Attacking Ovarian Cancer (July 26, 2004)

NEW ORLEANS (Ivanhoe Broadcast News)

Each year, more than 23,000 women will be diagnosed with ovarian cancer. It’s often diagnosed in the most advanced stages, making it difficult to treat and even harder to cure. Now, a new attack on the cancer may offer hope to thousands of women.

Each year, ovarian cancer claims the lives of more than 15,000 women. Treatment may help initially, but the cancer often comes back.

"These patients are relapsing one or two years later because a very small handful of cells eventually grow back," says Tyler Curiel, M.D., a medical oncologist at Tulane University Health Sciences Center in New Orleans.

Dr. Curiel says that relapse is even harder to treat. That’s why he’s searching for something better. "What we’re trying to do is harness the body’s own immune system to let the immune system clear the cancer out," he tells Ivanhoe.

Targeting the immune system is not new, but the way Dr. Curiel and his team are doing it is. Instead of giving patients more T cells -- the fighter immune cells -- they’re focused on destroying harmful immune cells.

"It turns out that one of the T-cells in your body, in cancer, is a bad actor. It’s like friendly fire," says Dr. Curiel. "The soldiers, instead of going out and shooting the enemy, they’re shooting other soldiers." He hopes a new drug that kills off those bad-acting immune cells will show the same success in humans as it did in the lab.

LeeAnna Guidry has the same hope. She was diagnosed with ovarian cancer two years ago. "When you’re faced with this illness, you’re just kind of hoping for a miracle," she says.

Guidry is one of four patients enrolled in the study so far. Dr. Curiel believes that, if it works, the treatment will extend patients’ lives.

Guidry says, "My hope is for whatever time I can get, I’ll take it."

Dr. Curiel says if it’s successful, this new approach could work for people with a variety of cancers. Tulane is the only center currently involved in the study. If positive results come in at the end of this study, he says they’ll likely expand the trial to include more sites and more patients across the country.

If you would like more information, please contact:
Fran Simon
Public Relations Director
Tulane University Health Sciences Center
(504) 588-5221

Drug Therapy Vital for Women with HIV (July 26, 2004)

(Ivanhoe Newswire)

A drug-combination therapy may have additional health benefits for HIV-infected women, according to new research. The study shows women with HIV on the drug treatment saw a regression of a common type of cervical abnormality that can lead to cancer.

Highly active antiretroviral therapy is a combination of several antiretroviral drugs that reduces the number of HIV particles in the bloodstream and helps boost immune-system function. Women with HIV are at an increased risk of a cervical abnormality called squamous intraepithelial lesions and also for human papillomavirus, which are known causes for cervical cancer. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore conducted a study to see if HAART is associated with reducing the cervical abnormalities in HIV-positive women.

The study included 2,000 women who were infected with HIV. Researchers say 312 of the women had normal Pap smears at the time they began the study and at some point in the following seven years were diagnosed with SIL. Researchers found women who were on HAART had a regression of SIL. Specifically, researchers say women not on HAART saw no regression of the lesions, but those on HAART had a regression rate of 12.5 percent.

Authors write in the study, “These findings underscore the importance of ensuring that women who are immunosuppressed have full access to antiretroviral therapy. It should be emphasized, however, that HIV-infected women on HAART must still receive careful gynecologic follow-up and close routine monitoring.”

In an accompanying editorial, doctors from the University of Washington in Seattle point out the regression rates may have changed because the women had less advanced HIV disease. They also point out that HIV women need to be encouraged to have cervical cancer screenings.

SOURCE: Journal of the National Cancer Institute, 2004;96:1070-1076

New Heart-Screening Device (July 26, 2004)

(Ivanhoe Newswire)

There may be a new way to identify patients at risk for a heart attack or stroke. A new study shows a device that measures the stiffness of arteries may help doctors accurately diagnose heart disease.

Researchers from Wake Forest University Baptist Medical Center in Winston-Salem, N.C., and elsewhere studied more than 250 participants. The patients were tested with a “blood-pressure-like” device, which measured blood volume in the leg as a way to determine artery stiffness. Patients were also screened with magnetic resonance imaging (MRI) to confirm the device’s effectiveness.

Results show the screening device was an accurate predictor of heart disease. David M. Herrington, M.D., says, “The study suggests another way to identify people who are at risk for coronary heart disease."

Patients who are in the early stages of heart disease experience a hardening or stiffness in their arteries. Researchers say using the non-invasive test to detect this stiffness earlier would allow treatment to begin sooner, which could save lives.

Dr. Herrington says, “Many people are unaware that they have early stages of heart disease that could be treated. We are working hard to develop new ways to identify these people, so they can begin preventive treatment sooner and avoid having a heart attack or stroke.”

Researchers say the test is still under development and is not yet ready for clinical use.

Heart disease is the leading cause of death for men and women in the United States. Researchers say about every one minute, someone in this country will die from a heart attack.

SOURCE: Circulation, published online July 22, 2004

Symptoms Predict Cancer Survival (July 26, 2004)

(Ivanhoe Newswire)

New research shows physical symptoms may predict survival in patients with deadly cancers.

Researchers from the McGill University Health Center in Montreal studied more than 1,000 patients who were diagnosed with various types of terminal cancer. Results show physical symptoms, such as nausea and shortness of breath, predicted shorter survival rates in these patients.

Researchers say shortness of breath increased the risk of death by 50 percent for all patients studied. Those who reported nausea and vomiting at the early stages of their terminal cancer had nearly a 70-percent increased risk of death.

Breast cancer patients who reported experiencing weakness had a five-fold increased risk of death, and those with colorectal cancer and weakness had a three-fold increased risk.

Although physical symptoms were a strong predictor of prognosis, researchers say clinical and tumor characteristics were more accurate predictors. Also, psychosocial factors, such as anxiety or spiritual stress, did not predict a shorter survival in the patients studied.

Authors of the study conclude, “Our findings indicate that patients presenting with chronic nausea and vomiting, shortness of breath, and weakness are more advanced in the progress toward the terminal wasting associated with cancer than patients who do not present these symptoms.”

SOURCE: CANCER, published online July 26, 2004

Earlier Detection for Breast Cancer (July 26, 2004)

(Ivanhoe Newswire)

Breast cancer may be detected earlier using a computer-assisted detection system, according to a study published in the August issue of Radiology.

CAD is a computer-based analysis designed to find breast abnormalities. It identifies calcifications in the breast that appear only as tiny white specks on mammography film. These tiny white specks could be early cancers. "CAD makes the doctor take another look at what it's marking, whether it is bunched up normal tissue, a normal anatomic structure, or microcalcifications," says Stamatia Destounis, M.D., lead author of the study from The Elizabeth Wende Breast Clinic in Rochester, N.Y.

Researchers reviewed the cases of 519 patients with breast cancer. Breast-imaging specialists used CAD to scan and analyze the missed cancers of mammograms and had the potential to identify 71 percent of them. The CAD was able to mark tumors as suspicious on mammograms taken one year before the diagnosis of cancer.

Overall, the false-negative rate before the CAD screening was 31 percent compared to 19 percent after the CAD analysis.

The authors emphasize that the CAD is not a replacement for readings by radiologists, but it can assist in isolating irregularities in the breast for the doctor to re-evaluate. Dr. Destounis says: "We all sometimes miss the forest for the trees. Perception is a very difficult thing to maintain throughout a busy day, while looking at multiple films and trying to diagnose minimal abnormalities. CAD can help with these perception issues."

The authors conclude that finding cancer earlier is the best way to increase cancer-free survival, resulting in less surgery, less chemotherapy, and less emotional stress for the patient and his or her family.

SOURCE: To be published in an upcoming issue of Radiology

Aspirin use not for Stroke (July 23, 2004)

(Ivanhoe Newswire)

For many heart disease patients, an aspirin a day and the drug clopidogrel (Plavix) is prescribed. However, new research shows this may not be the answer for patients who have had a stroke.

Patients who have a history of an ischemic stroke, which is a stroke caused by a blood clot, are often put on the drug clopidogrel. Researchers in Germany conducted a study to see if adding aspirin to this treatment would be beneficial as it is in heart disease patients.

The study included around 7,600 patients who received either aspirin or placebo on top of the existing clopidogrel therapy. After 18 months of treatment, researchers found a small decrease in vascular risks. However, they say the combination therapy doubled the risk of intracranial and gastrointestinal bleeding. Researchers say the risk of bleeding offsets any potential benefits from the combination treatment. Therefore, they do not recommend this combination therapy for patients who have had a stroke.

In an accompanying commentary, Peter Rothwell, M.D., from the University of Oxford in England, says this study shows the potential risks of adding aspirin to current clopidogrel therapy. He says patients with a previous stroke who are currently taking aspirin and clopidogrel should be advised of the risk.

SOURCE: The Lancet, 2004;364:331-337, 305-307

Mild Cigarettes Misleading (July 22, 2004)

(Ivanhoe Newswire)

Smokers may think they are taking a step in the right direction by switching to a “light” or “mild” cigarette, but a new study shows it may not be beneficial. Researchers say the reduction in nicotine is minimal, and in the end, the light or mild cigarette could actually increase a person’s risk for problems.

In Japan, more than half of the men smoke and most of them smoke mild or light brands. Previous studies have shown that low-yield cigarettes can be just as hazardous, but an attempt to raise awareness of this fact was stopped by tobacco companies in Japan. Researchers from Kyoto First Red Cross Hospital conducted a study looking at nicotine and health hazards of light and mild brands of cigarettes in Japan.

For the study, researchers assessed the nicotine dependence of 458 smokers and questioned them about their smoking habits. The researchers also measured the concentration of nicotine in the smokers' urine.

Researchers report that smokers who smoke more than 40 cigarettes per day would hardly reduce their nicotine intake by switching to a mild brand. They point out that smokers who switch to cigarettes with 0.1 milligrams of nicotine from cigarettes that have 1.1 milligrams of nicotine only reduce their intake by less than two-fold.

“Smokers who are heavily dependent on nicotine obtain no advantage by smoking low-yield cigarettes,” says lead study author Atsuko Nakazawa. She says they may actually increase their risks by inhaling more carbon monoxide or tar through taking more puffs per cigarette or increasing the depth of their inhalation.

Study authors say the current labeling practices are misleading and the public, especially the Japanese, needs to be informed about the truth.

SOURCE: BioMed Central Public Health, published online July 21, 2004

Healthy Lifestyle Slows Dementia (July 21, 2004)

(Ivanhoe Newswire)

New research shows while obesity may increase a person’s risk of developing dementia later in life, a healthy diet may have the opposite effect.

Researchers presented the results of their studies at the 9th International Conference on Alzheimer’s Disease and Related Disorders in Philadelphia.

In one study, investigators from Sweden and Finland followed nearly 1,500 participants for more than 20 years. They found those who were obese in middle age were twice as likely to develop dementia later in life. Also, patients who had high cholesterol and high blood pressure in middle age were six-times more likely to develop dementia later on.

Miia Kivipelto, M.D., Ph.D., who presented the study, says, “More and more research is pointing to common causes for cardiovascular disease and dementia.”

In another study, researchers from Harvard Medical School in Boston found women who reported eating more green leafy vegetables in middle age had better cognitive functioning when they entered their 70s.

Jae Hee Kang, Sc.D., author of the study, says, “This difference can be approximated as being one to two years younger in terms of cognitive aging. Although this difference may be modest, if confirmed by other studies, it may have a large impact in reducing the public health burden of dementia.”

The women who reported consuming the highest amount of vegetables rich in folate and antioxidants saw the most benefit.

Researchers conclude, “This study should make physicians and policy makers take notice that they can make significant contributions to health aging in several areas by encouraging people to eat healthful foods.”

SOURCE: The 9th International Conference on Alzheimer’s Disease and Related Disorders in Philadelphia, July 17-22, 2004

Eat Fish for Your Heart (July 20, 2004)

(Ivanhoe Newswire)

A new study suggests eating broiled or baked fish can help older people avoid a common medical condition that increases the risk for stroke.

In their study, researchers found those who ate these types of fish one to four times a week were 28-percent less likely to develop an irregular heartbeat, also known as atrial fibrillation, than those who ate fish prepared this way less than once a month. Those who ate five or more servings saw even greater benefit -- lowering their risk by 31 percent.

People who ate more fried fish or fish sandwiches, however, did not benefit.

The findings are based on data collected during a large study conducted by the National Heart, Lung, and Blood Institute on cardiovascular health. More than 4,800 people 65 years and older provided detailed information on their diet between 1989 and 1990 and were then followed for 12 years. During that period, 980 were diagnosed with irregular heartbeat.

The investigators believe the high levels of omega-3 fatty acids found in fish most likely to be broiled or baked -- such as tuna, salmon, mackerel and sardines -- may be what’s protecting the heart from developing an irregular beat. Fried fish and fish sandwiches, which are usually made of lean white fish like cod and pollock, do not contain significant amounts of these heart-healthy acids.

The authors comment, “These results suggest that regular intake of tuna or other broiled or baked fish may be a simple and important deterrent of atrial fibrillation among older men and women.”

SOURCE: Circulation, 2004;110:368-373

Anxious Mothers Equal Behavior Problems (July 20, 2004)

(Ivanhoe Newswire)

Mothers who are overly anxious during their pregnancies may be unintentionally “programming” their babies for behavioral problems later on.

According to researchers from Belgium who studied around 70 mothers and their first-born children, anxiety during pregnancy can have a worse effect on a child’s eventual behavior than maternal smoking, low birth weight, or other factors typically associated with problem behavior in kids.

The investigators decided to undertake the study to examine age-old theories that the emotional state of a woman during pregnancy can somehow affect her unborn child. Specifically, they wanted to find out whether high levels of anxiety could lead to behavioral problems like attention deficit/hyperactivity disorder, acting out, or anxiety in school age children. They also wanted to know if the fetus might be more susceptible to maternal anxiety during certain periods of a pregnancy.

Results showed mothers who reported high anxiety between the 12th and 22nd week of pregnancy were significantly more likely to have a child who suffered from a behavioral problem at age 8 or 9. Overall, maternal anxiety during this period explained between 9 percent and 22 percent of the variance in the childhood problems investigated by the study.

The authors believe these findings suggest more needs to be done to identify and treat anxiety in mothers-to-be, especially during the vulnerable period between the 12th and 22nd week of pregnancy.


SOURCE: Child Development, 2004;75:1085-1097

Intensive Treatment Helps Arthritis (July 16, 2004)

(Ivanhoe Newswire)

Patients with rheumatoid arthritis who receive a more intensive form of therapy are more likely to experience a remission of their disease, finds a new study out of the United Kingdom.

Researchers publishing in this week’s issue of The Lancet randomly assigned 111 patients with similar levels of disease to one of two groups. One group received monthly treatment with oral drugs to fight rheumatoid arthritis, along with steroid injections. The other group received standard care, which consisted of treatment every three months in an outpatient clinic. Patients on the more intense therapy also underwent monthly assessments of their disease to help doctors plan their treatment.

After 18 months, 82 percent of the patients in the intensive-treatment group had achieved a good response to therapy, compared to 44 percent in the routine-treatment group. Most significantly, 65 percent of intensive-therapy patients were in remission by the follow up vs. just 16 percent of those in the group who received routine care.

The authors note that better outcomes were achieved without adding additional costs to the overall treatment of the patients. They add that this finding suggests long-term savings may also result if patients receiving more intense therapy are able to avoid joint replacement surgery, the need for institutional care, or disabilities that cause them to stop working.

They write, “Implications for the management of patients with rheumatoid arthritis are considerable.”

SOURCE: The Lancet, 2004;364:263-269

More Accurate Eye Test (July 16, 2004)

PALM HARBOR, Fla. (Ivanhoe Broadcast News)

Diagnosing problems in a patient’s eye can be tricky because doctors can’t see all of the layers in the back of the eye. But a new test could change that.

Janet Tobin thought her vision was fine until she had her annual eye exam. With her left eye covered, she only saw blurriness with her right eye.

Tobin says, “I wonder, really, what is going on?” She was diagnosed with pre-retinal membrane or a wrinkle over her retina. She would need surgery to fix it, but first, she underwent a new test called optical coherence tomography or OCT.

“We’ve never really seen layers of the retina in a real, live human,” Dana Deupree, M.D., an ophthalmologist at The Macula Center in Palm Harbor, Fla., tells Ivanhoe.

He says the test uses light waves to reveal specific layers of the retina. “We can use it to compare and see if our therapy is effective and plan surgical strategies without really creating any discomfort for the patient.”

For example, in many OCT scans, it will be clear if a patient suffers from a macular hole. All of this information is gathered in about 40 seconds with the new scan. It’s also easy on the patient.

Tobin had the new eye scan, and she says: “My interpretation of it is there’s nothing to it. You put your head up there and one, two, three, it’s done.” For her, it gave her peace of mind before heading into surgery. “I was much more relaxed that he knows and is able to know more with this machine,” she says.

Today, Tobin is on the road to recovery with her vision improving each day.

Most insurance companies cover the OCT test. Without insurance, the test runs about $100 per eye. The OCT is used to help diagnose and make treatment decisions on any condition that causes changes in the macula.


If you would like more information, please contact:
Mark Erickson
The Macular Center
3890 Tampa Rd.
Palm Harbor, FL 34684
(727) 789-8770
mark@maculacenter.com
http://www.maculacenter.com

Eye Conditions in the Elderly (July 16, 2004)

(Ivanhoe Newswire)

Blacks living in nursing homes are significantly more likely to have sight-robbing cataracts than whites.

According to a new study in the Archives of Ophthalmology, 54 percent of blacks suffer from the condition, which can generally be corrected with surgery. Whites living in nursing homes also had a significant number of cataracts, with 37 percent of residents affected. Cataracts cause low vision among nearly a quarter of the blacks, compared to about 12 percent of whites.

Other age-related eye changes were also noted in the study, which was conducted among about 300 black and nearly 1,000 white nursing home residents by investigators from the Wilmer Eye Institute in Baltimore. Specifically, 29 percent of whites had low vision due to macular degeneration and 4 percent due to glaucoma. Among blacks, 7 percent suffered low vision attributed to macular degeneration and 10 percent to glaucoma.

The investigators believe these findings suggest there is much room for improvement in the treatment of older people with vision problems, particularly cataracts. They write, “Low vision and blindness are highly prevalent among residents of nursing homes, with more than one third affected ... Appropriate interventions for nursing home residents, who face significant obstacles in accessing eye-care services, have the potential to improve the quality of life of this at-risk older population.”

They recommend vision screening upon admission to a nursing home, followed by periodic examinations throughout the resident’s stay to identify and treat these problems.

SOURCE: Archives of Ophthalmology, 2004;122:1019-1024
 

Diabetic Weight-Loss Drugs: Caution Advised (July 15, 2004)

(Ivanhoe Newswire)

Two weight-loss drugs and an antidepressant show signs of helping people with type 2 diabetes shed unwanted pounds, but long-term effects of the medications are uncertain.

That is the key finding of researchers from the Centers for Disease Control and Prevention who looked at the medical evidence for the antidepressant fluoxetine (Prozac or Sarafem) and the weight loss drugs orlistat (Xenical) and sibutramine (Meridia). All of the medications resulted in modest weight loss over 52 weeks, and they also produced small reductions in glycated hemoglobin levels, a key marker of overall diabetes control. The medications also appeared to be well tolerated.

Since long-term follow up of patients on these medications is lacking, the investigators stop short of recommending them across the board for people with the disease.

“Further work is needed to examine whether the combination of lifestyle modification and pharmacotherapy improves the efficacy of drug therapy,” they write. “The incidence of adverse events must be carefully monitored over the long term in diabetic populations, which already have multiple risk factors for major cardiovascular and neurologic events.”

The authors note type 2 diabetes is on the rise in the United States, mirroring the rise in obesity that has occurred over the past decade. The prevalence of obesity rose from 12 percent to 18 percent between 1991 and 1998, and the incidence of diabetes climbed by 49 percent between 1990 and 2000.


SOURCE: Archives of Internal Medicine, 2004;164:1395-1404
 

Beta Blockers OK for Heart Failure (July 15, 2004)

(Ivanhoe Newswire)

According to new research from Yale in New Haven, Conn., doctors should not hesitate to prescribe beta blockers for patients with heart failure. The researchers examined nine previous studies involving more than 14,000 patients.

When compared to a sham treatment, patients with heart failure who took these drugs cut their risk of death by about a quarter and were also less likely to be hospitalized or experience a worsening of the condition.

Despite the beneficial effects of beta blockers on the cardiovascular system -- the drugs relieve stress on the heart and reduce blood vessel contraction throughout the body -- doctors have worried about giving these drugs to heart patients because they are known to lower blood pressure, cause dizziness, and slow the heart beat. This study, published in this month’s Archives of Internal Medicine, pooled the results of existing studies to better determine whether these adverse effects outweigh the benefits of the drugs.

Results showed 34 fewer deaths per 1,000 patients per year among those taking the active drug, 40 fewer hospitalizations, and 52 fewer worsening conditions. Most significantly, fewer people taking beta blockers for heart failure withdrew from treatment during the studies -- a reduction of 14 per 1,000 patients for beta blockers when compared to the sham treatment.

The researchers also found no substantial increase in fatigue among the patients taking beta blockers, another troublesome symptom previously associated with the drugs.

The researchers conclude, “Our findings should alleviate concerns of physicians who are reluctant to prescribe beta blockers because of their cardiovascular adverse effects and support the implementation of this lifesaving therapy to appropriate candidates with heart failure.”

SOURCE: Archives of Internal Medicine, 2004;164:1389-1394

Pregnant with Hypothyroidism? Increase Your Meds! (July 15, 2004)

(Ivanhoe Newswire)

If you’re pregnant and suffer from hypothyroidism, it may help to increase the dose of medication you take, report researchers publishing in this week’s New England Journal of Medicine.

The study out of Brigham and Women’s Hospital-Harvard Medical School in Boston finds 85 percent of pregnant women with hypothyroidism -- a condition in which the thyroid gland fails to produce enough thyroid hormone -- need additional doses of levothyroxine to protect their developing fetuses. Babies born to mothers with hypothyroidism are at increased risk for cognitive problems and also more likely to be stillborn than those born to women without the condition.

The research was conducted among 19 women who were planning to become pregnant. All were tested for thyroid function and other factors prior to becoming pregnant and then every two weeks during pregnancy. An increase in the levothyroxine dose was required in 17 out of 20 pregnancies occurring in the women. The mean increase in dose was 47 percent and occurred, on average, at about eight weeks into the pregnancy. In most of the women, the dose stabilized by the 16th week and was maintained until delivery.

The authors write, “We suggest that women with hypothyroidism be instructed to increase their usual levothyroxine intake by two additional doses each week immediately on confirmation of pregnancy and to contact their health care provider so that a program of test-guided dose adjustments can be instituted.”


SOURCE: New England Journal of Medicine, 2004;351:241-249

Eat to Fight Endometriosis (July 15, 2004)

(Ivanhoe Newswire)

Women who eat more fruits and vegetables are less likely to suffer from the painful condition known as endometriosis, shows a new study out of Italy.

Endometriosis develops when the tissues lining the uterus grow outside of the uterus and begin to surround other organs in the abdomen. The condition can cause bleeding, pain and discomfort. It is considered one of the most common gynecological diseases, affecting as many as five out of every 100 women.

These researchers decided to see what role diet plays in the development of the condition. They surveyed 504 women diagnosed with endometriosis, comparing their results to 504 other women without the disease. All were under age 65.

Results showed consumption of fruits and green vegetables protected women against the disease. Compared with those who ate the least amount of these foods, those who ate the most had about a 40-percent relative reduction in risk. Eating more red meat and ham, however, had the opposite effect. Those who ate the most red meat and ham had up to a 100-percent increase in relative risk when compared to those who ate the least.

The investigators believe further study is needed to confirm these findings. But if additional research also shows a protective effect for diet in endometriosis, the incidence of the disease could drop to as low as around 3 percent to 4 percent, preventing about 10,000 women in Italy alone from acquiring the disease every year.


SOURCE: Human Reproduction, 2004;8:1755-1759

Geography and Breast Cancer (July 14, 2004)

(Ivanhoe Newswire)

Viruses common to the region you live in may contribute to your risk of breast cancer.

A new study shows nearly three-quarters of a small sample of breast cancer patients in Tunisia presented evidence of a virus similar to one known to cause breast cancer in mice.

Previous studies show a large number of breast cancers carry viral sequences from the mouse mammary tumor virus. That same sequence in not found in normal tissue. MMTV is believed to be spread by a species of house mouse that is common in North Africa but less so in the United States.

In the new study, investigators found 74 percent of samples from Tunisia tested positive for an MMTV-specific genetic sequence while 36 percent from the United States tested positive, 38 percent from Italy, 42 percent from Australia, and 31 percent from Argentina.

Viruses play a primary role in the development of several cancers, such as the human T-cell lymphotropic virus and adult T-cell leukemia/lymphoma, human herpes virus 8, and Kaposi sarcoma. These viruses have been noted to vary in certain regions. For example, Kaposi sarcoma and human herpes virus 8 are least common in the United States and more common in the Mediterranean and Central Africa.

SOURCE: CANCER, published online July 12, 2004

Solution for Emphysema  (July 14, 2004)

PHILADELPHIA (Ivanhoe Broadcast News)

Lung volume reduction surgery, which removes a portion of a patient’s diseased lung, has been performed on patients with emphysema for some time. The concern was its high mortality rate and whether it really worked. Now, Medicare has finished a seven-year study on this technique and its impact.

A couple months ago, Andy Gustchen would have needed oxygen to ride a stationary bike. Forty-three years of smoking took its toll on Gustchen's lungs. He has severe emphysema. “You can’t plan to do things," he says. "You don’t know how you’re gonna feel from one day to the next.”

Gustchen had lung volume reduction surgery -- a procedure in which the most damaged part of the lungs is removed to make room for the healthy portion. But the surgery has been controversial. It is not always successful, and it carries significant risks, including death.

“Patients who have a survival advantage are those who have a predominance of emphysema in the upper portions of the lung field," Gerard Criner, M.D., a pulmonologist/critical care specialist at Temple University Hospital in Philadelphia, tells Ivanhoe.

Because of the questionable outcome, Medicare would not pay for the $60,000 operation until they did their own research. “Patients who received lung volume reduction surgery, as a group, had an improvement in exercise capacity, breathlessness, an improvement in quality of life that was superior to those who received optimized medical therapy alone,” Dr. Criner says.

Based on those findings, in January 2004, Medicare decided to cover patients who meet certain approved criteria.

That was a breath of fresh air for sufferers like Gustchen. “It’s been phenomenal so far," he says. "I haven’t had any oxygen since I’ve been out of the hospital.”

Dr. Criner says the surgery is only recommended for patients with moderate to severe emphysema. Medicare has several additional requirements. For more information call (800) MEDICARE.


If you would like more information, please contact:
Jordan Reese
Public Relations Manager
Temple University Hospital
Philadelphia, PA
(215) 707-5083

Asthmatics at Risk for Lung Diseases (July 14, 2004)

(Ivanhoe Newswire)

Asthmatics may have reason to worry about future lung diseases. According to a 20-year study, adults with asthma may have an increased risk of developing chronic obstructive pulmonary disease.

Researchers at the University of Arizona College of Medicine in Tucson find active asthmatics are 12-times more likely to develop COPD later in life than non-asthmatics. However, the researchers did find a significant difference between active and inactive asthmatics -- those who were previously diagnosed with asthma but did not experience symptoms. The authors say this suggests the increased risk is only associated with those who currently have asthma.

Lead author Graciela E. Silva, MPH, says for years health officials have regarded asthma and COPD as distinct conditions with separate courses. She said, “However, over time, the two diseases may develop features that are quite similar.”

COPD refers to a group of diseases that affect the lungs, including emphysema and chronic bronchitis. COPD is characterized by permanent lung damage and irreversible airflow limitation. With asthma, on the other hand, the airways become inflamed, causing airflow obstruction and difficulty breathing, but the damage to the lungs is not thought to be permanent. Plus, the symptoms of asthma can usually be relieved spontaneously or with medication.

In the study, the authors write: “Smoking has been described as the main risk factor for the development of COPD. However, less than 20 percent of cigarette smokers acquire COPD, suggesting that other factors convey significant additional risk.” Silva said minimizing asthmatics’ exposure to risk factors such as tobacco smoke and air pollution may delay disease progression to COPD.

Co-author Robert A. Barbaee, M.D., also suggests effective anti-inflammatory therapy at the onset of asthma may decrease the likelihood of developing COPD.


SOURCE: CHEST, 2004;126:59-64

Expectations of Cancer Treatment (July 14, 2004)

(Ivanhoe Newswire)

A new study shows patients who undergo chemotherapy or radiation expect a high number of side effects.

Researchers from the University of Rochester in New York found side effects from chemotherapy or radiation can diminish the quality of life for patients. If a patient expects a certain side effect, such as nausea, he or she is more likely to develop that symptom. The study also shows age, gender, educational background, and the type of cancer influence how many side effects a patient expects.

Researchers studied the expectation of side effects for nearly 950 cancer patients prior to treatment. Patients anticipated an average of nine symptoms including fatigue, nausea, hair loss, skin problems, weight loss, pain, and sleep problems.

Those who were 60 years or younger expected more side effects than patients who were older than 60. Women expected more symptoms than men, and patients with a college education anticipated more side effects than those with a high school education. Patients with hematologic cancers, such as leukemia, and those with lung cancer expected the greatest number of side effects while those with prostate cancer expected the least.

"A potential clinical application of these results is to identify, before treatment begins, a group of people for whom extra attention in terms of side effect management and informational preparation may be quite beneficial," researchers conclude.

SOURCE: To be published in an upcoming issue of CANCER

Irregular Heart Beat and Sleep Apnea Link (July 16, 2004)

(Ivanhoe Newswire)

People with an irregular heart rhythm are more likely than other cardiology patients to have sleep apnea, according to a new study.

In addition, the link between the two conditions was greater than the association of sleep apnea with its traditional risk factors including body mass index, neck circumference, and hypertension.

Atrial fibrillation is a heart-rhythm abnormality in which the heart’s two upper chambers, the atria, quiver instead of beating effectively. This can cause blood to pool and clot. A blood clot that leaves the heart and lodges in a brain artery can cause a stroke.

Results of the study show nearly half of the atrial fibrillation patients were identified as being at high risk for sleep apnea compared to about a third of general cardiology patients. Patients with atrial fibrillation were twice as likely to have sleep apnea.

The study suggests there may be a unique physiological interaction between sleep apnea and atrial fibrillation. Atrial fibrillation and sleep apnea share associations with other common risk factors such as male gender, hypertension, congestive heart failure and coronary artery disease.

Obstructive sleep apnea contributes to heart attack and stroke risks. It is marked by repeated breathing interruptions during sleep. The prevalence of sleep apnea is directly related to body mass index. As obesity increases, so does the incidence of sleep apnea.

According to researchers, atrial fibrillation is predicted to affect more than 5 million people by the year 2050 as obesity rises.


SOURCE: To be published in an upcoming issue of Circulation

Ginseng and Blood Thinners: A Dangerous Mix? (July 9, 2004)

(Ivanhoe Newswire)

Millions of Americans take a blood-thinning drug every day to prevent blood clots. New research shows mixing warfarin with ginseng, one of the best-selling herbal supplements, could have significant consequences.

Researches from the University of Chicago say anyone who takes both ginseng and warfarin, also known as Coumadin, should tell his or her doctor. They also urge doctors prescribing the anti-clotting drug to ask their patients if they regularly take ginseng.

Study author Chun-Su Yuan, M.D., Ph.D., says warfarin has a narrow therapeutic index, which means precise dosing is crucial. He says, “With too small a dose, the risk of clots increases, but too much can cause serious bleeding. So a substance, such as ginseng, that alters warfarin’s effects, even slightly, can have significant consequences.”

Researchers recruited 20 healthy volunteers for four weeks. All participants received five milligrams a day of warfarin for three days during week one and again in week four. Starting in week two, 12 of the subjects were given two grams of powdered ginseng capsules and eight were given a placebo.

After two weeks, researchers found the daily doses of ginseng significantly reduced the blood levels and the anti-clotting effects of warfarin, compared to the placebo.

Dr. Yuan and his team were surprised by the findings because ginseng alone can promote bleeding and delay clot formation. They speculate that substances within the herbal supplement may enhance the function of enzymes that break down the anti-clotting drug, therefore clearing it from the blood stream more rapidly.

The authors also note that their study involved young, healthy adults compared to the typical users of warfarin -- older patients with significant health problems. They say metabolism of ginseng and warfarin may differ between their study group and actual patients.


SOURCE: Annals of Internal Medicine, 2004;141:23-26

Vitamin use in Babies Linked to Asthma and Allergies (July 8, 2004)

(Ivanhoe Newswire)

Don’t start your kids on vitamins too early, say experts, or the result may be asthma or food allergies.

New research links vitamin supplementation during the first six months after birth to an increased risk for asthma in black children and to food allergies in children who are only formula fed. Vitamin use at age 3 was also linked to an increased risk for food allergies but not asthma.

A higher risk for asthma was also associated with being male, having a smoker in the house, child care, prematurity, no history of breastfeeding, lower income, and lower education.

Researchers say their findings may indicate very early environmental exposures, stimulated by vitamins, can affect the risk for later development of allergic disease.

Investigators are unclear whether the associations in black children are biological or a result of bias. However, they conclude higher doses of multivitamins for any child may not always be best.

The American Academy of Pediatrics recently recommended all breastfed infants receive supplements of vitamin D4.


SOURCE: Pediatrics, 2004;114:27-32

Vacuum-Assisted Deliveries Safe (July 6, 2004)

(Ivanhoe Newswire)

In 1998, the Food and Drug Administration issued a warning that vacuum-assisted deliveries may result in fetal complications. Now, a study in this week's British Medical Journal reports that vacuum extraction is a safe alternative to a forceps delivery.

The use of vacuum extraction has increased in the United States, accounting for 68 percent of all vaginal deliveries in 2000 compared to 41 percent in 1990. Researchers from the University of Medicine and Dentistry of New Jersey in Newark conducted a large study to compare the safety of vacuum extraction vs. the use of forceps.

The study included data on more than 11 million births in the United States. Researchers compared the risk of death and birth injuries with the two different birthing instruments. Study authors report the overall risk of death and birth injuries were similar between infants delivered by vacuum and by forceps. Study authors point out that the relatively low rates of fetal complications among vacuum deliveries argues against the 1998 FDA warning.

Researchers conclude vacuum extraction is at least as safe as forceps delivery, though both have risks. They feel standards in performing instrumental deliveries are needed. They also say encouraging instrumental vaginal deliveries could reduce the number of Caesarean sections in the United States.


SOURCE: British Medical Journal, 2004;329:24-26

New Findings for Pregnancy Loss (July 5, 2004)

(Ivanhoe Newswire)

New research shows the immune system may play a key role in women who have had repeated miscarriages.

About 50 percent to 70 percent of all conceptions fail, and around 1 percent to 3 percent of couples experience recurrent pregnancy loss. While many of the cases are due to fetal abnormalities, others are due to the maternal response to the fetus. New research links the reproductive hormone secretion system to the immune system.

Researchers from Harvard School of Public Health in Boston conducted the study. They put together a mouse model focusing on early pregnancy loss. The mouse model showed that a specific immune receptor is activated early in the pregnancy that results in the pregnancy loss. When they looked closer at the molecular mechanisms, researchers found the loss of embryo was due to a decrease in progesterone. Progesterone is the hormone responsible for preparing the body for pregnancy and maintaining it until birth.

Study authors say the study shows the immune system interferes with the reproductive hormones and that may contribute to pregnancy loss. They hope these findings will provide new means of therapy for women who suffer from repeated miscarriages.

In an accompanying commentary, Jane Salmon, from Weill Medical College of Cornell University in New York, says this research lays the framework for new therapies for pregnant women. She says, “[The authors] describe and define a novel interaction between the innate immune system and the reproductive endocrine system that, if operative in humans, would be a target treatment for women with recurrent early miscarriage.”


SOURCE: The Journal of Clinical Investigation, 2004;114:39-47,15-17

Drinking not bad for the Bones (July 2, 2004)

(Ivanhoe Newswire)

There has been a great deal of controversy over whether drinking alcohol negatively affects bone health in women. A new study out of St. Thomas’s Hospital in London reports moderate drinking does not increase the risk of osteoporosis.

The importance of the study, say researchers, is that women are drinking more and it is important for health care providers to know what to recommend to maintain optimal bone health. Researchers in London conducted a study looking at identical twins, alcohol consumption, and bone health.

For the study 46 pairs of identical twins were surveyed. In each set of twins, one drank very little while the other drank moderately. Moderate drinking was defined as eight drinks a week. The twins had their bone mineral density measured as well as chemical markers.

While moderate drinking was associated with thinner bones, researchers say there was no clear link between chemical markers in bone turnover and alcohol intake. Therefore, they say alcohol may actually be beneficial to bone health. Researchers also point out that drinking this amount would not likely increase the risk of falls contributing to the fracture rate.

Researchers say the controversy remains about the risk of osteoporosis and alcohol consumption. However, they write this study “lends weight to the growing evidence that moderate alcohol consumption is not detrimental to bone health in women.”


SOURCE: Annals of the Rheumatic Diseases, published online June 30, 2004