HOUSTON, April 18 -- Evidence linking a decrease in the annual incidence of breast cancer to a decline in hormone replacement therapy is as robust as first reported, investigators here said. As Peter Ravdin, M.D., Ph.D., of the University of Texas M.D. Anderson Cancer Center, and colleagues reported at the San Antonio Breast Cancer Symposium last December, the incidence fell 7% from 2002 to 2003, reversing a 20-year trend.
That reversal followed closely on the heels of publication of the Women's Health Initiative results, which showed that five years of hormone replacement therapy (HRT) in postmenopausal women increased breast cancer risk by 24%, and a subsequent plunge in HRT prescriptions.
And now, in an extended analysis of their previous study, Dr. Ravdin, and colleagues, showed that the breast cancer incidence was unchanged from 2003 to 2004, indicating that the decline they had previously seen was not a statistical fluke, they reported in the April 19 issue of the New England Journal of Medicine.
"This kind of study can't prove causality, but the data present a very compelling link between hormone replacement therapy and breast cancer," said co-author Donald Berry, Ph.D., also of M.D. Anderson.
In their earlier report, Dr. Ravdin and colleagues used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, which collects information on 9% of the U.S. population, to study breast cancer rates.
Using the SEER data, they found that the total decrease from 2002
Thursday, April 19, 2007
Smoking indicator of alcohol misuse
New Haven, Conn. -- Where there is cigarette smoking there is probably misuse of alcohol too, according to a study by Yale School of Medicine researchers in the Archives of Internal Medicine.
"This means cigarette smoking status can be used as a clinical indicator for alcohol misuse, which presents an opportunity for intervention," said the principal investigator, Sherry McKee, assistant professor of psychiatry.
She said that although brief screening and brief intervention provided in primary care settings are effective, clinicians do not frequently screen for alcohol misuse. This is a matter of concern because 26 percent of the U.S. population is drinking at hazardous levels, which puts them at increased risk for alcohol-related consequences such as injuries from motor vehicle crashes, hypertension, depression, and certain cancers.
"Only an estimated 30 percent of individuals who had a primary care visit reported being screened for an alcohol or drug use problem," McKee said. "Physicians are much more likely to ask patients whether and how often they smoke."
She and her collaborators arrived at their conclusions after analyzing data obtained from 42,374 adults in a national epidemiological survey on alcohol misuse and other related conditions. Following guidelines that physicians use to assess tobacco and alcohol use, they found that non-daily smokers are five times more likely to have a problem with alcohol compared to people who have never smoked. Daily smokers are three times more likely to have an alcohol problem.
"This is the first study to document that individuals who are smokers, but don’t smoke every day, have the highest rates of problem drinking," McKee said. "Using smoking status as a ‘red flag’ for more aggressive assessment of alcohol use is a highly feasible and clinically sensible approach to screening."
The findings, she said, highlight the importance of physicians adopting standard alcohol screening questions into their practice.
"This means cigarette smoking status can be used as a clinical indicator for alcohol misuse, which presents an opportunity for intervention," said the principal investigator, Sherry McKee, assistant professor of psychiatry.
She said that although brief screening and brief intervention provided in primary care settings are effective, clinicians do not frequently screen for alcohol misuse. This is a matter of concern because 26 percent of the U.S. population is drinking at hazardous levels, which puts them at increased risk for alcohol-related consequences such as injuries from motor vehicle crashes, hypertension, depression, and certain cancers.
"Only an estimated 30 percent of individuals who had a primary care visit reported being screened for an alcohol or drug use problem," McKee said. "Physicians are much more likely to ask patients whether and how often they smoke."
She and her collaborators arrived at their conclusions after analyzing data obtained from 42,374 adults in a national epidemiological survey on alcohol misuse and other related conditions. Following guidelines that physicians use to assess tobacco and alcohol use, they found that non-daily smokers are five times more likely to have a problem with alcohol compared to people who have never smoked. Daily smokers are three times more likely to have an alcohol problem.
"This is the first study to document that individuals who are smokers, but don’t smoke every day, have the highest rates of problem drinking," McKee said. "Using smoking status as a ‘red flag’ for more aggressive assessment of alcohol use is a highly feasible and clinically sensible approach to screening."
The findings, she said, highlight the importance of physicians adopting standard alcohol screening questions into their practice.
World first test potential to identify breast cancer patients who will react badly to radiotherapy
Medical scientists at the University of Leicester have announced a potentially unique advance in breast cancer research by identifying two genes associated with adverse reaction to cancer treatment.
The research could mean people who might react badly to radiotherapy could be warned in advance or alternative treatments be sought. There is no test at present for an abnormal reaction to radiotherapy. No-one in the past has proposed such a test.
The team who carried out the study included Drs Paul Symonds, Mark Plumb, Irene Peat and George Giotopoulos of the Department of Cancer Studies and Molecular Medicine and the Department of Genetics at the University of Leicester. Their results are published in the British Journal of Cancer.
Dr Symonds said: "Radiotherapy is a very important treatment for breast cancer. A small number of people can develop severe side effects."
"During treatment patients can get redness of the skin which may peel off. Later the breast may shrink (atrophy) and the tissues under the skin may become hard and thickened (fibrosis). Red widened blood vessels can appear in the skin (telangiectasia)."
After examining patients at the Glenfield Hospital, Leicester Royal Infirmary and the City Hospital Nottingham, the team at the University of Leicester, funded in part by the Hope Foundation for Cancer Research, has found 2 separate genes strongly associated with either thickening of tissue or red widened blood vessels.
"About 8% of women carry the fibrosis gene
The research could mean people who might react badly to radiotherapy could be warned in advance or alternative treatments be sought. There is no test at present for an abnormal reaction to radiotherapy. No-one in the past has proposed such a test.
The team who carried out the study included Drs Paul Symonds, Mark Plumb, Irene Peat and George Giotopoulos of the Department of Cancer Studies and Molecular Medicine and the Department of Genetics at the University of Leicester. Their results are published in the British Journal of Cancer.
Dr Symonds said: "Radiotherapy is a very important treatment for breast cancer. A small number of people can develop severe side effects."
"During treatment patients can get redness of the skin which may peel off. Later the breast may shrink (atrophy) and the tissues under the skin may become hard and thickened (fibrosis). Red widened blood vessels can appear in the skin (telangiectasia)."
After examining patients at the Glenfield Hospital, Leicester Royal Infirmary and the City Hospital Nottingham, the team at the University of Leicester, funded in part by the Hope Foundation for Cancer Research, has found 2 separate genes strongly associated with either thickening of tissue or red widened blood vessels.
"About 8% of women carry the fibrosis gene
Wednesday, April 18, 2007
Omega-3 Fatty Acid May Thwart Alzheimer's Disease
TUESDAY, April 17 (HealthDay News) -- A type of omega-3 fatty acid called docosahexaenoic acid (DHA) may help slow the growth of two kinds of brain lesions associated with Alzheimer's disease, a new study suggests.
The researchers at the University of California, Irvine, said their finding suggests that a diet rich in DHA -- found in fish, eggs, organ meats, micro-algae, fortified foods and food supplements -- may help prevent the development of Alzheimer's as people age.
In this study with genetically modified mice, the scientists found that DHA slowed accumulation of tau, a protein that leads to the development of neurofibrillary tangles, one of the two signature brain lesions of Alzheimer's.
The researchers also found that DHA reduced levels of the protein beta amyloid, which can clump in the brain and form plaques, another kind of lesion associated with Alzheimer's.
"We are greatly excited by these results, which show us that simple changes in diet can positively alter the way the brain works and lead to protection from Alzheimer's disease pathology," study co-author Frank LaFerla, professor of neurobiology and behavior, said in a prepared statement.
He and his colleagues also learned how DHA keeps beta amyloid in check. DHA reduces levels of presenilin, an enzyme that separates beta amyloid from its "parent," the amyloid precursor protein. Without presenilin, beta amyloid cannot be generated.
The study, published in the April 18 issue of The Journal of Neuroscience, adds to growing evidence that diet and lifestyle changes may help people lower their risk of developing Alzheimer's disease, the researchers said.
The researchers at the University of California, Irvine, said their finding suggests that a diet rich in DHA -- found in fish, eggs, organ meats, micro-algae, fortified foods and food supplements -- may help prevent the development of Alzheimer's as people age.
In this study with genetically modified mice, the scientists found that DHA slowed accumulation of tau, a protein that leads to the development of neurofibrillary tangles, one of the two signature brain lesions of Alzheimer's.
The researchers also found that DHA reduced levels of the protein beta amyloid, which can clump in the brain and form plaques, another kind of lesion associated with Alzheimer's.
"We are greatly excited by these results, which show us that simple changes in diet can positively alter the way the brain works and lead to protection from Alzheimer's disease pathology," study co-author Frank LaFerla, professor of neurobiology and behavior, said in a prepared statement.
He and his colleagues also learned how DHA keeps beta amyloid in check. DHA reduces levels of presenilin, an enzyme that separates beta amyloid from its "parent," the amyloid precursor protein. Without presenilin, beta amyloid cannot be generated.
The study, published in the April 18 issue of The Journal of Neuroscience, adds to growing evidence that diet and lifestyle changes may help people lower their risk of developing Alzheimer's disease, the researchers said.
Intensive psychotherapy benefits bipolar patients
NEW YORK (Reuters Health) - Patients treated with drugs for bipolar disorder benefit greatly from the addition of intensive psychotherapy, according to findings published in the Archives of General Psychiatry.
"Bipolar disorder is an extremely debilitating illness, in large part because of the difficulty in treating bipolar depressive disorders," Dr. David J. Miklowitz, of the University of Colorado, Boulder, and colleagues write. Clinical trials support the effectiveness of adding psychotherapy to drug treatment for preventing the recurrence of depressive and manic episodes. However, the effectiveness of various strategies has been unclear.
To investigate, the researchers compared the time to recovery and the likelihood of remaining well for 12 months after four disorder-specific psychotherapies. The 293 outpatients with bipolar I or II disorder also received drug treatment.
About half of the patients were assigned to one of three types of intensive psychotherapy (family-focused treatment, cognitive behavioral therapy, or interpersonal and social rhythm therapy) and the other half were assigned to collaborative care, which was a brief psychoeducational intervention.
Intensive psychotherapy consisted of up to 30 sessions for 9 months, and collaborative care included 3 sessions over 6 weeks. About 66 percent of patients in all of the groups completed therapy.
More patients in the intensive psychotherapy group recovered compared with patients in the collaborative care group, Miklowitz and colleagues report. The recovery rate at 12 months for patients in the intensive psychotherapy group was 64.4 percent; in the collaborative care group, it was 51.5 percent.
The average time to recovery was 113 days for patients who received intensive psychotherapy and 146 days for those who received collaborative care, the authors add.
"Bipolar disorder is an extremely debilitating illness, in large part because of the difficulty in treating bipolar depressive disorders," Dr. David J. Miklowitz, of the University of Colorado, Boulder, and colleagues write. Clinical trials support the effectiveness of adding psychotherapy to drug treatment for preventing the recurrence of depressive and manic episodes. However, the effectiveness of various strategies has been unclear.
To investigate, the researchers compared the time to recovery and the likelihood of remaining well for 12 months after four disorder-specific psychotherapies. The 293 outpatients with bipolar I or II disorder also received drug treatment.
About half of the patients were assigned to one of three types of intensive psychotherapy (family-focused treatment, cognitive behavioral therapy, or interpersonal and social rhythm therapy) and the other half were assigned to collaborative care, which was a brief psychoeducational intervention.
Intensive psychotherapy consisted of up to 30 sessions for 9 months, and collaborative care included 3 sessions over 6 weeks. About 66 percent of patients in all of the groups completed therapy.
More patients in the intensive psychotherapy group recovered compared with patients in the collaborative care group, Miklowitz and colleagues report. The recovery rate at 12 months for patients in the intensive psychotherapy group was 64.4 percent; in the collaborative care group, it was 51.5 percent.
The average time to recovery was 113 days for patients who received intensive psychotherapy and 146 days for those who received collaborative care, the authors add.
No quick fix for dirty hands in hospitals: study
CHICAGO (Reuters) - Hand washing is something most people learned about as children, but a British study finds that health workers are not faithful about washing their hands and few strategies to improve hygiene have worked.
Infections spread by health workers are a major cause of illness and death, and simple hand washing is shown to be one of the best ways to prevent it.
In Britain, 10 percent of patients develop health care-associated infections, which kill 5,000 people each year at a cost of $1.86 billion a year, the researchers said.
In the United States, health workers' dirty hands infect about 5 percent of patients at a cost of $4.5 billion a year, they said.
A team of researchers led by Dr. Dinah Gould of the School of Nursing and Midwifery at City University in London performed a systematic review to determine whether strategies to improve hand hygiene are effective.
The researchers, whose study was published in this week's Cochrane Library Newsletter, found only two trials that were even worth consideration and both were of poor quality.
Based on those, they concluded that a single teaching session or seminar was not likely to affect hand washing behavior, even in the short term.
Infections spread by health workers are a major cause of illness and death, and simple hand washing is shown to be one of the best ways to prevent it.
In Britain, 10 percent of patients develop health care-associated infections, which kill 5,000 people each year at a cost of $1.86 billion a year, the researchers said.
In the United States, health workers' dirty hands infect about 5 percent of patients at a cost of $4.5 billion a year, they said.
A team of researchers led by Dr. Dinah Gould of the School of Nursing and Midwifery at City University in London performed a systematic review to determine whether strategies to improve hand hygiene are effective.
The researchers, whose study was published in this week's Cochrane Library Newsletter, found only two trials that were even worth consideration and both were of poor quality.
Based on those, they concluded that a single teaching session or seminar was not likely to affect hand washing behavior, even in the short term.
"Instant face lift" chemical DMAE damages skin cells
NEW YORK (Reuters Health) - A chemical used in using cosmetic products promising an "instant face lift" makes wrinkles disappear by damaging skin cells, Canadian researchers report.
"From our point of view the cells are altered. They stop dividing, they stop secreting, and after...24 hours a certain proportion of them die," Dr. Francois Marceau of the Centre Hospitalier Universitaire de Quebec told Reuters Health.
Marceau, a cell biologist, said he is reluctant to recommend that these products not be used, however, the findings make it clear that more research is needed on how these and similar products work. "I don't want to scare people," he added. "The risk is not probably very big, but in my opinion it hasn't been measured accurately."
Marceau and his team tested 2-dimethylaminoethanol (DMAE) in cultured rabbit and human skin cells. As the researchers predicted, applying the product caused a massive and rapid swelling of the cells as they filled with DMAE and water, leading to a thickening of the epidermal layer. They also found that DMAE was toxic to the skin cells, halting cell division, inhibiting secretion, and killing some cells after 24 hours of exposure.
This "facelift in a jar" chemical is certainly safer than a real facelift, or Botox injections, Marceau noted. Nevertheless, the fact that DMAE and other "cosmeceuticals," such as triethanolamine, aren't considered drugs means they are soled with very minimal information about how they work and their toxicity.
"From our point of view the cells are altered. They stop dividing, they stop secreting, and after...24 hours a certain proportion of them die," Dr. Francois Marceau of the Centre Hospitalier Universitaire de Quebec told Reuters Health.
Marceau, a cell biologist, said he is reluctant to recommend that these products not be used, however, the findings make it clear that more research is needed on how these and similar products work. "I don't want to scare people," he added. "The risk is not probably very big, but in my opinion it hasn't been measured accurately."
Marceau and his team tested 2-dimethylaminoethanol (DMAE) in cultured rabbit and human skin cells. As the researchers predicted, applying the product caused a massive and rapid swelling of the cells as they filled with DMAE and water, leading to a thickening of the epidermal layer. They also found that DMAE was toxic to the skin cells, halting cell division, inhibiting secretion, and killing some cells after 24 hours of exposure.
This "facelift in a jar" chemical is certainly safer than a real facelift, or Botox injections, Marceau noted. Nevertheless, the fact that DMAE and other "cosmeceuticals," such as triethanolamine, aren't considered drugs means they are soled with very minimal information about how they work and their toxicity.
Sleep enforces the temporal sequence in memory
We have usually quite strong memories of past events like an exciting holiday or a jolly birthday party. However it is not clear how the brain keeps track of the temporal sequence in such memories: did Paul spill a glass of wine before or after Mary left the party?
Previous findings from a research group headed by Jan Born at the University of Lübeck have confirmed the widely held view that long-term memories are formed particularly during sleep, and that this process relies on the brain replaying recently encoded experiences during the night. The same research group now provides evidence that sleep not only strengthens the content of a memory but also the particular order in which they were experienced, probably by a replay of the experiences in "forward" direction.
Students were asked to learn triplets of words presented one after the other. Afterwards they slept, whereas in a control condition no sleep was allowed. Later, recall was tested by presenting one word and asking which one came before and which one came after during learning. Sleep was found to enhance word recall, but only when the students were asked to reproduce the learned words in forward direction.
This finding shows that sleep associated consolidation of memories enforces the temporal structure of the memorized episode that otherwise might be blurred to a timeless puzzle of experiences.
Previous findings from a research group headed by Jan Born at the University of Lübeck have confirmed the widely held view that long-term memories are formed particularly during sleep, and that this process relies on the brain replaying recently encoded experiences during the night. The same research group now provides evidence that sleep not only strengthens the content of a memory but also the particular order in which they were experienced, probably by a replay of the experiences in "forward" direction.
Students were asked to learn triplets of words presented one after the other. Afterwards they slept, whereas in a control condition no sleep was allowed. Later, recall was tested by presenting one word and asking which one came before and which one came after during learning. Sleep was found to enhance word recall, but only when the students were asked to reproduce the learned words in forward direction.
This finding shows that sleep associated consolidation of memories enforces the temporal structure of the memorized episode that otherwise might be blurred to a timeless puzzle of experiences.
Don't use drains in uncomplicated open cholecystectomy
The latest findings from the Cochrane Library
Drains increase harm without providing any benefit for patients undergoing open cholecystectomy, a Cochrane Review discovered – they should therefore be avoided.
Cholecystectomy is the term used to describe the surgical removal of a gallbladder. It is performed mainly as a treatment for chronic gallstones. Although many operations are now carried out by laparoscopy, some are still done by open surgery. In these operations there is an ongoing debate about whether drains should be used. Some argue that it will prevent fluid build-up and infections around the patient's liver after the operation, others say that drains increase wound and chest infections.
To assess the benefits and harms of using a drain in this operation, a team of Cochrane Researchers performed a systematic review. They identified 28 trials involving 3,659 patients.
By assessing all the data, the team found that having or not having a drain did not affect the incidence of death or internal infections. Having a drain did, however, significantly increase the rate of chest and wound infections.
"Our review has shown that routine drain use after open cholecystectomy does not benefit the patient in any way, and does increase their risk of infection; they should no longer be used in this type of operation," says lead author Dr Gurusamy, who works at the Royal Free Hospital in London.
Drains increase harm without providing any benefit for patients undergoing open cholecystectomy, a Cochrane Review discovered – they should therefore be avoided.
Cholecystectomy is the term used to describe the surgical removal of a gallbladder. It is performed mainly as a treatment for chronic gallstones. Although many operations are now carried out by laparoscopy, some are still done by open surgery. In these operations there is an ongoing debate about whether drains should be used. Some argue that it will prevent fluid build-up and infections around the patient's liver after the operation, others say that drains increase wound and chest infections.
To assess the benefits and harms of using a drain in this operation, a team of Cochrane Researchers performed a systematic review. They identified 28 trials involving 3,659 patients.
By assessing all the data, the team found that having or not having a drain did not affect the incidence of death or internal infections. Having a drain did, however, significantly increase the rate of chest and wound infections.
"Our review has shown that routine drain use after open cholecystectomy does not benefit the patient in any way, and does increase their risk of infection; they should no longer be used in this type of operation," says lead author Dr Gurusamy, who works at the Royal Free Hospital in London.
Cancer patients are at high risk for potential drug interactions
Potential drug interactions from prescribed medications are common among cancer patients and may cause unnecessary harm, according to a study in the April 18 Journal of the National Cancer Institute.
Cancer patients often take several medications at the same time, not only for treating their cancer but also for side effects and other secondary illnesses. Because of this, they can be at high risk for adverse drug interactions and duplicate medications. Consequences of these interactions can range from inactivation of cancer-fighting medications to severely injuring or killing the patient.
Rachel Riechelmann, M.D., of the Princess Margaret Hospital in Toronto, and colleagues gave 405 cancer patients a questionnaire about the medications they had taken in the last four weeks. Their responses were analyzed using a drug interaction software program that could identify potential interactions and rank them by severity.
Nearly a third of patients were exposed to at least one potential drug interaction. The researchers identified 276 drug combinations with the potential to interact. About nine percent of the interactions considered of major severity—risk of death—and 77 percent of moderate severity—risk of serious health problems. About eight percent of the patients received duplicate medications.
Cancer patients often take several medications at the same time, not only for treating their cancer but also for side effects and other secondary illnesses. Because of this, they can be at high risk for adverse drug interactions and duplicate medications. Consequences of these interactions can range from inactivation of cancer-fighting medications to severely injuring or killing the patient.
Rachel Riechelmann, M.D., of the Princess Margaret Hospital in Toronto, and colleagues gave 405 cancer patients a questionnaire about the medications they had taken in the last four weeks. Their responses were analyzed using a drug interaction software program that could identify potential interactions and rank them by severity.
Nearly a third of patients were exposed to at least one potential drug interaction. The researchers identified 276 drug combinations with the potential to interact. About nine percent of the interactions considered of major severity—risk of death—and 77 percent of moderate severity—risk of serious health problems. About eight percent of the patients received duplicate medications.
Proteins important in Alzheimer's, Parkinson's disease travel in the slow lane
PHILADELPHIA -- Using a novel video-imaging system, researchers at the University of Pennsylvania School of Medicine have been able to observe proteins important in Alzheimer’s and Parkinson’s disease moving along axons, extensions of nerve cells that carry proteins away from the cell body. Understanding this process of axonal transport is important for studying many neurodegenerative diseases. The study appeared in the Journal of Neuroscience.
Axonal transport often breaks down and many neurodegenerative diseases are characterized by defects in this process. Of particular interest is a group of transported proteins called slow component-b that includes synuclein and tau, disease proteins involved in Parkinson’s and Alzheimer’s disease, respectively, in addition to many other proteins critical for axonal growth and regeneration.
"There are two basic transport groups called fast and slow components, with a 200 to 300 fold difference in average velocities," says first author Subhojit Roy, MD, PhD, a neuropathologist and Research Associate in the Department of Pathology and Laboratory Medicine. "While scientists have seen proteins in the fast component move rapidly to the tip of the axon, until now, mechanisms of the slow movement of these disease-related proteins have been unclear as their transport had not been directly visualized."
Axonal transport often breaks down and many neurodegenerative diseases are characterized by defects in this process. Of particular interest is a group of transported proteins called slow component-b that includes synuclein and tau, disease proteins involved in Parkinson’s and Alzheimer’s disease, respectively, in addition to many other proteins critical for axonal growth and regeneration.
"There are two basic transport groups called fast and slow components, with a 200 to 300 fold difference in average velocities," says first author Subhojit Roy, MD, PhD, a neuropathologist and Research Associate in the Department of Pathology and Laboratory Medicine. "While scientists have seen proteins in the fast component move rapidly to the tip of the axon, until now, mechanisms of the slow movement of these disease-related proteins have been unclear as their transport had not been directly visualized."
Cancer vaccines -- Taking a jab at cancer by stimulating the immune system
LOS ANGELES -- As the first FDA-approved cancer vaccine, designed to protect against human papillomavirus, has moved from scientific discussion to social debate, other vaccine studies are continuing to make progress. While HPV vaccine efforts had the "benefit" of a viral source for the disease, other researchers are developing vaccines for cancers that are not virally based, in an effort to coax the immune system into attacking cancerous cells. Today at the 2007 Annual Meeting of the American Association for Cancer Research, presentations on ongoing HPV trials and other new approaches to stimulating the immune system are injecting momentum into cancer vaccine research.
Substantial impact on precancerous lesions and HPV infections through 5.5 years in women vaccinated with the HPV-16/18 L1 VLP AS04 candidate vaccine: Abstract 4900
Ongoing evaluation of a phase II trial of a human papillomavirus vaccine, developed to prevent cervical cancer, shows that the vaccine continues to protect against HPV types 16 and 18 at five and a half years into the study, according to researchers from the University of Louisville. Their findings also show that the vaccine offers significant cross-protection for HPV types 45 and 31.
The study follows 1113 women between the ages of 15 and 25 in North America and Brazil randomized to receive three doses of either the vaccine or the control. The vaccine, made by GlaxoSmithKline, which funded the study, is designed to protect against two strains of HPV, types 16 and 18, which together are thought to cause nearly 72 percent of all cases of cervical cancer.
Substantial impact on precancerous lesions and HPV infections through 5.5 years in women vaccinated with the HPV-16/18 L1 VLP AS04 candidate vaccine: Abstract 4900
Ongoing evaluation of a phase II trial of a human papillomavirus vaccine, developed to prevent cervical cancer, shows that the vaccine continues to protect against HPV types 16 and 18 at five and a half years into the study, according to researchers from the University of Louisville. Their findings also show that the vaccine offers significant cross-protection for HPV types 45 and 31.
The study follows 1113 women between the ages of 15 and 25 in North America and Brazil randomized to receive three doses of either the vaccine or the control. The vaccine, made by GlaxoSmithKline, which funded the study, is designed to protect against two strains of HPV, types 16 and 18, which together are thought to cause nearly 72 percent of all cases of cervical cancer.
Pancreatic cancer vaccine halts progression of disease in some patients
LOS ANGELES, April 17 -- A dendritic cell-based therapeutic vaccine for pancreatic cancer developed by researchers at the University of Pittsburgh School of Medicine has successfully stalled the disease from progressing in a handful of patients three years post-vaccination. The results, part of a press briefing on cancer vaccines held at the annual meeting of the American Association of Cancer Research in Los Angeles, provide promising evidence that the vaccine can trigger a patient’s own immune system to rally against pancreatic cancer and offer new insights into how the vaccine could be made even more effective. The study is abstract number 4896 in the meeting proceedings.
"Pancreatic cancer is extremely resistant to chemotherapy and radiation and, as a result, has a very high mortality rate," said Andrew Lepisto, Ph.D., first author of the study and post-doctoral researcher, department of immunology, University of Pittsburgh School of Medicine. "One strategy to improve the odds of survival is to help the immune system recognize the presence of pancreatic cancer cells and attack them. Our study, although small, demonstrates that this strategy can be used with some success in pancreatic cancer patients by slowing down, or even stopping, the progression of cancer."
The Pitt team created a therapeutic vaccine for pancreatic cancer made up of a synthetic version of MUC1 – a tumor-associated protein that is expressed by pancreatic tumor cells – combined with the patient’s own dendritic cells, which act as the quarterbacks of the immune system by coordinating its attack against foreign invaders.
"Pancreatic cancer is extremely resistant to chemotherapy and radiation and, as a result, has a very high mortality rate," said Andrew Lepisto, Ph.D., first author of the study and post-doctoral researcher, department of immunology, University of Pittsburgh School of Medicine. "One strategy to improve the odds of survival is to help the immune system recognize the presence of pancreatic cancer cells and attack them. Our study, although small, demonstrates that this strategy can be used with some success in pancreatic cancer patients by slowing down, or even stopping, the progression of cancer."
The Pitt team created a therapeutic vaccine for pancreatic cancer made up of a synthetic version of MUC1 – a tumor-associated protein that is expressed by pancreatic tumor cells – combined with the patient’s own dendritic cells, which act as the quarterbacks of the immune system by coordinating its attack against foreign invaders.
What's in the water? Estrogenic activity documented in fish caught in Pittsburgh's rivers
LOS ANGELES, April 17 – A new study from the University of Pittsburgh Cancer Institute's Center for Environmental Oncology suggests that fish caught in Pittsburgh rivers contain substances that mimic the actions of estrogen, the female hormone. Since fish are sentinels of the environment, and can concentrate chemicals from their habitat within their bodies, these results suggest that feminizing chemicals may be making their way into the region's waterways.
The study, abstract number 3458, being presented at the annual meeting of the American Association for Cancer Research, April 14-18, at the Los Angeles Convention Center, also demonstrated that the chemicals extracted from the local fish can cause growth of estrogen-sensitive breast cancer cells cultured in the laboratory. Extracts of fish caught in areas heavily polluted by industrial and municipal wastes resulted in the greatest amount of cell growth.
"We decided to look at pisciverous fish, those that eat other fish, for this project because we know that they bioaccumulate contaminants from water and their prey, which may include toxic metals, farm and industrial runoff and wastes from aging municipal sewer systems," said Conrad D. Volz, Dr.P.H., M.P.H., principal investigator, department of environmental and occupational health, University of Pittsburgh Graduate School of Public Health. "The goals of this project are to use fish as environmental sensors of chemicals in the water and the aquatic food chain, and to determine the origins of these chemical contaminants," said Dr. Volz. The study examined white bass and channel catfish caught in the Allegheny, Monongahela and Ohio Rivers. These fish are among those commonly caught as a food source by local anglers.
The study, abstract number 3458, being presented at the annual meeting of the American Association for Cancer Research, April 14-18, at the Los Angeles Convention Center, also demonstrated that the chemicals extracted from the local fish can cause growth of estrogen-sensitive breast cancer cells cultured in the laboratory. Extracts of fish caught in areas heavily polluted by industrial and municipal wastes resulted in the greatest amount of cell growth.
"We decided to look at pisciverous fish, those that eat other fish, for this project because we know that they bioaccumulate contaminants from water and their prey, which may include toxic metals, farm and industrial runoff and wastes from aging municipal sewer systems," said Conrad D. Volz, Dr.P.H., M.P.H., principal investigator, department of environmental and occupational health, University of Pittsburgh Graduate School of Public Health. "The goals of this project are to use fish as environmental sensors of chemicals in the water and the aquatic food chain, and to determine the origins of these chemical contaminants," said Dr. Volz. The study examined white bass and channel catfish caught in the Allegheny, Monongahela and Ohio Rivers. These fish are among those commonly caught as a food source by local anglers.
UGA study suggests that lowering blood pressure following stroke may reduce damage
Athens, Ga. – A new University of Georgia study suggests that commonly prescribed drugs used to lower blood pressure may help reduce brain damage when given within 24 hours of a stroke.
The finding, based on a study using rats and published in the April issue of the Journal of Hypertension, may ultimately revolutionize emergency stroke care by putting blood pressure-lowering medications alongside clot-busting drugs and blood thinners as front-line medications.
"There is a long-standing controversy about whether you should even treat elevated blood pressure in stroke victims," said lead author Susan Fagan, professor of clinical and administrative pharmacy at the UGA College of Pharmacy and the Medical College of Georgia. "We were able to show that lowering blood pressure in the 24 hours following a stroke can reduce brain damage."
Fagan and her team induced strokes in rats by occluding a major artery in the brain. After three hours, the suture was removed to simulate the effect of thrombolytic, or clot-busting, drugs. The rats were then given one of two common blood pressure lowering drugs or – for the control group – a saline solution.
When the researchers measured the amount of brain damage, they found that the rats that had received the blood pressure lowering drugs fared significantly better. While the control group showed damage in 50 percent of the brain, those receiving the drugs hydralazine and enalapril showed 30 percent damage.
The finding complements a study Fagan and her colleagues published last year in the same journal that found similar reductions in brain damage using the common blood pressure drug, candesartan, a popular drug in the class known as angiotensin receptor blockers (ARBs). The rats given candesartan, however, showed the additional benefit of improved function while the rats receiving the other blood pressure medications had less benefit. Fagan said that in addition to protecting the brain and blood vessels through lowering blood pressure, ARBs appear to provide additional benefits by blocking the damaging effects of angiotensin II, a molecule released from the brain and probably other tissues following stroke.
The finding, based on a study using rats and published in the April issue of the Journal of Hypertension, may ultimately revolutionize emergency stroke care by putting blood pressure-lowering medications alongside clot-busting drugs and blood thinners as front-line medications.
"There is a long-standing controversy about whether you should even treat elevated blood pressure in stroke victims," said lead author Susan Fagan, professor of clinical and administrative pharmacy at the UGA College of Pharmacy and the Medical College of Georgia. "We were able to show that lowering blood pressure in the 24 hours following a stroke can reduce brain damage."
Fagan and her team induced strokes in rats by occluding a major artery in the brain. After three hours, the suture was removed to simulate the effect of thrombolytic, or clot-busting, drugs. The rats were then given one of two common blood pressure lowering drugs or – for the control group – a saline solution.
When the researchers measured the amount of brain damage, they found that the rats that had received the blood pressure lowering drugs fared significantly better. While the control group showed damage in 50 percent of the brain, those receiving the drugs hydralazine and enalapril showed 30 percent damage.
The finding complements a study Fagan and her colleagues published last year in the same journal that found similar reductions in brain damage using the common blood pressure drug, candesartan, a popular drug in the class known as angiotensin receptor blockers (ARBs). The rats given candesartan, however, showed the additional benefit of improved function while the rats receiving the other blood pressure medications had less benefit. Fagan said that in addition to protecting the brain and blood vessels through lowering blood pressure, ARBs appear to provide additional benefits by blocking the damaging effects of angiotensin II, a molecule released from the brain and probably other tissues following stroke.
Researcher focuses on pros, cons of antioxidants from fruits and vegetables
COLLEGE STATION – Nutrition: It's not just the four basic food groups any more.
Researcher Dr. Susanne Mertens-Talcott of Texas A&M University is looking into how plant-based phytochemicals, including antioxidants and herbal supplements, can be useful in the promotion of health and prevention of chronic diseases.
This field is still growing. In the U.S. more than $20 billion was spent on dietary supplements in 2005, said Talcott, who is in a joint research and teaching position with the department of nutrition and food science and the department of veterinary physiology and pharmacology.
"Over $7 billion was spent on herbal dietary supplements in 2005." These supplements are plant-based, including grape seed extract, St. John's wort, ginseng and biloba extract, she added.
"In addition to that there is the segment of so-called 'functional foods,' including antioxidant foods – for example, fruit juices and beverages and grain-based products," Talcott said.
Researcher Dr. Susanne Mertens-Talcott of Texas A&M University is looking into how plant-based phytochemicals, including antioxidants and herbal supplements, can be useful in the promotion of health and prevention of chronic diseases.
This field is still growing. In the U.S. more than $20 billion was spent on dietary supplements in 2005, said Talcott, who is in a joint research and teaching position with the department of nutrition and food science and the department of veterinary physiology and pharmacology.
"Over $7 billion was spent on herbal dietary supplements in 2005." These supplements are plant-based, including grape seed extract, St. John's wort, ginseng and biloba extract, she added.
"In addition to that there is the segment of so-called 'functional foods,' including antioxidant foods – for example, fruit juices and beverages and grain-based products," Talcott said.
AACR: Familial Breast Cancer Risk for Black Women Hits Younger and Harder
An African-American woman whose mother or sister was diagnosed with breast cancer before age 50 has triple the likelihood that she will be diagnosed with the malignancy before age 45, researchers here reported. The familial breast cancer risk for black women is similar to that of white women, but black women are more likely to develop breast cancer at a younger age and the cancers are often more aggressive, said Boston University epidemiologist Julie R. Palmer, Sc.D., at the American Association for Cancer Research meeting.
The take-home message for physicians, she said, is simple. That message is to ask young African-American women -- those in the 20s, 30s, and 40s--about family history of breast cancer, she said.
"The risk associated with having a mother or sister with breast cancer has been well recognized for white women, but we have not previously assessed the family history risk for African American women,” she said, discussing findings from the 59,000-participant Black Women's Health Study.
The take-home message for physicians, she said, is simple. That message is to ask young African-American women -- those in the 20s, 30s, and 40s--about family history of breast cancer, she said.
"The risk associated with having a mother or sister with breast cancer has been well recognized for white women, but we have not previously assessed the family history risk for African American women,” she said, discussing findings from the 59,000-participant Black Women's Health Study.
Tuesday, April 17, 2007
Novel gene therapy hints at improvement
WASHINGTON - The first dozen Parkinson's patients to have holes drilled in their skulls for a novel gene therapy attempt weren't harmed — and hints at some improvement have researchers embarking on a larger study to see if the treatment really may work. Doctors reported initial results of the closely watched experiment at a neurology meeting Monday, but cautioned that it's far too soon to raise hopes.
At issue: Using a nerve growth factor to try to rescue dying brain cells.
Some 1.5 million Americans have Parkinson's, a disease that gradually destroys brain cells that produce dopamine, a chemical crucial for the cellular signaling that controls muscle movement. Too little dopamine causes increasingly severe tremors and periodically stiff or frozen limbs.
Standard treatments can control tremors for a while but can't stop the disease's inevitable march. So scientists are hunting ways to protect remaining dopamine-producing neurons, and rescue dying ones.
Previous attempts with growth factors haven't panned out. The new approach uses gene therapy — injecting a virus that carries a gene that in turn produces the growth factor neurturin — to try to get the protective protein right where it's needed.
None of the first 12 patients to undergo the experiment — at the University of California, San Francisco and Chicago's Rush University Hospital — suffered serious side effects, UCSF neurosurgeon Dr. Philip Starr reported Monday.
A year after treatment, three patients showed no difference on a standard rating scale of movement. But the other nine showed a 38 percent improvement, Starr told a meeting of the American Association of Neurological Surgeons.
That doesn't mean the therapy worked, Starr cautioned. It could have been coincidence; some previous attempts found similar hints of effectiveness, only to fail when put to more rigorous testing.
But the results were encouraging enough that researchers are enrolling more Parkinson's sufferers — 56 of them — for the next stage of testing. A third of those patients will undergo sham surgery, getting the holes drilled in their skulls but no gene-carrying virus, to try to tease out whether the therapy really works.
At issue: Using a nerve growth factor to try to rescue dying brain cells.
Some 1.5 million Americans have Parkinson's, a disease that gradually destroys brain cells that produce dopamine, a chemical crucial for the cellular signaling that controls muscle movement. Too little dopamine causes increasingly severe tremors and periodically stiff or frozen limbs.
Standard treatments can control tremors for a while but can't stop the disease's inevitable march. So scientists are hunting ways to protect remaining dopamine-producing neurons, and rescue dying ones.
Previous attempts with growth factors haven't panned out. The new approach uses gene therapy — injecting a virus that carries a gene that in turn produces the growth factor neurturin — to try to get the protective protein right where it's needed.
None of the first 12 patients to undergo the experiment — at the University of California, San Francisco and Chicago's Rush University Hospital — suffered serious side effects, UCSF neurosurgeon Dr. Philip Starr reported Monday.
A year after treatment, three patients showed no difference on a standard rating scale of movement. But the other nine showed a 38 percent improvement, Starr told a meeting of the American Association of Neurological Surgeons.
That doesn't mean the therapy worked, Starr cautioned. It could have been coincidence; some previous attempts found similar hints of effectiveness, only to fail when put to more rigorous testing.
But the results were encouraging enough that researchers are enrolling more Parkinson's sufferers — 56 of them — for the next stage of testing. A third of those patients will undergo sham surgery, getting the holes drilled in their skulls but no gene-carrying virus, to try to tease out whether the therapy really works.
Fitness a struggle for disabled people
CHARLESTON, W.Va. - Three times a week, Vince Stankoski is lifted from his wheelchair onto a stationary bicycle. Electrodes are attached to three of his muscle groups, coaxing his paralyzed legs to pedal. It is the highlight of his workout.
"I like that I can look down at my legs and still see muscles there," says the Allentown, Pa., man who lost the use of his legs after falling from a tree in 1998.
Apart from the bike, he also likes using the upper body weights, which come equipped with a seat that swivels away so he can move his wheelchair into position and lift.
Stankoski is one of the fortunate ones. He belongs to a gym specifically designed to accommodate people with disabilities.
Few other disabled people have that option. The basics of good health — diet and exercise — often present challenges for people with disabilities, a situation made more difficult by a common assumption that disability and poor health go hand in hand.
The result, according to the federal Centers for Disease Control and Prevention, is that people with disabilities — roughly 19 percent of all Americans — are far less healthy than the average American. Since those with disabilities are the biggest users of medical services, that disparity could be costing hundreds of millions of tax dollars a year.
Those costs are likely to increase as the baby boomer generation grows older and more susceptible to disabilities.
"There's an enormous number of barriers that people with disabilities face when they try to become healthy," says Dr. James Rimmer, director of the National Center on Physical Activity & Disability, and a professor at the University of Illinois at Chicago.
Those barriers range from health clubs that view people with disabilities as potential liabilities to public health campaigns that bypass them entirely.
"There's a mind-set that people with disabilities are also ill and they shouldn't be exercising," says Jerry McCole, who heads the National Disability Sports Alliance. The group promotes athletic competition and physical activity among people with cerebral palsy, traumatic brain injury, stroke and other physically disabling conditions.
"It's like any minority group — out of sight, out of mind," McCole says.
"I like that I can look down at my legs and still see muscles there," says the Allentown, Pa., man who lost the use of his legs after falling from a tree in 1998.
Apart from the bike, he also likes using the upper body weights, which come equipped with a seat that swivels away so he can move his wheelchair into position and lift.
Stankoski is one of the fortunate ones. He belongs to a gym specifically designed to accommodate people with disabilities.
Few other disabled people have that option. The basics of good health — diet and exercise — often present challenges for people with disabilities, a situation made more difficult by a common assumption that disability and poor health go hand in hand.
The result, according to the federal Centers for Disease Control and Prevention, is that people with disabilities — roughly 19 percent of all Americans — are far less healthy than the average American. Since those with disabilities are the biggest users of medical services, that disparity could be costing hundreds of millions of tax dollars a year.
Those costs are likely to increase as the baby boomer generation grows older and more susceptible to disabilities.
"There's an enormous number of barriers that people with disabilities face when they try to become healthy," says Dr. James Rimmer, director of the National Center on Physical Activity & Disability, and a professor at the University of Illinois at Chicago.
Those barriers range from health clubs that view people with disabilities as potential liabilities to public health campaigns that bypass them entirely.
"There's a mind-set that people with disabilities are also ill and they shouldn't be exercising," says Jerry McCole, who heads the National Disability Sports Alliance. The group promotes athletic competition and physical activity among people with cerebral palsy, traumatic brain injury, stroke and other physically disabling conditions.
"It's like any minority group — out of sight, out of mind," McCole says.
Brain changes seen in Alzheimer's victims before memory loss
CHICAGO (AFP) - People who develop Alzheimer's disease or dementia exhibit brain structure changes years before they show any signs of memory loss, a study released Monday said.
The finding may allow doctors to identify people at risk for the cognitive problems that lead to the devastating brain disease, according to the US study.
The research is based on a small study involving 136 seniors over the age of 65 who were given brain scans and cognitive testing on a regular basis over a five-year period.
By the end of the study, 23 of the volunteers had developed a condition known as mild cognitive impairment (MCI) and, of those, nine went on to develop Alzheimer's disease, a progressive brain disorder which is on the rise in developed nations.
When the researchers compared the brain scans of the 23 individuals who went on to develop memory problems with the 113 volunteers who did not, they found that the first group had less gray matter in areas of the brain involved with memory processing than the second group even when their brain function was normal.
"We found that changes in brain structure are present in clinically normal people an average of four years before MCI diagnosis," said Charles Smith, author of the study and an expert on memory and aging at the University of Kentucky Medical Center in Lexington.
"We knew that people with MCI or Alzheimer's disease had less brain volume but before now we didn't know if these brain structure changes existed, and to what degree, before memory loss begins," he said.
Moreover, the individuals who later developed memory problems had lower scores on cognitive test scores at the beginning of the study compared to the other seniors in the study, although the scores were within normal range.
"These findings of structural changes in cognitively normal people before memory loss begins aren't surprising given Alzheimer's disease may be present for many years before symptoms of the disease begin to appear," said Smith.
The paper appears in Tuesday's issue of Neurology, the scientific journal of the American Academy of Neurology.
The finding may allow doctors to identify people at risk for the cognitive problems that lead to the devastating brain disease, according to the US study.
The research is based on a small study involving 136 seniors over the age of 65 who were given brain scans and cognitive testing on a regular basis over a five-year period.
By the end of the study, 23 of the volunteers had developed a condition known as mild cognitive impairment (MCI) and, of those, nine went on to develop Alzheimer's disease, a progressive brain disorder which is on the rise in developed nations.
When the researchers compared the brain scans of the 23 individuals who went on to develop memory problems with the 113 volunteers who did not, they found that the first group had less gray matter in areas of the brain involved with memory processing than the second group even when their brain function was normal.
"We found that changes in brain structure are present in clinically normal people an average of four years before MCI diagnosis," said Charles Smith, author of the study and an expert on memory and aging at the University of Kentucky Medical Center in Lexington.
"We knew that people with MCI or Alzheimer's disease had less brain volume but before now we didn't know if these brain structure changes existed, and to what degree, before memory loss begins," he said.
Moreover, the individuals who later developed memory problems had lower scores on cognitive test scores at the beginning of the study compared to the other seniors in the study, although the scores were within normal range.
"These findings of structural changes in cognitively normal people before memory loss begins aren't surprising given Alzheimer's disease may be present for many years before symptoms of the disease begin to appear," said Smith.
The paper appears in Tuesday's issue of Neurology, the scientific journal of the American Academy of Neurology.
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