009 Health Research Report 16 OCT 2007

                      

Health Technology Research Synopsis

9th Health Research Report 16 OCT 2007

Compiled By Ralph Turchiano

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1.      Creatine in addition to exercise enhances strength in older adults
2.      Tamiflu survives sewage treatment
3.      Combination vaccines okay for infants, study shows (questionable)
4.      Breast cancer chemo may damage heart
5.      Study: diabetic neuropathy costs billions per year in lost work time
6.      Got calcium? UWM researcher finds that food labels confuse consumers
7.      Limiting refined carbohydrates may stall AMD progression
8.      Hip size of mothers linked to breast cancer in daughters
9.      Folic acid lowers blood arsenic levels, according to Mailman School of Public Health study
10.  Anti-depressant drugs can double risk of gastrointestinal bleeding
11.  Appendix isn’t useless at all: It’s a safe house for bacteria
12.  Prostate cancer therapy linked to increased risk of heart disease death
13.  Protein enhances lethality of influenza virus
14.  Cancer conflict with chemotherapy treatment
15.  Obesity boosts gullet cancer risk 6-fold
16.  Red Wine and Grape Juice Help Defend Against Food-Borne Diseases, according to MU Researchers
17.  Patients can’t recall their medications to tell doctors
18.  Even occasional use of spray cleaners may cause asthma in adults
19.  Study measures impact on productivity from functional gastrointestinal disorders
20.  2 studies highlight the risks and significant health-care costs of NSAIDs injury
21.  Garlic Boosts Hydrogen Sulfide To Relax Arteries

Public release date: 2-Oct-2007

Creatine in addition to exercise enhances strength in older adults

Hamilton, ON (Oct. 1, 2007) – Lower muscle mass and an increase in body fat are common consequences of growing older.

While exercise is a proven way to prevent the loss of muscle mass, a new study led by McMaster researcher Dr. Mark Tarnopolsky shows that taking a combination of creatine monohydrate (CrM) and conjugated linoleic acid (CLA) in addition to resistance exercise training provides even greater benefits.

The study to be published on Oct. 3 in PLoS One, an international, peer-reviewed online journal of the Public Library of Science, involved 19 men and 20 women who were 65 years or older and took part in a six-month program of regular resistance exercise training.

In the randomized double blind trial, some of the participants were given a daily supplement of creatine (a naturally produced compound that supplies energy to muscles) and linoleic acid (a naturally occurring fatty acid), while others were given a placebo. All participants took part in the same exercise program.

The exercise training resulted in improvements of functional ability and strength in all participants, but those taking the CrM and CLA showed even greater gains in muscle endurance, an increase in fat-free mass and a decrease in the percentage of body fat.

“This data confirms that supervised resistance exercise training is safe and effective for increasing strength and function in older adults and that a combination of CrM and CLA can enhance some of the beneficial effects of training over a six month period,” said Tarnopolsky, a professor of pediatrics and medicine.

This study provides functional outcomes that build on an earlier mechanistic study co-led by Tarnopolsky and Dr. S. Melov at the Buck Institute of Age Research, published in PLoS One this year, which provided evidence that six months of resistance exercise reversed some of the muscle gene expression abnormalities associated with the aging process.

Public release date: 2-Oct-2007

Tamiflu survives sewage treatment

Swedish researchers have discovered that oseltamivir (Tamiflu); an antiviral drug used to prevent and mitigate influenza infections is not removed or degraded during normal sewage treatment. Consequently, in countries where Tamiflu is used at a high frequency, there is a risk that its concentration in natural waters can reach levels where influenza viruses in nature will develop resistance to it. Widespread resistance of viruses in nature to Tamiflu increases the risk that influenza viruses infecting humans will become resistant to one of the few medicines currently available for treating influenza

The Swedish research group demonstrated that oseltamivir, the active substance in Tamiflu, passes virtually unchanged through sewage treatment

Influenza viruses are common among waterfowl, especially dabbling ducks such as mallards. These ducks often forage for food in water near sewage outlets. Here they can potentially encounter oseltamivir in concentrations high enough to develop resistance in the viruses they carry.

“The biggest threat is that resistance will become common among low pathogenic influenza viruses carried by wild ducks.” adds Björn Olsen. These viruses could then recombinate with viruses that make humans sick to create new viruses that are resistant to the antiviral drugs currently available.

The Swedish researchers advise that this problem must be taken seriously so that humanity’s future health will not be endangered by too frequent and unnecessary prescription of the drug today.

Ralph’s Note – The irony being that in trying to prevent the low level threat of the Bird Flu. Could result in the mutations necessary to make it into the lethal virus that many fear.

Public release date: 3-Oct-2007

Questionable Science

Combination vaccines okay for infants, study shows

A University of Rochester study brings relief to new parents who, while navigating a jam-packed childhood vaccine schedule, can expect to soothe their newborn through as many as 15 “pokes” by his or her six-month checkup

The study, recently published in The Journal of Pediatrics, shows that no efficacy or safety is compromised when clinicians administer a new combination vaccine that streamlines the process – in effect, tripling up three of the recommended shots to reduce the “poke” total from five to three, at each of three bimonthly, well-child checkups.

“Only more immunizations will enter the schedule,” said Michael Pichichero, M.D., professor of Microbiology/Immunology, Pediatrics and Medicine at the University of Rochester and the study’s lead author. “Coupling or tripling of these vaccines is increasingly important, as this streamlining helps to promote parent compliance, timely vaccination and fewer administration errors.”

The study overturns findings (and fears) from a previous study that suggested problems when two specific vaccines were given at the same time – Pediarix, a combination of vaccines that guard against diphtheria, tetanus, whooping cough, hepatitis B and poliovirus, and Prevnar, which protects against 76 strains of Streptococcus pneumonia. The earlier studies found that when the vaccines were co-administered, a suboptimal immune response was produced against whooping cough, and more uncomfortable reactions, such as swelling at the injection site, could be expected

Both Pediarix and Prevnar are recommended for administration at 2-, 4- and 6-month checkups; Prevnar was approved in 2000, shortly before the licensure of Pediarix.

Minor symptoms were more common in the Combination Vaccine Group; however higher fevers and more severe shot site reactions were not significantly more likely to occur in infants in any of the three groups.

For example, swelling and pain were significantly higher at the injection site of the combination vaccine, but Pichichero said that is to be expected, given that there are more ingredients in that single shot (vaccines are made from killed or modified forms of bacteria or viruses, or only pieces or products of the germs). But, he added, it was noteworthy that at no time did any local symptoms (swelling, redness, pain) lead to an infant obtaining a medical attention visit.

When you administer more vaccines, you expect more symptoms, more fevers, he said. Fever, swelling, redness are all indicators that the vaccine is working, that the body is busy creating the right immunity to prevent disease

“So long as they are mild, they pale in comparison to benefits of convenience to the parent, the fewer number of pokes to the infant, and of course, the severity of the diseases we are preventing,” he said

Ralph’s Note- This study was only 5 months long. Not long enough to access a true immune response, or long term risk of side effect’s. It would be wise to follow the children to at least the age of two, when the SID’s and Autism window is lowered. In addition the study was funded by a grant from GlaxoSmithKline Biologicals, makers of Pediarix.

Public release date: 3-Oct-2007

Breast cancer chemo may damage heart

Drugs called anthracyclines are a breast cancer chemo staple despite a well-known risk: They weaken some women’s hearts. What’s new is research suggesting the drugs work no better than safer alternatives for most women.

It’s a controversy born of success: Treatment advances are enabling more women than ever before to beat breast cancer, and some 2.4 million survivors are alive today. Now a move is underway to determine just how many women are vulnerable to heart disease because of their cancer battle, and how to help them.

Dr. Dennis Slamon of UCLA’s Jonsson Cancer Center cites nine studies, here and abroad, that conclude that only the 20% of patients whose tumors have an overactive gene called Her2 are specifically sensitive to anthracyclines

Chemo is only one cardiac culprit. Other factors play a role, too: Chest radiation, the weight gain that plagues many survivors, physical inactivity during treatment and stress.

Then Slamon’s closer inspection found that not all Her2 patients are alike — and only those who have a second overactive gene, called TopoII, derive special benefit from anthracyclines. That’s about 8% of breast cancer patients.

The powerful Her2-targeting drug Herceptin — key for women with Her2-positive tumors — also comes with a heart-damage warning. But adding it to anthracyclines increases the heart risk fivefold, with no extra benefit, Slamon found

And in this month’s Journal of Clinical Oncology, researchers tracked breast cancer survivors ages 66 to 70 who had undergone chemo 10 years earlier. Those who had received an anthracycline were 26% more likely to have developed heart failure in the following decade than those on different chemo.

“It’s almost like the perfect storm,” Slamon says of all the research. “We’re adding no incremental benefit with plenty of incremental toxicity.”

But many oncologists aren’t convinced, and want more evidence that other chemos work as well.

Ralph’s Note – At least 80% to 92% of breast cancer patients don’t respond to this Chemo; However, it may increase the risk of heart failure 5 fold; forgetting about other possible side effects. Hmmm.

Public release date: 5-Oct-2007

Study: diabetic neuropathy costs billions per year in lost work time

DANVILLE, PA. – Workers who have diabetes with neuropathic symptoms such as numbness or tingling in feet or hands lose the equivalent of 1.4 hours a week or $3.65 billion per year in health-related lost productive time, a recent study finds

Geisinger Center for Health Research investigators looked at 19,075 working adults, including 1,003 who were diagnosed with diabetes. Of these workers, 38% reported diabetes-related numbness or tingling in their feet or hands

Those with diabetes were about twice more likely than those without diabetes to be unemployed.

Public release date: 5-Oct-2007

Got calcium? UWM researcher finds that food labels confuse consumers

The research, which involved three separate studies and a follow-up, is discussed in “The Calcium Quandary: How Consumers Use Nutrition Labels for Daily Diet,” published in the Journal of Public Policy and Marketing. Peracchio and Block found that:

In Study 1, only two of 37 respondents correctly translated the calcium information on a carton of yogurt from %DV to milligrams.

In Study 2, when 20 physicians were shown the same label, only six gave the right answer in milligrams. (Asked how the calculation was done, one physician who gave an incorrect answer replied: “I have no idea. I made it up.”) Yet most doctors dispense calcium recommendations to their patients in milligrams

Public release date: 8-Oct-2007

Limiting refined carbohydrates may stall AMD progression

Eating fewer refined carbohydrates may slow the progression of age-related macular degeneration (AMD), according to a new study from researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

AMD results in partial or total blindness in 7 to 15% of the elderly, according to the Eye Diseases Prevalence Research Group. “Dietary changes may be the most practical and cost-effective prevention method to combat progression of AMD,” says Allen Taylor, PhD, director of the Laboratory for Nutrition and Vision Research at the USDA HNRCA. “It is surprising there is so little attention focused on the relationship between AMD and carbohydrates.”

In the present study, Taylor and colleagues analyzed diet questionnaires completed by 4,757 non-diabetic men and women participating in the nationwide Age-Releated Eye Disease Study (AREDS). The eight-year AREDS study enrolled participants between the ages of 55 and 80 with varying stages of AMD. Taylor and colleagues examined the participants’ carbohydrate intake over a one-year period and used the data to calculate the participants’ dietary glycemic index.

“Our data showed those people in the high-glycemic-index group were at greater risk of AMD progression, especially those already in the late stages,” says first author Chung-Jung Chiu, DDS, PhD, scientist in the Laboratory for Nutrition and Vision Research at the USDA HNRCA and assistant professor at Tufts University School of Medicine. “Participants who consumed the most refined carbohydrates were 17 percent more likely to develop blinding AMD than the group that consumed the least.”

According to the authors, public health officials believe the condition could spur a public health crisis in the United States by 2020, when they predict the cases of AMD-related vision loss will have doubled to three million.

Public release date: 8-Oct-2007

Hip size of mothers linked to breast cancer in daughters

PORTLAND, Ore. – In a study of the maternity records of more than 6,000 women, David J.P. Barker, M.D., Ph.D., and Kent Thornburg, Ph.D., of Oregon Health & Science University discovered a strong correlation between the size and shape of a woman’s hips and her daughter’s risk of breast cancer. Wide, round hips, the researchers postulated, represent markers of high sex hormone concentrations in the mother, which increase her daughter’s vulnerability to breast cancer.

The study, carried out with colleagues in Finland and the United Kingdom., is described in an article just published online by the peer-reviewed American Journal of Human Biology. The authors followed up on 6,370 women born in Helsinki from 1934 to 1944 whose mothers’ pelvic bones were measured during routine prenatal care. The study found that breast cancer rates were more than three times higher among the women in the cohort, born at or after term, whose mothers had wide hips. They were more than seven times higher if those mothers had already given birth to one or more children.

A woman’s vulnerability to breast cancer, the study found, was greater if her mother’s “intercristal diameter” – the widest distance between the wing-like structures at the top of the hip bone – was more than 30 centimeters, or 11.8 inches. The risk also was higher if these wing-like structures were round. The breast cancer risk was 2.5 times higher for the daughters of women in whom the widest distance was more than 3 centimeters greater than the distance at the front.

The OHSU study published today proposes that breast cancer is initiated in the first trimester of a pregnancy by exposure of the embryo’s developing breast tissue to the mother’s circulating sex hormones. The primary mammary cord, which gives rise to milk-producing breast lobules, develops in the fetus at 10 weeks. The fetal breast is known to be stimulated by circulating hormones; the intensity of the stimulation is such that half of all newborn babies have breast secretions.

“Our findings support the hypothesis that wide round hips reflect high levels of sex hormone production at puberty, which persist after puberty and adversely affect breast development of the daughters in early gestation,” the authors commented. They could only speculate, they said, on the exact nature of this adverse effect but pointed out: “Catechol estrogen, a metabolite or estradiol, is thought to cause chromosomal instability by breaking DNA strands. High catechol estrogen concentrations in the maternal circulation could produce genetic instability in differentiating breast epithelial cells, which would make the breast vulnerable to cancer in later life.”

Public release date: 8-Oct-2007

Folic acid lowers blood arsenic levels, according to Mailman School of Public Health study

October 8, 2007 — A new study by researchers at Columbia University Mailman School of Public Health finds that folic acid supplements can dramatically lower blood arsenic levels in individuals exposed to arsenic through contaminated drinking water. This toxic element, naturally present in some aquifers used for drinking, is currently a significant public health problem in at least 70 countries, including several developing countries and also parts of the U.S. Chronic arsenic exposure is associated with increased risk for skin, liver and bladder cancers, skin lesions, cardiovascular disease, and other adverse health outcomes. The study results are published in the October issue of the American Journal of Clinical Nutrition.

The researchers found that treatment with 400 micrograms a day of folic acid, the U.S. recommended dietary allowance, reduced total blood arsenic levels in the study population by 14 percent. Folate, a B vitamin found in leafy vegetables, citrus fruits, beans, and whole grains, can also be taken as a vitamin supplement, and in the U.S., is added to flour and other fortified foods. The researchers found that folate deficiency is very common in Bangladesh, where the study was conducted.

“Folic acid supplementation enhanced the detoxification of arsenic to a form that is more readily excreted in urine,” said Mary Gamble, PhD, assistant professor of Environmental Health Sciences at the Mailman School, and lead author. The study is jointly supported by the National Institute of Environmental Health Sciences, part of the National Institutes of Health and the federally funded Superfund Basic Research Program (SPRB), which seeks solutions to the complex health and environmental issues associated with the nation’s hazardous waste sites.

Folic acid increased the methylation or detoxification of arsenic in the body, allowing the body to change some of its more toxic metabolite, or methylarsonic (MMA) acid, to a form that could more easily be excreted from the body, thus lowering the levels of arsenic found in the blood.

Ralph’s Note – That means Folic acid should be a powerful cancer fighter in arsenic induced skin cancer.

Public release date: 8-Oct-2007

Anti-depressant drugs can double risk of gastrointestinal bleeding

WINSTON-SALEM, N.C. – New research shows that selective serotonin reuptake inhibitors (SSRIs), a group of drugs commonly used to treat depression, may double the risk of gastrointestinal bleeding, according to researchers from Wake Forest University School of Medicine and colleagues. When the drugs are taken with aspirin and other similar pain medications, the risk is more than 600 percent higher.

“Clinicians who prescribe these medications should be aware of the potential risk and may need to consider alternatives,” said Sonal Singh, M.D., senior researcher and an assistant professor of internal medicine. “In addition, regulatory authorities should consider revising existing package inserts to highlight the magnitude of the risk.”

The research was reported online this month in Alimentary Pharmacology & Therapeutics. Emerging evidence has shown that SSRIs may be associated with bleeding of the lining of the digestive tract including the esophagus, stomach or upper part of the small intestine, which together are called the upper gastrointestinal (GI) tract. Upper gastrointestinal bleeding may be potentially serious and require hospitalization for blood transfusions and other treatments.

The researchers pooled data from four studies involving 153,000 patients, which allowed them to detect effects that might not show up in the individual studies. They found patients taking SSRIs were nearly twice as likely to develop upper GI bleeding than patients not taking the drugs. When the patients also took NSAIDs, the risk of upper gastrointestinal bleeding was six times higher than in patients taking neither medication.

In addition to the clinical studies, the researchers analyzed 101 reports on adverse effects submitted to the Canadian Adverse Events Database and the U.S. Food and Drug Administration’s Adverse Event Reporting System. They found that bleeding associated with SSRI use occurred after a median of 25 weeks on the drugs. About 67 percent of those patients were also taking NSAIDs. The adverse reaction was not limited to the elderly, with 38 percent of cases occurring in patients below the age of 60.

Public release date: 8-Oct-2007

Appendix isn’t useless at all: It’s a safe house for bacteria

DURHAM, N.C. – Long denigrated as vestigial or useless, the appendix now appears to have a reason to be – as a “safe house” for the beneficial bacteria living in the human gut.

Drawing upon a series of observations and experiments, Duke University Medical Center investigators postulate that the beneficial bacteria in the appendix that aid digestion can ride out a bout of diarrhea that completely evacuates the intestines and emerge afterwards to repopulate the gut. Their theory appears online in the Journal of Theoretical Biology.

The gut is populated with different microbes that help the digestive system break down the foods we eat. In return, the gut provides nourishment and safety to the bacteria. Parker now believes that the immune system cells found in the appendix are there to protect, rather than harm, the good bacteria.

For the past ten years, Parker has been studying the interplay of these bacteria in the bowels, and in the process has documented the existence in the bowel of what is known as a biofilm. This thin and delicate layer is an amalgamation of microbes, mucous and immune system molecules living together atop of the lining the intestines.

“Our studies have indicated that the immune system protects and nourishes the colonies of microbes living in the biofilm,” Parkers explained. “By protecting these good microbes, the harmful microbes have no place to locate. We have also shown that biofilms are most pronounced in the appendix and their prevalence decreases moving away from it.”

This new function of the appendix might be envisioned if conditions in the absence of modern health care and sanitation are considered, Parker said.

“Diseases causing severe diarrhea are endemic in countries without modern health and sanitation practices, which often results in the entire contents of the bowels, including the biofilms, being flushed from the body,” Parker said. He added that the appendix’s location and position is such that it is expected to be relatively difficult for anything to enter it as the contents of the bowels are emptied.

“Once the bowel contents have left the body, the good bacteria hidden away in the appendix can emerge and repopulate the lining of the intestine before more harmful bacteria can take up residence,” Parker continued. “In industrialized societies with modern medical care and sanitation practices, the maintenance of a reserve of beneficial bacteria may not be necessary. This is consistent with the observation that removing the appendix in modern societies has no discernable negative effects.

”Several decades ago, scientists suggested that people in industrialized societies might have such a high rate of appendicitis because of the so-called “hygiene hypothesis,” Parker said. This hypothesis posits that people in “hygienic” societies have higher rates of allergy and perhaps autoimmune disease because they — and hence their immune systems — have not been as challenged during everyday life by the host of parasites or other disease-causing organisms commonly found in the environment. So when these immune systems are challenged, they can over-react.

“This over-reactive immune system may lead to the inflammation associated with appendicitis and could lead to the obstruction of the intestines that causes acute appendicitis,” Parker said. “Thus, our modern health care and sanitation practices may account not only for the lack of a need for an appendix in our society, but also for much of the problems caused by the appendix in our society.”

Public release date: 9-Oct-2007

Prostate cancer therapy linked to increased risk of heart disease death

The use of androgen deprivation therapy to treat localized prostate cancer is associated with an increased risk of death from heart disease, according to a study published online October 9 in the Journal of the National Cancer Institute

Androgen deprivation therapy is frequently used to treat high-risk localized prostate cancer. Studies have shown that androgen deprivation therapy, when used with external beam radiation therapy, improves survival in patients with advanced and localized prostate cancer. But the use of androgen deprivation therapy can also lead to the development of metabolic syndrome, which increases the risk of type II diabetes or coronary artery disease

Henry Tsai, M.D., of Harvard Medical School in Boston and colleagues investigated whether androgen deprivation therapy increases the risk of death from heart disease in patients treated for localized prostate cancer. They collected data on 3,262 patients treated by surgical removal of the prostate and 1,630 patients treated with certain radiation therapies or cryotherapy (in which the tumor tissue is frozen to kill the cells). Of these patients, about 1,000 were also treated with androgen deprivation therapy.

After a median follow-up of nearly 4 years, 131 patients died of heart disease. Both androgen deprivation therapy and older age were associated with an increased risk of death from heart disease. Among men 65 years and older who had their prostates removed, the 5-year incidence of heart disease-related death was 5.5 percent for those receiving androgen deprivation, and 2 percent among those who did not. For men younger than 65 years, the rates were also increased, 3.6 percent and 1.2 percent respectively. There was also an increased risk of death in men who received androgen deprivation in addition to radiation or cryotherapy, but it was not statistically significant.

Public release date: 10-Oct-2007

Protein enhances lethality of influenza virus

It is relatively rare for an influenza virus to be virulent enough to cause death in healthy humans. Many deaths associated with influenza are caused by the combined influence of viral disease and the following secondary bacterial infection. Although the 1918 pandemic strain was one of the few influenza viruses capable of killing healthy victims on its own, the majority of fatal cases from the “Spanish Flu” can be attributed to secondary bacterial pathogens rather than primary viral disease. This important interaction between influenza viruses and bacteria is not well understood.

Dr. Jonathan A. McCullers from the Department of Infectious Diseases at St. Jude Children’s Research Hospital in Memphis, Tennessee and colleagues examined this interaction by studying a newly discovered influenza A virus (IAV) protein, called ?????. The gene encoding ?????is present in nearly all IAVs, including highly pathogenic avian IAVs that have infected humans and the IAV associated with the 1918 pandemic. “????? was recently shown to enhance viral pathogenicity in a mouse infection model, raising questions about its effects on the secondary bacterial infections associated with high levels of influenza morbidity and mortality,” explains Dr. McCullers.

The researchers found that expression of ?????increased the incidence of and exacerbated secondary bacterial pneumonia in a mouse model. Intranasal delivery of a synthetic peptide derived from a portion of ?????had the same effects. Further, an influenza virus engineered to express a version of ?????identical to that in the 1918 pandemic strain was more virulent in mice and led to more severe bacterial pneumonia, explaining in part both the unparalleled virulence of the 1918 strain and the high incidence of fatal pneumonia during the pandemic.

The finding that ?????promotes lung pathology in primary viral infection and secondary bacterial infection also provides critical information for the future. “Given the importance of IAV as a leading cause of virus-induced morbidity and mortality year in and year out, and its potential to kill tens of millions in the inevitable pandemic that may have its genesis in the viruses currently circulating in southeast Asia, it is imperative to understand the role of ?????in IAV pathogenicity in humans and animals,” says Dr. McCullers. “These findings also reinforce the recent suggestion of the American Society for Microbiology that nations should stockpile antibiotics for the next pandemic, since many of the deaths during this event are likely to be caused by bacterial super-infections.”

Ralph’s Note – I  replaced the protein type with question marks, in protest of the release of this information. How easy due we want the next pandemic to be created through an act of terrorism? This should be a DOD project only…

Public release date: 10-Oct-2007

Cancer conflict with chemotherapy treatment

Young women suffering from breast cancer do not necessarily benefit from chemotherapy treatment

Women under the age of forty with breast cancer who are given drugs in addition to lumpectomies or radiotherapy, known as adjuvant chemotherapy, may not be benefiting from these drugs. This is especially true if their tumors respond to changing levels of hormones such as estrogen, according to research published in the online journal, Breast Cancer Research.

“Developing breast cancer at a young age is very worrying in terms of survival,” explained lead researcher Dr J van der Hage. “But some young women may be undergoing not only unpleasant but also unnecessary chemotherapy, which can be avoided.”

Almost 10% of women diagnosed with breast cancer in Europe are under the age of forty. Two thirds of breast cancers, known as estrogen receptor positive (ER+), contain high levels of cells which contain estrogen receptors. These tumors tend to grow less aggressively than estrogen receptor negative (ER-) tumors. Young patients with breast cancer are currently advised to undergo courses of chemotherapy as well as removal of the tumor and/or entire breast. A research team of the European Organisation for Research and Treatment of Cancer (EORTC) selected patients from four EORTC-trials which were coordinated by Professor C.J.H. van de Velde from the Leiden University Medical Center, to study the effect of chemotherapy in young women. The research team found that ER+ patients, while they benefited from their chemotherapy treatment, did not survive at higher rates than ER- patients

The difference in survival rates between the two treatment groups was just 5% (in favour of the ER- group), indicating that the chemotherapy gave no advantage. Of all the patients examined, including those who had only undergone primary treatment such as mastectomy, over 25% had died seven years after initial diagnosis

“Adjuvant chemotherapy is a well established, but ineffective treatment in ER+ breast cancer patients aged 40 years or less . Hormone responsiveness is the key to tailoring therapy in the future fight against this disease for young women,” concluded Dr van der Hage.

Ralph’s Note- Well established but useless, so why?

Public release date: 10-Oct-2007

Obesity boosts gullet cancer risk 6-fold

Obese people are six times as likely to develop gullet (oesophageal) cancer as people of ‘healthy’ weight, shows research published ahead of print in the journal Gut.

Rates of oesophageal cancer have been rising rapidly, and in some countries, they have risen faster than those of every other major cancer, say the authors

The link between acid reflux and gullet cancer is well known, and unsurprisingly, repeated symptoms of severe heartburn or gastrointestinal reflux disease (GORD) were associated with a much higher risk of the cancer

GORD quintupled the risk of oesophageal cancer, and a combination of obesity and acid reflux boosted the chances of having it by a factor of 16.

Those with a body mass index (BMI) of 40 or more were six times as likely to have the cancer as those with a BMI between 18.5 and 25.

Higher levels of fat tissue in the body boost insulin production, which in turn increases the amount of circulating insulin-like growth factor.

Both these hormones stimulate cell growth and curb cell death, conditions which favour the development of cancers, explain the authors.

Fat cells also produce other hormones, collectively known as adipocytokines, which speed up cell growth and are involved in inflammatory processes in the body, they say.

Public release date: 10-Oct-2007

Red Wine and Grape Juice Help Defend Against Food-Borne Diseases, according to MU Researchers

COLUMBIA, Mo. – Red wine is known to have multiple health benefits. Researchers at the University of Missouri-Columbia have found that red wine may also protect humans from common food-borne diseases

Researchers Azlin Mustapha, associate professor of food science in the College of Agriculture, Food and Natural Resources, and Atreyee Das, a doctoral student in the food science program, are conducting on-going studies examining the inhibitory effects of numerous types of red wines, as well as grape juice, against pathogens and probiotic bacteria, which naturally reside in the intestinal tract and can be beneficial in combating, among other things, high cholesterol and tumors.

They found that red wines – Cabernet, Zinfandel and Merlot in particular – have anti-microbial properties that defend against food-borne pathogens and don’t harm naturally useful bacteria like probiotic bacteria.

E. coli, Salmonella Typhimurium, Listeria monocytogenes and H. pylori were among the pathogens examined. E. coli and Listeria can be fatal. Mustapha said the most promising results involved Helicobacter pylori, which can be transmitted via food and water and is the main cause of stomach ulcers.

In lab tests, Mustapha and Das focused on ethanol, pH levels and reseveratrol, which is a phytochemical found in grape vines and the skin of grapes. It also is responsible for the red coloring in red wines. They found that in addition to ethanol, pH and reseveratrol also may inhibit food-borne pathogens.

Numerous white wines also were tested, but yielded no positive results, the researchers said.

“It’s not just ethanol in the red wine that is inhibitory toward food-borne pathogens, but other factors which include the pH of the wine – because wines are a little acidic, and possibly the phytochemicals may have an effect,” said Mustapha, noting that grape juice produces similar results. “We hypothesize that these phytochemicals, reseveratrol being the main one, also play a role not just as antioxidants but also may have some inhibitions against food-borne pathogens. Now, we’re concentrating mainly on the reseveratrol effects on these pathogens.”

The findings were recently presented at the Institute of Food Technologists annual conference in Chicago.

Public release date: 11-Oct-2007

Patients can’t recall their medications to tell doctors

New research from Northwestern University’s Feinberg School of Medicine has found that nearly 50 percent of patients taking antihypertensive drugs in three community health centers were unable to accurately name a single one of their medications listed in their medical chart. That number climbed to 65 percent for patients with low health literacy.

“It was worse than we expected,” said lead author Stephen Persell, M.D., an assistant professor of medicine, and of the Institute for Healthcare Studies at the Feinberg School, and a physician at Northwestern Memorial Hospital. “It means doctors can’t ask patients to tell them the medications they are taking for their chronic conditions like hypertension. It’s very hard to get at the truth of what medications the patient is actually taking.”

The study will be published in the November issue of the Journal of General Internal Medicine.

Even examining patients’ medical records won’t necessarily tell a doctor what pills a patient is swallowing. Persell said some patients continue to fill old prescriptions even if a doctor has changed the dosages or the medication.

“I’ve seen patients who continued on drugs that I told them to discontinue and stop taking drugs I never told them to stop using,” Persell said.

Public release date: 12-Oct-2007

Even occasional use of spray cleaners may cause asthma in adults

Using household cleaning sprays and air fresheners as little as once a week can raise the risk of developing asthma in adults, say researchers in Europe. Such products have been associated with increased asthma rates in cleaning professionals, but a similar effect in nonprofessional users has never before been shown.

“Frequent use of household cleaning sprays may be an important risk factor for adult asthma,” wrote lead author Jan-Paul Zock, Ph.D., of the Centre for Research in Environmental Epidemiology at the Municipal Institute of Medical Research in Barcelona, Spain.

The epidemiological study, the first to investigate the effects of cleaning products on occasional users rather than occupational users, appeared in the second issue for October of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

The investigators used baseline data from the first phase of the European Community Respiratory Health Survey (ECRHS I), one of the world’s largest epidemiologic studies of airway disease, and interviews conducted in the follow-up phase, ECRHS II. Altogether, the study included more than 3,500 subjects across 22 centers in 10 European countries. Subjects were assessed for current asthma, current wheeze, physician-diagnosed asthma and allergy at follow-up, which took place an average of nine years after their first assessment. They were also asked to report the number of times per week they used cleaning products

Two-thirds of the study population who reported doing the bulk of cleaning were women, about six percent of whom had asthma at the time of follow-up. Fewer than ten percent of them were full-time homemakers.

The risk of developing asthma increased with frequency of cleaning and number of different sprays used, but on average was about thirty to fifty percent higher in people regularly exposed to cleaning sprays than in others. The researchers found that cleaning sprays, especially air fresheners, furniture cleaners and glass-cleaners, had a particularly strong effect.

Despite the uncertainty of the biological mechanism, the findings have important clinical relevance. “Clinicians should be aware of the potential for cleaning products used in the home to cause respiratory symptoms and possibly asthma,” wrote Kenneth D. Rosenman, M.D., professor at Michigan State University, in an editorial in the same issue of the journal.

The research may have also significant implications for public health. “The relative risk rates of developing adult asthma in relation to exposure to cleaning products could account for as much as 15 percent, or one in seven of adult asthma cases,” wrote Dr. Zock.

Public release date: 15-Oct-2007

Study measures impact on productivity from functional gastrointestinal disorders

Impairment from chronic digestive problems amounts to 1 lost day per week

Philadelphia, PA, October 15, 2007— Those who suffer from common functional gastrointestinal disorders face work productivity losses and impairments in daily activity that amount to the loss of at least one day of work in a 40-hour workweek, according to a new study presented at the Annual Scientific Meeting of the American College of Gastroenterology

In the analysis, Dr. Locke and colleagues found that patients with IBS-C, CC and FD reported greater work productivity loss and daily impairment over a six-month period than patients with GERD alone. The mean hours lost per week for the GERD patients were 6.3 compared to 10.3 hours per week for those with the other functional GI disorders. GERD patients also scored lower on a scale measuring impairment/productivity loss resulting from GI disorders than those patients with chronic functional GI problems, reflecting a greater burden of illness for conditions such as IBS with constipation, chronic constipation and chronic abdominal problems. According to Dr. Locke, “This research demonstrates the significant economic impact of these common conditions.”

Public release date: 15-Oct-2007

2 studies highlight the risks and significant health-care costs of NSAIDs injury

Philadelphia, PA, October 15, 2007 – Patients underreported their use of common but potentially dangerous over-the-counter pain medications known as NSAIDs, according to research presented at the Annual Scientific Meeting of the American College of Gastroenterology. “This is a serious issue given what we know about the significant risk of injury and bleeding in the GI tract in patients using NSAIDs,” said David Johnson, M.D., FACG, one of the researchers and President of the America College of Gastroenterology.

Serious gastrointestinal complications such as bleeding, ulceration and perforation can occur with or without warning symptoms in people who take NSAIDS (non-steroidal anti-inflammatory drugs.) Ulcers and gastrointestinal bleeding are serious health problems in the United States. With millions taking NSAID pain medications every day, it is estimated that more than 100,000 Americans are hospitalized each year and between 15,000 and 20,000 Americans die each year from ulcers and gastrointestinal bleeding linked to NSAID use.

Of particular concern are patients with arthritic conditions. More than 14 million such patients consume NSAIDs regularly. Up to 60 percent will have gastrointestinal side effects related to these drugs and more than 10 percent will cease recommended medications because of troublesome gastrointestinal symptoms

Dr. Abraham and her colleagues reviewed prescription records linked to inpatient, outpatient and death files for the VA medical system and Medicare. In an overall population of almost half a million veterans, Dr. Abraham identified 3,200 events of GI bleeding, of which 36 percent were treated by the VA. A review of their prescription and hospitalization records revealed that half of those with GI bleeding events were hospitalized. Importantly, the one third of patients with GI bleeding events prescribed a PPI were 60 percent less likely to be hospitalized. Their overall median total medical costs were significantly lower than patients who were not prescribed a PPI.

Public release date: 15-Oct-2007

Garlic Boosts Hydrogen Sulfide To Relax Arteries

BIRMINGHAM, Ala. – Eating garlic is one of the best ways to lower high blood pressure and protect yourself from cardiovascular disease. A new study from the University of Alabama at Birmingham (UAB) shows this protective effect is closely linked to how much hydrogen sulfide (H2S) is produced from garlic compounds interacting with red blood cells.

The UAB researchers found this interaction triggered red blood cells to release H2S, which then led to the relaxation of blood vessels. Fresh garlic was used at a concentration equal to eating two cloves. The resulting H2S production caused up to 72 percent vessel relaxation in rat arteries.

This relaxation is a first step in lowering blood pressure and gaining the heart-protective effects of garlic, said David Kraus, Ph.D., a UAB associate professor in the Departments of Environmental Health Sciences and Biology and the study’s lead author.

Exactly how H2S affords the cardiovascular system so much protection is not entirely clear, but it may involve limiting oxidative damage in cells, Kraus said.

“The role of garlic compounds in preventing platelet aggregation, which can trigger a heart attack or stroke, and in limiting cancer growth and the progression of several diseases is well documented,” he said.

The new findings show H2S may be the mediator for these protective benefits. Future studies are being planned to better understand how much H2S production is needed through garlic or supplements to maximize those benefits.

The research is supported grants from the American Heart Association and the National Institutes of Health

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