Hot Medical News |
- Microarray technology could help predict patient response to adjuvant therapy for breast cancer
- High-Altitude Research Advances Low-Altitude Medicine, A Special Issue Of Progress In Cardiovascular Diseases
- Polypill Could Reduce Multiple Risk Factors For Cardiovascular Disease (Tips Study)
- The HFSP Journal Publishes New Article On The Impact Of Mechanical Stimulation On The Initiation Of Colon Cancer
- 41 Million Americans Have Pre-Diabetes says US Government
- Even Mild Sleep Apnea Increases Cardiovascular Risk
- Immune Mediated Survival Advantage And Primary Tumor Control Of Cryoablation Compared To Nephrectomy In A Murine Model Of Advanced Renal Cancer
- Link Between Successful Weight Loss And Vitamin D Levels
- UPMC Cardiologist Named Master Clinician Chair In Cardiovascular Medicine At UPMC Cardiovascular Institute
- WFP To Increase Food Handouts In Malawi After Receiving Maize Donation From Government
| Microarray technology could help predict patient response to adjuvant therapy for breast cancer Posted: 09 Feb 2011 09:05 AM PST Microarray technology could be used to tailor therapy according to the A team of researchers led by Jonas Bergh from the Karolinska Institutet in An analysis of the genes expressed in the tumours of all 159 patients showed The present lack of criteria to help tailor breast cancer treatment to Article: Gene expression profiling spares early breast cancer patients from Journal URL: BioMed Central biomedcentral.com) is an independent online BioMed Central currently publishes over 130 journals across biology and |
| Posted: 07 Feb 2011 11:13 PM PST High altitude medicine is a “natural research laboratory” for the study of cardiovascular physiology and pathophysiology. As such, it can shed light on conditions and diseases that mimic the low oxygen content of the atmosphere at the top of mountains. Yves Allemann, MD, FESC, Swiss Cardiovascular Center, University Hospital, Bern, and Urs Scherrer, MD, Centre Hospitalier Universitaire Vaudois, Lausanne, have assembled an international group of leading authorities to contribute to a special issue of Progress in Cardiovascular Diseases dedicated to high-altitude medicine and novel insights into disease mechanisms provided by high-altitude research. “We have demonstrated that in recent years, the scope of high-altitude research has broadened considerably, because it has become clear that high-altitude offers a unique opportunity to study fundamental mechanisms of disease,” according to Guest Editors Allemann and Scherrer. “During the past decade, high-altitude studies have elucidated fundamental novel mechanisms involved in the pathogenesis of lung edema and hypoxic pulmonary hypertension. The new knowledge generated by these high-altitude studies has already been transferred to the bedside of patients having these problems at low altitude. Second and equally important, we have shown that high-altitude exposure facilitates the detection of vascular dysfunction in humans. Capitalizing on this observation, high-altitude exposure of young apparently healthy children has allowed demonstrating fetal programming of vascular dysfunction at a very early stage. We predict that high-altitude exposure, real or simulated, will become an important tool for the detection of early vascular dysfunction in humans.” At high altitude, lack of oxygen principally affects the respiratory, cardiovascular, neuroendocrine, and renal systems. At low altitude, the same effects may occur, not due to ambient lack of oxygen, but as the result of hypoxemia, deficient oxygenation of the blood, which is the consequence of an organ insufficiency, usually the heart or the lung. Allemann and Scherrer observe that “the ultimate goal of most high-altitude researchers is not only to understand physiologic (mal)adaptation to hypoxia for the benefit of the millions exposing themselves to high altitude, but to think beyond that, imagining how the knowledge gained from field research at high altitude may be applied to the much larger number of patients with hypoxia/hypoxemia-associated diseases.” The issue provides cutting-edge insight into the current state of research in the field, as well as up-to-date information on the treatment and prevention of the three major high-altitude related diseases: acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema. Articles provide unique information useful to clinician-scientists interested in high-altitude medicine and advice for practicing cardiologists and family doctors who have patients suffering from cardiovascular disease planning to travel to high altitude. For the clinician, the article by Scherrer et al demonstrates how studies at high altitude have provided important insights into fundamental mechanisms underpinning pulmonary hypertension and pulmonary edema in humans. They show how these insights have been translated into novel approaches for the treatment of patients suffering from these problems at low altitude. Finally, it provides some hints on how the natural research laboratory of high altitude may provide novel insight into cardiovascular disease mechanisms in the future. For the practicing physician, the article by Rimoldi et al provides concise information and practical advice on how to counsel cardiovascular patients planning to travel to high altitude. There is tremendous variability in individual responses to low oxygen that may be further amplified by external factors such as exercise and stress. These responses may induce major problems in patients with cardiovascular diseases, particularly those with already limited functional reserves at low altitude. High-altitude pulmonary edema is a life-threatening problem, and physicians need to know how to advise individuals planning high-altitude activities. The article by Maggiorini et al provides up-to-date information on how to treat and prevent this important disease. Sometimes, a hypoxic environment is deliberately sought by endurance athletes who try to naturally augment their oxygen transport capacity. Should the athlete live high and train low or live low and train high? Vogt and Hoppeler bring together the latest concepts on that topic of debate. Of course, for high altitude populations in the Andes, the Himalayas, or other mountainous regions around the globe, hypoxia is a natural condition of life. In an article by Stuber et al, they describe the cardiovascular adaptation mechanisms of the Bolivian Aymaras and how these differ from chronic adaptation mechanisms of Caucasians living at the same altitude. These differences and their possible positive or negative long-term consequences on cardiopulmonary health are also discussed. Adaptation mechanisms to hypoxia can sometimes go beyond their primary goal of maintaining adequate tissue oxygenation. In chronic mountain sickness, affected patients develop, usually insidiously over time, excessive erythrocytosis, hypoxemia, and pulmonary hypertension that can have a major negative impact on quality of life. These cardiovascular consequences of chronic mountain sickness are explained by León-Velarde et al. These articles appear in a special issue of Progress in Cardiovascular Diseases, High Altitude Cardiopulmonary Physiology, Pathophysiology and Disease, Volume 52, Number 6, (May/June 2010), published by Elsevier. Source: Elsevier |
| Polypill Could Reduce Multiple Risk Factors For Cardiovascular Disease (Tips Study) Posted: 07 Feb 2011 12:46 AM PST 2.5 (2 votes) A polypill containing a statin, aspirin, and three blood pressure-lowering drugs could massively reduce future incidence of heart attack and stroke in currently healthy people. The findings of the TIPS* study are discussed in an Article published Online First and in an upcoming edition of The Lancet. Publication of the Article coincides with the announcement of the findings at the American College of Cardiology (ACC) meeting in Florida, USA. Dr Salim Yusuf, Population Health Research Institute, McMaster University, Hamilton, ON, Canada, and Dr Prem Pais, St John’s Medical College, Bangalore, India, and colleagues selected a formulation containing low doses of the blood-pressure-lowering drugs (BPLDs) hydrocholorothiazide (12•5 mg), atenolol (a β-blocker) (50 mg), and ramipril (5 mg); the statin simvastatin (20 mg), and finally aspirin (100 mg) per day, for the polypill (branded Polycap**). They wanted to address several questions in this study. First, can one pill (or capsule) be formulated that can deliver an effect similar to all its separate components added together? Second, what degree of reduction in blood pressure and LDL (bad) cholesterol can be achieved in people with normal levels of risk factors? Third, will a polypill with five components be tolerated? Fourth, do unexpected interactions arise when these drugs are given in a single pill? Fifth, does aspirin reduce the blood-pressure-lowering effects of the three BPLDs? In this randomised trial, in 50 centres in India, 2053 people aged 45-80 years – without cardiovascular disease but with one risk factor*** for it – were assigned to Polycap (412 people), or to eight other groups, each with about 200 individuals, of aspirin alone, simavastatin alone, hydrochlorothiazide alone, the three possible combinations of two out of three BPLDs, the three BPLDs alone, or the three BPLDs plus aspirin. All participants were also counselled on appropriate lifestyle modification. The researchers found that compared with groups not receiving BPLDs, the Polycap reduced systolic blood pressure by 7.4 mm Hg and diastolic blood pressure by 5.6 mm Hg, which was similar when three BPLDs were used, with or without aspirin. Reductions in blood pressure increased with the number of BPLDs used (2.2/1.3 mm Hg with one drug, 4.7/3.6 mm Hg with two drugs, and 6.3/4.5 mm Hg with all three). Polycap reduced LDL cholesterol by 0.70 mmol/L, which was slightly less than that with simavastatin alone (0.83 mmol/L). The reductions in heart rate with Polycap and other groups using atenolol were similar (7.0 beats/min) and both were substantially greater than in groups without atenolol. The reductions in urinary 11-dehydrothromboxane B2**** were similar in the Polycap (283 ng/mmol) compared with the three BPLDs plus aspirin (350 ng/mmol), and in aspirin alone (349 ng/mmoL) compared with groups without aspirin. Tolerability of the Polycap was similar to the other groups, with no evidence of increasing intolerability with increasing number of active components in one pill. The authors say: “Our study has shown that the Polycap is non-inferior to its individual components in lowering blood pressure and heart rate (an indicator of β blockade). It lowers LDL cholesterol and urinary 11-dehydrothromboxane B2 substantially, but to a degree that is slightly less than that with simvastatin or aspirin alone. They add: “The reductions in blood pressure that we recorded in this non-hypertensive population with the Polycap could theoretically lead to about a 24% risk reduction in cardiovascular heart disease and 33% risk reduction in strokes in individuals with average blood pressure levels…On the basis of the more modest lowering of LDL cholesterol that we noted, a 27% relative risk reduction in cardiovascular heart disease and an 8% risk reduction in stroke can be projected.” The authors believe that the combined effects of all the components in the Polycap could potentially halve cardiovascular events, in average, middle-aged individuals. The authors say that adherence to multiple drugs even in patients after a heart attack is suboptimal, and believe the polypill could substantially improve adherence and therefore the benefits. They conclude: “By including nine groups and a large number of patients, we have been able to assess the effects of various combinations of drugs on a range of outcomes and on safety and tolerability… the formulation of the Polycap used in this study can be conveniently used to reduce multiple risk factors and cardiovascular risk.” In an accompanying Comment, Dr Christopher P Cannon, Cardiovascular Division, Brigham and Women’s Hospital, Boston, and Harvard Medical School, Boston, says that a large phase III is now required to fully evaluate the feasibility of the polypill. He also the discusses the problem of getting the doses of each drug right, and the possibility of polypills of different strengths. Dr Cannon underlines his hopes that use of a polypill would not lead people to abandon appropriate exercise and diet, which would make the root causes of cardiovascular disease worse. He adds that due to simplicity and presumably cheap cost, a polypill would fit well into the health systems of less developed countries, as well as into more modern medical systems, in which large proportions of patients with risk factors are untreated. He concludes: “The study… raises hope that, in conjunction with other global efforts on improving diet and exercise, the polypill could one day substantially reduce the burden of cardiovascular disease in the world.” DOI:10.1016/S0140-6736(09)60611-5 ** The Polycap is manufactured by Cadila Pharma, Ahmedabad, India. ***Risk factors: type 2 diabetes; blood pressure >140 mm Hg systolic or > 90 mm Hg diastolic, but 0.85 for women and >0.90 for men); or abnormal blood fats (LDL/bad cholesterol >3.1 mmol/L or HDL/good cholesterol |
| Posted: 06 Feb 2011 08:31 AM PST The HFSP Journal, the new interdisciplinary journal for scientists conducting high quality, innovative research at the interface between biology and the physical sciences is pleased to announce that the latest article on the impact of mechanical stimulation on the initiation of colon cancer in now available online at http://hfspj.aip.org. Inappropriate activity of the beta-catenin transcriptional factor, most often due to truncating mutations in the adenomatous polyposis coli (APC) gene, is known to be the principal cause of colon cancer development, yet loss of APC appears to be necessary but not sufficient in itself to trigger neoplastic transformation. Environmental signals, in addition to loss of both APC alleles, were suggested to be required for both initiation of tumourigenesis and for tumour progression. Understanding the source of these additional environmental cues which promote tumour initiation and progression will allow the development of alternative approaches to colon cancer prevention and treatment. Because the gastrointestinal tract is naturally submitted to significant endogenous mechanical strains, Emmanuel Farge and his colleagues at the Curie Institute in Paris have tested the ability of colon explants from normal or APC-deficient mice to respond to mechanical strain by analyzing changes in the distribution of beta-catenin and expression of its target genes and report on their findings in the HFSP Journal. HFSP PUBLISHING http://www.hfsp-publishing.org |
| 41 Million Americans Have Pre-Diabetes says US Government Posted: 06 Feb 2011 04:41 AM PST 5 (1 votes) The US government says that 41 million Americans have pre-diabetes, this means they have signs of what could later becomes diabetes type 2, the estimates are twice as high as previously thought. The estimates have gone up because the criteria for diagnosing people has changed. Some research found that doctors were missing too many people who were passing through the net without being diagnosed properly (as pre-diabetics). American Health and Human Services Secretary Tommy Thompson said “These latest numbers show how urgent the problem really is. We need to help Americans take steps to prevent diabetes or we will risk being overwhelmed by the health and economic consequences of an ever-growing diabetes epidemic.” If you have the symptoms of pre-diabetes all you really have to do to reduce your risk of developing full blown diabetes is to eat more carefully and become more physically active. Francine Kaufman, ex-president of the American Diabetes Association says the tragedy is that most people who are pre-diabetic do not know they are. Many only find out when the diabetes itself has surfaced. Diabetes causes a myriad of health problems, such as blindness, kidney failure, heart disease, limb amputations and strokes. 18 million people in the USA have diabetes and 180,000 every year die as a result of it. There are two types of diabetes, type 1 and type 2. Type 1 is something you are born with, your pancreas loses the ability to produce (enough) insulin. Type 2 is something you develop later in life, usually as a result of lifestyle – eating incorrectly (getting fat) and not being physically active enough. In type 2 your body eventually loses the ability to convert blood sugar into energy. Obesity and inactivity are the main causes of type 2 diabetes – as many Americans are overweight and do not do enough exercise type 2 diabetes is growing. Developing type 2 diabetes is a gradual thing. Your glucose (sugar) blood levels gradually creep up. The reason the diagnosis criteria has changed is that many people were getting normal blood test results even though their glucose levels were rising – but not hitting diabetic levels yet. Before, your blood sugar levels had to be above 110 milligrams per decilitre for alarm bells to start ringing. The tests were (are) given in the morning before you have anything to eat. The minimum has now been brought down to 110 milligrams per decilitre. If your test is now above 100 you will be classified as pre-diabetic. 40% of 40-70 year olds have a blood sugar count of 100-110, hence the large increase in the number of pre-diabetics in the USA. Experts say that the decision to bring the miminum from 110 to 100 is not arbitrary. The risk of glucose-spurred heart disease began rising at lower levels than once thought. The screening consists of two tests, one before food (early morning ‘fasting’) and a second test two hours after a glucose-rich drink. The second test remains the same as it used to be, levels between 140-199 are classed as pre-diabetic. The American Diabetes Association (ADA) says that anyone over the age of 45 who is overweight should do this test. If you are over 45 and of normal weight, you should discuss testing with your doctor to see if it is appropriate, they say. If a younger person is overweight and has a relative who is diabetic, or has high cholesterol, or has high blood pressure, or had diabetes during pregnancy, or gave birth to a big baby (more than nine pounds) he/she should consider having the test done. Tests are usually done at three year intervals. The more risk factors you have the smaller the intervals will be. If you have a test and find you are a pre-diabetic, you should walk 30 minutes a day for five days of each week and lose 5-7% of your body weight. Research has proved that this works in preventing full-blown diabetes from developing. |
| Even Mild Sleep Apnea Increases Cardiovascular Risk Posted: 06 Feb 2011 03:08 AM PST 4 (3 votes) Article Opinions: 1 posts People with even minimally symptomatic obstructive sleep apnea (OSA) may be at increased risk for cardiovascular disease because of impaired endothelial function and increased arterial stiffness, according to a study from the Oxford Centre for Respiratory Medicine in the UK. “It was previously known that people with OSA severe enough to affect their daytime alertness and manifest in other ways are at increased risk of cardiovascular disease, but this finding suggests that many more people some of whom may be completely unaware that they even have OSA are at risk than previously thought,” said lead author of the study, Malcolm Kohler, M.D. The study will be published in the first issue for November of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. “Only one out of approximately five subjects with [clinically defined OSA] complains of excessive daytime sleepiness in population studies,” wrote Geraldo Lorenzi-Filho, M.D., Ph.D. in an editorial in the same issue of the Journal. “[I]t is now recognized that OSA triggers a cascade of biological reactions, including increased sympathetic activity, systemic inflammation, oxidative stress, and metabolic alterations that are potentially harmful to the cardiovascular system.” To determine the exact nature of some of these effects, Dr. Kohler and colleagues performed a controlled, cross-sectional study to assess differences in endothelial function (often a harbinger for cardiovascular problems to come), arterial stiffness and blood pressure in patients with minimally symptomatic OSA. They compared 64 patients who had proven OSA to matched control subjects without OSA. Their findings suggested that minimally symptomatic OSA is a cardiovascular risk factor to a degree not previously known. “In our study, the augmentation index, a measure of central arterial stiffness that independently predicts cardiovascular events in high-risk populations, was significantly higher in patients with minimally symptomatic OSA compared to matched controls,” said Dr. Kohler. “We also found impaired endothelial function as indicated by decreased vascular reactivity of their arteries compared to control subjects without OSA.” The difference in arterial stiffness between OSA patients and control subjects, Dr. Kohler said was “comparable in size to the effect seen after four weeks’ continuous positive airway pressure (CPAP) therapy in patients with moderate to severe symptomatic OSA.” This suggests that asymptomatic or minimally symptomatic patients with OSA may enjoy a cardiovascular benefit from CPAP therapy. Dr.Kohler and colleagues from the Oxford Centre for Respiratory Medicine are currently investigating the effects of 6 month CPAP therapy on arterial stiffness and endothelial function as part of an international randomized controlled trial (Multicentre Obstructive Sleep Apnoea Interventional Cardiovascular Trial; MOSAIC) which will show the impact of CPAP therapy on cardiovascular risk in patients with minimally symptomatic OSA. American Thoracic Society (ATS) http://www.thoracic.org |
| Posted: 05 Feb 2011 04:15 AM PST UroToday.com – An interesting study by Hedican and colleagues suggests that energy ablative therapies such as cryoablation may offer more than just local tumor control, by augmenting host immune function, to improve survival. Tumors were implanted orthotopically in both immunocompetent and nude (T-suppressor cell deficient) mice. Mice were then randomized to receive nephrectomy, cryoablation of the implanted tumor, or a sham operation. Mice where then followed for survival following local tumor therapy. The authors noted a significant prolongation of survival in the immunocompetent mice treated with cryotherapy, relative to the groups treated with nephrectomy or sham control. Furthermore, this benefit was not seen in nude mice treated with cryoablation, suggesting that the survival benefit is immune mediated, possibly through tumor antigen release associated with local tumor destruction. By Christopher G. Wood, MD Abstract 404 UroToday – the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: http://www.urotoday.com Copyright © 2006 – UroToday |
| Link Between Successful Weight Loss And Vitamin D Levels Posted: 05 Feb 2011 02:52 AM PST 3.74 (38 votes) Article Opinions: 4 posts Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success, a new study found. The results, which suggest a possible role for vitamin D in weight loss, were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C. “Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around,” said the study’s lead author, Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota. In this study, the authors attempted to determine whether baseline vitamin D levels before calorie restriction affect subsequent weight loss. They measured circulating blood levels of vitamin D in 38 overweight men and women before and after the subjects followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Subjects also had their fat distribution measured with DXA (bone densitometry) scans. On average, subjects had vitamin D levels that many experts would consider to be in the insufficient range, according to Sibley. However, the authors found that baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship. For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol – the precursor form of vitamin D and a commonly used indicator of vitamin D status – subjects ended up losing almost a half pound (0.196 kg) more on their calorie-restricted diet. For each 1-ng/mL increase in the active or “hormonal” form of vitamin D (1,25-dihydroxycholecalciferol), subjects lost nearly one-quarter pound (0.107 kg) more. Additionally, higher baseline vitamin D levels (both the precursor and active forms) predicted greater loss of abdominal fat. “Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss,” Sibley said. She cautioned, however, that more research is needed. “Our findings,” she said, “need to be followed up by the right kind of controlled clinical trial to determine if there is a role for vitamin D supplementation in helping people lose weight when they attempt to cut back on what they eat.” The National Institutes of Health, the University of Minnesota, and the Pennock Family Endowment at the University of Minnesota funded this study. Source: |
| Posted: 05 Feb 2011 12:17 AM PST 1 (1 votes) William P. Follansbee, M.D., professor of medicine and radiology at the University of Pittsburgh School of Medicine and director of Nuclear Cardiology at the UPMC Cardiovascular Institute, has been selected the inaugural Master Clinician Chair in Cardiovascular Medicine at the UPMC Cardiovascular Institute. Named in his honor, the William P. Follansbee, M.D., Master Clinician Chair in Cardiovascular Medicine was established to recognize a faculty member who is both an outstanding academic clinician and educator. This chair allows the recipient to support the training of tomorrow’s physicians, teaching them to apply scientifically advanced treatments while preserving the traditions of bedside care. He also intends to author a book and develop courses and training materials about medical decision making. “Dr. Follansbee has made countless contributions to the School of Medicine, the Division of Cardiology and the Cardiovascular Institute since joining the University of Pittsburgh in 1980,” said Barry London, M.D., Ph.D., director of the UPMC Cardiovascular Institute and chief of the Division of Cardiology at the University of Pittsburgh School of Medicine. “He is a master clinician and educator who has influenced an entire generation of students, residents and fellows.” Dr. Follansbee has received many honors throughout his distinguished career, including being named to every Pittsburgh Magazine “Top Doctors” list since 1992. He is a recipient of the American Heart Association’s Teacher of the Year Award and the Peter J. Safar Pulse of Pittsburgh Award. He received his undergraduate degree from Princeton University, and his medical degree from the University of Pennsylvania School of Medicine. He is a fellow of the American College of Cardiology, the American College of Physicians, the American Heart Association and the American Society of Nuclear Cardiology. Source |
| WFP To Increase Food Handouts In Malawi After Receiving Maize Donation From Government Posted: 04 Feb 2011 11:02 PM PST The World Food Programme on Monday announced that it will almost double food handouts to people living with HIV/AIDS in Malawi after receiving maize donations from the government, Reuters Health reports. Before the donation, WFP was providing monthly food assistance to more than 110,000 people living with HIV/AIDS and about 1,500 malnourished women and children in the country. The agency in a statement said with the donation, it will be able to provide food to up to 203,000 Malawians in November and December. Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. |
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