(HealthDay News) -- Older adults should take additional precautions to preserve their health and safety during winter, according to the American Geriatric Society's Foundation for Health in Aging.
The foundation has released a checklist of safety steps seniors can take to avoid the ill effects of colder weather.
Hypothermia, frostbite, falls, injury while shoveling snow, carbon-monoxide poisoning and driving accidents are on the list of dangers to look out for.
The foundation reminds older adults to dress for the weather. As people age, metabolisms slow and produce less body heat, but older adults may still have a hard time determining whether they are feeling the chill, says the foundation. Wearing two or three layers of loose-fitting clothing, as well as a hat, mittens, a coat, boots and a scarf to provide cover for the face are among the group's suggestions.
Older adults should stay indoors when it's very cold outside, especially if it is windy and wet. The foundation recommends keeping the thermostat indoors set to at least 65 degrees Fahrenheit.
Hypothermia is a condition in which the core body temperature drops to unhealthy levels. It can be fatal. The warning signs of hypothermia include: lots of shivering; cold skin that is pale or ashy; feeling very tired, confused and sleepy; feeling weak; problems walking; slowed breathing or heart rate. Unfortunately, older people do not shiver as much as they used to, so it is best to look for other warning signs, according to foundation recommendations.
Frostbite may also result from exposure to cold weather. Nose, ears, cheeks, chin, fingers and toes are all at risk. Keep an eye out for skin that is turning red or darkening and beginning to hurt. That's a sign to go inside. When skin is already frostbitten, it is often white, ashy or yellowish and feels numb and waxy. Immediate help is needed.
Aging bones may be more at risk during the winter, when icy sidewalks increase the chance of slipping and falling. The foundation recommends seeking out dry areas to walk if possible, putting new rubber tips on any canes or walkers, and wearing boots with non-skid soles.
Older people may find themselves shoveling snow, but the foundation suggests checking in with a physician before the season starts. Shoveling is heavy work that can affect older hearts. Hiring someone to shovel the snow may be a healthier option.
Indoors, fires can create an undetectable hazard: carbon monoxide. The odorless gas can build up with fatal results, according to the foundation. Before the season starts, people should have their chimneys cleaned and checked out. Opening a window a crack for circulation is also helpful.
People who are relying on space heaters for warmth should keep them at least three feet from anything flammable, such as curtains and furniture. Make sure all smoke detectors and fire extinguishers are ready for use.
Finally, winterizing cars and stocking them for bad weather can help reduce the risk of accidents. Emergency supplies inside the car should include a first-aid kit, blankets, extra warm clothes, a windshield scraper, rock salt, a bag of sand or cat litter, a shovel, booster cables, a flashlight and some water and food. Above all, drive carefully and slowly, after checking the weather reports, the foundation says.
More information
To learn more about how to stay safe in cold weather, visit the U.S. Centers for Disease Control and Prevention.
Senin, 31 Desember 2007
Jumat, 28 Desember 2007
Brain Turns to Positive Thoughts When Faced With Death
(HealthDay News) -- When thoughts of death intrude, the human mind isn't paralyzed with negativity or fear. Instead, the brain instinctively moves toward happier notions and images, a new study suggests.
The finding supports the notion that people are stronger, emotionally, when faced with their own or a loved one's death than they may have ever thought possible.
"It again speaks to how resilient humans are and how this tendency to cope with threats is some sort of indicator of mental health," said study co-author Nathan DeWall, assistant professor of psychology at the University of Kentucky.
DeWall and co-researcher Roy Baumeister, of Florida State University, published their findings in a recent issue of Psychological Science.
Humans are the only animal known to have a clear understanding that their life will end. On the surface, this knowledge could prove psychologically paralyzing -- why compete, learn and grow if these achievements will end?
However, DeWall and other scientists believe that as humans developed an awareness of death, they also evolved what's been called the "psychological immune system."
During crisis, this mechanism tilts thoughts and attitudes toward the positive -- even when the grimmest of events intervene. This mental shift is typically unconscious, DeWall said.
"That's why, when you ask people to predict how they'll respond to something negative, they usually say, 'Oh, it will be horrible, and it will last a long time,' " he said. However, studies don't bear that out -- research involving people stricken with disease or disability show that people tend to bounce back emotionally much more rapidly than they would have expected.
In evolutionary terms, "how and when this came about, we don't know for sure," DeWall said. "I suspect that this capacity to cope with potentially disastrous events in a relatively easy way really did aid our survival."
In their latest experiments, DeWall and Baumeister first primed more than 100 healthy young adult volunteers to think about death as a reality. They asked them to imagine the process of their own death, as well as what it might be like to be dead.
Another group of young adults was asked to think about an unpleasant event -- a trip to the dentist's office -- but not death.
Immediately after the priming exercise, the researchers had all of the participants undergo standard word tests that tapped into unconscious emotional states. In one test, participants were give a word stem -- "jo-" for example and asked to complete it to form a word ( i.e., "job", "jog", "joy").
According to the researchers, individuals primed to think about death were much more likely than the other participants to choose the word "joy," compared to more neutral or negative words.
In another word test, the participants were offered a word and asked to pair it with one of two other words. One of the words was similar to the target word in its meaning, while the other word was more emotionally similar. For example, "puppy" might be paired with either "beetle" (another many-legged animal), or "parade" (not an animal, but fun, enjoyable, as puppies are).
Again, people primed to think about death were much more likely to choose "parade" over "beetle" compared to the other participants. This suggests they were unconsciously preferring the positive emotion embedded in that choice, the researchers said.
"People really don't know that they do this," DeWall said. "It's actually very counterintuitive. This picks up on the idea that when people are confronted with their own mortality, these sorts of concepts -- positive emotion words -- become readily accessible to them."
Another expert agreed that humans may be hardwired to "go to their happy place" when thoughts of death intrude.
"This is interesting work, because what it's really saying is that once you are primed with this idea that you're going to die, it sets off this automatic network," said Todd Kashdan, an expert in the psychology of positive emotions and an assistant professor of psychology at George Mason University, in Fairfax, Va.
The findings suggest that, in the face of death, "I'm going to grab onto something that I know I can hang on to. It's not going to be negative things, I can't really hold on to that," Kashdan said. "So, I'm going to focus on these positive things."
"These things are happening below the level of awareness," he added.
The new findings dovetail with much of the research on how people survive -- and even thrive -- after some of life's most difficult events. In fact, people's tendency to think sunny thoughts actually increases with age and with their proximity to the end of life, DeWall said.
"As people grow older, they become more focused on positive emotions," he said.
There's one exception to that rule, however: Clinically depressed individuals tend not to think positively when confronted with the idea of death, suggesting that their psychological immune system may have gone off-track, DeWall said.
In contrast, the minds of healthy, non-depressed people typically balance darker imaginings with more hopeful images, he said.
Kashdan stressed that the Kentucky experiments focused on the very short-term, however. Coping over the longer term may be much tougher, he said.
"What's going to happen to these people -- not over the next few minutes but rather the next two weeks, six months? Do they end up reorganizing or shifting their life projects? There's research to show that for some people, it does, and for some people, it doesn't," he said.
More information
For more on positive psychology, visit the University of Pennsylvania.
The finding supports the notion that people are stronger, emotionally, when faced with their own or a loved one's death than they may have ever thought possible.
"It again speaks to how resilient humans are and how this tendency to cope with threats is some sort of indicator of mental health," said study co-author Nathan DeWall, assistant professor of psychology at the University of Kentucky.
DeWall and co-researcher Roy Baumeister, of Florida State University, published their findings in a recent issue of Psychological Science.
Humans are the only animal known to have a clear understanding that their life will end. On the surface, this knowledge could prove psychologically paralyzing -- why compete, learn and grow if these achievements will end?
However, DeWall and other scientists believe that as humans developed an awareness of death, they also evolved what's been called the "psychological immune system."
During crisis, this mechanism tilts thoughts and attitudes toward the positive -- even when the grimmest of events intervene. This mental shift is typically unconscious, DeWall said.
"That's why, when you ask people to predict how they'll respond to something negative, they usually say, 'Oh, it will be horrible, and it will last a long time,' " he said. However, studies don't bear that out -- research involving people stricken with disease or disability show that people tend to bounce back emotionally much more rapidly than they would have expected.
In evolutionary terms, "how and when this came about, we don't know for sure," DeWall said. "I suspect that this capacity to cope with potentially disastrous events in a relatively easy way really did aid our survival."
In their latest experiments, DeWall and Baumeister first primed more than 100 healthy young adult volunteers to think about death as a reality. They asked them to imagine the process of their own death, as well as what it might be like to be dead.
Another group of young adults was asked to think about an unpleasant event -- a trip to the dentist's office -- but not death.
Immediately after the priming exercise, the researchers had all of the participants undergo standard word tests that tapped into unconscious emotional states. In one test, participants were give a word stem -- "jo-" for example and asked to complete it to form a word ( i.e., "job", "jog", "joy").
According to the researchers, individuals primed to think about death were much more likely than the other participants to choose the word "joy," compared to more neutral or negative words.
In another word test, the participants were offered a word and asked to pair it with one of two other words. One of the words was similar to the target word in its meaning, while the other word was more emotionally similar. For example, "puppy" might be paired with either "beetle" (another many-legged animal), or "parade" (not an animal, but fun, enjoyable, as puppies are).
Again, people primed to think about death were much more likely to choose "parade" over "beetle" compared to the other participants. This suggests they were unconsciously preferring the positive emotion embedded in that choice, the researchers said.
"People really don't know that they do this," DeWall said. "It's actually very counterintuitive. This picks up on the idea that when people are confronted with their own mortality, these sorts of concepts -- positive emotion words -- become readily accessible to them."
Another expert agreed that humans may be hardwired to "go to their happy place" when thoughts of death intrude.
"This is interesting work, because what it's really saying is that once you are primed with this idea that you're going to die, it sets off this automatic network," said Todd Kashdan, an expert in the psychology of positive emotions and an assistant professor of psychology at George Mason University, in Fairfax, Va.
The findings suggest that, in the face of death, "I'm going to grab onto something that I know I can hang on to. It's not going to be negative things, I can't really hold on to that," Kashdan said. "So, I'm going to focus on these positive things."
"These things are happening below the level of awareness," he added.
The new findings dovetail with much of the research on how people survive -- and even thrive -- after some of life's most difficult events. In fact, people's tendency to think sunny thoughts actually increases with age and with their proximity to the end of life, DeWall said.
"As people grow older, they become more focused on positive emotions," he said.
There's one exception to that rule, however: Clinically depressed individuals tend not to think positively when confronted with the idea of death, suggesting that their psychological immune system may have gone off-track, DeWall said.
In contrast, the minds of healthy, non-depressed people typically balance darker imaginings with more hopeful images, he said.
Kashdan stressed that the Kentucky experiments focused on the very short-term, however. Coping over the longer term may be much tougher, he said.
"What's going to happen to these people -- not over the next few minutes but rather the next two weeks, six months? Do they end up reorganizing or shifting their life projects? There's research to show that for some people, it does, and for some people, it doesn't," he said.
More information
For more on positive psychology, visit the University of Pennsylvania.
Selasa, 25 Desember 2007
Playing Catch in Winter Could Save Kids' Pitching Arms
(HealthDay News) -- Playing catch with your young pitcher months before baseball season can help prevent an increasingly common pediatric pitching pitfall: torn rotator cuff injuries, according to doctors at Methodist Hospital in Houston.
The data suggest that two factors - a high pitch count and throwing curve balls -- increases the risk of shoulder pain in young pitchers. Easing into baseball season by beginning practice in December may help reduce the risk of such shoulder injuries.
"Most high school athletes go from football to basketball and then start throwing a baseball at full speed," Dr. David Lintner, an orthopedic surgeon who serves as head team physician for the Houston Astros, said in a prepared statement. Lintner reported seeing more and more high school pitchers with torn rotator cuffs. "The problem is that their arms are not in baseball shape, and they open themselves up to serious rotator cuff problems."
The rotator cuff is a group of four muscles and their tendons that connect the shoulder blade to the upper arm bone. Pain and/or weakness in the shoulder as well as difficulty raising an arm over the head may signal damage to the rotator cuff, which in turn can lead to problems with the rest of the pitching arm.
"Pitchers should play catch, not pitch off the mound, for a few minutes every day beginning in December, and gradually increase throwing as it gets closer to the start of spring training," recommended Lintner.
Lintner also suggested that young pitchers start a weight-training program focusing on multiple repetitions of three- to five-pound weights, aiming for flexibility and strength, not bulk. Pitchers will also benefit from strengthening their upper body and legs, adding speed to their fastball but reducing stress on their arm, he said.
More information
To learn more about rotator cuff injuries, visit the U.S. National Library of Medicine.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
The data suggest that two factors - a high pitch count and throwing curve balls -- increases the risk of shoulder pain in young pitchers. Easing into baseball season by beginning practice in December may help reduce the risk of such shoulder injuries.
"Most high school athletes go from football to basketball and then start throwing a baseball at full speed," Dr. David Lintner, an orthopedic surgeon who serves as head team physician for the Houston Astros, said in a prepared statement. Lintner reported seeing more and more high school pitchers with torn rotator cuffs. "The problem is that their arms are not in baseball shape, and they open themselves up to serious rotator cuff problems."
The rotator cuff is a group of four muscles and their tendons that connect the shoulder blade to the upper arm bone. Pain and/or weakness in the shoulder as well as difficulty raising an arm over the head may signal damage to the rotator cuff, which in turn can lead to problems with the rest of the pitching arm.
"Pitchers should play catch, not pitch off the mound, for a few minutes every day beginning in December, and gradually increase throwing as it gets closer to the start of spring training," recommended Lintner.
Lintner also suggested that young pitchers start a weight-training program focusing on multiple repetitions of three- to five-pound weights, aiming for flexibility and strength, not bulk. Pitchers will also benefit from strengthening their upper body and legs, adding speed to their fastball but reducing stress on their arm, he said.
More information
To learn more about rotator cuff injuries, visit the U.S. National Library of Medicine.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
Jumat, 21 Desember 2007
Breast Cancer Surgeons Don't Discuss Reconstruction Options
(HealthDay News) -- Only a third of breast cancer patients get to discuss their breast reconstruction options with their general cancer surgeon before the tumor is removed, new research finds.
In the study, more than 70 percent of general surgeons who removed the cancer did not talk over options for reconstruction -- which is typically done by a plastic surgeon -- before the woman underwent cancer surgery.
"It's disappointing," said lead researcher Dr. Amy K. Alderman, assistant professor of plastic surgery at the University of Michigan Medical School, Ann Arbor.
These discussions do matter: Women who discussed their options for reconstructing the breast beforehand with their physician were four times more likely to have a mastectomy (versus lumpectomy) compared to those who did not talk about the option, the researchers noted.
Th findings were published online Dec. 21 in Cancer and were expected to be published in the journal's Feb. 1 print edition.
Alderman and others contend it's crucial for a woman to understand all surgical options, and that includes reconstruction, so they can better choose the best treatment for them. About 180,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society.
Long-term outcomes are equal, Alderman said, regardless of whether a woman is treated with lumpectomy or mastectomy. Knowing initially about the option to reconstruct definitely affects a woman's decision, as the study showed.
Alderman and her colleagues looked at almost 1,200 women, average age 59. The women were diagnosed with breast cancer and lived in the Detroit and Los Angeles areas. All were candidates for either mastectomy or breast-conserving surgery. They had all undergone breast cancer surgery and were contacted about three months after their diagnosis.
Alderman's team asked them: Did you discuss reconstruction with your surgeon before the cancer surgery?
Just one-third of patients did, with younger, more educated women more likely to hear about the options from their general surgeon. Those with larger tumors were also more likely to hear about reconstruction options.
The operation to reconstruct a breast can be done right after mastectomy, in which the entire breast is removed, or it can be delayed. Immediate reconstruction offers a better cosmetic outcome and is psychologically better, Alderman said.
"It's helpful if they know all their options at that initial decision-making process," Alderman said. "There's no right or wrong answer."
Women will choose their course, she said, based on a number of factors, including their fear of cancer recurrence, their body image, and other factors.
"What we need to get across to consumers is, they need to be educated consumers of their own health care," Alderman said. If the surgeon doesn't bring up the topic of reconstruction, a woman should, she said, and the sooner the better.
The study didn't delve into why the surgeons didn't talk about the reconstruction option or refer the women to plastic surgeons. But Alderman suspected the "hassle" factor may play a role. The general surgeon must make sure, she said, that the women get in to see the surgeon who will do the reconstruction in a timely manner. "And then the general surgeon and the plastic surgeon have to coordinate their operating room schedules," she said.
Women themselves may be so focused on eliminating the cancer that they don't even broach the topic of reconstruction, Alderman said.
Another expert agreed that the small number of surgeons who initially discussed the reconstruction option was surprising.
"It's very sad that that so few surgeons are sending women for reconstructive appointments," said Dr. Mehra Golshan, director of Breast Surgical Services at the Dana-Farber/Brigham and Women's Cancer Center, Boston, who reviewed the study.
An initial meeting with a surgeon who does reconstruction will provide a woman with information on all options, "even if they decide to do [reconstruction] down the road," he said.
Like Alderman, Golshan couldn't say for sure why such a low number of surgeons referred their breast cancer patients to plastic surgeons for reconstruction discussions, but he speculated on a few possible reasons. "They may think complication rates are too high with immediate reconstruction," he said.
In truth, Golshan said, complications can be higher with immediate reconstruction if post-mastectomy radiation is required. "But not always," he said. And, "when there is no post-mastectomy radiation, the complications rates are equal between immediate reconstruction and delayed."
It's also possible that surgeons may be so focused on cancer elimination that they may not think about referring the patients for reconstruction information, Golshan added.
More information
To learn more about breast reconstruction, visit the American Society of Plastic Surgeons.
In the study, more than 70 percent of general surgeons who removed the cancer did not talk over options for reconstruction -- which is typically done by a plastic surgeon -- before the woman underwent cancer surgery.
"It's disappointing," said lead researcher Dr. Amy K. Alderman, assistant professor of plastic surgery at the University of Michigan Medical School, Ann Arbor.
These discussions do matter: Women who discussed their options for reconstructing the breast beforehand with their physician were four times more likely to have a mastectomy (versus lumpectomy) compared to those who did not talk about the option, the researchers noted.
Th findings were published online Dec. 21 in Cancer and were expected to be published in the journal's Feb. 1 print edition.
Alderman and others contend it's crucial for a woman to understand all surgical options, and that includes reconstruction, so they can better choose the best treatment for them. About 180,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society.
Long-term outcomes are equal, Alderman said, regardless of whether a woman is treated with lumpectomy or mastectomy. Knowing initially about the option to reconstruct definitely affects a woman's decision, as the study showed.
Alderman and her colleagues looked at almost 1,200 women, average age 59. The women were diagnosed with breast cancer and lived in the Detroit and Los Angeles areas. All were candidates for either mastectomy or breast-conserving surgery. They had all undergone breast cancer surgery and were contacted about three months after their diagnosis.
Alderman's team asked them: Did you discuss reconstruction with your surgeon before the cancer surgery?
Just one-third of patients did, with younger, more educated women more likely to hear about the options from their general surgeon. Those with larger tumors were also more likely to hear about reconstruction options.
The operation to reconstruct a breast can be done right after mastectomy, in which the entire breast is removed, or it can be delayed. Immediate reconstruction offers a better cosmetic outcome and is psychologically better, Alderman said.
"It's helpful if they know all their options at that initial decision-making process," Alderman said. "There's no right or wrong answer."
Women will choose their course, she said, based on a number of factors, including their fear of cancer recurrence, their body image, and other factors.
"What we need to get across to consumers is, they need to be educated consumers of their own health care," Alderman said. If the surgeon doesn't bring up the topic of reconstruction, a woman should, she said, and the sooner the better.
The study didn't delve into why the surgeons didn't talk about the reconstruction option or refer the women to plastic surgeons. But Alderman suspected the "hassle" factor may play a role. The general surgeon must make sure, she said, that the women get in to see the surgeon who will do the reconstruction in a timely manner. "And then the general surgeon and the plastic surgeon have to coordinate their operating room schedules," she said.
Women themselves may be so focused on eliminating the cancer that they don't even broach the topic of reconstruction, Alderman said.
Another expert agreed that the small number of surgeons who initially discussed the reconstruction option was surprising.
"It's very sad that that so few surgeons are sending women for reconstructive appointments," said Dr. Mehra Golshan, director of Breast Surgical Services at the Dana-Farber/Brigham and Women's Cancer Center, Boston, who reviewed the study.
An initial meeting with a surgeon who does reconstruction will provide a woman with information on all options, "even if they decide to do [reconstruction] down the road," he said.
Like Alderman, Golshan couldn't say for sure why such a low number of surgeons referred their breast cancer patients to plastic surgeons for reconstruction discussions, but he speculated on a few possible reasons. "They may think complication rates are too high with immediate reconstruction," he said.
In truth, Golshan said, complications can be higher with immediate reconstruction if post-mastectomy radiation is required. "But not always," he said. And, "when there is no post-mastectomy radiation, the complications rates are equal between immediate reconstruction and delayed."
It's also possible that surgeons may be so focused on cancer elimination that they may not think about referring the patients for reconstruction information, Golshan added.
More information
To learn more about breast reconstruction, visit the American Society of Plastic Surgeons.
Rabu, 19 Desember 2007
Many States Still Fall Short in Emergency Preparedness: Report
(HealthDay News) -- Most Americans don't feel safer now than they did before 9/11, and their fears might be justified, a new report claims.
For example, seven states have not purchased antiviral medications in the event of a pandemic, 13 states don't have effective plans to distribute vaccines, antidotes and medical supplies in a public health emergency, and seven states and the District of Columbia don't have the ability to test for biological threats.
The report, compiled by the Trust for America's Health and released Tuesday, says that while many states have made progress in preparing for a potential public health disaster, much more needs to be done, and cuts in federal funding for state and local preparedness programs "threaten the nation's safety."
"Sept. 11, the anthrax attacks, Hurricane Katrina and the growing threat of a pandemic flu outbreak have all been wake-up calls to the country revealing gaps in our public health system's ability to respond to major crises," Jeffrey Levi, executive director of the trust, said during a midmorning teleconference.
Some important lessons have been learned from these events, Levi said. "Significant progress has been made in the nation's health emergency preparedness effort, but a number of areas still require serious attention."
That concern is heightened by the continual cuts in state, local and federal funding for preparedness, Levi added. "All Americans have the right to expect fundamental health protection during public health emergencies, no matter where they live," he said.
The report evaluates each state on 10 indicators of health emergency preparedness. Among the states, 35 plus Washington, D.C., scored eight or higher. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia scored 10 out of 10, while Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming scored the lowest, with six out of 10.
To remedy some of these problems, Levi's group is calling upon the federal government to increase public health and disaster preparedness funding. In addition, the U.S. Department of Health and Human Services should be expanding efforts to improve hospital surge capacity and community and hospital preparedness for public health emergencies, Levi said.
A public survey of more than 1,000 adults included in the report found that six years after 9/11, 54 percent of Americans believe the United States is not as safe as it was before 9/11, and two years after Hurricane Katrina, almost 60 percent of Americans do not think their community is prepared to respond to a natural disaster.
The survey also found that nine out of 10 Americans would accept a voluntary quarantine and stay home in the case of a pandemic flu. But of the 10 percent who would not adhere to a voluntary quarantine, 64 percent said they could not stay home because of lost income, and 39 percent feared losing their jobs altogether.
The report also evaluated progress by the U.S. government in preparing for bioterrorism, disasters and disease. The Pandemic and All-Hazards Preparedness Act of 2006, issuance of presidential directives, and the new Office of the Assistant Secretary for Preparedness and Response are all important steps, the report said.
However, challenges remain, including adequate funding for the Biomedical Advanced Research and Development Authority and increasing "transparency and accountability in all federally funded preparedness programs."
Other findings in the report include:
For example, seven states have not purchased antiviral medications in the event of a pandemic, 13 states don't have effective plans to distribute vaccines, antidotes and medical supplies in a public health emergency, and seven states and the District of Columbia don't have the ability to test for biological threats.
The report, compiled by the Trust for America's Health and released Tuesday, says that while many states have made progress in preparing for a potential public health disaster, much more needs to be done, and cuts in federal funding for state and local preparedness programs "threaten the nation's safety."
"Sept. 11, the anthrax attacks, Hurricane Katrina and the growing threat of a pandemic flu outbreak have all been wake-up calls to the country revealing gaps in our public health system's ability to respond to major crises," Jeffrey Levi, executive director of the trust, said during a midmorning teleconference.
Some important lessons have been learned from these events, Levi said. "Significant progress has been made in the nation's health emergency preparedness effort, but a number of areas still require serious attention."
That concern is heightened by the continual cuts in state, local and federal funding for preparedness, Levi added. "All Americans have the right to expect fundamental health protection during public health emergencies, no matter where they live," he said.
The report evaluates each state on 10 indicators of health emergency preparedness. Among the states, 35 plus Washington, D.C., scored eight or higher. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia scored 10 out of 10, while Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming scored the lowest, with six out of 10.
To remedy some of these problems, Levi's group is calling upon the federal government to increase public health and disaster preparedness funding. In addition, the U.S. Department of Health and Human Services should be expanding efforts to improve hospital surge capacity and community and hospital preparedness for public health emergencies, Levi said.
A public survey of more than 1,000 adults included in the report found that six years after 9/11, 54 percent of Americans believe the United States is not as safe as it was before 9/11, and two years after Hurricane Katrina, almost 60 percent of Americans do not think their community is prepared to respond to a natural disaster.
The survey also found that nine out of 10 Americans would accept a voluntary quarantine and stay home in the case of a pandemic flu. But of the 10 percent who would not adhere to a voluntary quarantine, 64 percent said they could not stay home because of lost income, and 39 percent feared losing their jobs altogether.
The report also evaluated progress by the U.S. government in preparing for bioterrorism, disasters and disease. The Pandemic and All-Hazards Preparedness Act of 2006, issuance of presidential directives, and the new Office of the Assistant Secretary for Preparedness and Response are all important steps, the report said.
However, challenges remain, including adequate funding for the Biomedical Advanced Research and Development Authority and increasing "transparency and accountability in all federally funded preparedness programs."
Other findings in the report include:
- Twenty-one states don't have laws that protect health-care volunteers from liability during emergencies.
- Twelve states don't have disease surveillance systems that work with the U.S. Centers for Disease Control and Prevention's National Electronic Disease Surveillance System.
- Another speaker focused on the lack of preparedness of U.S. hospitals to handle public health emergencies.
"To get hospitals up to speed in terms of their disaster responsibility would require an initial investment of $5 billion and about $1 billion a year to maintain that level of preparedness," Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health in New York City, said during the teleconference.
The funding for hospitals, which started at $500 million dollars, has dropped to around $400 million. "It's a situation that's going in reverse," Redlener noted.
One expert thinks progress has been made, but much more is needed to maintain and improve emergency preparedness in the United States.
"The report readily captures the breadth and complexity of the many dimensions involved in emergency preparedness," said Dr. Howard Koh, director of the Harvard School of Public Health Center for Public Health Preparedness, and the former Commissioner of Public Health of Massachusetts.
Preparedness is not an endpoint but rather a process of continuous improvement, Koh said.
"By that measure, the country has made advances in planning and coordination, but there are still many areas in need of improvement. For example, the broad challenge of surge capacity, that is the need to mobilize additional staff, supplies and space in the event of an emergency, remains a major issue, especially when the health-care system is already severely stretched," he said.
Because disasters are uncommon events, there should be greater emphasis on rigorous drills and exercises that demonstrate effective coordination and mobilization of the many partners involved, Koh said.
In addition, public trust is essential, Koh said. "We need to sustain a long-term public health commitment to build an enduring system that will protect people and communities against all threats," he said.
More information
To see the full report, visit Trust for America's Health.
Kamis, 13 Desember 2007
Report Finds 'Widespread Steroid Use in Baseball'
(HealthDayNews) -- New York Yankees pitchers Roger Clemens and Andy Pettitte, Houston Astros All-Star shortstop Miguel Tejada and home run king Barry Bonds are among the big-name players cited in a highly anticipated report into the use of performance-enhancing drugs in Major League Baseball.
The report climaxed a 20-month probe by former U.S. Senate Majority Leader George Mitchell, who was hired by baseball Commissioner Bud Selig to examine the use of performance-boosting drugs during the so-called "steroids era," which began in the mid-1990s and was marked by record-shattering performances by many players.
"For more than a decade, there has been widespread anabolic steroid use in baseball," Mitchell said, adding that all 30 major-league teams have players involved with drugs, ESPN.com reported.
"Everyone involved in baseball over the past two decades -- commissioners, club officials, the players' association and players -- shares to some extent the responsibility for the steroids era,'' said Mitchell, who called for stricter drug testing. "There was a collective failure to recognize the problem as it emerged and to deal with it early on."
It was not clear if the report would result in any penalties or suspensions, the Associated Press reported.
Clemens was one of the most prominent names in the report. Others include Most Valuable Player award-winners Barry Bonds, the late Ken Caminiti, Jose Canseco, Jason Giambi, Juan Gonzalez, Mo Vaughn and Tejada. The report also includes the names of three of the top 10 home-run leaders of all time: Bonds, Mark McGwire and Rafael Palmiero, The New York Times reported.
Anabolic-androgenic steroids are man-made substances that help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone. But they can produce a variety of dangerous side effects, including heart trouble.
According to the U.S. National Institute on Drug Abuse, the major side effects can include high blood pressure; increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); liver tumors and cancer; kidney tumors; severe acne; and trembling. There are also some gender-specific side effects:
The report climaxed a 20-month probe by former U.S. Senate Majority Leader George Mitchell, who was hired by baseball Commissioner Bud Selig to examine the use of performance-boosting drugs during the so-called "steroids era," which began in the mid-1990s and was marked by record-shattering performances by many players.
"For more than a decade, there has been widespread anabolic steroid use in baseball," Mitchell said, adding that all 30 major-league teams have players involved with drugs, ESPN.com reported.
"Everyone involved in baseball over the past two decades -- commissioners, club officials, the players' association and players -- shares to some extent the responsibility for the steroids era,'' said Mitchell, who called for stricter drug testing. "There was a collective failure to recognize the problem as it emerged and to deal with it early on."
It was not clear if the report would result in any penalties or suspensions, the Associated Press reported.
Clemens was one of the most prominent names in the report. Others include Most Valuable Player award-winners Barry Bonds, the late Ken Caminiti, Jose Canseco, Jason Giambi, Juan Gonzalez, Mo Vaughn and Tejada. The report also includes the names of three of the top 10 home-run leaders of all time: Bonds, Mark McGwire and Rafael Palmiero, The New York Times reported.
Anabolic-androgenic steroids are man-made substances that help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone. But they can produce a variety of dangerous side effects, including heart trouble.
According to the U.S. National Institute on Drug Abuse, the major side effects can include high blood pressure; increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); liver tumors and cancer; kidney tumors; severe acne; and trembling. There are also some gender-specific side effects:
- For men -- shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, and increased risk for prostate cancer.
- For women -- growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, a deepened voice.
- For teens -- growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.
"For males in the U.S., heart disease is the number one cause of death, and steroid abuse makes heart disease even worse," Dr. Linn Goldberg, a professor at Oregon Health and Science University, and an expert on steroid abuse, told HealthDay following the 2004 heart-attack death of Caminiti, who had admitted to abusing both steroids and cocaine.
Dr. Nieca Goldberg, a spokeswoman for the American Heart Association and medical director of the Women's Heart Program at New York University School of Medicine, said steroids raise almost all heart disease risk factors.
"One, steroid use raises blood pressure," she told HealthDay. "Two, it can also alter your sugar metabolism, so you have an increased risk of diabetes. Three, it makes the arteries vulnerable since, because of elevated cholesterol, you get cholesterol plaque buildup."
Steroid abuse can also cause a dangerous thickening of heart muscle called hypertrophy --- the same kind of heart-muscle enlargement seen in patients with congestive heart failure, experts warn.
Linn Goldberg (no relation to Nieca Goldberg) said his biggest concern remains the health risks to America's teenagers, who are increasingly influenced by the behaviors of their favorite sports stars.
"These are very dangerous drugs, and their effects on children are even greater than on adults, because they affect all their biological systems," he said. "It's a shock to their body, because the hormones are so powerful."
More information
To learn more about steroid dangers, visit the American Academy of Pediatrics.
Selasa, 11 Desember 2007
Good Physical Function Halves Stroke Risk
(HealthDay News) -- Being in good physical form appears to protect middle-aged and older men and women from stroke, a new British study suggests.
The finding highlights an apparent association -- rather than a direct cause-and-effect -- between the physical ability to function well and a reduced risk for stroke.
After sifting through thousands of quality-of-life reports provided by patients themselves, the research team found that those functioning at the higher end of the physical capacity spectrum appear to have half the risk for stroke as their poorest functioning compatriots, independent of other risk factors.
"We were surprised at the magnitude of the relationship, as this is comparable to established stroke risk factors such as smoking," noted study author Dr. Phyo Kyaw Myint, who works with the Clinical Gerontology Unit at Addenbrooke's University Hospital in Cambridge.
The findings are published in the Dec. 11 issue of Neurology.
Myint and his colleagues uncovered an apparent stroke-physical function connection by analyzing data concerning more than 13,600 British men and women between the ages of 40 and 79.
All the participants first completed a health examination and questionnaire between 1993 and 1997. At that time, patient blood pressure, body-mass index, respiratory capacity, and cholesterol levels were assessed. Researchers also noted any history of diabetes, smoking and alcohol consumption.
None of the patients had experienced any incidence of cancer, stroke or heart attack before their initial exam.
Eighteen months after the initial exam, patients completed a follow-up questionnaire by mail, in which patients were asked to indicate their degree of physical and social functioning; their mental health status; any physical and/or emotional limitations on carrying out routines; energy levels; experiences of pain; and self-perceptions regarding their overall health.
All participants were followed until 2005, by which point 244 strokes were recorded.
The researchers found that those men and women who reported better physical function had a considerably lower risk for stroke.
After adjusting for all other observed characteristics -- including gender and age -- Myint and his team found that patients in the top quarter of physical function capacity had half the risk of stroke when compared with patients in the lowest quarter of physical function.
The authors concluded that poor physical function could indicate a high risk for stroke, thereby highlighting a specific segment of the general population that could derive particular benefit from some form of intervention.
Myint stressed, however, that to date his team has simply conducted a hands-off review of patient self-reports regarding their physical capacity and lined those reports up against stroke incidence records. At no time were patients assessed for their ability to follow a prescribed physical activity routine of varying intensities and durations.
He cautioned against leaping to the notion that greater physical function or activity directly causes a drop in the risk for stroke.
"We don't know whether physical function per se is causally related to stroke or simply a good marker for other factors that influence stroke risk," Myint noted. "These findings need confirmation from other studies. However, there is already a substantial body of evidence for public health recommendations to increase physical activity."
In the meantime, Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab at Tufts University in Boston, said that people should not sit idly by while investigators continue to unravel the complex web of factors related to stroke risk.
"This study does not show causation, but clearly, individuals who follow current guidelines for decreasing risk for stroke and general cardiovascular risk -- including keeping physically active -- have better outcomes," she said. "So, in terms of both physical function and activity, what people need to try to do is go from where they are to more."
"For some people, doing more may literally mean just walking around the block once, or picking up the pace, or adding extra time moving," said Lichtenstein. "For others, it can even be something like doing the housecleaning. And it can be cumulative: 10 minutes at one point, 10 minutes at another. Because although we'd like everyone to set aside special time just for physical activity every day, we know that for a lot of people, it's just not going to happen. So, any increase is going in the right direction, and that should be the goal."
This week, the American Society for Nutrition is poised to issue a new set of national recommendations regarding both physical activity and nutrition.
The recommendations are described as "comprehensive, scientific guidelines on physical activity for all Americans." According to the U.S. Department of Health and Human Services, the guidelines will gather together the latest knowledge on both healthy eating and regular physical activity.
More information
To learn about stroke risk, visit the American Heart Association.
The finding highlights an apparent association -- rather than a direct cause-and-effect -- between the physical ability to function well and a reduced risk for stroke.
After sifting through thousands of quality-of-life reports provided by patients themselves, the research team found that those functioning at the higher end of the physical capacity spectrum appear to have half the risk for stroke as their poorest functioning compatriots, independent of other risk factors.
"We were surprised at the magnitude of the relationship, as this is comparable to established stroke risk factors such as smoking," noted study author Dr. Phyo Kyaw Myint, who works with the Clinical Gerontology Unit at Addenbrooke's University Hospital in Cambridge.
The findings are published in the Dec. 11 issue of Neurology.
Myint and his colleagues uncovered an apparent stroke-physical function connection by analyzing data concerning more than 13,600 British men and women between the ages of 40 and 79.
All the participants first completed a health examination and questionnaire between 1993 and 1997. At that time, patient blood pressure, body-mass index, respiratory capacity, and cholesterol levels were assessed. Researchers also noted any history of diabetes, smoking and alcohol consumption.
None of the patients had experienced any incidence of cancer, stroke or heart attack before their initial exam.
Eighteen months after the initial exam, patients completed a follow-up questionnaire by mail, in which patients were asked to indicate their degree of physical and social functioning; their mental health status; any physical and/or emotional limitations on carrying out routines; energy levels; experiences of pain; and self-perceptions regarding their overall health.
All participants were followed until 2005, by which point 244 strokes were recorded.
The researchers found that those men and women who reported better physical function had a considerably lower risk for stroke.
After adjusting for all other observed characteristics -- including gender and age -- Myint and his team found that patients in the top quarter of physical function capacity had half the risk of stroke when compared with patients in the lowest quarter of physical function.
The authors concluded that poor physical function could indicate a high risk for stroke, thereby highlighting a specific segment of the general population that could derive particular benefit from some form of intervention.
Myint stressed, however, that to date his team has simply conducted a hands-off review of patient self-reports regarding their physical capacity and lined those reports up against stroke incidence records. At no time were patients assessed for their ability to follow a prescribed physical activity routine of varying intensities and durations.
He cautioned against leaping to the notion that greater physical function or activity directly causes a drop in the risk for stroke.
"We don't know whether physical function per se is causally related to stroke or simply a good marker for other factors that influence stroke risk," Myint noted. "These findings need confirmation from other studies. However, there is already a substantial body of evidence for public health recommendations to increase physical activity."
In the meantime, Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab at Tufts University in Boston, said that people should not sit idly by while investigators continue to unravel the complex web of factors related to stroke risk.
"This study does not show causation, but clearly, individuals who follow current guidelines for decreasing risk for stroke and general cardiovascular risk -- including keeping physically active -- have better outcomes," she said. "So, in terms of both physical function and activity, what people need to try to do is go from where they are to more."
"For some people, doing more may literally mean just walking around the block once, or picking up the pace, or adding extra time moving," said Lichtenstein. "For others, it can even be something like doing the housecleaning. And it can be cumulative: 10 minutes at one point, 10 minutes at another. Because although we'd like everyone to set aside special time just for physical activity every day, we know that for a lot of people, it's just not going to happen. So, any increase is going in the right direction, and that should be the goal."
This week, the American Society for Nutrition is poised to issue a new set of national recommendations regarding both physical activity and nutrition.
The recommendations are described as "comprehensive, scientific guidelines on physical activity for all Americans." According to the U.S. Department of Health and Human Services, the guidelines will gather together the latest knowledge on both healthy eating and regular physical activity.
More information
To learn about stroke risk, visit the American Heart Association.
Kamis, 06 Desember 2007
Common Household Chemical Could Raise Breast Cancer Risk
(HealthDay News) -- A chemical found in many plastic products used in households caused accelerated breast development and genetic changes in newborn female lab rats, a condition that might predispose the animals to breast cancer later in life, a new study says.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers and plastics. It's found in everything from plastic pipes, vinyl floor tiles and carpet backing to lipstick. BBP has also been found to be an endocrine disruptor, which mimics the effect of hormones. Endocrine disruptors are known to damage wildlife and have also been implicated in reduced sperm counts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to this compound (BBP) soon after birth results in alterations in the expression of genes present in the mammary gland," said lead researcher Dr. Jose Russo, a breast cancer expert at the Fox Chase Cancer Center, in Philadelphia.
The findings are important, Russo said, because the researchers are studying the lifetime effect of BBP on the mammary gland, long before it starts developing under the influence of the hormones of puberty, and the potential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP could increase the risk for developing breast cancer later in life, Russo said.
"To prevent breast cancer in adulthood, it is necessary to protect both the newborn child and the mother from exposure to this compound that has an estrogenic effect and could act as an endocrine disruptor," he added.
For the study, Russo's team fed lactating rats BBP, which their offspring absorbed through breast milk. The rat pups received levels of the chemical equivalent to the U.S. Environmental Protection Agency's safe dose limit for humans, according to the report in the Dec. 5 online issue of BMC Genomics.
The researchers found that BBP affected characteristics of the female offspring of the rats, such as more rapid breast development and changes in the genetic profile of the mammary glands.
While these effects wore off after exposure to BBP was stopped, the changes caused by the chemical might have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBP occur very early in life, and they could result in significant modifications in the risk of the mammary gland to develop cancer later on in life," Russo said.
Russo said he and his colleagues are currently evaluating how changes in gene expression caused by BBP respond to cancer-causing chemicals given to adult rats.
"We are also studying the effects of exposure to BBP before birth. In addition, we are following a cohort of girls entering puberty for determining the tempo of breast development and their first menstrual period and associating these events with exposure to environmental agents such as BBP," Russo said.
One expert said scientists are only beginning to learn how many genes are affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may therefore alter the susceptibility to breast cancer," said Dr. Ted Schettler, science director at the Science and Environmental Health Network, in Ames, Iowa.
Schettler thinks people need to be aware of the possible effects of chemicals on genes during early life, and how these changes can influence susceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matter later in life," Schettler said.
"When people see that commonly encountered environmental agents like BBP can cause genetic changes, it's of public health interest."
However, Dr. Jonathan Borak, a clinical professor of environmental medicine at Yale University School of Public Health, said there's no evidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP and breast cancer," Borak said. "This study doesn't add specific information on breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industry group, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBP in toys and baby products such as teething rings, according to published reports.
And in March, a study published in the journal Environmental Health Perspectives suggested that exposure to phthalates could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men.
More information
For more on breast cancer, visit the American Cancer Society.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers and plastics. It's found in everything from plastic pipes, vinyl floor tiles and carpet backing to lipstick. BBP has also been found to be an endocrine disruptor, which mimics the effect of hormones. Endocrine disruptors are known to damage wildlife and have also been implicated in reduced sperm counts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to this compound (BBP) soon after birth results in alterations in the expression of genes present in the mammary gland," said lead researcher Dr. Jose Russo, a breast cancer expert at the Fox Chase Cancer Center, in Philadelphia.
The findings are important, Russo said, because the researchers are studying the lifetime effect of BBP on the mammary gland, long before it starts developing under the influence of the hormones of puberty, and the potential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP could increase the risk for developing breast cancer later in life, Russo said.
"To prevent breast cancer in adulthood, it is necessary to protect both the newborn child and the mother from exposure to this compound that has an estrogenic effect and could act as an endocrine disruptor," he added.
For the study, Russo's team fed lactating rats BBP, which their offspring absorbed through breast milk. The rat pups received levels of the chemical equivalent to the U.S. Environmental Protection Agency's safe dose limit for humans, according to the report in the Dec. 5 online issue of BMC Genomics.
The researchers found that BBP affected characteristics of the female offspring of the rats, such as more rapid breast development and changes in the genetic profile of the mammary glands.
While these effects wore off after exposure to BBP was stopped, the changes caused by the chemical might have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBP occur very early in life, and they could result in significant modifications in the risk of the mammary gland to develop cancer later on in life," Russo said.
Russo said he and his colleagues are currently evaluating how changes in gene expression caused by BBP respond to cancer-causing chemicals given to adult rats.
"We are also studying the effects of exposure to BBP before birth. In addition, we are following a cohort of girls entering puberty for determining the tempo of breast development and their first menstrual period and associating these events with exposure to environmental agents such as BBP," Russo said.
One expert said scientists are only beginning to learn how many genes are affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may therefore alter the susceptibility to breast cancer," said Dr. Ted Schettler, science director at the Science and Environmental Health Network, in Ames, Iowa.
Schettler thinks people need to be aware of the possible effects of chemicals on genes during early life, and how these changes can influence susceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matter later in life," Schettler said.
"When people see that commonly encountered environmental agents like BBP can cause genetic changes, it's of public health interest."
However, Dr. Jonathan Borak, a clinical professor of environmental medicine at Yale University School of Public Health, said there's no evidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP and breast cancer," Borak said. "This study doesn't add specific information on breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industry group, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBP in toys and baby products such as teething rings, according to published reports.
And in March, a study published in the journal Environmental Health Perspectives suggested that exposure to phthalates could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men.
More information
For more on breast cancer, visit the American Cancer Society.
Sabtu, 01 Desember 2007
FDA Report Says Nation's Health at Risk
(HealthDay News) -- A new report by a U.S. Food and Drug Administration subcommittee says the agency can no longer adequately protect the nation's food and drug supply.
The Subcommittee on Science and Technology lays the blame squarely on inadequate funding, which it says has not kept pace with increasing demands on the agency.
"This imbalance is imposing a significant risk to the integrity of the food, drug, cosmetic and device regulatory system, and hence the safety of the public," the report states.
And things could get worse, the report stresses: "...the Agency suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities."
William Hubbard, a former FDA associate commissioner and an advisor to the Coalition for a Stronger FDA, a group that lobbies on behalf of the agency, called the report "one of the most remarkable reports I've ever seen. They are basically saying the FDA can't protect the public, and they are saying that our future competitiveness in new technology, emerging science and pharmaceuticals and devices is seriously threatened."
Hubbard also thinks that more money is needed for the FDA to do its job. "The number doesn't matter -- it just needs to be a lot," he said. "You would need a steady increase over five years to fix the FDA."
The report started as a review of the science at the FDA, Hubbard said, and mushroomed into something more.
"The committee was horrified that the science wasn't there, then they were horrified that the capabilities weren't there -- and the only way to fix that is funding," he said.
The FDA budget request for 2008 is $1.74 billion, plus another $444 million in user fees. These fees are paid by drug makers and medical device makers to underwrite the approval process of their products.
Another expert thinks that the FDA needs more money, but to really protect the public the agency's culture also needs changing.
"You need not only an overhaul of resources but an overhaul of philosophy on what safety and efficacy really means," said Dr. A. Mark Fendrick, a professor of internal medicine and professor of health management and policy at the University of Michigan.
"While a substantial increase in resources will enhance the scientific capabilities and capacity of the FDA, funding alone will not address the inherent tension between America's insatiable demand for immediate access for innovative products and an unwillingness to tolerate products that are anything but perfectly safe," Fendrick explained.
Another FDA supporter also thinks that improving the FDA starts with money.
"There are a lot of problems in the FDA that can't be solved without more resources," said Steven Grossman, a spokesman for the FDA Alliance, which lobbies on behalf of the agency. "All the problems don't go away if you have more money, but there are a whole lot of problems you can't confront without money."
Grossman thinks there is need for another $450 million in unrestricted spending to start bringing the agency up to snuff. That request is currently winding its way through Congress. "We hope to get at least a third of that," he said. It's going to take several years of increased funding to get the FDA to where it should be, he added.
According to the report, the FDA's "inability to keep up with scientific advances means that American lives are at risk." The committee noted that while science had undergone radical changes, the agency' evaluation methods haven't hanged in more than 50 years.
In addition, the food supply is at risk, the report said: "Crisis management in [the] FDA's two food safety centers, [the] Center for Food Safety and Applied Nutrition (CFSAN) and [the] Center for Veterinary Medicine (CVM), has drawn attention and resources away from FDA's ability to develop the science base and infrastructure needed to efficiently support innovation in the food industry, provide effective routine surveillance, and conduct emergency outbreak investigation activities to protect the food supply."
The report also calls for better-trained FDA scientists and improvements in the agency's computer technology. The full report will be presented at a meeting of the FDA's Science Board on Monday.
In recent years, numerous food recalls and the withdrawal from the market of popular medications -- the removal of the painkiller Vioxx in 2004 was one of the most high-profile examples -- have eroded public confidence in the FDA. A recent survey found that 47 percent of Americans rated its performance as fair or poor.
And a study published in September found the number of serious adverse drug events more than doubled between 1998 and 2005 in the United States, as did the number of related deaths. From 1998 to 2005, the number of reported serious adverse drug events increased from 34,966 to 89,842. The number of fatal adverse drug events almost tripled during the same time period, from 5,519 in 1998 to 15,107 in 2005.
The number of adverse events increased four times faster than the total number of outpatient prescriptions, which rose from 2.7 billion to 3.8 billion during that time frame, according to the study, which was published in the Archives of Internal Medicine.
Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group, called the new FDA report a "partial and simplistic view of what is wrong with the FDA."
"There seems to be more importance placed on satisfying industry [at the FDA]. It's not an atmosphere where people are free to express their differing opinions," he said.
Wolfe thinks the agency needs to be changed substantially, including new legislation that would strengthen its ability to regulate food additives, drugs and dietary supplements. He also thinks user fees should be abolished, because the fees make the relationship between the agency and drug companies too close.
More information
For more on what the FDA is doing about drug safety, visit the Food and Drug Administration.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
The Subcommittee on Science and Technology lays the blame squarely on inadequate funding, which it says has not kept pace with increasing demands on the agency.
"This imbalance is imposing a significant risk to the integrity of the food, drug, cosmetic and device regulatory system, and hence the safety of the public," the report states.
And things could get worse, the report stresses: "...the Agency suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities."
William Hubbard, a former FDA associate commissioner and an advisor to the Coalition for a Stronger FDA, a group that lobbies on behalf of the agency, called the report "one of the most remarkable reports I've ever seen. They are basically saying the FDA can't protect the public, and they are saying that our future competitiveness in new technology, emerging science and pharmaceuticals and devices is seriously threatened."
Hubbard also thinks that more money is needed for the FDA to do its job. "The number doesn't matter -- it just needs to be a lot," he said. "You would need a steady increase over five years to fix the FDA."
The report started as a review of the science at the FDA, Hubbard said, and mushroomed into something more.
"The committee was horrified that the science wasn't there, then they were horrified that the capabilities weren't there -- and the only way to fix that is funding," he said.
The FDA budget request for 2008 is $1.74 billion, plus another $444 million in user fees. These fees are paid by drug makers and medical device makers to underwrite the approval process of their products.
Another expert thinks that the FDA needs more money, but to really protect the public the agency's culture also needs changing.
"You need not only an overhaul of resources but an overhaul of philosophy on what safety and efficacy really means," said Dr. A. Mark Fendrick, a professor of internal medicine and professor of health management and policy at the University of Michigan.
"While a substantial increase in resources will enhance the scientific capabilities and capacity of the FDA, funding alone will not address the inherent tension between America's insatiable demand for immediate access for innovative products and an unwillingness to tolerate products that are anything but perfectly safe," Fendrick explained.
Another FDA supporter also thinks that improving the FDA starts with money.
"There are a lot of problems in the FDA that can't be solved without more resources," said Steven Grossman, a spokesman for the FDA Alliance, which lobbies on behalf of the agency. "All the problems don't go away if you have more money, but there are a whole lot of problems you can't confront without money."
Grossman thinks there is need for another $450 million in unrestricted spending to start bringing the agency up to snuff. That request is currently winding its way through Congress. "We hope to get at least a third of that," he said. It's going to take several years of increased funding to get the FDA to where it should be, he added.
According to the report, the FDA's "inability to keep up with scientific advances means that American lives are at risk." The committee noted that while science had undergone radical changes, the agency' evaluation methods haven't hanged in more than 50 years.
In addition, the food supply is at risk, the report said: "Crisis management in [the] FDA's two food safety centers, [the] Center for Food Safety and Applied Nutrition (CFSAN) and [the] Center for Veterinary Medicine (CVM), has drawn attention and resources away from FDA's ability to develop the science base and infrastructure needed to efficiently support innovation in the food industry, provide effective routine surveillance, and conduct emergency outbreak investigation activities to protect the food supply."
The report also calls for better-trained FDA scientists and improvements in the agency's computer technology. The full report will be presented at a meeting of the FDA's Science Board on Monday.
In recent years, numerous food recalls and the withdrawal from the market of popular medications -- the removal of the painkiller Vioxx in 2004 was one of the most high-profile examples -- have eroded public confidence in the FDA. A recent survey found that 47 percent of Americans rated its performance as fair or poor.
And a study published in September found the number of serious adverse drug events more than doubled between 1998 and 2005 in the United States, as did the number of related deaths. From 1998 to 2005, the number of reported serious adverse drug events increased from 34,966 to 89,842. The number of fatal adverse drug events almost tripled during the same time period, from 5,519 in 1998 to 15,107 in 2005.
The number of adverse events increased four times faster than the total number of outpatient prescriptions, which rose from 2.7 billion to 3.8 billion during that time frame, according to the study, which was published in the Archives of Internal Medicine.
Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group, called the new FDA report a "partial and simplistic view of what is wrong with the FDA."
"There seems to be more importance placed on satisfying industry [at the FDA]. It's not an atmosphere where people are free to express their differing opinions," he said.
Wolfe thinks the agency needs to be changed substantially, including new legislation that would strengthen its ability to regulate food additives, drugs and dietary supplements. He also thinks user fees should be abolished, because the fees make the relationship between the agency and drug companies too close.
More information
For more on what the FDA is doing about drug safety, visit the Food and Drug Administration.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
Rabu, 28 November 2007
Health Tip: Severe Food Allergy?
(HealthDay News) - If you or a loved one has a serious allergy to one or more foods, it's important to have an action plan in case of accidental ingestion.
Here are some guidelines, courtesy of the American Academy of Family Physicians:
Here are some guidelines, courtesy of the American Academy of Family Physicians:
- Work with your doctor and family members to create a clear, detailed emergency action plan. Always carry it with you.
- Designate a trusted third party as an emergency contact.
- At all times, carry emergency medications recommended by your doctor, which may include an epinephrine pen and an antihistamine.
Minggu, 25 November 2007
Diet Drug Rimonabant Tied to Depression, Anxiety
(HealthDay News) -- People who take the weight-loss drug rimonabant may face heightened risks for severe depression and anxiety, Danish researchers report.
The finding follows a recommendation by a U.S. Food and Drug Administration panel in June that the agency not approve the diet drug because of continuing concerns about increased risks for suicidal thoughts among some users. Previously, the FDA rejected the drug as an aid to help people quit smoking.
"Up to this point in time, there has been controversy over the rates and severity of psychiatric adverse effects with rimonabant," noted Dr. Philip Mitchell, head of the School of Psychiatry at the University of New South Wales in Sydney, Australia, and co-author of an editorial that accompanies the study.
This is the first review to examine rates of severe psychiatric symptoms with rimonabant (Acomplia), symptoms severe enough that patients discontinue treatment, Mitchell said.
The report is published in the Nov. 17 edition of The Lancet.
In the meta-analysis, Dr. Arne Astrup, from the department of human nutrition at the University of Copenhagen, collected data on more than 4,100 patients enrolled in four clinical trials. Those trials compared taking rimonabant (20 milligrams a day) against a placebo.
The researchers found that people taking rimonabant did lose weight -- about 15 pounds in a year -- compared to those receiving a placebo.
However, those taking rimonabant were also 40 percent more likely to have an adverse reaction than people not taking it. In fact, those taking rimonabant were 2.5 times more likely to stop taking the drug because of depression and three times more likely to stop the drug because of anxiety, compared to people on placebo.
"Our findings suggest that 20 milligrams per day of rimonabant increases the risk of psychiatric events -- i.e., depressed mood disorders and anxiety -- despite depressed mood being an exclusion criterion in these trials," Astrup's team said. "Taken together with the recent U.S. Food and Drug Administration finding of increased risk of suicide during treatment with rimonabant, we recommend increased alertness by physicians to these potentially severe psychiatric adverse reactions."
Mitchell noted that depression is common in overweight and obese people, and is something that doctors need to take into account when prescribing weight-loss drugs.
"This increased risk of depression and anxiety is a major safety issue in the treatment of obesity, as obese patients already have an increased risk of depression even prior to treatment," Mitchell said.
As far as rimonabant is concerned, Mitchell believes doctors should consider alternate weight-loss drugs for people who are depressed. "If one is using rimonabant, patients should be monitored carefully for the emergence of depressive symptoms and/or suicidal thoughts," he added.
In June, rimonabant's maker, French pharmaceutical giant Sanofi-Aventis, said in a statement that despite the FDA's decision, the company "is confident in the positive benefit-risk ratio of rimonabant 20 milligrams when used in the appropriate population."
Another expert said more data on the safety of rimonabant is needed.
"Rimonabant is potentially beneficial in some patients, but we really need long-term data demonstrating reductions in major obesity-related comorbidities such as heart attack, stroke and sleep apnea and/or mortality, to be completely certain," said Dr. Raj Padwal, an assistant professor of general internal medicine at the University of Alberta in Edmonton, Canada.
The drug needs to be avoided in anyone who has a mood disorder, Padwal added. "Since many patients with weight issues have depression, this means that the drug cannot be used in a large number of people. In the remaining individuals in whom the drug is used, the patient and physician must be cognizant of the risk of a mood disorder and monitor accordingly," he said.
In a related study in the Nov. 16 issue of the British Medical Journal, Padwal's team found that long-term users of weight-loss drugs such as orlistat (Xenical), sibutramine (Meridia) and rimonabant experienced only modest weight loss -- less than 11 pounds, which was less than 5 percent of their total body weight.
Padwal's team also noted that the U.S. National Institute for Clinical Excellence recommends stopping the use of weight-loss drugs if 5 percent of total body weight is not lost after three months.
Commenting on Padwal's study, Dr. Gareth Williams, dean of the Faculty of Medicine & Dentistry at the University of Bristol in the U.K., wrote in an accompanying editorial: "Selling anti-obesity drugs over the counter will perpetuate the myth that obesity can be fixed simply by popping a pill and could further undermine the efforts to promote healthy living, which is the only long-term escape from obesity."
More information
For more information on obesity, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
The finding follows a recommendation by a U.S. Food and Drug Administration panel in June that the agency not approve the diet drug because of continuing concerns about increased risks for suicidal thoughts among some users. Previously, the FDA rejected the drug as an aid to help people quit smoking.
"Up to this point in time, there has been controversy over the rates and severity of psychiatric adverse effects with rimonabant," noted Dr. Philip Mitchell, head of the School of Psychiatry at the University of New South Wales in Sydney, Australia, and co-author of an editorial that accompanies the study.
This is the first review to examine rates of severe psychiatric symptoms with rimonabant (Acomplia), symptoms severe enough that patients discontinue treatment, Mitchell said.
The report is published in the Nov. 17 edition of The Lancet.
In the meta-analysis, Dr. Arne Astrup, from the department of human nutrition at the University of Copenhagen, collected data on more than 4,100 patients enrolled in four clinical trials. Those trials compared taking rimonabant (20 milligrams a day) against a placebo.
The researchers found that people taking rimonabant did lose weight -- about 15 pounds in a year -- compared to those receiving a placebo.
However, those taking rimonabant were also 40 percent more likely to have an adverse reaction than people not taking it. In fact, those taking rimonabant were 2.5 times more likely to stop taking the drug because of depression and three times more likely to stop the drug because of anxiety, compared to people on placebo.
"Our findings suggest that 20 milligrams per day of rimonabant increases the risk of psychiatric events -- i.e., depressed mood disorders and anxiety -- despite depressed mood being an exclusion criterion in these trials," Astrup's team said. "Taken together with the recent U.S. Food and Drug Administration finding of increased risk of suicide during treatment with rimonabant, we recommend increased alertness by physicians to these potentially severe psychiatric adverse reactions."
Mitchell noted that depression is common in overweight and obese people, and is something that doctors need to take into account when prescribing weight-loss drugs.
"This increased risk of depression and anxiety is a major safety issue in the treatment of obesity, as obese patients already have an increased risk of depression even prior to treatment," Mitchell said.
As far as rimonabant is concerned, Mitchell believes doctors should consider alternate weight-loss drugs for people who are depressed. "If one is using rimonabant, patients should be monitored carefully for the emergence of depressive symptoms and/or suicidal thoughts," he added.
In June, rimonabant's maker, French pharmaceutical giant Sanofi-Aventis, said in a statement that despite the FDA's decision, the company "is confident in the positive benefit-risk ratio of rimonabant 20 milligrams when used in the appropriate population."
Another expert said more data on the safety of rimonabant is needed.
"Rimonabant is potentially beneficial in some patients, but we really need long-term data demonstrating reductions in major obesity-related comorbidities such as heart attack, stroke and sleep apnea and/or mortality, to be completely certain," said Dr. Raj Padwal, an assistant professor of general internal medicine at the University of Alberta in Edmonton, Canada.
The drug needs to be avoided in anyone who has a mood disorder, Padwal added. "Since many patients with weight issues have depression, this means that the drug cannot be used in a large number of people. In the remaining individuals in whom the drug is used, the patient and physician must be cognizant of the risk of a mood disorder and monitor accordingly," he said.
In a related study in the Nov. 16 issue of the British Medical Journal, Padwal's team found that long-term users of weight-loss drugs such as orlistat (Xenical), sibutramine (Meridia) and rimonabant experienced only modest weight loss -- less than 11 pounds, which was less than 5 percent of their total body weight.
Padwal's team also noted that the U.S. National Institute for Clinical Excellence recommends stopping the use of weight-loss drugs if 5 percent of total body weight is not lost after three months.
Commenting on Padwal's study, Dr. Gareth Williams, dean of the Faculty of Medicine & Dentistry at the University of Bristol in the U.K., wrote in an accompanying editorial: "Selling anti-obesity drugs over the counter will perpetuate the myth that obesity can be fixed simply by popping a pill and could further undermine the efforts to promote healthy living, which is the only long-term escape from obesity."
More information
For more information on obesity, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
Rabu, 21 November 2007
Make Thanksgiving a Feast of Health
(HealthDay News) -- If the pilgrims could do without marshmallows atop their sweet potatoes, so can you.
Especially if your sweet potato casserole is topped instead with a pecan streusel that's just as tasty as marshmallow but healthier and lower in fat, nutritionists say.
By tweaking traditional Thanksgiving dinner recipes, you can avoid as much as 60 grams of fat, ensuring a healthier meal and a good beginning to the diet-busting holiday season.
"Thanksgiving dinner provides one of the healthiest food options of any holiday, because turkey is a low-fat meat, and sweet potatoes, pumpkin pie and cranberries are healthy foods and excellent sources of antioxidants," said Kathy Goldberg, a dietitian and cooking teacher at the University of Michigan Health System's health promotion program, called MFit.
But many traditional recipes -- think creamed onions, sausage stuffing, potato casseroles -- rely on lots of fat, cream, butter and sugar, both white and brown, resulting in a dinner that can range from 2,000 to 3,000 calories, an amount that should suffice an average person for a whole day, she said.
"By cleaning it up a bit," Goldberg said, which means making some simple recipe substitutions, you can provide equally delicious dishes that are nutritious as well.
"Nobody will feel like they're being cheated. Your guests won't even know, as long as you don't talk about it," she added.
Alice Lichtenstein, the Gershoff Professor of Nutrition Science and Policy at Tufts University in Boston, agreed. "No one wants to take the fun out of Thanksgiving. You just want to provide good choices that will set the stage for the next month as people face the holidays, which I call 'the license-to-eat season,'" she said.
Lichtenstein said people tend to eat more when they are sitting at a table for long stretches of time, and when there's a wide variety of foods to choose from -- both of which occur at Thanksgiving.
"You want to create an environment at the Thanksgiving table that makes it easier for people not to overdo it," she said.
The more you can replace calorie-dense foods such as buttery mashed potatoes with lower-calorie dishes like salads and vegetables that are well-prepared and tasty, the better your guests will feel, Lichtenstein said.
Goldberg, who teaches a healthy holiday cooking class at MFit, offers the following suggestions to "lighten up" your Thanksgiving dinner without sacrificing taste:
Especially if your sweet potato casserole is topped instead with a pecan streusel that's just as tasty as marshmallow but healthier and lower in fat, nutritionists say.
By tweaking traditional Thanksgiving dinner recipes, you can avoid as much as 60 grams of fat, ensuring a healthier meal and a good beginning to the diet-busting holiday season.
"Thanksgiving dinner provides one of the healthiest food options of any holiday, because turkey is a low-fat meat, and sweet potatoes, pumpkin pie and cranberries are healthy foods and excellent sources of antioxidants," said Kathy Goldberg, a dietitian and cooking teacher at the University of Michigan Health System's health promotion program, called MFit.
But many traditional recipes -- think creamed onions, sausage stuffing, potato casseroles -- rely on lots of fat, cream, butter and sugar, both white and brown, resulting in a dinner that can range from 2,000 to 3,000 calories, an amount that should suffice an average person for a whole day, she said.
"By cleaning it up a bit," Goldberg said, which means making some simple recipe substitutions, you can provide equally delicious dishes that are nutritious as well.
"Nobody will feel like they're being cheated. Your guests won't even know, as long as you don't talk about it," she added.
Alice Lichtenstein, the Gershoff Professor of Nutrition Science and Policy at Tufts University in Boston, agreed. "No one wants to take the fun out of Thanksgiving. You just want to provide good choices that will set the stage for the next month as people face the holidays, which I call 'the license-to-eat season,'" she said.
Lichtenstein said people tend to eat more when they are sitting at a table for long stretches of time, and when there's a wide variety of foods to choose from -- both of which occur at Thanksgiving.
"You want to create an environment at the Thanksgiving table that makes it easier for people not to overdo it," she said.
The more you can replace calorie-dense foods such as buttery mashed potatoes with lower-calorie dishes like salads and vegetables that are well-prepared and tasty, the better your guests will feel, Lichtenstein said.
Goldberg, who teaches a healthy holiday cooking class at MFit, offers the following suggestions to "lighten up" your Thanksgiving dinner without sacrificing taste:
- Instead of buying a self-basting turkey, baste your own bird with low-fat, low-sodium chicken stock. Rubbing herbs and olive oil under the skin of the meat will give it more flavor.
- When the turkey is done, use the drippings -- "de-fatted" -- to make gravy. "De-fat" by pouring the drippings into a baggie that you've set in a large measuring cup. The fat will rise to the top of the baggie. Then lift the bag out of the measuring cup, prick the bottom and pour the de-fatted drippings back into a pan before thickening with flour or cornstarch.
- Whole wheat English muffins cut up into cubes are a great base for stuffing, Goldberg said, increasing nutrients, adding more fiber to the stuffing and tasting good. And don't be shy about adding vegetables and fruits like chopped apples or cranberries to the traditional celery and onions in your recipe.
- Steam or roast vegetables, and serve lots of them. Instead of butter and cream sauces, try low-fat products and/or flavor the dishes with shallots, carmelized onions, lemon zest, herbs and spices.
- Make it easy on yourself by using frozen vegetables and the bags of prewashed and cut-up vegetables now available in most supermarkets. For only a slight extra cost, you can save time and provide healthful choices.
- Vary rich pie desserts with an apple crisp or crumble.
"Your food will taste like the traditional recipes. Only the cook has to know the secrets," Goldberg said.
Looking for other nutritious treats? How about kiwis?
"In a recent study, kiwi was found to be one of the most nutritionally dense fruits out of 27 fruits," Stephanie Dean, a dietitian with Baylor University Medical Center at Dallas, said in a prepared statement.
Kiwis are full of antioxidants, vitamin E and lutein, and they ward off vision problems, blood clots and even lower cholesterol, Dean said.
Dean's also high on cranberries. "The crimson color of cranberries signal that they are full of flavonoids," she explained, adding that flavonoids are high in antioxidants and help prevent everything from infections to strokes and cancer.
And, for a final recommendation, Dean likes broccoli sprouts, which, she said, are sold by the package and can be thrown on top of salads or be an addition to sandwiches.
"Broccoli sprouts have been shown to actually contain 20 percent more anti-cancer agents than regular broccoli," Dean said.
More information
For a selection of tasty and nutritious Thanksgiving recipes, including Goldberg's sweet potato casserole, visit the University of Michigan.
Minggu, 18 November 2007
Hispanics Receive Fewer Surgeries for Vascular Disease
(HealthDay News) -- Compared to the general population, Hispanics in the United States have fewer vascular surgeries, less favorable outcomes for treatment of vascular disease, and often have advanced vascular disease by the time they seek treatment, according to a new study.
While the reasons for these disparities aren't understood, they may be due to a number of socioeconomic and genetic factors, said the study authors, led by a vascular surgery team from New York-Presbyterian Hospital, Columbia University Medical Center and Weill Cornell Medical College.
Their findings were published in the November issue of the Journal of Vascular Surgery.
The research focused on three common vascular surgery procedures -- lower extremity revascularization (LER), carotid revascularization (CR), and abdominal aortic aneurysm (AAA) repair -- performed at hospitals in New York and in Florida between 2000 and 2004.
Compared to whites, Hispanic patients had a higher rate of amputation (6.2 percent vs. 3.4 percent) following LER -- meant to restore blood supply to a body part or organ -- and higher death rates following elective AAA repair (5.0 percent vs. 3.4 percent). The study also found that Hispanic patients were as much as two times more likely than whites to seek treatment only after developing advanced vascular disease, and they had longer hospital recovery times.
"These are significant disparities, and the reasons for them must be determined in order to make improvements," principal investigator Dr. Nicholas J. Morrissey, director of clinical trials and a vascular surgeon at New York-Presbyterian Hospital/Columbia University Medical Center, said in a prepared statement.
"One explanation may be socioeconomic factors, particularly insurance status, which could impede Hispanic patients' access to proper preventive and diagnostic care," said Morrissey, who is also an assistant professor of surgery at Columbia University College of Physicians and Surgeons and Weill Cornell Medical College.
More information
The Society of Interventional Radiology has more about vascular diseases.
While the reasons for these disparities aren't understood, they may be due to a number of socioeconomic and genetic factors, said the study authors, led by a vascular surgery team from New York-Presbyterian Hospital, Columbia University Medical Center and Weill Cornell Medical College.
Their findings were published in the November issue of the Journal of Vascular Surgery.
The research focused on three common vascular surgery procedures -- lower extremity revascularization (LER), carotid revascularization (CR), and abdominal aortic aneurysm (AAA) repair -- performed at hospitals in New York and in Florida between 2000 and 2004.
Compared to whites, Hispanic patients had a higher rate of amputation (6.2 percent vs. 3.4 percent) following LER -- meant to restore blood supply to a body part or organ -- and higher death rates following elective AAA repair (5.0 percent vs. 3.4 percent). The study also found that Hispanic patients were as much as two times more likely than whites to seek treatment only after developing advanced vascular disease, and they had longer hospital recovery times.
"These are significant disparities, and the reasons for them must be determined in order to make improvements," principal investigator Dr. Nicholas J. Morrissey, director of clinical trials and a vascular surgeon at New York-Presbyterian Hospital/Columbia University Medical Center, said in a prepared statement.
"One explanation may be socioeconomic factors, particularly insurance status, which could impede Hispanic patients' access to proper preventive and diagnostic care," said Morrissey, who is also an assistant professor of surgery at Columbia University College of Physicians and Surgeons and Weill Cornell Medical College.
More information
The Society of Interventional Radiology has more about vascular diseases.
Rabu, 14 November 2007
A Full and Long Life, Despite Diabetes
(HealthDay News) -- Bob Cleveland may be 87 years old, but he still remembers the day he was first diagnosed with type 1 diabetes -- in 1925."I went to the hospital at five years of age, and I thought to myself, 'OK, I'm going to die.' Because never having been to the hospital before, I just thought that's where you went to die," said Cleveland, of Syracuse, N.Y.
He didn't die. The hospital personnel just tested and confirmed that he had type 1 diabetes. But Cleveland has gone on to enjoy life to the fullest, pursuing mountain climbing and other outdoor adventures, having a rewarding career as an accountant at General Motors, and raising a family -- with his wife, Ruth, 86 -- all the while monitoring his blood sugar and taking insulin as needed each day.
"He amazes me," Ruth Cleveland said. "He's still able to take care of the yard, even drive a 32-foot motor home to Florida -- and he does it well."
People like Cleveland -- and his older brother Gerald, who is 91, and also has type 1 diabetes-- serve as a reminder on Nov. 14 , World Diabetes Day, that amid the grim statistics lies the notion that a life with diabetes can be active, healthy and without limits.
According to the World Health Organization, 3.2 million people worldwide die from diabetes each year and, if improperly managed, the illness can shorten lifespans by an average of 12 years. More than 18 million Americans have diabetes, with 95 percent developing the obesity-linked type 2 disease.
Type 1 disease usually begins in childhood and is linked to an inability of the insulin-producing cells to do their job. It typically means a lifetime of blood glucose monitoring and insulin supplementation.
Most type 1 diabetics don't let it overwhelm them, however.
"Yes, diabetes is something that you have to deal with, but it's just another part of your life," said 73-year-old Alan Lewis, professor emeritus of oceanography at the University of British Columbia, Vancouver.
Lewis was first diagnosed with type 1 diabetes 69 years ago but has also spent most of his adult life as a competitive swimmer. He only eased up on the competition at age 71, after a back injury got in the way of his breaststroke.
That setback is only temporary, he said. "The old juices are still flowing, so I have a feeling that I will get back into competitive swimming in about a year," Lewis said.
Experts say that type of can-do attitude, coupled with steadfast attention to blood sugar monitoring, diet and exercise, are the keys that allow diabetics to live well into their 70s, 80s, and even beyond.
Diabetes care has certainly improved since the Clevelands and Lewis were diagnosed as children. Today, high-tech pocket-sized glucose monitors mean quick, easy blood-sugar monitoring is literally at your fingertips. Insulin delivery is also easier than ever.
In the 1930s and 1940s, however, blood sugar could only be tested at home via urine sampling, which provided patients with only a much-delayed look at blood glucose levels. Medical crises -- moments when sugar levels dipped so low a coma might result -- were common.
"When you talk to the elderly with diabetes who have gotten to live to today, they have lived through a time and place when we really couldn't take care of diabetes very well," said Dr. Larry Deeb, immediate past president for medicine and science at the American Diabetes Association.
"However, even then, they made the commitment to take care of themselves," he added. "They reviewed their urine glucose, they took their insulin every day, they watched their diet and were active."
"It takes a huge commitment to take care of yourself with diabetes, to mind it every day," he said. "There's never a day off."
And yet, most elderly diabetics say that managing their diabetes quickly became routine.
"I think I was so focused on what was of interest to me in my life that diabetes was simply something I got used to," Lewis said. "It became just a hurdle I needed to go through to get someplace."
Indeed, many older diabetics may have lived so long, because "they have turned their diabetes into an asset," explained Dr. Sheri Colberg, a Virginia Beach, Va., exercise physiologist who has done much research on diabetes, longevity and lifestyle.
Colberg -- a type 1 diabetic herself -- interviewed dozens of diabetic seniors for her book, 50 Secrets of the Longest Living People With Diabetes. "I actually had some people who told me, 'Diabetes saved my life,' " she said. "They said to themselves, 'If I don't do this, I am going to die sooner.' They used diabetes as an incentive to adopt a healthier lifestyle, better eating patterns. And to stay physically active -- every one of them was physically active."
That's something Cleveland and Lewis agreed with.
"I've always been more of an outdoor person and more interested in exercise, games, swimming, thing like that," Cleveland said. "They were definitely advantageous for a diabetic."
Lewis added that the discipline and energy expenditure demanded by competitive swimming forced him early on to closely track his blood sugar highs and lows.
"I would advise people to test frequently, to get to know what your own [blood sugar] profile is, and then to set up a game plan to deal with those effects," he said.
Exercise also helps people stay slim, which is always a good thing when it comes to either type 1 or adult-onset type 2 diabetes, Deeb said. Indeed, all of the advice for people with type 1 disease would apply to the greater population of people with type 2 illness, he said.
Another key to a long, healthy life with diabetes: the support of loved ones.
Lewis said his wife, Carolyn, has helped him manage his diabetes for more than 50 years.
Cleveland credits Ruth with helping him get him through the tough times.
"I got married at age 27, and my wife has done the most wonderful job of helping me that anyone ever could," Cleveland said.
Ruth Cleveland said her husband initially kept his diabetes a secret from her when they were first courting more than 60 years ago, due to the stigma then attached to the disease.
"He claims he was afraid to tell me, afraid that I wouldn't want to continue seeing him," she said.
Those fears were unfounded.
"If anything, it made me appreciate him more and want to be a part of his life," Ruth said. "Which has turned out to be wonderful."
Minggu, 11 November 2007
Arthritis-related disability can have a major impact on a person's employment, forcing them to change work hours, the type and na
(HealthDay News) -- Living farther away from transplant centers doesn't explain why black Americans with end-stage renal (kidney) disease are less apt than whites to be placed on the kidney transplant waiting list, researchers say.
A team that analyzed data on end-stage renal (kidney) disease patients in Georgia and the Carolinas from 1998 to 2002 found that black patients in poorer neighborhoods were 56 percent less likely to than whites to be placed on the transplant waiting list.
"This finding warrants further exploration but suggests that racial disparity in the wait-listing process may indeed be a reflection of differential access to health care," study co-author Dr. Sandra Amaral, of Emory University in Atlanta, said in a prepared statement.
Of the almost 12,600 patients (62 percent of them black) included in the study, 17 percent were placed on the kidney transplant waiting list during the study period. Black patients were more likely than whites (27 percent versus 9 percent) to live in areas where more than 25 percent of the population lived below the poverty line.
The researchers had hypothesized that patients who lived farther from transplant centers would be less likely to be placed on the kidney transplant waiting list. But they found that distance to the transplant center didn't have a major impact on the likelihood of being placed on the list. They did find that black patients living in poorer neighborhoods were 56 percent less likely than whites to make it on the list.
"Racial disparities persist in the U.S. transplantation process," Amaral said. "The reasons for this are poorly understood, but multiple factors are likely involved."
"To our knowledge, this is the first study to examine the impact of community poverty on racial disparity in transplant wait-listing. It also introduces a potential new approach to addressing the disparities: reaching out to poorer communities with advocacy and education," she said.
The study was scheduled to be presented at the American Society of Nephrology annual meeting, in San Francisco.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about kidney transplantation.
A team that analyzed data on end-stage renal (kidney) disease patients in Georgia and the Carolinas from 1998 to 2002 found that black patients in poorer neighborhoods were 56 percent less likely to than whites to be placed on the transplant waiting list.
"This finding warrants further exploration but suggests that racial disparity in the wait-listing process may indeed be a reflection of differential access to health care," study co-author Dr. Sandra Amaral, of Emory University in Atlanta, said in a prepared statement.
Of the almost 12,600 patients (62 percent of them black) included in the study, 17 percent were placed on the kidney transplant waiting list during the study period. Black patients were more likely than whites (27 percent versus 9 percent) to live in areas where more than 25 percent of the population lived below the poverty line.
The researchers had hypothesized that patients who lived farther from transplant centers would be less likely to be placed on the kidney transplant waiting list. But they found that distance to the transplant center didn't have a major impact on the likelihood of being placed on the list. They did find that black patients living in poorer neighborhoods were 56 percent less likely than whites to make it on the list.
"Racial disparities persist in the U.S. transplantation process," Amaral said. "The reasons for this are poorly understood, but multiple factors are likely involved."
"To our knowledge, this is the first study to examine the impact of community poverty on racial disparity in transplant wait-listing. It also introduces a potential new approach to addressing the disparities: reaching out to poorer communities with advocacy and education," she said.
The study was scheduled to be presented at the American Society of Nephrology annual meeting, in San Francisco.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about kidney transplantation.
Rabu, 07 November 2007
AyurDog
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http://www.india-herbs.com/aff/dreddyclinic/ayurdog
If you want to maximize your dog's longevity and eliminate fluctuating weight, molting fur, bad odor, anxiety, aggression, or sluggish behavior, there is proven help available. India's domesticated animals have been reaping the powerful benefits of Ayurveda Medicine for the past 5,000 years!
AyurDog is a natural herbal supplement geared towards optimizing your dog's overall health, appearance, and longevity. It will: Fortify Your Dog's Immune System. Reduce Aggression and Stress. Increase Receptivity to Learning. Remove Parasites and Toxins.
Enhance Your Dog's Coat Luster. Rejuvenate Joints and Muscles. Eliminate Bad Odor. AyurDog is a product of: 5000 years of Ayurvedic wisdom. Modern testing and research. Breakthrough encapsulation technique. Laboratory-controlled potency. Doctor-approved, carefully calibrated formula.
http://www.india-herbs.com/aff/dreddyclinic/ayurdog
Minggu, 04 November 2007
New Heart Pump Helps Women Awaiting Transplants
(HealthDay News) -- An implantable device that helps the heart pump blood -- and is about the size of a "D" battery, one-quarter the weight of the traditional device -- benefits women as well as men who are waiting for heart transplants.
That's the conclusion of new research that's expected to be presented Sunday at the American Heart Association annual meeting in Orlando, Fla.
"In the past, they were not as beneficial in women as in men, partly because of size," said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City. "It didn't match up anatomically."
The new device in question, the HeartMate II, is an implantable left ventricular assist device that helps heart function in people with severe congestive heart failure. The U.S. Food and Drug Administration is currently reviewing an application to approve the pump-like device.
According to background information for the study, women with advanced heart failure tended to be underrepresented in studies of left ventricular assist devices (LVADs). Only 9 percent to 16 percent of participants in trials of the first generation of the device were women.
The new trial included 231 patients with heart failure, 23 percent of whom were women being treated at one of 40 different U.S. heart transplant centers and were awaiting heart transplants.
The device serves as a "bridge" to transplantation.
The average age of the women was 56 (the range was 20 to 69 years). Men in the study averaged 54 years old, with an age range of 17 to 68.
Coronary artery disease was more likely to be the cause of heart failure in men -- 43 percent, compared with 31 percent in women.
The women may have suffered a weakened heart because of pregnancy, cancer chemotherapy, a viral infection or some other unknown cause, the researchers said.
Several study participants regained enough pumping power in the heart to have the device removed and no longer needed a transplant. And they've resumed normal physical activities, said the study authors, who are affiliated with such research centers as the Texas Heart Institute in Houston; the University of Rochester in New York; Johns Hopkins Hospital in Baltimore; Duke University, in Durham, N.C.; and Massachusetts General Hospital, in Boston.
Among the study's other findings:
That's the conclusion of new research that's expected to be presented Sunday at the American Heart Association annual meeting in Orlando, Fla.
"In the past, they were not as beneficial in women as in men, partly because of size," said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City. "It didn't match up anatomically."
The new device in question, the HeartMate II, is an implantable left ventricular assist device that helps heart function in people with severe congestive heart failure. The U.S. Food and Drug Administration is currently reviewing an application to approve the pump-like device.
According to background information for the study, women with advanced heart failure tended to be underrepresented in studies of left ventricular assist devices (LVADs). Only 9 percent to 16 percent of participants in trials of the first generation of the device were women.
The new trial included 231 patients with heart failure, 23 percent of whom were women being treated at one of 40 different U.S. heart transplant centers and were awaiting heart transplants.
The device serves as a "bridge" to transplantation.
The average age of the women was 56 (the range was 20 to 69 years). Men in the study averaged 54 years old, with an age range of 17 to 68.
Coronary artery disease was more likely to be the cause of heart failure in men -- 43 percent, compared with 31 percent in women.
The women may have suffered a weakened heart because of pregnancy, cancer chemotherapy, a viral infection or some other unknown cause, the researchers said.
Several study participants regained enough pumping power in the heart to have the device removed and no longer needed a transplant. And they've resumed normal physical activities, said the study authors, who are affiliated with such research centers as the Texas Heart Institute in Houston; the University of Rochester in New York; Johns Hopkins Hospital in Baltimore; Duke University, in Durham, N.C.; and Massachusetts General Hospital, in Boston.
Among the study's other findings:
- Six-month survival was about the same for men and women -- 80.6 percent versus 79.5 percent.
- The study found that 3.3 percent of women and 2.2 percent of men experienced strokes within two days of surgery; 13.6 percent of women and 4 percent of men experienced strokes after that.
- After three months with the device, 76 percent of women and 57 percent of men had increased the distance they could walk in six minutes by more than 200 meters.
- Functionally, it helped women more than men," Steinbaum said.
At the beginning of the study, all patients had Class IV heart failure, meaning they couldn't engage in any physical activity without discomfort. After three months with the device, 84 percent of women and men had only Class I and Class II heart failure symptoms -- no or slight limitations on physical activity. "Eighty-four percent of men and women went from Class IV heart failure -- they couldn't even move without being short of breath -- to Class I and II," Steinbaum said. "It's very exciting."
The trial was funded by Thoratec Corp. of Pleasanton, Calif., which manufactures the device.
One of the study authors is the company's vice president for research and scientific affairs. The other study authors are consultants and serve on a Thoratec advisory board.
More information
The American Heart Association has more on left ventricular assist devices.
Sabtu, 03 November 2007
Radiation Seed Treatment Helps Younger Men Fight Prostate Cancer
(HealthDay News) -- Radiation seed implants, known as brachytherapy, are just as effective for treating prostate cancer in men 60 and younger as they are for older men, a new study finds.
Brachytherapy is a minimally invasive procedure in which small radioactive seeds are placed in the prostate to kill cancer cells. Recovery time after seed implantation is much shorter than surgery, and studies have found brachytherapy to be as effective as surgery.
However, men 60 and younger are often advised to have surgery to remove part or all of the prostate, because many surgeons believe it's more effective long-term, according to background information in a news release about the study.
In this study, researchers analyzed the outcomes of more than 1,700 men with localized prostate cancer treated with brachytherapy at Mount Sinai Medical Center in New York between 1990 and 2005.
They found that men 60 and younger had the same outcomes as older men.
"These results suggest that brachytherapy is extremely effective in curing localized prostate cancer for men aged 60 and younger," lead author Dr. Alice Ho, a radiation oncologist at Memorial Sloan-Kettering Cancer Center in New York, said in a prepared statement.
"When younger men are diagnosed with localized prostate cancer, they should be presented with all viable treatment options, including brachytherapy. Every man with prostate cancer, regardless of his age, should have access to the treatment that is best for his cancer and lifestyle," Ho said.
The findings were expected to be presented Wednesday at the American Society for Therapeutic Radiology and Oncology annual meeting, in Los Angeles.
More information
The American Academy of Family Physicians outlines prostate cancer treatment options.
Brachytherapy is a minimally invasive procedure in which small radioactive seeds are placed in the prostate to kill cancer cells. Recovery time after seed implantation is much shorter than surgery, and studies have found brachytherapy to be as effective as surgery.
However, men 60 and younger are often advised to have surgery to remove part or all of the prostate, because many surgeons believe it's more effective long-term, according to background information in a news release about the study.
In this study, researchers analyzed the outcomes of more than 1,700 men with localized prostate cancer treated with brachytherapy at Mount Sinai Medical Center in New York between 1990 and 2005.
They found that men 60 and younger had the same outcomes as older men.
"These results suggest that brachytherapy is extremely effective in curing localized prostate cancer for men aged 60 and younger," lead author Dr. Alice Ho, a radiation oncologist at Memorial Sloan-Kettering Cancer Center in New York, said in a prepared statement.
"When younger men are diagnosed with localized prostate cancer, they should be presented with all viable treatment options, including brachytherapy. Every man with prostate cancer, regardless of his age, should have access to the treatment that is best for his cancer and lifestyle," Ho said.
The findings were expected to be presented Wednesday at the American Society for Therapeutic Radiology and Oncology annual meeting, in Los Angeles.
More information
The American Academy of Family Physicians outlines prostate cancer treatment options.
Senin, 29 Oktober 2007
New Guidelines Should Improve Ovarian Cancer Detection
(HealthDay News) -- Ovarian cancer has long had a reputation as a silent killer, because many people believed it gave no warning signs until far advanced.
But women suffering from the disease knew differently. They knew they had certain symptoms that were common from patient to patient.
"Survivors for years have said there are symptoms for the disease, but no one listened to them," said Jane Langridge, chief executive officer for the National Ovarian Cancer Coalition.
Now, doctors have agreed with them.
A screening test has been developed that, in one study, accurately detected early stage ovarian cancer 57 percent of the time.
Based on that and similar studies, experts from the American Cancer Society, the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists have agreed on a set of symptoms that can be signs of early ovarian cancer.
"We want people to know it's not the silent killer. There are symptoms women can bring to their doctors that are important to pay attention to," said Dr. Linda Duska, a member of the National Ovarian Cancer Coalition's medical advisory board and a gynecologic oncologist at Massachusetts General Hospital Cancer Center, in Boston.
"This agreement is significant in the fact that, maybe if we pay more attention to symptoms, we can catch them sooner and have more success in treating them," she continued.
Early detection of ovarian cancer is crucial.
More than 22,000 U.S. women will be diagnosed with the disease this year, and three-fourths of them -- more than 15,000 -- will die from it, according to the National Cancer Institute.
If caught in the early stages, the five-year survival rate for ovarian cancer is 90 percent. But 75 percent of women are still diagnosed in the advanced stages, when the prognosis is poor.
Ovarian cancer is the eighth most common cancer among American women, not including skin cancer, according to the American Cancer Society. An estimated two-thirds of women with ovarian cancer are 55 or older.
"It is a disease that is detected in stage 3 and above, and that is unacceptable," said Sherry Salway Black, executive director of the Ovarian Cancer National Alliance and a survivor of the disease. "Our mortality figures are unacceptable."
The symptoms of ovarian cancer can be subtle and hard to assess, because they often mimic common digestive and gastrointestinal disorders. They include persistent swelling, bloating, pressure or pain in the abdomen, gastrointestinal upset, difficulty eating or feeling full quickly, and the frequent or urgent need to urinate.
Because these symptoms are so common, women should be careful not to assume the worst, Duska said.
"The goal of this is not to make everyone think they have ovarian cancer," she said. "If women have these symptoms, and they persist over time, they should have them investigated.
Everyone with bloating does not have ovarian cancer."
Typically, two or more symptoms occur simultaneously and increase in severity over time, according to the National Ovarian Cancer Coalition.
The screening test developed late last year involves an extensive checklist of symptoms and their frequency. It picked up early stage ovarian cancer 56.7 percent of the time, and late stage ovarian cancer 80 percent of the time. The test also produced "false-positive" findings 10 percent to 13 percent of the time.
The test searches for many of the symptoms agreed upon by cancer experts as indicative of ovarian cancer.
"When women go to their doctors and have had some of these symptoms, and they are new and have persisted for two or more weeks, perhaps a doctor now would be willing to perform some pretty simple tests to rule out ovarian cancer," Langridge said.
Women who have a family history of breast or ovarian cancer are at increased risk and should pay particular attention to the symptoms, Duska said.
Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.
Advances in chemotherapy have made the late-stage disease more survivable, Duska said.
In a more intensive regimen recently shown to improve survival, standard intravenous chemotherapy is combined with chemotherapy injected directly into the abdominal cavity. The abdominal injection exposes hard-to-reach cancer cells to higher levels of chemotherapy than can be reached intravenously.
"That was a breakthrough, I think," Duska said.
Other treatments being explored include new chemotherapy drugs, vaccines, gene therapy and immunotherapy, which boosts the body's own immune system to help combat cancer, according to the Mayo Clinic.
More information
To learn more about ovarian cancer, visit the U.S. National Library of Medicine.
But women suffering from the disease knew differently. They knew they had certain symptoms that were common from patient to patient.
"Survivors for years have said there are symptoms for the disease, but no one listened to them," said Jane Langridge, chief executive officer for the National Ovarian Cancer Coalition.
Now, doctors have agreed with them.
A screening test has been developed that, in one study, accurately detected early stage ovarian cancer 57 percent of the time.
Based on that and similar studies, experts from the American Cancer Society, the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists have agreed on a set of symptoms that can be signs of early ovarian cancer.
"We want people to know it's not the silent killer. There are symptoms women can bring to their doctors that are important to pay attention to," said Dr. Linda Duska, a member of the National Ovarian Cancer Coalition's medical advisory board and a gynecologic oncologist at Massachusetts General Hospital Cancer Center, in Boston.
"This agreement is significant in the fact that, maybe if we pay more attention to symptoms, we can catch them sooner and have more success in treating them," she continued.
Early detection of ovarian cancer is crucial.
More than 22,000 U.S. women will be diagnosed with the disease this year, and three-fourths of them -- more than 15,000 -- will die from it, according to the National Cancer Institute.
If caught in the early stages, the five-year survival rate for ovarian cancer is 90 percent. But 75 percent of women are still diagnosed in the advanced stages, when the prognosis is poor.
Ovarian cancer is the eighth most common cancer among American women, not including skin cancer, according to the American Cancer Society. An estimated two-thirds of women with ovarian cancer are 55 or older.
"It is a disease that is detected in stage 3 and above, and that is unacceptable," said Sherry Salway Black, executive director of the Ovarian Cancer National Alliance and a survivor of the disease. "Our mortality figures are unacceptable."
The symptoms of ovarian cancer can be subtle and hard to assess, because they often mimic common digestive and gastrointestinal disorders. They include persistent swelling, bloating, pressure or pain in the abdomen, gastrointestinal upset, difficulty eating or feeling full quickly, and the frequent or urgent need to urinate.
Because these symptoms are so common, women should be careful not to assume the worst, Duska said.
"The goal of this is not to make everyone think they have ovarian cancer," she said. "If women have these symptoms, and they persist over time, they should have them investigated.
Everyone with bloating does not have ovarian cancer."
Typically, two or more symptoms occur simultaneously and increase in severity over time, according to the National Ovarian Cancer Coalition.
The screening test developed late last year involves an extensive checklist of symptoms and their frequency. It picked up early stage ovarian cancer 56.7 percent of the time, and late stage ovarian cancer 80 percent of the time. The test also produced "false-positive" findings 10 percent to 13 percent of the time.
The test searches for many of the symptoms agreed upon by cancer experts as indicative of ovarian cancer.
"When women go to their doctors and have had some of these symptoms, and they are new and have persisted for two or more weeks, perhaps a doctor now would be willing to perform some pretty simple tests to rule out ovarian cancer," Langridge said.
Women who have a family history of breast or ovarian cancer are at increased risk and should pay particular attention to the symptoms, Duska said.
Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.
Advances in chemotherapy have made the late-stage disease more survivable, Duska said.
In a more intensive regimen recently shown to improve survival, standard intravenous chemotherapy is combined with chemotherapy injected directly into the abdominal cavity. The abdominal injection exposes hard-to-reach cancer cells to higher levels of chemotherapy than can be reached intravenously.
"That was a breakthrough, I think," Duska said.
Other treatments being explored include new chemotherapy drugs, vaccines, gene therapy and immunotherapy, which boosts the body's own immune system to help combat cancer, according to the Mayo Clinic.
More information
To learn more about ovarian cancer, visit the U.S. National Library of Medicine.
Kamis, 25 Oktober 2007
FDA to Review Clotting Drug After Trial Suggests Death Risk
(HealthDay News) -- The U.S. Food and Drug Administration said Thursday that it will review the safety of the clotting drug aprotinin (Trasylol), after a major Canadian trial was stopped early due to an increase in deaths for cardiac surgery patients placed on the drug.
Trasylol, first approved by the FDA in 1993, is typically used to limit blood loss in patients undergoing cardiac surgery.
While less bleeding was noted in the aprotinin group versus patients assigned one of two other drugs, "a trend toward increased mortality in the aprotinin group had been observed throughout the study," the FDA noted in a statement released Thursday.
That elevated 30-day and overall death risk caused the Canadian study's Data Safety Monitoring Board (DSMB) to recommend stopping patient enrollment in the so-called BART trial. The trial was set to recruit about 3,000 adults who were candidates for a variety of cardiac surgeries and were at high risk of bleeding.
"The DSMB concluded that continued enrollment of patients into the aprotinin group was unlikely to significantly change the study findings," the FDA said.
Trasylol's maker, Bayer, also issued a new "guidance" to doctors on Thursday. The German company advises "that physicians use Trasylol only in accordance with approved product labeling." Bayer said it believes the drug "remains a safe and effective treatment option for physicians," but it is working with the FDA and international health authorities to see if any label changes might become necessary as new data emerges.
Trasylol has had a checkered history since it was first approved by the FDA in 1993.
On Sept. 12, a U.S. Food and Drug Administration advisory panel recommended that aprotinin remain on the market, despite evidence that it might have serious side effects.
In February, a study published in the Journal of the American Medical Association found patients on the drug were at greater risk of dying over the next five years than those given two other medications. The same researchers linked aprotinin to an increased risk of kidney failure, heart failure and stroke in a study published in 2006.
"Our present findings deal with death," one of the JAMA study's authors, Dr. Dennis T. Mangano, said at the time. Mangano, director of the Ischemia Research and Education Foundation, a California-based nonprofit group, said that "the death rate for aprotinin patients far outstrips that for the other two drugs."
His team's study tracked the long-term survival of nearly 3,900 heart patients who underwent coronary artery bypass surgery at 62 medical centers worldwide. The researchers tabulated survival at six weeks, six months, and then annually for five years.
The five-year death rate for patients given aprotinin was 20.8 percent, compared to 15.8 percent for those given another drug, aminocaproic acid, and 14.7 percent for those given tranexamic acid. Both alternative drugs are available in generic versions.
After the 2006 report from Mangano's group, the FDA advised doctors to carefully monitor aprotinin patients for kidney, heart and brain damage -- an action taken after Bayer disclosed study data showing that it increased the risk of death, kidney damage, congestive heart failure and stroke.
The 2006 report led to a 37 percent reduction in surgeons' use of aprotinin, Mangano said. "Clinicians, more than anyone else, will decide whether this drug should be on the market or its use should be limited," he said.
Aprotinin does have its defenders.
Dr. T. Bruce Ferguson Jr., associate director of cardiothoracic and vascular surgery at East Carolina University, wrote an accompanying editorial to the JAMA study. He believes the study "was inadequate to address the question they were asking because of the way the database was designed."
"The most important factor they were unable to control was why patients got aprotinin," Ferguson said. "There were no data to address that issue, and therefore it cannot account for physician-related bias."
For example, the higher rate of death and other complications linked to the drug might be due to aprotinin being prescribed for "higher-risk patients who could be expected to have a worse outcome and higher mortality," Ferguson said. Other studies have shown that "in carefully selected patients, aprotinin is a good drug," he said.
The information used in the study was thorough and complete, Mangano countered. "In terms of the database, we had between 7,000 and 10,000 pieces of data per patient from 59 centers in 16 countries, including 23 of the 25 top cardiac centers in the United States."
"The findings speak for themselves," Mangano said. "I think they are as accurate as you can get."
He believes that aprotinin's use should be restricted to about 5 percent of patients in whom other drugs could not be used.
"And the surgeon would have to tell each patient before using this drug that there is literature out there showing that this drug is associated with renal [kidney] failure and death," Mangano said. "For the vast majority of patients, there are the two other alternatives."
More information
There's more on cardiac surgery at the U.S. National Library of Medicine.
Trasylol, first approved by the FDA in 1993, is typically used to limit blood loss in patients undergoing cardiac surgery.
While less bleeding was noted in the aprotinin group versus patients assigned one of two other drugs, "a trend toward increased mortality in the aprotinin group had been observed throughout the study," the FDA noted in a statement released Thursday.
That elevated 30-day and overall death risk caused the Canadian study's Data Safety Monitoring Board (DSMB) to recommend stopping patient enrollment in the so-called BART trial. The trial was set to recruit about 3,000 adults who were candidates for a variety of cardiac surgeries and were at high risk of bleeding.
"The DSMB concluded that continued enrollment of patients into the aprotinin group was unlikely to significantly change the study findings," the FDA said.
Trasylol's maker, Bayer, also issued a new "guidance" to doctors on Thursday. The German company advises "that physicians use Trasylol only in accordance with approved product labeling." Bayer said it believes the drug "remains a safe and effective treatment option for physicians," but it is working with the FDA and international health authorities to see if any label changes might become necessary as new data emerges.
Trasylol has had a checkered history since it was first approved by the FDA in 1993.
On Sept. 12, a U.S. Food and Drug Administration advisory panel recommended that aprotinin remain on the market, despite evidence that it might have serious side effects.
In February, a study published in the Journal of the American Medical Association found patients on the drug were at greater risk of dying over the next five years than those given two other medications. The same researchers linked aprotinin to an increased risk of kidney failure, heart failure and stroke in a study published in 2006.
"Our present findings deal with death," one of the JAMA study's authors, Dr. Dennis T. Mangano, said at the time. Mangano, director of the Ischemia Research and Education Foundation, a California-based nonprofit group, said that "the death rate for aprotinin patients far outstrips that for the other two drugs."
His team's study tracked the long-term survival of nearly 3,900 heart patients who underwent coronary artery bypass surgery at 62 medical centers worldwide. The researchers tabulated survival at six weeks, six months, and then annually for five years.
The five-year death rate for patients given aprotinin was 20.8 percent, compared to 15.8 percent for those given another drug, aminocaproic acid, and 14.7 percent for those given tranexamic acid. Both alternative drugs are available in generic versions.
After the 2006 report from Mangano's group, the FDA advised doctors to carefully monitor aprotinin patients for kidney, heart and brain damage -- an action taken after Bayer disclosed study data showing that it increased the risk of death, kidney damage, congestive heart failure and stroke.
The 2006 report led to a 37 percent reduction in surgeons' use of aprotinin, Mangano said. "Clinicians, more than anyone else, will decide whether this drug should be on the market or its use should be limited," he said.
Aprotinin does have its defenders.
Dr. T. Bruce Ferguson Jr., associate director of cardiothoracic and vascular surgery at East Carolina University, wrote an accompanying editorial to the JAMA study. He believes the study "was inadequate to address the question they were asking because of the way the database was designed."
"The most important factor they were unable to control was why patients got aprotinin," Ferguson said. "There were no data to address that issue, and therefore it cannot account for physician-related bias."
For example, the higher rate of death and other complications linked to the drug might be due to aprotinin being prescribed for "higher-risk patients who could be expected to have a worse outcome and higher mortality," Ferguson said. Other studies have shown that "in carefully selected patients, aprotinin is a good drug," he said.
The information used in the study was thorough and complete, Mangano countered. "In terms of the database, we had between 7,000 and 10,000 pieces of data per patient from 59 centers in 16 countries, including 23 of the 25 top cardiac centers in the United States."
"The findings speak for themselves," Mangano said. "I think they are as accurate as you can get."
He believes that aprotinin's use should be restricted to about 5 percent of patients in whom other drugs could not be used.
"And the surgeon would have to tell each patient before using this drug that there is literature out there showing that this drug is associated with renal [kidney] failure and death," Mangano said. "For the vast majority of patients, there are the two other alternatives."
More information
There's more on cardiac surgery at the U.S. National Library of Medicine.
Senin, 22 Oktober 2007
Whole Grains Do a Heart Good
(HealthDay News) -- Diets rich in whole grains, fruits, vegetables and even a little alcohol may help ward off heart woes, new studies show.
In one study, regular consumption of whole-grain breakfast cereal cut the risk of heart failure for male American physicians.
Another study, this time from Sweden, touted the benefits of fruits, veggies and the occasional drink in helping women beat heart attack.
The American study analyzed the association between breakfast cereal intake and new cases of heart failure, in which the heart progressively loses its ability to pump blood.
The study included data on more than 21,000 participants in the Physicians' Health Study who were followed for almost 20 years.
Compared to those who ate no whole-grain cereal, men who consumed 2 to 6 servings per week saw their risk of heart failure fall by 21 percent, while those who ate 7 or more servings per week reaped a 29 percent reduction in risk, the researchers reported in the Oct. 22 issue of the Archives of Internal Medicine.
That effect is due, in part, to the high levels of magnesium, potassium and fiber in those breakfast cereals, said study co-author Dr. Luc Djousse, an associate in epidemiology at Brigham and Women's Hospital in Boston.
"Our recommendation is that a lay person consuming breakfast cereal should look at fiber," Djousse said. "At least four grams of fiber [per serving], that should be sufficient."
Fiber increases cells' sensitivity to insulin, thus reducing the risk of diabetes, while potassium and magnesium lower blood pressure, he explained.
Breakfast cereal is best taken with skim milk, Djousse said, "and if you want to add to it, a piece or half-piece of fruit would be good."
While the study included only men, there is "no reason at all" why the results shouldn't apply to women, he said.
The Swedish study, done at the Karolinska Institute, Stockholm, took a much broader approach to the food intake of more than 24,000 postmenopausal women who supplied information on how often they ate 96 common foods.
The study, published in the same issue of the journal, identified four major dietary patterns: healthy (vegetables, fruits and legumes); Western/Swedish (red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes, fish); alcohol (wine, liquor, beer and some snacks); and sweets (sweet baked goods, candy, chocolate, jam and ice cream).
In an average 6.2-year follow-up period, 308 of the women had heart attacks. However, two dietary patterns, healthy and alcohol, were associated with a reduced risk of heart attack, the researchers said.
A low-risk diet is characterized by a high intake of whole grains, fish, vegetables, fruit and legumes, moderate alcohol consumption, along with not smoking and being physically active and relatively thin, the researchers concluded. "This combination of healthy behaviors -- present in 5 percent [of those studied] -- may prevent 77 percent of myocardial infarctions [heart attacks] in the study population," the team wrote.
The study was called "empowering" by Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York, because "it demonstrates that people have control over their health and can take control, eat properly and exercise and prevent onset of disease."
"This study clearly demonstrates that it is within an individual's control to change destiny and the ability to control his or her health," Steinbaum said.
"What's amazing is that a study of 24,000 women shows that a reduction of 77 percent is possible," she said. "What could be more empowering than that?"
The issue is muddied by a plethora of books urging different diets, she acknowledged. But the real road to long-term health "is not so much going on a diet as adopting a healthy lifestyle," Steinbaum said.
More information
There's more on heart-healthy lifestyles at the American Heart Association.
In one study, regular consumption of whole-grain breakfast cereal cut the risk of heart failure for male American physicians.
Another study, this time from Sweden, touted the benefits of fruits, veggies and the occasional drink in helping women beat heart attack.
The American study analyzed the association between breakfast cereal intake and new cases of heart failure, in which the heart progressively loses its ability to pump blood.
The study included data on more than 21,000 participants in the Physicians' Health Study who were followed for almost 20 years.
Compared to those who ate no whole-grain cereal, men who consumed 2 to 6 servings per week saw their risk of heart failure fall by 21 percent, while those who ate 7 or more servings per week reaped a 29 percent reduction in risk, the researchers reported in the Oct. 22 issue of the Archives of Internal Medicine.
That effect is due, in part, to the high levels of magnesium, potassium and fiber in those breakfast cereals, said study co-author Dr. Luc Djousse, an associate in epidemiology at Brigham and Women's Hospital in Boston.
"Our recommendation is that a lay person consuming breakfast cereal should look at fiber," Djousse said. "At least four grams of fiber [per serving], that should be sufficient."
Fiber increases cells' sensitivity to insulin, thus reducing the risk of diabetes, while potassium and magnesium lower blood pressure, he explained.
Breakfast cereal is best taken with skim milk, Djousse said, "and if you want to add to it, a piece or half-piece of fruit would be good."
While the study included only men, there is "no reason at all" why the results shouldn't apply to women, he said.
The Swedish study, done at the Karolinska Institute, Stockholm, took a much broader approach to the food intake of more than 24,000 postmenopausal women who supplied information on how often they ate 96 common foods.
The study, published in the same issue of the journal, identified four major dietary patterns: healthy (vegetables, fruits and legumes); Western/Swedish (red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes, fish); alcohol (wine, liquor, beer and some snacks); and sweets (sweet baked goods, candy, chocolate, jam and ice cream).
In an average 6.2-year follow-up period, 308 of the women had heart attacks. However, two dietary patterns, healthy and alcohol, were associated with a reduced risk of heart attack, the researchers said.
A low-risk diet is characterized by a high intake of whole grains, fish, vegetables, fruit and legumes, moderate alcohol consumption, along with not smoking and being physically active and relatively thin, the researchers concluded. "This combination of healthy behaviors -- present in 5 percent [of those studied] -- may prevent 77 percent of myocardial infarctions [heart attacks] in the study population," the team wrote.
The study was called "empowering" by Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York, because "it demonstrates that people have control over their health and can take control, eat properly and exercise and prevent onset of disease."
"This study clearly demonstrates that it is within an individual's control to change destiny and the ability to control his or her health," Steinbaum said.
"What's amazing is that a study of 24,000 women shows that a reduction of 77 percent is possible," she said. "What could be more empowering than that?"
The issue is muddied by a plethora of books urging different diets, she acknowledged. But the real road to long-term health "is not so much going on a diet as adopting a healthy lifestyle," Steinbaum said.
More information
There's more on heart-healthy lifestyles at the American Heart Association.
Jumat, 19 Oktober 2007
Childlessness Bothers Men More Than Women
(HealthDay News) -- Women are more comfortable with the idea of childlessness than men, new research shows, and the surprise finding might really reflect differences in how each gender views the pressures of parenthood.
"On a basic level, for men and women, parenting and parenthood mean different things," said study author Tanya Koropeckyj-Cox. "For me, it reflects that there's something important happening in the experiences of men and women where those different experiences are leading to different perceptions of family, relationships, gender and children."
Differences in socioeconomic factors such as race, age, employment, attitudes toward marriage and religion explain only part of the gender gap. "Instead, these responses indicate greater acceptance of childlessness, particularly among women, as one possible life path whether chosen or shaped by circumstances," the study concluded.
The research is published in the November issue of the Journal of Marriage and Family. The study is based on data collected in two national surveys that were conducted in 1987 to 1988 and in 1994. Over the past few decades, the number of women who are childless has varied widely, said Koropeckyj-Cox, an assistant professor of sociology at the University of Florida.
During the Baby Boom years, only about 9 percent of women were childless in their 40s. Recent statistics indicate that about 20 percent of women in their 40s are now childless, she added. "As women wait longer to have children, they may be less likely to have children," she explained.
"It's definitely a big shift," Koropeckyj-Cox said. "1962 is the tail end of the Baby Boom, and there definitely was a feeling that having children was what everybody did. The attitudes were definite and specific. Those who couldn't were regarded with pity, and those who could but didn't were disrespected."
Koropeckyj-Cox speculated that some women may not be choosing motherhood because of the burden of how difficult the dual roles of mom and working women are. "Other studies have documented that men tend to experience pretty strong economic and social rewards from being a dad, whereas women experience more of the pressures and more of the demands of the immediate day-to-day reality of parenting and juggling work."
The study argues that even though its data is at least 10 years old, that gender gap still may be pivotal in shaping attitudes toward childlessness. Conditions in terms of work and other issues for women considering parenthood don't seem to have changed much, Koropeckyj-Cox noted, but "one of my next steps would be to keep looking at it with more recent data."
At first, the findings seem "counterintuitive," said Irene Goldenberg, a professor emerita of psychiatry at University of California, Los Angeles. "People would say that women care more" about children. But, as the study implies, "women know the costs more."
The finding that women's acceptance of childlessness increases with the amount of education they have shows that "the smarter you are, the more you know about the costs," Goldenberg added. "You understand that it's difficult to do both things. The whole idea of doing both is really tough. Doing both at a high level is maybe possible for only a few women. Ordinary women can't handle it all."
Goldenberg added that she thinks "women are not really going for childlessness, but that they are more attuned to the demands -- both economic and social demands -- of parenthood, and they carry more of these responsibilities."
Nadine Kaslow, chief psychologist at Emory Medical School in Atlanta, viewed the findings similarly, adding that "women who are successful professionals make a choice that they don't want to have children in their lives, because they have other things in their lives." Men, however, "tend to think that is what you do in life. You grow up and have a baby."
That male attitude may come from their most primal being, explained Barry Ginsberg, a Pennsylvania psychologist specializing in relationships. "For a man, the loss of having a family and carrying on the gene pool makes men helpless, because they can't give birth," Ginsberg said.
From an "evolutionary standpoint, men would go around impregnating all the women they could find, so that at least one of those women would survive" and produce a child, he explained.
More information
The National Association of Mothers' Center has support and advice for moms.
"On a basic level, for men and women, parenting and parenthood mean different things," said study author Tanya Koropeckyj-Cox. "For me, it reflects that there's something important happening in the experiences of men and women where those different experiences are leading to different perceptions of family, relationships, gender and children."
Differences in socioeconomic factors such as race, age, employment, attitudes toward marriage and religion explain only part of the gender gap. "Instead, these responses indicate greater acceptance of childlessness, particularly among women, as one possible life path whether chosen or shaped by circumstances," the study concluded.
The research is published in the November issue of the Journal of Marriage and Family. The study is based on data collected in two national surveys that were conducted in 1987 to 1988 and in 1994. Over the past few decades, the number of women who are childless has varied widely, said Koropeckyj-Cox, an assistant professor of sociology at the University of Florida.
During the Baby Boom years, only about 9 percent of women were childless in their 40s. Recent statistics indicate that about 20 percent of women in their 40s are now childless, she added. "As women wait longer to have children, they may be less likely to have children," she explained.
"It's definitely a big shift," Koropeckyj-Cox said. "1962 is the tail end of the Baby Boom, and there definitely was a feeling that having children was what everybody did. The attitudes were definite and specific. Those who couldn't were regarded with pity, and those who could but didn't were disrespected."
Koropeckyj-Cox speculated that some women may not be choosing motherhood because of the burden of how difficult the dual roles of mom and working women are. "Other studies have documented that men tend to experience pretty strong economic and social rewards from being a dad, whereas women experience more of the pressures and more of the demands of the immediate day-to-day reality of parenting and juggling work."
The study argues that even though its data is at least 10 years old, that gender gap still may be pivotal in shaping attitudes toward childlessness. Conditions in terms of work and other issues for women considering parenthood don't seem to have changed much, Koropeckyj-Cox noted, but "one of my next steps would be to keep looking at it with more recent data."
At first, the findings seem "counterintuitive," said Irene Goldenberg, a professor emerita of psychiatry at University of California, Los Angeles. "People would say that women care more" about children. But, as the study implies, "women know the costs more."
The finding that women's acceptance of childlessness increases with the amount of education they have shows that "the smarter you are, the more you know about the costs," Goldenberg added. "You understand that it's difficult to do both things. The whole idea of doing both is really tough. Doing both at a high level is maybe possible for only a few women. Ordinary women can't handle it all."
Goldenberg added that she thinks "women are not really going for childlessness, but that they are more attuned to the demands -- both economic and social demands -- of parenthood, and they carry more of these responsibilities."
Nadine Kaslow, chief psychologist at Emory Medical School in Atlanta, viewed the findings similarly, adding that "women who are successful professionals make a choice that they don't want to have children in their lives, because they have other things in their lives." Men, however, "tend to think that is what you do in life. You grow up and have a baby."
That male attitude may come from their most primal being, explained Barry Ginsberg, a Pennsylvania psychologist specializing in relationships. "For a man, the loss of having a family and carrying on the gene pool makes men helpless, because they can't give birth," Ginsberg said.
From an "evolutionary standpoint, men would go around impregnating all the women they could find, so that at least one of those women would survive" and produce a child, he explained.
More information
The National Association of Mothers' Center has support and advice for moms.
Senin, 15 Oktober 2007
Psychiatric Woes Can Postpone Weight-Loss Surgery
(HealthDay News) -- About one in every five people who were candidates for bariatric weight-loss surgery did not receive the recommended psychiatric clearance for the procedure, a U.S. study shows.
Psychiatric evaluations are part of the preoperative screening process in most bariatric surgery programs, notes a team from the Rhode Island Hospital and Brown University in Providence.
The most common reasons why patients did not receive psychiatric clearance included frequent overeating to cope with stress/emotional distress; a current eating disorder; or uncontrolled psychiatric disorders.
The researchers also found that the decision to clear candidates for bariatric surgery is made with high reliability -- meaning that a review of available information by independent psychiatrists would result in the same decision.
"The goal of psychiatric evaluation is not to keep patients from having the surgery. Rather, the goal is to determine if there are any problems that might interfere with the success of surgery, and have the patient get treatment for these problems," study author Dr. Mark Zimmerman, director of outpatient psychiatry at Rhode Island Hospital and a professor of psychiatry and human behavior at Brown University, said in a prepared statement.
He said a patient is "more likely to have a positive outcome from surgery that is delayed to allow time to address the problems."
The study appears in the October issue of the Journal of Clinical Psychiatry.
More information
MedlinePlus explains gastric bypass surgery.
Psychiatric evaluations are part of the preoperative screening process in most bariatric surgery programs, notes a team from the Rhode Island Hospital and Brown University in Providence.
The most common reasons why patients did not receive psychiatric clearance included frequent overeating to cope with stress/emotional distress; a current eating disorder; or uncontrolled psychiatric disorders.
The researchers also found that the decision to clear candidates for bariatric surgery is made with high reliability -- meaning that a review of available information by independent psychiatrists would result in the same decision.
"The goal of psychiatric evaluation is not to keep patients from having the surgery. Rather, the goal is to determine if there are any problems that might interfere with the success of surgery, and have the patient get treatment for these problems," study author Dr. Mark Zimmerman, director of outpatient psychiatry at Rhode Island Hospital and a professor of psychiatry and human behavior at Brown University, said in a prepared statement.
He said a patient is "more likely to have a positive outcome from surgery that is delayed to allow time to address the problems."
The study appears in the October issue of the Journal of Clinical Psychiatry.
More information
MedlinePlus explains gastric bypass surgery.
Jumat, 12 Oktober 2007
Experts Offer Answers on Colonoscopy Options
(HealthDay News) -- Two recent studies comparing the use of conventional (optical) colonoscopy and CT (virtual) colonoscopy for colorectal cancer screening may raise questions among people considering the test, says the American College of Gastroenterology (ACG).The studies included a large multi-center trial called ACRIN that was sponsored by the U.S. National Institutes of Health and a University of Wisconsin study published in the New England Journal of Medicine. Both trials compared the accuracy of CT colonoscopy to conventional colonoscopy (the current gold standard for colorectal cancer screening) in detecting polyps or cancer in the colon.
In order to help inform the public, the ACG has developed an FAQ (frequently asked questions) resource describing both colonoscopy techniques.
Conventional colonoscopy involves insertion of a flexible tube into the rectum. The tube, which carries a tiny camera, allows the doctor to directly view the entire colon and to detect and remove suspicious polyps. Three studies found that this method prevents about 80 percent of colorectal cancers from developing, according to the ACG.
In CT colonoscopy, air is pumped into the colon until it's fully distended and a CT scan is used to examine the colon. Studies suggest that between 30 percent and 50 percent of patients who have a CT colonoscopy will need a conventional colonoscopy to remove suspicious polyps.
On average, research has shown that CT colonoscopy is inferior to regular colonoscopy for detection of colon polyps, the ACG said.
Both types of colonoscopy require the same bowel-cleansing regimen.
More information
The U.S. National Cancer Institute has more about colorectal cancer screening.
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