healthy living websites: May 2014

Does Timing Play a Role in Survival After Hospital Admission, Surgery?

By Robert Preidt, HealthDay Reporter

SATURDAY, May 31, 2014 (HealthDay News) -- The timing of your surgery or hospital admission could affect your risk of death, according to new research.

One study found that a patient's risk of death after surgery is highest on weekends, afternoons and in February. Another study concluded that patients admitted to hospitals on weekends have a higher risk of death than those admitted on weekdays.

The studies were scheduled for presentation this weekend at the European Society of Anaesthesiology meeting in Stockholm, Sweden.

In the first study, researchers analyzed data from nearly 219,000 patients who had surgery in Berlin, Germany, between 2006 and 2011. Patients operated on in the afternoon were 21 percent more likely to die compared with those who had surgery at other times of the day.

Surgery on the weekend carried a 22 percent higher risk of death than surgery on weekdays, the study found. And patients operated on in February were 16 percent more likely to die than those who had surgery in all other months.

"Several factors may have influenced this outcome. For example, it may be that standard of care differs throughout the day and between weekdays and weekends," wrote Dr. Felix Kork and Claudia Spies, of Charite-University Medicine Berlin, and colleagues.

"Although we controlled for risk factors including emergency surgery in our study, it may very well be that the patients treated in the afternoon and on the weekends were more severely ill. We need more data to draw conclusions regarding seasonal variation in postoperative outcome," they said in a society news release.

The authors added that the findings show the need to further improve patient safety. However, research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.

In the second study, researchers analyzed data from 55 million hospital patients worldwide. They found those admitted on weekends were 15 percent to 17 percent more likely to die than those admitted on weekdays.

"There are at least two potential explanations for our results," said Dr. Hiroshi Hoshijima of Tohoku University in Sendai, Japan, and colleagues. "First, these differences reflect poorer quality of care in hospitals on the weekend, and second, patients admitted on the weekend could be more severely ill than those admitted on a weekday," Hoshijima's team suggested.

"We believe that poorer care at the weekends is the much more likely explanation," the study authors said in the news release.

More information

The U.S. National Institutes of Health has more about surgery.

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New drugs may make a dent in lung, ovarian cancer

By MARILYNN MARCHIONE, AP Chief Medical Writer

CHICAGO (AP) — New drugs are making a dent against some hard-to-treat cancers, but some results raise fresh questions about whether the benefit is worth the cost.

For the first time in a decade, an experimental drug has extended the lives of patients with advanced lung cancer who relapsed after standard chemotherapy. But the drug used in the study gave patients just six extra weeks of life on average, and costs $6,000 per infusion as currently sold to treat a different form of cancer.

Eli Lilly and Co.'s drug, Cryamza, was discussed Saturday at a cancer conference in Chicago, where other studies showed:

—The drug Imbruvica, sold by Pharmacyclics Inc. and Janssen Biotech, substantially improved survival and could set a new standard of care for relapsed chronic lymphocytic leukemia, or CLL, the most common leukemia in adults. Doctors say the pill more precisely targets cancer and is a good option for older people who can't tolerate standard chemotherapy infusions.

—Two experimental pills from AstraZeneca PLC worked much better than one alone against ovarian cancer that resisted or came back after standard chemo. The drugs significantly prolonged the time women lived without their disease worsening.

LUNG CANCER

Cyramza is sold now to treat stomach cancer and fights the formation of blood vessels that feed tumors. French researchers led a study with 1,253 patients who relapsed after initial treatment of advanced lung cancer, a more common disease.

All were given the chemo drug docetaxel and half also received Cyramza infusions every three weeks. Median overall survival was 10.5 months for those on the combo and 9 months for the others; there were significantly more side effects with the combo.

"I don't think a six-week increment is that impressive" for survival, said Dr. Derek Raghavan, an independent expert and president of the Levine Cancer Institute at Carolinas HealthCare System in Charlotte, North Carolina. He also is on a task force on value in cancer care for the American Society of Clinical Oncology, the group hosting the conference.

The fact it prolonged survival at all suggests it is worth testing earlier in the course of the disease to see whether those patients fare better, he said. But for people whose lung cancer has come back, he said, "I'd try something else that's cheaper" first.

Other doctors were more positive.

"It's exciting to see progress in this disease where the steps are small but cumulative," said Dr. Gregory Masters of the Helen F. Graham Cancer Center in Newark, Delaware, and an ASCO spokesman.

LEUKEMIA

The value of another expensive drug seemed clearer, doctors said. Imbruvica won approval earlier this year for treating chronic lymphocytic leukemia based on a small study that found it delayed the time until the disease got worse.

Ohio State University's Dr. John C. Byrd led a more definitive study in nearly 400 patients who did not respond or had a relapse after standard chemo. They were given Imbruvica or Arzerra, a GlaxoSmithKline drug often used in such cases.

One-year survival was 90 percent for those on Imbruvica and 81 percent for those originally assigned to get Arzerra. Imbruvica also reduced the chances of the disease getting worse by 78 percent.

The results were especially impressive because patients on Arzerra were allowed to switch to Imbruvica early in the study once its benefit became apparent. Treatment costs $8,200 a month.

The drug "may transform the treatment of CLL," said Masters, the oncology society spokesman.

OVARIAN CANCER

Ovarian cancer usually is treated with surgery and chemo but about 80 percent of patients relapse, said Dr. Joyce Liu of the Dana-Farber Cancer Institute in Boston.

She led a federally funded study of 90 such women to test cediranib, a drug that blocks tumor blood vessel formation, plus olaparib, part of a new class of experimental drugs called PARP inhibitors, which keep cancer cells from repairing damage to their DNA.

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Experimental Drug May Extend Lung Cancer Survival, Study Suggests

SATURDAY, May 31, 2014 (HealthDay News) -- A new "targeted" therapy might help extend the lives of patients with advanced lung cancer who have a relapse after their initial treatment, a clinical trial suggests.

The drug, ramucirumab, improved survival by more than a month when combined with standard chemotherapy, researchers are scheduled to report Saturday at the American Society of Clinical Oncology annual meeting in Chicago.

Ramucirumab fights cancer by preventing the creation of new blood vessels in tumors, robbing them of needed nutrients and oxygen.

The study found that median overall survival in patients with advanced non-small cell lung cancer was 10.5 months for those taking ramucirumab plus chemotherapy, compared with 9.1 months for patients who received a placebo, or dummy drug, with their chemo.

The significance of this advance may be subject to debate.

Currently, very limited chemotherapy options exist for patients whose lung cancer returns, said study lead author Dr. Maurice Perol, head of thoracic oncology at the Cancer Research Center of Lyon in France.

Those options provide relatively poor results, shrinking tumors only about 10 percent and extending patient survival 7 to 9 months, he said.

"This is the first treatment in approximately a decade to improve the outcome of patients in the second-line setting," Perol said. "The survival improvement is significant because patients with advanced non-small cell lung cancer typically have a very short survival time following second-line therapy."

The findings should be considered preliminary until published in a peer-reviewed medical journal. Also, if the drug receives U.S. Food and Drug Administration approval, doctors and patients will have to weigh the effectiveness of the treatment against what's expected to be its enormous cost.

The clinical trial involved 1,253 patients with stage IV non-small cell lung cancer that had progressed despite standard chemotherapy. Non-small cell lung cancer is the most common type of lung cancer.

All of the patients were treated with the chemotherapy drug docetaxel. Some then were randomly given ramucirumab as well, while others received a placebo.

Adding ramucirumab improved the effectiveness of chemotherapy, the investigators found, with nearly 23 percent of patients experiencing tumor shrinkage compared with 13.5 percent of those who received placebo.

Ramucirumab also improved survival against all types of non-small cell lung cancer, indicating that it could be useful in treating all patients battling a recurrence of this type of lung cancer, Perol said.

The progression-free survival periods for ramucirumab patients was 4.5 months, versus 3 months in the placebo group.

The experimental drug came with few serious side effects. "There was no increase in adverse events or in pulmonary hemorrhage [bleeding from the lung], which is one of the greatest potential risks," Perol said.

The findings from the clinical trial don't represent a huge advance over current treatment, said Dr. Norman Edelman, senior medical advisor for the American Lung Association.

However, ramucirumab does show promise as part of a new class of targeted therapies, he added.

"I find this drug interesting because it represents an attempt to step beyond the usual cytotoxic agents. But on its own, it's not a remarkable breakthrough," Edelman said.

"Some people will have an extra year. Other people will have nothing," Edelman said. "And it won't be cheap. The new biologics are expensive. We're talking tens of thousands of dollars for cost of treatment. These are complicated decisions."

More information

For more on treatment of recurring lung cancer, visit the U.S. National Cancer Institute.

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New Drug Shows Promise for Resistant Thyroid Cancer

By Randy Dotinga, HealthDay Reporter

SATURDAY, May 31, 2014 (HealthDay News) -- A new oral drug called lenvatinib looks promising as a treatment for a type of thyroid cancer that resists standard radiation, according to a later-stage clinical trial.

"We are confident that, based on our findings, lenvatinib will eventually become a standard treatment for radioiodine-resistant thyroid cancer," said study lead author Dr. Martin Schlumberger, a professor of oncology at the University Paris Sud in Paris, France.

"As little as a year ago, this group of patients had no effective treatment options. It's remarkable that we now have two active drugs in this setting, both of them tyrosine kinase inhibitors," he added in a statement provided by the American Society of Clinical Oncology.

Eisai Inc., lenvatinib's manufacturer, supported the research. Findings from the study are scheduled to be presented Monday at the annual meeting of the American Society of Clinical Oncology in Chicago. Research presented at meetings is generally viewed as preliminary until it's published in a peer-reviewed journal.

An estimated 60,000 annual new cases of thyroid cancer are diagnosed in the United States. This research includes the most common subtype of thyroid cancer called "differentiated." These types of tumors can typically be cured with a combination of therapy and radiation treatment, but about 5 to 15 percent of patients develop resistance to the radiation treatment.

Another new drug, sorafenib, received federal approval last year to be used as a treatment for people with differentiated thyroid cancer. The drug now being studied, lenvatinib, works in a similar way.

In the new study, almost 400 people with advanced, radiation-resistant, differentiated thyroid cancer were given lenvatinib or a placebo. Tumors shrunk in 65 percent of the patients who took the drug compared to 3 percent of those who took the placebo; those who took the drug went for an average of 18 months without disease progression, compared to just under four months for those who took the placebo.

The researchers don't know yet how long the patients will survive on average.

Side effects such as high blood pressure, diarrhea, decreased appetite, decreased weight and nausea, caused physicians to lower doses in almost 80 percent of patients, although Schlumberger said the smaller doses didn't disrupt the drug's effect.

"The progress we're seeing with targeted agents for uncommon cancers is encouraging," said oncologist Dr. Gregory Masters in a statement provided by the American Society of Clinical Oncology. "Patients with differentiated thyroid cancer have historically had limited options when the disease progresses despite radioactive iodine therapy. Now this new drug, lenvatinib, offers an effective option with reasonable side effects and can help patients live longer before the disease worsens."

More information

For more about thyroid cancer, try the American Cancer Society.

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Pair of Pills Shows Promise for Recurrent Ovarian Cancer

SATURDAY, May 31, 2014 (HealthDay News) -- A combination of two new pills may nearly double the length of survival for patients with recurrent ovarian cancer, according to preliminary clinical trial results.

The therapy combines the drugs olaparib and cediranib. It provided nearly 18 months of progression-free survival on average, as opposed to nine months' survival with olaparib treatment alone, said Dr. Joyce Liu, a gynecologic oncologist at Dana-Farber Cancer Institute in Boston.

Liu was scheduled to present the study findings Saturday at the American Society of Clinical Oncology meeting in Chicago.

The results "compare favorably to what you'd see in chemotherapy," Liu said. This raises the possibility that this drug combination "might offer a non-chemotherapy alternative for the treatment of ovarian cancer," she said. Patients could swallow pills rather than go through intravenous chemo treatment.

As many as four out of five women with aggressive ovarian cancer experience a relapse after chemotherapy, the researchers said. When the cancer returns, it is more likely to have spread to other parts of the body and to have developed resistance to chemotherapy.

Because of this, researchers have been exploring alternate treatments for ovarian cancer that can overcome resistance to chemotherapy.

Olaparib works by targeting an enzyme called PARP that repairs DNA damage in cells and, if inhibited, could cause cancer cells to die. Cediranib blocks the growth of blood vessels in a tumor, starving the cancer of the nutrition and oxygen it needs to survive.

Both drugs are awaiting U.S. Food and Drug Administration approval, Liu said. And as with most studies presented at meetings, the findings should be considered preliminary until published in a peer-reviewed medical journal.

The U.S. National Cancer Institute-funded trial involved 90 women with aggressive ovarian cancer that returned after chemotherapy. Participants were randomly assigned to receive treatment with olaparib alone or a combination of olaparib and cediranib. All had cancers that responded to platinum-based chemotherapy.

Tumors shrank more dramatically during combination therapy -- 80 percent compared to 48 percent for patients who only received olaparib, the researchers found.

The combination treatment delayed disease progression, with a median progression-free survival of 17.7 months, the researchers said. Past trials of standard chemotherapy for platinum-sensitive patients have demonstrated median progression-free survival times between eight and 13 months, they noted.

Five patients in the combination arm and two patients in the olaparib-alone arm had a complete remission, the findings showed.

"If you combine these two agents, we saw significantly improved activity," Liu said.

The drugs seem to be synergistic, meaning they make each other more effective when used together.

It's not clear how the drugs work in tandem, Liu said. One theory is that by depriving cancer cells of oxygen using cediranib, they are more vulnerable to DNA damage left unrepaired by olaparib. Another is that both might work to retard the growth of blood vessels to the tumor.

Using both drugs together does increase side effects, most commonly high blood pressure, fatigue and diarrhea, the researchers said. For the most part, side effects were managed by treating the symptoms or adjusting the dosage of the drugs, Liu said.

Dr. David Fishman is a gynecologic oncologist at Mount Sinai Hospital and a professor at Mount Sinai's Icahn School of Medicine in New York City. He called the new findings "extremely exciting."

"We're entering an era where we are identifying unique pathways for cancer, and therapies that attack the unique biology of cancer will be much more effective than we've had in the past," he said.

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Preventing Tick Bites

By Robert Preidt, HealthDay Reporter

FRIDAY, MAY 30, 2014 (HealthDay News) -- Hikers, campers, gardeners and other Americans are flocking outdoors to enjoy the warm weather, and they need to take steps to protect themselves from tick bites, cautions an expert.

Ticks love the warm weather, too, and can transmit Lyme disease and other types of infections to people through their bite. Fortunately, there are a number of steps you can take to prevent tick bites, according to Stephen Wikel, professor and chair of the department of medical sciences at Quinnipiac University in Hamden, Conn.

Wear long pants and tuck them in to high socks. It's also a good idea to wrap duct tape -- sticky-side out -- around where your pants and socks meet. The tape will trap ticks that try to crawl onto you.

Adults should use an insect repellant that contains less than 40 percent DEET. But, children should use a repellant with no more than 30 percent DEET, Wikel said. Another option is to buy clothing treated with insect repellant. Such products can be bought online and in sporting goods shops.

Reduce the tick threat around your home by eliminating habitats that attracts rodents, deer and other tick-carriers. Keep your lawn trimmed and use wood chips, mulch or gravel to eliminate tall grasses and create barriers between the woods and your home.

It's also a good idea to get rid of wood piles and stones that provide shelter for tick-carrying mice, chipmunks and squirrels, Wikel advised.

After being outdoors, do a thorough check for ticks. If you find one, gently lift it with thin forceps or tweezers, and use a magnifying glass to see what you are doing. Your goal is to remove the tick intact.

It's important to know what type of tick you're dealing with. You can do this by placing it in a Ziploc bag and bringing the tick to your doctor or local health department, Wikel said.

Be sure your dog or cat wears a flea collar or gets anti-flea/tick treatments, which are highly effective in protecting pets against ticks. Check your pet for ticks when they come in from outdoors so ticks don't crawl off your pets and on to you.

You won't always know if you've been bitten by a tick. A bulls-eye rash indicating a Lyme disease infection appears less than 60 percent of the time. Symptoms of Lyme disease include fever, headache and fatigue, according to Wikel.

Left untreated, the infection can spread to the joints, heart or nervous system. Early treatment with antibiotics can cure Lyme disease, he said.

More information

The U.S. Centers for Disease Control and Prevention has more about ticks.

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Prom Isn't a Good Reason to Hit the Tanning Salon

By Robert Preidt, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- A visit to a tanning salon is one way many American girls prepare for their high school proms, but experts warn that teens should think twice before getting into a tanning booth.

"The obsession with looking tan is causing some teenagers to place themselves at risk for skin cancers and premature aging, despite the fact that safe sunless tanners exist," Dr. Lily Uihlein, a pediatric dermatologist at Loyola University Health System in Maywood, Ill., said in a recent university news release.

"There also are many misconceptions associated with indoor tanning, which are helping to perpetuate this habit," she added.

One myth is that indoor tanning will reduce acne. While sun exposure may temporarily improve acne, it tends to flare up when the tan goes away, according to Loyola's pediatric dermatologists.

Another misconception is that indoor tanning helps prevent vitamin D deficiency. Your skin manufacturers vitamin D when exposed to UVB light, but tanning beds mostly emit UVA light. The dermatologists say that vitamin D can also be obtained from certain foods and from supplements.

Many people mistakenly believe that a base tan prevents sunburns. But tans do not protect your skin from the harmful effects of the sun, and you still need to use sunscreen when you're outdoors, according to the dermatologists.

Still, 30 million people use tanning salons in the United States each year. About 2.3 million of those customers are teens, according to the American Academy of Dermatology (AAD). Nearly 70 percent of tanning salon customers are white females, ages 16 to 29.

It's been reported that people who use indoor tanning have a 59 percent increased risk of deadly melanoma skin cancer, according to the AAD.

"Indoor tanning is a legitimate health problem among this population," Dr. Wendy Schumacher-Kim, a pediatric dermatologist at Loyola, said in the news release.

And, it's a behavior that can become a habit. "When a person visits a tanning booth, the body releases endorphins. These chemicals produce the same feelings of euphoria or well-being that is felt when people use drugs or alcohol," explained Schumacher-Kim.

More information

The U.S. Centers for Disease Control and Prevention has more about the dangers of indoor tanning.

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Why Youngest, Oldest Marathoners Post Similar Times

By Robert Preidt, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- A new study explains why an 18-year-old marathoner has a similar finishing time as a 60-year-old runner.

It's because marathon runners have their best times when they are in their late 20s, with poorer performances when they're younger and older, according to Spanish researchers who analyzed data from more than 45,000 runners who took part in the New York City Marathon in 2010 and 2011.

The best race times were achieved at age 27 for men and age 29 for women. Times were 4 percent slower for every year younger than these ages, and 2 percent slower for every year after those ages, according the findings in the journal Age.

"While the rate at which performance drops is moderate until the age of 55, from then on the drop becomes sharper in both male and female runners," study author Juan Del Coso Garrigos, of Camilo Jose Cela University in Madrid, said in a Spanish Foundation for Science and Technology news release.

The researchers also found that gender differences in finishing times increase dramatically after a certain age.

"The difference in the amount of time it takes men and women to finish a marathon remains at approximately 20 percent until age 55. But from this age onwards the differences between the sexes are greater, and reach more than 40 percent at 70 years old," Del Coso said.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

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Do Stressed-Out Men Have Weaker Sperm?

FRIDAY, May 30, 2014 (HealthDay News) -- A small new study suggests that higher levels of stress may hurt the quality of men's sperm, potentially making it more difficult for them to impregnate women.

The findings aren't definitive and don't prove cause-and-effect, since it's possible that stressed-out men share another trait that disrupts their reproductive systems. Also, it's not clear if men with more stress are actually less fertile.

Still, "men who reported a higher number of stressful events happening in their life, or those who reported feelings of stress, had a lower percentage of sperm that moved well or were formed correctly, as well as lower numbers of sperm," said study lead author Teresa Janevic, an assistant professor at Rutgers School of Public Health's Department of Epidemiology in Piscataway, N.J. "Lower values of each of these measures are associated with lower fertility because of their reduced ability to fertilize an egg."

Prior research has linked stress to lower quality of semen, the fluid that contains sperm. But, "the results are not consistent across studies, and this is likely due to different populations and varied methods of measuring stress in these studies," said Audra Gollenberg. She is an assistant professor of public health at Shenandoah University College of Arts and Sciences in Winchester, Va., and was not involved in the new research.

The study was designed to "really get to the bottom of the question how stress is influencing the reproductive health of average men," Janevic said.

The researchers tracked 193 healthy men aged 38 to 49 from northern California who agreed to take part in a study and provide semen samples at a clinic. The men also answered questions about their levels of overall life stress and their stress at work.

The design of the study doesn't allow the researchers to link specific levels of stress to specific effects on sperm, Janevic said. And she added that "small increases in stress may not to be important for the semen quality in any individual man."

However, the study did find that men who were stressed in general had more dysfunctional sperm. This held true even after the researchers adjusted their statistics so they wouldn't be thrown off by traits like age, education level or race.

The researchers did not find a connection between work stress, specifically, and the quality of a man's sperm. "It's very possible that the levels of work stress in the men in our study were not high enough to see an effect," Janevic said. She did note that sperm were in worse shape in unemployed men compared to men who had jobs.

Gollenberg, the Shenandoah University professor, said other research has been inconsistent about the question of whether work stress might affect sperm quality.

"Work stress may be a different beast than life events, which are thought to be more traumatic and long-lasting," she said. "Some individuals are greatly affected by work stress, whereas others are able to leave 'work at work.'"

What might be going on biologically? It's not clear how a man's stress might affect his sperm, although scientists suspect that it has something to do with brain chemicals and testosterone. One theory suggests that stress in pregnant mothers could translate to sperm problems in their sons when they encounter stress, decades later.

So, what can stressed-out men do to ensure highly fertile sperm? The new findings don't say.

"We didn't study whether stress reduction can increase chances of conception," Janevic said. "However, stress reduction can contribute to health in various ways, and men can't go wrong to limit stress when possible as part of an overall healthy lifestyle."

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Scientists Spot Clues to Why Males Have Tougher Time in the Womb

By Randy Dotinga, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- Why do male babies have a tougher time in the womb than their female counterparts?

A new study suggests that the placenta -- the organ that connects the developing fetus to the mother and provides nourishment in the womb -- plays a major role in creating differences that go beyond the obvious physical differences between the genders.

"Our research has found that there are undeniable genetic and physiological differences between boys and girls that extend beyond just the development of their sexual characteristics," study co-author Claire Roberts, leader of the fetal growth research priority for the University of Adelaide's Robinson Research Institute in Australia, said in an university news release.

"We've known for some time that girls are clearly winning in the battle for survival, with markedly better outcomes for female babies for preterm birth, stillbirth, neonatal death and other complications after birth, such as macrosomia [a baby that weighs more than 8 pounds 13 ounces at birth]," Roberts said. "Male babies generally grow faster and bigger than females. This occurs in both the animal and human worlds, but until now we haven't really understood how or why."

In the new study, researchers found that genes produced by the placenta are different in males and females.

"We found that with female babies, there is much higher expression of genes involved in placental development, the maintenance of pregnancy and maternal immune tolerance," study co-author Sam Buckberry, a graduate student at Adelaide, said in the news release.

Roberts pointed out that "these findings may be important to help guide future sex-specific therapeutics [treatments] for pregnant women and for babies in the neonatal nursery."

The study is published in the May 27 online issue of the journal Molecular Human Reproduction.

More information

For more about fetal development, try the U.S. National Library of Medicine.

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Drug May Lower Odds of Early Menopause in Breast Cancer Patients

By Robert Preidt, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- Adding a drug called goserelin to chemotherapy reduces the risk of early menopause in breast cancer patients and seems to improve survival, according to a new study.

Early menopause is one of the most upsetting side effects of chemotherapy among young breast cancer patients, the researchers noted.

The investigators found that adding goserelin to chemotherapy significantly reduced the risk of early menopause in breast cancer patients, and increased the chances that survivors could get pregnant and have a healthy baby later.

Goserelin (Zoladex) temporarily puts the ovaries "at rest" during chemotherapy, according to study senior author Dr. Kathy Albain, of Loyola University Medical Center in Maywood, Ill.

"We found that, in addition to reducing the risk of early menopause, and all of the symptoms that go along with menopause, goserelin was very safe and may even improve survival," she said in a Loyola news release. "I think these findings are going to change our clinical practice."

The study included 257 premenopausal women younger than 50 with early stage estrogen- or progesterone-receptor-negative breast cancers. The patients were randomly assigned to receive either standard chemotherapy or chemotherapy plus goserelin.

After two years, 45 percent of women in the chemotherapy-only group showed signs of early menopause, compared with just 20 percent of those in the chemo plus goserelin group. In addition, the authors noted, the pregnancy rate was 11 percent in the chemotherapy-only group and 21 percent in the goserelin group.

After four years, 89 percent of the women in the chemo plus goserelin group showed no signs or symptoms of cancer, compared with 78 percent of those in the chemotherapy-only group. Survival rates at four years were 92 percent in the goserelin group and 82 percent in the chemotherapy-only group, according to the report.

"Premenopausal women beginning chemotherapy for early breast cancer should consider this new option to prevent premature ovarian failure," the study authors concluded.

The findings are scheduled for presentation Saturday at the annual meeting of the American Society of Clinical Oncology (ASCO), held in Chicago. Research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.

Goserelin is an injection drug that is similar to a natural hormone made by the body. It is approved by the U.S. Food and Drug Administration for treatment of prostate cancer, certain benign gynecological conditions and certain breast cancers.

More information

The U.S. National Library of Medicine has more about breast cancer.

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Stopping Statins for Terminal Patients a Safe Option: Study

By Randy Dotinga, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- A new study suggests that it's safe and helpful to stop treating dying patients with the cholesterol-lowering drugs known as statins.

Patients who were expected to live less than a year didn't die any sooner after they stopped taking the drugs, and researchers report that their overall quality of life improved.

"Many doctors argue that, near the end of life, it is not necessary to continue medications for chronic illnesses that are not life-threatening. But we have no guidance on what medicines to stop and when to do so," study author Dr. Amy Abernethy, a medical oncologist and palliative care specialist at Duke University Medical Center in Durham, N.C., said in a Duke news release. "Our study provides the first evidence that stopping statins is safe and improves patient quality of life."

It can be helpful to reduce medications in the final year of life because terminally ill patients often have little appetite and difficulty swallowing. Medications can also cause side effects, especially when they interact with other drugs.

The researchers tracked 381 patients who had a life expectancy of a year or less and had been taking statins for at least three months. The patients were randomly assigned to continue taking the drugs or stop taking them.

The investigators found that stopping the drugs made little difference in terms of heart problems. Those who stopped taking statins actually lived longer (an average of 229 days compared to 190 days among those who didn't stop the drugs).

"Discontinuing chronically administered medications near the end of life has limited study," cancer researcher Dr. Patricia Ganz said in a statement provided by the American Society of Clinical Oncology (ASCO). "However, now we have evidence that discontinuing certain medications is safe, specifically in the case of the widely prescribed statin drugs, and can improve quality of life for patients."

The study is to be presented June 3 at the ASCO annual meeting, in Chicago. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

Try the U.S. National Library of Medicine for more on statins.

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Calcium Supplements Don't Raise Women's Heart Risks, Study Says

FRIDAY, May 30, 2014 (HealthDay News) -- In the wake of concerns that calcium supplements increase the risk for heart attack or stroke, a large, new U.S. study offers women and their doctors some reassurance.

Researchers from Brigham and Women's Hospital in Boston found, in a study of more than 74,000 women, that these supplements are safe in terms of heart health.

Millions of women take calcium supplements in an attempt to boost bone strength, especially after menopause when the risk of fractures increases. This is so even though experts generally recommend that calcium come from diet rather than supplements.

"One study found that more than 60 percent of women 60 and over were taking calcium supplements," said lead researcher Dr. Julie Paik of the hospital's Channing Division of Network Medicine.

Some recent research has linked calcium supplementation with heart disease. Such studies suggested the daily supplements may increase calcification of the arteries and veins, which could raise the risk of heart attack.

This new study found no raised risk of heart attack or stroke among women taking calcium supplements during 24 years of follow-up. Calcium supplementation was actually associated with lower risk of heart disease, the researchers said.

However, the medical community is still uncertain of the effects of calcium supplements in women, Paik added.

"Our study adds to the existing body of evidence supporting that calcium supplements do not increase the risk of heart attack or stroke in women," she said.

Women in the study who took calcium supplements exercised more, smoked less and ate less trans fat than women who did not take supplements, the researchers noted.

Dr. Mary Ann McLaughlin, director of the cardiac health program at Mount Sinai Hospital in New York City, said the study doesn't prove that supplements prevent heart attacks or stroke, because those other positive behaviors might have affected the women's health.

What it does show is that in women who already engage in healthy behaviors, calcium supplements didn't harm them, she said.

The report was published online in the May issue of Osteoporosis International.

Noting that all women are different, Paik said patients should talk with their doctor about whether taking calcium supplements is right for them.

Also, more studies are needed to further understand the effects of calcium supplements on the heart and arteries, she said.

McLaughlin believes in eating calcium-rich foods, such as milk, cheese, tofu, rice milk, salmon, sardines, broccoli, kale and almonds before relying on supplements.

For the study, Paik and colleagues collected data on 74,245 women who took part in the Nurses' Health Study. Calcium supplement use was assessed every four years.

During 24 years of follow-up, there were 2,709 heart attacks and 1,856 strokes.

After adjusting for heart-risk factors such as age, body mass index and dietary calcium, there was no significant difference in the rate of heart attack or stroke between women who took more than 1,000 milligrams of calcium a day and those who took none. The results were similar when the researchers analyzed nonsmokers, women without high blood pressure and those who exercised regularly.

Dr. Nieca Goldberg, a clinical associate professor of medicine at NYU Langone Medical Center in New York City, said it's important that women balance the calcium they get from their diet and supplements, she said. "Many women don't get enough calcium in their diet," she acknowledged.

Women need about 1,200 milligrams of calcium a day. She recommends that all or most of that calcium come from food intake. "I think it's always better for us to get our nutrients from food, because that forces us to eat healthier," she said.

Foods rich in calcium include dairy products such as milk, cheese and yogurt, green, leafy vegetables, sardines and salmon, and calcium-enriched foods such as cereals and fruit juices.

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Steroids May Not Be Wise Choice for Intensive-Care Patients

By Robert Preidt, HealthDay Reporter

FRIDAY, May 30, 2014 (HealthDay News) -- Intensive-care unit patients who receive steroids seem to be at greater risk of developing delirium, according to a new study by Johns Hopkins researchers.

Steroids are given to ICU patients for a number of reasons, including to reduce inflammation and to treat septic shock, the study authors said.

The researchers examined the medical records of 330 lung injury patients who were on ventilators in intensive-care units of four Baltimore hospitals between 2004 and 2007. Patients were 52 percent more likely to develop delirium if they'd received steroids the previous day.

Being older was also linked with an increased risk of delirium, which can cause poor memory and thinking, hallucinations, agitation and disorientation, the researchers said.

The study authors noted that delirium typically subsides after a few days. But previous research has shown that delirium in intensive-care unit patients can have lasting effects, including mental impairment equal to moderate brain injury or mild Alzheimer's disease.

The study findings, published in the June issue of the journal Critical Care Medicine, suggest that limiting the use of steroids in intensive-care patients could reduce their risk of delirium.

"We need to be cautious in our use of steroids in critically ill patients and weigh the risks and benefits of using them," study leader Dr. Dale Needham, an associate professor of medicine and of physical medicine and rehabilitation, said in a Hopkins news release.

"Sometimes they are necessary, but we need to be thoughtful about minimizing the dose and duration of steroid use when possible," he added.

The study was supported, in part, by a grant from the U.S. National Institutes of Health's National Heart, Lung, and Blood Institute.

More information

The U.S. National Library of Medicine has more on delirium.

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Richard III's Curved Spine Had Little Impact on His Mobility: Study

By Robert Preidt, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- The bones of England's King Richard III are yielding up more secrets about the 15th century monarch, two years after his remains were excavated under a parking lot in Leicester, Great Britain.

The new research, published May 29 in The Lancet, suggests the spinal scoliosis noted initially in Richard's skeleton may not have unduly hampered his movement or appearance.

"There is no evidence to suggest Richard would have walked with an overt limp, as his curve was well balanced and the bones of the lower limbs symmetric and well formed," study co-author Dr. Jo Appleby, lecturer in human bioarchaeology at the University of Leicester, said in a journal news release.

Richard III, immortalized in a play of the same name by Shakespeare, ruled England from 1483 until he was killed in battle in 1485.

In numerous historical and literary sources, Richard III is referred to as "crook-backed" or "hunch-back'd," but it's never been clear whether such descriptions are accurate or were used to portray him in a negative way.

His skeleton was discovered in Leicester in 2012 and initial examinations revealed that he did have scoliosis, in which the spine curves to the side.

However, the new research suggests that the spinal condition had little effect on his physical appearance and would not have affected his ability to exercise.

In this study, researchers used data from CT scans to create 3-D images and actual models of the king's spine. This enabled them to get a better understanding of Richard III's spinal condition and how it affected his appearance.

The investigators concluded that the king's scoliosis was unlikely to have been genetic and likely appeared sometime after age 10. The condition is called adolescent-onset idiopathic scoliosis, and is one of the most common types of scoliosis, the study authors noted.

"The physical deformity produced by Richard's scoliosis was probably slight as he had a well-balanced curve of the spine," study author Piers Mitchell, of the department of archaeology and anthropology at the University of Cambridge in England, said in the news release.

"His trunk would have been short relative to the length of his limbs, and his right shoulder a little higher than the left. However, a good tailor to adjust his clothing and custom-made armor could have minimized the visual impact of this," Mitchell added.

And, Appleby said, "The moderate extent of Richard's scoliosis is unlikely to have resulted in any impaired tolerance to exercise from reduced lung capacity."

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about scoliosis.

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Diabetes Drug May Spur Weight Loss in Obese Nondiabetics

THURSDAY, May 29, 2014 (HealthDay News) -- The diabetes drug liraglutide (Victoza) may help obese people without the disease lose weight, a new study suggests.

In this test of its effectiveness as a diet aid, people taking Victoza for over a year lost an average of 8 percent of their body weight, compared with 2.6 percent shed by those taking a placebo (dummy drug), researchers found.

"Liraglutide, an injection treatment already approved for diabetes treatment, can help reduce body weight in people with obesity when used at a higher dose than is usually used in diabetes," said lead researcher Dr. John Wilding, head of the department of obesity and endocrinology at the University of Liverpool in England.

"These results suggest liraglutide is effective and overall well-tolerated for obesity treatment," he said.

Although this study didn't compare Victoza with other weight loss drugs, Wilding said that a previous study showed Victoza could produce about twice as much weight loss as another drug, orlistat (Xenical).

Xenical works by reducing the amount of fat the intestines can absorb. People taking Xenical lose an average of five to seven pounds, studies have shown.

Victoza works by lowering blood sugar.

The results of the study were scheduled for presentation Thursday at the European Congress on Obesity in Sofia, Bulgaria. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn., wasn't surprised by the findings. "A number of drugs used to treat type 2 diabetes tend to produce weight loss as one of their effects," said Katz, who was not involved in the study.

This is predictable because the insulin resistance that precedes and often accompanies type 2 diabetes results in frequent hunger and weight gain. Lowering blood sugar results in weight loss, he said.

Whether Victoza improves long-term weight management or leads to better health outcomes over years when used for weight loss is unknown, he said.

"But for now, Victoza takes its place alongside other drugs studied initially for diabetes, but [found to be] potentially useful for weight loss as well," Katz said.

"Such drugs will never replace diet and physical activity, but may prove a reasonable addition to lifestyle intervention in some patients," Katz added.

For the study, Wilding and colleagues randomly selected 3,731 obese and overweight adults to take daily injections of Victoza or a placebo. The participants' average age was 45.

People in both groups also followed a diet containing 500 fewer calories than a normal diet. And they had to increase physical activity by walking briskly for 30 minutes at least five times a week.

Many participants (61 percent) had blood sugar levels that made them prediabetics, but none had full-blown type 2 diabetes, the researchers note.

The researchers found that almost two-thirds of those taking Victoza lost 5 percent or more of their body weight, and one-third lost 10 percent or more. Among those taking the placebo, 27 percent lost 5 percent of their body weight or more, and one in 10 lost 10 percent or more.

People taking Victoza also saw a drop in their blood sugar, blood pressure and cholesterol, the study found.

Based on these phase 3 trial findings, drug maker Novo Nordisk is asking the U.S. Food and Drug Administration to approve Victoza for weight loss. Phase 3 is the final step in the drug-approval process.

The most common side effects were nausea and diarrhea. Most of these were mild and short-lived, the researchers said.

Gallbladder and pancreas problems (pancreatitis) were more common among those taking Victoza, but the numbers were small. About 10 percent of the participants in both groups left the study because of side effects.

Wilding has served as a consultant to Novo Nordisk, which funded the study.

More information

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Heart Risks Depend on Which Blood Pressure Number Is High: Study

By Robert Preidt, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- When you have high blood pressure, exactly what type of increased heart risk you face may be determined by which number in your blood pressure reading is high, new research shows.

In a blood pressure reading, systolic pressure is the top number and diastolic pressure is the bottom number.

People with higher systolic blood pressure had a greater risk of bleeding strokes and stable angina (chest pain), while those with higher diastolic blood pressure were more likely to be diagnosed with an abdominal aortic aneurysm. An abdominal aortic aneurysm is an overstretched, weakened section in the body's main artery, that occurs in the belly. If it bursts, it can cause serious bleeding and even death.

To reach their conclusion, researchers analyzed the health records of more than 1 million people in England who were aged 30 and older and who did not have heart disease. They were followed for an average of 5.2 years.

The study, published in the May 29 issue of The Lancet, will be presented at the Hypertension 2014 meeting in Athens in June.

"Our findings do not support the widely held assumptions that systolic and diastolic pressure have similar strong associations with the occurrence of all cardiovascular [heart] diseases across a wide age range," lead investigator Dr. Eleni Rapsomaniki, from The Farr Institute for Health Informatics Research in London, England, said in a journal news release.

The researchers also found that despite modern medications, people with high blood pressure, or "hypertension," still face greater lifetime health risks. For example, a 30-year-old with high blood pressure has a 63 percent lifetime risk of developing heart disease, compared with 46 percent for a person with normal blood pressure.

Also, someone with high blood pressure would typically develop heart disease five years sooner than someone with normal blood pressure, the study authors noted.

"With lifetime risks this high, the need for new blood pressure-lowering strategies is paramount," Rapsomaniki said in the news release.

"Our estimates provide vital new information that can be used to improve patient counseling and decision-making for people with hypertension, which are currently based mainly on the risks of heart attack and stroke, and will help to focus guidelines and doctors to the cardiovascular conditions that might be more common, and in which screening and treatments are more likely to have an effect," Rapsomaniki added.

In a commentary accompanying the study, Thomas Kahan, from the Karolinska Institute in Stockholm, said that although the effectiveness of blood pressure-lowering drugs is undisputed, "observational studies suggest that few patients reach target blood pressure. Several steps therefore need to be taken to improve antihypertensive treatment and control."

Those steps include assessing patients' heart risks more carefully, pushing patients to stick with their medication schedules, expanding the use of home blood pressure monitoring and more aggressive treatment of those with tough-to-treat high blood pressure.

More information

The U.S. National Library of Medicine has more about high blood pressure.

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Scientists See Environmental Changes to Genes in Kids With Autism

By Mary Elizabeth Dallas, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- New research appears to confirm that environmental influences on genes, and not just gene mutations, play a role in the development of autism.

Scientists from Albert Einstein College of Medicine of Yeshiva University in New York City said this may help explain why older pregnant women are at greater risk for having a baby with autism.

Previous research has suggested that gene mutations account for only about half of the risk for developing autism, the study authors pointed out.

Scientists know that men who are older than 40 are at greater risk for having a child with autism because of genetic mutations that accumulate over the years in sperm-making cells. Women who are 35 and older also face a greater chance for having a child with autism. The reason why, however, has been unclear.

In conducting the study, the researchers looked at environmental changes to genes that could help explain this increased risk, such as conditions in the mother's uterus, stress and diet. These types of changes are called epigenetic changes.

The study, published online May 29 in the journal PLOS Genetics, involved 47 children with autism spectrum disorder (ASD) and 48 typically developing children of women aged 35 and older. The kids lived throughout the United States, as well as in Chile and Israel.

To look for differences in genes between the children, the researchers analyzed cells that lined their cheeks (the buccal epithelium).

"We hypothesized that whatever influences lead to ASD in children of older women probably are already present in the reproductive cells that produce the embryo or during the very earliest stages of embryonic development in cells that give rise to both the buccal epithelium and the brain," study senior author Dr. John Greally, director of the Center for Epigenomics at Einstein, said in a news release.

The researchers first examined the children's cheek cell samples for abnormal chromosome numbers, as well as other chromosomal defects. None of these abnormalities were found in the cheek cells of the children with autism or the typically developing children.

Next, the children's cheek cells were examined for signs of environmental influences upon genes.

"If environmental influences were exerted during embryonic development, they would encode a "memory" in cells that we can detect as chemical alterations of genes," Greally explained.

The researchers identified two groups of altered genes in a subset of the kids with autism that were different from the genes in the typically developing children. These altered genes, the researchers explained, are known to code for proteins involved in functions that have been shown to be impaired in those with autism.

"Our findings suggest that, at least in some individuals with an ASD, the same pathways in the brain seem to [be] hit by both [gene] mutations and epigenetic changes. So, the severity of someone's ASD may depend on whether or not a gene mutation is accompanied by epigenetic alterations to related genes," Greally said.

"In the case of older mothers at risk for having children with ASDs, one possible environmental influence might the aging process itself, which could disturb epigenetic patterns in their eggs, but there are other possibilities as well," Greally said.

More information

The U.S. National Institute of Mental Health provides more information on autism spectrum disorders.

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Many Pets Are Too Plump

By Randy Dotinga, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- Much like their human companions, many of America's pets are overweight.

Just over half of dogs in the United States are overweight or obese, and 58 percent of cats are carrying too many pounds, according to a survey from the Association for Pet Obesity Prevention.

And, like people, animals can face health consequences from excess weight.

"Overweight animals also have certain health issues," said Dr. Susan Nelson, clinical associate professor in the department of clinical sciences and veterinarian at the Kansas State University Veterinary Health Center, in a university news release.

Excess weight "can aggravate joint disease. It can lead to type 2 diabetes. It can aggravate heart conditions, and it can lead to skin diseases as folds in the pet's skin get bigger. It can even shorten their life span," noted Nelson.

How can you know if your pet is overweight? You may not be able to tell by appearance alone, since pets can appear to be in good shape even when they aren't.

At the appropriate weight, Nelson said, pets should only have a thin layer of fat over their ribs and show an hourglass shape from above. If you have a long-haired pet, it may be best to do this when your dog is wet.

Nelson also recommends using a measuring cup to figure out how many calories your pet is eating each day. It's also important to re-check that information every time you switch brands or types of food since calories may vary as much as 200 to 300 per cup between different brands or types of food, she said.

Calorie information should be available via the bag or can of pet food. If you can't find calorie details on the packaging, contact the manufacturer.

Be cautious about the suggested amount of food for your pet, Nelson said. "In the testing facilities, these animals are typically mandated to have a certain amount of exercise per day because they are research animals," she said. "In reality, a lot of the pets that we own don't get as much exercise as those dogs and cats in the research facilities."

Nelson suggests cutting back on treats too, keeping them to no more than 10 percent of your pet's diet. And exercise your pet 20 to 30 minutes per day, if possible.

Exercising dogs is usually simple, but what about cats?

"You can try scattering the food around in small portions throughout the house so that they have to hunt for it and get more exercise that way, or you can place the food in a location where the cat has to go up and down stairs," Nelson said. "There are also items call food puzzles that you fill with food and the pet needs to work at it to slowly retrieve the kibble."

If you think your pet is overweight, it's important to consult your veterinarian before putting your pet on a weight-loss regimen, Nelson cautioned.

More information

To learn more about excess weight in dogs, go to the ASPCA.

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Animal Trials Show Promise for Treating Eye Cancer

By Randy Dotinga, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- New findings about the genetic roots of eye melanoma could lead to more effective treatments, scientists say. They also report an existing drug shows benefits as a treatment for eye tumors in mice.

So-called uveal melanoma -- cancer that attacks parts of the eye that contain pigment cells -- affects about 2,000 people in the United States each year. If the cancer hasn't spread, patients usually undergo radiation treatment and have the affected eye removed. Oftentimes, however, the cancer spreads to the liver and quickly kills patients.

The study, published in the May 29 online issue of the journal Cancer Cell, offers insight into genetic mutations found in about 70 percent of the eye tumors. It also reveals a pathway that could be a target for medications.

The researchers suggest an existing drug, verteporfin (brand name Visudyne), could be a possible treatment. Tests on mice are promising, the study authors noted.

"The beauty of our study is its simplicity," said study co-author Kun-Liang Guan, professor of pharmacology at University of California, San Diego Moores Cancer Center. "The genetics of this cancer are very simple and our results have clear implications for therapeutic treatments for the disease."

This cancer is "caused by a very simple genetic mechanism," Guan said in a university news release. "And we have a drug that works on this mechanism. The clinical applications are very direct," Guan added.

However, results achieved in animal studies are not always replicated in humans.

More information

For more about melanoma of the eye, visit the U.S. National Library of Medicine.

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Viewing E-Cigarette Use May Keep Smokers From Quitting

By Randy Dotinga, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- When young smokers see someone "vape" a smokeless e-cigarette, it may help trigger the urge to smoke a traditional cigarette, a new study finds.

"There could be effects of being in the company of an e-cigarette user, particularly for young smokers," study author Andrea King, professor of psychiatry and behavioral neuroscience at the University of Chicago, said in a statement provided by the university.

"For example, it's possible that seeing e-cigarette use may promote more smoking behavior and less quitting," she said.

In the study, 60 young adult smokers took part in what they thought was a study about social interactions. An actor talked to them while smoking an e-cigarette or regular cigarette, and then the participants were tested about their urge to smoke.

Watching someone else smoke an e-cigarette boosted the urge to smoke a regular cigarette at about the same level as watching someone smoke a regular cigarette, according to researchers.

"We know from past research that seeing regular cigarette use is a potent cue for someone to want to smoke," King said. "We did not know if seeing e-cigarette use would produce the same effect [on smokers], but that is exactly what we found. When we retested participants 20 minutes after exposure, the desire to smoke remained elevated."

The researchers stress that the study took place in a laboratory setting, so it's not clear what would happen in real life.

"E-cigarette use has increased dramatically over the past few years, so observations and passive exposure will no doubt increase as well," King noted.

The study appeared this month in the journal Tobacco Control.

More information

For more on quitting smoking, head to the American Cancer Society.

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Sperm Swim Against the Current, Study Finds

By Robert Preidt, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- Sperm are highly adept at swimming against a current, new research shows.

This finding may help explain how sperm cells can travel the long distances necessary to reach and fertilize an egg. And, that could lead to more efficient artificial insemination techniques, according to the researchers.

"We wanted to know which physical mechanisms could be responsible for navigation. If you think of salmon, for example, they can swim against the stream, and the question was whether something similar could really be confirmed for human sperm cells," Jorn Dunkel, an assistant professor of mathematics at the Massachusetts Institute of Technology, said in an MIT news release.

Because observing sperm swimming in the human body is too difficult, Dunkel and colleagues conducted lab experiments in which they changed the flow of fluid in specially designed tubes, to observe how sperm responded to different current speeds.

They noted that hundreds of millions of sperm begin the journey, but only a few ever reach an egg. They have to swim in the right direction over distances that are about 1,000 times their own length, and are exposed to different chemicals and currents along the way.

At certain current speeds, sperm will able swim very efficiently upstream, according to the findings in the journal eLife. The researchers also noted that the sperm don't swim upstream in a straight line. Instead, the swim in a spiral motion near the walls of the tube, where the current flow would likely be slower.

"We found that if you create the right flow velocities, you can observe them swimming upstream for several minutes," Dunkel said. "The mechanism is very robust."

The researchers are planning to examine whether sperm work together to reach an egg.

"It is a commonly held belief that there is competition between sperm cells, with the fittest reaching the egg first," Dunkel said. "But recent studies by our team and others show that sperm practically always accumulate at the surface of a tube, and you can end up with a high local concentration of sperm cells, so there could actually be cooperation among these cells that allows them to swim faster collectively."

More information

The National Library of Medicine has more on male infertility.

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FDA Orders New Warning Labels for Tanning Beds

THURSDAY, May 29, 2014 (HealthDay News) -- Just in time for summer, the U.S. Food and Drug Administration announced on Thursday that tanning beds and tanning booths now must carry a visible warning explicitly stating that the devices should not be used on people under age 18.

"There's mounting evidence showing that indoor tanning in childhood and early adult life further increases risk of melanoma later in life due to greater lifetime exposure," Nancy Stade, deputy director for policy at the FDA's Center for Devices and Radiological Health, said in a press conference announcing the order.

However, the order does not outright ban teen use of tanning beds. "It reflects a very strong statement by the FDA that they should not be used by individuals under age 18," Stade said.

The CDC estimates that about 13 percent of all high school students have used indoor tanning, Stade said. Teenage girls are most likely to use the devices, with 32 percent of all 12th grade girls reporting that they had used a tanning bed.

The FDA will also require manufacturers to warn in their advertisements and marketing materials that these and other tanning devices put users at greater risk for skin cancer, the agency said in a news release.

The FDA's order on the issue also reclassified sunlamps and UV lamps from low-risk to moderate-risk devices.

"The FDA has taken an important step today to address the risk to public health from sunlamp products," Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said in the agency new release. "Repeated UV exposure from sunlamp products poses a risk of skin cancer for all users -- but the highest risk for skin cancer is in young persons under the age of 18 and people with a family history of skin cancer."

Tanning beds and sunlamps emit UV rays that have been linked to skin cancer, burns, premature skin aging and eye damage, the FDA said.

People who have been exposed to UV radiation from indoor tanning experience a 59 percent increase in the risk of melanoma, the deadliest type of skin cancer, according to the American Academy of Dermatology.

"The risk increases with each use, which presents a serious health public health problem for children under 18," Stade said.

According to the FDA, one required warning will read: "Persons repeatedly exposed to UV radiation should be regularly evaluated for skin cancer."

One skin cancer expert applauded the FDA's move.

"Hindsight is 20/20, but what we need is foresight, something that most teenagers do not have with their skin," said Dr. Joshua Zeichner, director of cosmetic and clinical research in the department of dermatology at The Mount Sinai Hospital in New York City.

"I support this legislation as it will help protect the health of youth, who may feel invincible, but in reality are at the most risk because they are not properly protecting their skin from the harmful effects of UV light," he said.

Under the new rule, manufacturers will now have to apply for FDA approval prior to marketing indoor tanning devices, which until now were exempt from premarket review. They will have to show that the devices meet basic standards of performance and product design.

The FDA's final order reclassifying tanning beds and sunlamps follows the recommendations from a panel of outside experts convened in March 2010. The panel evaluated the risks of sunlamp products, and recommended that FDA increase regulation of these devices. Certain members of the panel recommended that children and teenagers not use the products.

The agency released a proposed order on indoor tanning devices in May 2013, and received comments from industry, patient groups and professional societies before issuing its final order a year later.

More information

There's more on the skin cancer-tanning link at the Skin Cancer Foundation.

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Sagging Eyelids More Common in Men, Fair-Skinned and Overweight: Study

THURSDAY, May 29, 2014 (HealthDay News) -- The dreaded drooping eyelids that often come with age are more likely to appear on men, people with fair skin and those who are overweight, a new study finds.

The study also suggests that sagging eyelids can run in families, and researchers have found at least one gene that may play a role in causing eyelid sag.

There's no clear evidence that any of the risk factors directly cause sagging eyelids, and the researchers say these findings don't offer an easy fix for droopy lids.

"Unfortunately, we cannot treat genes yet. But we can inform patients about risk factors like obesity, smoking and sun exposure, which they are able to modify themselves," said study author Dr. Leonie Jacobs, a dermatology resident at Erasmus Medical Center in Rotterdam, the Netherlands.

Sagging eyelids occur when gravity causes eyelid skin to sag, sometimes even covering up the eyelashes.

"Due to aging, the connective tissue in the skin will change. The collagen and elastin fibers are reduced in number and functionality. Therefore the skin loses its strength and elasticity," Jacobs said. "Typically, this process starts from the age of 40 and worsens with increasing age, but in some rare cases it starts in young adulthood."

In one part of the new study, researchers looked at the eyelids of more than 5,500 white Dutch people. Their average age was 67. Eighteen percent showed moderate or severe eyelid sagging, with higher risk for men, smokers, those with lighter skin color (the kind that rarely tans) and those with extra pounds.

Severe eyelid sagging is linked to problems like blocked vision and headaches from trying to keep your eyes open wide enough to see more clearly.

In another part of the study, researchers looked at eyelid sagging in a British study of more than 2,100 twins with an average age of 53. About 90 percent were female. Of the twins, 15 percent showed signs of sagging eyelids.

The researchers found a genetic trait that seems to be related to the problem. They estimated that inherited factors account for 61 percent of the risk of sagging eyelids, with the rest of the risk influenced by factors such as age, gender and lifestyle.

"One is at a much higher risk when his or her close relatives are affected," Jacobs said.

Dr. Michael Migliori, chief of the division of ophthalmology at Rhode Island Hospital, said the study won't change any practices for plastic surgeons or dermatologists.

"I don't think this paper adds much except to suggest that genetic studies might help identify who is likely to get saggy lids, although you can probably do that much more easily by looking at pictures of their parents," Migliori said.

So, what can you do to prevent sagging eyelids? Maintain a healthy weight, don't smoke and protect your skin from the sun.

"Lighter skin color is a risk factor. We did not prove that this is because of the higher susceptibility to UV-induced damage in light skin, although this is a known mechanism in skin aging," Jacobs said. Therefore, I would also advise protecting your eyes and skin from the sun by wearing sunglasses or a hat with a brim."

Surgery is an option, but blepharoplasty -- the most common procedure to fix sagging eyelids -- can cost between $2,000 and $5,000, Migliori said.

The study appears online May 28 in the journal JAMA Dermatology.

More information

Try the Mayo Clinic for more on plastic surgery to fix drooping eyelids.

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Abnormal Lung Scan May Be 'Teachable Moment' for Smokers

By Robert Preidt, HealthDay Reporter

THURSDAY, May 29, 2014 (HealthDay News) -- The more serious their lung cancer screening results, the more likely smokers are to give up cigarettes, a new study finds.

While it's known that screening leads to early detection and treatment of lung cancer, this new finding suggests it could also help motivate smokers to quit.

The study results show that "abnormal screening results may present a 'teachable moment,'" wrote Martin Tammemagi, of Brock University in St. Catharines, Canada, and colleagues.

"Future lung cancer screening programs should take advantage of this opportunity to apply effective smoking cessation programs," they added.

For the study, published May 28 in the Journal of the National Cancer Institute, researchers analyzed data from more than 14,000 smokers, aged 55 to 70, in the United States. They underwent an initial lung cancer screening and follow-up screenings one and two years later.

Their screening results were classified in five levels ranging from normal to suspicious for lung cancer. The more serious their screening results, the more likely they were to stop smoking. This effect lasted for five years after the last screening.

People who developed lung cancer during the follow-up were excluded from the study.

More information

The U.S. National Cancer Institute has more about lung cancer screening.

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Health Tip: Strap Big Kids in a Booster Seat

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Obesity, Overweight Rates Jump Worldwide, Report Finds

By Robert Preidt, HealthDay Reporter

WEDNESDAY, May 28, 2014 (HealthDay News) -- In the past three decades, the number of overweight and obese people worldwide has jumped from 857 million to 2.1 billion, a new analysis shows.

Not only that, the United States is home to the highest proportion of the world's obese people, at 13 percent.

The study shows that obesity is a major public health epidemic in both developing and developed nations, said the researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle.

They analyzed data collected between 1980 and 2013 about children and adults in 188 countries.

Rates of overweight and obesity rose from 29 percent to 37 percent among men and from 30 percent to 38 percent among women. Rates of overweight and obesity among men were higher in developed nations, while rates among women were higher in developing nations.

The researchers also found that peak obesity rates are occurring at younger ages in developed nations, according to the study that appears May 29 in The Lancet.

Rates of overweight and obese children worldwide rose by nearly 50 percent between 1980 and 2013. In 2013, more than 22 percent of girls and nearly 24 percent of boys in developed nations were overweight or obese. The rates in developing nations were nearly 13 percent for both boys and girls.

"The rise in obesity among children is especially troubling in so many low- and middle-income countries," study author Marie Ng, an assistant professor of global health at IHME, said in an institute news release.

"We know that there are severe downstream health effects from childhood obesity, including cardiovascular disease, diabetes and many cancers. We need to be thinking now about how to turn this trend around," she said.

The study also found that more than 50 percent of the world's 671 million obese people live in 10 countries: the United States, China, Russia, Brazil, Mexico, Egypt, Germany, Pakistan and Indonesia.

"Obesity is an issue affecting people of all ages and incomes, everywhere," IHME Director Dr. Christopher Murray said in the news release. "In the last three decades, not one country has achieved success in reducing obesity rates, and we expect obesity to rise steadily as incomes rise in low- and middle-income countries in particular, unless urgent steps are taken to address this public health crisis."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases outlines the health risks of being overweight.

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Facing Death, Most U.S. Doctors Would Decline Extraordinary Measures

By Robert Preidt, HealthDay Reporter

WEDNESDAY, May 28, 2014 (HealthDay News) -- Most American doctors would decline aggressive treatment if they were dying, a new study finds.

Researchers looked at the responses of nearly 1,100 doctors in California who took part in a 2013 survey about their end-of-life care preferences and 790 doctors in Arkansas who completed a similar survey in 1989.

Although conducted decades apart, both surveys yielded similar findings. Most doctors (88 percent in the 2013 survey) would give do-not-resuscitate orders if they were terminally ill, according to the study published May 28 in the journal PLoS One.

Even though most doctors don't want extraordinary measures to keep them alive if they are dying, they tend to order aggressive, life-prolonging treatment for terminally ill patients, the Stanford University School of Medicine researchers said.

Further research is needed to understand this discrepancy, said study author Dr. V.J. Periyakoil, a clinical associate professor of medicine at Stanford.

"Why do we physicians choose to pursue such aggressive treatment for our patients when we wouldn't choose it for ourselves? The reasons likely are multifaceted and complex," Periyakoil said in a university news release.

She is director of the Stanford Palliative Care Education and Training Program and associate director of palliative care services at the Palo Alto VA Center in California.

Most Americans say they would prefer to die at home without life-prolonging treatments, according to the study authors.

"A big disparity exists between what Americans say they want at the end of life and the care they actually receive," the researchers wrote. "More than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life, but their wishes are often overridden."

More information

The U.S. National Library of Medicine has more about end-of-life issues.

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