Quick Surgery Best for Breast Cancer in the Young

Delaying surgery for breast cancer in girls and young women significantly decreases their already lower survival rates, particularly if they are African American or Hispanic, poor, or inadequately insured, a study found.

Among younger women, a treatment delay longer than 6 weeks was significantly associated with worse 5-year survival compared with those who were treated within 2 weeks or within 2 to 4 weeks (78% versus 84% and 83%, respectively, P=0.005 for both), reported Erlyn C. Smith, MD, of Children's Hospital of Orange County in Orange, Calif., and colleagues.

Such long treatment delays were harder on African Americans and Hispanics, who had 5-year survival rates of 57% and 74%, respectively, compared with 86% in white women (P<0.001 for both), they reported online in the JAMA Surgery.

Similar survival outcomes were seen in young women lacking insurance, compared with women who had private or military insurance (69% versus 82%, P<0.001). Women with low socioeconomic status (SES) compared with those with high socioeconomic status (69% versus 84%, P=0.003) showed poorer outcomes as well, they reported.

Of all breast cancer in females in the U.S., 5% to 6% is seen in 15-to-39-year-olds, the authors said. In those adolescents and young women, breast cancer carries a worse prognosis than in older women; they have the lowest 5-year survival rates among all age groups. But few studies have examined the impact of treatment delay, race and ethnicity, and socioeconomic factors on survival in this cohort, the authors noted.

"After a diagnosis of breast cancer is established, it may be difficult for a physician to make arrangements for surgery because of barriers such as a patient's lack of insurance or pending public insurance due to unemployment," they wrote. "Consequently, although surgical delay time is seen mostly as a physician-related delay, it can be affected by other patient-related factors such as insurance status and SES."

Smith and colleagues conducted the retrospective case-only study of 8,860 breast cancer cases among adolescents and young adults diagnosed from 1997 to 2006 using the California Cancer Registry database.

In multivariate analysis, they found that longer treatment delay time, estrogen receptor-negative status, having public or no insurance, and late cancer stage were significant risk factors for shorter survival.

Women with estrogen receptor-negative tumors had the worst 5-year survival compared with patients with estrogen receptor-positive tumors when stratified by treatment: surgery (hazard ratio 3.14, 95% CI 2.18 to 4.53, P<0.001), neoadjuvant chemotherapy (HR 2.19, 95% CI 1.63 to 2.94, P<0.001), and chemotherapy after surgery (HR 2.26, 95% CI 1.92 to 2.66, P<0.001).

Study limitations included using registry data that might exclude cancer stage and dates of diagnosis and surgery, the authors said. Also, data for pregnant women might be affected by treatment delayed until after childbirth. The authors also noted that, anecdotally, some young women presented to their primary care physicians on numerous occasions prior to being diagnosed with breast cancer.

"It is crucial to prevent further physician-related delays before and after the diagnosis of breast cancer is established to maximize the survival of these young women who are in the most productive time of their life," the authors said.

In an invited critique, Leigh Neumayer, MD, of University of Utah in Salt Lake City, noted that patients who received chemotherapy were not found to have an independent association between treatment delay and survival.

Commenting about the need for timely and appropriate treatment, Jennifer Litton, MD, of the University of Texas MD Anderson Cancer Center, said in an interview: "A lot of things have changed as far as treating young women with breast cancer during these years, such as using tamoxifen, such as using the anti-HER2 agent trastuzumab [Herceptin] ... It's been a real game-changer for a lot of women with HER2 over-expressed cancers."

News Source: www.medpagetoday.com

Eggs, Too, May Provoke Bacteria to Raise Heart Risk

For the second time in a matter of weeks, a group of researchers reported a link between the food people eat and bacteria in the intestines that can increase the risk of heart attacks.

Two weeks ago, the investigators reported that carnitine, a compound found in red meat, can increase heart disease risk because of the actions of intestinal bacteria. This time they reported that the same thing happens with lecithin, which is abundant in egg yolks.

The lecithin study, published Wednesday in The New England Journal of Medicine, is part of a growing appreciation of the role the body’s bacteria play in health and disease. With heart disease, investigators have long focused on the role of diet and heart disease, but expanding the scrutiny to bacteria adds a new dimension.

“Heart disease perhaps involves microbes in our gut,” said the study’s lead researcher, Dr. Stanley Hazen, chairman of the department of cellular and molecular medicine at the Cleveland Clinic Lerner Research Institute.

In the case of eggs, the chain of events starts when the body digests lecithin, breaking it into its constituent parts, including the chemical choline. Intestinal bacteria metabolize choline and release a substance that the liver converts to a chemical known as TMAO, for trimethylamine N-oxide. High levels of TMAO in the blood are linked to increased risk of heart attack and stroke.

To show the effect of eggs on TMAO, Dr. Hazen asked volunteers to eat two hard-boiled eggs. They ended up with more TMAO in their blood. But if they first took an antibiotic to wipe out intestinal bacteria, eggs did not have that effect.

To see the effects of TMAO on cardiovascular risk, the investigators studied 4,000 people who had been seen at the Cleveland Clinic. The more TMAO in their blood, the more likely they were to have a heart attack or stroke in the ensuing three years.

Carnitine — the red meat chemical — and lecithin are chemically related, Dr. Hazen said. As with lecithin, when carnitine is digested, choline is released and can be acted on by intestinal bacteria.

The results of the new studies, though, do not directly prove that reducing TMAO protects against heart disease. That would require large studies following people who lowered their TMAO levels, which should be possible with a vegetarian or high-fiber diet.

Dr. Hazen said that people who are worried about heart attacks may want to consider reducing lecithin and choline in their diet, which would require eating less of foods high in fat and cholesterol. Dr. Hazen said it also may be wise to avoid supplements or vitamins with added choline.

In an accompanying editorial, Dr. Joseph Loscalzo of Brigham and Women’s Hospital in Boston suggested that in the future there may be other ways to reduce blood levels of TMAO. People might take probiotics to help grow bacteria that do not lead to an increase in TMAO. Or perhaps drugs could squelch the synthesis of TMAO. Those probiotics and drugs, though, do not yet exist, and even the specific bacteria responsible for the increase in TMAO are not yet identified.

News Source: www.nytimes.com

Diabetes warning over soft drinks

Drinking one or more cans of sugary soft drinks a day is linked to an increased risk of diabetes in later life, a study suggests.

A can a day raises the relative risk of diabetes by about a fifth, compared with one can a month or under, say European scientists.

The report in the journal Diabetologia mirrors previous US findings.

A diabetes charity recommends limiting sugary foods and drinks as they are calorific and can cause weight gain.

The latest research was carried out in the UK, Germany, Denmark, Italy, Spain, Sweden, France and the Netherlands.

Some 350,000 individuals were questioned about their diet, as part of a large European study looking at links between diet and cancer.

"The consumption of sugar sweetened soft drinks increases your risk of diabetes - so for every can of soft drinks that you drink per day, the risk is higher," lead researcher Dora Romaguera from Imperial College London told BBC News.

She called for clearer public health information on the effects of sugary soft drinks.

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“Start Quote

In and of themselves, sugary soft drinks are only part of the picture - they're just one of the potential risk factors for Type-2 diabetes”

Professor Patrick WolfeUniversity College London

• Living with type 1 diabetes

"Given the increase in sweet beverage consumption in Europe, clear messages on its deleterious effect on health should be given to the population," Dr Romaguera and colleagues conclude in their research paper.

'Not definitive evidence'

An increased risk of diabetes was also linked to drinking artificially sweetened soft drinks, but this disappeared when body mass index was taken into account.

Fruit juice consumption was not associated with diabetes incidence, however.

Commenting on the results, Dr Matthew Hobbs, head of research at Diabetes UK, said the link between sugar-sweetened soft drinks and Type-2 diabetes persisted even when body mass index was taken into account.

This suggests the increased risk is not solely due to extra calories, he said.

"Even so, it is not definitive evidence that sugar-sweetened soft drinks increase the risk of Type 2 diabetes, other than through their effect on body weight," he added.

"We do, though, already recommend limiting consumption of sugary foods and drinks as these are usually high in calories and so can lead to weight gain if you have too many of them.

"This is important for Type 2 diabetes because we know that maintaining a healthy weight is the single most important thing you can do to prevent it."

Statistics expert Professor Patrick Wolfe, from University College London, said the absolute risk of Type-2 diabetes is low at about 4% of the adult UK population.

"In and of themselves, sugary soft drinks are only part of the picture - they're just one of the potential risk factors for Type-2 diabetes," he said.

"But since they are one we can easily eliminate - by switching to diet soft drinks or, even better, cutting them out of our diets altogether - it makes good sense to do so."

News Source: www.bbc.co.uk

Child without bones begins to develop skeletal frame thanks to enzyme therapy

Janelly has one of the most severe forms of hypophosphatasia (HPP), a inherited disorder that affects 1 out of every 100,000 babies. Although the disease is genetically linked, Janelly is the first in her family to have the disorder.

All people are born with a skeletal structure. Throughout our lives, our bones undergo a process of constant turnover and calcification, which occurs when the body collects calcium salts inside our tissues, resulting in creation of new bone.

In patients with HPP, they lack an enzyme called alkaline phosphatase. This causes their bones to be fragile and break down easily. On top of this, they have a problem with the calcification process, which in Martinez-Amador case caused her bones to "disappear" to the point where her ribs were not visible on an X-ray.

"She felt sort of like rubber," Dr. Jill Simmons, a pediatric endocrinologist at Vanderbilt University in Nashville, Tenn. who treated Martinez-Amador, described to CBSNews.com. "She had a very rubbery consistency. If you moved her arm, it would move in any direction you wanted. She was very soft and squishy, for lack of a better term."

Because Janelly had no bones, she couldn't move at all on her own. Her head remained soft because she did not develop a skull, putting her at immediate risk for brain injuries. She couldn't hold herself up.

"Imagine your child laying all the time in bed, not being able to lift herself, not being able to move herself, making sure she is not falling or tripping on things," her father, Salvadore Martinez, said in a press release through a Spanish interpreter.

"She couldn't reach for things," Simmons added. "She couldn't even move her body against gravity. She couldn't lift her arms to play with a mobile above her head even if she was interested."

One of the most pressing problems that Janelly faced was that she had no rib cage, and that prevented her lungs from expanding. Typically, more than half of the children with disease die before their first birthday, with the majority passing away by the time they reach age 5 due to respiratory problems and infections. Martinez-Amador spent two years of her life in the hospital, mostly in the ICU. Due to the fact that she was constantly on a ventilator, she easily developed infections because her airways were always open. If she had a cold, it would quickly develop into pneumonia.

Doctors enrolled the girl in a clinical trial to receive enzyme-replacement drug therapy called asfotase alfa. She was one of 11 children enrolled in the study. Martinez-Amador had a port surgically inserted into her abdomen so she could receive the medication, according to The Tennessean.

Doctors feared that because Janelly had the worst form of the disease out of all the trial participants, she would not benefit from the treatment. But, slowly, she began to move her limbs, started moving towards things she was interested in and began to roll over, Simmons said. Eighteen months into therapy, doctors began to see a rib cage on her X-rays.

"She had absolutely no calcification," Simmons said. "Now, she has a skeleton that is becoming more and more normal in appearance, and becoming more and more calcified. The bones came back right place and at the weight they are supposed to be, and they are thicker and stronger."

Now, The Tennessean reports that Janelly has also started to dance. She has had the port removed from her abdomen and receives the enzyme treatment through three shots each week.

Because the girl was on her back for five years of her life unable to move, and she was older than age 2 when she began to receive the therapy, Simmons explained that Janelly's cognitive development has been delayed. She has recently begun to communicate non-verbally. Simmons hopes that because other children with the disorder who were given the enzyme therapy at earlier ages were shown to reach normal cognitive development, Janelly may catch up to her age.

"It's wonderful that you had the faith that a treatment might come along. For many years, it seemed there was nothing that was very helpful for this disorder," study lead investigator Dr. Michael Whyte, medical-science director of the Center for Metabolic Bone Disease and Molecular Research at Shriner Hospitals for Children in St. Louis, said in a press release. "We were fearful that her bone disease was so terribly severe that it might not work. But by looking at the X-rays and hearing about her visits, we were thrilled to hear about her progress."

News Source: www.cbsnews.com

How Much Exercise Will It Take to Work Off a Burger? Menus May Soon Tell You

More restaurants display calorie counts on their menus, but what if they also informed you what it would take to burn off those calories?

It’s one thing to know how many calories are packed into a meal you’re about to eat, and quite another to fully appreciate what your body does with them. That’s been clear since cities like New York mandated calorie counts on fast food and restaurant menus so consumers would have a better idea of what they were eating. Despite the added information, studies haven’t shown that the counts led people to eat less. In fact, some surveys found they prompted people to order more food. So caloric information, it seems, doesn’t  have much impact on eating behavior.

Better strategies are clearly needed, so researchers Dr. Meena Shah and Ashlei James from Texas Christian University tried another approach — replacing the calorie counts with the number of minutes of brisk walking a person would need to complete to burn off what they just ate.

(MORE: Do Calorie Counts on Menus Curb Eating? Not So Much)

The researchers chose brisk walking since it’s a physical activity most people can do, and can easily fit into their day, as opposed to running or jogging. “We did the study specifically in younger adults. The reason why we chose young adults is because they exercise more than older adults and we felt that they would relate to it more than older adults,” says Shah.

The scientists recruited 300 men and women ages 18 to 30 and randomly assigned them to order lunch from one of three menus: one that was calorie-free, one that included calorie counts and another labeled with the minutes of walking needed to burn the calories in the food. All the menus had the same food offerings, including burgers, chicken sandwiches, chicken tenders, salad, fries, desserts, soda and water.

The participants who were provided the walking information ordered and consumed fewer calories compared to those who ordered off the menu without calorie labels. However, as with some previous studies, there was no difference in the calories consumed between those who ordered off the menu with calorie count labels and those who were not provided with calorie information.

(MORE: Are Calorie Counts on Menus Accurate? Not So Much)

The findings suggest that putting caloric information in context may help consumers to better appreciate how much they are eating. And while the study focused on participants under age 30, the researchers say the results could have implications for changing eating habits for all adults. “It could take anywhere from one to two hours of moderate exercise such as brisk walking to burn the calories in some of the energy-dense foods. This may then help them make more appropriate food choices,” says Shah. The more information people have, he says, the more informed their food choices might be; there’s nothing like the prospect of more exercise to help fight the urge to eat.

News Source: http://healthland.time.com

More Cancers than Expected in WTC Responders

Incidence rates of all cancers -- and some in particular -- were higher among World Trade Center rescue workers than expected, researchers reported.

In an ongoing registry study, incidence rates of all cancers combined were 15% higher than expected (Standardized Incidence Ratio [SIR]: 1.15, 95% CI 1.06 to 1.25), Samara Solan, MD, of the Icahn School of Medicine at Mount Sinai Medical Center in New York, and colleagues reported in Environmental Health Perspectives.

Incidence rates were also higher for thyroid, prostate, hematopoietic/lymphoid, and soft-tissue cancers, they found.

Solan acknowledged in a statement that the "findings of this study, while significant, should be interpreted with caution given the short follow-up and long latency period for most cancers; the intensive medical surveillance of this cohort by Mount Sinai researchers and our partners; and the small numbers of cancers at specific sites.

"However," she added, "our findings strongly highlight the need for continued follow-up and medical surveillance of WTC responders."

Solan and her colleagues analyzed data from their ongoing WTC Health Program, which has enrolled 20,984 workers who were involved in rescue efforts on and after Sept. 11. Overall, 575 cancers were diagnosed in 552 patients.

They found increases in incidence rates for several types of cancers that were higher than expectations:

All cancer sites combined SIR 1.15, 95% CI 1.06 to 1.25
Thyroid cancer: SIR 2.39, 95% CI 1.70 to 3.27
Prostate cancer: SIR 1.21, 95% CI 1.01 to 1.44
Combined hematopoietic and lymphoid cancers: SIR 1.36, 95% CI 1.07 to 1.71
Soft tissue cancers: SIR 2.26, 95% CI 1.13 to 4.05
They also saw positive associations for non-Hodgkin lymphoma and kidney cancer, but those weren't significant.

When the study was restricted to the 302 cancers diagnosed 6 or more months after enrollment, the incidence rates for all cancers combined and for hematopoietic/lymphoid cancers became nonsignificant, falling to SIR 1.06 (95% CI 0.94 to 1.18) and to SIR 0.77 (95% CI 0.49 to 1.16), respectively.

But thyroid and prostate cancer diagnoses still remained greater than expected, they wrote.

Lung cancer incidence rates were significantly lower than expected in both the initial and restricted analyses (SIR 0.89 and SIR 0.62, respectively), but it's not clear why this may be.

The researchers cautioned that the observation about thyroid cancer may be an artifact due to increased medical surveillance, particularly because there was no evidence of Iodine-131 -- which has a strong causal link to thyroid cancer -- at Ground Zero.

The case may be similar for prostate cancer, since patients may have been subject to more PSA screening as a result of more frequent medical care.

Solan and colleagues also found that the relative risk of all cancers combined was higher in those who had very high exposure to the rescue scene than in those with low exposure, but the finding was not significant (RR 1.40, 95% CI 0.70 to 2.76).

Risk was also higher for those directly exposed to the dust cloud (RR 1.13, 95% CI 0.79 to 1.61) and for those who experienced significant amounts of dust (RR 1.23, 95% CI 0.85 to 1.76), but again, those findings did not reach significance.

The findings are similar to those of other studies that have found a higher risk of cancer among World Trade Center rescue workers, but, the researchers noted, their findings differ from previous work because they are the first to look at varying levels of exposure.

The short follow-up time, they noted, is a major limitation of the study, since most occupational cancers become manifest at least a decade after the exposure. It was also limited because the WTC Health Program is a voluntary program, which raises the possibility of self-selection bias.

Still, they concluded that the findings highlight the need for prolonged follow up of these workers to assess their risks of cancer and other chronic diseases.

News Source: www.medpagetoday.com

NHS medical director: cosmetic industry needs tougher regulation

Following a report recommending tighter regulation in the cosmetic surgery industry, NHS Medical Director Sir Bruce Keogh says a patient undergoing implants or fillers has no more protective "regulation than a toothbrush or ballpoint pen".
Anti-wrinkle treatments are a “crisis waiting to happen” and should be available on a prescription-only basis, a wide-reaching report on the cosmetic surgery industry has said.
It warned that dermal fillers, which are injected to plump up lips and skin, were “no more controlled than floor cleaners”.
The review, led by Sir Bruce Keogh, the NHS medical director, called for a host of recommendations to become enshrined into law in order to regulate the industry and protect patients undergoing cosmetic procedures from face lifts to laser hair removal.
"If you have a buttock implant, a calf implant or fillers, you have no more regulation of that than you have around a toothbrush or a ballpoint pen," Sir Bruce said.
The report was requested by Andrew Lansley, the former health secretary, following the scandal in which 50,000 British women were given faulty breast implants. The PIP implants, made in France, were passed by European regulators but the filling was then switched from medical grade silicone to industrial filler normally used in mattresses.
The committee recommended that all cosmetic procedures, from breast implants to laser hair removal should be carried out solely by medical practitioners who appear on a newly formed central register, to which access is only gained with appropriate training and specific qualifications. Those not on the register should not be able to get insurance, it said.
There was also a call for an ombudsman to be appointed to assist private patients who receive inadequate care.
The committee said that aggressive marketing techniques and incentives such as two-for-one and time-limited deals should be banned.

News Source: www.telegraph.co.uk

Poisoned bread 'gift' puts 25 Germans in hospital

The emergency services were called
after an employee noticed a suspicious substance on the sandwiches

Twenty-five people are in hospital in Germany after eating bread rolls laced with rat poison, which were left at their firm as "a gift", police say.

The workers at a plastics company in Lower Saxony helped themselves to the food, left in a box with a note.

Tests carried out on the bread overnight at a Berlin laboratory confirmed the presence of rat poison.

Police said the 25 were under observation but so far no-one had shown symptoms of poisoning.

"We don't believe the amount of poison used would have been deadly, but it could have caused serious illness," police spokesman Frank Soika was quoted by the Associated Press as saying.

The victims are being monitored as medical staff were unsure how long it would take for the poison to work, according to local media.

The employees had begun eating the rolls when someone noticed an unusual substance on them and called the emergency services.

The leftover rolls were flown by helicopter to a specialist laboratory in Berlin for testing.

The identity of the perpetrator and the motive remain unclear.

News Source: www.bbc.co.uk

Colic in infants may be early sign of migraine headache

(Photo: Tatjana Alvegard, Getty Images)

Colic has long been believed to be gastrointestinal pain in babies, say doctors, but new research suggests it may actually be related to migraine headaches instead.

Could colic — bouts of frequent, inconsolable crying during an infant's first months of life — be an early symptom of a migraine? A study out today is the latest to suggest that the two common pain conditions may be connected.

According to the study in the Journal of the American Medical Association, children diagnosed with migraine headaches were more likely to have experienced colic as infants (72.6%) than those who did not have migraine (26.5%).

And the increased odds existed for the two major migraine subtypes, as well: migraines preceded or accompanied by an "aura" — sensory warning symptoms such as flashes of light or blind spots (69.7%) and migraine without aura (73.9%). This association was not found for children with tension-type headaches (35%).

Researchers analyzed health records and questionnaires completed by parents for 208 children ages 6 to 18 who were diagnosed as having migraines and compared them with information on 471 kids and teens who were not. A comparison group of 120 children diagnosed with tension headaches also was studied.

A study published last year found that mothers who suffer from migraines are more than twice as likely to have babies with colic than mothers without a history of migraines.

Often thought of as a disorder of adulthood, migraine is "one of the most common causes of primary headaches in children," according to the article, written by Silvia Romanello of the APHP-Hospital Robert Debré, Paris, and colleagues.

An accompanying editorial notes that the prevalence of migraine headache by age groups is 1% to 3% from ages 3 to 7; 4% to 11% from ages 7 to 11; and 8% to 23% from ages 11 to 15 years old. Colic occurs in about 16% to 20% of infants.

Much more than a headache, a migraine is a "brain condition that can produce a variety of neurological symptoms," ranging from nausea and vomiting to sensitivity to light, sound, touch and smell, to dizziness and extreme fatigue, says Andrew Charles, a professor of neurology and director of the Headache Research and Treatment Program at UCLA School of Medicine. He was not involved in the new study.

"We've assumed for some time that colic was a gastrointestinal phenomenon, but in fact, that may not necessarily be true," says Charles. "That's one of the things that may surprise people about this study. It points out the possibility that this may be more of a brain issue than a gut issue."

Brain chemicals that are also shared by the gastrointestinal tract may be involved, but the actual mechanism at work "remains quite a mystery," he says.

News Source: www.usatoday.com

Fame may 'lead to a shorter life'

Having a glittering career in the public eye may come at the cost of a shorter life, an analysis of obituaries in a US newspaper suggests.
It showed performers and sports stars tended to die a few years younger than people successful in other careers.

The researchers acknowledge the study does not provide any conclusive answers, but said it asked interesting questions about the cost of fame.

The data was published in QJM: An International Journal of Medicine.

Researchers in Australia looked at 1,000 obituaries in the New York Times between 2009 and 2011.

They showed that performers, such as actors, singers and musicians, as well those who made a career in sport died the youngest - at an average age of 77.

Writers, composers and artists died at 79. Those classed as academics, including historians and economists, survived until 82 on average while those in business or politics made 83.

The researchers, at the University of Queensland and the University of New South Wales, said cancer, particularly tumours in the lungs, was more common in performers.

Costly
Professor Richard Epstein said: "A one-off retrospective analysis like this can't prove anything, but it raises some interesting questions.

Continue reading the main story
“
Start Quote

They may be paying a high price for their career”

Honey Langcaster-James
Psychologist
"First, if it is true that successful performers and sports players tend to enjoy shorter lives, does this imply that fame at younger ages predisposes to poor health behaviours in later life after success has faded?

"Or that psychological and family pressures favouring unusually high public achievement lead to self-destructive tendencies throughout life?

"Or that risk-taking personality traits maximise one's chances of success, with the use of cigarettes, alcohol or illicit drugs improving one's performance output in the short term?"

He added that, whatever the reason, the findings should be considered as a "health warning to young people aspiring to become stars".

Honey Langcaster-James, a psychologist who specialises in celebrity behaviour, said so few people achieved star status that it made it difficult to scientifically study the effect on people's lives.

She said: "The results are interesting of themselves as they suggest an inherent hazard of a public career and that all that glitters is not necessarily gold.

"They may be paying a high price for their career."

However she said it was not easy to come up with a scientific explanation.

On the one hand she said such a career "has unique stressors" such as "the pressure to live up to a public image, which can lead to risky behaviours".

Yet she suspected that "particular personal characteristics predispose people to wanting a career in the public arena", which may also lead to lifestyle choices affecting health.

News Source: www.bbc.co.uk

Fish oil can prevent very premature births: study

Very premature births can be prevented by taking oily fish supplements, a new study by an Australian scientist has claimed.

The new findings have been made by Maria Makrides, a professor at the University of Adelaide, while studying the effect of omega 3 supplements on post-natal depression and neuro-development in young children, according to an AAP report today.

Fish oil supplements in pregnancy do not prevent post-natal depression. Neither do they aid development in children. They do, however, prevent "very early pre-term" birth,' the report said.

Very early pre-term has been defined as a birth before 34 weeks of gestation while normal full-term pregnancy lasts from 37 to 40 weeks.

The study involved 2,400 women at five Australian maternity hospitals and has been used to support international research on premature birth. The research indicated omega-3 fatty acid supplements made pregnancy last longer, allowing more growth and development time for the baby.

Long-chain omega-3 fatty acids are found naturally in oily fish such as tuna and salmon. Susan Carlson, a professor at the University of Kansas, who reviewed the outcomes of Makrides' study said women who took the supplements tended t have slightly larger and heavier babies and gave birth some days later than the placebo group.

"So we have intriguing new evidence that long-chain omega-3 fatty acid supplementation does reduce the prevalence of very premature birth", Carlson said. Makrides said the finding is important because most pre-term births occur spontaneously without an obvious cause.

She is undertaking a second specific trial, which she hopes will enable health professionals to recommend omega-3 fatty acids as a way to prevent preterm birth.

News Source: www.indianexpress.com

Scientists make 'laboratory-grown' kidney

A kidney "grown" in the laboratory has been transplanted into animals where it started to produce urine, US scientists say.

Similar techniques to make simple body parts have already been used in patients, but the kidney is one of the most complicated organs made so far.

A study, in the journal Nature Medicine, showed the engineered kidneys were less effective than natural ones.

But regenerative medicine researchers said the field had huge promise.

Kidneys filter the blood to remove waste and excess water. They are also the most in-demand organ for transplant, with long waiting lists.

The researchers' vision is to take an old kidney and strip it of all its old cells to leave a honeycomb-like scaffold. The kidney would then be rebuilt with cells taken from the patient.

This would have two major advantages over current organ transplants.

The tissue would match the patient, so they would not need a lifetime of drugs to suppress the immune system to prevent rejection.

It would also vastly increase the number of organs available for transplant. Most organs which are offered are rejected, but they could be used as templates for new ones.

Scaffolding
Researchers at Massachusetts General Hospital have taken the first steps towards creating usable engineered kidneys.

They took a rat kidney and used a detergent to wash away the old cells.

The remaining web of proteins, or scaffold, looks just like a kidney, including an intricate network of blood vessels and drainage pipes.

Continue reading the main story
Analysis

James Gallagher
Health and science reporter, BBC News
Grow-your-own organs might seem like a fantasy, but there are people walking around today with organs made in this way.

A major breakthrough came in 2006 when bladders made from patients' own cells were implanted.

Grown windpipes have also been transplanted.

In regenerative medicine there are four levels of complexity: flat structures such as skin; tubes such as blood vessels; hollow organs such as the bladder; and solid organs such as the kidney, heart and liver.

The last group is the most difficult as they are complex organs containing many types of tissue.

However, there have been early glimmers of success.

Beating rat hearts have been produced, and grown lungs have been able to keep rats alive, if only for a short time.

Growing solid organs is still in its infancy, but these animal studies provide an interesting window on what could be the future of organ transplants.

Will we ever grow replacement hands?
This protein plumbing was used to pump the right cells to the right part of the kidney, where they joined with the scaffold to rebuild the organ.

It was kept in a special oven to mimic the conditions in a rat's body for the next 12 days.

When the kidneys were tested in the laboratory, urine production reached 23% of natural ones.

The team then tried transplanting an organ into a rat. Once inside the body, the kidney's effectiveness fell to 5%.

Yet the lead researcher, Dr Harald Ott, told the BBC that restoring a small fraction of normal function could be enough: "If you're on haemodialysis then kidney function of 10% to 15% would already make you independent of haemodialysis. It's not that we have to go all the way."

He said the potential was huge: "If you think about the United States alone, there's 100,000 patients currently waiting for kidney transplants and there's only around 18,000 transplants done a year.

"I think the potential clinical impact of a successful treatment would be enormous."

'Really impressive'
There is a huge amount of further research that would be needed before this is even considered in people.

The technique needs to be more efficient so a greater level of kidney function is restored. Researchers also need to prove that the kidney will continue to function for a long time.

There will also be challenges with the sheer size of a human kidney. It is harder to get the cells in the right place in a larger organ.

Prof Martin Birchall, a surgeon at University College London, has been involved in windpipe transplants produced from scaffolds.

He said: "It's extremely interesting. It is really impressive.

"They've addressed some of the main technical barriers to making it possible to use regenerative medicine to address a really important medical need."

He said that being able to do this for people needing an organ transplant could revolutionise medicine: "It's almost the nirvana of regenerative medicine, certainly from a surgical point of view, that you could meet the biggest need for transplant organs in the world - the kidney."

News Source: www.bbc.co.uk

'Bed-of-needles' super-grip plaster for surgical wounds

US scientists have designed a super-grip plaster covered with microscopic needles to heal surgical wounds.
The "bed-of-needles" patch, inspired by a parasitic worm that lives in the guts of fish and clings on using its cactus-like spikes, fixes skin grafts firmly in place without the need for staples.

Its creators say the patch is three times stronger than the materials currently used for burns patients.

Tests in animals have been a success, Nature Communications journal reports.

The Boston team, based at Brigham and Women's Hospital, says the four-sq-cm (0.6-sq-in) patch could also deliver therapeutic drugs via its tiny needles.

Wet wounds

The parasite has spines that swell when wet
Most self-adhesive bandages stick poorly to wet skin. Staples and stitches can help anchor dressings and skin grafts but inevitably cause some trauma to the tissue.

To get round this problem, Dr Jeffrey Karp and his team looked to nature in the form of a parasitic worm called Pomphorhynchus laevis.

The parasite anchors itself to the slippery surface of the host intestine using micro-needle tips that pierce the surface and then, once wet, swell to lock tight.

This means the needles cause little damage as they go in, yet achieve maximum grip.

Dr Karp's patch mimics this action using minute needles made of plastic with tips that are rigid when dry but swell once they have pierced wet tissue.

Dr Karp said: "The unique design allows the needles to stick to soft tissues with minimal damage to the tissues.


"Moreover, when it comes time to remove the adhesive, compared to staples, there is less trauma inflicted to the tissues, blood and nerves, as well as a reduced risk of infection."

News Source: www.bbc.co.uk

Lotus Birth trend keeps umbilical cord and placenta attached to baby for days

Think caring for a newborn is hard? Try a newborn that's still attached to its placenta!
The all-natural trend, called Lotus Birth or umbilical nonseverance, calls for a mother to allow the umbilican border to detach from her baby naturally, The New York Post reported.
In practical terms, that means carting around a blob of red matter (aka the placenta) that can stayed plugged into the baby's tummy for up to 10 days.
Related: New trend: Moms saving breast milk in jewelry
Mary Ceallaigh, a Lotus Birth advocate and midwife educator, talks with The Post about the benefits to the non-traditional practice and how it can help with the mother and baby's health. The 47-year-old Austin, Texas native, who's helped in more than 100 natural births, says keeping the umbilical cord intact is actually a beautiful thing.
Q: What made you start believing in the importance of the Lotus Birth?
I first learned of Umbilical Nonseverance from Jeannine Parvati, an expert on prenatal yoga. She taught me there are natural and safe ways for mothers to give birth.
Q: What are the best reasons to practice Lotus Birth?
There’s no wound created at the umbilical site, which lessens the chance of infection.
It allows a complete transfer of placental/cord blood into the baby at a time when the baby needs that nourishment the most. Babies’ immune systems are going through huge changes at a very rapid rate when they’re first born. Not disrupting the baby’s blood volume at that time helps prevent future disease.
The mother and baby benefit from having all the focused placed on bonding, rather than the common focus of "who's going to cut the cord, cut the bond?" Invading the natural process when there's a healthy mother and baby is likely to cause harm in some way seen or unseen.
Q: How often do you see patients practice Lotus Birth ?
About five percent of the clients I’ve worked with have practiced Lotus Birth.
Q: How do you eat meals, go to the restroom or run errands with a placenta attached to your newborn?
The cord usually dries and breaks off by the third day, so no mother would be running errands during that time anyway...hopefully not until at least the fourth week after giving birth!
In humid conditions, however, it may take up to 10 days for the cord to break, particularly in areas like Bali or the Australian rainforest. In these cases, the early weeks after giving birth is even more low key for the mother - and that can be a good thing....
While the placenta remains attached, it’s kept in a nice cloth, and the cord is wrapped in silk or cotton ribbon. Babies are left on a safe surface or with a caregiver while the mother goes to the restroom. For cuddling and nursing, the placenta pillow is kept near the mother and baby.
Q: Does the placenta start to smell after a while? How soon does it start to smell? What does it smell like?
If the placenta has air circulating around it like through cloth, there’s no odor for the first day. There’s a slight musky smell the second and third day.
After the cord breaks, some mothers like to keep the wrapped placenta in a special place in their bedroom, and if it has not had a salt or herbal treatment and its cloth isn’t changed, it will start to smell gamey, indeed. But the kind of terrible, stinky, decayed smell that some fear is a non-issue when proper procedures are followed. The only time that sort of thing happens is if the placenta is wrapped in a plastic wrap or sealed in a Tupperware container— that is a whole other situation, and not a good one, as the placenta will rot before it dries.

News Source: www.foxnews.com

Pay close attention to symptoms to determine if cause is sinus infection or allergies

DEAR MAYO CLINIC: I have long suffered from allergies. But there have been times when I haven't been sure if my symptoms are really from my allergies or may be caused by a sinus infection instead. How can I tell the difference?

ANSWER: Allergies and sinus infections are often mistaken for one another. But they are two separate conditions. By paying close attention to the specific symptoms you have, you can usually identify which one is more likely to be causing the problem.

A sinus infection, also called sinusitis, affects the cavities around your nasal passages. The infection causes your sinuses to become inflamed and swollen. The swelling makes it hard for your sinuses to drain, and mucus builds up. You become congested and have trouble breathing through your nose. Sinusitis often causes thick yellow or green nasal discharge. A sore throat, cough or headache, as well as pressure or tenderness around your eyes, cheeks, nose or forehead, may also accompany sinusitis.
In most cases, viruses cause sinusitis. These viral infections usually go away on their own within a week to 10 days. Self-care measures such as extra rest and fluids along with over-the-counter pain relievers and decongestants can help. When sinusitis is caused by bacteria, the infection may not require treatment, either. But if it is persistent or severe, then antibiotics -- such as amoxicillin, doxycycline and others -- may be used to treat the infection.

Allergies can produce many of the same cold-like symptoms as a sinus infection, including sinus pressure, a runny nose and congestion. But the condition itself, called allergic rhinitis, is different. It is caused by an allergic response to allergens, such as pollen, dust mites or pet dander. This reaction happens when your immune system releases chemicals, such as histamine, into your bloodstream. These immune system chemicals lead to your allergy symptoms.

One of the key ways to tell if you are experiencing allergic rhinitis is if you have itchy, watery eyes along with your other symptoms. Itchiness is rarely a symptom of a sinus infection. Another way to tell the difference is if you have very thick yellow or green nasal discharge. That's more likely a symptom of a sinus infection.

If you have seasonal allergies triggered by pollen or spores, then the timing of your symptoms may help you decide if they're likely caused by allergies. For example, tree pollen is most common in the spring. Grass pollen is common in late spring and early summer, while ragweed pollen is prevalent in the fall. Mold and fungi spores are usually more plentiful in warm-weather months. The seasons for these allergens may be different, though, depending on the region of the country where you live.

Over-the-counter medications, such as antihistamines, can be quite effective in relieving allergy symptoms. If you are regularly bothered by allergies, ask your doctor if a prescription nasal corticosteroid may be right for you. These nasal sprays help prevent and treat nasal inflammation and congestion, while antihistamines treat the itching and runny nose that allergies can cause.

Nasal corticosteroids can be particularly helpful if you have seasonal allergies and use them just as the allergy symptoms begin. That's because when the season first starts, you need a lot of the allergen to cause symptoms. But as symptoms progress, lower amounts of allergen produce more symptoms. By starting the medication early, you might be able to diminish this effect and reduce your symptoms throughout the entire allergy season.

News Source: articles.chicagotribune.com

Sounds during sleep can improve memory

For almost a century, scientists have known that sleep plays a critical role in the creation of long-term memories. What we experience during the day is processed and stored away in our brains as we sleep.

Now, German researchers say they have found a relatively simple way to boost memory formation by playing sounds at certain times during the sleep cycle. If they are right, the discovery could be a godsend to students cramming for exams or anyone who wants to improve their recall.
Previous studies have shown that memory consolidation occurs when brain waves are generating a slow oscillating rhythm, said one of the researchers, Jan Born of the University of Tubingen. The new study, published Thursday in the journal Neuron, reveals that if a person is exposed to an auditory stimulation that is in sync with this rhythm, the oscillations become amplified and last longer – and memory is improved.

For the study, the researchers recruited 11 healthy students who spent two nights at a sleep lab. On both occasions, the participants were asked to memorize a list of word associations (120 word pairs like brain/consciousness and solution/problem) before going to bed. Electrodes were attached to their scalps so their brain waves could be observed as they slept.

On one of the nights, the volunteers were exposed to auditory stimulation synchronized to their brain waves. On the other night, sleepers got sham stimulation that was out of phase with the brain’s slow oscillation rhythm.

“We saw the same effect in all subjects,” Born said. “Memory improved with auditory stimulation,” but not with the sham therapy. “And the effect was statistically very robust.”

Born said the stimulation works in the same way as a child’s swing set. “If you push the swing at the right phase, the swing will increase in amplitude,” he explained. “You don’t need to use a lot of energy. It’s all about the timing.”

In a similar fashion, the auditory stimulation was fairly subdued. It consisted of a series of low-volume bursts, each one lasting a fraction of a second. Only a few of the subjects had any recall of hearing something out of the ordinary during the night.

To get their timing right, the researchers closely monitored the data picked up by the scalp electrodes. “Slow oscillations occur in kind of a train of several oscillations succeeding one another,” he said. “When one slow oscillation was detected, it triggered the computer to deliver an auditory stimulus at exactly the time … the next one was expected.”

Several years ago, the German researchers carried out a similar experiment, but used electric current instead of sound. During that study, the electrical stimulation wasn’t co-coordinated with brain waves.

“The charm of the auditory approach, compared to electrical stimulation, is that it is less invasive and it is very easy to achieve the results. The brain itself is the pacesetter” for determining when to deliver the stimulus.

Although the study was conducted in a sleep lab and the participants had to wear bulky electrodes, Born believes it’s possible to create compact equipment suitable for use in a home. But the researchers have no plans to commercialize their discovery. “We are basic scientists,” said Born. “If someone wants to make money out of this, he should feel free to make such [home] devices.”

News Source: www.theglobeandmail.com

Pregnancy hope for world's first womb transplant woman

A Turkish housewife has become the first woman in the world to fall pregnant after undergoing a womb transplant.
Married Derya Sert, 22, conceived after undergoing IVF treatment in a world first that will bring hope to thousands of British women without uteri.
Mrs Sert has already made medical history once when she became the first woman to have a successful womb transplant in August 2011, receiving a new uterus from a dead donor.
Doctors waited 18 months to start fertility treatment and last week implanted an embryo – one of Mrs Sert’s eggs fertilised with her husband’s sperm – into her new womb.
Professor Mustafa Ünal, chief physician at Akdeniz University where the procedure was carried out, said: 'Two weeks after we implanted Mrs Sert with a fertilised embryo, test results are consistent with early pregnancy.
'The patient's health is good. We will continue to announce any further developments.'
that blood tests would reveal within days whether the embryo would lead to a pregnancy.
Before the news was announced, British doctors said that if the pregnancy was successful, it could mean similar transplants being carried out in the UK within a couple of years.
There are 15,000 women in Britain who were born without  a womb or who have had theirs removed for medical reasons.
Richard Smith, a consultant at Imperial College London, welcomed the news of the embryo implantation.
He has already trialled womb transplants on rabbits and will move on to human transplants if he is given ethical approval.
Mrs Sert, who is married to 35-year-old Mustafa, has said previously: ‘If I had  a magic wand, I would want to be pregnant now. I just want to hold my baby in my arms, to be a mother.’
Those in favour of womb transplants argue it is the only way to meet the desperate desire of many of these women to ‘carry’ their own baby.
This need cannot be met if they use another woman as a surrogate, a controversial process that is strictly regulated in the UK and illegal in some countries, including France and Germany.

News Source: www.dailymail.co.uk

Apple-shaped body type linked with kidney disease, study finds

Individuals who carry excess weight around their stomachs rather than their hips – commonly referred to as being “apple-shaped” – are more likely to have kidney disease, regardless of BMI, Medical News Today reported.
According to a new study from the Netherlands, apple-shaped people not only have poorer kidney function than their pear-shaped counterparts, but they also have lower blood flow and higher blood pressure in the kidneys.
Carrying excess fat around the mid-section has long been associated with poor kidney function, but scientists have not fully understood the underlying mechanisms of the link.
Arjan Kwakernaak, lead author of the study, and colleagues at the University Medical Center Groningen focused on an individual’s waist-to-hip ratio (WHR), which ultimately measures the amount of body fat carried around the mid-section.  They analyzed the WHRs of 315 healthy individuals with an average body mass index (BMI) of 24.9 kg/m2 – in relation to their kidney health.  A normal weight BMI is anywhere between 18.5 and 24.9 kg/m2.
Ultimately, those with higher WHRs had lower glomerular filtration rates (GFR) – the volume of fluid the kidneys are capable of filtering during a given period of time.  The relationship held true even for apple-shaped people, even though they were completely healthy and had normal BMIs.
"WHR was associated with lower GFR, lower effective renal plasma flow, and higher filtration fraction, even after adjustment for sex, age, mean arterial pressure, and BMI," the authors wrote.

News Source: www.foxnews.com

Study: Listening to Certain Sounds Seems to Improve Sleep

PROBLEM: Out at the fringes of sleep research, small studies have shown that applying a "gentle electric current" can ease the brain into deep sleep, improving sleep quality and increasing overnight memory retention. But the potential therapy has yet to gain popular appeal, probably because the whole sticking electrodes to your head thing just screams "don't try this at home." (There are, of course, companies that are trying to sell you on trying it at home, but you'll need to find upwards of $600 and a doctor willing to write you a note.)

METHODOLOGY: German researchers recruited 11 subjects to spend two nights in their sleep lab. During one night, as the participants approached deep sleep, the researchers played sounds ("pink noise") that were synchronized to their brain rhythms. As a control, no sounds were played the other night.

In addition, the participants were shown 120 pairs of words each night before going to be. First thing in the morning, they were tested to see how many of the pairs they remembered.

RESULTS: While it didn't cause them to experience more deep sleep cycles, the pink noise appeared to prolong deep sleep and to increase the size of the subject's brain waves during that period, as evinced by their EEGs.

The slow brain waves that characterize deep sleep are implicated in information processing and memory formation, and sure enough, on the mornings after those brain waves appeared to have been enhanced, the participants remembered a higher number of word pairs (an average of 22, as opposed to 13).

IMPLICATIONS: Sound stimulation has been tried before, unsuccessfully. The key here, write the researchers, is that the frequency of the sounds was in sync with the subjects' brain waves. Were this technique to be further developed, it could potentially be used to improve sleep in general, and possibly even to enhance brain activity when we're awake. Although it's even less viable, for now, than electric brain stimulation, the latter has been proposed as a way of treating Alzheimer's, fighting depression, easing pain, and the ever-popular "boosting creativity."

News Source: www.theatlantic.com

Study: We're Closer to Idenitfying the Genes That Cause Laziness

PROBLEM: Lab animals don't care about heart health or weight loss, I'm pretty sure. So what could it possibly be that motivates a caged rat to run rapidly nowhere on its wheel each night? And why is that some humans, who we at least try to make care about heart health and weight loss, are so much more willing to jump on the treadmill than others?
METHODOLOGY: Researchers at the University of Missouri took lab rats that spent the most time voluntarily running, and bred them with other highly active rats. They then did the same for the least active rodents. Eight generations later, they analyzed the behavior and physiology of the original rats' great-great-great-great-great-great grandchildren.
RESULTS: The rats had subtle differences in body composition and in the levels of mitochondria in their muscle cells. But those bred to be lazy chose to spend significantly less time on the wheel, ran shorter distances, and were generally slower. By the tenth generation, the active mice were running ten times as much as the lazy ones. And after six days of that, they had lost considerable body fat, while the others neither gained nor lost weight. The researchers narrowed down the discrepancy in motivation to 36 genes that appeared to be responsible.

IMPLICATIONS: The answer to promoting physical activity in humans probably isn't selective breeding, despite the best efforts of Fitness Singles ("where relationships workout!'). But if we can isolate the gene for laziness in humans, perhaps we can better understand how to motivate those for whom the urge to exercise isn't innate. Or we can at least be more understanding about their indifference toward the idea of a bicycle desk.

News Source: www.theatlantic.com

Living near traffic linked to increased cancer risk in children

Researchers have already uncovered worrying signs that exposure to traffic – and the vehicle emissions that come with it – can increase a child’s risk of developing asthma and autism. Now comes evidence that it may make children more susceptible to certain kinds of cancers.

Researchers used the California Department of Transportation’s computer model of traffic-related air pollution to estimate pollution exposure in communities across the state. They also used the California Cancer Registry to identify 3,590 children born between 1998 and 2007 who were diagnosed with some type of cancer. Then they compared the two to look for links between traffic and cancer incidence.

The researchers – from UCLA, USC and UC Irvine – ranked places in the state according to their degree of pollution resulting from traffic and sorted them into four groups, from the least exposure to the most. They discovered that the more pollution in a place, the higher the incidence of certain kinds of childhood cancers. These included acute lymphoblastic leukemia, a type of blood cancer in which the bone marrow overproduces a type of immature white blood cell called a lymphocyte; tumors in the ovaries, testicles and other reproductive organs; and retinoblastoma, an eye cancer that affects the retina and usually develops in children before they turn 5 years old.

In general, these cancers are rare and the increases in risk associated with traffic exposure were relatively small. For example, during the second trimester of pregnancy, moving from one group of pollution exposure to the next-higher group was associated with a 4% increased risk of acute lymphoblastic leukemia, a 17% increased risk of tumors in the reproductive organs (also known as germ cell tumors) and a 14% increased risk of retinoblastoma. (For cases involving both eyes, the risk increased by 19%.)

There were also signs that more exposure to traffic was associated with more cases of non-Hodgkin's lymphoma (another blood cancer) and ependymoma (a cancer of tissues in the brain and spinal cord), but those links could have been due to chance, the researchers reported.

Overall, the team found that any increases in cancer risk were the same during all three trimesters of pregnancy as well as for the first year of a child’s life. Put another way, there was no period in early development when children were particularly susceptible to the harmful effects of traffic-related pollution.

Team members also emphasized that their results were preliminary and that more studies were needed to nail down any link between traffic exposure and childhood cancers.

The results were presented Tuesday at the annual meeting of the American Assn. for Cancer Research in Washington.

News Source: www.latimes.com

British "test tube baby" pioneer Robert Edwards dies

(Reuters) - Robert Edwards, a British Nobel prize-winning scientist who pioneered the development of "test tube babies" conceived through in-vitro fertilization (IVF), died on Wednesday after a long illness, his university said.

Edwards, who won the Nobel prize for medicine in 2010, started work on fertilization in the 1950s, and the first so-called test tube baby, Louise Brown, was born in 1978 as a result of his pioneering research.

He founded the world's first IVF clinic in his home town of Cambridge, eastern England in 1980.

"It is with deep sadness that the family announces that Professor Sir Robert Edwards, Nobel prize winner, scientist and co-pioneer of IVF, passed away peacefully in his sleep," Cambridge University said in a statement.

It said he would be greatly missed by family, friends and colleagues, adding "his work has had an immense impact throughout the world".

News Source: www.reuters.com