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"Weight loss is typically accomplished through changes in diet and exercise. But a new study sheds light on some other factors that can help an individual achieve success. Getting a healthy amount of sleep avoiding stress and complying with specific elements of a weightloss plan such as keeping a food diary seem to boost the odds of success according to a new study. The study conducted by Kaiser Permanente Center for Health Research in Portland Ore. involved nearly adults who had an average body mass index of . or greater is considered obese. The participants whose average age was were instructed to attend group counseling sessions over weeks reduce dietary intake by calories a day by following a lowfat lowsugar diet and increase exercise to at least minutes a week. After six months of the participants had lost at least pounds and were enrolled in a maintenance phase of the study. Researchers found that the people who lost at least pounds had some common characteristics. They were more likely to attend their counseling sessions keep food diaries and exercise. But coming into the study the successful dieters were more likely to report that they slept between six and eight hours each night. People who had lower stress scores coming into the study were also able to lose more weight. People who need to lose weight should consider changes in their sleep patterns and exposure to stress the study authors said. ... if stress becomes chronic and eating is learned to be an effective coping behavior highly palatable food may appear to be addictive they wrote. The study did not find that screen time was linked to weight loss. But TV watching may have a different effect on weight loss than time spent on computers at work the researchers said. The study is published in the International Journal of Obesity http Related Obese and overweight women and children may underestimate how heavy they are. http Return to Booster Shots blog http"

"Lightly shocking a persons brain just before they learned a new task appeared to strengthen memory in a handful of patients with epilepsy a tantalizing result that could have implications for Alzheimers disease U.S. researchers said on Wednesday. Pacemaker devices known as deep brain stimulators made by Medtronic and St. Jude Medical are already used to calm muscle tremors in patients with Parkinsons disease and other movement disorders and are being tested for a host of other conditions such as treatmentresistant depression. The devices are implanted under the skin in the chest with wires leading up the neck connected to tiny electrodes implanted deep in the brain which produce electrical impulses. The current study was done at the University of California at Los Angeles in seven epileptic patients awaiting surgery who had electrodes implanted deep in their brains to help pinpoint the source of their seizures. The team used this opportunity to see how stimulating the brain affects memory. They focused on an area of the brain called the entorhinal cortex which helps form and store memories. The entorhinal cortex is the golden gate to the brains memory mainframe Dr. Itzhak Fried professor of neurosurgery at the David Geffen School of Medicine at UCLA who worked on the study said in a telephone interview. The research was published in the New England Journal of Medicine. Fried said sensory experiences that eventually become memories pass through this hub before they are stored in the hippocampus the brains chief memory center. For the study patients played a video game in which they had to shuttle people around in taxis to different shops in a virtual city. The team tested whether stimulating the entorhinal cortex or the hippocampus while they were learning their way around the city improved their recall. When we stimulated the hippocampus itself there was not an effect. It was really stimulation in the gateway to the hippocampus the entorhinal cortex where we got the beneficial effect in terms of memory Fried said. Compared to testing before stimulation zapping this part of the brain helped people recognize landmarks and navigate the virtual city more quickly. Fried said the findings suggest stimulating the brain just as memories are forming is key. IMPACT ON ALZHEIMERS In Alzheimers disease this area of the brain is affected early on when signs of dementia begin to appear. Fried said the study might have implications for treatments for patients with early Alzheimers disease but he cautioned that the results are very preliminary. The question would be whether this can help memory in patients with memory impairments he said. Scientists are increasingly focused on ways to treat the memoryrobbing disease which affects more than million Americans. Despite costly efforts no drug has been found that can keep Alzheimers from progressing and policymakers are growing increasingly worried about the swelling ranks of dementia patients as the population ages. Suzanne Haber a neuroscientist at the University of Rochester Medical Center in New York who was not involved in the study said she was very excited about the finding but she cautioned that the treatment is very invasive very expensive and unproven in Alzheimers patients. The Obama administration said on Wednesday it plans to spend an additional million over the next two years to help find an effective treatment for Alzheimers. One team has already tried deep brain stimulation in Alzheimers patients. In a study published in the Annals of Neurology in researchers tested deep brain stimulation in six patients over the course of a year and found the treatment to be relatively safe. They also saw signs the treatment might have an effect on memory. Dr. Sandra Black a brain researcher at the University of Toronto who wrote an editorial on the current study said the findings could have implications for early stage Alzheimers disease if tests were developed to identify this process early through imaging or genomics. Although the current evidence is preliminary is based on small samples and requires replication the potential application of deepbrain stimulation in amnestic disorders is enticing Black wrote."

"More than years after the gene behind cystic fibrosis http_Genomeposterschromosomecftr.shtml was identified a pill that could fix the problem in some people is getting closer to reality. The experimental medicine taken twice a day goes by the code name VX. Now there are some promising results from a study httpclinicaltrials.govctshowNCTtermvxrank in people with a specific genetic mutation that affects about four percent of cystic fibrosis patients. Lung function got percentage points better on average in people who got the drug compared with those taking a placebo. The improvement at six months was still present almost a year after the studys start. That much improvement is a big deal for CF patients Robert Beall http president of the Cystic Fibrosis Foundation told Shots. It is larger than any other clinical intervention weve ever had in cystic fibrosis. Beall said there were no significant side effects. The foundation has championed the development of drugs including VX and has provided million to Vertex http to get the medicine this far. If the drug makes it to market the foundation will receive royalties from sales. This pill for people with the GD mutation http of the cystic fibrosis gene helps a defective protein in cell membranes httpghr.nlm.nih.govgeneCFTR do a better job moving things around. Lisa Jarvis has more details httpcenblog.orgthehaystackvertexunveilsexcitingdataforcysticfibrosisdrug on that at the Haystack blog. But a key takeaway is that the medicine gets at a root cause of cystic fibrosis in some people rather than just relieving their symptoms. Article continues after this message from our sponsor Now to be perfectly clear all we know about the latest data is from press releases. And the drug hasnt been submitted for review by the Food and Drug Administration though Vertex expects to do that later this year. But these results even with plenty of caveats suggest the drug is on the right track. Vertexs shares jumped percent Wednesday as investors figured VX looks even better than theyd expected. Wow wrote Dr. Mark Schoenebaum http a biotech and drug analyst ISI Group in a note to investors. The effectiveness of VX looks best case he wrote. Ultimately the drug might be used by around patients worldwide if approved and Schoenebaum expects it would be command a very high price perhaps a year."

"Vanda Pharmaceuticals Inc said its experimental drug for a rare sleep disorder proved effective in a second latestage trial and the company now plans to apply for a U.S. approval for the drug in mid. The study named Reset was a patient trial designed to test the maintenance effect of a mg dose of the drug tasimelteon. Vanda on December said the drug performed better than a placebo in the first of the four planned latestage trials on the drug. The companys shares rose as much as percent on that day. While the first two are efficacy studies the remaining two are intended to establish the safety profile of the drug. The second trial showed that patients treated by the drug maintained their clinical benefits while placebotreated patients showed significant deterioration in measures of nighttime sleep daytime naps and timing of sleep. The drug is being tested for nonhour disorder that has no approved treatment. The condition in which a persons body clock does not automatically set to the hour day affects a majority of blind people. These results also highlight the importance of chronic therapy in treating Non CEO Mihael Polymeropoulos said in a statement on Wednesday. Tasimelteon received orphan drug status which offers several years of marketing exclusivity for drugs developed for rare conditions from the FDA in and from the European Commission in . An orphan drug if approved can usually fetch a premium pricing in the market. Shares of Vanda which has a market of about million closed at . on Tuesday on the Nasdaq. They have gained nearly percent since December . Reporting by Esha Dey in Bangalore Editing by Maju Samuel Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The benefits for the heart of eating strawberries and blueberries can build up over a lifetime according to the latest research. Brightcolored berries have long been a part of any healthy diet owing mainly to the anthocyanins httphealthland.time.comcanblueberryjuiceboostyourmemory that give them their vibrant color and act as antioxidants to fight off damage to cells. Now a study published in the journal Circulation confirms and quantifies that benefit women who ate three or more servings of blueberries and strawberries per week reduced their risk of heart attack by up to one third. In the study researchers from the Harvard School of Public Health and the University of East Anglia in the U.K. analyzed data from women ages to enrolled in the Nurses Health Study II. For years the women filled out surveys detailing their diets at fouryear intervals. MORE Study Flavonoids May Help Protect Against Parkinsons httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons During the study the women experienced heart attacks httptopics.time.comheartattacks. But women who consumed the most blueberries and strawberries had a reduced risk of heart attack compared with the women who ate berries once a month or less. The women who ate more berries also tended to eat healthier overall consuming more vegetables and fruits than those who didnt eat as many berries but when the scientists broke down the womens diets they found that the highest consumers httptopics.time.comconsumers of berries even had a lower risk of heart attack compared with women who still ate plenty of fruits and vegetables but fewer berries. The effect remained even after the researchers adjusted for other things that can influence heartdisease risk such as obesity high blood pressure smoking httptopics.time.comsmoking low levels of physical activity and a family history of heart disease. These foods can be readily incorporated into diets and simple dietary changes could have an impact in reducing risk of heart disease in younger women says study author Aedin Cassidy from the University of East Anglia. This supports growing lab data showing that these compounds can help keep arteries healthy and flexible. So what is it about berries that help the heart The researchers focused on blueberries httphealthland.time.comcanblueberrieshelpfightfat and strawberries httphealthland.time.comcaneatingstrawberriespreventcancer because these are the most widely consumed varieties in the U.S. Both berries contain high levels of anthocyanins as well as other flavonoids which fight the effects of stress and freeradical damage to cells as they age. They can also keep heart vessels more elastic and flexible which helps combat the growth of plaques that can build up and rupture causing heart attacks. MORE Can Eating Fruits and Veggies Outwit Bad Heart Genes httphealthland.time.comeatingfruitsandveggiesmayoutwitbadheartgenes The results are particularly encouraging because they showed that a change in diet could affect heartdisease risk for relatively young women. That means that regular consumption of berries might be a relatively easy way to lower a womans risk of having a heart attack later in life possibly even insulating her from heart problems. Although we know about the effects of antioxidants httphealthland.time.comstudyveggiesstillreallygoodforyou and flavonoids httphealthland.time.comstudyflavonoidsmayhelpprotectagainstparkinsons and their effects in wine httphealthland.time.comcheersladiesadrinkadaymaymeangoodhealthinolderage and chocolate httphealthland.time.comsweetalittlechocolateadaymayhelplowerbloodpressure it is interesting to look at their effects in such a large group of women over a long period of time says Dr. Suzanne Steinbaum director of women and heart disease at Lenox Hill Hospital in New York City who was not involved in the study. The takehome lesson is that even if you are eating these early in life youre getting benefits that last for life. When were making choices in our s we may think that a burger and fries is great but the message is that there are alternatives that make a difference for the rest of your life. It is a powerful message that we can prevent cardiovascular disease by what we eat. Something worth remembering the next time youre in the produce aisle."

"The promise of genetic medicine is beginning to be fulfilled but its been a long hard slog. Take the story of Kalydeco http Its designed to treat people with a lung disease called cystic fibrosis. While not quite a cure the drug is extremely effective for some CF patients. But the success of Kalydeco has been more than two decades in the making. A good starting point for the story is Aug. . Thats the day scientists from the U.S. and Canada announced the discovery of the gene associated with the disease. It was the early days of gene hunting and the CF gene was a big prize. CF is the most common genetic disease in Caucasians. When people inherit a damaged form of the CF gene a critical protein inside cells doesnt work properly. As a result sticky mucus builds up in a patients lungs causing infections and making it hard to breathe. The announcement was supposed to be made in conjunction with three papers http in the Sept. issue of Science but a reporter for Reuters got hold of the story early. Science took the unusual step of allowing the scientists to speak to the media before publication. Article continues after this message from our sponsor At the time scientists predicted that a genetic test for CF was just around the corner. But they also thought a drug to treat the disease was in reach. The first prediction turned out to be right. But it wasnt until years later that we were able to find drugs that directly target the underlying cause of cystic fibrosis says Fred Van Goor who led the team at what is now Vertex Pharmaceuticals http that developed Kalydeco. So it was a long time between the discovery of the gene and the discovery of Kalyedco. It took awhile to find a drug that would help restore the function of the protein the CF gene makes. We tested over chemicals in cells with the defective protein that causes cystic fibrosis says Van Goor. One of those chemicals ultimately became a successful drug but it had to be modified so patients could take it by mouth and so it would last the right length of time in a patients body. From the start Van Goor and his colleagues knew there was a problem with Kalydeco It only works on a small subset of people with CF. They have to have a particular mutation in the CF gene or the drug is of little use. But for people who do have that mutation the drug works remarkably well. Emily Schaller was in one of the early studies of Kalydeco. As part of the study researchers first gave her a placebo then switched her to the active drug. She knew within days that something was different. I was with my brother in Florida and we were walking down the street and I took a deep breath and when I took a deep breath in and I let it out I didnt cough says Schaller. But not only did I not cough but I felt that my lungs were clear and that something huge had happened. It was just something I had never felt in my life before. Schaller isnt cured. She still has a damaged CF gene. The only way to fix that would be gene therapy http where a healthy form of the gene would supplant the damaged one. Although it seems simple in theory in practice gene therapy has been incredibly difficult to accomplish. Schaller isnt particularly bothered by that. Everyone talks about curing a disease cure CF cure these other diseases. But Kalydeco controls CF at the basic defect so Im OK with the other c word control because Im living it and Ive never felt better in my life. The time from gene discovery to successful drug may be shortening but there are only a handful of successful drugs so far and for a while at least the appearance of new ones will be slow. Theyre also likely to be expensive. Kalydeco costs in the neighborhood of per year."

"Researchers at Johns Hopkins Medicine have identified in live human brains new radioactive tracer molecules that bind to and light up tau tangles a protein associated with a number of neurodegenerative diseases including Alzheimers disease and other related dementias. Two studies will be published backtoback in the December issue of Journal of Nuclear Medicineone as featured article of the monthdescribing testing of three candidate molecules in patients with Alzheimers disease as well as the use of one molecule to measure the accumulation of tau proteins. One of the greatest public health challenges is Alzheimers disease for which there currently is no cure and no definitive diagnostic until autopsy says Dean Wong M.D. Ph.D. https professor of radiology and radiological sciences psychiatry and behavioral sciences neurology and neuroscience and director of the Section of High Resolution Brain PET Imaging Division of Nuclear Medicine at the Johns Hopkins University School of Medicine. We have been working hard to identify new radiopharmaceuticals that can help speed the discoveries of diagnostics and treatments for these devastating neurodegenerative disorders. Alzheimers disease is characterized in the brain by the appearance of two abnormal protein structures amyloid plaques and tangled fibers made up of a protein called tau. One of the biggest challenges in studying Alzheimers disease thus far according to Wong is the inability to watch these socalled neurofibrillary tangles develop in real time. As part of a longer term project funded by F. HoffmanLa Roche the team previously tested a collection of approximately potential tracer molecules and identified six promising tracers eventually narrowing them down to three to be made and tested as candidate Tau PET radiopharmaceuticals. These three most promising tracers were previously tested in nonhuman primates and the results looked promising enough to test in people. The researchers recruited a total of patients with Alzheimers disease seven younger healthy controls ages years old and five older healthy controls age or older for brainonly PET scans. An additional six older healthy controls were recruited for fullbody scanning. The study was divided into three parts. In the first part each person was injected with two of the three randomly designated tracers on separate visits prior to receiving a brain PET scan with subsequent evaluation to determine which molecule performed best. In the second part of the study researchers tested the optimal tracer called F RO with additional brain imaging in five patients with Alzheimers and five older controls with followup of previously seen patients to evaluate the potential progression of tau protein tangling after an average span of approximately months. The third part of the study examined six older controls undergoing wholebody scanning. In total the researchers looked at different regions in the brain to evaluate how well the tracers were taken up by the brain how well they penetrated through the tissue and how specifically they bound to the tau protein rather than just sticking indiscriminately to anything. Regions of the brain that typically contain accumulated tau protein include the temporal lobe parietal lobe and occipital lobe among others grey matter in the cerebellum is thought to contain low or no tau in patients with Alzheimers. They found that healthy brains retained little to no tracer whereas the brains of those with Alzheimers showed tau to be in regions of the brain consistent with previously reported postmortem data on filamentous tangles. In the second paper the team examined the detailed quantification of tau binding via F RO in patients with Alzheimers disease five young cognitively normal controls and five older cognitively normal controls. They verified that detailed quantification of the tested and retested tracer in those five patients with Alzheimers and five older controls generated good and reproducible results. According to Wong this body of work reveals that as compared with the currently used Tau tracer F AV the new tracer F RO does not bind randomly to other tissue offering greater clarity into quantification of potential tau burden within the human brain. It really takes a village to make progress in biomedical research and this project was no exception with the involvement of the PET team at Hopkins a CRO who helped recruit healthy subjects colleagues in psychiatry and behavioral sciences colleagues at the National Institute of Aging and neuroscience imaging experts at Roche says Wong. This is a true example of crossdisciplinary collaboration and Im honored to have such great collaborators. This study was made available online in May ahead of peerreview and publication. It was published in the December issue of the journal. Authors of the first Journal of Nuclear Medicine featured paper Characterization of Novel Tau Radiopharmaceuticals CRO CRO and FRO in Healthy Controls and in Alzheimer Subjects httpjnm.snmjournals.orgcontent include Dean F. Wong Hiroto Kuwabara Paul B. Rosenberg Esther Oh Constantine G. Lyketsos Noble George Lorena Gapasin Kelly Kitzmiller Josh Roberts Ayon Nandi James Brasic Chakradhar Mishra Abhay Moghekar Anil Mathur Marilyn Albert and Robert F. Dannals of The Johns Hopkins University Baltimore Maryland Robert A. Comley Susanne Ostrowitzki Cristina Vozzi Frank Boess Michael Honer Luca Gobbi Gregory Klein Jeff Sevigny and Edilio Borroni Pharma Research and Early Development HoffmannLa Roche Basel Switzerland and Susan M. Resnick and Madhav Thambisetty Lab of Behavior and Neuroscience NIHs National Institute on Aging Intramural Research Program Baltimore Maryland. This study was funded by an F. HoffmannLa Roche Ltd. contract to The Johns Hopkins University. Susan Resnick and Madhav Thambisetty are employees of the NIH National Institute on Aging. The authors report no other relevant potential conflict of interest."

"The U.S. Food and Drug Administration took a fresh step on Thursday towards setting a maximum nicotine level for tobacco products in a bid to lower tobaccorelated deaths across the country saying it would collect public comment and scientific research over the next three months. The move was part of a comprehensive plan the agency announced last summer to regulate tobacco and nicotine FDA Commissioner Scott Gottlieb said on a call with reporters. That plan marked a major shift designed to give adult smokers a wider range of alternatives including potentially less harmful ecigarettes. The agency is seeking to determine a level of nicotine in cigarettes and other tobacco products that would be minimally addictive or nonaddictive according to a draft proposal. It hopes setting such a standard would also help prevent teenagers who experiment with tobacco from becoming addicted. The FDA estimates that setting such a standard would help million smokers quit within a year and prevent more than million teens and young adults from becoming regular smokers by the year . There is no other single action our country can take that would prevent more young people from smoking or save more lives said Matthew L. Myers president of Campaign for TobaccoFree Kids. Major tobacco players such as Altria Group and British American Tobacco are grappling with sales declines in the U.S. market and hoping to recoup revenue through novel tobacco and nicotine products such as ecigarettes. Altria Group has partnered with Philip Morris International to sell a novel device called iQOS which heats but does not burn tobacco. The FDA is currently reviewing the iQOS application. The FDA is seeking additional research and data for public review Gottlieb said as it tries to develop a nicotine product standard. Gottlieb said the FDA was also seeking public opinion on whether a product standard should be implemented all at once or gradually. The comment period will be open through midJune said Mitch Zeller director of FDAs Center for Tobacco Products. The FDA will continue to take enforcement actions against companies that inappropriately target children including through the promotion of ecigarettes Gottlieb said. James Figlar executive vice president of research and development for R.J. Reynolds Tobacco Company part of British American Tobacco said the company would work with the agency to create a path for alternative less harmful tobacco products to reach the market. The FDA will seek public input and scientific research on the role that flavors such as menthol play in tobacco addiction and for the regulation of premium cigars Gottlieb said. Well also advance key parts of our tobacco plan very soon he said. Reporting by Yasmeen Abutaleb in Washington and Sharnya G in Bengaluru Editing by Savio DSouza and Bernadette Baum Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"The Maryland Proton Treatment Center MPTC is now offering deeptissue external thermal therapy in combination with highprecision protonbeam radiotherapy as a potential way to boost survival chances for certain cancer patients. MPTC is the only center in the world to offer these two treatments at the same facility an advantage to patients because these therapies are typically given within an hour of each other. Research has shown that thermal therapy can be especially useful in difficulttoreach cancers in the abdomen and pelvic region. Studies have found that adding thermal therapy to standard treatments can significantly shrink tumors and can improve survival for some patients. External thermal therapy or hyperthermia in the range of up to F. sensitizes tumor cells to chemotherapy and radiation therapy. In addition heat has been shown to enhance antitumor immune response. We are very pleased to be able to offer deeptissue thermal therapy which can be combined with standard radiation therapy as well as protonbeam therapy to enhance the cancerkilling effects of the radiation says Zeljko Vujaskovic MD PhD a professor of radiation oncology and director of the Division of Translational Radiation Sciences DTRS in the Department of Radiation Oncology at the University of Maryland School of Medicine UMSOM. Early research suggests that adding thermal therapy to protonbeam therapy may be associated with an even greater benefit than when combined with standard radiation therapy and we are excited to be at the forefront of making this combination therapy available to cancer patients says Dr. Vujaskovic an internationally recognized expert in hyperthermic oncology. Proton therapy is a precise form of radiation therapy that deposits all of its energy within the tumor and allows for less irradiation of noncancerous tissue. MPTC which is affiliated with the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center UMGCCC at the University of Maryland Medical Center is the only proton treatment center in Maryland. Radiation oncologists at UMGCCC already use external thermal therapy to treat a range of cancers but do not currently use it for cancers that are deeper in the body. According to Dr. Vujaskovic the new deeptissue thermal therapy equipment which is made by Pyrexar will be used to treat cancers of the abdominal and pelvic region including cancer of the bladder rectum cervix ovaries pancreas and connective tissue which are known as sarcomas. Patients would typically receive the thermal therapy two times a week for an hour before or after they receive standard photon radiation or protonbeam therapy. The system heats the tumor tissue to F. with internal and external probes that enable doctors to continuously monitor the temperature. A waterfilled applicator is placed over the area to be treated and noninvasive radio frequency energy is directed at the tumor. The heat causes the blood vessels in the tumor to dilate bringing more oxygen into the tumor which makes cancer cells more vulnerable to radiation therapy. The acquisition of the deeptissue thermal therapy system was made possible by donations from Jack and Emily Howell and the Middendorf Foundation Inc. Within the Department of Radiation Oncology and throughout our cancer center we strive to make every available tool in the cancerfighting toolbox available to our patients says William F. Regine MD FACR FACRO the Isadore Fannie Schneider Foxman Endowed Chair and Professor of radiation oncology at UMSOM and chair of radiation oncology at UMGCCC. By continuing to develop a comprehensive thermal oncology program we are giving patients more effective treatment options and therefore another reason to hope for better outcomes. The Maryland Proton Treatment Center has achieved another milestone by becoming the first center to offer both deepthermal therapy and proton therapy says E. Albert Reece MD PhD MBA Executive Vice President for Medical Affairs at UM Baltimore and the John Z. and Akiko K. Bowers Distinguished Professor and dean at UMSOM. This achievement is a testament to Dr. Vujaskovics considerable expertise in hyperthermic oncology and leadership in developing an outstanding thermal oncology program at the University of Maryland. Its this type of innovation that sets MPTC apart from other proton treatment centers. About the University of Maryland School of Medicine Commemorating its th Anniversary the University of Maryland School of Medicine was chartered in as the first public medical school in the United States. It continues today as one of the fastest growing toptier biomedical research enterprises in the world with academic departments centers institutes and programs and a faculty of more than physicians scientists and allied health professionals including members of the National Academy of Sciences and a distinguished recipient of the Albert E. Lasker Award in Medical Research. With an operating budget of more than billion the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide researchintensive academic and clinicallybased care for more than . million patients each year. The School has over students residents and fellows and nearly million in extramural funding with more than half of its academic departments ranked in the top among all public medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland Baltimore campus the School of Medicine has a total workforce of nearly individuals. The combined School and Medical System University of Maryland Medicine has a total budget of billion and an economic impact of nearly billion on the state and local community. The School of Medicine faculty which ranks as the thhighest public medical school in research productivity is an innovator in translational medicine with active patents and startup companies. The School works locally nationally and globally with research and treatment facilities in countries around the world. Visit medschool.umaryland.edu httpmedschool.umaryland.edu About the Maryland Proton Treatment Center The Maryland Proton Treatment Center MPTC offers proton therapy a highly advanced and precise form of radiation therapy that can increase radiation dose to tumor while decreasing dose to healthy surrounding tissue to the BaltimoreWashington region and beyond. It is a highly effective treatment for a wide range of localized tumors such as those found in the brain base of the skull head and neck area eye tumors tumors of the esophagus lung prostate liver breast spinal cord as well as gastrointestinal malignancies. It is also an important treatment option for children with cancer. At MPTC each treatment room is equipped with the most advanced form of pencil beam proton therapy which essentially paints the radiation onto the tumor while stopping precisely at the site of the tumor. Proton therapy is performed on an outpatient basis and is a welltolerated noninvasive treatment that can reduce side effects. It can be used in conjunction with other modalities of cancer treatments such as chemotherapy and surgery. MPTC offers a robust clinical trial program to all its patients to further evidencebased medicine. MPTC has been patientcentered from the beginning with a focus on accessibility and affordability. The center was designed to be a regional resource providing the same training privileges and clinical guidelines to physician groups across the region that work sidebyside with MPTC faculty and staff thus improving efficiency and affordability. MPTC offers free concierge services to ensure a seamless patient experience and a successful reconnection back to their referring physician. One of the goals of MPTC is to remain costneutral to insurance providers meaning patients pay the same for proton treatment as they would for other more conventionally available intensitymodulated treatments at the University of Maryland Medical Center. http"

"Drinking beet juice increases blood https flow to the brain https in older people a finding that suggests the dark red vegetable may fight the progression of dementia https a new study shows. Beet roots contain high concentrations of nitrates which are converted into nitrites by bacteria in the mouth https And nitrites help open blood https vessels in the body increasing blood flow and oxygen to places lacking in oxygen. Previous studies have shown that nitrites also found in high concentrations in celery cabbage and other leafy green vegetables like spinach widen blood vessels but researchers say this was the first to find that nitrites also increase blood flow to the brain https Blood Flow to the Brain There have been several very highprofile studies showing that drinking beet juice can lower blood pressure https but we wanted to show that drinking beet juice also increases perfusion or blood flow to the brain https Daniel KimShapiro PhD director of the Translational Science Center at Wake Forest University says in a news release. There are areas in the brain https that become poorly perfused as you age and thats believed to be associated with dementia and poor cognition. Researchers from the Translational Science Center looked at how dietary nitrates affected adults aged and older over a fourday period. On day one subjects reported to a laboratory after a hour fast completed a health status report and had either a high or lownitrate breakfast https The highnitrate breakfast https included ounces of beet juice. Then they were sent home with lunch dinner and snacks that conformed to their assigned diets. On the second day after another hour fast the participants returned to the lab and ate their assigned breakfasts. An hour later an MRI https scan recorded brain flow in each persons brain. And blood tests before and after breakfast confirmed nitrite levels in the body. On the third and fourth days researchers switched diets and repeated the process for each person. MRI scans showed that after eating a highnitrate diet the older adults had increased blood flow to the white matter of the frontal lobes which are the areas of the brain most commonly associated with the degeneration that leads to dementia and other cognitive conditions. Diets Rich in Fruits and Vegetables I think these results are consistent and encouraging that good diet consisting of a lot of fruits and vegetables https can contribute to overall good health says senior investigator Gary Miller PhD an associate professor in Wake Forests Department of Health and Exercise https Science. Because beet juice doesnt exactly taste like a sugary soda Wake Forest has worked with a company to create a new beet juice beverage that is tastier than plain beet juice and a news release says the university is investigating ways to market this beverage. The researchers say that their study and future ones like it may lead to interventions that could improve cognitive and physical functional health in older adults. The findings are published online in Nitric Oxide Biology and Chemistry the peerreviewed journal of the Nitric Oxide Society."

"Exercise can reverse damage to sedentary aging hearts and help prevent risk of future heart failure if its enough exercise and if its begun in time according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit the exercise regimen should begin by late middle age before age when the heart apparently retains some plasticity and ability to remodel itself according to the findings by researchers at the Institute for Exercise and Environmental Medicine IEEM which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas. And the exercise needs to be performed four to five times a week. Two to three times a week was not enough the researchers found in an earlier study. Based on a series of studies performed by our team over the past years this dose of exercise has become my prescription for life said senior author Dr. Benjamin Levine Director of the Institute and Professor of Internal Medicine at UT Southwestern. I think people should be able to do this as part of their personal hygiene just like brushing your teeth and taking a shower. The regimen included exercising four to five times a week generally in minute sessions plus warmup and cooldown One of the weekly sessions included a highintensity minute workout such as aerobic interval sessions in which heart rate tops percent of peak rate for minutes with minutes of recovery repeated four times a socalled x . Each interval session was followed by a recovery session performed at relatively low intensity. One days session lasted an hour and was of moderate intensity. As a prescription for life Levine said this longer session could be a fun activity such as tennis aerobic dancing walking or biking. One or two other sessions were performed each week at a moderate intensity meaning the participant would break a sweat be a little short of breath but still be able to carry on a conversation the talk test. In the study exercise sessions were individually prescribed based on exercise tests and heart rate monitoring. One or two weekly strength training sessions using weights or exercise machines were included on a separate day or after an endurance session. Study participants built up to those levels beginning with three minute moderate exercise sessions for the first months and peaked at months when two highintensity aerobic intervals were added. The more than participants in the study were divided into two groups one of which received two years of supervised exercise training and the other group a control group which participated in yoga and balance training. At the end of the twoyear study those who had exercised showed an percent improvement in their maximum oxygen intake during exercise and a more than percent improvement in compliance or elasticity of the left ventricular muscle of the heart Dr. Levine noted. He compared the change in the heart to a stretchy new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the hearts left ventricle the chamber that pumps oxygenrich blood back out to the body he explained. When the muscle stiffens you get high pressure and the heart chamber doesnt fill as well with blood. In its most severe form blood can back up into the lungs. Thats when heart failure develops said Dr. Levine who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. He also holds the Distinguished Professorship in Exercise Sciences at UT Southwestern which is celebrating its th anniversary this year. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who dont exercise and arent fit leaving them with small stiff chambers that cant pump blood as well. However the researchers also found that the heart chamber in competitive masterslevel athletes remains large and elastic and that even four to five days of committed exercise over decades is enough for noncompetitive athletes to reap most of this benefit. In the current study researchers wanted to know if exercise can restore the hearts elasticity in previously sedentary individuals especially if begun in late middle age. Previous studies from Dr. Levines research program have shown substantial improvements in cardiac compliance in young individuals after a year of training but surprisingly little change if the training was started after age . To start the study researchers recruited participants ages to . Many came from the Dallas Heart Study which includes Dallas residents and is the only singlecenter heart study of its size and multiethnic composition. The Dallas Heart Study is designed to improve the diagnosis prevention and treatment of heart disease. The new study appears in Circulation a journal of the American Heart Association. Collaborators on the study included first author Dr. Erin Howden Research Fellow with UT Southwesterns Graduate School of Biomedical Sciences and the IEEM and now a faculty member at the Baker Heart and Diabetes Institute in Melbourne Australia. Funding came from the National Institutes of Health and the American Heart Association. About UT Southwestern Medical Center UT Southwestern one of the premier academic medical centers in the nation integrates pioneering biomedical research with exceptional clinical care and education. The institutions faculty has received six Nobel Prizes and includes members of the National Academy of Sciences members of the National Academy of Medicine and Howard Hughes Medical Institute Investigators. The faculty of more than is responsible for groundbreaking medical advances and is committed to translating sciencedriven research quickly to new clinical treatments. UT Southwestern physicians provide care in about specialties to more than hospitalized patients emergency room cases and oversee approximately . million outpatient visits a year."

"Acupuncture https may allow people with the lung disease COPD https chronic obstructive pulmonary disease https to breathe a bit easier. COPD https is the umbrella term for chronic lung diseases https including chronic bronchitis https and emphysema https It is often marked by a chronic cough https and shortness of breath. Treatment typically involves the use of inhaled steroids https and bronchodilators https_inhalers_bronchodilators to open airways and make breathing easier. In a new study of people with COPD https some got acupuncture https along with their daily medication https for three months. Others got a sham acupuncture treatment in which the needles did not enter their skin https Those who received acupuncture along with their daily medication for three months were able to walk longer without becoming breathless compared to those who got the sham acupuncture treatment. The study appears online in the Archives of Internal Medicine. People who received real acupuncture also showed improvements in their quality of life and ability to exercise https according to researchers from Kyoto University and Meiji University of Integrative Medicine https in Kyoto Japan. Many people with COPD have problems getting optimal nutrition https because of their condition. The study showed that acupuncture may improve stomach https function making it easier for people with COPD to eat a healthy diet and maintain a normal weight https_assetscontrolled_contenthealthwisespecialweight_managementare_you_at_a_healthy_weight_special_aa.xml. Acupuncture and COPD Symptoms Exactly how acupuncture improves symptoms of COPD is not fully understood. Researchers speculate that needling the acupuncture points on the rib cage area may help relax muscles involved in breathing. This makes perfect sense to TongJoo Gan https_assetscontrolled_contenthealthwisenordgiant_axonal_neuropathy_nord_nord.xml MD. He is a professor of anesthesiology at Duke University Medical Center in Durham N.C. It also may help reduce anxiety https levels he says. When you become breathless your anxiety https goes up so relaxation is another possible explanation for the benefit. Acupuncture has been shown to release chemicals that relax the lungs https and dilate the airways he says. Clearly it looks like a viable alternative to treat chronic COPD Gan says. The downside is so little and the upside is so huge that acupuncture is well worth a try for those who find it difficult to control their COPD despite medications. If you do try it you must choose a licensed and experienced acupuncturist Gan says. If you have COPD or another lung disease acupuncture is worth a shot literally says Len Horovitz MD. He is a pulmonary specialist at Lenox Hill Hospital in New York. Horovitz regularly uses acupuncture to help smokers kick the habit. It also helps people with asthma https and can allow them to use fewer steroids he says. Kim Tsao a licensed acupuncturist in New York and her brother Jianhua Tsoi in Greenwich and Wilton Conn. often use acupuncture to help people with COPD. Most people think it is only for pain but acupuncture can help with lung and other diseases Tsao tells WebMD. But she and her brother are quick to caution that acupuncture should be used with medication and other COPD treatments not in place of it. Most of these patients do see Western doctors already Tsoi says. If they come to us first we tell them to go to Western doctors and get proper medication to stay under control."

"GSK LSENYSE GSK httpstudio.financialcontent.comprnewsPageQuoteTickerGSK today announced the publication of detailed results from a randomised phase III study ZOE of its investigational shingles vaccine Shingrix showing efficacy in adults aged years and older that is maintained for at least four years. The results were published in the New England Journal of Medicine NEJM. The study from which headline results were reported in October showed that the twodose candidate shingles vaccine had efficacy confidence interval compared to placebo in people over years old. Vaccine efficacy was maintained across the various age groups included in the study ranging between in people aged years confidence interval and in those aged years and above confidence interval . The high efficacy is in line with the results of the ZOE trial a study in people over years old which was presented and published last year showing a efficacy confidence interval . A pooled analysis of data from both trials showed the vaccine demonstrated efficacy against shingles confidence interval in adults aged years and older compared to placebo. This efficacy was maintained with an reduction in the risk of shingles confidence interval in the fourth year after vaccination. The risk of serious adverse events potential immunemediated diseases or deaths observed in ZOE was similar in people receiving Shingrix and placebo. The most commonly reported local adverse reaction was pain at the injection site and the most frequently reported systemic adverse reaction was fatigue. The majority of injection site and systemic reactions occurred within seven days of vaccination with most lasting days and generally were mildtomoderate in intensity. In addition a pooled analysis of data from the ZOE and ZOE trials showed that the candidate vaccine effectively reduced the risk of subsequent chronic neuropathic pain also known as postherpetic neuralgia PHN which is the most common and often severe complication of shingles. The candidate vaccine was shown to be confidence interval efficacious in preventing PHN in people aged years and older and efficacious confidence interval in people aged years and over. Dr Emmanuel Hanon Senior Vice President Vaccines Research and Development GSK said This is the first time that such high efficacy has been demonstrated in a vaccine candidate for older people and it is remarkable as we know that these people frequently have an agerelated weakening of their immune system. If approved this candidate vaccine could be an important tool for the prevention of shingles and the pain associated with it which would significantly impact the health and quality of life of so many people. Anthony Cunningham Executive Director of the Westmead Institute for Medical Research in Australia and Principal Investigator of the ZOE study said These data show that this investigational vaccine maintains high efficacy against herpes zoster in people over and years of age the age groups who are most affected by the disease. Importantly it also prevents a common and feared complication of herpes zoster prolonged pain or post herpetic neuralgia in these groups. Based on these and the previously reported ZOE data GSK expects to start submitting regulatory applications for the candidate vaccine for the prevention of shingles in people years and above later this year. About Shingrix Shingrix is a nonlive adjuvanted subunit HZsu candidate vaccine to help prevent herpes zoster and its complications. The candidate vaccine combines glycoprotein E a protein found on the varicella zoster virus VZV that causes shingles with an adjuvant system ASB which is intended to enhance the immunological response to the antigen. Additional trials to evaluate the ability of Shingrix to help prevent shingles are ongoing in healthy people aged and older and in adults with compromised immune systems. These studies will provide additional information with respect to the efficacy and safety profile of the candidate vaccine as well as its ability to stimulate immune responses in other populations and in specific circumstances. Notes to editors The name Shingrix is not yet approved for use by regulatory authorities in most countries including the US Food and Drug Administration FDA. About the ZOE trial The ZOE ZOster Efficacy in adults aged years and over NCT study is a randomised observerblind placebocontrolled saline solution multicentre multinational North America Europe Latin America AsiaPacific phase III trial involving more than adults aged years and older. Two doses were given intramuscularly two months apart. The study which started in August in parallel with the ZOE trial includes subjects in the age ranges and years. The primary objective of ZOE is overall vaccine efficacy against shingles in people years and over compared to placebo. The coprimary objectives of the pooled analysis over both studies are the assessment of overall vaccine efficacy in reducing the risk of developing shingles and PHN in people aged years and over using pooled data from both ZOE and ZOE studies. About the ZOE trial The ZOE ZOster Efficacy in adults aged years and over NCT study is a randomised observerblind placebocontrolled saline solution multicentre multinational North America Europe Latin America AsiaPacific phase III trial involving adults aged years and older. The study started in August . Two doses were given intramuscularly two months apart. The primary objective of this study is the overall vaccine efficacy against shingles in people aged years or older compared to placebo. The study includes subjects in the age ranges and years. About the phase III study programme Involving more than subjects globally the phase III programme for GSKs candidate shingles vaccine evaluates its efficacy safety and immunogenicity. In addition to older adults the candidate vaccine is being evaluated in immunocompromised patient populations including solid and haematological cancer patients haematopoietic stem cell and renal transplant recipients and HIVinfected people. About shingles Shingles typically presents as a painful itchy rash that develops on one side of the body as a result of reactivation of latent chickenpox virus varicella zoster virus VZV. Anyone who has been infected with VZV is at risk of developing shingles with age and altered immune system being recognised as the main risk factors. Complications from shingles can include PHN the most common complication scarring vision complications secondary infection and nerve palsies.PHN is often defined as a localized pain of significant intensity persisting at least days after the appearance of the acute shingles rash. Data from many countries indicate that older adults aged and over are at highest risk for shingles as more than of older adults have been infected with wild type VZV. A persons risk for shingles increases sharply after years of age. Risk of complications including PHN and hospitalisation also increase with age. The individual lifetime risk of developing shingles is approximately one in three for people in the USA however for individuals aged and over this risk increases to one in two people. References . Cunningham et al. N Engl J Med . Efficacy of the herpes zoster subunit vaccine in adults years of age or older. . Lal et al. N Engl J Med Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults . Shingles Herpes Zoster Clinical Overview. US Centers for Disease Control and Prevention. Accessed at http on Sept . . Cohen et al. N Engl J Med Clinical practice Herpes zoster. . The GSK proprietary AS adjuvant system contains QS Stimulon adjuvant licensed from Antigenics Inc a wholly owned subsidiary of Agenus Inc. NASDAQ AGEN httpstudio.financialcontent.comprnewsPageQuoteTickerAGEN MPL and liposomes GSK one of the worlds leading researchbased pharmaceutical and healthcare companies is committed to improving the quality of human life by enabling people to do more feel better and live longer. For further information please visit http"

"U.S. health regulators said on Tuesday they approved a stent by Abbott Laboratories that is the first designed to be absorbed into the bloodstream after it is implanted. The stent called Absorb is made of a plastic similar to dissolving sutures and offers patients an alternative to metal stents currently used to prop open arteries cleared of blockages. Unlike traditional stents that remain in place after implantation Absorb is designed to disappear fully within three years of the procedure. Absorbs appeal is that it allows the blood vessel to return to a natural state free from a permanent metal implant. The approach holds particular promise for patients whose coronary artery disease could require multiple implants over the course of several decades said Mitchell Krucoff a professor at Duke University Medical Center who has advised Abbott on Absorb. This is a game changer he said in an interview. There are no longer going to be permanent metal implants in the artery. Absorb releases the drug everolimus to combat the growth of scar tissue that can form within a stent and cause the artery to narrow again the U.S. Food and Drug Administration which approved the stent said. No metal means the treated artery can pulse and flex naturally as demands on the heart change with everyday activities said Gregg Stone of Columbia University Medical Center who led clinical trials for Absorb. No metal may also reduce the potential of future blockages that occur with permanent metallic stents. Data released in October concluded Absorb was comparable to Abbotts own Xience drugcoated metal stent in safety and effectiveness but showed a higher risk of heart attacks and blood clots. Abbott said it expects the risks to lessen as surgeons gain experience with it. Absorb also will compete with Medtronic Plcs traditional drugcoated Resolute stent and Boston Scientific Corps Synergy and Promus stents. Synergys polymer coating disappears over time after delivering a drug that helps prevent the artery from reclogging leaving a metal stent in place. Abbott plans to roll out the device to about hospitals in the next several months as it trains surgeons on the implant procedure before ramping up sales said spokesman Jonathon Hamilton. Absorb will be priced at a modest premium to Xience he said. Analysts have predicted Absorb will gain a market niche but not surpass drugdispensing metal stents such as Xience in share until longerterm data show more favorable clinical results."

"Almost two million Americans have severe heart failure and for them even mundane tasks can be extraordinarily difficult. With blood flow impeded throughout their bodies patients may become breathless simply walking across a room or up stairs. Some must sleep sitting up to avoid gasping for air. Drugs may help to control the symptoms but the disease takes a relentless course and most people with severe heart failure do not have long to live. Until now there has been little doctors can do. But on Sunday researchers reported that a tiny clip inserted into the heart sharply reduced death rates in patients with severe heart failure http In a large clinical trial doctors found that these patients also avoided additional hospitalizations and described a drastically improved quality of life with fewer symptoms. The results reported at a medical meeting in San Diego and published simultaneously in the New England Journal of Medicine were far more encouraging than heart specialists had expected. Its a huge advance said Dr. Howard Herrmann the director of interventional cardiology at the University of Pennsylvania which enrolled a few patients in the study. It shows we can treat and improve the outcomes of a disease in a way we never thought we could. If the device is approved by the Food and Drug Administration for treatment of severe heart failure as expected then insurers including Medicare most likely will cover it. Like the Science Times page on Facebook. httpon.fb.mepaTQh Sign up for the Science Times newsletter. httpnyti.msMbHaRU In heart failure the organ itself is damaged and flaccid often as a consequence of a heart attack. The muscle pumps inefficiently and in an attempt to compensate the heart enlarges and becomes misshapen. The enlarged organ tugs apart the mitral valve which controls blood flow from the left atrium into the left ventricle. The distorted valve functions poorly its flaps swinging apart. Blood that is supposed to be pumped into the body backs up into the heart and lungs. A vicious cycle ensues The heart enlarges so the mitral valve leaks. The leaky mitral valve makes the heart enlarge even more as it tries to compensate and heart failure worsens. In the new study a device called the MitraClip was used to repair the mitral valve by clipping its two flaps together in the middle. The clip is made by Abbott which funded the study outside experts reviewed the trial data. The result was to convert a valve that barely functioned into one able to regulate blood flow in and out of the heart. Until today researchers were not sure that fixing the mitral valve would do much to help these patients. A smaller study in France with similar patients failed to find a benefit for the MitraClip https But that research included many patients with less severe valve problems the procedure was not performed as adeptly and the patients medications were not as well optimized as in the new study. In the new trial patients with severe heart failure in the United States and Canada were randomly assigned to receive a MitraClip along with standard medical treatment or to continue with standard care alone. Among those who received only medical treatment were hospitalized for heart failure in the ensuing two years. Sixtyone died. In contrast just who got the device were hospitalized for heart failure during the period and died. The results have left leading researchers unexpectedly optimistic. The trial sends a very very powerful message said Dr. Gilbert Tang a heart surgeon at Mount Sinai Medical Center which enrolled a patient in the trial. This is a game changer. This is massive said Dr. Mathew Williams director of the heart valve program at NYU Langone Health which had a few patients in the study. Estimates of how many heart failure patients in the United States are like those in the trial range from . million to . million Dr. Williams said. But he adds the number who might ultimately be treated will be less than the number who could be treated. The device itself costs about not counting the cost of the hospital and doctors a surgeon an interventional cardiologist and an echocardiologist among others all in the operating room. Cardiologists said the study was impeccably executed. The doctors inserting the device first had to demonstrate their expertise doing so. An independent group of experts ascertained that patients medical care was optimal all too often heart failure patients do not receive ideal treatment. Patients with severe heart failure often are gravely ill too sick to have openheart surgery to have mitral valves replaced. Its not worth the risk said Dr. Gregg Stone of Columbia University Medical Center and NewYorkPresbyterian Hospital the studys principal investigator. Dr. Stone reported no relevant conflicts but said that Columbia University gets royalties from the sale of the MitraClip. But the new procedure is much less invasive than openheart surgery. A cardiologist threads the device to the heart through a blood vessel in the groin. Once it reaches the heart the MitraClip is guided to the valve and the device is used to clip the two flaps together. Not every cardiologist is equipped to insert the clip. These are difficult procedures that require training and dedication Dr. Herrmann said. During the procedure for example a tiny echocardiogram camera is placed into the patients esophagus behind the heart to show where the catheter with the clip is going. Doctors must watch an Xray screen and an echocardiogram as they guide the clip to the mitral valve. When the clip arrives you have to see where you are grasping to get a good result Dr. Tang said. The device is already approved by the F.D.A. for patients too frail for surgery but whose hearts are fine except for a mitral valve that does not function properly. Advertisement Cardiologists predicted the F.D.A. would quickly approve the device for patients with severe heart failure as well. It already is used in Europe for these patients but there had been no rigorous studies showing it helped. The new trial promises to alter prospects for many people with severe heart failure who had relatively few options. This will change how we treat these patients Dr. Williams said. Its possible he added that many would fare even better with the valve repair procedure if they were not so frail when they got it. Maybe we need to start intervening earlier he said."

"Theres too little evidence to say definitively whether treating early localized prostate cancer with radiation is a better option than watchful waiting new research finds. In a study funded by the Agency for Healthcare Research and Quality AHRQ researchers from Tufts University reviewed the available literature on radiation and prostate cancer including randomized controlled trials and observational studies. They concluded there was insufficient evidence to say with certainty whether radiation treatment compared to watchful waiting is more likely to save lives. We just dont have sufficient information to say much of anything said Dr. Stanley Ip an assistant professor of medicine at Tufts University Medical Center. In part thats because researchers found no randomized controlled trials considered the gold standard of research that compared radiation therapy with watching waiting Ip said. Though there were observational studies those may be biased because men who opt to hold off on treatment may be those whose tumors are lower risk to begin with he said. The study is published in the June issue of the Annals of Internal Medicine. Watchful waiting which does not involve cancer treatment means having regular exams while keeping an eye on the tumor to see if it grows or spreads. It is usually recommended when doctors feel someones advanced age will allow them to outlive the generally slowmoving cancer or when someone has other conditions that are more likely to prove lethal. Men who are diagnosed with early prostate cancer meaning its confined to the prostate gland and has not spread are confronted with a bewildering array of options for treating it surgery radiation drugs to deprive the tumor of the hormone androgen that may drive its growth or watchful waiting. In AHRQ also commissioned a review of studies on other prostate cancer treatment options but that report could not draw conclusions on the best approach either. What all of these analyses have found is there is very limited data that allows us to determine which of these approaches in the best approach said Dr. Durado Brooks director of prostate cancer for the American Cancer Society. Brooks said more comparative effectiveness research which compares different kinds of treatments is needed. In the meantime what are men diagnosed with early prostate cancer to do Men and their doctors need to consider what the tumor looks like under the microscope which can help gauge how aggressive it may be. They should also consider age and overall health status including whether or not the patient has other conditions more likely to cause death than the prostate cancer. Finally patients and their doctors should weight the potential debilitating side effects of the treatments such as incontinence and erectile dysfunction against how comfortable the man is with holding off on treatment experts say. Men need to learn as much as they can about the possible outcomes and benefits of the various treatments and the potential side effects and choose which direction they are most comfortable with Brooks said. In the current review researchers found several trials that compared different doses of radiation and different types of radiation therapy including external beam radiation therapy in which a radiation is delivered through a beam through the skin or brachytherapy in which radioactive isotopes are delivered via injection into the prostate. For those methods too there was too little research to say with confidence which method was superior in preventing deaths from prostate cancer the researchers said. Retrospective studies however found that radiation treatments were associated with increased urinary or bowel problems compared with no treatment or no initial treatment. There was also moderate strength evidence that a higher external beam radiation was more effective than a lower dose. Taken together the review does point out that based on current evidence doctors should not be telling their patients that this form of radiation is better than that form Brooks said. Some of the distinctions being made are not really supported by the evidence. Proton beam therapy in particular is expensive but according to this report there isnt enough evidence to show its any better than other option. Radiation he noted may be the best option for men whose tumors have spread outside the gland since simply removing the prostate gland surgically is not likely to be as effective he said. The American Cancer Society estimates that in approximately men were diagnosed with prostate cancer and approximately men died of the disease. More information The National Cancer Institute http has more on prostate cancer. SOURCES Stanley Ip M.D. assistant professor medicine Tufts University Medical Center Boston Durado Brooks M.D. director prostate cancer American Cancer Society Atlanta June Annals of Internal Medicine"

"Rupture of an abdominal aortic aneurysm is one of the most dramatic medical emergencies a person can face. It usually strikes without warning killing approximately percent of those who experience it before they reach a hospital. Of those who do get to a health facility alive only about percent survive. When diagnosed through screening aortic aneurysms are carefully monitored for signs of enlargement and surgical intervention often is needed to prevent rupture of the vessel. Now University of Missouri researchers have found that patients who took cholesterollowering medications before endovascular surgery experienced fewer complications and better outcomes. Although this condition usually occurs in men older than with a family history of the disease anyone can have an abdominal aortic aneurysm said Todd Vogel associate professor and chief of the Division of Vascular Surgery at the MU School of Medicine and lead author of the study. Most patients with this disease are older and tend to have other health conditions such as high cholesterol. In an effort to prevent cardiovascular disease they take statin medications. These cholesterollowering medications protect blood vessels from plaque formation and stress and in some cases can even slow the progression of aortic aneurysms. We wanted to understand the impact statin use has on surgical outcomes when repairing this type of aneurysm. Vogels research team reviewed nearly cases where patients either had open surgery or an endovascular repair a minimally invasive procedure that uses a catheter to access the aneurysm. The team then identified patients who took cholesterollowering medication before surgery. Our research showed that patients who took statins before either open or minimally invasive interventions had better outcomes compared to those who did not take statin medications Vogel said. The patients who took statins and had endovascular repairs had a percent decrease in mortality up to one year after surgery. Patients who took statins and had traditional open procedures also did better but the difference was not nearly as significant as with endovascular repair. The bottom line is that patients who used statins were more likely to survive during and after an elective endovascular procedure. Additionally the study showed that statin use also reduced postsurgical complications for patients with other health issues such as peripheral artery disease a condition that causes arterial blockages of blood vessels in the limbs. This information could be beneficial to patients who are about to have elective endovascular abdominal aortic aneurysm repair Vogel said. However further research is needed to assess the benefits of using statins before surgical repair of other types of aneurysms. The study The Impact of Preoperative Statin Therapy on Open and Endovascular Abdominal Aortic Aneurysm Repair Outcomes recently was published in Vascular the official publication of the International Society for Vascular Surgery. About the MU School of Medicine The MU School of Medicine has improved health education and research in Missouri and beyond for more than years. MU physicians treat patients from every county in the state and more Missouri physicians received their medical degrees from MU than from any other university. For more information visit httpmedicine.missouri.edu."

"A North Carolina teen said hes feeling hopeful after getting an infusion of stem cells httpabcnews.go.comtopicslifestylehealthstemcellresearch.htm during an experimental procedure that may help heal his heart and extend his life. Caleb Sizemore was diagnosed with Duchenne muscular dystrophy years ago. The genetic disorder httpabcnews.go.comtopicslifestylehealthgeneticscreening.htm is characterized by progressive muscle degeneration and weakness. The disease can lead to scarring on muscles including the heart. As scarring on the heart worsens it affects the organs ability to function and can be fatal. In February Sizemore became the first patient ever to get an infusion of stem cells into his heart in the hopes of stopping or even reversing some of the scarring related to the disease. Dr. John Jefferies director of advanced heart failure and cardiomyopathy at the Cincinnati Childrens Hospital Medical Center is treating Sizemore. He said a person suffering from Duchenne usually lives into his or her early s because of scarring on the heart. Were going in and trying to reverse the scar tissue and potentially even mitigate the new development of scar tissue Jefferies told ABC News. If we can preserve his cardiac function he has a fantastic outlook. Baby Born Weighing Just Oz Finally Gets to Go Home httpabcnews.go.comHealthmiraclebabybornouncesfinallyhomestoryid Fiancee of NFL Star Dies of Ovarian Cancer at httpabcnews.go.comHealthfianceenflstartonystewarddiesovariancancerstoryid Jefferies explained that the process works by allowing the stem cells to enter the heart thus encouraging the heart to heal itself. The stem cells create a healthy environment in the heart and help the tissue go from abnormal state to normal state Jefferies noted. Jefferies said if the medication works on patients like Sizemore it could then be tested on millions of other Americans who have scarring on their heart due to the disease or past heart attacks. It is very exciting especially because of the impact it has on other kids and how it paves the way so that others can get the treatment and how this will change peoples lives and extend them Sizemore said. The teenager said he also has renewed optimism for his own health. Its made me more hopeful Sizemore said. Especially when I think of how amazing medical treatments and technology is and how far its gotten...especially since I was diagnosed years ago. Sizemore will return to Cincinnati in a few months so doctors can scan his heart and see if the scar tissue has been affected by the infusion."

"For years pregnant women have been warned about eating tuna https because of concerns about mercury exposure. But a federal panel has reignited the debate about the benefits and risks of eating tuna and other seafood during pregnancy. Experts agree that seafood is a rich source of important nutrients and that most of us dont eat enough of it. Fish is rich in omega fatty acids B vitamins iodine selenium and vitamin D. And numerous studies show that the nutrients in fish are particularly important for brain development in fetuses and nursing infants. As part of a sweeping review https of nutrition recommendations the Dietary Guidelines Advisory Committee https recently reiterated the current seafood guidelines Americans should eat a wide variety of seafood. The report also acknowledges the risk of mercury exposure from certain kinds of seafoods and notes that women who are pregnant nursing or may become pregnant should avoid certain kinds tilefish shark swordfish and king mackerel because of their high mercury content. The panel withheld a recommendation about tuna second only to shrimp in popularity in the United States. Current guidelines from the Food and Drug Administration https and the Environmental Protection Agency httpsyosemite.epa.govopaadmpress.nsfbdaceceeaccbedcdcfebcffOpenDocument warn pregnant and nursing women to limit tuna consumption to six ounces per week. The advisory committee has recommended that these agencies reevaluate their stance on tuna for pregnant women. In the report the panel argues that albacore tuna is a special case. They noted that even when women ate double the recommended weekly amount of tuna the benefits far outweighed the risks. All evidence was in favor of net benefits for infant development and cardiovascular disease risk reduction the panel wrote. The suggestion that pregnant women can eat more white albacore tuna the type of tuna typically used in canned tuna has upset advocacy groups that have called for increased warnings about mercury on tuna packaging. Tuna is responsible for nearly seven times more mercury exposure than the four highmercury fish that the Federal Food and Drug Administration advises pregnant women not to eat said Michael Bender director of the mercury policy project in a statement. So why would the proposed dietary guidelines recommend that pregnant women eat more of it But Dr. Steve Abrams a panel member involved in the seafood recommendations and medical director of the Neonatal Nutrition Program at Baylor College of Medicine said that while women need to be aware of the types of fish they are eating the evidence is strong that fish consumption by mothers is good for the brains of their babies. The goal of the dietary guidelines is to give people a healthy way to eat and not to include or exclude certain foods said Dr. Abrams. The benefit of having omega fatty acids in your diet really exceeds the likely risk of contamination. The point is that you should have a variety of types of seafood and not limit yourself to one type and variety includes canned tuna. Alice Lichtenstein senior scientist and director of the Cardiovascular Nutrition Laboratory at Tufts University said the panel hasnt suggested that pregnant women eat more tuna. The issue of fish contamination is a moving target and you need very current data said Dr. Lichtenstein. It may be that the issue is reevaluated and there is no change. Mercury levels in our oceans are on the rise due to an increase in industrial mercury emissions. Plants plankton and tiny fish that have absorbed small amounts of mercury are eaten by larger fish. Over time large fish sharks and swordfish accumulate high levels of mercury. As a result health officials recommend fish like sardines salmon tilapia and trout that are lower on the food chain and have accumulated less mercury in their tissue. The benefits of fish consumption on a developing fetus are clear. In a Harvard study of mothers and infants httpsdash.harvard.edubitstreamhandle.pdfsequence researchers tracked fish consumption during pregnancy and tested the mothers hair to measure her mercury exposure. They found that for each weekly serving of fish the mother ate while pregnant her babys score on visual recognition memory tests increased an average of four points. At the same time a babys score dropped by . points for every one part per million increase in mercury found in the mothers hair sample. The babies who scored highest on the memory tests were those whose mothers had consumed two or more servings of fish each week during their pregnancy but were tested to have very low mercury levels. Health officials have long worried about balancing warnings about mercury against the obvious benefits of consuming more fish. Currently fewer than one in five Americans https eats the recommended two servings a week of fish. About onethird eat one serving of seafood weekly and nearly half of us eats very little seafood or none at all. This fall Consumer Reports issued a lengthy paper https on fish and mercury exposure noting the special concerns about canned tuna due to its popularity. Six ounces of canned tuna contains micrograms of mercury compared to just micrograms of mercury in a sixounce serving of salmon according to Consumer Reports. A sixounce serving of swordfish contains micrograms the magazine said. For people who want to safely eat more seafood the magazine recommended shrimp scallops sardines salmon oysters squid and tilapia as the lowestmercury seafood. Also low are haddock pollock flounder and sole Atlantic croaker crawfish catfish trout Atlantic mackerel crab and mullet. In addition to the usual warnings about high mercury fish Consumer Reports added marlin and orange roughy to the list. They suggested limiting consumption of grouper Chilean sea bass bluefish halibut black cod Spanish mackerel and fresh tuna. To find out more about mercury in seafood go to the Got Mercury calculator created by the Sea Turtle Island Restoration Network at seaturtles.orgprogramsmercury httpsseaturtles.orgprogramsmercury."

"Tiny pellets could treat arthritic knee pain delaying the need for knee replacement surgery a small study has found. Microparticles inserted into small blood vessels around the knee helped reduce the pain and improve function in eight arthritis sufferers according to clinical trial results. The results were presented Monday at the Society of Interventional Radiologys annual meeting in Los Angeles. Patients overall were able to improve their physical function in the knee after the procedure and there were no adverse events related to this treatment said lead researcher Dr. Sandeep Bagla. Bagla is director of interventional radiology at the Vascular Institute of Virginia in Woodbridge. Boston Scientific maker of the microparticles funded the study. Much of the pain that comes from knee arthritis actually stems from inflammation in the lining of the knee joint also called the synovium Bagla said. In fact small blood vessels created by degenerative arthritis feed this inflammation by increasing blood flow to the lining. To treat this Bagla and his colleagues decided to try blocking those tiny blood vessels using microparticles spheres about a tenth of a millimeter in size made from a synthetic gellike material. The microparticles are inserted using a catheter run through a pinholesized incision in a procedure that lasts between and minutes Bagla said. Its an outpatient procedure and no physical therapy is required before or after this procedure he said. The small pilot study the first U.S. clinical trial of this procedure involved patients with moderate to severe arthritis pain. Only had undergone the procedure by the time of Mondays annual meeting and only eight had made it to the onemonth followup Bagla said. Those eight patients averaged a point decrease in pain as measured on a point visual scale used to estimate pain Bagla said. They started with an average baseline of which means their pain was brought down to manageable levels he said. Physical function of their knee also improved based on an index used to judge the effects of osteoarthritis Bagla added. Overall the two scales represented an percent improvement in function the researchers concluded. Bagla said no side effects are expected because the procedure only blocks additional blood flow to the knee rather than cutting it off altogether. You dont normally have this degree of increased blood supply to this lining. Were not blocking normal blood vessels to the knee or leg or bone or cartilage he said. Final results from this clinical trial are expected to be released this summer. Researchers are already kicking off a second larger trial to better understand how the procedure works and which patients it might benefit Bagla said. They think it will be most appropriate for people between ages and who arent ready to go through knee replacement or people who are on chronic pain medication for their knee arthritis Bagla said. Perhaps we can demonstrate and prove patients do not need to be on these medications and can alternatively go through a minimally invasive procedure like this to reduce their knee pain Bagla said. Dr. Suresh Vedantham president of the Society of Interventional Radiology called the new procedure very promising given that it focuses on the inflamed knee lining that causes the pain. This therapy is very welltargeted to that particular mechanism and certainly it should be investigated further said Vedantham who wasnt involved with the study. Hes a professor of radiology and surgery at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. Research presented at medical meetings is typically considered preliminary until it is published in a peerreviewed journal. More information The Arthritis Foundation has more about knee pain https SOURCES Sandeep Bagla M.D. director interventional radiology Vascular Institute of Virginia Woodbridge Suresh Vedantham M.D. professor radiology and surgery Mallinckrodt Institute of Radiology Washington University of St. Louis Society of Interventional Radiology annual meeting March Los Angeles"

"Osteoarthritis OA is one of the leading causes of disability in adults in the United States and knee OA specifically is ranked within the top noncommunicable diseases for global disabilityadjusted life years. The lifetime risk of suffering symptomatic knee OA is estimated to be . and approximately in of the US population is diagnosed with symptomatic knee OA by age . With this knowledge the American Medical Society for Sports Medicine AMSSM has released a new scientific statement that provides guidance for physicians and healthcare professionals who provide care for those patients with knee osteoarthritis. There is a general consensus that the initial management of knee OA treatment should include weight loss and strengthening exercises. However certain aspects of treatment for knee OA are controversial. In light of these issues the AMSSM convened an expert writing group of four sports medicine physicians to review the latest data and provide recommendations for the sports medicine community. We do not treat groups of people we treat individuals said Dr. Thomas Trojian Lead Author and Past AMSSM Board of Director. It is important to look at how a person responds to a medication. Does the person improve if given an injection of viscosupplementation more likely than placebo or intraarticular steroid Using a network metaanalysis we are able to compare the multiple studies done on viscosupplementation and have found that people are more likely to show clinical improvement with viscosupplementation over placebo saline and intraarticular steroids. This is different than studies recently published that say the average response differs. The full report published ahead of print in the Clinical Journal of Sport Medicince CJSM and will appear in the British Journal of Sports Medicine BJSM entitled AMSSM Scientific Statement Concerning Viscosupplementation Injections for Knee Osteoarthritis Importance for Individual Patient Outcomes includes the following notable AMSSM recommendations and one suggestion AMSSM RECOMMENDS viscosupplementation injections for Kellgren and Lawrence KL grade IIIII knee osteoarthritis in those patients above the age of based on HIGH quality evidence demonstrating benefit using OMERACTOARSI Responder Rating but the evidence should be downgraded due to indirectness for those under years of age. AMSSM SUGGESTS viscosupplementation injections for knee osteoarthritis for those under the age of based on MODERATE quality evidence due to response of treatment in those over . AMSSM RECOMMENDS clinicians and researchers collect OMERACTOARSI responder data to track individual response to the viscosupplementation. The full paper will be published in print in the January issues of CJSM and BJSM. Click here httphttp to view statement online. Thanks to members Drs. Thomas Trojian AMSSM Past Board of Director Susan Joy AMSSM Foundation Board Member Andrew Concoff and John Hatzenbuehler along with Whitney Saulsberry PharmD and Craig Coleman PharmD for serving on the expert writing group for this paper. The AMSSM hopes that this information can assist healthcare professionals as they provide care for patients with osteoarthritis. About AMSSM AMSSM is a multidisciplinary organization of sports medicine physicians dedicated to education research advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in nonsurgical sports medicine and serve as team physicians at the youth level NCAA NFL MLB NBA WNBA MLS and NHL as well as with Olympic teams. By nature of their training and experience sports medicine physicians are ideally suited to provide comprehensive medical care for athletes sports teams or active individuals who are simply looking to maintain a healthy lifestyle. http SEE ORIGINAL STUDY httpjournals.lww.comcjsportsmedAbstractpublishaheadAMSSM_Scientific_Statement_Concerning..aspx"

"A study that tracked tens of thousands of midlife and older men for more than years has found that vigorous exercise and other healthy lifestyle habits may cut their chances of developing a lethal type of prostate cancer by up to percent. While most prostate cancers are clinically indolent meaning they do not metastasize and are nonlifethreatening a minority of patients are diagnosed with aggressive disease that invades the bone and other organs and is ultimately fatal. Lead author Stacey Kenfield ScD of UCSF and a team of researchers at UCSF and Harvard focused on this variant of prostate cancer to determine if exercise diet and smokefree status might have lifesaving benefits. In the study published today Nov. in the Journal of the National Cancer Institute the researchers analyzed data from two U.S. studies the Health Professionals FollowUp Study that tracked more than males ages to from to and a second the Physicians Health Study that followed more than males ages to from to . To gage the effects of lifestyle habits the researchers developed a score based on the results of the health professionals survey then applied it to the physicians study. They assigned one point for each affirmative response to questions about regular intense exercise that induced sweating body mass index BMI under tobaccofree status for a minimum of years high intake of fatty fish high intake of tomatoes and low intake of processed meat. To reduce error participants had to be free of diagnosed cancer at the start of the study and a fouryear lag was imposed to rule out those who unknowingly had lethal prostate cancer which was determined by evidence of prostate cancer death or metastasis to the bones or other organs excluding the lymph nodes. Cases were confirmed through medical records and pathology reports and cause of death was determined by death certificate and medical record and secondarily by next of kin. Vigorous activity trumps other lifestyle factors The researchers identified cases of lethal prostate cancer in the health professionals group and cases in the physicians group. Participants with to points in the health professionals group had a percent decreased risk of lethal prostate cancer and a percent decreased risk was observed in the physicians group for the same comparison. For dietary factors alone men with three points versus those with zero points had a percent decreased chance of developing lethal prostate cancer in the health professionals group. In the physicians group this decrease was percent. While there were fewer cases and less detailed data collected in the physicians study the score was similar in both populations indicating the potential benefit of healthy lifestyle habits in warding off lethal prostate cancer said the authors. We estimated that percent of lethal prostate cancer cases would be prevented in the United States if men over had five or more of these healthy habits said Kenfield assistant professor in the Department of Urology at UCSF Medical Center and formerly of the Department of Medicine at Harvard Medical School in Boston where the study was initiated. Its interesting that vigorous activity had the highest potential impact on prevention of lethal prostate cancer. We calculated the populationattributable risk for American men over and estimated that percent of lethal prostate cancer would be reduced if all men exercised to the point of sweating for at least three hours a week Kenfield said. The researchers also calculated that lethal prostate cancer among American men over would be cut by percent if they consumed at least seven servings of tomatoes per week and that percent would be spared this diagnosis if they consumed at least one serving of fatty fish per week. Reducing intake of processed meats would cut the risk by percent they reported. In contrast the populationattributed risk for smoking was percent largely because the majority of older American men are longterm nonsmokers. Lifestyle changes also prevent heart disease diabetes This study underscores the ongoing need for more effective prevention measures and policies to increase exercise improve diet quality and reduce tobacco use in our population said senior author June M. Chan ScD from the departments of Urology and Epidemiology and Biostatistics at UCSF. It takes cooperation and effort from multiple areas like insurance companies employers policy makers and city planners to figure out how to creatively support and encourage more exercise into most busy adults working day. These lifestyle habits align with other recommendations to prevent diabetes and heart disease. About one man in seven will be diagnosed with prostate cancer during his lifetime making it the most frequently diagnosed cancer in the United States excluding nonmelanoma skin cancer. According to the American Cancer Society in there will be approximately cases of prostate cancer and approximately deaths. This study was supported by grants from the Prostate Cancer Foundation and the National Institutes of Health. Coauthors are Erin Van Blarigan ScD of the departments of Urology and Epidemiology and Biostatistics at UCSF Howard Sesso ScD MPH Edward Giovannucci MD ScD Meir Stampfer MD DrPH and Julie Batista ScD all of Harvard T.H. Chan School of Public Health Harvard Medical School and Brigham and Womens Hospital Mary Kathryn Downer and Jaquelyn Jahn both of Harvard T.H. Chan School of Public Health and Brigham and Womens Hospital. About UCSF UCSF is a leading university dedicated to transforming health worldwide through advanced biomedical research graduatelevel education in the life sciences and health professions and excellence in patient care. Founded in as a medical college UCSF now includes topranked graduate schools of dentistry medicine nursing and pharmacy a graduate division with worldrenowned programs in the biological sciences a preeminent biomedical research enterprise and toptier hospitals UCSF Medical Center and UCSF Benioff Childrens Hospitals. Please visit http"

"For infants with congenital malformations of the ear a treatment system called EarWell can gently reshape the earavoiding the pain and cost of later surgery reports a study in the March issue of Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg the official medical journal of the American Society of Plastic Surgeons http ASPS. But treatment must begin earlypreferably within the first three weeks after birth according to the study by ASPS Member Surgeon H. Steve Byrd MD and colleagues of Pediatric Plastic Surgery Institute Dallas. Dr. Byrd comments The EarWell system is effective in eliminating or reducing the need for surgery in all but the most severe congenital ear malformations. Nonsurgical Treatment Avoids Later Consequences of Infant Ear Malformations The researchers review their experience with nonsurgical correction of congenital ear malformations in infants. The EarWell system is a relatively simple technique for molding and reshaping the ear taking advantage of the increased malleability of the ear cartilage in newborns. For best results treatment should start within the first three weeks after birth or correspondingly later in infants born prematurely. The technique and length of EarWell treatment varies according to the type and severity of the infants ear deformity. Dr. Byrd and colleagues present a classification system and technical details for plastic surgeons to follow in evaluating the best treatment for specific types of malformations. For most infants in the study both ears were treated for a total of ears. Ninetyeight percent of infants had relatively mild constrictedtype ear deformities. EarWell treatment started at an average age of days and continued for days including an average of six followup visits to the plastic surgeons office. EarWell treatment was highly successful in correcting or reducing the severity of congenital ear malformations. Results were judged good to excellent in percent of ears with one simple deformity and percent with more complex mixed deformities. About percent of ears with constricted malformations were graded as having no deformity after treatment. Complications consisted mainly of skin injuries that healed without further problems. In eight cases treatment had to be stopped because of an allergic reaction to the adhesive tape used. While the EarWell system is not new the report is the largest study of congenital ear malformations treated with this approachincluding a standardized approach to treatment and assessment of the results. The results strongly support its use especially in infants with deformities and lesssevere malformations. But lack of awareness of this nonsurgical alternative is a key limiting factor. The opportunity for early treatment can be hampered by a failure to convince pediatricians that the majority of misshapen newborn ears do not selfcorrect Dr. Byrd and coauthors write. They also point out that EarWell is highly successful in the treatment of prominent earsa condition that commonly goes unnoticed by parents and pediatricians but is likely to get worse as the child grows. While we can operate on ears later in the patients life waiting not only increases the surgerys difficulty and expense but may expose the child to teasing bullying and loss of selfesteem comments EditorinChief Rod J. Rohrich MD in a featured video on the Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg website. If your baby has any type of ear deformity plastic surgeons can help with or without surgery. Discuss nonsurgical ear molding alternatives with your pediatrician and consult with a boardcertified plastic surgeon...the earlier the better Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg is published by Wolters Kluwer http Click here to read Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System. httpjournals.lww.complasreconsurgFulltextClassification_of_Newborn_Ear_Malformations_and..aspx Article Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System doi .PRS. About Plastic and Reconstructive Surgery For more than years Plastic and Reconstructive Surgery http has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons Plastic and Reconstructive Surgery brings subscribers uptotheminute reports on the latest techniques and followup for all areas of plastic and reconstructive surgery including breast reconstruction experimental studies maxillofacial reconstruction hand and microsurgery burn repair and cosmetic surgery as well as news on medicolegal issues About ASPS The American Society of Plastic Surgeons http is the largest organization of boardcertified plastic surgeons in the world. Representing more than physician members the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than percent of all boardcertified plastic surgeons in the United States. Founded in the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. About Wolters Kluwer Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal business tax accounting finance audit risk compliance and healthcare rely on Wolters Kluwers market leading informationenabled tools and software solutions to manage their business efficiently deliver results to their clients and succeed in an ever more dynamic world. Wolters Kluwer reported annual revenues of . billion. The group serves customers in over countries and employs over people worldwide. The company is headquartered in Alphen aan den Rijn the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam WKL and are included in the AEX and Euronext indices. Wolters Kluwer has a sponsored Level American Depositary Receipt program. The ADRs are traded on the overthecounter market in the U.S. WTKWY. Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization visit http httpwolterskluwer.com follow WKHealth httpstwitter.comwkhealth or Wolters_Kluwer httpstwitter.comWolters_Kluwer on Twitter like us on Facebook https follow us on LinkedIn https or follow WoltersKluwerComms on YouTube. https"

"People with diets short on omega fatty acids the kind found in fish oil were more likely to experience accelerated brain aging a new study found. People with lower levels of omega fatty acids had lower brain volumes that were equivalent to about two years of brain aging said Dr. Zaldy S. Tan http a member of the UCLA Easton Center for Alzheimers Disease Research in the Department of Neurology. The study http published Tuesday in the print edition of the journal Neurology. Tan and his colleagues compared blood levels of two nutrients in omega fatty acids with MRI brain scans and cognitive tests. They found people in the bottom scored lower on such mental tests as problem solving multitasking and abstract thinking. Tan said the MRI images showed those with lower levels of omega fatty acids were also more likely to have minute but significant structural changes in the brain. The MRIs showed higher white matter hyperintensity volume tiny lesions in the brain raising the risk for death stroke and dementia for the low omega fatty acids group. Tan said the results were consistent with signs of damage to the intricate network of blood vessels in the brain. A third of the brain by volume is composed of blood vessels. Tans team studied people with an average age of who were free of dementia. They controlled for such risk factors as age smoking gender body mass index physical activity and APOE httpghr.nlm.nih.govgeneAPOE the one known gene linked to dementia risk. Tan said the next step in the research is to follow these people to see if the risk factors they observed translates into a higher rate of cognitive deterioration. Fatty fish like salmon offer a concentrated source of the omega fatty acid nutrients Tan and his colleagues looked at eicosapentaenoic acid EPA and docosahexaenoic acid DHA. Vegetable and canola oils soybeans flaxseed walnuts and vegetables including spinach kale and salad greens are also a source of omega fatty acids. These contain alphalinolenic acid ALA which the body partially converts to EPA and DHA. Both types are thought to be beneficial. The typical American diet doesnt contain enough of either. Choose My Plate http the governments dietary guidelines recommends eating seafood twice a week. This is an important new finding that supports omega for brain health and brain size said Dr. Majid Fotuhi http chairman of the Neurology Institute for Brain Health and Fitness and assistant professor of neurology at Johns Hopkins University School of Medicine. Fotuhi recommends his patients get mg per day of DHA a nutrient that increases blood flow in the brain reduces inflammation in the brain heart and elsewhere and reduces the toxic aggregation of amyloid in the brain. DHA has the added benefit of improving mood and reducing symptoms of depression he said. The only people who should avoid DHA are patients on a blood thinner like Cumadin he added. Neurology http published weekly is the official journal of the American Academy of Neurology."

"A breath test to detect stomach and esophageal cancers shows promise researchers say. The test measures five chemicals in the breath. It was percent accurate in detecting these cancers in more than patients the new study found. Each year . million cases of cancer of the stomach and esophagus the tube leading from the throat to the stomach are diagnosed worldwide. Both tend to be diagnosed at a late stage and the fiveyear survival rate for the two cancers is percent the researchers said. Findings from the study were presented Monday at the European Cancer Congress ECC. At present the only way to diagnose esophageal cancer or stomach cancer is with endoscopy. This method is expensive invasive and has some risk of complications study author Dr. Sheraz Markar said in an ECC news release. Markar is from Imperial College London in England. With endoscopy a flexible tube is threaded down a sedated patients throat to the stomach to view the digestive tract. A breath test could be used as a noninvasive firstline test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment and better survival Markar said. Because cancer cells are different to healthy ones they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the esophagus and stomach and which do not he explained. Markar added that the test needs to be validated in a bigger group before it could be used on patients. The researchers said they are planning a larger trial of the breath test over the next three years. Study results presented at meetings are generally considered preliminary until theyve been published in a peerreviewed journal. More information The U.S. National Cancer Institute has more on stomach cancer https SOURCE European Cancer Congress news release Jan."

"When patients present with neurologic symptoms such as severe headaches or seizures the symptoms could suggest anything from infection cancer or an autoimmune disease of the brain or spinal cord leaving physicians scrambling to find the cause in a short amount of time. The differences in diagnosis can mean having mere hours to act or being able to take days or weeks to devise a treatment plan. Now researchers at Jefferson https Philadelphia University Thomas Jefferson University have developed a test that could rapidly parse out infections of the brain from other diseases. The diagnostic could prove particularly useful in infants and young children. We have many tests for making diagnoses but the ones that conclusively indicate infection can often take more time than wed like especially in cases of childhood meningitis or encephalitis said Mark Curtis https MD PhD Associate Professor of Pathology Anatomy and Cell Biology who also works as a hospital pathologist. Once confirmed with additional research our test could provide a first rapid and less invasive way to look at whats happening in the brain and guide treatment or further testing. The results were published in the journal PLOS ONE httpsjournals.plos.orgplosonearticleid.journal.pone. on October st. Rather than testing for the presence of bacteria or virus the researchers looked at the first telltale signs of infection the cytokines produced by the patients immune system in response to pathogens and other injury processes. Cytokines are an alarm system in the body said Dr. Curtis. Infectious agents activate a multipronged inflammatory response a key component of which is the release of different combinations of cytokines tailored to combat pathogens. Changes in cytokine levels of cerebrospinal fluid offer a very early measurable sign of infection. Dr. Curtis and colleagues decided to see if they could detect patterns within the cytokines that might differentiate infections from other brain diseases or disorders. In the retrospective analysis the investigators looked at samples collected from patients who had received spinal taps during their hospital stays. The researchers then tested the cerebral spinal fluid CSF for the presence of different cytokines and noticed that patients with confirmed infection of the central nervous system had a different cytokine fingerprint from those confirmed as having tumors or autoimmune disease. This suggested the test could be used to tell the conditions apart. Additionally within the patients identified with central nervous system infections the CSF cytokine fingerprint was different in cases of viral infection compared to those with nonviral pathogens such as bacteria or fungi. With only a small amount of spinal fluid needed CSF cytokine analysis could be used as one of the first diagnostic tests to rapidly triage serious central nervous system disorders and guide immediate intervention said first author Danielle Fortuna MD an Assistant Professor in the Department of Pathology and Laboratory Medicine at the Hospital of the University of Pennsylvania. Worldwide meningitis and encephalitis affect more than four million adults and children each year. Infants and young children have an especially high risk of meningitis and encephalitis and the related often serious sequelae said Dr. Curtis. Being able to rapidly identify a central nervous system disorder as infectious can be crucial in rapid response. In addition the test could distinguish viral from nonviral infections a distinction that could spare a child with a viral infection from an unnecessary course of antibiotics and tailor the care toward antiviral and supportive measures as needed said Dr. Curtis. Moving forward our goal is to formally validate our findings with a larger sample size that includes both adults and children for future use in the clinical arena. Article reference Danielle Fortuna D Craig Hooper Amity L Roberts Larry A Harshyne Michelle Nagurney Mark T Curtis Potential role of CSF cytokine profiles in discriminating infectious from noninfectious CNS disorders PLOS ONE DOI .journal.pone. httpsjournals.plos.orgplosonearticleid.journal.pone. . Media Contact Edyta Zielinska edyta.zielinskajefferson.edu mailtoedyta.zielinskajefferson.edu ."

"Merck Cos approved Keytruda lung cancer treatment provided superior overall survival to chemotherapy in a latestage study of patients with advanced disease whose tumors produce a protein called PDL associated with increased risk of the disease. The U.S. drugmaker on Monday said patients taking the approved milligram dosage of Keytruda and those taking an experimental milligram dose had longer overall survival compared with those taking docetaxel a standard treatment for non small cell lung cancer NSCLC the most common form of lung cancer. Keytruda thereby met its main goal of the study. Patients whose tumors had especially high levels of PDL also went longer without a progression of disease than those taking docetaxel Merck said. Those whose tumors expressed PDL but not at high levels did not show such a statistically significant benefit in progressionfree survival. Safety of Keytruda was consistent with what had been seen in previous trials among lung cancer patients Merck said in a release that included only summary topline information from the results. More detailed data from the study will be provided soon Merck said adding that it will ask the U.S. Food and Drug Administration later this year to add the new data to the drugs package insert label. U.S. regulators in October approved Keytruda on an accelerated basis for patients with advanced nonsmall cell lung cancer whose tumors produce PDL. The approval was contingent on the company providing more detailed data in the future on Keytrudas safety and effectiveness. Keytruda and a similar treatment from BristolMyers Squibb Co called Opdivo are antibodies designed to block the interaction between PDL and another protein PD whose natural function is to put checks on the immune system. By blocking the interaction the drugs aim to enable the patients own immune system to recognize and therefore attack the cancer. Wall Street analysts expect cancer immunotherapies to earn combined annual sales of over billion by ."

"Doctors should consider radiosurgery earlier for patients with severe facial pain according to a new study in the International Journal of Radiation OncologyBiologyPhysics the Red Journal the official journal of the American Society for Radiation Oncology ASTRO. In the research radiosurgery helped improve the quality of life for patients with trigeminal neuralgia and reduced their depression which is often exacerbated by the side effects of other treatments. The authors from Cleveland Clinic in the US say considering radiosurgery earlier on could make a big difference to patients lives. Trigeminal neuralgia TN is a very painful nerve disorder that causes an electrical shock feeling in the face usually in older people. Some things can trigger it like chewing or even the wind blowing but attacks can be random. On a scale of patients often describe the pain as off the scale. TN is commonly treated with antiepileptic medications. While this can reduce the pain it makes patients drowsy and tired and they report feeling drunk. This has an impact on their quality of life and frequently causes depression as it stops them from driving working or even just leaving the house. According to the new study radiosurgery which is normally a second line treatment to be used following the medication helps improve quality of life and reduce depression in patients with TN. By considering it earlier as a treatment option doctors could help improve the lives of patients with TN more quickly. We knew radiosurgery results in pain relief but we didnt know if the patients actually felt better said Dr. Samuel Chao corresponding author of the study. I think people go and see their neurologist and get the pain under control with medication but they dont realize how lousy this can make them feel. Using radiosurgery earlier on allows patients to get off the medications improving their quality of life by allowing them to return to activities they used to do. Radiosurgery is a method for physically treating the nerve using radiation with stereotactic radiosurgery doctors can focus beams of radiation on a single point. It is noninvasive so doesnt require the healing time of traditional surgery. Treatment takes less than an hour and requires no anesthetic. However it is often overlooked or delayed as a treatment because there is a lack of capability and experience with the method. Research has shown that radiosurgery reduces pain for of patients but the broader impact on their lives remained unknown. In the new study Dr. Chao Dr. Kotecha and his colleagues prospectively collected data from patients they treated with radiosurgery using two questionnaires EuroQOL Dimension and Patient Health Questionnaire . They asked questions about the patients pain and facial numbness their health and their ability to take care of themselves. The researchers analyzed patients answers before treatment and at each followup appointment and found that patients reported an improved quality of life and lower rates of depression after radiosurgery. Importantly the benefit of treatment was strongly driven by improvements in pain and discomfort as well as selfcare. Pain and the medication to stop the pain make it difficult for people with TN to go outside and live life explained Dr. Chao. With radiosurgery we can reduce pain improve quality of life and decrease depression people can go out and enjoy life without worrying they will have a random attack. Giving options empowers the patient to be more aware of themselves and manage their own condition. The team plans to analyze the impact of other treatment options and carry out a costbased analysis to establish the best treatment options for TN. Notes for editors The article is Stereotactic Radiosurgery for Trigeminal Neuralgia Improves PatientReported QualityofLife and Reduces Depression httpsdoi.org.j.ijrobp... by Rupesh Kotecha Jacob A. Miller Sujith Modugula Gene H. Barnett Erin S. Murphy Chandana A. Reddy John H. Suh Gennady Neyman Andre Machado and Sean Nagel. It appears in International Journal of Radiation OncologyBiologyPhysics available online April published by Elsevier. Copies of this paper are available to credentialed journalists upon request please contact Name at Email address or Phone number add country code. About International Journal of Radiation OncologyBiologyPhysics International Journal of Radiation Oncology Biology Physics IJROBP known in the field as the Red Journal is the official journal of the American Society for Radiation Oncology ASTRO. It publishes original laboratory and clinical investigations related to radiation oncology radiation biology medical physics and both education and health policy as it relates to the field. This journal has a particular interest in prospective clinical trials outcomes research and large database interrogation as well as reports of highimpact innovations in single or combined modality treatment tumor sensitization normal tissue protection including both precision avoidance and pharmacologic means brachytherapy particle irradiation and cancer imaging. About Elsevier Elsevier is a global information analytics company that helps institutions and professionals progress science advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management RD performance clinical decision support and professional education including ScienceDirect Scopus ClinicalKey and Sherpath. Elsevier publishes over digitized journals including The Lancet and Cell more than ebook titles and many iconic reference works including Grays Anatomy. Elsevier is part of RELX Group a global provider of information and analytics for professionals and business customers across industries. http"

"Johnson Johnsons Stelara helped a significantly higher percentage of Crohns disease sufferers than those who received a placebo according to a study of patients who had not been helped by other commonly used drugs. In addition nearly percent of patients who stayed on Stelara beyond the initial six weeks of the midstage study continued to respond to the drug and there was a significantly higher rate of remission at weeks than in a placebo group. Stelara known chemically as ustekinumab is already approved to treat the skin condition plaque psoriasis and is in latestage testing for psoriatic arthritis. An approval for Crohns would give the drug entry into an estimated . billion U.S. market and . billion market worldwide. The intravenous biotech drug met the primary goal of the study as almost percent of patients who received the milligrams per kilogram of weight dose of Stelara achieved a clinical response defined as a point reduction in the Crohns Disease Activity Index CDAI after six weeks of treatment. That compared with a response rate of . percent of patients who received a placebo. Two lower doses of Stelara were also tested in the study of patients with moderate to severe Crohns disease who were not helped by or could not tolerate treatment with a widely used class of drugs known as TNF antagonists such as Abbott Laboratories Humira. Those who received mgkg had a . percent response rate and the mgkg dose led to a . percent response rate. To see these kind of outcomes where you have high response rates in the short term and then good remission rates out toward five or six months of therapy it shows unequivocally that the drug is effective for treating Crohns disease said Dr. William Sandborn the studys lead investigator who presented the data at the Digestive Disease Week meeting in Chicago on Sunday. Its effective in the patient population that has the greatest unmet need at this point in time Sandborn said of patients who do not respond to antiTNF drugs. He said a point drop in the CDAI was clinically meaningful to patients. Theyll feel measurably better. The patient population was really quite ill and had very high disease activity and despite that we saw nice response rates Sandborn said. In a second phase of the study those who responded to Stelara after six weeks of treatment were given either a mg injection of Stelara at week eight and week or a placebo. After weeks . percent of the Stelara patients maintained a clinical response and . percent were deemed to be in clinical remission. That compared with . percent who maintained a clinical response and a . percent remission rate in the placebo group. Clinical remission was defined as a CDAI score down to . Patients in the study on average started at or on the CDAI scale researchers said. Crohns is a chronic autoimmune disorder of the gastrointestinal tract that affects an estimated Americans. Common symptoms are abdominal pain and diarrhea and it can lead to bowel perforations. Many Crohns patients require surgery when medicines no longer control symptoms. The rate of infections and other serious side effects was similar in the Stelara and placebo groups researchers said. Well need more patients and longerterm data to really fully characterize the safety profile in Crohns disease but so far so good Sandborn said. Reporting by Bill Berkrot Editing by Tim Dobbyn and Dale Hudson Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"If it werent for routine PSA https prostate cancer https screening an extra Americans each year would learn that they had the worst form of the disease a new study suggests. That kind of prostate cancer https metastatic prostate cancer in which the cancer https spreads to the bone or other parts of the body is rapidly fatal usually within two years or less. The new study seems to make a powerful argument in favor of PSA testing. It finds that in the three years before widespread PSA testing men getting their first diagnosis of prostate cancer were three times more likely to learn they had very latestage cancer https than men diagnosed in the most recent three years for which data is available . By not using PSA tests in the vast majority of men you have to accept you are going to increase very serious metastatic disease threefold says study leader Edward Messing MD chief of urology at the University of Rochester Medical Center. In about U.S. men were diagnosed with metastatic prostate https cancer https By projecting data from the prePSA era forward Messing calculates that without routine PSA tests men would have been diagnosed in an extra cases of deadly disease. But its not that simple says Barnett Kramer MD MPH associate director for disease prevention at the National Institutes of Health. Studies looking back at cancer trends in a population are very unreliable when it comes to showing what caused those trends. For example Kramer says what if a man got a PSA test when his prostate cancer was in the very earliest stages of metastatic disease Microscopic cancers already have seeded his body. But he would not yet have symptoms or detectable metastatic disease so hed be diagnosed with earlierstage disease. Hes subtracted forever from the men whose first diagnosis was latestage disease even though screening could not save his life. Messing says this misses the point of his study which appears in the online July issue of the journal Cancer. The reason our study has some meaning is that all a screening test can give you is a shift to lowerstage disease he says. It cant cure the disease and it cant prevent the disease. All it can do is allow you to catch it earlier and give appropriate treatment for the stage of disease you have caught it at. Kramer notes that another study using National Cancer Institute data recently found that latestage prostate cancers declined in men over age after it was recommended that they stop getting PSA tests. Its highly unlikely that not getting screened prevented these cancers. But it does show how easily false results creep into lookback studies. PSA Screening Controversy The U.S. Preventive Services https Task Force recently recommended against routine PSA screening. At best PSA screening may help one man in avoid death from prostate cancer after to years task force cochair Michael LeFevre MD MSPH of the University of Missouri writes in an email to WebMD. We now know that the PSA test harms many more men in the course of testing and treatment after a positive result. But what about Messings study This study is not a randomized trial and the results dont tell us much about whether screening reduces a mans chances of having metastatic prostate cancer LeFevre notes. Since death from prostate cancer will nearly always be preceded by metastatic disease one would expect a significant decline in metastatic disease to be accompanied by a significant reduction in deaths. But that is not what the clinical trials https show. Messing agrees that his study is not a screening study although he argues that the European trial of PSA screening did indeed show the same reduction in metastatic cancer as his study predicted. And this reduction he says argues strongly in favor of routine PSA tests for all men starting at age and older and for higher risk men starting in their s. Kramer says Messing is right when he says screening itself doesnt save lives. Only treatment can do that. And the evidence unfortunately shows that prostate cancer treatment https isnt as good as everyone would like it to be. A recent study in the New England Journal of Medicine looked at men whose earlystage prostate cancer was detected by PSA tests. Those treated with radical prostatectomy https considered the most effective if not the safest treatment were only about more likely to be alive years later than those not treated. And PSA testing carries risks. According to LeFevre Men with suspicious PSA scores get biopsied but up to of these biopsies https find no cancer. Once a biopsy finds cancer theres no way to tell for sure if its going to kill him. Nine out of U.S. men opt for treatment. For every men who get treatment after PSA screening one gets a blood clot https two have a heart attack https or stroke https and up to become incontinent or have urinary incontinence https One in men who gets PSA screening will avoid dying of prostate cancer but one in will die as a result of surgery. PSA Should Men Get the Test So should men get regular PSA tests Many urologists who often treat men suffering terribly from latestage prostate cancer agree with Messing that they should. But many experts on screening tests who often see doctors fail to accept medical evidence that conflicts with their experience agree with LeFevre that they should not. The American Cancer Society has this advice Men should only get the PSA test after having a detailed talk with a doctor about the benefits and risks of PSA screening."

"If you spend all day sitting on your rear end then you might want to schedule some time for a brisk walk just make sure you can spare at least an hour. Scientists analyzing data from more than million people found that it takes about to minutes of moderate intensity exercise to undo the damage of sitting for at least eight hours a day. Not exercising and sitting all day is as dangerous as being obese or smoking they found. And the added risk of parking yourself in front of a television for hours or more a day after sitting at the office is so high even the hour of exercise is not enough to reverse the damage. We cannot stress enough the importance of getting exercise whether its getting out for a walk at lunchtime going for a run in the morning or cycling to work said Ulf Ekelund of the Norwegian School of Sports Sciences in Norway one of the study authors in a statement. It has been long suspected that sitting a lot at work or at home is not healthy. Previous studies have found that prolonged sitting can raise the chances of heart disease various cancers and an earlier death. In the new research experts combed through papers with data on factors including how long people spend sitting their physical activity levels and their televisionwatching habits. The majority of studies included people older than age . All except one were done in the U.S. Western Europe and Australia. Researchers found that people with the highest levels of moderate physical activity to minutes daily erased the higher risk of death linked to being seated for more than eight hours a day. But even that exercise regime was not enough to counter the hazards of also watching more than five hours of television a day. The paper was published online Wednesday in the journal Lancet. Lars Bo Andersen who coauthored an accompanying commentary called the new research very convincing explaining that too much sitting increases the risk of problems including diabetes and heart disease because it can make insulin levels spike and might slow the bodys metabolism. Andersen said that watching lots of television was probably even worse than sitting at the office all day because it likely includes other unhealthy habits. A lot of people dont just watch TV they eat fatty snacks at the same time said Andersen of Sogn and Fjordane University College in Norway. Andersen said that some cultures make it easier than others to squeeze in an hour of exercise every day noting that in Denmark and much of Scandinavia about half of all people either cycle or walk to work. But he said that getting the recommended amount of physical activity shouldnt be overly arduous and doesnt necessarily mean going to the gym for an intense workout. If you are walking and can feel yourself getting a little warm and your breathing is a little heavier thats enough he said. You dont have to be sweaty and out of breath to get the benefits. Copyright The Associated Press http All rights reserved. This material may not be published broadcast rewritten or redistributed."

"Many heart doctor will tell you that one of the best ways to keep your heart healthy is to include more healthy oils httptime.complantssciencehealthierdietbestclimate such as omega fatty acids httptime.comfishoilomegaantidepressants found in fish in your diet. Studies have shown that people in parts of the world who eat more fish have lower rates of heart disease and fewer heart attacks though the same cant necessarily be true of those who take supplementssee this piece Fish Oil Is Hugely PopularBut Should You Take It httpstimeinc.slack.comfilesaliceparkFWFVKZUZcstl____article.pdf for more on that. One thing that has been less clear is what role fish oil plays in people who have already had a heart attack. Can omega fat provide similar benefit Researchers led by Dr. Raymond Kwong at Brigham and Womens Hospital wanted to find out so they took advantage of more sophisticated imaging techniques that can provide detailed pictures of the heart and how its changing in the days and weeks after a heart attack. For the study published in the journal Circulation they studied nearly people who recently had a heart attack who were randomly assigned to take g of omega fatty acids or a placebo pill for six months. Thats a high dose a oz. portion of salmon contains anywhere from half a gram to g of omega. Every two months the volunteers came in for an MRI of their heart to track how much the muscle was changing. Normally after a heart attack part of the heart is starved of oxygen and that portion never recovers. The remaining healthy tissue starts to compensate for the compromised tissue but has to work harder to maintain the hearts normal pumping function. Over time this overworking can lead to scar tissue and start to restrict even the healthy tissues ability to do its job. Kwong and his team found that people taking the high dose of omega fats showed less of this decline in heart function than those taking placebo. Whats more the people who showed the highest blood levels of the omega fats people absorb it at different rates showed the greatest reduction in scarring compared to those with the lowest levels. The effects remained strong even after the researchers accounted for the fact that all of the people were taking standard heart disease treatment drugs including cholesterollowering statins and blood pressure medications. The omega fatty acids seem to be preventing scarring of the otherwise healthy muscle that now has to overwork because of the heart attack says Kwong. Based on analysis of their blood samples the people taking omega supplements also showed lower levels of inflammatory markers httptime.cominflammationhealtheffects which suggests that the fish oil may be working by reducing inflammation following a heart attack. Its the first encouraging strategy for protecting the heart after a heart attack the more remaining healthy tissue that can be saved the stronger the heart will be. Kwong says that the findings are only the first step toward considering whether omega fatty acid supplements should be part of every emergency heart attack response. The g is a high dose previous studies in which people were given g of fish oil were more inconsistent. Most of the people also started taking the supplements two to four weeks after their heart attack. Might they have benefit more if they had started taking the supplements sooner How much omega is needed to start remodeling the heart in a beneficial way These are questions Kwong and others hope to answer with more studies. Kwong collected blood samples from the volunteers and will be studying them for hints about how omega fatty acids are working in the body after a heart attack. To say every heart attack patient should be taking omega fatty acids right away is a bit premature he says. But I do think its logical that our results hold promise and may reduce bad outcomes in patients after a heart attack."

"EPA and DHA omegas reduce the risk of coronary heart disease CHD according to results of a new comprehensive metaanalysis published in the Mayo Clinic Proceedings. Among randomized controlled trials RCTs there was a statistically significant reduction in CHD risk in higher risk populations including percent in those with high triglycerides and percent in those with high LDL cholesterol. A nonstatistically significant percent risk reduction among all populations in RCTs a finding supported by a statistically significant percent reduced risk of CHD among prospective cohort studies. What makes this paper unique is that it looked at the effects of EPA and DHA on coronary heart disease specifically which is an important nuance considering coronary heart disease accounts for half of all cardiovascular deaths in the U.S. said Dr. Dominik Alexander lead author and Principal Epidemiologist for EpidStat. The percent reduced risk among RCTs coupled with an percent risk reduction in prospective cohort studies which tend to include more reallife dietary scenarios over longer periods tell a compelling story about the importance of EPA and DHA omegas for cardiovascular health. Additional study details include The study reviewed randomized controlled trials RCTs and prospective cohort studies with and subjects respectively. The study examined outcomes such as myocardial infarction sudden cardiac death and coronary death. The study compared the results of RCTs which explore interventions under strict clinical conditions to those of prospective cohort studies that are observational and followed larger populations for longer periods of time. There are important public health implications related to reducing the risk of coronary heart disease and therefore we are encouraged by the results of this comprehensive analysis said Dr. Harry Rice Vice President of Regulatory and Scientific Affairs for the Global Organization for EPA and DHA Omegas GOED which funded the study. Its also important that the observed risk reductions were even stronger in patient populations with elevated triglycerides and LDL cholesterol levels two risk factors that affect more than one quarter of the American population. The results confirm that increasing omegas is a healthy lifestyle intervention that can contribute towards reductions in CHD risk added Adam Ismail Executive Director of GOED. Remember that increasing omega intakes is basically just improving the quality of ones diet slightly like reducing the amount of sodium or increasing your dietary fiber. It is a simple inexpensive and achievable change that most consumers need to make to optimize their health. An accompanying editorial in Mayo Clinic Proceedings also acknowledges the importance of the study. The metaanalyses of Alexander and colleagues suggests that omega fatty acid intake may reduce risk of adverse CHD events especially among people with elevated levels of TGs or LDLC....omega fatty acid intake of at least gram of EPADHA per day either from seafood or supplementation as recommended by the American Heart Association continues to be a reasonable strategy said the authors. Study authors did point out that further clinical trials looking specifically at CHD outcomes may continue to provide a better understanding of the promising beneficial relationship between EPADHA and CHD risk. Current RCTs have varying durations different baseline CHD status for study participants and utilize several methods for patient selection and randomization. Future studies should Increase patient populations to account for dropout rates in longer trials. Extensively detail how subjects are diagnosed to create uniform diagnostic criteria. Be appropriately powered to detect an effect in current clinical conditions. Measure baseline omega intake or status of study participants to determine the extent to which it confounds results. The study was supported by a grant from GOED which played no role in study design in the collection analysis and interpretation of data in the writing of the report or in the decision to submit the article for publication."

"An experimental drug appears to reduce the risk of bone fractures in postmenopausal women with osteoporosis better than a placebo and the currently available drug a new study finds. In this phase trial funded by the drugs maker Radius Health fewer women on the injectable drug abaloparatide had spine fractures . percent than women receiving a placebo . percent and slightly fewer than those taking a similar injectable drug teriparatide Forteo . percent. If this gets approved and there is no reason to think it wont this will be the second drug available for the treatment of highrisk osteoporosis said lead researcher Dr. Paul Miller of the Colorado Center for Bone Research. Forteo has been in use for the past years he said. Abaloparatide works differently from Forteo and improves bone density more than Forteo Miller said. Women taking abaloparatide also had fewer other types of fractures . percent than those who got a placebo . percent and slightly fewer than those on Forteo . percent the researchers found. Miller said many spine fractures are painless. Patients are often unaware they have happened until a doctor measures their height and finds they are up to an inch shorter than before he said. Abaloparatide and Forteo are synthetic peptides that help grow and strengthen bone Miller said. Along with building bone density they are the only ones that increase bone quality he said. Bone quality is an important aspect of bone strength the ability to withstand a break Miller said. He predicts that when abaloparatide is on the market it will compete with Forteo driving down the price of both drugs. I am hoping that having a second drug available that it will help reduce the cost he said. Forteo costs about a month if you dont have insurance. Even if a patient is insured monthly copays can range from to . Forteo is covered by Medicare Miller said. The report was published Aug. in the Journal of the American Medical Association. A study based on U.S. Census data estimated that more than million women between the ages of and have osteoporosis. A yearold woman has a percent lifetime risk of fracture due to low bone density. For the study Miller and colleagues randomly assigned nearly postmenopausal women with osteoporosis to receive daily injections of abaloparatide Forteo or a placebo for months. Their average age was . Among the nearly women who completed the trial increases in bone mineral density were greater with abaloparatide than placebo the researchers found. In addition fewer cases of hypercalcemia abnormally high levels of calcium in the blood occurred among women taking abaloparatide percent than Forteo percent. Hypercalcemia can weaken bones cause kidney stones and interfere with heart and brain function. There were no differences among the groups in other serious side effects such as nausea and heart palpations Miller said. Dr. Caroline Messer director of the Center for Pituitary and Neuroendocrine Disorders at Lenox Hill Hospital in New York City is eager for further research. There needs to be a large headtohead trial between Forteo and abaloparatide she said to really see which drug is better. Everybody is going to want to know if this is inferior or superior to Forteo she said adding that this is an early study. It shows more bone building and fewer fractures than Forteo but whether it will replace that drug is still up in the air. An editorial accompanying the study said which drug is selected may be less important than identifying and starting an approved treatment. The bar is high for any preventive treatment in the efforts to prevent a fracture that may or may not ever occur prescribers do not want to prescribe a therapy that causes a new problem. The way forward for fracture prevention involves not only the development of better therapies . . . and easier delivery systems but also improved adoption of existing osteoporosis therapies for patients with prior fractures and minimization of adverse effects particularly those associated with longterm use the editorial said. The editorial was cowritten by Dr. Anne Cappola of the Perelman School of Medicine at the University of Pennsylvania Philadelphia associate editor of JAMA and Dr. Dolores Shoback of the University of California San Francisco. More information To learn more about osteoporosis visit the American College of Rheumatology http SOURCES Paul Miller M.D. Colorado Center for Bone Research Lakewood Colo. Caroline Messer M.D. director Center for Pituitary and Neuroendocrine Disorders Lenox Hill Hospital New York City Aug. Journal of the American Medical Association"

"A new type of blood test may help physicians identify which patients with and without evidence of coronary blockages are at risk for heart attacks http and strokes http Even individuals with normal levels of lowdensity lipoprotein LDL known as the socalled bad cholesterol but still at risk seem to be identified according to Mayo Clinic research being presented at the American College of Cardiologys th Annual Scientific Session httpsaccscientificsession.acc.org. The test httpsnewsnetwork.mayoclinic.orgdiscussionmayocliniclaunchesfirstinusbloodtestthatassessesriskofheartattackusingplasmaceramides released commercially by Mayo Medical Laboratories http in August measures blood concentrations of plasma ceramides a class of lipids that are highly linked to cardiovascular disease processes. The study found that individuals with the highest levels of blood ceramides were found to have a to times greater risk of having a cardiovascular event compared with those with the lowest ceramide score regardless of their LDL cholesterol level or the presence of a blockage in the hearts arteries. Our research suggests that evaluating ceramide levels in patients who are not at immediate risk for coronary artery disease events may help cardiologists decide who could benefit from proactive and preventive treatment such as statins or lifestyle changes to prevent a serious cardiac event down the road says Jeff Meeusen Ph.D. http a clinical chemist codirector of Cardiovascular Laboratory Medicine at Mayo Clinic and the studys lead author. According to Dr. Meeusen ceramides are different than cholesterol which gathers and causes a clog in the arteries. Ceramides are more active attracting inflammatory cells and promoting clotting. In the study Mayo Clinic patients who were referred for coronary angiography http to check for possible artery blockages were included and followed prospectively for approximately eighteen years. Patients were similar in age and with regard to blood pressure smoking status and highdensity lipoprotein HDL the good cholesterol excluded were those who had diabetes or a previous heart attack stroke or procedure to open narrowed coronary arteries. Researchers measured four different types of ceramides in the blood at baseline and combined the values into a point scale. Patients were grouped into four risk categories according to their ceramide levels low intermediate moderate and high . Over the eighteen years researchers recorded occurrences of heart attack stroke revascularization and death. Overall . percent of patients had a major cardiovascular event each year. But the risk of having an event became higher as ceramide level increased for each point increase in the ceramide risk score the risk rose by percent. The rate of events was double among people with the highest ceramide score compared with those with the lowest . vs. . percent respectively. In patients without coronary artery disease following angiography the rate of cardiovascular events was only . percent lower than the average overall. But when researchers examined cardiovascular disease in this population by ceramide scores people with the highest levels of ceramides were four times more likely to have an event compared with those with the lowest . vs. . percent respectively. A similar trend was seen among people with low LDL levels mgdL typically considered a good LDL target. In this group the rate of heart attack stroke and revascularization and death was . percent among those with a low ceramide score but . percent in people with the highest ceramide levels. There is a need to identify patients at increased risk for cardiovascular events so that we can test strategies to prevent those events. This test seems to provide such information says Allan S. Jaffe M.D. http senior author of the study cardiologist at Mayo Clinic and chair of the Division of Clinical Core Laboratory Services. The trial was funded by Mayo Clinic. The new test is available to health care providers worldwide through Mayo Medical Laboratories which offers laboratory testing and pathology services to more than health care organizations in more than countries. Mayo Medical Laboratories collaborated with some of the original researchers who established the role of ceramides in cardiovascular disease and Zora Biosciences Oy a diagnostics discovery company based in Finland to develop and refine the test. The present study is also the first to test its clinical utility in a U.S. population. Coauthors are Leslie Donato Ph.D. Sandra Bryant Grant Spears Peter Berger M.D. and Linnea Baudhuin Ph.D. all of Mayo Clinic."

"The makers of POM Wonderful pomegranate juice say that the drink improves blood flow and heart health prevents and treats prostate cancer and works percent as well as Viagra whatever that means. All for about four bucks a bottle. Those impressive claims helped the company rack up million in sales in . They also earned the disapproval of the Federal Trade Commission FTC. Last month the agency sued POM Wonderful for making false and unsubstantiated health claims and is asking the company to remove the claims from its ads. A percent juice drink that contains antioxidants and no added sugar POM is just one of many beverages that bill themselves as promoting better health. VitaminWater kombucha tea coconut water and various brands of juice drinks made from acai goji berry and mangosteen have all used health claims in their marketing and some like POM have been the subject of scrutiny and legal action. The FTC along with the Food and Drug Administration FDA has been cracking down on food and beverage makers for allegedly overselling the health benefits of their products. In alone the FDA warned companies that they were providing misleading nutritional information on their packaging or making overly specific health claims. Health.com dietbusting foods you should never eat http Not all of the products were drinks but the beverage category stands out says Bruce Silverglade director of legal affairs at the Center for Science in the Public Interest a consumer advocacy group based in Washington D.C. At first blush it seems that beverage products are certainly a large proportion of food products that make bogus healthrelated claims. Drinks such as POM have become increasingly popular with consumers in recent years thanks in part to public health campaigns against soda that have been prompted by the obesity epidemic. The trend is away from traditional soda pop toward products claiming to provide magical health benefits Silverglade says. Are the health claims true Yes and no. The federal government doesnt require companies to vet health claims with the agency before plastering them on product packaging as long as the claims are accompanied by a disclaimer about their uncertainty. But that doesnt mean the claims are invented most are based in research. The research is often funded by the manufacturers however and industryfunded research can be prone to bias. A study found that research on health drinks that was funded entirely by beverage companies was between four and eight times more likely to find a favorable result than research with no industry support. If a cell phone company told you they tested all the models and their model came out the best would you believe it Probably not says Dr. Lenard Lesser M.D. one of the coauthors of that study and a researcher at UCLA. The same is true with nutrition research but the stakes are higher because were putting our bodies at risk. Wheres the line between research and marketing httpedition.cnn.comHEALTHcompany.funded.researchindex.html Sounds great hard to believe However farfetched the claims may sound POM is standing behind them. Two weeks before the FTC publicly announced its lawsuit POM preemptively sued the FTC claiming that preapproval of ads featuring health claims violates the companys right to free speech. But are shoppers really convinced that POM can unclog their arteries cure cancer and lead to hotter sex There seem to be more than a few believers out there. I started drinking POM after reading the studies two years ago my triglycerides were almost one of POM Wonderfuls fans breathlessly posted on Facebook after the FTC announced its lawsuit. Working out everyday drinking POM and eating healthy they are now less than . Forget what the Feds say I believe A triglycerides level of is still nearly three times higher than whats considered normal. Most health beverage drinkers arent as enthusiastic as the realtor from Alaska who posted the above testimonial. Quinton Ma a yearold marketing coordinator at Gawker Media in New York City started to drink VitaminWater as a middle schooler because it seemed like a healthy alternative to soda. I figured that if they were selling something that I could get extra vitamins from it couldnt hurt to drink Ma says. Once I learned they were really just cleverly marketed sugar waters I stopped. Health.com You are what you drink httpeating.health.comnewresearchyouarewhatyoudrinkcnnyes But the fact is even when people dont buy the health claims they often still buy the beverage. Thats the paradox of products such as POM Silverglade says The health claims on these products strain the imagination yet studies have repeatedly shown that health claims sell food. Thats because these claims however improbable they may seem distract shoppers from the real nutritional information and hook consumers with buzzwords like antioxidant. This phenomenon is known as a health halo an aura of healthfulness attached to a product based on labels like lowfat allnatural or made with whole grains that seduces consumers into overeating. According to a study by the FTC this halo effect can even lead people to overlook warning statements about the high sodium content of a product for example. A healthy halo develops around products like these says Frances LargemanRoth R.D. Health magazines senior food and nutrition editor. The healthconscious consumer incorporates them into their lifestyle thinking that theyre doing a world of good for themselves. Health.com Food label knowhow mistakes even savvy shoppers make httpeating.health.commistakesshoppersmakecnnyes Ceating a health halo The makers of POM Wonderful have spent million on scientific research on POM products and pomegranates. According to the FTCs complaint the studies POM has funded do not substantiate the companys claims and a closer look at the research seems to bear that out. One of the most prominent claims that POM can decrease arterial plaque by percent was taken from a single pilot study that included just people and was funded by the makers of POM. Another claim that POM drinkers experience a percent improvement in blood flow was taken from another POMfunded study that included just people and only lasted for three months. These days its possible for a food company to pay just about anybody to conduct a study says Silverglade. Michael Aviram Ds.C. a cholesterol researcher at Rambam Medical Center in Haifa Israel defended his studies on pomegranates many of them funded by POM by noting that they were published in very prestigious peer reviewed journals including the American Journal of Clinical Nutrition and Atherosclerosis. Dr. Harley Liker M.D. a physician at UCLA Medical Center who has also led research funded by POM directed all inquiries to a POM spokesman. A grocery store is a designed marketing environment to get people to buy things says Lesser. Lots of products are going to try to use health claims from research often from their own industry just to sell a product. Health.com health products you probably dont need http Iffy health claims dont mean that products like pomegranate juice should be avoided at all costs says Keri Gans R.D. a spokesperson for the American Dietetic Association. As long as consumers limit themselves to ounce servings and products with no added sugar juice can be an excellent source of vitamins and other nutrients Gans says. But its not going to solve any of your health issues she adds. The bottom line is that consumers shouldnt believe everything they read on labels. If they focus on consuming an overall wellbalanced diet they might not need to focus so much on finding a product that makes false promises Gans says."

"An ancient herbal remedy is getting fresh attention this cold and flu season https Some parents and even pediatricians believe elderberry extract or syrup can help kids stay healthy and lessen the symptoms when they do get sick. The Brennan family in Glen Rock New Jersey believes it works.. So we give the kids and we take it ourselves elderberry every morning right after breakfast Kevin Brennan told CBS News. He whips up a homemade concoction using frozen elderberries blueberries and honey. Some medical research suggests elderberry may reduce swelling in the mucous membranes to help relieve congestion. The Brennans pediatrician Dr. Lawrence Rosen explains Elderberry contains chemicals which are flavonoids which are antiinflammatory agents. One small study found an elderberry extract called Sambucol could shorten the duration of flu symptoms https after a person gets sick by about days. That would be similar to prescription antiviral medications https like Tamiflu or Relenza which have been proven effective in much larger studies and approved by the FDA to shorten the duration of the flu. There is not enough research about whether elderberry works in children and there is also isnt enough information about the proper dose in children Dr. Anna Minta of Johns Hopkins Childrens Center told CBS News. Before you start popping elderberries beware eating them raw can make you sick. The University of Maryland Medical Center httpumm.eduhealthmedicalaltmedherbelderberry says European elder also called black elder is the variety most often used for medicinal purposes. Raw or unripe elderberries as well as other parts of the plant contain a toxic compound related to cyanide. If the berries are not cooked thoroughly they can be poisonous. But Kevin Brennan says for his family the natural alternative seems to be working. The duration and the severity of how they get sick is much less and they get healthy quicker he said."

"Breastfeeding is not only good for babies there is growing evidence it may also reduce the risk for stroke in postmenopausal women who reported breastfeeding at least one child according to new research in Journal of the American Heart Association the Open Access Journal of the American Heart AssociationAmerican Stroke Association. Stroke is the fourth leading cause of death among women aged and older and is the third leading cause of death among Hispanic and black women aged and older according to the study. Some studies have reported that breastfeeding may reduce the rates of breast cancer ovarian cancer and risk of developing Type diabetes in mothers. Recent findings point to the benefits of breastfeeding on heart disease and other specific cardiovascular risk factors said Lisette T. Jacobson Ph.D. M.P.A. M.A. lead author of the study and assistant professor in the department of preventive medicine and public health at the University of Kansas School of MedicineWichita. This is among the first studies to examine breastfeeding and a possible relationship to stroke risk for mothers as well as how such a relationship might vary by ethnicity. Researchers analyzed data on participants in the Womens Health Initiative observational study a large ongoing national study that has tracked the medical events and health habits of postmenopausal women who were recruited between and . All women in this analysis had delivered one or more children and percent reported ever having breastfed. Among these women percent breastfed for onesix months percent for seven months and percent for or more months. At the time of recruitment the average age was . years and the followup period was . years. After adjusting for nonmodifiable stroke risk factors such as age and family history researchers found stroke risk among women who breastfed their babies was on average percent lower in all women percent lower in black women percent lower in Hispanic women percent lower in white women and percent lower in women who had breastfed for up to six months. A longer reported length of breastfeeding was associated with a greater reduction in risk. If you are pregnant please consider breastfeeding as part of your birthing plan and continue to breastfeed for at least six months to receive the optimal benefits for you and your infant Jacobson said. Our study did not address whether racialethnic differences in breastfeeding contribute to disparities in stroke risk. Additional research should consider the degree to which breastfeeding might alter racialethnic differences in stroke risk Jacobson said. Because the study was observational it couldnt establish a causeandeffect relationship between breastfeeding and lower stroke risk meaning that it is possible some other characteristic that distinguishes between women who breastfeed and those who dont is the factor changing the stroke risk. However because the Womens Health Initiative is large researchers were able to adjust for many characteristics and the effects of breastfeeding remained strong Jacobson said. Breastfeeding is only one of many factors that could potentially protect against stroke. Others include getting adequate exercise choosing healthy foods not smoking and seeking treatment if needed to keep your blood pressure cholesterol and blood sugar in the normal range Jacobson said. The study was also limited by the relatively small number of strokes that occurred during the followup period just . percent of the women experienced a stroke during the study period and . percent reported having had a stroke prior to the study and by the Womens Health Initiatives exclusion of women who had already had severe strokes at the time of recruitment. Currently the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for six months with continuation of breast feeding for one year or longer. For babies health the American Heart Association recommends breastfeeding for months with transition to other additional sources of nutrients beginning at about four six months of age to ensure sufficient micronutrients in the diet. Frontiers The Heartland Institute for Clinical and Translational Research and the Wichita Center for Graduate Medical EducationKansas Bioscience Authority funded the study. The WHI was supported by the National Health Lung and Blood Institute. Coauthors are Erinn M. Hade Ph.D. Tracie C. Collins M.D. M.P.H. M.H.C.D.S. Karen L. Margolis M.D. M.P.H. Molly E. Waring Ph.D. Linda V. Van Horn Ph.D. R.D. Brian Silver M.D. Maryam Sattari M.D. M.S. Chloe E. Bird Ph.D. Kim Kimminau Ph.D. Karen Wambach Ph.D. and Marcia L. Stefanick Ph.D. Author disclosures are on the manuscript. Additional Resources Available multimedia including photos and an audio interview are on the right column of the release link httpsnewsroom.heart.orgnewsbreastfeedingmayhelpprotectmothersagainststrokepreviewceddcddbff After Aug. view the manuscript online. Story on previous JAHA study June Breastfeeding may reduce a mothers heart attack and stroke risk Follow AHAASA news on Twitter HeartNews httpstwitter.comheartnewslangen For updates and new science from JAHA follow JAHA_AHA httpstwitter.comjaha_ahalangen Follow the researcher on Twitter ltj_ http_ Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the associations policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals. Foundations and corporations including pharmaceutical device manufacturers and other companies also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https About the American Heart Association The American Heart Association is devoted to saving people from heart disease and stroke the two leading causes of death in the world. We team with millions of volunteers to fund innovative research fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallasbased association is the nations oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved call AHAUSA visit heart.org http or call any of our offices around the country. Follow us on Facebook and Twitter."

"Call them brain pacemakers tiny implants that hold promise for fighting tough psychiatric diseases if scientists can figure out just where in all that gray matter to put them. Deep brain stimulation or DBS has proved a powerful way to block the tremors of Parkinsons disease. Blocking mental illness isnt nearly as easy a task. But a push is on to expand research into how well these brain stimulators tackle the most severe cases of depression obsessivecompulsive disorder and Tourettes syndrome to know best how to use them before too many doctors and patients clamor to try. Its not a light switch cautions Dr. Michael Okun of the University of Florida. Unlike with tremor patients the psychiatric patients who respond to DBS tend to improve gradually sometimes to their frustration. And just because the tics of Tourettes fade or depression lightens doesnt mean patients can abandon traditional therapy. They also need help learning to function much as recipients of hip replacements undergo physical therapy says Dr. Helen Mayberg of Emory University. Once your brain is returned to you now you have to learn to use it she told the annual meeting of the American Association for the Advancement of Science. Roughly people around the world have undergone deep brain stimulation for Parkinsons or other movement disorders when standard medications fail says Okun among leading researchers who gathered at that meeting last week to assess the field. How does it work Surgeons implant a wire deep in the brain. Tiny electrical jolts running from a pacemakerlike generator near the collarbone up the neck to that electrode disable overactive nerve cells to curb the shaking. Scientists figured out which spot to target based on surgery that sometimes helps worstcase Parkinsons patients by destroying patches of brain tissue. But with deep brain stimulation the electrodes dont destroy that tissue. The electrical signals can be adjusted or even turned off if they dont help or if they cause neurological side effects. The surgery however does sometimes cause dangerous brain bleeding or infections. Psychiatric illnesses require a similar operation but surgeons must implant the electrode into a different spot in the brain. Theres the rub Its not clear which spot is best for which psychiatric disease. In fact two manufacturers Medtronic and St. Jude Medical have begun major studies of DBS effects on depression. Each places the implant in a different region based on promising pilot studies. And the Food and Drug Administration in approved Medtronics version for a small group of obsessivecompulsive patients who get no relief from todays treatments under a special program that lets devices for rare conditions sell before theres final proof that they work. Dr. Joseph Fins medical ethics chief at New York Presbyterian Hospital worries that may hurt efforts to get such proof. The more available the electrodes are the more people may seek to try the surgeries without enrolling in strict trials. How good is the evidence so far The researchers are pushing for a registry to track DBS recipients to better tell but overall theyre cautiously optimistic. Just over people with intractable obsessivecompulsive disorder have undergone DBS since says Dr. Benjamin Greenberg a Brown University psychiatrist who is heading a major study funded by the National Institute of Mental Health. About threefourths of the first few dozen patients studied significantly improved some as long as eight years. You still have a burden but you have a life is how he describes the improvement. These are people who try to relieve fears or anxiety with obsessive behavior such as washing their hands or checking locks repeatedly many of whom never got out of the house because their daily rituals consumed so much time Greenberg says.Theyd failed behavior therapy designed to teach that whatever they fear doesnt happen if they skip the ritual. But with the brain pacemaker somehow that behavior therapy starts working Greenberg says maybe by enabling their brains to better remember the lessons. One big hurdle The battery tucked near the collarbone tends to last less than two years. Changing it entails outpatient surgery one reason that about a third of studied patients stop getting zapped. So Greenberg just began testing a newer version that patients can recharge every few days. Results on about DBS patients with severe depression have been published so far and roughly half improve regardless of which of the two targeted brain regions is zapped says Emorys Mayberg who shares a patent licensed to St. Jude. Separately shes now studying what the successfully treated brains have in common that might help predict the best candidates hoping to ease a tremendous burden on the patients as they decide whether to try these experiments."

"Many women with severe menopausal symptoms are not being treated for them even though safe effective remedies are available a study from Australia suggests. A woman photographs roses at Regents Park in London July . REUTERSNeil Hall The findings may be applicable to other countries too according to senior author Dr. Susan R. Davis from Monash University in Melbourne. From my interactions with colleagues from across the globe I do not believe that what we have observed is Australianspecific she told Reuters Health by email. The management of menopause has been relatively similar in the UK the USA and in Australia. Up to half of women in menopause experience socalled vasomotor symptoms such as hot flashes and night sweats. Hormone replacement therapy HRT which generally combines estrogen plus progestin is very effective. But after the initial findings of the Womens Health Initiative study showed that HRT can increase the risk of breast cancer stroke and other serious problems many women stopped using it. As reported in the journal Menopause in and Davis and her team analyzed survey responses from nearly women ages to . Seventeen percent were having moderate to severe vasomotor symptoms and percent reported moderate to severe sexual symptoms. But most were not receiving any kind of treatment. Only percent reported use of HRT and less than percent were using any type of therapy that didnt involve hormones. The women who did use hormones were mostly taking pills containing estrogen rather than preparations that are absorbed into the skin and that are potentially safer the researchers found. Extrapolating our findings to . million Australian women aged to years we found that women are likely to have moderate to severe vasomotor symptoms with most women remaining untreated they write. In addition very few women were receiving vaginal estrogen therapy for sexual symptoms. Vaginal dryness is common with menopause and affects sexual functioning. Vaginal estrogen preparations are very safe and effective for this problem but were prescribed to less than percent of the women the authors say. Why are so few women being treated Overall there is the uncertainty of women and of doctors as to what the options are what is and is not safe and of the safe options what and how to prescribe them Davis said. There is also she said a complete lack of understanding that for most women these symptoms are not fleeting. It isnt grin and bear it for a few months and it will all pass as many women suffer severe symptoms for fiveplus years she said. Women and doctors simply are not aware that symptoms can last this long. Finally many women dont realize that non hormonal options can be safe and effective she added. Dr. Wulf H. Utian medical director of the North American Menopause Society agrees that many reasons may underlie the lack of treatment. It is partly fall out from the controversy over hormone therapy he told Reuters Health in an email. But overall he said it is a combination of patients not wanting therapy or not having information about it and also the provider not prescribing it. SOURCE bit.lyhOWOoq httpbit.lyhOWOoq Menopause online July . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"A study finds that use of virtual colonoscopy a noninvasive way of scanning the colon for potentially cancerous growths is on the rise. Thats a bit of a surprise given that not all medical experts agree on whether the virtual screen is as reliable as a traditional colonoscopy in which doctors insert a scope with a small camera into the colon. Plus Medicare does not currently reimburse patients for routine screening with virtual colonoscopy but does cover evaluations with colonoscopy. Add to that the aggressive public awareness campaign for colonoscopy screening led by celebrities like Katie Couric who allowed TV cameras in as she got her first test and its clear why more people are familiar with the scope than with its virtual cousin. But in spite of those challenges Megan McHugh at the Health Research and Educational Trust in Chicago and her team report that about of hospitals in the U.S. now offer the screening test up from in . As its name implies virtual colonoscopy is way to survey the colon without actually using a scope. Patients lie in a CT scanner which takes a series of pictures from a variety of different angles and a computer compiles the snapshots in two different ways. The images can be viewed as two dimensional CT scans which display any possible abnormalities protruding from the lining of the colon. Or the images can be combined to generate a D view of the colon allowing the doctors to fly through the organ looking for any suspicious growths or protrusions. The prep for both the virtual and actual colonoscopy is the same the dreaded colon cleanse that many patients find is the worst part of the procedure. The night before the test they start drinking clear liquids and take agents to loosen their stools and empty their colon so any remaining debris isnt mistaken for a tumor during the screen. While the virtual colonoscopy does not require the sedation and insertion of a scope that colonoscopy does it involves exposure to a small amount of radiation. But according to Dr. Marc Gollub director of CT and gastrointestinal radiology at Memorial SloanKettering Cancer Center the radiation is much lower than a regular CT scan and has not been proven to be of any risk. Its similar to the exposure from cosmic radiation you might get on a long airplane flight. While a growing body of data suggest that virtual colonoscopy is as sensitive as colonoscopy in picking up potential tumors not all cancer experts agree that its a good alternative to the goldstandard scope. While the American Cancer Society the American College of Physicians and other gastroenterology experts recommend virtual screening every five years the U.S. Preventive Services Task Force a congressionally mandated but nonfederal independent group of medical experts concluded the evidence wasnt strong enough to justify Medicare coverage of the service. So which one is right for you Virtual colonoscopy is a good option for those who cant be sedated for colonoscopy or who simply cant tolerate the scope. In McHughs survey hospitals reported that these patients make up the bulk of their use. And given the relatively low cost of investing in the software and other equipment required to run a virtual scan more hospitals may be adding the option to their patient services. The virtual scan does involve radiation exposure and if doctors find an abnormality that needs to be removed youll have to undergo a colonoscopy anyway to avoid another colon cleanse consider scheduling a colonoscopy on the same day in case tumors need to be removed. But Gollub notes that only about of healthy adults getting regularly screened actually have tumors. Given the fact that more hospitals are offering virtual colonoscopy its worth discussing with your doctor. In the end its a matter of personal preference its less important how you get screened just that you do get screened."

"Because vertigo can have many causes treating it can be difficult but researchers have identified a new type that may be effectively treated with medication. These conditions can be difficult to diagnose and quite debilitating for people so its exciting to be able to discover this new diagnosis of a condition that may respond to treatment said Dr. JiSoo Kim a researcher at Seoul National University in South Korea. Vertigo episodes of dizziness that can last for minutes or days may be triggered by a number of health issues ranging from an inner ear disorder to tumors. In some cases the cause is unclear. Patients can also experience other uncomfortable symptoms including vomiting headaches and motion sickness. For the study researchers recruited people who had vertigo with an unknown cause. Some had attacks rarely maybe once a year. Others had them two to three times a week. Participants also developed nausea headaches and could not tolerate head movements during the attacks. To diagnose the new vertigo the researchers had patients sit in a dark room. They then moved each patients head forward and shook it from side to side for about seconds. Afterwards a video recorded the patients eye movements. The researchers noticed that uncontrolled eye movements called nystagmus lasted longer in people with this new form of vertigo. The findings were published online May in Neurology. Its possible that the vertigo occurs when this unstable mechanism is disrupted by factors either within the persons body or in their environment Kim said in a journal news release. This new form of the condition is called recurrent spontaneous vertigo with headshaking nystagmus. Thirtyfive study participants had this form of vertigo. They were compared to others whose vertigo is triggered by other conditions including the inner ear disorder Menieres disease. Those with the newly identified form of vertigo experienced uncontrolled eye movements for seconds twice as long as those with Menieres and five seconds longer than those with vestibular migraine and another inner ear disorder called vestibular neuritis. Those with the new form of vertigo were also more likely to have severe motion sickness than those with other forms of the condition the study showed. Preventative medication was given to of the people with the newly detected type of vertigo. Of these onethird saw their symptoms reduced or they recovered completely. The researchers followed the new vertigo patients for an average of years. Five had no more attacks had an improvement in their condition and only one person had a worsening of symptoms. The others outcomes were not revealed. More information The U.S. National Library of Medicine provides more on vertigo httpsmedlineplus.govdizzinessandvertigo.html. SOURCE American Academy of Neurology news release May"

"A modified version of the polio vaccine infused straight into aggressive brain tumors helped some patients live for years longer than they normally would have doctors reported Tuesday. Its no miracle cure only about percent of patients with gliomas were helped but some are alive six years later the team reported in the New England Journal of Medicine. https Its a hopeful enough finding to move forward and test the vaccine in more people the team at the Duke University School of Medicine said. Its very unusual almost unprecedented to get this kind of longterm survival neurologist Dr. Darell Bigner who led the study team told NBC News. The Duke team tested glioma patients over five years. They all had grade IV gliomas a group of brain tumors that includes glioblastoma. These patients have a dismal prognosis the Duke team wrote in the New England Journal of Medicine. There is currently no effective therapy. Standard treatment of brain tumors includes surgery if the tumor is somewhere reachable chemotherapy and radiation. But if the tumor is aggressive its usually fatal. These are people who failed everything Bigner said. Virtually all patients no matter what you treat them with are dead within in two years. About a third of all brain tumors are gliomas according to the National Brain Tumor Society. About people a year are diagnosed with a brain tumor and about of those are malignant. The average survival rate for all malignant brain tumor patients is only . percent the group says. But theres evidence that some viruses can home in on tumors and kill them. Its not clear why but viruses can also make tumors more visible to the immune system. The team at Duke worked with the National Cancer Institute to design and manufacture a modified version of polio vaccine virus. Polio viruses are attracted to nerve cells thats why they cause paralysis. The medical team used polio viruses already weakened and altered for use in polio vaccines and genetically engineered them to carry parts of a common cold virus called a rhinovirus known to be attracted to glioma cells. They infused various doses into the tumors of the glioma patients. We inject the virus directly into brain tumors and it kills all the tumor cells it comes in contact with Bigner said. The most important thing is it sets up a secondary immune response and really destroys the distant tumor cells. Im amazed The very first patient was Stephanie Hopper who was diagnosed with a glioblastoma when she was just . I was throwing up and I had a headache behind my eye. I didnt even know I had cancer until after the surgery to remove the tumor Hopper told NBC News. It was the size of a tennis ball. Hopper was a little wary of being infused with a polio virus but was ready to try. It worked. Shes still alive married and working as a nurse in Greenville South Carolina more than six years later. Im amazed she said. I never really felt like I was going die. I think my life was just put on hold. After three years percent of patients were still alive the team reported. That compares to months or less on average for similar patients. One patient had a hemorrhage and percent had a notable adverse event the team reported. More than half had headaches and half had hemiparesis weakness or paralysis on one side of the body. Another percent had a seizure. More than a quarter had aphasia brain damage that makes speaking and communication difficult. The patient who had the hemorrhage suffered aphasia but was still alive more nearly five years later. Two patients died during the trial. The nature of the treatment causes sideeffects Bigner said. The virus infection causes a very potent inflammation response and that response causes brain swelling. The cancer drug Avastin is used in low doses to control the swelling the team said. Its not clear why just one in five patients benefits said Dr. Annick Desjardins who worked on the study team. vaccine helped halt the growth of malignant brain tumors called gliomas in percent of patientsCourtesy Duke University Duke University Similar to many immunotherapies it appears that some patients dont respond for one reason or another but if they respond they often become longterm survivors Desjardins said. The big question is how can we make sure that everybody responds The Duke team compared their volunteers to similar past patients who did not get the treatment. All but one of those previous patients died after an average of months. Just percent were still alive two years after diagnosis and percent were alive three years later. But the percent or so of patients helped by the vaccine all survived at least three years. As of March of this year eight patients had no evidence of the tumors growing any more and two had no evidence of a brain tumor at all."

"Up to sixteen weeks of intermittent fasting without otherwise having to count calories helps fight obesity and other metabolic disorders. Such fasting already shows benefits after only six weeks. This is according to a study by KyoungHan Kim and Yun Hye Kim in the journal Cell Research which is published by Springer Nature. Intermittent fasting in mice helped to kickstart the animals metabolism and to burn fat by generating body heat. The research team was led by HoonKi Sung of The Hospital for Sick Children in Ontario Canada. Research has shown that our unhealthy eating habits and sedentary lifestyles are playing a major role in the development of lifestylerelated metabolic diseases such as diabetes heart disease and obesity. For this reason dietary interventions like intermittent fasting are gaining popularity to treat conditions such as obesity. The research team in this study wanted to better understand the reactions that interventions such as fasting trigger on a molecular level in the body. They exposed groups of mice to sixteen weeks of intermittent fasting. The recurring regimen saw the animals being fed for two days followed by one day without anything to eat. Their calorie intake was not adjusted otherwise. Four months later the mice in the fasting group weighed less than those in the control group who continued to eat the same volume of food. The lower body weight of the mice in the fasting group was not the only effect. The fasting regime helped lower fat buildup in the white fat by increasing the brownlike fat involved in burning energy and producing body heat of mice on the high fat diet. Their glucose and insulin systems also remained more stable. In a further experiment similar benefits were already seen after only six weeks of intermittent fasting. Through an analysis into the underlying biology involved the researchers found that such intermittent fasting tempers an immune reaction in fat cells. There are changes in certain gene pathways involved in the immune system and the bodys reaction to inflammation. A type of white blood cell known to play a role in fighting inflammation is triggered. Known as antiinflammatory macrophages these cells stimulate the fat cells to burn stored fats or lipids by generating heat. This happens during periods of intermittent fasting because there is an increase in vascular growth factor VEGF that help form blood vessels and activate antiinflammatory macrophage. Intermittent fasting without a reduction in calorie intake can be a preventative and therapeutic approach against obesity and metabolic disorders says KyoungHan Kim. Strikingly these fastingstimulated changes in the growth of vascular cells and subsequent immune alterations occur even after a single cycle of hour fasting and are completely reversed when mice start eating again adds Yun Hye Kim. Reference Kim KH. et al . Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGFmediated alternative activation of macrophage Cell Research DOI .cr.. Note KyoungHan Kims current affiliation is the University of Ottawa Heart Institute Canada"

"Details of a large heart safety study presented on Monday appear to give Merck and Cos diabetes drug Januvia a clean bill of health possibly setting the stage for a return to sales growth for the drugmakers biggest product. A view of the Merck Co. campus in Linden New Jersey March . REUTERSJeff Zelevansky Merck in April said the study called Tecos of patients with type diabetes and a history of heart disease demonstrated that adding Januvia to usual care did not increase major heart problems any more than adding a placebo removing a cloud that has been holding back sales of the medicine and the companys share price. Januvia an oral medication known chemically as sitagliptin that helps lower blood sugar levels had sales of about billion in plus another . billion for the related combination product Janumet On the studys main focus after about three years . percent of Januvia patients had experienced cardiovascular death nonfatal heart attack nonfatal stroke or hospitalization for unstable angina versus . percent in the placebo group. The detailed results also showed no increase in hospitalization for heart failure which had been a particular concern with DPP inhibitors the class to which Januvia belongs. There were such hospitalizations for Januvia and in the placebo group according to data also published in the New England Journal of Medicine. We can be reassured we can use this drug for glucose lowering without affecting the already high cardiovascular risk in people with type diabetes said Professor Rury Holman the studys lead investigator who presented the data at the American Diabetes Association meeting in Boston. For the heart failure concern raised by other agents in the class there is no difference with placebo he added. There was also no significant difference between Januvia and placebo in infections cancer kidney failure or severe hypoglycemia which is dangerously low blood sugar researchers reported. Acute pancreatitis a concern with some diabetes drugs was uncommon but higher with Januvia versus . That was not statistically significant. Numerically this is hardly a major risk just something we need to keep an eye on Holman said. Pancreatic cancers also uncommon were numerically fewer with Januvia versus . Death from any cause occurred in . percent of Januvia patients versus . percent for placebo. The Tecos heart safety study was conducted by an independent academic research collaboration between the University of Oxford Diabetes Trials Unit and the Duke University Clinical Research Institute. It was undertaken after heart safety concerns were raised over other diabetes medicines."