely to continue experiencing symptoms months or years after the headjarring event using a new noninvasive magnetic resonance imaging MRI method devised by a consortium of researchers led by UC San Francisco scientists. In their new study published online January in the Journal of Neurotrauma the researchers used a technique called functional MRI fMRI coupled with sophisticated statistical analysis to track activity in the brain networks of patients aged to within the first two weeks of their having experienced concussions. The study revealed telltale patterns of brain activity that six months later were associated with worse performance on behavioral and cognitive tests and were different from patterns seen in healthy control subjects. The fMRI method and analysis developed for the study highlighted abnormal patterns of brain activity that pointed to a higher risk for longterm postconcussive symptoms even among the study participants who had no evidence of bleeding or bruising in the brain in the immediate aftermath of brain trauma on computed tomography CT or ordinary MRI scans. This is an exploratory proofofconcept study showing that we can identify patients soon after mild brain trauma who may have more persistent symptoms despite no other evidence of injury within the brain said Pratik Mukherjee MD PhD professor of radiology and biomedical imaging at UCSF and the senior author of the study. We may be able to use this information to help guide treatment decisions and counseling of patients early on when it may be more effective. Only subjects who had lost consciousness for less than minutes were eligible for the study and many study subjects never lost consciousness during their injury. Scientists refer to concussion as mild traumatic brain injury mTBI but for some patients the harmful sometimes insidious effects are long lasting. Common symptoms in the aftermath of concussion include confusion headache changes in vision or hearing thinking or memory problems fatigue sleep changes and mood changes. Previously there has not been a way to predict whose symptoms will fade or persist following mTBI. Although effective drug treatments for mTBI await discovery rest and counseling are known to be helpful for patients Mukherjee said. In the new study the researchers focused on wellknown networks of activity that are observed when the brain is in a resting state. We asked subjects to close their eyes to relax and to not focus their attention on anything specific but also to not fall asleep Mukherjee said. In comparison to the control subjects who had never experienced TBI mTBI patients displayed less connectivity in frontal areas of the default mode network a set of brain regions that are particularly active in the resting brain. They also exhibited less connectivity within several other networks including those known as the executive control network the frontoparietal network the dorsal attentional network and the orbitofrontal network they showed an increase in connectivity in the visual network. Several of these differences were associated with worse performance months later in cognitive and behavioral tests. UCSF radiologist Esther Yuh MD PhD associate professor of radiology served as the lead neuroradiologist and also contributed to the analysis for the new study. Postdoctoral fellow and first author Eva Palacios PhD led the data analysis for the fMRI experiments. The study was part of the ongoing Transforming Research and Clinical Knowledge in Traumatic Brain Injury TRACKTBI project through which Mukherjee and study coauthor Geoffrey Manley MD PhD vice chairman of neurological surgery at UCSF and chief of neurosurgery at Zuckerberg San Francisco General Hospital along with collaborators from many other research institutions are leading studies and gathering common data across research sites to more quickly advance TBI research. Additional coauthors include researchers from UCSF the University of Texas at Austin the University of Pittsburgh Medical Center Virginia Commonwealth University the Icahn School of Medicine at Mount Sinai and University Hospital Antwerp Belgium. The research was funded through project grants from the National Institutes of Health and the Department of Defense. UC San Francisco UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research graduatelevel education in the life sciences and health professions and excellence in patient care. It includes topranked graduate schools of dentistry medicine nursing and pharmacy a graduate division with nationally renowned programs in basic biomedical translational and population sciences and a preeminent biomedical research enterprise. It also includes UCSF Health which comprises topranked hospitals UCSF Medical Center and UCSF Benioff Childrens Hospitals in San Francisco and Oakland and other partner and affiliated hospitals and healthcare providers throughout the Bay Area."

"Patients with castration resistant prostate cancer CRPC usually have a poor prognosis. In part this is due to the cancers ability to resist antiandrogen therapy. A University of Colorado Cancer Center study published today May in Oncotarget shows that combining a CPTA inhibitors with antiandrogen therapy increases the cancers sensitivity to the antiandrogen drug enzalutamide. This is a huge development for men with CRPC that previously did not have many options says Isabel Schlaepfer PhD CU Cancer Center member assistant professor in the Division of Medical Oncology and senior author of the study. There is a critical need for improved therapies for this specific cancer type. Most cells use the energy of glucose sugar. Some prostate cancers evolve to use energy from lipids fat. Previous work shows that metabolizing lipids helps prostate cancer escape antiandrogen therapy. However there are many steps involved in lipid metabolism and researchers have been working to break prostate cancers ability to harness this energy source. In this study the researchers focused on the CPTA enzyme. CPTA helps facilitate the entry of long chain fatty acids into the cells mitochondria for oxidation. This oxidation is vital to lipid metabolism and has been shown to aid cancer cell survival resistance to radiation oxidative stress and activation of oncogenic signaling pathways. We had to find a way to block this pathway so that the cancer would not be able to burn lipid in the mitochondria to acquire energy to resist therapy explains Schlaepfer. In fact we are already able to block the action of the CPTA enzyme. The drug ranolazine is a fat oxidation inhibitor that earned FDA approval in to treat angina. When Schlaepfer and colleagues experimented with fat burning inhibitors and antiandrogens in cancer cell lines they found that the addition of ranolazine to antiandrogen therapy made tumors more sensitivity to the antiandrogen drug enzalutamide. This finding may have a huge impact on patients with CRPC that had very few options before says Schlaepfer. Since the drugs are clinically safe a clinical trial can be designed in patients for whom enzalutamide is prescribed."

"When it comes to preventing blood clots after a knee replacement good old aspirin may be just as effective as newer more expensive drugs. That swap could help reduce the cost of caring for the nearly million Americans who have a knee fixed each year Michigan Medicine researchers say. After knee surgery theres a risk of blood clots in the legs or lungs. So its routine for patients to take clotpreventing drugs for some time afterward. Some doctors choose powerful anticlotting drugs like heparin Lovenox and rivaroxaban Xarelto but it hasnt been clear whether these expensive prescription drugs work any better than cheap readily available aspirin. Aspirin alone may provide similar protection compared to anticoagulation treatments says Brian R. Hallstrom M.D. an orthopaedic surgeon and associate chair for quality and safety at the University of Michigan Department of Orthopaedic Surgery. Hallstrom is the lead author of a new study published in JAMA Surgery that found few patients developed a blood clot after surgery and those patients on aspirin fared just as well as those on anticoagulants. Aspirin use growing During the twoyear study period from to aspirin use rose from percent to percent among the patients cared for by orthopaedic surgeons in the Michigan Arthroplasty Registry Collaborative Quality Initiative a statewide effort to give patients the best possible recovery and outcomes after hip and knee replacements. Since then the shift has become even more distinct Aspirin prescribing has risen to percent among Michigan surgeons says Hallstrom who is codirector of the initiative and a health services researcher at UMs Institute for Healthcare Policy and Innovation. Based on the experience of Michigan patients undergoing knee replacement the study may further the debate about the routine use of aspirin for clot prevention. A recent Canadian study looked at the issue but the analysis had a caveat Each of the more than clinical trial patients received rivaroxaban the first five days after surgery. After that they continued with the drug or switched to aspirin. The new UM study suggests patients may be adequately protected if they take aspirin alone from day one. This study is truly a realworld experience of what happened in Michigan when the majority of surgeons switched to aspirin Hallstrom says. The incidence of blood clots pulmonary embolus and death did not increase despite this dramatic change in practice. Shifting procedure and dialogue Over the past decade surgeons have turned away from powerful anticoagulants and toward aspirin used in addition to nondrug improvements such as compression devices for thwarting clots. These days most patients have a generally low risk of blood clots after knee replacement for a number of reasons. Those reasons include shorter surgical times less invasive procedures and use of regional anesthesia that allows early mobilization after surgery Hallstrom says. Some patients are even going home the same day. The most important way to prevent blood clots is getting moving says Hallstrom noting that people are at risk for blood clots when they sit or lie in one position for too long such as on an airplane or a hospital bed. Still pharmaceutical recommendations vary. The critical care specialists who make up the American College of Chest Physicians favor heparin to reduce the risk of blood clots while the American Academy of Orthopaedic Surgeons guidelines state that no one drug is better than another for preventing clots. Advantages of aspirin The UM study involved patients undergoing knee replacement surgery at any of the Michigan hospitals in the surgical quality group. Onethird of the patients took aspirin alone percent took only an anticoagulant and percent took an aspirinanticoagulant combination. Over three months just . percent of aspirin patients developed a serious blood clot. That was true for . percent of anticoagulant patients according to the Michigan study. This was not statistically different. So neither drug appeared better than the other but aspirin has some obvious advantages. Aspirin is easy to take and much less expensive Hallstrom says. Patients can get it over the counter for pennies while the other anticoagulants require monitoring injections frequent dose adjustments and are extremely expensive. The reported cost for a day supply of rivaroxaban is approximately to heparin is estimated at to . Although warfarin costs a few dollars for a day supply its cost approaches that of the other anticoagulants when doctor visits for monitoring are factored in Hallstrom says. In contrast aspirin costs approximately a month. The study suggests most patients can have just aspirin without increasing the risk for venous thromboembolism but doctors need to consider factors such as a patients history of clots obesity and ability to mobilize after surgery when determining the best measure for clot prevention Hallstrom adds."

"Columbus OH. Good news for the millions of people who suffer from skin wounds that wont heal. A team of researchers at The Ohio State University has brought a potentially transformative solution to the problem by creating a portable adhesive patch that drives a continuous small electrical current to stimulate healing and reduce the risk of infection. Nearly million Americans have chronic wounds typically a result of diabetes obesity or other conditions that impact circulation costing the healthcare system nearly billion each year. The nonhealing wounds are painful can permanently damage nerves prevent mobility and in extreme cases cause infection that can lead to death. The patchs design significantly advances existing FDAapproved wireless electroceutical dressing WED that harnesses the bodys innate response to injury to help wounds heal. A wound naturally produces its own electrical fields that help reduce bacteria and promote cell regeneration however this function is likely impaired in chronic wounds said Sashwati Roy PhD an Associate Professor in the Department of Surgery at Ohio States College of Medicine. The prototype dressing mimics this physiological process and while it has proven to create an optimal environment where chronic wounds can heal we are always looking for new ways to keep pathogens under better control. Roy notes that chronic wounds are particularly susceptible to infection because bacteria which at times are free floating within a wound can sometimes mobilize creating colonies covered by a thick sticky coating called a biofilm. The immune system cannot penetrate the biofilm and antibiotics cant get in either causing constant inflammation and lowlevel infection that can further dampen the healing process. Now with support from Ohio States Center for Clinical and Translational Science CCTS researchers from both the College of Engineering and the College of Medicine are taking the technology to the next level. Working with a mechanical and aerospace engineering team led by Shaurya Prakash PhD and Vish Subramaniam PhD the scientists have optimized the bandages design and the amount of electrical current delivered. Like present WEDs the new prototype is flexible portable and selfcontained. Made of silk and silver the experimental dressing includes a selfcontained battery that delivers a continuous safe lowlevel electrical current to the injury. Were hoping this new design may allow electric fields and currents to penetrate more deeply into wounds and really get to where these biofilms may be hiding said Subramaniam chair of the Department of Mechanical and Aerospace Engineering at Ohio State. The destruction of the biofilm would enable antibiotics to start killing off bacteria reduce chronic inflammation and allow the bodys natural immune response to work more effectively. Bacteria are known to quickly acquire resistance against antibiotics but to our knowledge bacteria do not develop resistance against electroceuticals. To test the experimental design Roy and a team of scientists developed an animal model to mimic the skin function of a person suffering from metabolic syndrome obesity high blood pressure high blood sugar which mirrors the type of patient that typically develops chronic wounds. Animal models had skin injuries infected with Pseudomonas aeruginosa Staphylococcus aureus or Acinetobacter baumannii three different types of bacteria that commonly infect wounds and develop biofilms that are treatment resistant. Early results which were presented at the Wound Healing Societys Annual Meeting in April indicate that infected wounds covered by the experimental bioelectric dressing healed better and more quickly than those covered with a plain dressing that is commonly used in the care of wounds today. Scientists hypothesize that the electrical currents may disrupt bacteria in two ways by interrupting the production of chemical messages that instruct bacteria to develop biofilms and by weakening the molecular structure of existing biofilms potentially making them more susceptible to antibiotics or the bodys natural immune response. The teams next move is to focus on the bioelectric bandage as a treatment for chronic wounds in a patient population however the technology could also be used to treat acute injuries. Roy also notes that the U. S. Department of Defense is very interested in the dressing as a temporary measure to help prevent infection in soldiers wounded on the battle front. This technology has a long shelf life and is compact enough to be put into any field medical kit. It could be applied immediately to wounds help keep bacteria from mobilizing and start promoting healing until the soldier could be transported to a facility for more intensive medical care. The team already has interest from several industry partners and is hoping to begin testing the new technology in patients before the end of the year to determine optimal treatment duration and more about the healing effects of electrical fields on skin cells on a molecular level. Roys research team includes Shomita S. Steiner PhD Shaurya Prakash PhD Gayle Gordillo MD Vish Subramaniam PhD and Chandan K. Sen PhD. The Ohio State University Center for Clinical and Translational Science CCTS is funded by the National Institutes of Health NIH Clinical and Translational Science Award CTSA program ULTR KLTR TLTR The CTSA program is led by the NIHs National Center for Advancing Translational Sciences NCATS. The content of this release is solely the responsibility of the CCTS and does not necessarily represent the official views of the NIH."

"German researchers say that highly trained dogs are able to reliably sniff out lung cancer https in human breath. In its early stages lung cancer https has few symptoms making it difficult for doctors to catch it early when its still treatable. This is the holy grail says Suresh S. Ramalingam MD associate professor and director of the lung program at Emory Universitys Winship Cancer https Institute in Atlanta. The whole field is focused on using something thats readily available that does not involve an expensive surgery or scan that would allow us to find early cancers says Ramalingam who is developing technology that aims to replicate the ability of dogs to smell trace amount of chemicals produced by cancerous tumors. He was not involved in the research. Recently a large governmentfunded study found that longtime smokers at high risk for lung cancer who received annual rapid computed tomography CT scans of their lungs https cut their risk of dying of the disease by . But that test has caused controversy because it falsely detects cancer https in about one out of four people leading to further invasive procedures. Checking for Lung Cancer The new study which is published in the European Respiratory Journal found that four trained dogs two German shepherds an Australian shepherd and a Labrador retriever correctly identified cancer https in of samples from lung cancer patients. They also ruled out cancer in out of samples that were known not to have cancer giving them a very low rate of false positives about . The surprising result of our study is the very high specificity of our dogs to identify lung cancer says study researcher Thorsten Walles MD a lung surgeon at Schillerhoehe Hospital in Gerlingen Germany. It even surpasses the combination of chest computed tomography CT scan and bronchoscopy https which is an invasive procedure that needs some form of anesthesia Walles tells WebMD in an email. Doctors have previously reported cases in which dogs have alerted their owners to undiagnosed skin https breast https and lung cancers by repeatedly pawing or nosing an affected body part. Some dogs have even been trained to smell low blood sugar levels https in people who have diabetes https But dogs have had more mixed success in carefully controlled studies where samples from healthy people and sick people have been mixed. A study published in BMJ in found that dogs correctly identified bladder cancer https an average of about of the time a rate that was better than the accuracy that could be expected by chance but was lower than available tests. But in June researchers in Japan reported that dogs could detect the presence of colon cancer https in human breath and stool samples with nearly accuracy a success rate only slightly lower than colonoscopy https The length of time the dogs are trained may be an important difference between the studies Walles says. In his study the four dogs were trained for nine months. Other studies have used dogs trained for as little as three weeks. The kind of sample the dogs are asked to smell urine breath blood https or stool may also influence the results he says. In his study volunteers who were healthy who had lung cancer and with chronic obstructive pulmonary disease https COPD https were asked to exhale into a glass tube filled with fleece. The tubes were mixed up so neither the dogs handlers nor two observers who placed the samples on the floor in front of the dogs knew the status of the person they were from to avoid inadvertently giving the dogs clues about what they should find. The dogs were presented with five tubes at a time. Only one contained a sample from a person with cancer. The dogs were trained to lie down and put their nose to the tube if they detected lung cancer. The dogs appeared to be able to accurately identify the samples from cancer patients even when they were in very early stages of the disease. And they were able to pick up the scent despite competing odors of cigarette smoke or food on a persons breath. How Dogs Detect Cancer Researchers think dogs and other animals are able to smell disease by picking up on minute changes in compounds called volatile organic compounds VOCs that comprise chemical signatures in the body. As many as different VOCs for example have been identified in human breath. A dogs sense of smell https has been estimated to be to times more powerful than a humans says Gary K. Beauchamp PhD director of the Monell Chemical Senses Center in Philadelphia. Its not just how sensitive their nose is. Its how they process this into a recognition pattern Beauchamp says. The reason dogs can do this is that theyre recognizing a complex picture and thats the big trick to find out how to mimic that in some sort of device that could be useful for diagnostic purposes in human disease. Other researchers agree. Ramalingam says because success rates vary between dogs and between samples the real value of knowing dogs can detect cancer will likely be in building technology that can reliably repeat what they can do. The dogs show that it can be done. We need to find out what the dogs are sniffing so we can do it in a more scientific manner."

"A recent study from the Center for BrainHealth http at The University of Texas at Dallas shows that a certain type of instructorled brain training protocol can stimulate structural changes in the brain and neural connections even years after a traumatic brain injury TBI. The findings published in Brain and Behavior httponlinelibrary.wiley.comdoi.brb.full further suggest that changes in cortical thickness and neural network connectivity may prove an effective way to quantitatively measure treatment efficacy an ability that has not existed until now. Building upon previous research the study challenges the widely held belief that recovery from a TBI is limited to two years after an injury. A TBI disrupts brain structure. These brain changes can interfere with brain network communication and the cognitive functions those networks support said Dr. Kihwan Han http_usteamkihwanhan research scientist at the Center for BrainHealth and lead author of the study. For people with chronic TBI they may have trouble with daily tasks such as creating shopping lists and resolving conflicts with others for many years after the injury. These findings provide hope for people who thought This is as good as my recovery is going to get and for the medical community who have yet to find a way to objectively measure a patients recovery he said. The study included adults with TBI symptoms lasting an average of eight years. Participants were randomly placed into one of two cognitive training groups strategybased training or knowledgebased training. Over an eightweek period the strategybased training group learned strategies to improve attention and reasoning. The knowledgebased training group learned information about the structure and function of the brain as well as the effects of sleep and exercise on brain performance. Magnetic resonance imaging measured cortical thickness and restingstate functional connectivity rsFC before training after training and three months posttraining. Previous studies have shown that cortical thickness and rsFC can be potential markers for traininginduced brain changes. Individuals in the strategybased reasoning training showed a greater change in cortical thickness and connectivity compared to individuals who received the knowledgebased training. Changes in cortical thickness and functional connectivity also correlated to an individuals ability to switch between tasks quickly and consistently to achieve a specific goal. People who showed the greatest change in cortical thickness and connectivity showed the greatest performance increases in our cognitive tasks. Perhaps future studies could investigate the added benefit of brain stimulation treatments in combination with cognitive training for individuals with chronic TBI who experience problems with attention memory or executive functions Han said. The work was supported by the Department of Defense the Meadows Foundation and the Friends of BrainHealth Distinguished New Scientist Award."

"Getting pregnant can be tricky. One way an aspiring mother can make it easier is to know when shes most fertile a period spanning a few days every month when her body undergoes hormonal changes. And certain bodytracking wristbands may be able to detect these subtle shifts in your biometrics like your heart rate and body temperature. Depending on the device it could even help you go one step further and actually conceive. Recently the womens health data startup Clue ran an internal test to see if Fitbits could improve the experience of women who track their periods on its popular app and are trying to get pregnant. Scientists put Fitbits on five employees and found that the devices could track their resting heart rate patterns during their menstrual cycles http The devices also showed that resting heart rate spiked shortly before ovulation began according to the Berlin company which presented data from the small preliminary study at the European Society of Human Reproduction and Embryologys annual meeting this month. Its a cheaper method for people who do want to get pregnant. The advantage of a passive sensor is these things are done kind of autonomously so you dont need to do much except check when the resting heart rate starts coming up Clues head of scientific research Dr. Vedrana Hgqvist Tabor told BuzzFeed News. Its a cheaper method for people who do want to get pregnant. Fitbits arent the only wearables that can track fertilityrelated biometrics in the background. After a Kickstarter campaign YONO just started shipping an earpiece http designed to track your body temperature at rest. And Ava http is working on a smart wristband that aims to help women conceive. How an Activity Tracker Caught an Unexpected Pregnancy Fitness trackers by nature of being worn around the clock have the potential to capture unexpected insights about how your body works and simplify laborious acts like manually figuring out httpamericanpregnancy.orgpreventingpregnancynaturalfamilyplanning your fertile days. That traditionally involves taking your temperature when your body is at rest http examining your cervical mucus and recording this data every single day on a calendar. Clues study which ran for months beginning in April didnt set out to see whether the Fitbit ChargeHR could identify when a woman becomes pregnant. Rather it was exploring whether the device could reliably track an alreadyknown occurrence http how a womans resting heart rate changes when shes experiencing rising hormonal levels linked to ovulation. For the experiment five women under wore a Fitbit ChargeHR to bed. Thats because resting heart rate data can be captured at its purest when a person is asleep and not moving. The women also logged their periods on Clues app and took daily urine tests to track when there was a surge in the key hormones that signaled they were entering ovulation. Researchers were watching all these biometrics as the study participants went through their cycles. A womans fertile window when shes likeliest to get pregnant usually occurs two weeks after the start of her last period and lasts for about six or seven days ending on the day of ovulation. As the researchers had hypothesized the participants Fitbits captured a portion of this fertile window by showing that their resting heart rates rose one or two days before ovulation as well as during ovulation itself. So a woman who saw a bump in her resting heart rate history could use that information to schedule intercourse with her partner Hgqvist Tabor said. And the study had one particularly unexpected outcome. Clues marketing director who was participating was puzzled when her Fitbit said her heart rate was up by several beats per minute. Hgqvist Tabor said she soon realized what the finding meant and broke the news to the marketing director She was pregnant. The happy discovery was similar to one earlier this year when a man posted on Reddit about how his wifes Fitbit showed an uptick in her resting heart rate. Upon a Redditors suggestion she took a test that confirmed she was in fact pregnant. An expert told BuzzFeed News https_term.kiKmZLkLQ at the time that her heart rate increase may have been an indirect result of elevated body temperature another symptom of pregnancy. But Dont Think Of This As Birth Control Even though Clues marketing director happened to find out she was pregnant from her Fitbit the point of the study was to demonstrate that its possible to use Fitbit as a conception tool not as a pregnancy test Hgqvist Tabor said. And thats provided that a couple doesnt have any other fertilityrelated problems. Manually figuring out your fertile days is a laborious multistep process you have to do every single day. However Hgqvist Tabor said this information by itself should not be used as a birth control method. A woman will be fertile four to five days before her increased resting heart rate will start showing up on a Fitbit so having unprotected intercourse during this period could in fact lead to an unintended pregnancy. If youre curious exactly what kind of increase in resting heart rate you should look out for Clue hasnt revealed that information yet but says it will publish that and other data in a paper later. Hgqvist Tabor says its tricky because it depends on the individual and can range from a few beats per minute to beats per minute. One reason to potentially shy away from trusting Fitbits heartrate sensors In a classaction lawsuit http some unhappy consumers have accused them of being inaccurate. Regardless Clue scientists say that they were more interested in the devices ability to capture the daytoday differences in someones resting heart rate which seemed to be consistent and less interested in whether the devices could produce the exact values of resting heart rate. You will get a relative change even though it might not be as accurate as a chest strap said Clue cofounder Mike LaVigne. And while resting heart rate can be a telltale sign of ovulation Lea von Bidder CEO of Ava says consumers shouldnt rely on that measurement alone if theyre serious about getting pregnant. Her companys wristband is designed to track eight physiological markers in addition to heart rate variability including skin temperature pulse rate breathing rate and sleep. The Ava bracelet will launch this summer. As a lowrisk medical device registered with the Food and Drug Administration it doesnt need indepth review by the agency to be sold according to the company. By monitoring these multiple biomarkers while a woman is asleep Avas wearable and app can notify her during the five days shes most fertile ending in ovulation according to von Bidder who says Ava has conducted studies on about people. Von Bidder said it was promising to see that Fitbit might be able to provide heart rate data to women trying to conceive. But we also know that heart rate alone will not be enough she said. Wearables have a wellworn reputation as stepcounting machines. But as Clues and Avas fertility research indicates increasingly sophisticated sensors and algorithms could significantly open up wearables capabilities and make them that much more able to tackle bigger complicated health issues."

"Taking aspirin https over a long period of time can substantially cut the risk of dying from a variety of cancers according to a study showing that the benefit is independent of dose gender or smoking https It also found that the protective effect increases with age. The study is by Peter Rothwell MD PhD FRCP of John Radcliffe Hospital in Oxford England and colleagues and has been published online by the journal the Lancet. A previous study https by the same authors showed that low doses of aspirin milligrams reduced the number of cases of colorectal cancer https by a quarter and deaths caused by the disease by more than a third. The latest study confirms the earlier results and concludes that similar effects can be shown for other types of cancers. New AspirinCancer Findings The study looked at eight trials examining the effects of a daily dose of aspirin on preventing heart attacks https involving patients of whom died from cancer https They showed a reduction in the number of deaths caused by cancer https among those who had taken aspirin compared with people who had not. The investigation also showed that the benefits of taking aspirin increased over time. After five years death rates were shown to fall by for all cancers and by for gastrointestinal cancers. Participants were also followed up after years by which point of the original participants had died as a direct result of cancer https This year followup established that the risk of cancer https death remained lower among those who had been allocated aspirin than those in the control group for all solid cancers including lung https prostate https brain https bladder https and kidney https cancers and by for gastrointestinal cancers. The fall in the risk of death broke down according to individual types of cancer Esophageal cancer https Colorectal cancer https Lung cancer https Prostate cancer https Reductions in pancreatic stomach https and brain https cancers were difficult to quantify because of smaller numbers of deaths the authors say. Protective Effect Increases Over Time The protective effect of taking low doses of aspirin varied according to the type of cancer and how long aspirin had been taken the authors found. For instance it only became apparent after about five years for esophageal pancreatic brain https and lung cancer https about years for stomach and colorectal cancer and about years for prostate cancer https Any benefit for lung and esophageal cancer was limited to adenocarcinomas which are most commonly seen in nonsmokers. Should MiddleAged People Take Aspirin Previous research has linked aspirin with reductions in heart attacks https and strokes but doctors have been wary when recommending whether people should take daily doses of aspirin because of the risk of gastric bleeding. Rothwell says The size of the effect on cancer I think is such that it does more or less drown out those sorts of risks. However he says the authors of the study do not make recommendations on taking aspirin based on this study. Peter Elwood MD DSc FRCP an expert on aspirin from Cardiff University who was not involved in the study says that doctors are often reluctant to recommend aspirin because the risk of causing a bleed by what the doctor prescribes is going to be uppermost in a doctors mind. A patient might interpret the risk differently he says. Rothwell and his colleagues say that more research is required in particular for the effect on breast cancer https and other cancers affecting women as well as the effect on patients beyond the year period. The results of further trials are expected to be published in . Promising Results Ed Yong head of health information and evidence at Cancer Research UK says in an emailed statement These promising results build on a large body of evidence suggesting that aspirin could reduce the risk of developing or dying from many different types of cancer. While earlier studies suggested that you only get benefits from taking high doses of aspirin this new study tells us that even small doses reduce the risk of dying from cancer provided it is taken for at least five years. In addition to the effect on cancer death aspirin can affect our health in other ways such as reducing the risk of stroke https but increasing the chances of bleeding from the gut. We await trials results expected next year to learn more about these different effects. We encourage anyone interested in taking aspirin on a regular basis to talk to their doctor first."

"Alzheimers disease now affects an estimated . million Americans and after decades of feverish work researchers have so far failed to find a treatment that halts or reverses the inexorable loss of memory function and thinking ability that characterize this feared illness. But researchers have been quite successful at devising ways to diagnose Alzheimers earlier and earlier. And that capability has emerged alongside evidence of a tantalizing possibility that if you can catch the disease early enough ideally when symptoms of confusion or memory loss are just emerging or before some therapies already in hand might essentially halt its progress. For anyone who detects some mental slippage and wonders Is it Alzheimers the current state of dementia research raises a very real and very wrenching dilemma If I can know do I want to know That is if its Alzheimers disease would I do anything differently Would there be some benefit in knowing for my loved ones for myself Doctors and insurers including the federal government which administers Medicare are asking some variants of the same questions If an effective test which costs between and a shot can diagnose dementia early and distinguish Alzheimers from other forms of dementia should it be recommended to patients with cognitive concerns and routinely covered by their insurance Would it make patients lives better or lower the cost of their care Newly unveiled research results are bringing some clarity to such deliberations. And other new research published Wednesday in the journal Neurology proposes a new diagnostic tool that may be able to detect Alzheimers and distinguish it from another form of dementia more simply and cheaply than does the best test now available. At the Alzheimers Assn. International Conference in London last week researchers reported their preliminary findings from a tria https_AAICWedbriefingDevelopingTopics.aspl https_AAICSunPETScanRelease.aspthat is testing the impact of diagnostic testing for Alzheimers disease on nearly Medicare beneficiaries. All of these study participants largely people in their s all with a diagnosis of either mild cognitive impairment or atypical dementia are living with the unconfirmed suspicion that they have Alzheimers. The study is underwritten by the Centers for Medicare Medicaid Services and the Alzheimers Assn. It set out to find out whether knowing getting the costly test that would offer either confirmation or reprieve would change the way that patients with cognitive troubles are treated or the way that they plan their lives. The preliminary results suggested it did. After getting the results of a PET brain scan to detect and measure amyloid deposits which are the key hallmark of Alzheimers disease roughly twothirds of the subjects saw their medication regimens changed or were counseled differently by their doctors about what to expect. That new information may have guided family caregivers in planning their own futures or prodded patients to make financial decisions and powerofattorney assignments sooner. Some who learned that they did not have Alzheimers discontinued medications that can have unpleasant side effects. Others learned they do have Alzheimers and decided to enroll in clinical trials that will test new drugs. A second study presented in London analyzed data from several studies and found that in a large population of research participants with cognitive concerns brain amyloid PET scans led to a change in diagnosis in approximately of cases. People should know whats coming said Dr. Maria Carrillo chief science officer for the Alzheimers Assn. The Centers for Medicare Medicaid Services has given amyloid scans a provisional approval meaning they do not routinely pay for them. The results may guide the agency to rethink its position she added. The PET scan bore bad news for Ken Lehmann who enrolled last year in the IDEAS trial short for Imaging Dementia Evidence for Amyloid Scanning. After his long slow decline that has flummoxed doctors Lehmanns brain scan clearly showed he has Alzheimers disease. The certainty that has brought has been a long time coming. When Lehmann began withdrawing from friends forgetting to pay bills and having trouble following conversations he was just . Now hes . Ken had always been considered a Renaissance man a furniture company executive who rebuilt Porsches played basketball and loved to entertain friends said his wife Mary Margaret Lehmann. But as years passed his judgment seemed off. He would lose track of points he was making and sometimes of where he was at. It would take the loss of their home and a business bankruptcy for the Lehmanns to demand answers to what was going on. In they moved from Sacramento to Edina Minn. to live with a daughter. And there at last they found a neurologist who despite initial skepticism but he presents so well the doctor proclaimed diagnosed dementia. For the Lehmanns and many patients and families like them as well as for neurologists that diagnosis is often just the beginning of a deeper mystery. Alzheimers disease is the most feared and most common form of dementia accounting for between and of all dementia cases diagnosed. But at least seven other forms of dementia and dementia linked to the movement disorder Parkinsons disease can cause loss of memory reasoning judgment and the ability to speak comprehend and care for oneself. To the estimated million Americans living with some form of cognitive impairment telling the difference could make a significant difference. Dementia forms with different origins progress differently or sometimes not at all. They respond best to different medications and will come to require different levels of care and treatment. Some though not Alzheimers can even be reversed with treatment. Being able to distinguish which form of dementia a patient has should help doctors and caregivers to make better choices. But its a question that until recently could be answered only after death. At that point a postmortem examination of the brain could be done to look for the builtup clumps and tangles of betaamyloid proteins the overall shrinkage and the loss of neurons in the brains hippocampus that are collectively the hallmarks of Alzheimers. No more. Improved medical imaging technologies developed over the last decade have made it possible to peer inside the brain of a living patient detect and measure the accumulation of betaamyloid and make a definitive diagnosis. In the Food and Drug Administration took a first step in making such imaging possible giving its blessing to the imaging agent florbetapir F which binds to amyloid aggregates in the brain and allows a PET scan to be used to make the diagnosis. In two new imaging agents won FDA approval and new imaging agents and techniques promise ever more precise means to visualize and diagnose Alzheimers in the brain. On Wednesday research published in the journal Neurology http suggested that transcranial magnetic stimulation a technique that can selectively turn up or down activity in different parts of the brain could prove useful in distinguishing between Alzheimers disease from frontotemporal dementia. In many ways Ken Lehmanns symptoms fit neatly into a diagnosis of frontotemporal dementia. A form of cognitive impairment that typically becomes evident earlier than most cases of Alzheimers FTD often affects judgment personality and verbal communication. This form of dementia progresses as inexorably as does Alzheimers. But its typical course differs slightly. As an enrollee in the IDEAS trial Lehmann was prepared to learn what it was he had. I had come to the conclusion they just dont know said Lehmann now from his home in Minnesota. In seven years my journey of decline has been very miniscule and they dont know why. It turns out he added I have all the biomarkers of Alzheimers disease. Once he and his wife learned that they stepped up their preparations for further decline. And they redoubled their efforts to do things that bring joy and that may slow Kens decline as well. They follow a diet rich in fatty fish healthful fats and fruits and vegetables and Ken does woodworking. He also sings in a Minneapolis chorus Giving Voice with other dementia patients. He has regained a longlost ability to read music. Just not knowing is very disconcerting says Mary Margaret who is her husbands principal caregiver. I dont know what the timeline is but I now know what the needs are in terms of financial and legal needs and endoflife issues. Those all need to be planned for ahead of time and now we have all of that in place. To me thats a safety net."

"The consensusone of the first of its kindcomes on the eve of the Ryder Cup the biennial golf tournament between Europe and the US. Amid a growing body of evidence on the health impacts of the sport the consensus aims to help current and wouldbe players maximise the health pros and minimise the health cons of golf and to guide policymakers and industry leaders on how best to make golf more inclusive and accessible and so encourage more people from all walks of life to take up the sport. The statement draws on a systematic review of the available published evidence eligible studies and discussions among an international working group of experts in public health and health policy and industry leaders. Agreement was reached on statements in three areas. These set out what is currently known about golfs associations with health the factors that may help or hinder takeup of the sport and a series of recommendations for golfers industry leaders and policy makers on how best to maximise its health benefits promote sustainability and widen participation. The evidence shows that playing golf regularly is associated with longevity and reducing the risk factors for heart diseasestroke. And it can boost older peoples strength and balance. The sport is also associated with good mental health and improving the overall health of those with disabilities. Compared with other sports the risk of injury is moderate but as its an outdoor activity golfers may be more at risk of skin cancer. Golf is sociable and gets people outdoors connecting with nature. It can provide moderate intensity aerobic physical activity and its health benefits are greatest for players and spectators who walk round the course rather than opt for a golf cart. While around million people play golf at least twice every year the participant profile is quite narrow players tend to be middle aged to older male of white European heritage relatively well off and living in North America Europe and Australasia. And the sport is often perceived as expensive male dominated difficult to learn and not a game for the young or those on the lower rungs of the social ladder. This can put people off says the statement. The sport needs to be more inclusive and welcoming of people from all walks of life and ethnic backgrounds and any such initiatives should be supported it says. More people might be keen to take it up if golf were promoted as an enjoyable lifelong outdoors activity that affords a sense of community and competitive challenge while providing some me time as well as helping to fulfil recommended exercise quotas says the statement. And the sport can do its bit for sustainability by practices that prioritise diversity healthy societies connection with and care of the environment environmental integrity and health and wellbeing the statement suggests. Among its raft of recommendations the consensus statement says that Golfers Should aim to play for minutesweek or do less but couple golf with other physical activity and walk the course rather than ride a golf cart Do warmupstrengthening exercises to cut the risk of injury and use suncream and wear collared shirtsblouses to minimise the risk of skin cancer Make everyone feel welcome ClubsIndustry should Build on existing initiatives to promote inclusivity and develop environments and price structures that will be attractive to everyone Develop a culture that will inspire more women and girls to play golf Make every effort to promote equality and diversity and boost accessibility Promote sustainability through wildlife conservation and by restricting the use of water energy and pesticides Provide additional facilities at clubs such as a gym walking routes crches and improve the focus on health and safety with the provision of healthy foods defibrillators and speed limiters on golf carts for example Policy makers should Promote the benefits of regular physical activity including golf for people of all ages genders and income brackets Promote the specific health enhancing aspects of golf Support diversity equality and sustainability Work with industry and national associations to boost take up of the sport particularly in groups where physical activity levels are low Work with industry and regulatory bodies to get golf included in the Paralympics These outputs if widely shared and adopted will contribute to an improved understanding of golf and health and aid these groups in making evidenceinformed decisions and to improve health and wellbeing the consensus statement concludes."

"Hair samples may help determine the risk of a child developing mental and other chronic illnesses later in their life research led by the University of Melbourne https has found. Researchers assessed the level of cortisol in the hair of nineyearold children from primary schools across Victoria. Cortisol is known as the stress hormone because it is released in response to acute stress to help the body react and cope. The greater number of traumatic events a child had experienced such as divorce injury moving house severe illness or the death of a family member the higher the hair cortisol concentrations were the researchers found. It suggests hair cortisol levels may provide a marker of trauma exposure in children and identify those at risk of developing psychosocial and behavioural problems and who may need medical and psychological support leader of the study and a fellow in child and adolescent mental health at the University of Melbourne Dr Julian Simmons said. Childhood is an imperative and sensitive period of development and when things go wrong it can have lifelong consequences not just on mental health but also on general health Simmons said. Whats less commonly understood is that beyond poor mental health it can also be associated with the development of other illnesses such as diabetes obesity and cholesterol issues because cortisol is also central to glucose availability blood pressure and immune function so identifying these children is important. While blood or saliva tests could be used to detect cortisol levels these methods were sometimes problematic especially in children Simmons said. Cortisol levels fluctuate during the day meaning results were not always accurate and only revealed cortisol levels at a single point in time. The tests could also be unpleasant and invasive for children given blood tests require a needle and saliva tests require the child to fast beforehand. However hair samples are not only easier to obtain but provide us with a picture of total cortisol throughout the system across many months rather than just at a point in time Simmons said. Looking at hair tells us new things. The research is part of https the ongoing Murdoch Childrens Research Institutes Childhood to Adolescence Study following a cohort of children in and around Melbourne and was published in the journal Psychoneuroendocrinology. Simmons said the results did not mean all children with elevated cortisol levels would go on to develop behavioural problems or mental illness with many other social environmental and genetic factors also involved. But it did reveal it was important to further study hormones and the bodys endocrine system and how they relate to mental illnesses like anxiety and depression he said. We hope this can be used as one of the tools to identify children at risk he said."

"People with psoriasis who havent seen improvement with standard treatments now have a new option. The Food and Drug Administration FDA has approved the injectable drug Siliq broadalumab for the treatment of moderatetosevere plaque psoriasis in adults. Because of an association with suicidal thoughts and behaviors Siliq will be sold with a black box warning and should be considered only for patients whose psoriasis has not respondedor has stopped respondingto phototherapy or to other systemic medicines taken orally or via injection. Plaque psoriasis http is an autoimmune condition that causes cells to build up on the surface of the skin forming thick red patches and flaky silverwhite scales. Current treatment options for psoriasis include topical treatments like corticosteroids phototherapy using an ultraviolet light box or a laser and systemic drugsdelivered via a pill an injection or an IV infusionthat work throughout the body. Siliq is unique because it binds to the receptor of a protein called interleukin a known contributor to inflammation. By blocking the receptor from being activated it keeps the body from receiving signals that can fuel inflammatory responses and psoriasis progression. Two other psoriasis drugs currently on the market work similarly but instead bind to the protein itself. This small difference is significant says Dr. Richard Fried a member of the National Psoriasis Foundation medical board since responses to drug treatments can vary dramatically from person to person. Having another agent in our armamentarium that works by a different mechanism is a welcome addition and may prove beneficial to many psoriasis suffers he says in an email. Fried says he has no involvement with the drug or the drug company. In the three clinical trials considered for drug approval more than of patients who used Siliq achieved total skin clearancethe ultimate goal of psoriasis treatmentswithin a year. The most common side effects of the drug were joint and muscle pain headache fatigue diarrhea throat pain nausea flu low white blood cell count fungal infections and reactions at the injection site. The drug also comes with a more serious warning as well. In a total of six clinical trials totaling about participants six suicides http were reported by people receiving Siliq. People with a history of suicide attempts or depression had an increased risk of suicidal ideation and behavior. Because of these events the labeling for Siliq will include a Boxed Warning and the drug will only be available through a restricted REMS Risk Evaluation and Mitigation Strategy program. In order to prescribe it doctors must be certified with the program and must counsel patients about this risk. Patients must also agree to seek medical attention should they experience new or worsening mood changes anxiety or suicidal thoughts. A causal association between Siliq and increased risk of suicidal ideation and behavior has not been established. Fried a dermatologist and clinical psychologist points out that psoriasis itself can be associated with mental health problems http Effective treatment has consistently shown reduction in the incidence and severity of depression and reduced likelihood of suicide says Fried. He adds that the data on Siliq suggests that it is not only effective in treating psoriasis but that many patients experience improvement in anxiety and depression as well. Siliq like other psoriasis medications also affects the immune system. It can raise patients risk of infections and shouldnt be used by people with certain chronic conditions such as Crohns disease or active tuberculosis infections. People should also avoid immunizations with live vaccines while being treated with Siliq. Patients and their health care providers should discuss the benefits and risks of Siliq before considering treatment said Dr. Julie Beitz director of the Office of Drug Evaluation III in the FDAs Center for Drug Evaluation and Research in an agency press release http The drugs recommended dosage schedule is an injection once a week for the first three weeks followed by an injection every other week. Valeant Pharmaceuticals Siliqs manufacturer says that pricing information is not available at this time and expects to begin sales and marketing in the second half of ."

"For years after it was administered growth hormone continued to reduce the risk of fractures and helped maintain bone density in postmenopausal women who had osteoporosis according to a new study published in the Endocrine Societys Journal of Clinical Endocrinology Metabolism. Osteoporosis http is a progressive condition that causes the bones to become weak and more likely to break. More than million American adults have osteoporosis and percent of the people being treated for the condition nationwide are women according to the Societys Endocrine Facts and Figures Report httpendocrinefacts.orghealthconditionsbonecalcium. Women are three times more likely to experience an osteoporosisrelated bone fracture in their lifetimes than men. Our study is the largest and longest controlled study of growth hormone treatment for osteoporosis in postmenopausal women to date said one of the studys authors Emily Krantz MD of Sdra lvsborgs Hospital in Bors Sweden. Years after treatment stopped women who were treated with growth hormone still experienced improved bone density and reduced fracture risk. During an monthlong randomized doubleblind trial postmenopausal women with osteoporosis received daily injections of either placebo a single unit of growth hormone or a .unit dose of growth hormone. The women were between the ages of and when they were recruited for the decadelong study. After months the women who received the placebo halted the injections. Women who received growth hormone continued to receive injections for another months. The researchers continued to follow up with the women for seven years after the growth hormone treatment was halted to monitor their bone density fractures and perception of their quality of life. The researchers compared the participants bone density and rate of fractures to those of a group of women who did not have osteoporosis. The controls were identified using the city census in Gothenburg Sweden. A decade after the study began the women who received the larger growth hormone dose still had higher bone mineral density levels than the participants who received the lower dose or the placebo. The rate of fractures in the treated women who had osteoporosis declined by percent during the yearlong study. More than half of the participants had fractured bones prior to the start of the study. In contrast the rate of fractures rose fourfold in the control group as some of those women were diagnosed with osteoporosis. The findings indicate the beneficial effects of growth hormone remained long after the treatment ceased Krantz said. Other authors of the study include Penelope Trimpou and Kerstin LandinWilhelmsen of Sahlgrenska University Hospital at the University of Gothenburg in Gothenburg Sweden. The study Effect of Growth Hormone Treatment on Fractures and Quality of Life in Osteoporosis A year Followup was published online at httppress.endocrine.orgdoi.jc. ahead of print. Founded in the Endocrine Society is the worlds oldest largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today the Endocrine Societys membership consists of over scientists physicians educators nurses and students in countries. Society members represent all basic applied and clinical interests in endocrinology. The Endocrine Society is based in Washington DC. To learn more about the Society and the field of endocrinology visit our site at http Follow us on Twitter at httpstwitter.comEndoMedia httpstwitter.com."

"Yale Cancer Center researchers have developed a vaccine strategy that reduces the risk of flu infections in cancer patients at highest risk for influenza. The findings were presented Dec. at the th annual meeting of the American Society of Hematology in Orlando Florida. Patients with cancers of the immune system like multiple myeloma are especially susceptible to common infections and a bout of the flu can lead to serious illness and even death. Even though patients with multiple myeloma and other plasma cell disorders may receive an annual flu vaccine studies show that a onetime flu shot does not offer adequate immune response. The Yale researchers developed a strategy that entailed offering patients a highdose flu vaccine followed by a second highdose booster shot one month later. The highdose vaccine Fluzone HighDose was approved in by the FDA as a single dose for adults over . The booster strategy lowered the flu infection rate among patients to versus an expected rate of and it improved protection against all flu strains covered by the vaccine in of patients said the studys first author Andrew Branagan M.D. a postdoctoral associate in medicine hematology. Using an approved flu vaccine in a novel dosing schedule yielded promising results for a group patients at high risk for infection Branagan said. We hope to confirm these results in a larger prospective randomized trial that is underway now at Yale during the flu season. We suspect this strategy could benefit other cancer patient populations. This study was supported by the Arthur R. Sekerak Cancer Research Fund a Yale Cancer Center philanthropic fund."

"A new drug appears to be effective for shrinking uterine fibroids https and controlling the heavy menstrual bleeding they often cause according to new research from Europe. In one study the drug ulipristal acetate proved to be much more effective than a placebo https for shrinking the nonmalignant uterine tumors. In another ulipristal acetate was found to be as effective as monthly injections of the drug Lupron for reducing heavy bleeding in women with uterine fibroids https Both studies appear in the Feb. issue of The New England Journal of Medicine. Ulipristal acetate is the active chemical in the emergency contraceptive sold in the U.S. as Ella but the daily doses taken by the fibroid patients in the studies were much smaller than those in the contraceptive. If trials now under way in the U.S. prove positive New Jerseybased Watson Pharmaceuticals Inc. and Swissbased PregLem hope to market ulipristal acetate as a fibroid treatment under the trade name Esmya says Watson spokesman Charlie Mayr. in Women Have Fibroid Symptoms Uterine fibroids are the most common indication for the close to hysterectomies performed each year in the U.S. About in women in their childbearing years have symptoms related to fibroids such as heavy periods https and related iron deficiency https abdominal pain https and fertility https problems according to figures from the National Institutes of Health. Surgery is the most common uterine fibroid treatment but many women want a nonsurgical treatment option says researcher Jacques Donnez MD PhD of SaintLuc Catholic University of Louvain in Brussels Belgium. Lupron improves symptoms and shrinks uterine fibroids but it does not make them go away. It works by blocking the production of estrogen https the hormone that fuels fibroids and many women who take it develop hot flashes https and other symptoms of menopause https In one of the newly published studies women with excessive bleeding caused by uterine fibroids who took ulipristal acetate for three months had similar improvements in bleeding as patients who got monthly injections of Lupron with significantly fewer side effects. Drug Controlled Bleeding Shrank Fibroids Moderate to severe hot flashes were reported in about of the women treated with ulipristal acetate and of women who took Lupron. In another study ulipristal acetate was compared to placebo in fibroid patients with heavy bleeding and anemia https Treatment with the drug for weeks controlled uterine bleeding in around of patients. In both studies significant reductions in fibroid size were seen during treatment with ulipristal acetate and for some time after. This was a surprise Donnez says. We know that when patients stop taking leuprolide https acetate their symptoms return quickly but this does not appear to be the case with ulipristal acetate. He says this could mean that the newer drug may help patients avoid surgery entirely. It may be that women can go on and off this drug intermittently taking it for a few months when symptoms return he says. Still Too Many Hysterectomies Elizabeth A. Stewart MD a professor of obstetrics and gynecology at the Mayo Clinic in Rochester Minn. says it remains to be seen if the drug is safe for longterm intermittent use. If it is Stewart agrees that ulipristal acetate could help many patients with symptomatic fibroids avoid surgery. She says there are good alternatives to hysterectomy https for the treatment of fibroids but many patients never hear about them. Fibroid patients need to understand their options so they can at least consider them she tells WebMD. There will still be some women who choose hysterectomy but many others may not."

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

"A common blood test could help diagnose cancer earlier according to research suggesting a high platelet count is strongly associated with the disease. Platelets are tiny blood cells https that circulate in the body helping wounds to clot. But in some individuals too many platelets are produced a condition known as thrombocytosis thought to affect about half a million people in the UK over the age of . Researchers say that raised platelet counts are as good a predictor of getting any cancer as a lump in the breast is for breast cancer. This is a clue which can be used in practice by GPs to help them select patients for further investigation most excitingly in some patients who may not already have other symptoms of cancer to achieve earlier diagnosis said Sarah Bailey coauthor of the research from the University of Exeter. Previous studies have suggested a link between thrombocytosis and various cancers with recent guidelines https from the National Institute for Health and Care Excellence advising high platelet counts could be a sign of cancer of the oesophageal stomach lung or uterus. But it remained unclear whether the condition could signal an increased risk of all cancers and how it ties in with factors such as age and sex. Writing in the British Journal of General Practice httpbjgp.orgcontentearlybjgpX Bailey and colleagues report how they examined data from almost individuals aged or over who had been given a blood test by their GP. The patients were selected at random from a national database. In total over patients found to have a raised platelet count and nearly without were included in the analysis. Within a year of the blood test the team found that cancer was more common among those who had thrombocytosis . of men and . of women were found to have cancer compared to . of men and . of women without a raised platelet count. In the general population about of individuals over the age of develop cancer each year. For comparison among women aged between and who have discovered a breast lump the proportion who are found to have breast cancer is .. We found cancer was more commonly diagnosed in men with raised platelet counts than it was in women with raised platelet counts and we believe that is because there are more causes of raised platelet counts in women that are not cancer said Bailey. The team add that cancer was more common among for those who had thrombocytosis for longer. Of the men who had a raised platelet count of the same value or higher six months after being diagnosed with thrombocytosis . developed cancer while for women the figure was .. While many different types of cancer were present in both groups the team found that breast and prostate cancers were less common among those with thrombocytosis than in the general population while lung and colorectal cancers were more common. For about a third of cases of lung and colorectal cancer in patients with thrombocytosis there had been no other symptoms that raised the suggestion of cancer. That say the researchers makes testing for raised platelet count a valuable tool and could speed up cancer diagnosis by at least three months for thousands of patients a year. Richard Neal professor of primary care oncology at the University of Leeds who was not involved in the research welcomed the study. This is an excellent study that demonstrates the potential for a commonly used blood test to identify some patients with cancer earlier he said. This work should begin to change practice so that GPs should be testing patients with raised platelet counts for cancer especially those without other potential cancer symptoms he added. Dr Jasmine Just Cancer https Research UKs health information officer said more research was need to confirm whether further tests following a high platelet count would save lives. There are lots of possible reasons a persons platelet count might be high and in most cases it wont be down to cancer she added. Measuring platelet count in patients who dont otherwise warrant a blood test is not necessarily a good idea. But if a patient has a blood test for another reason and a high platelet count is found then one of the possible diagnoses doctors should consider is cancer."

"German researchers who used a bone marrow transplant to treat a cancer patient with the AIDS virus have declared him cured of the virus a stunning claim in a field where the word cure is barely whispered. The patient who had both HIV infection and leukemia received the bone marrow transplant in from a donor who had a genetic mutation known to give patients a natural immunity to the virus. Nearly four years after the transplant the patient is free of the virus and it does not appear to be hiding anywhere in his body Thomas Schneider of Berlin Charite hospital and colleagues said. Our results strongly suggest that cure of HIV has been achieved in this patient they wrote in the journal Blood. AIDS researchers have rejected the approach on any kind of scale for patients with HIV. A bone marrow transplant is a lastditch treatment for cancers such as leukemia. It requires destruction of a patients own bone marrow itself a harrowing process and then a transplant from a donor who has a nearexact blood and immune system type. Months of recovery are needed while the transplant grows and reconstitutes the patients immune system. Its not practical and it can kill people said Dr. Robert Gallo of the Institute of Human Virology at the University of Maryland who helped discover the human immunodeficiency virus that causes AIDS. It is possibly a cure thats for sure you wont know for absolute sure until the person dies and undergoes extreme PCR genetic analysis of postmortem tissue. Sponsored ADVERTISING The mutation affects a receptor a cellular doorway called CCR that the AIDS virus uses to get into the cells it infects. Since the s scientists have known that some people mostly of Northern European descent have the mutation and are rarely infected with HIV. They are uninfectable virtually Gallo said. Some researchers are working on the idea of gene therapy to treat or try to cure HIV but the technology is still in experimental stages. I dont want to throw cold water on an interesting thing but thats what it is an interesting thing Gallo said. Schneiders team has been following the patient taking samples from his colon liver spinal fluid and brain as he developed various conditions that justified the tests. They tested all these samples for evidence of the virus which can be difficult to detect unless it is actively infecting cells. All these places are suspected reservoirs where HIV can hide out for years to rebound in patients who stop taking drugs that suppress the infection. This patient appears to have a fully functioning immune system they found which appears genetically identical to cells from the donor not the patients own immune cells. Schneiders team found no evidence of HIV anywhere. From these results it is reasonable to conclude that cure of HIV infection has been achieved in this patient they wrote. The AIDS virus infects million people globally and has killed more than million since the pandemic began in the s. Cocktails of strong drugs can suppress the virus keeping patients healthy and reducing the chance they will infect others but there is no vaccine."

"Results of a recent study to better understand modifiable factors such as physical activity that may affect a womans ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant. Credit UMass Amherst AMHERST Mass. Results of a recent study to better understand modifiable factors such as physical activity that may affect a womans ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant. The study was conducted by recent graduate Lindsey Russo and her advisor Brian Whitcomb associate professor of biostatistics and epidemiology in the School of Public Health and Health Sciences at the University of Massachusetts Amherst. Russo and Whitcombs findings among healthy women ages to years old with a history of one or two pregnancy losses are based on their secondary analysis of the multisite Effects of Aspirin in Gestation and Reproduction EAGeR study. It is led by Enrique Schisterman of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Results are in the current online issue of Human Reproduction. Russo says One of our main findings is that there was no overall relationship between most types of physical activity and the likelihood of becoming pregnant for women who had already had one or two pregnancy losses except for walking which was associated with higher likelihood of becoming pregnant among women who were overweight or obese. Whitcomb whose research on the determinants of fertility and pregnancy outcomes usually involves studying biomarkers at the molecular level adds Lifestyle is definitely relevant to these outcomes because it can have an effect at the molecular level. What we eat and what we do are potential factors we can change to shape our health. So this sort of research is important because it helps provide information on the things people can actually do something about. Further he says We were happy to be able to add scientific evidence to general recommendations about physical activity. This is especially true for the results about walking for even limited blocks of time. Walking has great potential as a lifestyle change because of its low cost and availability. For the women in the study the association of walking with the ability to become pregnant known as fecundability varied significantly by body mass index the authors report. Among overweightobese women walking at least minutes at a time was associated with improvement in fecundability. Further in statistically adjusted models women reporting more than four hours a week of vigorous activity had significantly higher pregnancy chances compared to no vigorous activity. Moderate activity sitting and other activity categories were not associated with fecundability overall or in BMIstratified analyses they add. Russo and Whitcomb say one finding that is still not clear is the different associations related to vigorous compared to moderate and lowintensity activities. Whitcomb says We dont know what to make of the finding that high intensity physical activity may have different biological effects than walking but our study doesnt offer enough detail to get at why vigorous activity would work differently than other levels. Among a number of cautions the researchers point to in this work is that physical activity is related to other behaviors and lifestyle factors and women who are more physically active may be different from women who are less active in many ways. Russo says We did our best to try to account for the differences and to address them statistically. The researchers also note that the overall generalizability of this work is limited because the study population may not be representative of the general population with regard to fecundability and exercise habits may differ in women with prior miscarriage compared to those without. Whitcomb says another way in which this study is distinct from other work in this area has to do with who was included in the study. The EAGeR trial focused on women with a history of one or two prior pregnancy losses. However he adds We were happy to be able to conduct research considering women having the most difficulty getting and staying pregnant and to provide messages about common lifestyle factors they may be able to address. The researchers conclude that these findings provide positive evidence for the benefits of physical activity in women attempting pregnancy especially for walking among those with higher BMI. Further study is necessary to clarify possible mechanisms through which walking and vigorous activity might affect timetopregnancy."

"A little spit may help predict whether a childs concussion symptoms will subside in days or persist for weeks. A test that measures fragments of genetic material in saliva was nearly percent accurate in identifying children and adolescents whose symptoms persisted for at least a month a Penn State team told the Pediatric Academic Societies Meeting https in San Francisco Calif. In contrast a concussion survey commonly used by doctors was right less than percent of the time. If the experimental test pans out a pediatrician could collect saliva with a swab send it off to the lab and then be able to call the family the next day says Steven Hicks httpsprofiles.psu.eduprofilesdisplay an assistant professor of pediatrics at Penn State Hershey. Hicks helped develop the test and consults for a company that hopes to market concussion tests. A reliable test would help overcome a major obstacle in assessing and treating concussions which affect more than one million children and adolescents in the U.S. each year. Many of the injuries are related to sports. Article continues after this message from our sponsor In most cases concussion symptoms last only a few days. But up to percent of young patients go on to have these prolonged headaches fatigue nausea and those symptoms can last sometimes one to four months Hicks says. And right now theres no way to know which kids are going to have longterm problems he says. Parents often say that their biggest concern is When is my child going to be back to normal again Hicks says. And thats something we have a very difficult time predicting. Hicks and a team of researchers have been looking for an objective test that might help. They knew that after a concussion injured brain cells try to heal themselves. As a part of this process brain cells release tiny fragments of genetic material called microRNAs. Some of these fragments eventually turn up in blood and even in saliva. The team did an experiment that involved concussion patients between the ages of and . When they came to our medical center and received the diagnosis of concussion we evaluated them with some standard surveybased tools and then we also got a sample of their saliva Hicks says. Most samples were collected about a week after the injury. The team measured levels of many different microRNAs in the samples and eventually they identified a handful that let them predict how long symptoms would last. They also identified one microRNA that predicted which children would have a specific concussion symptom difficulties with memory and problem solving Hicks says. A saliva test could greatly improve care for young people who dont have obvious symptoms of a concussion says Manish Bhomia an adjunct assistant professor at the Uniformed Services University of the Health Sciences in Bethesda Md. A lot of children get mild concussion and oftentimes it goes ignored he says. A reliable lab test would help ensure that children who have a head injury dont go back to school or to the soccer field before their brain has healed Bhomia says. And microRNAs offer a promising way to assess concussions in adults as well as children says Bhomia whose research involves a range of biomarkers for traumatic brain injury. But saliva may not be the best place to measure microRNAs Bhomia says. A better option he says might be blood samples which tend to contain greater numbers of the genetic fragments."

"New research published in Lancet Neurology and reported by CNN has found using a green tea extract decaffeinated in combination with cognitive training improves some measures of cognition and behavior in subjects with Down syndrome. Eightyseven volunteers aged to with Down syndrome were enrolled in the phase randomized controlled trial. The study was conducted at the IMIMHospital del Mar Medical Research Institute in Barcelona Spain. Participants were randomly assigned to take the decaffeinated green tea extract or placebo for one year. All subjects also underwent cognitive training during the month trial. After one year of treatment functional brain scans fMRI showed that epigallocatechingallate EGCGtreated subjects had improved neuronal connectivity in certain brain regions. Participants who took the green tea extract also scored significantly better on assessments of visual recognition memory inhibitory control and adaptive behavior compared with those who took the placebo. Its an important trial says Dr. Steven Hirsh director of clinical research for Life Extension in Fort Lauderdale Fla. The findings are very noteworthy and support further study in randomized controlled trials with larger sample sizes and durations. It is very encouraging that this catechin EGCG from green tea extract has the potential to benefit people with Down syndrome. Down syndrome is a genetic condition that affects about Americans. Individuals with Down syndrome have an extra full or partial copy of chromosome . The team of researchers led by Dr. Rafael de la Torre program director of IMIM Hospital del Mar Medical Research Institute and study coprincipal investigator and Dr. Mara Dierssen group leader at Center for Genomic Regulation Barcelona Spain and study coprincipal investigator proposed that EGCG might have conferred these benefits by inhibiting an enzyme called DYRKA which has been implicated in Down syndrome and neurodegenerative conditions including Alzheimer disease. The level of DYRKApositive cells is elevated in certain regions of Alzheimer disease patients brains and is roughly fold higher in the frontal cortex compared to normal brains. DYRKA is implicated in the formation of neurofibrillary tangles via tau hyperphosphorylation and amyloid plaques both of which are features of Alzheimer disease. Tea catechins may also modulate the damaging effects of amyloidbeta. Several animal studies have found that EGCG and related compounds from tea suppress amyloidbetainduced cognitive dysfunction and neurotoxicity. Other possible mechanisms by which EGCG may influence cognition include epigenetic regulation restoration of mitochondrial function and antioxidative functions. In an earlier pilot study supported by Life Extension Drs. de la Torre and Dierssens team showed that three months of EGCG treatment improved symptoms in individuals with Down syndrome and in mice with a Downsyndromelike condition characterized by overexpression of DYRKA. We are excited that the benefits observed in the early pilot and preclinical research extended to this larger trial says Luke G. Huber ND MBA vice president of product innovation and scientific development at Life Extension. This new research adds to the growing body of evidence that suggests compounds in green tea such as EGCG may support cognitive health. In acknowledging the novelty of their findings and calling for more research the Spanish research team noted that this study is the first wellpowered trial that shows improvement in adaptive behavior functional academics and brainrelated changes in young adults with Downs syndrome. However more research is needed to clarify the nature of the beneficial association between the EGCG and cognitive training intervention ie synergistic or additive. References . de la Torre R de Sola S Hernandez G et al. Safety and efficacy of cognitive training plus epigallocatechingallate in young adults with Downs syndrome TESDAD a doubleblind randomised placebocontrolled phase trial. The Lancet Neurology. . . Senthilingam M. Cable News Network CNN U. S. Edition online. Can green tea boost your brainpower and treat disease http Last updated . Accessed . . . CDC. Centers for Disease Control and Prevention. Birth Defects. Key Findings Prevalence of Down syndrome in the United States. http Last updated . Accessed . . . NDSS. What Is Down Syndrome http Accessed . . Stotani S Giordanetto F Medda F. DYRKA inhibition as potential treatment for Alzheimers disease. Future medicinal chemistry. . . Souchet B Latour A Gu Y et al. Molecular rescue of DYRKA overexpression in cystathionine beta synthasedeficient mouse brain by enriched environment combined with voluntary exercise. Journal of molecular neuroscience MN. . . Becker W Soppa U Tejedor FJ. DYRKA a potential drug target for multiple Down syndrome neuropathologies. CNS neurological disorders drug targets. . . Wegiel J Gong CX Hwang YW. The role of DYRKA in neurodegenerative diseases. The FEBS journal. . . Bhat RV Budd Haeberlein SL Avila J. Glycogen synthase kinase a drug target for CNS therapies. Journal of neurochemistry. . . Avila J Hernandez F. GSK inhibitors for Alzheimers disease. Expert review of neurotherapeutics. . . Jope RS Roh MS. Glycogen Synthase Kinase GSK in Psychiatric Diseases and Therapeutic Interventions. Current Drug Targets. . . Kim TI Lee YK Park SG et al. lTheanine an amino acid in green tea attenuates amyloidinduced cognitive dysfunction and neurotoxicity reduction in oxidative damage and inactivation of ERKp kinase and NFB pathways. Free Radical Biology and Medicine. . . RezaiZadeh K Arendash GW Hou H et al. Green tea epigallocatechingallate EGCG reduces amyloid mediated cognitive impairment and modulates tau pathology in Alzheimer transgenic mice. Brain research. . . Haque AM Hashimoto M Katakura M Hara Y Shido O. Green tea catechins prevent cognitive deficits caused by Abeta in rats. The Journal of nutritional biochemistry. . . De la Torre R De Sola S Pons M et al. Epigallocatechingallate a DYRKA inhibitor rescues cognitive deficits in Down syndrome mouse models and in humans. Molecular nutrition food research. . SOURCE Life Extension"

"A genetically modified poliovirus may help some patients fight a deadly form of brain cancer researchers report. The experimental treatment seems to have extended survival in a small group of patients with glioblastoma https who faced a grim prognosis because standard treatments had failed Duke University researchers say. Ive been doing this for years and Ive never seen results like this says Dr. Darell Bigner httpsneurosurgery.duke.edublogmeetdirectoremeritusbraintumorcenter the director emeritus of the The Preston Robert Tisch Brain Tumor Center at the Duke Cancer Institute who is helping develop the treatment. But the researchers and other braincancer doctors caution the research is at a very early stage. In the study only percent of patients experienced a prolonged survival. Much more followup research is needed to better assess and hopefully improve the treatments effectiveness the researchers say. We have to be careful says Annick Desjardins https a Duke neurooncologist who helped conduct the study. But we have longterm survivors. We are seeing something we dont normally see with patients with glioblastoma. Dr. David Reardon http clinical director of the Center for NeuroOncology at the DanaFarber Cancer Institute in Boston says the Duke groups results may represent a good solid important step forward for patients with no alternatives. Article continues after this message from our sponsor Unfortunately for most patients this is not going to be the answer yet says Reardon who used to work at Duke but wasnt involved in the new research. My fear is that every patient and family dealing with the devastating disease of glioblastoma is going to think the poliovirus is the cure. Unfortunately the patients who are benefiting do reflect a relatively small percentage of the population. The Duke results were published https Tuesday by the New England Journal of Medicine to coincide with their presentation at the nd International Conference on Brain Tumor Research in Norway. Glioblastoma is the most common and aggressive malignant brain tumor in adults. Its the cancer that killed former Sen. Edward Kennedy DMass. and former Vice President Joe Bidens son Beau. Sen. John McCain RAriz. is fighting glioblastoma. The Duke researchers decided to try to use a genetically modified version of the poliovirus https which can cause a devastating form of paralysis https because of the viruss ability to infect nervous system cells. The scientists removed one of the viruss genes to prevent it from causing polio and replaced that gene with one from a harmless virus known as a rhinovirus which ordinarily causes the common cold. The engineered virus was then infused directly into tumors in patients brains with a tube inserted through a hole in the skull. The modified virus retains the ability to infect and kill brain tumor cells and also appears to trigger the patients own immune system cells to attack the tumors the researchers say. Between and the researchers treated patients trying various doses of the modified virus to determine which was safest and most effective. There are substantial risks. The treatment can cause a dangerous swelling in the brain that can lead to seizures and other complications the researchers found. One patient suffered a lifethreatening blood clot in the brain that required surgery. But overall the median length of survival was . months for patients treated with poliovirus compared with . months for a similar group of patients treated in the past the researchers report. And starting at two years after treatment the two groups survival rate began to diverge the researchers reported. After months percent of the patients treated with the virus had survived compared with percent of the historical comparison group. After three years percent of the poliovirus treated patients survived compared with percent of the other group according to the researchers. Two patients have survived more than six years Bigner says. One has survived more than five years. You just dont see this percentage of longterm survivors with this disease Bigner says. Those that have survived more than two years are in remission and we expect them to continue to be longterm survivors. Some other researchers praised the results. Were extraordinarily encouraged by what we see with this data says Mitchel Berger httpneurosurgery.ucsf.eduindex.phpabout_us_faculty_berger.html chairman of neurosurgery at the University of California San Francisco and director of its center for brain tumors. Its phenomenal. But some cancer doctors caution that comparing the outcomes for patients receiving the virus treatment to what would have happened to similar patients in the past could produce misleading conclusions. The Duke researchers have started a followup study combining the treatment with a chemotherapy drug to try to improve the results. They also plan to combine the treatment with other drugs including some called checkpoint inhibitors https to harness the immune system to fight cancer. In addition the researchers are planning to try the approach on children with brain cancer as well as other types of cancer including melanoma and breast cancer. We believe we are going to be able to increase the results even more significantly Bigner says."

"For the first time scientists have precisely identified and targeted an area of the brain which is involved in hearing voices experienced by many patients with schizophrenia. They have been able to show in a controlled trial that targeting this area with magnetic pulses can improve the condition in some patients. This early clinical work is presented at the ECNP conference in Paris on Tuesday th September with later publication in Schizophrenia Bulletin. This is the first controlled trial to precisely determine an anatomically defined brain area where high frequency magnetic pulses can improve the hearing of voices said lead researcher Professor Sonia Dollfus University of Caen CHU France. Schizophrenia is a serious longterm mental health problem. People with schizophrenia experience a range of symptoms which may include delusions muddled thoughts and hallucinations. One of the bestknown is hearing voices also known as Auditory Verbal Hallucination AVH which around of people with schizophrenia experience at some point. These voices may be heard as having a variety of different characteristics for example as internal or external friendly or threatening they may be continuously present or present only occasionally and so on. Transcranial Magnetic Stimulation TMS has been suggested as a possible way of treating the hearing of voices in schizophrenia. TMS uses magnetic pulses to the brain and has been shown to be effective in several psychiatric conditions. However there is a lack of controlled trials to show that TMS works effectively with AVH sufferers. The French research team worked with patients who received active TMS treatment and as a control group who received sham placebo treatment. The researchers interviewed the patients using a standard protocol the Auditory Hallucinations Rating Scale which revealed most of the characteristic features of the voices which they were hearing. The treated patients received a series of Hz highfrequency magnetic pulses over sessions a day for days. Using magnetic resonance imaging MRI the pulses were targeted at a specific brain area in the temporal lobe which is associated with language the exact area is the crossing of the projection of the ascending branch of the left lateral sulcus and the left superior temporal sulcus After weeks the patients were reevaluated. The researchers found that . of the patients being treated by TMS showed a significant response whereas only . of patients in the sham group responded significant response was defined as a more than decrease in the Total Auditory Hallucinations Rating Scale score. Professor Sonia Dollfus said Auditory Verbal Hallucinations or hearing voices can be a disturbing symptom of schizophrenia both for patients and for those close to sufferers. This is the first controlled trial to show an improvement in these patients by targeting a specific area of the brain and using high frequency TMS. This means two things firstly it seems that we now can say with some certainty that we have found a specific anatomical area of the brain associated with auditory verbal hallucinations in schizophrenia. Secondly we have shown that treatment with high frequency TMS makes a difference to at least some sufferers although there is a long way to go before we will know if TMS is the best route to treat these patients in the longterm. Commenting Professor Andreas MeyerLindenberg Central Institute of Mental Health Mannheim and member of the ECNP executive board said This work builds on previous studies that have shown a critical role of excessive activity of subregions of the temporal lobe in the generation of voice hallucinations in schizophrenia. To move this into treatment controlled trial such as the one by Dollfus and coworkers are important. While response rates were moderate TMS is a welcome addition to the therapeutic repertoire especially for patients who do not respond to medication. NOTE The full title of this release is Scientists discover brain area which can be targeted for treatment in patients with schizophrenia who hear voices It has been shortened in some versions to comply with Eurekalert title limits. This work has been accepted in the peerreviewed journal Schizophrenia Bulletin The Journal of Psychoses and Related Disorders. The exact publication date has still to be determined. Note Around people have been diagnosed as having schizophrenia in England and Wales https"

"Women undergo more cesarean sections each year in the United States than any other major surgery with the procedure carrying a significant rate of infection at the incision site. A new study from Washington University School of Medicine in St. Louis offers strong guidance on the best way to reduce the infection risk. Rather than prepping patients with iodinealcohol a common antiseptic combination in Csections the research indicates that chlorhexidinealcohol is significantly more effective. The researchers argue that the evidence is strong enough to change standard skinprep practices for Csections. The study appears online Feb. in The New England Journal of Medicine and coincides with a presentation at the Society for MaternalFetal Medicines Annual Meeting in Atlanta. One of the biggest complications of surgery and of Csections in particular is infection said first author Methodius G. Tuuli MD assistant professor of obstetrics and gynecology. For a new mother who needs to care for her baby which is stressful even when all things are equal having an infection can really impair her ability to do that. We are very interested in clarifying the best ways to prevent these infections reducing the burden on the patients on their infants and on the healthcare system as a whole. An estimated . million women in the U.S. delivered their babies by Csection in with surgicalsite infections complicating to percent of those deliveries. The average cost of treating those cesareanrelated infections in the hospital is and may be much higher for severe infections. The research shows that patients in the chlorhexidinealcohol group developed significantly fewer infections than patients in the iodinealcohol group. Those who received the chlorhexidinealcohol combination had a percent infection rate which is nearly half that of the patients who received the iodinealcohol combination . percent. The clinical trial included patients who underwent cesarean sections at BarnesJewish Hospital from to . Of patients randomly assigned to receive the chlorhexidinealcohol combination developed an infection at the site of the surgery within days of the procedure. Of patients who randomly received the iodinealcohol combination developed a surgicalsite infection. The investigators pointed out that all other standard procedures for reducing the risk of infection after surgery including giving preventive antibiotics beforehand were the same in both groups. Studies of other types of surgeries also have suggested the superiority of chlorhexidine over iodine in preventing infection. But according to Tuuli the unique circumstances of a Csection that bacteria come from both skin and vagina and that a womans immune system is altered during pregnancy mean the results of these studies may not apply. In addition past trials comparing antiseptics before surgery included relatively few participants and often compared a chlorhexidinealcohol combination with iodine alone. These studies could not determine whether the worse performance of iodine alone was due to the chlorhexidine the alcohol or the combination. Although the new study was conducted at only one hospital the researchers said the patient population was racially diverse and that more than percent received public insurance. Tuuli and his colleagues also pointed out that the superiority of the chlorhexidinealcohol combination was consistent whether the Csection was scheduled or unscheduled whether or not the patient was obese whether staples or sutures were used to close the wound and whether the patient had chronic medical conditions including diabetes. Highlighting the significance of the findings the studys senior author George A. Macones MD the Mitchell and Elaine Yanow Professor and head of the Department of Obstetrics and Gynecology said This study is a tremendous addition to the literature on preventing surgicalsite infections after cesarean. There are few circumstances when a single study should change our practice. But based on the biological plausibility and the striking reduction in surgicalsite infections with chlorhexidine this is one of those circumstances. This work was supported by a Womens Reproductive Health Research Career Development grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health NIH grant number KHD and by the Department of Obstetrics and Gynecology at Washington University School of Medicine in St. Louis. Tuuli MG Liu J Stout MJ Martin S Cahill AG Odibo AO Colditz GA Macones GA. A randomized trial comparing skin antiseptic agents at cesarean delivery. New England Journal of Medicine. Feb. . Washington University School of Medicines employed and volunteer faculty physicians also are the medical staff of BarnesJewish and St. Louis Childrens hospitals. The School of Medicine is one of the leading medical research teaching and patientcare institutions in the nation currently ranked sixth in the nation by U.S. News World Report. Through its affiliations with BarnesJewish and St. Louis Childrens hospitals the School of Medicine is linked to BJC HealthCare."

"A new study may reassure some women considering shortterm use of hormones to relieve hot flashes and other menopause symptoms. Starting lowdose treatment early in menopause made women feel better and did not seem to raise heart risks during the fouryear study. However the research didnt address the risk of breast cancer perhaps the biggest fear women have about hormones since a landmark study a decade ago. The new one was too small and too short for that. Still it is the first fresh research in many years on the sometimes confusing effects of hormones on womens health. The advice remains the same Use hormones only for severe symptoms not to prevent bone loss or agingrelated problems at the lowest dose for the shortest time possible. The benefits outweigh the risks when hormone therapy is used for symptom management with relatively shortterm treatment said Dr. JoAnn Manson preventive medicine chief at Brigham and Womens Hospital in Boston. She was a study leader and will discuss results Wednesday at a conference of the North American Menopause Society in Orlando Florida. For decades doctors believed hormone pills helped prevent heart problems and were good for bones and minds. That changed in when a big federal study was stopped because women taking estrogenprogestin pills had higher rates of cardiovascular disease and cancer. Critics pounced on the studys limitations. Participants were well past menopause on average and most were not seeking symptom relief. Many were overweight and smokers and at higher risk of heart disease to start with. Only one type of pill in one dose was tested. Women who could take estrogen alone those who had had hysterectomies did not have the risks that women on the combination hormone pills did. In fact they had lower rates of breast cancer. These factors led many experts to think some hormones might help certain women and that the type and dose might matter. The new study tested that. It enrolled about healthy women ages to within three years of menopause. They were given either lowdose estrogen pills Premarin made by Wyeth now part of Pfizer Inc. a lowdose estrogen skin patch Climara made by Bayer or a placebo. Women on estrogen also received Prometrium a progesterone that more closely mimics what the body makes. All women received a patch and two types of pills but some of those were fake treatments and neither they nor their doctors knew who had the real medicine versus placebos until the study ended. That is standard study design to test who is really helped by a medication. The main goal was seeing whether hormones made a difference in hardening of the arteries a precursor to heart disease as seen on imaging tests. Other health measures also were tracked. After four years doctors found No effect on blood pressure or artery hardening. Both types of estrogen reduced hot flashes and improved bone density mood and sexual health. Estrogen pills raised good cholesterol and lowered the bad form but also caused triglycerides another type of fat in the bloodstream to rise. Estrogen patches did not affect cholesterol but improved bloodsugar levels and insulin sensitivity possibly making them a better choice for overweight women at risk of diabetes. Patches and pills have different effects said Dr. S. Mitchell Harman an endocrinologist and director of the Kronos Longevity Research Institute a Phoenixbased group with no industry ties that paid for the study. Oral estrogen goes straight to the liver resulting in higher concentrations than when its absorbed through the skin. That raises bloodclotting factors that might be especially harmful to smokers. But higher estrogen levels also cause the liver to make more HDL or good cholesterol. So estrogen can have good and bad effects depending on the form he said. Skin patches account for just percent of hormone use some studies estimate. Besides Climara at least one other is on the market VivelleDot sold by Novartis and Noven Pharmaceuticals Inc. A generic version is expected in about a year. Dr. Sanjay Asthana a geriatrician at the University of WisconsinMadison led a separate analysis that found estrogen pills and patches improved depression and anxiety but had no effect on cognition or memory. The National Institute on Aging paid for that study. Women need to realize the new study is much less definitive than the big federal one that found more lung and breast cancer deaths among women on estrogenprogestin pills said one researcher involved in the earlier work Dr. Rowan Chlebowski of the Los Angeles Biomedical Research Institute at HarborUCLA Medical Center. It would be unwise to try to prevent certain health problems by using a treatment that increased the two leading causes of cancer deaths in women he said. Manson agreed that hormones should be used only for severe symptoms. Two study participants found they helped. My mood leveled out. I found that I was just generally calmer on the estrogen patch said Kathy Smerko a nurse practitioner from Phoenix. Dianne Fraser an accountant from suburban Boston said the patch eliminated the drenching sweats that woke her in the night. She was able to quit treatment after five years and seldom has problems now. It was enough to get me through that crazy period right after menopause began she said."

"Max Rowan and Charlie Vertins muscles have been slowly collecting damage since the day they were born. Someday they will not be able to walk. They will not be able to stand. Eventually they will not be able to live. The brothers ages through suffer from a debilitating and deadly genetic condition called Duchenne muscular dystrophy DMD. Yet on September Max Rowan and Charlie Vertin got dressed up. In dark suits and blue shirts with serious expressions on their round faces they walked to stand next to their mother in a very beige room outside Washington D.C. The people in that room they believed could change the course of their lives. For years the Vertin brothers have been participating in a clinical trial for a new medication called ataluren intended to keep the progression of their disease at bay. By October theyll know if they will be able to keep taking that drug. That is the deadline for the Food and Drug Administration to make a choice. The agency could approve the drug allowing the brothers and others like them to continue to take it. Or it could reject the drug for the third time and throw them into an uncertain future. An FDA committee has already voted that data about the drugs effectiveness was inconclusive. The agencys final decision almost always echos the decisions of its committees. So if this were any other kind of drug at any other time in FDA history the FDAs final answer would be a very predictable no. If they do say no the Vertins could lose access to the drug that has stabilized their condition. But theres still a chance the FDA could approve the drug. Input from people affected by DMD may have convinced the agency once before to approve a drug for the condition despite iffy data. That is what the Vertinsand the company that produces the drugare hoping will happen again. Falling Behind It started out so innocent his mother Betty Vertin told Newsweek. Max was a big infant born lbs oz and nearly two feet long. When he was missing milestones I just thought it was because it was a big baby. Even doctors assumed that he would eventually catch up. But when he started preschool the difference between Max and other children became more obvious. When other kids were running and jumping and climbing Max wasnt doing those things. He was just behind physically. When Max was in a genetic test confirmed that he had DMD. Betty had never heard of it. Before we started living this life I was clueless she said. DMD is one of a class of similar genetic disorders. About boys out of every in the United States under years old have DMD or a milder form called Becker muscular dystrophy. Most of the children affected are boys. The illness affects the way their legs heart and lungs work. Maxs diagnosis was devastating for Betty. I feel like I walked into the room with a healthy fouryearold boy and I walked out with a child that was dying she said. But the familys struggles with DMD were just beginning. At the time Rowan was and Betty suspected that he also had the disease shed seen how her son struggled to stand up onto a stepstool in the bathroom to brush his teeth. She was also ten weeks pregnant with Charlie. Genetic tests eventually confirmed both Rowan and Charlie also had DMD. Bettys two daughters Lexi and Mary as well as a fourth son Chance do not. I felt like we had a year and a half of the same horrible diagnosis over and over and over again she said. It was the hardest months Ive ever had and I hope I ever had. Still Walking DMD always results in muscle weakness due to a lack of a protein called dystrophin. Some of the newest treatments for the condition try to fix that. One drug which the FDA approved in works for people whose illness springs from a mutation in the gene that codes for dystrophin. The drug called Exondys or eteplirsen allows the genetic machinery that produces the protein to skip over the mutated part to make something that will work better. About percent of people with DMD have this particular mutation according to https the FDA. The Vertin brothers are not among them the drug shouldnt help them at all. So they tried ataluren. The drugs brand name is Translarna. The company that produces ataluren PTC Therapeutics says that its drug forces cells to make the proteins in spite of a different kind of mutation called a nonsense mutation. Instead of having an error in the protein the protein is accidentally cut short. This is the kind of mutation that three of Betty Vertins children have. The Vertins have received the drug free through the clinical trial and expenses for their trip from Nebraska to Washington D.C. were paid by PTC Therapeutics. Ataluren works by ordering a cell to use a slightly different piece to build the proteinas if someone spraypainted the word dont on the molecular version of a stop sign. Exactly how it does that is still mysterious. A paper published by the companys scientists in the Proceedings of the National Academies of Science http said it probably affected the ribosome a key part of how proteins are put together in a cell. Researchers not affiliated with the company did not find httpjournals.plos.orgplosbiologyarticleid.journal.pbio. the same kind of activity. Regardless of what mutation causes the illness most people with DMD die in their s. Betty was told to expect her oldest son Max to be in a wheelchair fulltime by the time he was or . Max is now. His th birthday is in early November. He uses an electric mobility scooter for long distances but he can still walk. He rides a bike without training wheels and without any modifications. He has a part in a school play and goes up and down stairs to get to the stage. He even plays a trumpet in his schools band. Hes got the lung capacity to blow that thing very loudly Betty said. For that Betty credits ataluren which Max started three years ago. His life isits not like his peers but hes getting a lot of the experiences that his peers are having she said. Hes living a sort of a typical sixthgrade life and that diagnosisI didnt know what it would look like for him. I didnt expect it to look like this. But not everyone considers ataluren to be a miracle drugwith good reason. The clinical trial results havent been great. Most of the companys studies tested how fast a child could go about feet or walk up and down stairs or how far they could walk in six minutes. They did see some slight positive results many of which came from a study done with the specific kind of patient the company discovered benefited most in a previous trial. The FDA needs good data to make their decision because when the agency approves a drug is sends a signal to the world. An approval is the FDA saying this drug is safe and effective. You could use it for your child too. PTC Therapeutics has tried to get FDA approval for the drug twice before. Both times the agency refused to even consider the application. This time the application for approval was filed over the FDAs protest. The drug has been conditionally approved in Europe. A Million Dollar Issue Part of the reason that the drug has struggled is because of this requirement if the drug is effective the data should show it. But that hasnt happened consistently with ataluren. Many of the clinical trials failed to satisfy the statistical requirement to prove a drug worksat least not for the main outcome the company was looking at. Other secondary measurements did seem to have good statistics. Certain groups of children seemed to have better results than others too. PTC Therapeutics founder and CEO Stuart Peltz says the statistics arent a reason to reject the drug. Just because a drug doesnt measure up in that way he says doesnt mean the drug is not effective. But even if the FDA agrees to overlook some of the negative data about ataluren insurers may not. That could be a milliondollar issue for the families with affected children. If the evidence isnt good then insurance companies wont pay for drugs said National Center for Health Research NCHR president Diana Zuckerman. Two recently approved drugs have run into this problem Spinraza a drug for spinal muscular atrophy and Exondys . Both drugs cost hundreds of thousands of dollars a year. Pharmaceutical companies traditionally will not discuss prices before drugs are approved that said ataluren costs about in Britain https During clinical trials participants like the Vertins normally do not pay for the treatment. The NCHR also presented at the FDA meeting in September to discuss ataluren urging the agency to not approve the drug http without more research. The organizations statement also raised concerns about side effects associated with the drug specifically about the chance that it raises blood pressure and cholesterol levels in children. The company says these shifts are small and not clinically significant. In an emailed statement FDA spokesperson Sandy Walsh confirmed that the FDAs decisions are all based on an assessment of the available data and whether the benefits of the drug outweigh its risks. That data can include the experience of patients like Max Rowan and Charlie. To Betty the benefits are clear even if they arent easily quantified. Rowans gait seems better. Max still doesnt need to use a wheelchair all the time bucking the prediction she heard when he was first diagnosed. However financial analysts who track the biotech sector are not optimistic about atalurens immediate prospects. Matthew Eckler a senior biotechnology analyst at RBC Capital Markets said that analysts and investors are betting the FDA will not approve the drug. The FDA hasnt said no yet. The agency still has nearly two more weeks to make a decision. Until then Betty and her sons are living with a lot of uncertainty. Im really scared that my boys will have to go off ataluren she said. Will they have access to the drug if its rejected Would their conditions deteriorate if they didnt What other options do they have Betty has no good answers. She is hoping she wont need to come up with them. DMD is a progressive disease and my boys are stable Vertin said. If we can just have a few more years with our boys or buy some time until there is a cure out there thats huge."

"Although effective for the treatment of diabetes exercise is sometimes difficult for overweight or elderly people. A new wearable medical device developed by Kumamoto University has been found to effect visceral fat loss and improve blood glucose sugar. The current study reports clinical trial results for optimal use frequency. Type diabetes is a disease of systemic organ failure due to chronic hyperglycemia and inflammation from the accumulation of excess visceral fat. Metabolic disorders such as hyperglycemia attenuate stress resistance in the human body and exacerbate insulin resistance. The ability of insulin to lower blood sugar levels is reduced and insulin secretion is decreased. The heat shock response HSR is activated as a response to stress in the human body but its function decreased in those with type diabetes. A research team from Kumamoto University Japan has found that by restoring the function of HSP the main protein of HSR improved glucoserelated abnormalities. The team found that a suitable combination of mild electrical stimulation MES with heat shock HS activated HSP more efficiently. The researchers developed a belttype medical device that uses a special type of rubber to transmit MES and HS at the same time. They then performed a clinical trial of MES HS on obese men suffering from type diabetes. Results showed a decrease fasting glucose levels a loss of visceral fat improve insulin resistance and a significant . improvement in glycated hemoglobin HbAc values. About half of all subjects . achieved less than . HbAc which is a treatment goal for diabetes. The first trial showed that activation of the HSR produced a large therapeutic effect. In the researchers next clinical trial obese patients with type diabetes from both genders were given a week treatment with the beltshaped MESHS medical device. Trial subjects received treatments for minutes each time and were separated into three groups of and treatments per week. This determined the most effective treatment frequency. The reduction in the visceral fat area was . sq. cm in the treatment per week group . sq. cm in the per week group and . sq. cm in the per week group. Declines in HbAc were . . and . in the and treatmentperweek groups respectively. Improvements in chronic inflammation fatty liver markers renal function and lipid profile were also shown. Furthermore adding the MESHS treatment to a DPP inhibitor which is the most often used therapeutic drug for diabetes in Japan showed an even stronger blood glucose improvement. This device is very easy to use since it simply attaches to the abdomen and it has a lowimpact on the patient. One can expect the effects to be similar to exercise therapy said Dr. Tatsuya Kondo who lead the research. Even in patients who have difficulty exercising such as those who are overweight elderly or have some form of disability this device can be expected to provide acceptable treatment in addition to conventional diabetic medical care. This research was posted online in the nature.com journal Scientific Reports on October th . CITATION T. Kondo R. Goto K. Ono S. Kitano M. A. Suico M. Sato M. Igata J. Kawashima H. Motoshima T. Matsumura H. Kai and E. Araki Activation of heat shock response to treat obese subjects with type diabetes a prospective frequencyescalating randomized openlabel triplearm trial Scientific Reports vol. p. . DOI .srep"

"A UCLAled study has found that a treatment that uses a bacterialike agent in combination with an immunotherapy drug could help some people with advanced melanoma an aggressive form of skin cancer live longer. The research showed that using the immunotherapy drug pembrolizumab and the experimental agent SD a sequence of nucleic acids that mimics a bacterial infection altered the microenvironment around the tumor in a way that enabled the immune system to more effectively attack the cancer. The research was an earlystage study conducted to test the side effects and best dosage of a potential new combined therapy and the findings were published httpcancerdiscovery.aacrjournals.orgcontentearly.CD today in the journal Cancer Discovery. Pembrolizumab which is marketed under the brand name Keytruda works by blocking a protein called PD which interferes with immune system function. Blocking PD with pembrolizumab enables the immune system cells to better attack the cancer. While pembrolizumab has been a significant advancement for treating people with a variety of advanced or metastatic cancers a majority of metastatic melanoma tumors are still resistant to the drug. We have found that the reason patients with metastatic melanoma do not initially respond to immunotherapy with an antiPD is that their immune system was not ready said Dr. Antoni Ribas the studys lead author a professor of medicine at the David Geffen School of Medicine at UCLA and director of the UCLA Jonsson Comprehensive Cancer Center httpscancer.ucla.edu Tumor Immunology Program. So we thought What if we change that by injecting the therapy drug into the metastatic lesions and change the microenvironment of the cancer Its like having a pile of wood but not having a match to light it. With this new approach SD is the match that starts the fire. The researchers found that SD not only directs T cells to cancer cells but it also makes the microenvironment more hospitable for the T cells so that they can better kill the cancer cells. All people in the study had an advanced stage of inoperable or metastatic melanoma. Nine were receiving an immunotherapy treatment for the first time as part of the study. Seven of those nine had a positive response to the drug combination including two for whom the tumors disappeared completely. The other people in the study had previously received a type of immunotherapy before the study. Of them two had a partial response meaning parts of the tumors shrank but the tumors did not go away completely. Five more showed some reduction in the tumors but the other participants did respond to the therapy. The results of the study suggest that the combination of pembrolizumab and SD could provide an alternative treatment for people with melanoma whose tumors have not responded or would be unlikely to respond to other therapies. For all patients with advanced cancer immunotherapy using PD inhibitors has really changed the face of cancer treatment. Unfortunately this therapy still only works in a subset of patients said Dr. Deborah Wong assistant clinical professor of medicine at the Geffen School of Medicine and an oncologist at the Ronald Reagan UCLA Medical Center who was also an author of the paper. This particular combination has been especially gratifying because not only does the SD therapy drug induce tumor shrinkage at the actual site where its injected but its working in conjunction with pembrolizumab to shrink tumors outside of the ones were directly injecting. The study highlights the need for more research into combination therapies like this one because many people with cancer do not respond to immunotherapy or experience a reoccurrence of their tumors after treatment. We are really starting to understand the science of how immunotherapies work in patients said Ribas who is also the director of the Parker Institute for Cancer Immunotherapy Center at UCLA. By understanding that we can find more ways to make that therapy more active. One way is by combining the therapy with another agent that can overcome the resistance that some cancers have to these therapies. The study was funded by Dynavax Technologies Corp. which provided SD. Merck Co. provided pembrolizumab. Ribas research is funded by the Parker Institute for Cancer Immunotherapy and the National Institutes of Health."

"Tofu is one soyfood that may help at least some women survive lung cancer better a study finds Soy foods long shown to help lower the risk of cancer may also help people survive at least some forms of cancer better researchers reported on Monday. They found that Chinese women who ate the most soy were also less likely to die of lung cancer the No. cancer killer across the world. The findings published in the Journal of Clinical Oncology lends support to the idea that adding soy foods to the diet can help people in multiple ways says Dr. Jyoti Patel a lung cancer specialist at Northwestern University in Chicago who was not involved in the study. It may be that we do need to change our diets a little bit and eat more of these soybased diets. The benefits may go beyond cardiac health Patel said in a telephone interview. For the study Gong Yang and colleagues at Vanderbilt University Medical Center Shanghai Cancer Institute and the National Cancer Institute looked at data from a large study of Chinese women called the Shanghai Womens Health Study. They pulled out the records of of the women who had lung cancer. The women had all filled out questionnaires that included details of what they normally ate. They did this twice when they enrolled in the study and two years later. Of the patients with lung cancer died during the three years of followup the researchers wrote. Initial analyses including all patients showed that higher intake of soy food was associated with better overall survival after adjusting for demographic and lifestyle characteristics and other nonclinical factor they wrote. Women who reported eating the least soy were . times as likely to die on average. Those who ate the most were about percent less likely to die. This finding along with our previous observation of an approximately percent reduction in risk of incident lung cancer associated with high intake of soy food provides further support for the role of soy food intake in lung cancer development and prognosis the researchers wrote. Most of the women in the study had never been smokers and theres a lot of evidence to suggest that lung cancer is a different disease in smokers versus nonsmokers. In Asian countries percent of women with lung cancer are never smokers Patel said. We dont know if there is an inherited susceptibility to it she added. There might be an infectious disease that causes some cases of lung cancer like the virus that causes cervical cancer or the bacteria that causes stomach cancer. Although the risks are probably different for American women for developing lung cancer I do think it is a call to action for more research about how we develop lung cancer Patel said. There are probably people in the U.S. who never smoked and who have lung cancer. Lung cancer kills Americans a year. Its diagnosed in women and men a year in the United States alone. It accounts for percent of all cancer deaths according to the American Cancer Society. Studies suggest that people who eat the most soy have a lower risk of heart disease and osteoporosis. Women may have fewer menopausal symptoms and perhaps a lower risk of some cancers. The Food and Drug Administration says soy products may carry a hearthealthy label saying that soy may reduce cholesterol when eaten as part of a diet that is low in saturated fat and cholesterol. It wouldnt be difficult to eat enough soy to be protected Patel noted. The high soy level patients were eating what the FDA has said is hearthealthy or grams of soy a day she said. Studies have shown that supplements containing soy protein dont have much health benefit. But foods such as soy milk tofu and edamame do. We think that consuming food in their whole forms is more important than the supplements Patel said. Some researchers have wondered whether Western people who eat more soy food are benefiting from the soy itself or because they perhaps use it as a substitute for meat and dairy foods. Patel says this study in China where soy is a normal part of the diet and where dairy foods are less commonly eaten suggests its the soy itself that adds the benefit. Soy and many other plant foods contain hormonelike substances called phytoestrogens. These may be affecting a cell compound called estrogen receptor beta she said. That compound interacts with another one called epidermal growth factor receptor or EGRF which is known to play a role in many cases on lung cancer. Lung cancer is the most common cause of cancer death. There are many neversmokers with lung cancer she said. People should consider eating a diet that is healthy. By all accounts one that includes soy decreases cardiac risks and could also affect lung cancer Patel concluded. How can people add soy to their diets A cup of vanilla soymilk poured over cereal provides grams of soy protein while an eightounce glass provides grams. A soy burger delivers grams of soy protein while ounces of tofu has . grams."

"Higher vitamin D levels in patients with advanced colon cancer appear to improve response to chemotherapy and targeted anticancer drugs researchers say. We found that patients who had vitamin D levels at the highest category had improved survival and improved progressionfree survival compared with patients in the lowest category said lead author Dr. Kimmie Ng an assistant professor of medicine at Harvard Medical School in Boston. Those patients survived onethird longer than patients with low levels of vitamin D an average . months compared with . months the researchers found. The report scheduled for presentation this week at the Gastrointestinal Cancers Symposium in San Francisco adds more weight to suspicions that vitamin D might be a valuable cancerfighting supplement. However colon cancer patients shouldnt try to boost vitamin D levels beyond the normal range one expert said. The study only found an association between vitamin D levels and colon cancer survival rates. It did not prove cause and effect. Researchers for years have investigated vitamin D as a potential anticancer tool but none of the findings have been strong enough to warrant a recommendation said Dr. Len Lichtenfeld deputy chief medical officer for the American Cancer Society. Everyone comes to the same conclusion yes there may be some benefit but we really need to study it carefully so we can be certain there arent other factors that make vitamin D look better than it is Lichtenfeld said. These findings are interesting and show that vitamin D may have a role in improving outcomes in cancer care. In this study researchers measured blood levels of vitamin D in patients enrolled in a phase clinical trial comparing three firstline treatments for newly diagnosed advanced colon cancer. All of the treatments involved chemotherapy combined with the targeted anticancer drugs bevacizumab andor cetuximab. Vitamin D is called the sunshine vitamin because human bodies produce it when the suns ultraviolet rays strike the skin. It promotes the intestines ability to absorb calcium and other important minerals and is essential for maintaining strong healthy bones according to the U.S. National Institutes of Health. But vitamin D also influences cellular function in ways that could be beneficial in treating cancer Ng said. For example she said it appears to reduce cell growth promote the death of diseased cells and inhibit the formation of new blood vessels to feed cancerous tumors. The study authors found that certain types of cancer patients tended to have lower vitamin D levels. These included people whose blood specimens were drawn in the winter and spring months people who live in the northern and northeastern states older adults blacks overweight or obese people and those who had lower physical activity and were in worse physical condition. The patients were divided into five groups based on vitamin D levels ranging from low to high. After adjusting for prognosis and healthy behaviors the researchers found that patients in the group with the highest levels of vitamin D lived about eight months longer on average than those in the group with the lowest levels. We had a lot of information on their tumor their treatment and their survival times and their diet and lifestyle Ng said. That really allowed us to adjust for other potential factors that could influence what were seeing. It also took longer for cancer to progress in people with higher vitamin D levels an average . months compared with about months in the group with the lowest. No significant differences were seen with regard to the type of therapy the patients received. This increase in progressionfree survival is the most compelling evidence indicating that vitamin D makes a difference in colon cancer said Dr. Smitha Krishnamurthi an associate professor of hematology and oncology at Case Western Reserve University School of Medicine in Cleveland. That is interesting because thats more of a cancerspecific endpoint as opposed to overall survival which could be influenced by other factors like heart health Krishnamurthi said. Everyone should maintain healthy vitamin D levels anyway to protect their bone health Ng and Krishnamurthi said. Based on this new study Krishnamurthi said she would emphasize the importance of vitamin D for patients with colon cancer. They should take supplements to bring it into normal range because we know it is good for bone health and it may have an anticancer effect she said. However if someone has a normal vitamin D level I wouldnt take supplements to increase it because we wont know the true effect on cancer until we see the results of a clinical trial she said. The U.S. National Institutes of Health funded the study. Research presented at meetings is considered preliminary until published in a peerreviewed medical journal. More information For more on vitamin D and cancer visit the U.S. National Cancer Institute. SOURCES Kimmie Ng M.D. M.P.H. assistant professor medicine Harvard Medical Schools DanaFarber Cancer Institute Boston Len Lichtenfeld M.D. M.A.C.P. deputy chief medical officer American Cancer Society Smitha Krishnamurthi M.D. associate professor hematology and oncology Case Western Reserve University School of Medicine Cleveland abstract Jan. Gastrointestinal Cancers Symposium San Francisco"

"Overweight people who used a new motivational intervention called Functional Imagery Training FIT lost an average of five times more weight than those using talking therapy alone shows new research published today by the University of Plymouth and Queensland University. In addition users of FIT lost .cm more around their waist circumference in six months and continued to lose weight after the intervention had finished. Led by Dr Linda Solbrig from the School of Psychology the research involved participants who were allocated either to FIT or Motivational Interviewing MI a technique that sees a counsellor support someone to develop highlight and verbalise their need or motivation for change and their reasons for wanting to change. FIT goes one step further than MI as it makes use of multisensory imagery to explore these changes by teaching clients how to elicit and practice motivational imagery themselves. Everyday behaviours and optional app support are used to cue imagery practice until it becomes a cognitive habit. Maximum contact time was four hours of individual consultation and neither group received any additional dietary advice or information. Dr Solbrig who completed the work as part of a PhD funded by The National Institute for Health Research NIHR Collaboration for Leadership in Applied Health Research and Care CLAHRC South West Peninsula said Its fantastic that people lost significantly more weight on this intervention as unlike most studies it provided no dietphysical activity advice or education. People were completely free in their choices and supported in what they wanted to do not what a regimen prescribed. The study showed how after six months people who used the FIT intervention lost an average of .kg compared with an average of .kg among the MI group. After months six months after the intervention had finished the FIT group continued to lose weight with an average of .kg lost compared with .kg in the MI group. Dr Solbrig continued Most people agree that in order to lose weight you need to eat less and exercise more but in many cases people simply arent motivated enough to heed this advice however much they might agree with it. So FIT comes in with the key aim of encouraging someone to come up with their own imagery of what change might look and feel like to them how it might be achieved and kept up even when challenges arise. We started with taking people through an exercise about a lemon. We asked them to imagine seeing it touching it juicing it drinking the juice and juice accidently squirting in their eye to emphasise how emotional and tight to our physical sensations imagery is. From there we are able to encourage them to fully imagine and embrace their own goals. Not just imagine how good it would be to lose weight but for example what would losing weight enable you to do that you cant do now What would that look sound smell like and encourage them to use all of their senses. As well as being delighted by the success of the study in the short term there are very few studies that document weight loss past the end of treatment so to see that people continued to lose weight despite not having any support shows the sustainability and effectiveness of this intervention. Trisha Bradbury was one of the participants allocated to the FIT study and she explains I lost my mum at and being myself with a variety of health problems my motivation was to be there for my daughter. I kept thinking about wearing the dress Id bought for my daughters graduation and on days I really didnt feel like exercising kept picturing how Id feel. Ive gone from stone to stone and have managed to lower the dosage I need for my blood pressure tablets. Id still like to lose a touch more but Im so delighted with the mindset shift. Professor Jackie Andrade Professor in Psychology at the University of Plymouth is one of the cocreators of FIT and she explains FIT is based on two decades of research showing that mental imagery is more strongly emotionally charged than other types of thought. It uses imagery to strengthen peoples motivation and confidence to achieve their goals and teaches people how to do this for themselves so they can stay motivated even when faced with challenges. We were very excited to see that our intervention achieved exactly what we had hoped for and that it helped our participants achieve their goals and most importantly to maintain them. The full study entitled Functional Imagery Training versus Motivational Interviewing for Weight Loss A randomised controlled trial of brief individual interventions for overweight and obesity is available to view in the International Journal of Obesity doi .s."

"Antiinflammatory drugs similar to those used to treat conditions such as rheumatoid arthritis and psoriasis could in future be used to treat some cases of depression concludes a review led by the University of Cambridge which further implicates our immune system in mental health disorders. Researchers from the Department of Psychiatry at Cambridge led a team that analysed data from clinical trials involving the use of anticytokine drugs to treat a range of autoimmune inflammatory diseases. By looking at additional beneficial sideeffects of the treatments the researchers were able to show that there was a significant antidepressant effect from the drugs compared to a placebo based on a metaanalysis of seven randomised controlled trials. Metaanalyses of the other types of clinical trials showed similar results. When we are exposed to an infection for example influenza or a stomach bug our immune system fights back to control and remove the infection. During this process immune cells flood the blood stream with proteins known as cytokines. This process is known as systemic inflammation. Even when we are healthy our bodies carry trace levels of these proteins known as inflammatory markers which rise exponentially in response to infection. Previous work from the team found that children with high everyday levels of one of these markers are at greater risk of developing depression and psychosis in adulthood suggesting a role for the immune system particularly chronic lowgrade systemic inflammation in mental illness. Inflammation can also occur as a result of the immune system mistaking healthy cells for infected cells and attacking the body leading to autoimmune inflammatory diseases such as rheumatoid arthritis psoriasis and Crohns disease. New types of antiinflammatory drugs called anticytokine monoclonal antibodies and cytokine inhibitors have been developed recently some of which are now routinely used for patients who respond poorly to conventional treatments. Many more are currently undergoing clinical trials to test their efficacy and safety. The team of researchers carried out a metaanalysis of these clinical trials and found that the drugs led to an improvement in the severity of depressive symptoms independently of improvements in physical illness. In other words regardless of whether a drug successfully treated rheumatoid arthritis for example it would still help improve a patients depressive symptoms. Their results are published today in the journal Molecular Psychiatry. Dr Golam Khandaker who led the study says Its becoming increasingly clear to us that inflammation plays a role in depression at least for some individuals and now our review suggests that it may be possible to treat these individuals using some antiinflammatory drugs. These are not your everyday antiinflammatory drugs such as ibuprofen however but a particular new class of drugs. Its too early to say whether these anticytokine drugs can be used in clinical practice for depression however adds Professor Peter Jones coauthor of the study. We will need clinical trials to test how effective they are in patients who do not have the chronic conditions for which the drugs have been developed such as rheumatoid arthritis or Crohns disease. On top of this some existing drugs can have potentially serious side effects which would need to be addressed. Dr Khandaker and colleagues believe that antiinflammatory drugs may offer hope for patients for whom current antidepressants are ineffective. Although the trials reviewed by the team involve physical illnesses that trigger inflammation and hence potentially contribute to depression their previous work found a connection between depression and baseline levels of inflammation in healthy people when someone does not have an acute infection which can be caused by a number of factors such as genes and psychological stress. About a third of patients who are resistant to antidepressants show evidence of inflammation adds Dr Khandaker. So antiinflammatory treatments could be relevant for a large number of people who suffer from depression. The current approach of a onesizefitsall medicine to treat depression is problematic. All currently available antidepressants target a particular type of neurotransmitter but a third of patients do not respond to these drugs. We are now entering the era of personalised medicine where we can tailor treatments to individual patients. This approach is starting to show success in treating cancers and its possible that in future we would use antiinflammatory drugs in psychiatry for certain patients with depression. The research was mainly funded by the Wellcome Trust with further support from the National Institute for Health Research NIHR Cambridge Biomedical Research Centre. Reference Kappelmann N et al. Antidepressant activity of anticytokine treatment a systematic review and metaanalysis of clinical trials of chronic inflammatory conditions. Molecular Psychiatry Oct DOI .mp.."

"From the Jewish schvitz to Mesoamerican houses of heat people all over the world have long associated a good sweat with a wide assortment of health benefits. And some of the latest research seems to support those ideas. One longterm study http of middleaged Finnish men found those who spent time in a sauna days a week enjoyed a drop in their risk for a fatal heart disease or episode. The heart health benefits were even greater for men who sweated it out in a sauna more frequently. Sauna bathing leads to a significant increase in heart rate and reduction in total vascular resistance thereby decreasing blood pressure says Dr. Ernst van der Wall chief of cardiology at the Netherlands Leiden University Medical Centre. In a recent editorial http appearing in the Netherlands Heart Journal van der Wall lays out the research in support of sauna bathing as a safe and salubrious habit for healthy people of all ages. He also says expert concerns about the safety of sauna bathing for those with heart conditions may be overblown. Death in the sauna is a rare event even in Finland where the frequency of sauna bathing is high he writes. Still the big questions surrounding sauna bathings safety have always centered on its occupants and her hearts ability to withstand the heat. Traditional saunas use either wood or electricity to warm the air in a chamber to a temperature of degrees which many people find unendurable for more than a few minutes. Infrared saunas by contrast do not heat the air around you. Using electromagnetic radiation infrared lamps warm your body directly. That may sound freaky or even unsafe but neonatal beds for newborns have long utilized infrared heating elements to ensure babies are kept warm without being stifled. As infrared heat penetrates more deeply than warmed air users develop a more vigorous sweat at a lower temperature than they would in traditional saunas says Dr. Richard Beever a clinical assistant professor of family medicine at the University of British Columbia. While theres not a ton of published research looking specifically at infrared saunas Beever has published a review httptime.cominfraredsaunabenefitshealthyareview of all the existing studies he could turn up on the subject. He says theres evidence to support the use of infrared saunas for high blood pressure congestive heart failure and chronic pain. People who spent minutes a day for two weeks in an infrared sauna enjoyed a significant drop in blood pressure compared to a control group who spend the same amount of time in a roomtemperature space one Japanese study http reported. More research http found time spent in an infrared sauna could help even out irregular heartbeats improve scores on physical fitness tests and boost endothelial function in the hearts vessels. Beevers review also looked at some of the other purported health benefits of infrared saunasincluding pain management. Among chronic pain sufferers those who spent time each day in a sauna for four weeks enjoyed a improvement in sleep quality and were more likely to return to work compared to a nosauna group. Beever makes it clear all of these reports were based on small groups and require further study. Also he found no strong evidence of lost weight improved cholesterol scores or some of the other benefits frequently linked to sauna bathinginfrared or otherwise. But he also points out that no accidents or adverse reactions occurred in any of the studies he reviewed. For men hoping to father children spending time in hot saunas or baths has long been a nono. Healthy sperm and heat dont play well together. Beever says infrared heat may damage sperm as do other forms of heat but at this point theres no data on those risks. So what to think of infrared saunas The existing evidence though scanty suggests spending up to minutes a day in one could benefit your heart and ease symptoms associated with chronic pain. And for now there dont seem to be any significant health risks. Ask your doctor first. But if youre wondering whether an infrared sauna is worth a try the evidence suggests you have little to lose and possibly something to gain by checking one out."

"A study looked at the effects of weightloss surgery on obese women most at risk for cancer. It found that bariatric surgery slashed participants weight by a third produced a mean weight loss of more than pounds eliminated precancerous uterine growths improved physical quality of life improved insulin levels and glucose use altered the composition of gut bacteria CHARLOTTESVILLE Va. Oct. A study evaluating the effects of bariatric surgery on obese women most at risk for cancer has found that the weightloss surgery slashed participants weight by a third and eliminated precancerous uterine growths in those that had them. Other effects included improving patients physical quality of life improving their insulin levels and ability to use glucose which may reduce their risk for diabetes and even altering the composition of their gut bacteria. The study speaks both to the benefits of bariatric surgery and to the tremendous toll obesity takes on health. If you look at cancers in women about a fifth of all cancer deaths would be prevented if we had women at normal body weight in the U.S. said Susan C. Modesitt MD of the University of Virginia Cancer Center. When youre looking at obesityrelated cancers the biggest one is endometrial cancer but also colon cancer breast cancer renal cancer and gall bladder cancer. We think about percent to percent of all endometrial cancer which is in the lining of the uterus is caused by obesity. Effects of Obesity and Morbid Obesity The study looked at women with a mean age of . years and a mean body mass index BMI of .. Women are considered obese at a BMI of and morbidly obese at which is typically about pounds over a womans ideal body weight yet almost a third of women presenting for bariatric surgery did not identify themselves as obese. The study looked at the effects of bariatric surgery in a relatively short timeframe one to three years after surgery. A total of participants underwent the procedure two opted out of the surgery and another died of a heart condition prior to surgery. The effects of surgery on body weight were dramatic Mean weight loss was more than pounds. Preventing Cancer Ten percent of study participants who had not had a hysterectomy showed precancerous changes in the lining of the uterus and all of those resolved with weight loss. Were talking about small numbers really tiny numbers of study participants Modesitt said noting one limitation of the study. So I could never say that effect is definitive but it is suggestive given that we know already the incredibly strong link between endometrial cancer and obesity. Modesitt of the UVAs Division of Gynecologic Oncology in the Department of Obstetrics and Gynecology was most surprised by the dramatic changes seen in the patients metabolic profiles derived from the gut microbiome the population of microorganisms living inside us. The study results demonstrate that there is a huge alteration but I dont even know what to say about that except it is really new and intriguing area to look at in the link between obesity and cancer. For example before groundbreaking work by Dr. John Marshall at UVA in the past no one knew that ulcers were from bacteria. Who knows what role the gut bacteria play in promoting obesity but metabolic parametermarkers of the bacteria definitely changed after study participants lost weight. While the study speaks to the transformative effect bariatric surgery can have Modesitt urged people to avoid gaining weight in the first place and for those seeking to lose weight to exercise and eat more healthily before turning to surgery. We really should be working on diet and exercise from the getgo in our entire society starting with our children. And exercise does seem to be protective even if you dont lose all the weight it absolutely has beneficial effects she said. There are lots of studies showing if you exercise it improves your insulin your glucose all of those sorts of things that go along with the cancercausing effect. Almost everybody agrees adding exercise would be wonderful and improve health on many levels. But losing excess weight would also be good. Findings Published The findings have been published as a lead article in the scientific journal Gynecologic Oncology. The article was written by Modesitt Peter T. Hallowell Jill K. SlackDavis Ryan D. Michalek Kristen A. Atkins Sarah L. Kelley Sanja Arapovic Margaret A. Shupnik and Kyle Hoehn."

"A new pill may help in the fight with cystic fibrosis. A study funded in part by Vertex Pharmaceuticals http the drug ivacaftor pronounced eye va kaf tor caused patients with a specific type of cystic fibrosis to improve lung function gain weight and fight other aspects of the disease. This is the first time that we have a therapy that is directed at the cause of cystic fibrosis says Dr. Michael Konstan httpcf.case.eduKonstan.html the chair of the Department of Pediatrics at Rainbow Babies and Childrens Hospital http Cleveland and one of the authors of the study. There is no cure for this disease and existing treatments just help alleviate some of the symptoms. This is a big deal says Robert Beall http the president and CEO of the Cystic Fibrosis Foundation http The fact is it is obviously going to make a very big difference in the lives of patients. Cystic fibrosis is a genetic disease that causes problems with the balance of salt going in and out of cells. A sticky mucus clogs organs particularly the lungs and liver. It can also cause digestive problems. About new cases are diagnosed each year according to the Cystic Fibrosis Foundation and the average person with the disease dies before age . Ivacaftor works for people with the GD mutation of cystic fibrosis. Konstan says that only about of the people with the disease have this specific mutation. It really is a major milestone in the treatment of cystic fibrosis he says. Even thought it only affects a small percentage of patients the hope is there that we can finally do something about this disease. The study published in the New England Journal of Medicine http looked at people who got the drug. Those taking ivacaftor saw improvements within two weeks which continued for the nearly yearlong trial. Drug recipients could blow out more than more air from their lungs compared with patients who were not taking the drug and were about half as likely to have a pulmonary exacerbation or a worsening of their lung disease that often requires hospitalization. On average patients taking the drug grew more and put on more weight than the placebo group according to the study and had lower sweat chloride an indicator of the disease. Beall says the improved lung function helped patients double their ability to walk and one patient even started going the gym for the first time. We have an incredible proof of concept Beall says. He points to other research under way with ivacaftor combined with another drug that could help people with the most common mutation of cystic fibrosis. That trial is ongoing and the treatment is at least four or five years away from approval but if it works Beall says it could help of the people with cystic fibrosis. In an editorial accompanying the study Dr. Pamela Davis httpcasemed.case.eduaboutbrief_bio.cfmdirectory_id of Case Western University paraphrased Winston Churchill This study is also a great victory in the war against genetic diseases and marks the end of the beginning for the treatment of the cystic fibrosis defect. Ivacaftor has been submitted to the FDA for approval and could be available next year according to Konstan. When it goes on sale it will be sold under the brand name Kalydeco pronounced kuhLYEdehkoh."

"Cancer experts said Tuesday that the actress and filmmaker Angelina Jolie Pitt was wise to have had her ovaries and fallopian tubes removed last week because she carries a genetic mutation BRCA that significantly increases the risk of ovarian cancer a disease so difficult to detect that it is often found only at an advanced untreatable stage. They also said Ms. Jolie Pitts decision to discuss her own choices so frankly will encourage women in similar situations to consider their own options. BRCA mutations cause about to percent of breast cancers and to percent of ovarian cancers among white women in the United States. It is unclear how common the mutations are in other racial and ethnic groups. Prophylactic removal of ovaries and fallopian tubes is strongly recommended in women before age in BRCA and BRCA mutation carriers said Dr. Susan Domchek executive director of the University of Pennsylvanias Basser Research Center which specializes in BRCA mutations. There is no effective screening for ovarian cancer and too many women with advanced stage ovarian cancer die of their disease. Writing for The New York Timess OpEd page http_rmoduleinline Ms. Jolie Pitt said she had expected to have her ovaries and fallopian tubes removed a procedure called a laparoscopic bilateral salpingooophorectomy but that a cancer scare made her decide to undergo the procedure sooner. Her mother aunt and grandmother died of cancer. To my relief I still had the option of removing my ovaries and fallopian tubes and I chose to do it she wrote. Two years ago she ignited a worldwide discussion about options for women at high risk for breast cancer when she wrote that she had had both breasts removed because BRCA the same genetic mutation that prompted her surgery last week increased her risk of breast cancer. Several doctors said that for women in similar situations they generally recommend that ovaries be removed before breasts but the cost is that women who do so go into early menopause and can no longer bear children. However removing the ovaries substantially decreases a womans risk of developing breast cancer. Also breast cancer is generally more detectable and treatable than ovarian cancer. Were really quite pushy about oophorectomy Dr. Domchek said. And we talk about mastectomy as an option. Experts said that some details mentioned by Ms. Jolie Pitt might not apply to all women with such mutations or might be characterized differently by doctors. For example Ms. Jolie Pitt wrote that she was advised to have the surgery about years before the age at which her mother was first diagnosed which was . But doctors said a better rule of thumb is between ages and ideally after a woman has finished having children but before her cancer risk rises sharply. https_idactionclickmoduleeditorContentpgtypeArticleregionCompanionColumncontentCollectionTrending Ms. Jolie Pitt also said she had a yearly test for the CA protein to monitor the possibility of ovarian cancer. She noted that her doctor said the test missed a high percentage of cancers. Some experts said they had stopped such tests because they miss so many cancers and have not been shown to improve survival rates. Weve basically said theres no data to support it and were recommending the surgery said Dr. Kenneth Offit chief of the clinical genetics service at Memorial Sloan Kettering Cancer Center. He added In the end what she did is fine. She got to the right place. She had ovarian surgery done within the window of time. Ms. Jolie Pitts decision not to remove her uterus was consistent with what experts recommended. There is no research showing that having a BRCA mutation puts women at risk for uterine cancer said Dr. Jamie BakkumGamez a gynecologic oncologist at the Mayo Clinic. Dr. Jamie BakkumGamez and other experts endorsed her decision to take hormone replacement therapy an estrogen patch and a progesterone intrauterine device to counteract symptoms of surgeryinduced menopause. Ms. Jolie Pitt who has six children three adopted wrote that she knows these decisions are far harder for women who still want to get pregnant and that she had learned they might have options to remove their fallopian tubes but keep their ovaries. Experts cautioned that the evidence is still slim on whether fallopian tube removal is effective at preventing ovarian cancer. Shira Krance who has a BRCA mutation had a double mastectomy two years ago and said she has considered whether to have the fallopian tubes removed before her ovaries. Doctors will give you a lot of options but nobody will tell you what to do said Ms. Krance who lives in Valley Cottage N.Y. and has two young children. Its scary the idea of not being around when your children grow up. Thats the worst thing and Im going to do everything I can to avoid that. Ethel Zelenske a BRCA carrier who lives in Baltimore had her tubes and ovaries removed in . A few years later she was diagnosed with peritoneal cancer a condition that Dr. Offit said each year occurs in about half of a percent of women who have had their ovaries removed. Ms. Zelenske was treated but had a recurrence of the peritoneal cancer two years ago. My doctors have told me that I will always be in treatment said Ms. Zelenske who like many other women welcomed Ms. Jolie Pitts public disclosure. I really love that she said knowledge is power because I say that all the time."

"A new treatment might open the door for more patients with advanced kidney disease to get a transplant a preliminary study suggests. Of the plus Americans waiting for a donor kidney about onethird are sensitized said Dr. Robert Montgomery director of the Transplant Institute at NYU Langone in New York City. Those patients face a tough situation They harbor immune system antibodies that are primed to attack a donor organ. The antibodies can form when a person is exposed to foreign tissue Montgomery explained. So a patient whos had a prior kidney transplant may be highly sensitized meaning they have a large number of the offending antibodies. It can also happen to patients whove had blood transfusion or ever been pregnant Montgomery said. Its almost impossible to find a compatible donor for those patients. But they might be able to receive a kidney from an incompatible donor if they first undergo an extensive desensitization process. That involves various treatments including IV drugs called immune globulin and rituximab that try to quash the antibodies that would attack the donor organ. Now the new research suggests a simple approach an infusion of a particular enzyme hours before the transplant could offer a better alternative. Researchers found that the treatment dubbed IdeS quickly wiped out the dangerous antibodies allowing all but one of patients to have a successful transplant. The findings were published in the Aug. issue of the New England Journal of Medicine. Funding for the study came from the company developing IdeS Hansa Medical. Montgomery who was not involved in the study said hes never seen anything like it. When you give this all of the antibodies are gone Montgomery said. Im hopeful that this will turn out to be a gamechanger. However he stressed many questions remain. Critically the enzyme does not banish the antibodies forever. They come back Montgomery said and the results of that comeback vary from patient to patient. In the study patients had an episode of antibodymediated rejection anywhere from two weeks to five months after their transplant. That means antibodies started to attack the new kidney. Those patients were all successfully treated with standard antirejection drugs according to the researchers. Still its not yet clear how the patients will fare in the long term said Dr. Julie Ingelfinger a professor at Harvard Medical School in Boston. Ingelfinger who wrote an editorial published with the study echoed Montgomerys cautious optimism. If larger longer studies bolster the current findings she said this could potentially be practicechanging. But Ingelfinger stressed only time will tell. Lead researcher Dr. Stanley Jordan agreed that more work is necessary. But the findings mark another step forward for patients like these according to Jordan who is medical director of the kidney transplant program at CedarsSinai in Los Angeles. Traditionally highly sensitized patients in need of a kidney have languished on waiting lists because its so hard to find a compatible donor. But in the past years or so desensitization has emerged as an alternative. Last year a landmark study proved that patients who receive transplants after desensitization live significantly longer than those who stay on dialysis. The outcomes have been good Jordan said. But he added theres clearly room for improvement. Ingelfinger agreed. The desensitization protocols now in use are timeconsuming and they dont always work she said noting that they can leave dangerous antibodies behind. Desensitization adds about to to the cost of the transplant according to the University of Wisconsins transplant center. The new approach is quite different Ingelfinger said. Patients receive one infusion of an enzyme called IdeS four to six hours before the transplant. The enzyme is derived from a strain of Streptococcus bacteria and it essentially chops up the antibodies that would attack the organ. Jordan acknowledged that the source sounds scary but stressed that patients do not receive the bacteria itself but an engineered version of the enzyme. In all U.S. and Swedish patients received an infusion of IdeS before their kidney transplant. All but one had a successful transplant and none had detectable antibodies immediately afterward. IdeS patients still received additional treatment including a week of immune globulin and rituximab infusions. And as with all transplants they needed standard antirejection drugs. Because IdeS so readily banishes the offending antibodies it might make transplants feasible for even the most highly sensitized patients Montgomery said. But the question remains he said Can it extend the survival of the donor kidney and ultimately patients lives IdeS is still experimental and the only way patients could receive it is through a clinical trial. It will be a few years before it could be more widely available Montgomery said. More information The National Kidney Foundation has more on kidney transplantation. https SOURCES Stanley Jordan M.D. medical director kidney transplant program CedarsSinai Medical Center Los Angeles Robert Montgomery M.D. director Transplant Institute and professor transplant surgery NYU Langone Medical Center New York City Julie R. Ingelfinger M.D. professor pediatrics Harvard Medical School Boston and deputy editor New England Journal of Medicine Aug. New England Journal of Medicine"

"Min Read Deep brainstimulation device helped stabilise mood Half of patients in small trial gained weight Anorexia among most common psychiatric disorders in girls By Kate Kelland LONDON March Reuters Scientists have for the first time reported successful use of a brainstimulating implant to help patients with severe anorexia whose condition had not improved with other treatments. Doctors implanted a device similar to a pacemaker in the brains of six severe anorexics and found at least half put on weight and showed improvements in mood. Under previous therapies none had shown progress. This success in a small study designed as a pilot to test the safety of the technique suggests larger trials will confirm the effectiveness of the deep brain stimulation DBS device the researchers wrote in the medical journal The Lancet. Anorexia has one of the highest mortality rates of any psychiatric disorder and is among the most common psychiatric disorders in girls aged between and years. Symptoms include deliberate weight loss induced and sustained by the patient and a need to control calorie intake and output. Treatment usually focuses on changing behaviour but experts say up to percent of patients get no benefit from such treatments and are at risk of dying prematurely. Commenting on the results of this small trial Janet Treasure and Ulrike Schmidt of Kings College Londons Institute of Psychiatry said the technique looked promising and would give hope to patients with especially pernicious forms of anorexia. Sponsored ADVERTISING inRead invented by Teads The fact that the procedure was associated ... with improvements in affective and obsessional symptoms is of key importance they said. This will go some way towards reassuring patients that DBS is not just another treatment designed to fatten them up without making them feel better. DBS is used to treat several neurological illnesses including Parkinsons disease and chronic pain. Scientists are also investigating its use in depression and epilepsy but this was the first time it had been used in patients with anorexia. Implanting the DBS device requires minimally invasive surgery which can be completely reversed if problems occur the researchers said. For their study a team at the Krembil Neuroscience Centre and University Health Network in Canada identified an area of the brain known to be important when using DBS in depression. They implanted electrodes into the area and connected them to a pulse generator under the skin. The devices were activated days later and researchers measured changes in the patients mood and anxiety to help find the correct level of stimulation. The patients all women were aged between and and had had anorexia for between four and years. Initially all six lost weight but researchers said this was expected since studies of DBS in patients with depression also found a delay of a few months before treatment starts to work. Three months after treatment the weight loss began to reverse in some patients and after nine months three patients weighed more than before treatment the longest period of sustained weight increase since they had become ill. Around half also had better moods and less obsessivecompulsive behaviour. Land Rover Sponsored by Land Rover Land Rovers Main Event Enjoy Savings On Land Rover Discovery And Discovery Sport Read more Andres Lozano who led the study said the results were encouraging because they pointed to a genuine therapeutic effect rather than a placebo or hungerincreasing effect. He also said the improvements in mood and anxiety even in patients who were still underweight were especially striking given that severely anorexic patients did not respond well to conventional medicines or psychotherapies. Editing by Andrew Roche"

"Americans suffering from muscle pain are used to taking a pill or rubbing in a cream to help soothe their aches. But a new form of pain relief seems to be catching on analgesics delivered through a medicated patch placed directly where it hurts. The U.S. Food and Drug Administration approved the countrys first overthecounter painrelieving transdermal patches in . But the patches marketed under the brand name Salonpas are nothing new. Theyve been sold in various countries in Asia since the s according to their manufacturer the Japanese firm Hisamitsu Pharmaceutical. Salonpas is the Western world catching up with Asia said Dr. Rick Rosenquist a professor of anesthesia and director of pain medicine at the University of Iowa Carver College of Medicine and chairman of the American Society of Anesthesiologists committee on pain medicine. If you are an Asian kid youve had these placed on you since time immemorial he said. Its just now starting to hit more mainstream in the United States. Theyre gaining more acceptance. Before the FDA action painrelieving patches were available in the United States only by prescription said Dr. John Dombrowski director of the Washington Pain Center in Washington D.C. Their active ingredients include such medications as lidocaine capsaicin and nonsteroidal antiinflammatory drugs or NSAIDs. The active ingredients in Salonpas are methyl salicylate and menthol common components of painrelieving gels and creams such as Bengay. Pain patches have a number of benefits Rosenquist and Dombrowski said not the least of which is convenience. With a patch you put it on and forget about it rather than having to remember to take pills Dombrowski said. The patches also deliver their medicine directly to the site of a persons pain. This may eliminate some of the side effects that come with taking pills. For instance some analgesics are likely to cause an upset stomach unless theyre taken with food. Obviously patches get around that he said. Its a very clever way of getting the medications right where they need to be. And because patches release their medication slowly into the body through the skin people also should get more consistent pain relief than they do with pills. On the other hand people have to be sure to carefully follow instructions for using the patches to avoid overdose. The main downside to pain patches however apparently comes from their effect on the skin. Some people may find themselves allergic to either the active ingredient in a patch or the adhesive used to keep the patch on the body. You need to pay attention when you put them on to see if you have any kind of skin reaction to the compounds that are contained in the patch Rosenquist said. Both doctors said that they expect more overthecounter pain patches to hit the market if the popularity of Salonpas continues to grow. Future overthecounter options they predicted could include reduceddosage versions of the NSAIDdelivering patches now available through prescription. Success begets success Dombrowski said. If this does very well other drug companies will say I want a piece of this action. More information The U.S. National Institute of Neurological Disorders and Stroke has more about pain http_paindetail_chronic_pain.htm. SOURCES Rick Rosenquist M.D. professor anesthesia and director Center for Pain Medicine and Regional Anesthesia Carver College of Medicine University of Iowa Iowa City Iowa John Dombrowski M.D. director Washington Pain Center Washington D.C."

"For more than a century scientists have been attempting to harness the immune system to fight cancer trying to get the antibodies and cells that protect us from bacteria and viruses to kill diseased cells. Every once in a while a tantalizing success occurred. But time and again the treatment could not be repeated. The case begins with a drug called ipilimumab approved in for advanced melanoma treatment. The drug turns the immune system into a cancerkiller bringing some patients back from the brink of death. Melanoma is one of the deadliest forms of skin cancer striking Americans and killing more than every year. Because there are few treatments for advanced melanoma the new drug was greeted with excitement by doctors and patients. But ipilimumab sold under the brand named Yervoy by Bristol Myers Squibb works in only to percent of patients. Until now no one knew why. Valerie Esposito a yearold mother of three was taking ipilimumab for advanced melanoma and it wasnt working very well. The cancer was spreading through her body. One huge tumor in fact was pressing on her spine. To relieve the pressure her doctors at Memorial Sloan Kettering Cancer Center in New York radiated the lump. Within weeks other tumors throughout her body started shrinking dramatically. This has occurred before in cancer immunology. But this time oncologist Dr. Jedd Wolchok and his team of melanoma specialists at Sloan Kettering think they have figured out at the molecular level exactly how that shot of radiation altered her immune system to allow the drug to kill far more cancer cells. It created pieces of tumors proteins called antigens that sparked specific changes in how antibodies and diseasefighting white cells recognized the cancer cells as foreign and thus destroyed them. Already the researchers are planning a nationwide clinical trial to determine if the findings can allow the drug to help many more patients with advanced melanoma. They also believe the same approach could work for kidney lung and other cancers. Source http"

"GALVESTON Texas Researchers from The University of Texas Medical Branch at Galveston http found that testosterone replacement therapy may slow disease progression of chronic obstructive pulmonary disease. The paper httpjournals.sagepub.comdoifull. is currently available in Chronic Respiratory Disease httpjournals.sagepub.comhomecrd. Chronic obstructive pulmonary disease or COPD is predicted by the World Health Organization to be the thirdleading cause of illness and death internationally by . Low testosterone is common in men with COPD and may worsen their condition. Men with COPD have shortness of breath and often take steroidbased medications for an extended time both of which increase their risk of low testosterone. Previous studies have suggested that testosterone replacement therapy may have a positive effect on lung function in men with COPD said Jacques Baillargeon UTMB professor in preventive medicine and community health. However we are the first to conduct a large scale nationally representative study on this association. The goal of the study was to find out whether testosterone replacement therapy reduced the risk of respiratory hospitalizations in middleaged and older men with COPD. Using the Clinformatics Data Mart a database of one of the largest commercially insured populations in the U.S. Baillargeon and colleagues examined data of men aged to with COPD who began testosterone replacement therapy between and . They also used the national Medicare database to study data from men with COPD aged and older who initiated testosterone replacement therapy between and . We found that testosterone users had a greater decrease in respiratory hospitalizations compared with nonusers. Specifically middleaged testosterone replacement therapy users had a . percent greater decrease in respiratory hospitalizations compared with nonusers and older testosterone replacement therapy users had a . percent greater decrease in respiratory hospitalizations compared with nonusers said Baillargeon. The findings suggest that testosterone replacement therapy may slow the progression of disease in men with COPD. Other authors include UTMBs Dr. Randall Urban Wei Zhang Mohammed Zaiden Zulqarnain Javed Melinda SheffieldMoore YongFang Kuo and Dr. Gulshan Sharma. The University of Texas Medical Branch Office of Marketing and Communications University Boulevard Suite . Galveston Texas UTMB Newsroom utmbnews httpstwitter.comutmbnews ABOUT UTMB HEALTH Texas first academic health center opened its doors in and today has three campuses four health sciences schools three institutes for advanced study a research enterprise that includes one of only two national laboratories dedicated to the safe study of infectious threats to human health and a health system offering a full range of primary and specialized medical services throughout Galveston County and the Texas Gulf Coast region. UTMB is a part of the University of Texas System and a member of the Texas Medical Center"

"A new method of stimulating the renewal of living stem cells in tooth pulp using an Alzheimers drug has been discovered by a team of researchers at Kings College London. Following trauma or an infection the inner soft pulp of a tooth can become exposed and infected. In order to protect the tooth from infection a thin band of dentine is naturally produced and this seals the tooth pulp but it is insufficient to effectively repair large cavities. Currently dentists use manmade cements or fillings such as calcium and siliconbased products to treat these larger cavities and fill holes in teeth. This cement remains in the tooth and fails to disintegrate meaning that the normal mineral level of the tooth is never completely restored. However in a paper published today in Scientific Reports scientists from the Dental Institute at Kings College London have proven a way to stimulate the stem cells contained in the pulp of the tooth and generate new dentine the mineralised material that protects the tooth in large cavities potentially reducing the need for fillings or cements. The novel biological approach could see teeth use their natural ability to repair large cavities rather than using cements or fillings which are prone to infections and often need replacing a number of times. Indeed when fillings fail or infection occurs dentists have to remove and fill an area that is larger than what is affected and after multiple treatments the tooth may eventually need to be extracted. As this new method encourages natural tooth repair it could eliminate all of these issues providing a more natural solution for patients. Significantly one of the small molecules used by the team to stimulate the renewal of the stem cells included Tideglusib which has previously been used in clinical trials to treat neurological disorders including Alzheimers disease. This presents a real opportunity to fasttrack the treatment into practice. Using biodegradable collagen sponges to deliver the treatment the team applied low doses of small molecule glycogen synthase kinase GSK to the tooth. They found that the sponge degraded over time and that new dentine replaced it leading to complete natural repair. Collagen sponges are commerciallyavailable and clinicallyapproved again adding to the potential of the treatments swift pickup and use in dental clinics. Lead author of the study Professor Paul Sharpe from Kings College London said The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities by providing both pulp protection and restoring dentine. In addition using a drug that has already been tested in clinical trials for Alzheimers disease provides a real opportunity to get this dental treatment quickly into clinics. Notes for Editors The paper Promotion of natural tooth repair by small molecule GSK antagonists by Vitor Neves Rebecca Babb Dhivya Chandrasekaran and Paul T Sharpe will be published in Scientific Reports at am on Monday January http Professor Paul Sharpe is the head of the Craniofacial Development and Stem Cell Biology Division at the Kings College London Dental Institute. The Kings College London Dental Institute Kings College London Dental Institute is one of the foremost Dental Schools in the world. Recently ranked fourth in the world in dentistry by the QS World University Rankings and first in the UK the Dental Institute aims to maximise impact on health and wellbeing by integrating excellence across four areas Education teaching Worldclass science Clinical approaches Patient care The Facultys international reputation attracts students and staff from across the globe. The largest dental academic centre in the UK they teach over undergraduate students graduate taught students distance learning students and graduate research students. The Dental Institute has over academic staff and is organised into four research divisions Craniofacial Development Stem Cell Biology Mucosal Salivary Research Tissue Engineering Biophotonics and Population Patient Health. The research divisions complement the teaching and clinical service initiatives. As well as excellent research facilities the Dental Institute has internationally recognised education programmes. With highly skilled teachers and supervisors there are exceptional facilities including access to over patients each year across the two worldfamous hospitals Guys and St Thomas for handson clinical training. They are one of the most comprehensive dental academic health science centres in Europe. Further details of the Institute may be found on its website http"

"A nicotine addiction pill can help smokers quit gradually when they cant go cold turkey a study finds suggesting that it may be time to revisit practice guidelines that focus primarily on immediate cessation. A man smokes a cigarette in Los Angeles California May . REUTERSJonathan Alcorn Smokers who took the pill sold as Chantix in the U.S. and Champix elsewhere were much more likely to quit after cutting back on cigarettes than smokers who didnt use the drug the study found. This allows us to reach a much broader population of smokers who arent willing to quit abruptly or set a quit date and it shows that people can quit without going cold turkey said lead study author Dr. Jon Ebbert a professor in primary care and internal medicine at the Mayo Clinic in Rochester Minnesota. This is very strong support for changing clinical practice to include gradual reduction aided by medication. Smoking is the leading cause of preventable death in the U.S. according to the Centers for Disease Control and Prevention. And tobacco kills one in people worldwide according to the World Health Organization. Quitting can reduce the risk of heart attacks strokes and cancers of the mouth throat esophagus and bladder. Ten years after quitting the risk of lung cancer drops by half according to the CDC. To see if Chantix which is manufactured by Pfizer could help smokers quit without going cold turkey Ebbert and colleagues randomly assigned people at centers in countries to receive either the drug or a placebo for weeks. They asked study participants to reduce cigarette use by percent by the fourth week and by percent by the eight week with the goal of quitting by week . By the last ten weeks of treatment weeks to the group taking the pill had significantly higher abstinence rates than the group on placebo. This held true even after treatment stopped. For weeks through of the study percent of the people who had previously taken the drug successfully avoided smoking compared with less than percent of those who received the placebo. This is the first study of its kind to enroll a group of smokers who are not traditionally enrolled in clinical trials because they are not ready to quit said Dr. Caryn Lerman professor of psychiatry and deputy director of the Abramson Cancer Center at the University of Pennsylvania in Philadelphia. It offers compelling evidence that gradual reduction should be considered to facilitate quitting she said. But even though the approach helped some hardtoreach smokers the majority of them still failed to quit noted Lerman who wasnt involved in the study. Other treatments such as nicotine patches and gum can also help some smokers cut back gradually she said. While the study shows that Chantix which is known generically as varenicline can be effective for some smokers the group taking the pill also experienced more side effects such as nausea abnormal dreams insomnia constipation vomiting and weight gain. Previous research has linked Chantix to side effects including suicidal thoughts erratic behavior and drowsiness. The U.S. Food and Drug Administration placed a black box warning its most severe and restrictive warning on the product in highlighting the drugs adverse neuropsychological effects. People with a history of major depressive or anxiety disorder suicidal behavior panic disorder posttraumatic stress disorder schizophrenia or psychosis were excluded from the study published in the American Medical Associations journal JAMA. SOURCE bit.lytacc httpbit.lytacc JAMA online February . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Imagine. A nick of the skin a flash of cold and minutes on an exam table. For thousands of women this may soon replace surgery as a treatment for breast cancer. Cryoablation using extreme cold to destroy diseased cells is potentially the first ever procedure to treat breast cancer tumors without the trauma of surgery. Following numerous limited studies a growing number of women are now being treated with the technique as part of a groundbreaking clinical trial involving leading breast cancer specialists across the country. Utilizing IceCure Medicals innovative IceSense cryoablation system the multicenter trial is examining cryoablation of certain types of breast cancer. Potentially it will usher in a new and gentler pathway for the treatment of a disease that affects one in every eight women annually. The benefits of cryoablation over traditional breast cancer surgery are significant. The procedure is typically performed in a physicians office under ultrasound guidance in less than minutes. It involves a small incision and placement of an IceSense nitrogencooled probe into the center of a tumor to freeze it from the inside out. The diseased cells then crack open and die. Eventually they are absorbed by the immune system and new cells take their place. By contrast surgical cancer removal often means several hours in the operating room complications of general anesthesia and weeks or months of recovery. Surgery also typically involves significant breast tissue damage and disfigurement due to large incisions and removal of sizable breast mass. Cryoablation however precisely targets the tumor site and involves insertion of only a slim probe. Therefore it boasts fast recovery time significantly improved cosmetic results and greater patient comfort overall. In fact most women are able to resume normal activities almost immediately following treatment. They experience minimal scarring and excellent cosmetic results. Physicians participating in the trial report that patients feel minimal discomfort and can watch the procedure on the ultrasound screen. Most are extremely relieved to avoid painful disfiguring surgery and long recovery times. For women with certain types of breast cancer cryoablation is showing promise as an alternative to surgery particularly for patients over age says Susan K. Boolbol MD Chief of the AppelVenet Comprehensive Breast Service Mount Sinai Beth Israel who is participating in the trial. For older patients the risks associated with invasive procedures and general anesthesia as well as the discomfort of long recoveries also makes this procedure particularly desirable. As our understanding of tumor biology grows the ability to offer treatment options other than surgery is important. There is growing awareness treatment should be based on individual tumor biology. We are excited to be participating in this trial where some breast cancer patients can be treated without surgery adds Richard Fine MD The West Comprehensive Breast Center Memphis TN another surgeon active in the cryoablation trial. Over the next years women and older will make up one of the fastest growing populations diagnosed with breast cancer. We are confident that the ICE trial can prove certain women can be successfully treated less aggressively than in the past. The option of a nonsurgical treatment has significant benefits for patients and the overall health care system. Cryoablation is wellestablished in the treatment of liver kidney prostate and other cancers. Its effectiveness in breast cancer has been proven in a number of smaller studies including a recent American College of Surgeons Oncology Group ACOSOG trial and extensive longterm ongoing unpublished studies in Japan. The ICE trial which began patient enrollment in October will significantly expand data on the technique as a treatment for breast cancer. Patents will be followed for five years to ensure they remain cancer free. Developed by IceCure Medical Caesarea IsraelMemphis TN specifically for breast applications the IceSense Cryoablation System has a long history of successful treatment of benign breast fibroadenomas. The ongoing refinement of the technology makes treatment more precise and extremely reliable. The IceSense device delivers a stable cycle of extremely cold temperatures and relies on a maneuverable disposable probe and compact high tech console. For the first time these advances make precise targeting of tumors extremely reliable. The ICE trial is recruiting and following women aged years and older diagnosed with certain tumor subtypes and measuring less than . centimeters in diameter. Developed by a diverse esteemed scientific advisory board the trial is underway at carefully selected sites throughout the United States. As a market leader in cryoablation treatment of breast disease IceCure will utilize its resources to provide clinical and technological support to sites in the cancer trial. CONTACT William Irby wirbyicecuremedical.com mailtowirbyicecuremedical.com Photo httpphotos.prnewswire.comprnh SOURCE IceCure Medical"

"Scientists are inching closer to a drug that may protect peanut allergy sufferers from potentially lifethreatening complications that can occur due to accidental consumption. While the drug is not being hailed as a cure for peanut allergy it has proven successful in building up patients tolerance to peanuts over time lessening the potential for lifethreatening complications. Were excited about the potential to help children and adolescents with peanut allergy protect themselves against accidentally eating a food with peanut in it said allergist Stephen Tilles MD ACAAI former president study coauthor and consulting advisor for Aimmune Therapeutics according to EurekAlert. Our hope when we started the study was that by treating patients with the equivalent of one peanut per day many would tolerate as much as two peanuts. We were pleased to find that two thirds of people in the study were able to tolerate the equivalent of two peanuts per day after nine to months of treatment and half the patients tolerated the equivalent of four peanuts. FDA WARNS AGAINST HONEY PACIFIERS AFTER TEXAS INFANTS HOSPITALIZED WITH RARE ILLNESS https The results which were presented Sunday at the College of Allergy Asthma and Immunology Annual Scientific Meeting and published in the New England Journal of Medicine were based on study participants ranging in age from to years old. All participants who mostly fell between ages and had a peanut allergy but one third received a placebo while the rest were given a peanut protein powder that increased in dose over time. Participants ingested the peanut protein under the supervision of a boardcertified allergist as part of a process called an oral food challenge OFC. Reactions from the oral challenges at the end of the study were much milder than prior to treatment Tilles said according to EurekAlert. On average the participants were able to tolerate a fold higher dose of peanut at the end of the study than they did at the beginning. In addition the symptoms caused by the fold higher dose at the end of the study were milder than the symptoms on the lower dose at the beginning of the study. EXPERTS CHILDREN AT RISK OF LEAD POISONING IN CHATTANOOGA https With FDA approval this drug would mark the first treatment available by prescription for peanut allergies. The studys authors noted that patients would need to stay on the drug in order to receive protection against the allergy. This is not a quick fix and it doesnt mean people with peanut allergy will be able to eat peanuts whenever they want Jay Lieberman MD vice chair of the ACAAI Food Allergy Committee and study coauthor said according to EurekAlert. But it is definitely a breakthrough. The hope would be to have a treatment available in the second half of . If that happens people who receive and are able to tolerate this treatment should be protected from accidental exposures."

"When U.S. Marine Chris Merkle returned from his last tour of duty in Afghanistan his family was thrilled to have him back. Interested in Add as an interest to stay up to date on the latest news video and analysis from ABC News. Add Interest But for Merkle the welcome home was also accompanied by some dark problems. He couldnt sleep. He was irritable and had anger issues. He would avoid certain stressful situations like driving in traffic. And he would stay on high alert in the classroom. And then soon theyre like Youre not the same Merkle recalled of what his family told him. They start to notice that youre not really enjoying the parties of our friends. You only get really excited when youre going to visit former Marines and the people you used to hang out with. Merkle served three tours in Iraq httpabcnews.go.comtopicsnewsiraq.htm and four in Afghanistan. Readjusting to being a civilian was tough he said and he was finding it difficult to function. There was almost years of deploying back and forth back and forth there was this void this monster in the room thats not talked about until finally it came out. It was like You need to see somebody. Something is going on with you. While Merkle was a patient at the VA he heard of a clinical psychologist named Skip Rizzo at the University of Southern California Institute of Creative Technologies. Merkle was trying traditional oneonone therapy and said that at the time it wasnt really taking that well. He was looking for an alternative and heard about Skips research that used a new and unexpected way to treat posttraumatic stress disorder with virtual reality. Finding the Next full episodes will release Tuesdays on ABCNews.com and ABC News mobile apps. The entire series is available now on ABC News apps on Apple TV httpabcnews.go.comtopicsnewstechnologyappletv.htm Roku and Xbox httpabcnews.go.comtopicsentertainmentvideogamesxbox.htm One. Nearly million adults suffer from PTSD httpabcnews.go.comtopicslifestylehealthposttraumaticstressdisorder.htm during a given year according to the National Center for PTSD. The condition can occur after someone has been exposed to a significant stressor and often includes symptoms such as avoidance hypervigilance anger issues and mood swings. One common method for treatment is called exposure therapy. The patient recounts their trauma visualizing it in their imagination and narrates it to a clinician. By repeatedly confronting and processing the trauma the brain can start to reduce the level of anxiety httpabcnews.go.comtopicslifestylehealthmentalhealth.htm and response to those memories. Thats exactly the approach Rizzo uses with virtual reality therapy. My mission is to drag psychology kicking and screaming into the st century Rizzo said noting that virtual reality offers a unique opportunity for clinicians and clients alike to be immersed in the environment that evokes the original trauma rather than relying on the patients imagination. Rizzo has created virtual worlds for patients and clinicians can add custom elements including helicopters clouds smallarms fire and missiles. The first thing to keep in mind is that we are never going to replicate an exact simulation of what the patient went through Rizzo said. But we really dont need to. Merkle explained how the virtual reality experience works. Your brain assumes OK this must be where were at and it fills in the blanks. And as youre talking through it you feel like youre physically there. Each session lasts for about an hour and a half and the patient speaks about their experience with a clinician as they go through the virtual simulation. For Merkle virtual reality allowed him to start unlocking memories and work through his trauma. So it really allowed me to open the door and begin my healing process he said. Im still a work in process obviously but Im so far forward leaps and bound beyond where I would have been without virtual reality."

"Heterosexuals who are HIV negative can significantly reduce their risk of infection by taking a daily dose of an antiviral drug according to a new study by the Centers for Disease Control and Prevention. The study called TDF httpthechart.blogs.cnn.comtakingmedsbeforeexposurecutshivriskforheterosexualsPreexposuredrugsreducesriskofHIVinfectioninHeterosexuals followed uninfected heterosexual men and women between the ages of and years in Botswana Africa. Study participants took a tablet containing tenofovir disoproxil fumarate and emitricitabine TDFFTC whose brand name is Truvada http or a placebo. On average patients were followed for a year although some were followed for about three and a half years. The risk of infection was reduced overall but for participants who actually got the drugs that risk decreased by . Giving daily antiretroviral drugs to uninfected individuals to prevent the disease is called preexposure prophylaxis or PrEP http Previous studies have shown PrEP to be effective in reducing infection rates among the uninfected. Dr. Kevin Fenton director of the CDCs national Center for HIVAIDS Viral Hepatitis STD and TB Prevention called the news a milestone. It is clear we are not going to find one magic pill to solve the issue of HIV but by combining this approach with others we are beginning to get a better handle on combination packages. There is reason to be excited. The news comes at the same time a second study looking at PrEP in heterosexual couples in Kenya and Uganda also found significant reductions in infection rates. The Partners PrEP study http participants took either TDFFTC the drug tenofovirbrand name Viread or a placebo. Preliminary results showed both treatments significantly reduced transmission in couples where one partner was already infected with the virus. Patients who took tenofovir had fewer infections while those taking the combination drug had fewer infections than those who got the placebo. Just a few years ago the tool kit for HIV prevention was not very large says Dr. Jared Baeten the principal investigator of the Partners PrEP study at the University of Washington. Now we have a nice collection of really powerful strategies that work for the population at greatest risk in the world. This is really a game changer. We now have findings from two studies showing that PrEP can work for heterosexuals the population hardest hit by HIV worldwide Fenton said. Taken together these studies provide strong evidence the power of this prevention strategy. In fact an interim review of the Partners data on effectiveness was so compelling that the trial was stopped early and the placebo arm was discontinued. Clear evidence Baeten said that PrEP substantially reduces infection risk. At the same time he says there was no evidence of safety concerns. Patients taking the placebo will be put on one of the drugs. In the TDF study those taking the drug reported nausea vomiting and dizziness. An earlier PrEP trial the iPrEx study http looked at treatment in men who have sex with men. Infection rates dropped by in patients who consistently used PrEP. We are in a critical moment in HIV prevention research said Robert Grant M.D. M.P.H of the Gladstone Institutes and the University of California at San Francisco. He is the iPrEx protocol chair. iPrEx provided the first proof of an important new method of HIV prevention that can help slow the global toll of . million new HIV infections each year. Partners PrEP and the TDF study have now expanded that finding by demonstrating the effectiveness of PrEP in heterosexual women and men. Developing and deploying proven HIV prevention methods including PrEP microbicides vaginal gels clean needles medical male circumcision early treatment counseling testing condoms and suppressive therapy for pregnant women will all be key to slowing the global epidemic he said. The CDC says the next step is to fully review all the data and begin to develop guidelines for the use of these drugs in heterosexual men and women here in the U.S."

"Cancer patients admitted to the hospital with advanced stages of disease who were referred early to palliative care had decreased health care utilization and increased use of support services following discharge according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai. Published today in the Journal of Oncology Practice the study also determined that a systemized process of referrals resulted in significant improvements in day readmission rates hospice referral and receipt of chemotherapy after discharge in patients with advanced cancers. This is the first study to demonstrate that among advanced cancer patients admitted to an inpatient oncology service standardized use of triggers for palliative care consultation is associated with substantial improvement on multiple quality measures. Patients with advanced cancers often have significant symptoms that affect their emotional status quality of life and functional ability. The integration of palliative care improves symptom control and decreases unwanted health care use yet many patients are never offered these services. As cancer progresses patients are often at high risk for physical pain and emotional distress said Cardinale B. Smith MD MSCR Associate Professor of Medicine Hematology and Medical Oncology and of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Health care utilization is extremely high once cancer progresses with hospital readmission rates as high as percent and death in the acute care setting ranging from percent both measures of poorquality cancer care. To improve the quality of care researchers at the Icahn School of Medicine developed standardized criteria or triggers for palliative care consultation for patients admitted to the cancer unit at The Mount Sinai Hospital. Patients were eligible for this prospective cohort study if they met one or more eligibility criteria advanced solid tumor cancer prior hospitalization within days hospitalization for more than days or active symptoms. Care for patients with advanced cancer is often characterized by time spent on acutecare hospital wards and intensive care units or receiving invasive procedures chemotherapy infusions and radiographic imaging. Such interventions drive escalating costs and are often directly in conflict with patients prior stated wishes said Dr. Smith. Consultation with the palliative care team included establishment of goals of care advance care plans using standardized communication protocols transition planning and symptom assessment and treatment using the Edmonton Symptom Assessment Scale ESAS. The palliative team was composed of one board certified PC physician one nurse practitioner one social worker a chaplain and one to two trainees. Our results highlight the need to adopt this practice at acute care hospitals across the nation said Dr. Smith. Palliative care involvement helps patients understand their prognosis establish goals of care and formulate discharge plans in line with those goals and this study is the first to confirm the impact of using standardized criteria and automatic palliative care consultation on quality of cancer care. Coauthors of the study include Kerin Adelson MD Division of HematologyOncology at Yale University School of Medicine. About the Mount Sinai Health SystemThe Mount Sinai Health System is an integrated health system committed to providing distinguished care conducting transformative research and advancing biomedical education. Structured around seven hospital campuses and a single medical school the Health System has an extensive ambulatory network and a range of inpatient and outpatient servicesfrom communitybased facilities to tertiary and quaternary care. The System includes approximately primary and specialty care physicians jointventure ambulatory surgery centers more than ambulatory practices throughout the five boroughs of New York City Westchester Long Island and Florida and affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the Honor Roll of best hospitals in America ranked No. nationally in the Best Hospitals issue of U.S. News World Report. The Mount Sinai Hospital is also ranked as one of the nations top hospitals in Geriatrics GastroenterologyGI Surgery CardiologyHeart Surgery DiabetesEndocrinology Nephrology NeurologyNeurosurgery and Ear Nose Throat and is in the top in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. nationally for Ophthalmology while Mount Sinai Beth Israel Mount Sinai St. Lukes and Mount Sinai West are ranked regionally. Mount Sinais Kravis Childrens Hospital is ranked in seven out of ten pediatric specialties by U.S. News World Report in Best Childrens Hospitals. For more information visit http or find Mount Sinai on Facebook Twitter and YouTube."

"Brain surgery for children whose epilepsy is resistant to drug therapy can produce a fold increase in the odds of being seizurefree after one year and can do it without affecting IQ according to a new Indian study of patients in The New England Journal of Medicine. Seventyseven percent of the children were free of seizures at one year after the surgery compared with seven percent in a control group of youngsters who received medical therapy alone while waiting for surgery. Behavior and quality of life also improved. But surgery also produced serious adverse effects in onethird of the children most frequently a weakness on one side of the body known as hemiparesis. The researchers said that was to be expected and without surgery patients probably would have experienced similar problems as a result of their continuing seizures. What the study clearly shows is surgery for children produces seizure freedom compared to children not operated on for similar conditions senior author Dr. Manjari Tripathi a professor of neurology and epilepsy at the All India Institute of Medical Sciences in New Delhi told Reuters Health in a telephone interview. Not only does it reassure us that several surgical procedures are effective she said it demonstrates that surgery should be done as early as possible once it becomes clear that a child is not responding to two antiseizure medications. About million people worldwide suffer with epilepsy and drugs cant control the seizures in approximately percent of the cases. This is the first randomized study to look at surgical outcome in children said Dr. Donald Schomer director of the Comprehensive Epilepsy Program at Beth Israel Deaconess Medical Center in Boston. He was not involved in the research. The results are impressive he told Reuters Health by phone. Adults who undergo surgery often suffer from the collective effect of years of uncontrolled seizures. The study in kids shows if you reduce the time from the onset of seizures from the to years you see in adults down to four to five years the outcome is much better. Its documentation that these techniques really work. Although percent were judged by the Tripathi team to be seizurefree at the end of the study some of those children actually had seizures immediately after surgery. Yet the cases were judged to be a success because the seizures decreased in frequency over time. Ultimately percent never had a seizure in the year after surgery. When all seizures were taken into account children who did not have surgery were four times more likely to have a seizure during that year than youngsters in the surgery group the researchers calculated. Success rates ranged from percent to percent depending on the type of surgery used to correct the childs particular brain abnormality. Surgery improved quality of life and social wellbeing and it didnt affect IQ something that can decline with ongoing seizures. But Dr. Schomer said the children were only followed for one year and that may be too soon to see a noticeable change in the intelligence quotient. Postsurgery weakness was seen in of the patients who had a serious side effect following surgery. The weakness is significant Dr. Tripathi said. The child may not be able to ambulate by his or herself. But with physical therapy all regain the lower and upper limb function within six months. The only thing that does not improve is the wrist and the fingers. They are left with this minor deficit. But even before surgery some of them have this weakness. Other side effects depended on the area of the brain that was removed or disconnected from the rest of the brain. In contrast . percent of the children waiting for surgery had a serious injury as a result of their continuing seizures. The surgery had a transforming effect on how they get along in life Dr. Tripathi said. Many could go back school earlier or go back to being tutored and get on with their life. But a major problem facing these children is getting insurance companies to pay for such surgeries said Dr. Schomer of Beth Israel. Rather than pay to on surgery that might cure the problem and prevent further damage to the child insurance companies prefer to demand that more drugs be tried even if the odds of them working in drugresistant cases is small he said. Studies like this lend credence to the idea that the earlier you do it the better the outcome he said. I hope insurance companies will look at this and realize that early detection and surgery if appropriate will ultimately save them money in the long term. SOURCE bit.lygVClQv httpbit.lygVClQv The New England Journal of Medicine online October . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Take two slices of cherry pie and call me in the morning. OK. Thats not quite the advice doctors are wont to give. But it might make at least a sliver of sense. Cherry pie contains the same sort of antiinflammatory compounds as aspirin and other nonsteroidal antiinflammatory drugs at least the cherries do. Theyre tart or sour cherries which as far as is known contain more of these antiinflammatory compounds than any other food says Dr. Kerry Kuehl assistant director of the Human Performance Laboratory at Oregon Health and Science University in Portland. Kuehl is a coauthor of a new study suggesting that tart cherries could someday provide an alternative treatment for patients with inflammatory osteoarthritis who cant tolerate the standard drug therapy. Its What We Have Suspected All Along And Even Worse... Participants in the study presented at the American College of Sports Medicine Conference in San Francisco in May were women to years old who had all been diagnosed with inflammatory osteoarthritis and had experienced joint swelling at least once in the last year. Twice a day half of the women drank . fluid ounces of tart cherry juice. The other half drank that much fake cherry juice with the same calorie content flavor and consistency. After three weeks the women who got the real stuff had significantly less inflammation as measured by Creactive protein in their blood than those who had been drinking the counterfeit. The antiinflammatory powers of tart cherries can make them a smart choice for healthy people too. In a number of studies athletes who drank tart cherry juice before running a race or doing intensive strength exercises felt less pain afterward and bounced back faster than those who didnt. But tart cherries arent just loaded with whambam antiinflammatories. Theyre chockablock with antioxidants. And a study in the European Journal of Nutrition suggests that drinking tart cherry juice during the day may pay off in better snoozing at night thanks to high levels of the sleepregulating antioxidant melatonin. These studies have been done with people but other promising research has only been done with lab animals so far. In one study in the Journal of Medicinal Food tart cherries helped fat rats. Not our favorite role models perhaps but the obese beasties risk of Type diabetes and heart disease were reduced significantly and parallel studies are now in the works with members of our own species says lead author E. Mitchell Seymour There are some interesting and potentially exciting results on the horizon. Stay tuned. So whats not to like about tart cherries Not much ... except for maybe the tart part. Lets just say the cherry topping off your hot fudge sundae is not a tart cherry. The alluring cherries in the produce aisle are not tart cherries. And those cherries that a happy life is supposedly just a bowl of Theyre not tart cherries either. Tart cherries are extremely bitter raw Kuehl admits. Unpalatable. But hey There is a solution Dont eat tart cherries raw. Eat them dried or frozen in smoothies or drink them in juice. Even unsweetened something about juicing makes them taste better Kuehl says. Some people really like it. And of course you can always bake a pie. healthlatimes.com mailtohealthlatimes.com"

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

"Bariatric surgery is probably the most effective intervention we have in health care says Laurie K. Twells a clinical epidemiologist at Memorial University of Newfoundland. She bases this bold claim on her experience with seriously obese patients and a detailed analysis of the best studies yet done showing weightloss surgerys ability to reverse the often devastating effects of being extremely overweight on health and quality of life. I havent come across a patient yet who wouldnt recommend it Dr. Twells said in an interview. Most say they wish theyd done it years sooner. She explained that the overwhelming majority of patients who undergo bariatric surgery have spent many years trying and failing to lose weight and keep it off. And the reason is not a lack of willpower http_rmoduleinline. These patients have lost hundreds of pounds over and over again Dr. Twells said. The weight that it takes them one year to lose is typically back in two months often because a body with longstanding obesity defends itself against weight loss by drastically reducing its metabolic rate an effect not seen after bariatric surgery which permanently changes the contours of the digestive tract. In reviewing studies https that followed patients for five to years after weightloss surgery Dr. Twells and colleagues found major longlasting benefits to the patients health and quality of life. Matched with comparable patients who did not have surgery those who did fared much better physically emotionally and socially. They rated themselves as healthier and were less likely to report problems with mobility pain daily activities social interactions and feelings of depression and anxiety among other factors that can compromise wellbeing. Equally important are the undeniable medical benefits of surgically induced weight loss. They include normalizing blood sugar blood pressure and blood lipid levels and curing sleep apnea. Although bariatric surgery cannot cure Type diabetes it nearly always puts the disease into remission and slows or prevents the lifethreatening damage it can cause to the heart and blood vessels. Even in the small percentage of patients who ultimately lose little weight after surgery significant metabolic benefits persist according to findings at the Cleveland Clinic. In a study of obese diabetic patients https who had not lost a lot of excess weight five to nine years after surgery a modest weight loss of just to percent resulted in a reduction of cardiovascular risk factors and blood sugar abnormalities Dr. Stacy Brethauer and colleagues reported. For the two most popular surgical techniques the gastric bypass and the gastric sleeve the metabolic benefits are independent of weight loss Dr. Brethauer said in an interview. Both methods permanently reduce the size of the stomach. However the gastric band procedure which is reversible lacks these benefits unless patients achieve and maintain significant weight loss he said. Furthermore as a study last year of surgical patients https at the Veterans Affairs Medical Center in Durham N.C. found those who underwent bariatric surgery had lower overall death rates up to years later than comparable patients who did not have weightloss surgery. Experts in the field regard the reluctance of some medical insurers including Medicaid programs in many states to cover the cost of bariatric surgery as a pennywise poundfoolish position. Failing to reverse extreme obesity can end up costing far more per patient than the typical price tag of bariatric surgery sometimes even millions of dollars more. Counter to popular impressions that most people treated surgically regain most or all the weight they lose initially the latest longterm research has shown otherwise. In a decadelong followup of veterans httpjamanetwork.comjournalsjamasurgeryfullarticle who underwent gastric bypass a mere . percent returned to within percent of their initial weight years later. This finding is especially meaningful because the researchers at the V.A. center in Durham were able to keep track of percent of gastric bypass patients a task too challenging for most clinics. The study by Matthew L. Maciejewski and colleagues published in August in JAMA Surgery found that years later more than percent of surgical patients lost more than percent of their starting weight and about percent had lost more than percent. Gastric bypass an operation called RouxenY resulted in a somewhat greater weight loss at years than the newer gastric sleeve surgery and significantly more than the adjustable gastric band LapBand surgery which has fallen out of favor in the last two or three years Dr. Maciejewski said. Bariatric surgery regardless of the method used is also much safer nowadays than it was even a decade ago said Dr. Jon C. Gould a surgeon at the Medical College of Wisconsin in Milwaukee who wrote a commentary httpjamanetwork.comjournalsjamasurgeryfullarticle on the V.A. study. However he noted the surgery is vastly underutilized to the detriment of patients health and the nations health care costs. Less than percent who would qualify for bariatric surgery are actually getting it Dr. Gould said. Although the vast majority have health coverage insurance companies and many Medicaid programs put it out of reach for most people by demanding that they already have several obesityrelated health conditions and are taking a slew of medications to control them. For example he said to be covered for bariatric surgery Wisconsin Medicaid requires that a person with dangerously high blood pressure has to be taking three or more medications for it and still not have a normal pressure. He cited a further deterrent to bariatric surgery a perception that its dangerous and doesnt work beliefs countered by the research findings cited above. Most of the surgeries are now done laparoscopically through tiny incisions. Given the welldocumented safety and effectiveness of bariatric surgery it is now increasingly being performed in people whose obesity is less severe those with a body mass index B.M.I. of or perhaps even less but who have a metabolic disorder like Type diabetes related to their weight. In recent years the profession has promoted what Dr. Gould calls centers of excellence where or more bariatric operations are usually done in a year. Practitioners at these centers learn from experience share their knowledge and push for quality improvements he said. Dr. Gould suggested that people interested in bariatric surgery seek out programs that have been jointly accredited by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery which have combined forces to promote quality control. While experts agree that money would be better spent on prevention than treatment Dr. Twells pointed out that we have yet to find a way to prevent obesity and people whose health is compromised by their weight deserve to be treated by the most effective method we have."

"German researchers say theyre a step closer to developing an electronic nose that can distinguish between people who have heart failure https and those who dont. The device has gas sensors that detect various odorous molecules in sweat. Specially developed software divides patients into groups depending on the pattern of molecules detected. We saw two distinct patterns one of which correlated with heart failure says study leader Vasileios Kechagias a PhD candidate at the University Hospital Jena. The goal of the project is to develop a simple accurate noninvasive and reproducible method for early identification of chronic heart failure he tells WebMD. Million Have Heart Failure in U.S. More than million Americans have heart failure which occurs when the heart muscle loses its ability to pump enough blood throughout the body. http Fluid can back up into the lungs https leaving people short of breath. The new study involved people with heart https failure so severe that they were comfortable only at rest people with less severe heart failure and healthy people. The electronic nose correctly identified of the people who had heart failure and of people that didnt have the condition. Still that means that of cases would have been missed and of people would have been told they had a lifethreatening condition when they didnt. The new device was about that accurate at differentiating between severe and less severe heart failure patients. The findings were presented here at the European Society of Cardiology Congress . Frank Ruschitzka MD of Zurich University Hospital tells WebMD that ideas that at first seem crazy can turn out to be lifesaving. We need people to swim against the stream. Someone had the idea to put three leads in a device and pace the heart the pacemaker https now saves millions of lives he says. Still much more work is needed before we will know if the electronic nose will make it to the clinic says Ruschitzka who moderated a news briefing to discuss the findings. The researchers are now testing more than patients and trying to identify the odorous molecules unique to heart failure patients Kechagias says."

"We all know what aging looks like from the outside wrinkled skin gray hair a growing need to turn up the volume on Jeopardy. But in recent years scientists have made some breakthrough discoveries about how we age on the inside right down to our genes. The science of aging has created a glimmer of hope that we could someday slow the process a dream that has already spread beyond the lab to the marketplace. Antiaging research used to be mainly about finding new ways to get lab mice to take their vitamins. But if you visited a lab today youd be more likely to hear scientists talking excitedly about telomeres protective strands of DNA at the end of chromosomes that seem to play an important some would say crucial role in aging. Whenever a healthy cell divides the telomeres get a little shorter. In fact you could tell a lot about the age of a person simply by looking at the length of his or her telomeres. Studies have found that in people older than short telomeres are one sign that the end may be relatively near Older people with short telomeres seem to be especially vulnerable to disease including heart disease and infections. But telomeres arent as reliable as a clock or even a tree ring. Recent studies suggest that you can help your telomeres stay relatively long and youthful if you get regular exercise eat a healthful diet and avoid stress. At a time when people are willing to spend big bucks to look and feel younger its not surprising that telomeres have become a buzzword in the supplement industry. One expensive option TA supposedly works by stimulating telomerase a natural enzyme that helps restore telomeres after a cell divides. The TA stands for telomerase activator. Created by Geron Corp. a biotech research company TA contains extracts of astragalus an herb often used as an immunitybooster in traditional Chinese medicine. Although TA is legally classified as a dietary supplement TA Sciences the company that bought the licensing rights from Geron makes it available only through select doctors who have paid a fee and have passed a test on telomere biology. Seven doctors offer TA in California including two in Los Angeles according to the company website. When TA was first released in patients spent a year on the supplement and accompanying tests. Now patients spend to for a sixmonth supply depending on the dose. The company recommends taking the supplement for two years. Patients must spend an additional on doctors fees and they have the option of spending several hundred to a couple of thousand dollars more on tests to check the results. Reneuve a supplement sold online supposedly lengthens telomeres by giving users an extralarge dose of telomerase. You wont see telomerase in the list of ingredients but Reneuve does offer select proprietary glandular extracts from pig thymuses that provide enough telomerase enzyme for the cellular infrastructure of one adult. A single milliliter vial of Reneuve purchased through the company website costs . Users are instructed to drink the vial in a single sitting perhaps with some Mountain Dew or Gatorade. The effects are said to last six months. Claims The TA Science website says the company is the first and only in the world to offer TelomeraseActivating products to combat the effects of aging through leadingedge science. Company founder Noel Patton says Our product is not the fountain of youth. You wont miraculously turn into a yearold again. But it is a fountain of youth for certain cells. Specifically Patton says the product will strengthen and rejuvenate the immune system. He points to an unpublished companyrun study that compared an astragalus supplement similar to TA to a placebo in men ages to . The study reportedly found that men who took the supplement for six months developed stronger immune system cells better eyesight improved sexual satisfaction and youngerlooking skin. He also says that tests paid for by patients show that the supplement improves bone density cognitive function cholesterol levels and control of blood sugar. The Reneuve website says the product uses Nobel Prizewinning technology to supply immunesystem enhancing and antiaging enzymes to the body. It also says that thanks to Reneuve aging is now a choice not a fact. Rasjesh Sharma the chief scientific officer of Reneuve declined to be interviewed but said in an email that the supplement helps replace the telomerase that people make naturally until they turn . The bottom line"

"Jane Adrian a landscape architect in Glendale Calif. saw her parents and two coworkers suffer from the painful blistering condition known as shingles so when the vaccine became available she got it. Even though the vaccine is only about percent effective its better than nothing she said. Now I feel relieved. A study of a crosssection of adults enrolled with a healthmanagement organization in southern California shows that the vaccine provides protection for many older adults without many side effects. The findings are published in the Jan. issue of the Journal of the American Medical Association. Shingles is caused by the herpes zoster virus and only strikes people who have had chicken pox. It usually starts as a rash on one side of the face or body often causing pain itching and tingling. About a million cases occur in the United States each year and attacks can last two to four weeks. Even after the rash has healed the pain can last for months or even years said lead study author HungFu Tseng a research scientist at the Kaiser Permanente Division of Research and Evaluation in Pasadena Calif. Zostavax as the vaccine is called was approved in based on the results of clinical trials. The U.S. Centers for Disease Control and Prevention recommends the shot for eligible people aged and older. Tsengs team wanted to test the vaccines realworld performance so they compared vaccinated members of the Kaiser Permanente health plan to members who elected not to have the shot. Kaiser funded the study. In vaccinated individuals the rate of shingles was . cases per people in a year while it was twice that per in the unvaccinated population the investigators found. The vaccine also reduced the risk of ophthalmic herpes zoster infection that affects the eye by percent and hospitalization by percent. Those who had been vaccinated were more likely to be white female and in better overall health than the unvaccinated people the researchers noted. Lack of awareness concerns about effectiveness or safety and cost may have kept some people from getting the shot Tseng said. People and over can consider talking to their physician about the possibility of receiving the vaccine to reduce their risk and the doctor can evaluate if they are eligible said Tseng. Patients with leukemia lymphoma HIV or an allergy to any ingredients in the vaccine are ineligible for the shot. It does bolster our confidence that its effective in the real world said Dr. Bruce Hirsch an attending physician in infectious diseases at North Shore University Hospital in Manhasset N.Y. who was not involved with the study. But the vaccine can cost a couple of hundred dollars he said perhaps making it out of reach for those with limited resources. Because shingles is not contagious and doesnt present a risk of death Hirsch said he would recommend the flu vaccine and the pneumococcal vaccine over this one for uninsured patients who would have to pay outofpocket. This study helps me in terms of advising patients and prioritizing Hirsch added. While less reliable than some childhood vaccines which are usually percent effective in preventing certain illnesses the shingles vaccination is still worthwhile said Dr. Ciro Sumaya professor of health policy and management at Texas AM Health Science Center School of Rural Public Health. I think its a very good vaccine and its a safe vaccine but obviously there needs to be continuing surveillance of usage of the vaccine to make sure there are no adverse effects that are seen in one in a million cases versus one in five or people said Sumaya also a member of CDCs Advisory Committee on Immunization Practices. For now he advises getting it. Its protecting against a severe disease particularly in elderly adults he said so the benefit I think is overwhelming that we should be using this because its recommended. More information The CDC has more on the shingles vaccine http SOURCES HungFu Tseng Ph.D. research scientist Kaiser Permanente Division of Research and Evaluation Pasadena Calif. Jane Adrian landscape architect Glendale Calif. Bruce Hirsch M.D. attending physician in infectious diseases North Shore University Hospital Manhasset N.Y. Ciro Sumaya M.D. professor of health policy and management Texas AM Health Science Center School of Rural Public Health and member U.S. Centers for Disease Control and Preventions Advisory Committee on Immunization Practices Jan. Journal of the American Medical Association"

"Imagine feeling horribly sick day after day yet doctors repeatedly tell you they cant find anything wrong. That typically happens to people with the mysterious illness commonly known as chronic fatigue syndrome. Research findings from Stanford University released Monday could point the way to a longsought diagnostic laboratory test for the condition and possibly a firstever treatment. Believed to affect at least a million people in the U.S. the condition is now increasingly termed myalgic encephalomyelitischronic fatigue syndrome https or MECFS for short. Many patients see the name chronic fatigue syndrome as trivializing and misleading giving the impression that theyre simply tired or depressed. In fact theyre experiencing profound exhaustion that isnt relieved with sleep flulike symptoms muscle pain brain fog and various other physical symptoms all of which characteristically worsen with even minor exertion. A Institute of Medicine report http proposed the name systemic exertion intolerance disease but it hasnt really stuck. Article continues after this message from our sponsor The symptoms can range from mild to extremely severe with about a quarter of patients so ill theyre mostly or completely confined to bed. Now the Stanford researchers have linked MECFS to variations in certain cytokines http immunesignaling proteins that track with illness severity. The study results http were published online Monday in the the Proceedings of the National Academy of Sciences. The link to gradation in severity rather than simply seeking a positive versus negative result represents a new approach to the search for biological markers for the illness. The study involved MECFS patients and healthy controls matched for age and sex. Out of cytokines investigated via sophisticated fluorescencebased testing https only two of the cytokines differed in their total concentrations between the MECFS and control groups. But levels of of the cytokines varied dramatically between the patients with mild versus severe MECFS symptoms. Of those cytokines were types that promote inflammation. This is significant because symptoms in these patients and findings from other studies also suggest that chronic inflammation plays a major role in the illness. This is a field that has been full of skepticism and misconception where patients have been viewed to have invented their disease. These data clearly show the contrary and demonstrate what can be achieved when we couple good research design with new technology lead author Dr. Jose Montoya httpsprofiles.stanford.edujosemontoya professor of infectious diseases at Stanford tells Shots. According to Dr. Anthony L. Komaroff httpsconnects.catalyst.harvard.eduProfilesdisplayPerson a Harvard internist and epidemiologist who has written a commentary to accompany the study For many years medical scientists have speculated that the symptoms of MECFS might be caused by cytokines molecules that the immune system use to wage war against foreign invaders of the body. Past studies have shown high levels of many cytokines but it was not clear that these high levels were causing symptoms. What the latest research shows Komaroff tells Shots is that levels of many cytokines do correlate with symptoms The higher the blood level the worse the symptoms. That supports the theory that the cytokines are a cause of the symptoms. So why do routine lab tests that doctors order often come back negative or not informative in MECFS patients Simply put Montoya says those tests arent measuring the right things. Two classic laboratory measures of inflammation are sedimentation rate the ability of red blood cells to clump together which isnt a factor in MECFS and Creactive protein which reflects levels of a single cytokine that wasnt one of those linked to severity in this study. Inflammation is much more complicated than two imperfect old measures Montoya says. Were showing an inflammation that has not been seen before. The multidisciplinary Stanford team is now working on developing a panel that could be used commercially that would test for around five of the cytokines and would likely involve the doctor first classifying patients by severity in order to interpret the results. Such a test could both establish the diagnosis and serve to monitor patients responses to treatment. Whats more the findings also point to possible treatment with immunemodifying or antiinflammatory therapy. Montoya hopes that by publishing these findings a team of researchers somewhere in the world will see these cytokines and say they have the drug for that inflammation. We hope drug companies will pursue it. Indeed a major drug trial is now being conducted in Norway investigating whether the immunemodifying drug rituximab alleviates MECFS symptoms after preliminary studies httpjournals.plos.orgplosonearticleid.journal.pone. suggested that it did in some patients. Interestingly the drug is approved to treat certain autoimmune diseases and also nonHodgkin lymphoma a cancer that one study found uniquely occurs at a higher rate https among older people with MECFS. Komaroff also notes a recent increase in research funding https by the National Institutes of Health which has included a comprehensive inhouse study http aimed at unraveling the underlying causes of the condition. And in an ongoing privately funded study Stanford geneticist Ron Davis httpsmed.stanford.eduprofilesronalddavistabbio and a team including three Nobel laureates https is taking a similar big data approach https to investigate a group of MECFS patients who are all severely ill including Davis own adult son. There is much to learn Komaroff writes in the journal. Hopefully a decade from now doctors will know better what to measure and more importantly what to do to ease the suffering caused by this illness."

"New findings add to confusion over whether taking aspirin ibuprofen or related painkillers reduces the risk of developing melanoma. Animal experiments have suggested that the class of painkillers known as nonsteroidal antiinflammatory drugs NSAIDs could play a role in preventing melanoma but a large study failed to find any evidence to support this possibility. Now a smaller study that asked people with melanoma and those without the disease to recall their use of NSAIDs has found that taking these drugs particularly aspirin at least once a week for more than years may have offered some protection against the deadly disease. The findings are interesting but should not lead people to conclude that popping a few painkillers will reduce their risk of skin cancer cautioned Dr. Maryam Asgari of Kaiser Permanente Northern California and the University of California San Francisco who coauthored the study. NSAIDs which include aspirin naproxen marketed as Aleve and ibuprofen Advil have side effects she noted such as stomach bleeding. People with a family history of melanoma are better off wearing sunscreen and getting regular skin checks from a dermatologist Asgari recommended. I think its just too early to say NSAIDs offer any protection she said. I think the jury is still out. Theres reason to hope NSAIDs might offer some protection against this type of cancer however earlier this year a review found that people who use painkillers such as ibuprofen on a regular basis may be less likely to get bladder cancer. Other research has consistently supported the benefits of NSAIDs in preventing colorectal cancer and provided some evidence they may work for breast esophagus and stomach cancers as well. Melanoma is the most lethal form of skin cancer killing almost people in the U.S. last year according to the National Cancer Institute. To investigate whether NSAIDs offer any protection Dr. Clara CurielLewandrowski of Harvard Medical School and the University of Arizona asked people diagnosed with melanoma and similar people without the disease to recall their use of the painkillers. The researchers found that people without cancer had a longer history of taking NSAIDs than people who eventually developed melanoma. Specifically more than percent of people who were cancerfree said theyd been taking NSAIDs at least once per week for more than years versus only percent of those who developed melanoma. Overall regular use of NSAIDs for more than years appeared to reduce the risk of developing cancer by more than percent the authors report in the Journal of Investigative Dermatology. Unfortunately the technique comparing people with melanoma to those without is fraught with potential problems said Asgari. For one you have to get the comparison right she noted theres always a concern that people without cancer who agree to participate in the study may be more health conscious to begin with and its this that protects them from cancer not their use of NSAIDs. Did you somehow get a biased sample of people and is that why youre seeing this difference Her study analyzed data from nearly people who were melanomafree at the beginning of the investigation then followed them for a few years to see who developed the disease. She and her colleagues found no evidence that taking NSAIDs had any effect on risk of developing the deadly skin cancer. As a result I wouldnt recommend taking NSAIDs to reduce melanoma just based on this new study Asgari noted. SOURCE bit.lyhjfo httpbit.lyhjfo Journal of Investigative Dermatology March . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"